STIs Flashcards
Common Presentations in Men
Asymptomatic Urethral discharge Dysuria Scrotal swelling/pain Rash/sores Systemic symptoms
COmmon presentations in women
Asymptomatic Vaginal discharge +/- urethral, rectal Ulceration painful/painless Itching/soreness, lumps/growths Abnormal bleeding IMB PCB Abdo pain, dyspareunia, Dysuria Systemic symptoms
COnditions that present with discharge
GOnorrhea Chlamydia Trichomonas Candida Bacterial Vaginosis
COnditions that present with ulceration
Syphilis HSV LGV Chancroid Donovanosis
Conditions that present with rashes, lumps/Growths
Genital warts - HPV
Molluscum contagiosum
Scabies
Pubic lice
Painful genital ulcers
herpes > Chancroid
Painless genital ulcers
Syphilis > Lymphogranuloma venerum/granuloma inguinale
Obligate intracellular Gram -ve diplococcus
Gonorrhea
Untreated Gonorrhea in neonates
Opthlamia neonatorum
Pts with complement deficiency
disseminated gonococcal infection - septicaemia, rash, arthritis
Diagnosis of gonorrhea
Urethral (95%)
Rectal (20%)
Produce from culture is gold standard
Treatment of gonorrhea
Ceftriaxone IM - 250mg single dose
Cefixime PO - 400mg single dose
Resistant - Spectinomycin IM 2g single dose
Complications of Gonorrhea in men
Non-gonococcal urethritis (mucoid discharge) Post GOnococcal Urethritis (Tetracycline) Rectal proctitis (MSM)
Prostatis
COmplcations of gonorrhea in women
Mucopurulent cervicitis - erythema and oedema
- Urethra vaginal leakage
PID (Salpingitis) - Ascending infection - infertility
Obligate intracellular pathogen that cannot be cultured on agar
Gram -ve
Chlamydia Trachomatis
Features of Chlamydia
Assoc with younger age (10% of
Serovars A, B, C or chlamydia
Trachoma - infection of eyes - blindness
Serovars D-K
Genital chlamydia, opthalmia neonatorum
COmplications of Chlamydia
PID, Tubal Factor infertility, ectopic risk, endometriosis risk, chronic pelvic pain, epididymitis, reiters syndrome, adult conjunctivitis, opthalmia neonatorum
Diagnosis of CHlamyida
Nucleic Acid Amplification Test
GOld standard - high spec and sens
Treatment of chlamydia
Azithromycin 1g stat
Doxycycline - 100 mg BD 7/7
Complicated
Erythromycin - 500mg QDS 7/7 or 500mg BD 2/52
SE: GI
Side effects of chlamydia treatment
N&V, Photosensitivity
C/I in pregnancy (bone growth disturbance, tooth discolouration)
Lymphatic infection with Chlamydia serovars L1, 2, 3
Lympho-granuloma venereum
Demographic of LGV
ENdemic in developing world
More recently in MSM in developed world
Symptoms of stages of LGV
Primary stage - 3-12 days - Genital ulcers, painless non-indurated. Balanitis, proctitis, cervicitis
Secondary Stage - 2-25 weeks - Inguinal buboes - painful 2/3 unilateral, may rupture
Fever, malaise, rarely (hepatitis, meningo-encephalitis, pneumonitis) Proctocolitis, Hyperplasia of lymphoid tissue
Late - Inguinal LNpathy, abscesses, genital elephantitis, genital ulcers, frozen pelvis, rectal strictures, perirectal ascesses + fistulae, lymphorroids
Current outbreak - Rectal symptoms - Pain, tenesmus, bleeding, mucous discharge O/E Proctitis
Diagnosis of LGV
NAAT (unlicensed)
Sent to lab if +ve
Confirmation by real time PCR
Genotypic identification of L 1, 2, 3
Treatment of LGV
Tetracyclines: Doxycycline 100mg BD for 3 weeks
Erythromycin - 500 mg QDS for 3 weeks
Azithromycin - 1g weekly for 3 weeks
