STIs Flashcards
What are the different STIs that can present with discharge?
- Gonorrhoea
- Chlamydia
- Trichomonas
(Candida + BV)
What are the different STIs that can present with ulcers?
- Syphilis - painful
- HSV - painless
- (other more niece - LGV, Chancroid, Donovanosis)
What are the different STIs that might present with genital Rashes/ Lumps
- HPV - genital warts
- Molluscum contagiosum
- Scabies
- Public lice
What pathogen is Neisseria gonorrhoeae?
Obligate intracellular Gram -ve diplococcus
What Are the main clincial signs and sympts of gonorrhoea in men?
Often asymptomatic (but less commonly asmyptomatic compared to women)
- Urethitis - purulent urethral discharge
- Dysuria, increased urinary frequency
- Potentially: epidedimitis, prostatitis
- Rectal procttitis (in MSM)
How does gonococcal infection usually present in females?
Most commonly asymptomatic but can present with
- Discharge + Cervicitis (malodorous, purulent discharge)
- Cervical motion tenderness
Can also progress to PID
incl. Fitz-Hugh-Curtis syndrome (perihepatitis with RUQ pain)
What is Disseminated gonococcal infection?
Disseminated gonorrhoea infection in patients with complement deficiencies. Can present as
- Arthritis-dermatitis syndrome (polyarthritis –> migration, asymmetrial ) + purulent dermatitis
- Or Purulent gonococcal arthritis:
- Abrupt inflammation in up to 4 joints (commonly knees, ankles, and wrists)
- No skin manifestations, rarely tenosynovitis
NOT reactive arthritis
What is the management of Gonococcal infection?
Referral for all people to GUM
ABX
- Ceftriaxone 1 g intramuscular (IM) injection as a single dose (also safe in pregnancy)
- Abstain from sex for 7 days
What pathogen is Chlamydia transmitted by?
Chlamydia trachomatis
obligate intracellular gram -ve pathpgen, cannot be cultured on agar
There are different serotypes that can cause different diseases
- ABC: trachoma (infection of eyes that can cause blindness)
- D-K: genital chlamydia
What is the epidemiology of chlamydia?
common - in the UK
10% of all under 25 are infected
How does chlamydia infection ususally present
Usually aymptomatic (50% of men, 80% of women)
Can cause urethritis
But one of the most common pathogens causind PID
What are the main complications from a chlamydia infection?
- PID (incl. tubular factor infertility, ectopica, chronic pelvic pain)
- Epididymitis
- Reactive arthritis (incl. conunctivitis)
- Adjult conjunctivitis or ophtlamia neonatorum
What is the treatment of chlamydia infections?
GUM referral
ABX
1st line: Doxycycline 100mg BD for 7 days
2nd line: Azithromycin 1g stat for one day, followed by 500 mg orally once daily for 2 days.
No sex for 7 days (if stat) or until treatment completet
Partner notification and treatment in last 60 days
What pathogen causes syphillis infections?
Treponema pallidum - obligate gram-ve spirochaete
Recap the 3 phases of a syphillis infection + the respective timings
- Primary: single painful genital ulter 1-12 weeks after transmission + regional adenopathcy
- Secondary: 1-6 months after infection witth rash on palmes and soles, malaise ad genital warts)
- Tertiary: 2-30 years incl. Neurosyphillis, CVS and skin/bone/ mucosa granulomas
What is Trichomoniasis?
STI caused by T. vaginalis (causes 4-35% of all vulvovaginitis)
–> Flagellated protozoa
What is the main clinical presentation of Trichomoniasis?
Usually asymptomatic in men
In females
- Foul-smelling, frothy, yellow-green, purulent discharge
- Vulvovaginal pruritus, burning sensation, dyspareunia, dysuria, strawberry cervix (erythematous mucosa with petechiae)
How is Trichomoniasis usually diagnosed?
Referral to GUM
there
- Wet prep microscopy (visualisation of flagellated organism)
- PCR
How is Bacterial Vaginosis usually diagnosed?
- Microscopy and Gram Stain of vaginal wet mount preparatioon: reduced lactobacilli, clue cells (vaginal epithelial cells with a stippled appearance and fuzzy borders due to bacteria adhering to the cell surface)
- pH = raised
