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Cecils Ch 107 STIs

Terms in this set (23)

Herpes
Incubation
Primary lesion
Adenopathy
Dx
Rx
2-7 d
multiple painful vesicles
tender, sof; often b/l
Tzanck or Ag
Acyclovir etc. 7-10 days
Syphillis
10-90 d
Chancre (painless papule that ulcerates with a firm,raised border and smooth base; single/ genital or anywhere, disapppears within 6 wks, thin scar left behind.
1 wk after chancre ; firm dizcrete movable or skin changes, painless, months
Darkfield, VDRL, FTA-abs
Penicillin unless neurosyphillis (Aq. Penicillin G IV and latent/tertiary Pen. G oral)
Chancroid (H. Ducreyi)
3-5 days
very painful, vesicle or papule to ulcer/pustule ; soft, not indurated
in 1 wk mostly u/l
Gram stain best yield is lymph node
azithromycin, cefriazone, cipro, erythro; treat partner(s)
Lymphogranuloma Venerum (chlamydia trachomatis) also called Donovanosis
5-21 d
painless papule,vesivle or ulcer
matted ilica or femoral rgion "groove sign", yellow pus, fistulas etc
culture, nucleic acid, or fluoro
surgical drainage ; doxy for 21 d, azithro
condyloma acuminatum (HPV)
large soft fleshy , cauliflower like
rx is topical podophyllin +/- cryosurgery, laser resection
screened for gonorrhea, chlamydia, syphilis, and HIV infection
person who engages in high-risk sexual behavior
<25 years should be screened routinely for
chlamydia
at the first prenatal visit
screening for HIV infection, syphilis, and chlamydia. Gonorrhea in high risk areas
a systemic disease with genital ulcers as one component; the ulcers often are painful. Other features include recurrent oral aphthous ulcers, uveitis, pathergy, arthritis, gastrointestinal manifestations, and central nervous system disease
Behcets disease
Gono. and Tracho cause ...
cervicitis, urethritis and proctitis
triad of disseminated gonorrhea
dermatitis, mono/oligoarthritis , twnosynovitis
best diagnostic test for gono and tacho.
PCR (tracho in women you need a endocervical swab
two criteria of NGU
urethritis
leukocytosis on gram stain
how long shuold a pt. abstain for secual contact for tx
1 week (HSV is not eradicated
reportable STDs
syph
gono
chlam
Gono Rx
Ceftriaxone or Cefixime
Chlamydial
Azithro or doxy (amox for pregnancy)
PID outpt/inpt
ceftriaxone + doxy / Cefoxitin + doxy f/u in 48-72 hours
how to follow up with sexual partner in syphillis
Perform serologic testing if >90 d after sexual contact. Treat empirically if <90 d after sexual contact.
f/u with Chlamydia contacts
Treat all sexual contacts of the last 60 d.
for gono and chlamydia f/u in
3-4 d
in a non-high risk pt. with multiple partners under 24 screen for
Screen for HIV, chlamydia, and gonorrhea (only if multiple partners). Syphillis if high risk
define cervicitis
either mucopurulen discharge (yellow) or endocervical bleeding . Indicative of gono (DGI necrotizing rash on palms etc) and tracho
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