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Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult. Condition: Symptoms: Treatment: Reportable to the CDC?

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Presentation on theme: "Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult. Condition: Symptoms: Treatment: Reportable to the CDC?"— Presentation transcript:

1 Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult. Condition: Symptoms: Treatment: Reportable to the CDC?

2 Genital Herpes Simplex Virus Infection Epidemiology: Prevalence - 50 million people in US Cause: Virus, HSV-2 (85-90%) and HSV-1 (10-15%) Clinical findings: Ulcer disease, recurrent, multiple, painful vesicles Test: Viral Culture First Treatment: Valacyclovir 1g BID for 7-10 days Recurrence: Valacyclovir 500mg BID for 3 days Suppression: Valacyclovir 500mg SID Reportable? No Adapted from Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2010. MMWR 2010;59(RR-12):21–2.

3 Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult. Condition: Symptoms: Treatment: Reportable to the CDC?

4 Lymphogranuloma Venereum Epidemiology: Rare in US, most common in Africa, Asia, South America, Carribbean Cause: Bacteria, Chlamydia trachomatis L1,2,3 Clinical findings: Ulcer disease, painless vesicle then ulcer, location penis, anus, vulvovaginal area Test: Culture of lesion Treatment: Doxycycline 100mg BID for 3 weeks Reportable? No Adapted from Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2010. MMWR 2010;59(RR-12):21–2.

5 Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult. Condition: Symptoms: Treatment: Reportable to the CDC?

6 Primary Syphilis Epidemiology: 7.8 cases per 100,000 in men; 1.4 cases per 100,000 in women Cause: Spirochete, Treponema pallidum Clinical findings: Ulcer disease, painless, indurated, singular ulcer, bilateral lymphadenopathy Test: Darkfield microscopy of specimens from lesion; serumVDRL or RPR Treatment: Benzathine penicillin G 2.4 mU IM x 1 Reportable? Yes Adapted from Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2010. MMWR 2010;59(RR-12):21–2.

7 Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult. DeCherney AH, Nathan L. Current Diagnosis and Treatment Obstetrics and Gynecology, 10 th edition. McGraw Hill Companies. Condition: Symptoms: Treatment: Reportable to the CDC?

8 Chancroid Epidemiology: Incidence – 28 US cases in 2009, but most common ulcer STI in the world Cause: Bacteria, Haemophilus ducreyi Clinical findings: Ulcer disease, painful ulcer, involves penis or vulvovaginal area, unilateral inguinal adenopathy Lab: Difficult, but gram stain and culture lesion Treatment: Azithromycin 1g PO x 1 Reportable? Yes Adapted from Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2010. MMWR 2010;59(RR-12):21–2.

9 Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult. Condition: Symptoms: Treatment: Reportable to the CDC? Vaginal Discharge pHWBCMicroscopySymptoms NormalWhite, thick, smooth ≤4.5AbsentLactobacilliNone CandidiasisWhite, thick, curdlike ≥4.5AbsentMyceliaVulvar pruritus, external or superficial dysuria TrichomoniasisFrothy or purulent ≥4.5PresentMobile trichomonads present; Amine odor Vulvar erythema and edema, punctate strawberry lesions on cervix Neisseria gonorrhoeae infection None or mucopurulent discharge from cervicitis ≥4.5PresentGram-negative diplococci within or adjacent to polymorphonuclear leukocytes on Gram stain Vaginal and pelvic discomfort, dysuria, most often asymptomatic Chlamydia trachomatis infection None or mucopurulent discharge from cervicitis ≥4.5PresentOrganisms not visualizedVaginal and pelvic discomfort, dysuria, most often asymptomatic Bacterial vaginosis Thin, white homogeneous ≥4.5AbsentAbsent Paucity of lactobacilli; Amine odor; Clue cells Fishy odor and increased vaginal discharge

10 Chlamydial urethritis/cervicitis Epidemiology: Incidence – 1.2 million cases in 2009 Cause: Bacteria, Chlamydia trachomatis Clinical findings: Asymptomatic. Lower urinary tract symptoms in men. Mucopurulent discharge and PID in women. Screen: Yes, annually for sexually active women <26 Test: Urethral, endocervical culture or urine culture Treatment: Azithromycin 1g PO x 1 Reportable? Yes Adapted from Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2010. MMWR 2010;59(RR-12):21–2.

