STIs Flashcards
Name the pathogen that causes gonorrhoea
Neisseria gonorrhoeae
Clinical presentations of uncomplicated urogenital gonorrhoeae for males and females?
Males:
- Purulent urethral discharge
- Dysuria
- Urinary frequency
Females:
- Mucopurulent vaginal discharge
- Dysuria
- Urinary frequency
What are the clinical presentations of complications of gonorrhoea (if left untreated) for males, females and both?
Note: gonorrhoea is a disseminated disease!
Males:
- Epididymitis
- Prostatitis
- Urethral stricture
- Disseminated disease
Females:
- Pelvic inflammatory disease
- Ectopic pregnancy
- Infertility
- Disseminated disease
Both:
- Disseminated skin lesions, tenosynovitis, monoarticular arthritis
How is gonorrhoea diagnosed? (3)
- Gram-stain of genital discharge
- Culture
- NAAT
First-line for uncomplicated gonococcal infections?
What other infection must we treat it with?
**MUST also treat for chlamydial infection (unless it has been excluded)
IM ceftriaxone 500mg (for persons weighing < 150kg) (single dose)
PLUS
PO doxycycline 100mg bd x 7d (Anti-chlamydial Tx)
For uncomplicated gonococcal infections, if the first line is not available, what should we use instead?
IM gentamicin 240mg (single dose)
PLUS
PO azithromycin 2g (single dose)
Name the pathogen that causes chlamydia
Chlamydia trachomatis
What is the clinical presentation of chlamydia?
Similar to gonorrhoea but milder.
Like gonorrhoea, can infect various sites
How is chlamydia diagnosed?
NAAT
First-line Tx for chlamydia?
What is the alternative regimen?
First-line:
PO doxycycline 100mg bd x 7d
Alternative regimen:
PO azithromycin 1g (single dose)
OR
PO levofloxacin 500mg od x 7d
Is test of cure required for chlamydia?
No, unless pt is pregnant, non-adherent or s/sx persist.
Name the pathogen that causes syphilis
Treponema pallidum
How is syphilis diagnosed?
- Darkfield microscopy of exudates from lesions
- 2 serological tests → (1) Treponemal and (2) Non-treponemal test
Tx for syphilis: primary, secondary or early latent (<1 year duration)?
If penicillin allergic? + counselling?
IM benzathine penicillin G 2.4 million units x 1 dose
If penicillin allergic:
- PO doxycycline 100mg bd x 14d
⚠️Counselling: Take with food to reduce GI upset. Take with glass of water and maintain upright for at least 30 min to prevent heartburn. Do not take with milk, Ca or Fe, take 2hrs apart.
SEs: GI, photosensitivity
Tx for syphilis: late latent (> 1 year) or unknown duration or tertiary?
If penicillin allergic? + counselling?
IM benzathine penicillin G 2.4 million units oiw x 3 doses
If penicillin allergic:
PO doxycycline 100mg bd x 28d
⚠️Counselling: Take with food to reduce GI upset. Take with glass of water and maintain upright for at least 30 min to prevent heartburn. Do not take with milk, Ca or Fe, take 2hrs apart.
SEs: GI, photosensitivity