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

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.

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

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.

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

Primary Syphilis Epidemiology: 7. 8 cases per 100,000 in men; 1 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.

Condition: Symptoms: Treatment: Reportable to the CDC? 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, 10th edition. McGraw Hill Companies.

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.

Condition: Symptoms: Treatment: Reportable to the CDC? Vaginal Discharge pH WBC Microscopy Symptoms Normal White, thick, smooth ≤4.5 Absent Lactobacilli None Candidiasis White, thick, curdlike ≥4.5 Mycelia Vulvar pruritus, external or superficial dysuria Trichomoniasis Frothy or purulent Present Mobile trichomonads present; Amine odor Vulvar erythema and edema, punctate strawberry lesions on cervix Neisseria gonorrhoeae infection None or mucopurulent discharge from cervicitis Gram-negative diplococci within or adjacent to polymorphonuclear leukocytes on Gram stain Vaginal and pelvic discomfort, dysuria, most often asymptomatic Chlamydia trachomatis infection Organisms not visualized Bacterial vaginosis Thin, white homogeneous Absent Paucity of lactobacilli; Amine odor; Clue cells Fishy odor and increased vaginal discharge Condition: Symptoms: Treatment: Reportable to the CDC? Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult.

Chlamydial urethritis/cervicitis Epidemiology: Incidence – 1 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 Most common cause of epididymitis in young men (<35) Adapted from Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2010. MMWR 2010;59(RR-12):21–2.

Condition: Symptoms: Treatment: Reportable to the CDC? Vaginal Discharge pH WBC Microscopy Symptoms Normal White, thick, smooth ≤4.5 Absent Lactobacilli None Candidiasis White, thick, curdlike ≥4.5 Mycelia Vulvar pruritus, external or superficial dysuria Trichomoniasis Frothy or purulent Present Mobile trichomonads present; Amine odor Vulvar erythema and edema, punctate strawberry lesions on cervix Neisseria gonorrhoeae infection None or mucopurulent discharge from cervicitis Gram-negative diplococci within or adjacent to polymorphonuclear leukocytes on Gram stain Vaginal and pelvic discomfort, dysuria, most often asymptomatic Chlamydia trachomatis infection Organisms not visualized Bacterial vaginosis Thin, white homogeneous Absent Paucity of lactobacilli; Amine odor; Clue cells Fishy odor and increased vaginal discharge Condition: Symptoms: Treatment: Reportable to the CDC? Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult.

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.

Condition: Treatment: Reportable to the CDC? Vaginal Discharge pH WBC Microscopy Symptoms Normal White, thick, smooth ≤4.5 Absent Lactobacilli None Candidiasis White, thick, curdlike ≥4.5 Mycelia Vulvar pruritus, external or superficial dysuria Trichomoniasis Frothy or purulent Present Mobile trichomonads present; Amine odor Vulvar erythema and edema, punctate strawberry lesions on cervix Neisseria gonorrhoeae infection None or mucopurulent discharge from cervicitis Gram-negative diplococci within or adjacent to polymorphonuclear leukocytes on Gram stain Vaginal and pelvic discomfort, dysuria, most often asymptomatic Chlamydia trachomatis infection Organisms not visualized Bacterial vaginosis Thin, white homogeneous Absent Paucity of lactobacilli; Amine odor; Clue cells Fishy odor and increased vaginal discharge Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult.

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.

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

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.

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

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.