11 Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult. Condition: Symptoms: Treatment: Reportable to the CDC? Vaginal Discharge pHWBCMicroscopySymptoms NormalWhite, thick, smooth ≤4.5AbsentLactobacilliNone CandidiasisWhite, thick, curdlike ≥4.5AbsentMyceliaVulvar pruritus, external or superficial dysuria TrichomoniasisFrothy or purulent ≥4.5PresentMobile trichomonads present; Amine odor Vulvar erythema and edema, punctate strawberry lesions on cervix Neisseria gonorrhoeae infection None or mucopurulent discharge from cervicitis ≥4.5PresentGram-negative diplococci within or adjacent to polymorphonuclear leukocytes on Gram stain Vaginal and pelvic discomfort, dysuria, most often asymptomatic Chlamydia trachomatis infection None or mucopurulent discharge from cervicitis ≥4.5PresentOrganisms not visualizedVaginal and pelvic discomfort, dysuria, most often asymptomatic Bacterial vaginosis Thin, white homogeneous ≥4.5AbsentAbsent Paucity of lactobacilli; Amine odor; Clue cells Fishy odor and increased vaginal discharge

12 Gonorrhea Epidemiology: Prevalence - 50 million people in US Cause: Bacteria, Neisseria gonorrhea Clinical findings: Men- Lower urinary tract symptoms, Women – mucopurlent endocervical discharge Test: Urethral, cervical swab for culture Treatment: Ceftriaxone 250mg x 1 IM Reportable? Yes Adapted from Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2010. MMWR 2010;59(RR-12):21–2.

13 Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult. Condition: Treatment: Reportable to the CDC? Vaginal Discharge pHWBCMicroscopySymptoms NormalWhite, thick, smooth ≤4.5AbsentLactobacilliNone CandidiasisWhite, thick, curdlike ≥4.5AbsentMyceliaVulvar pruritus, external or superficial dysuria TrichomoniasisFrothy or purulent ≥4.5PresentMobile trichomonads present; Amine odor Vulvar erythema and edema, punctate strawberry lesions on cervix Neisseria gonorrhoeae infection None or mucopurulent discharge from cervicitis ≥4.5PresentGram-negative diplococci within or adjacent to polymorphonuclear leukocytes on Gram stain Vaginal and pelvic discomfort, dysuria, most often asymptomatic Chlamydia trachomatis infection None or mucopurulent discharge from cervicitis ≥4.5PresentOrganisms not visualizedVaginal and pelvic discomfort, dysuria, most often asymptomatic Bacterial vaginosis Thin, white homogeneous ≥4.5AbsentAbsent Paucity of lactobacilli; Amine odor; Clue cells Fishy odor and increased vaginal discharge

14 Trichomoniasis Epidemiology: Prevalence – 174 million cases worldwide in 1999 Cause: Protozoan, Trichomonas vaginalis Clinical findings: Asymptomatic in men; frothy white or green, malodorous discharge; strawberry cervix Treatment: Metronidazole 2gm x1 PO Reportable? No Adapted from Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2010. MMWR 2010;59(RR-12):21–2.

15 Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult. Habif (2009). Clinical Dermatology, 5 th Edition. Elsevier. MD Consult. Condition: Symptoms: Treatment: Reportable to the CDC?

16 Scabies Epidemiology: Treat entire household, not just sexual partners Cause: Mite, Sarcoptes scabiei Clinical findings: Wavy, elongated papules, eruption with pruritis Testing: Microscopic evidence of mite or eggs Treatment: Permethrin cream (5%) all over, wash off after 8-14 hours Reportable? No Adapted from Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2010. MMWR 2010;59(RR-12):21–2.

17 Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult. Condition: Symptoms: Treatment: Reportable to the CDC?

18 HPV, Genital Warts Epidemiology: Prevalence – 20 million, 80% of women by age 50 will have had the infection Cause: Human Papilloma Virus, various subtypes HPV 6 & 11 - warts HPV 16 & 18 – 99% of cervical cancers Clinical findings: recurrent vesicular lesions Treatment: Podofilox 0.5% gel q12h application x 3 days Reportable? No Adapted from Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2010. MMWR 2010;59(RR-12):21–2.


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