STIs

Question 1

Clinical manifestations of gonorrhea

Answer 1

Anorectal infection: most patients are asymptomatic, symptoms such as anal pruritis, tenesmus, purulent discharge, rectal bleeding /discharge

Pharyngeal infection: orogenital sex, may develop pharyngitis or cervical lymphadenitis

Can cause conjunctivitis in newborns when passed through birth canal

Question 2

Uncomplicated Gonococcal infections first line treatment

Answer 2

< 150 kg–>Ceftriaxone 500 mg IM x 1–>chlamydia (not excluded)–>doxycycline 100 mg PO BID x 7 days, if pregnant Azithromycin 1 g PO x 1

> or equal to 150 kg–>Ceftriaxone 1 g mg IM x 1–>chlamydia (not excluded)–>doxycycline 100 mg PO BID x 7 days, if pregnant Azithromycin 1 g PO x 1

Question 3

Uncomplicated Gonococcal infections alternatives

Answer 3

Ceftriaxone not available or severe allergy:
- Gentamicin 240 mg IM x 1 + azithromycin 2 gm PO x 1

Ceftriaxone not available or severe allergy
- Cefixime 800 mg PO x 1
- Chlamydia not excluded: doxycycline 100 mg PO BID x 7 days, if pregnant Azithromycin 1 g PO x 1