We review Sexually Transmitted Infections and pertinent updates in diagnosis and management.
Hosts:
Avir Mitra, MD
Brian Gilberti, MD
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Sexually_Transmitted_Infections_2_0.mp3
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Tags:
gynecology,
Infectious Diseases,
Urology
Show Notes
Table of Contents
(1:49) Chlamydia
(3:31) Gonorrhea
(4:50) PID
(6:14) Syphilis
(8:08) Neurosyphilis
(9:13) Tertiary Syphilis
(10:06) Trichomoniasis
(11:13) Herpes
(12:49) HIV
(14:10) PEP
(15:13) Mycoplasma Genitalium
(18:00) Take Home Points
Chlamydia:
* Prevalence:
Most common STI.
High percentage of asymptomatic cases (40% to 96%).
* Presentation:
Urethritis, cervicitis, pelvic inflammatory disease (PID), prostatitis, proctitis, pharyngitis, arthritis.
Importance of considering extra-genital sites (oral and rectal infections).
* Testing:
Gold Standard: Nucleic Acid Amplification Test (NAAT) via PCR.
* Sampling Sites:
Endocervical or urethral swabs preferred over urine samples due to higher sensitivity.
Triple-site testing (genital, rectal, pharyngeal) recommended for comprehensive detection.
* Treatment Updates:
Previous Regimen: Azithromycin 1 g orally in a single dose.
Current First-Line Treatment: Doxycycline 100 mg orally twice daily for 7 days.
* Alternatives:
Azithromycin remains an option for patients unlikely to adhere to a 7-day regimen or for pregnant patients.
Note: PID treatment differs and will be discussed separately.
Gonorrhea:
* Presentation:
Similar to chlamydia; can be asymptomatic.
Symptoms include urethritis, cervicitis, PID, prostatitis, proctitis, pharyngitis.
* Testing:
Gold Standard: NAAT.
* Sampling Sites:
Endocervical swabs are more sensitive than urine samples.
Triple-site testing is crucial to avoid missing infections.
