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Table: STI worksheetSTI: bacterial or viral OrganismTransmissionIncubationClinical manifestationsDiagnosis & TreatmentComplicationsFetalGonorrhea2ndmost frequentRisk: Neisseria. gonorrhoeaeGram negative diplococcusVaginal, anal, or oral sex: men and womenDirect physical contact with infected host.3-8 daysNo immunity, can reinfectWomen: asymptomatic or minor symptoms that are often overlooked. If notedRedness, swelling at site of contact (usually cervix and urethraGreen/yellow purulent exudatedysuriaMen:UrethritisDysuriaProfuse, purulent drainagePainful/swollen testesCultureGram negative smear ofdischarge for menHistory of contactRX: start before culture results: cephalosporin antibioticsCeftriaxone (Rocephin) 250 mg IM once or Cefixime (Suprax) orally ANDAzithromycin 1 g poonce or doxycycline if chlamydial infection not ruled outAll sexual contacts mustbe evaluated and treated. No alcohol or sexual intercourse during treatmentMale: prostatitis, urethral stricture,Sterility from orchitis orepididymitisFemale: PID, Bartholin’sgland abscess, ectopic pregnancy, infertilityGonococcal infection during delivery from aninfected mother. Untreated infants develop permanent blindness: almost all states have low requiring the use of prophylactic drug/eye care after delivery:Silver nitrate aqueous solution or erythromycin ophthalmic ointment.Preterm birth.SyphilisCo infection with HIV due to lesions on genitalenhance HIV transmission. This increases risk for CNS involvement Treponema pallidumA spirocheteEnters the body through very small breaks in the skin or mucous membranes.Entry is facilitated by the minor abrasions that often occur duringsexual intercourse.Contact with infectiousInitial 10-90 daysAverage 21 daysShort period of antibiotic production after infection but antibx level decreases and can be reinfectedPrimary:chancre at site of contactgenital ulcersregional lymphadenopathyexudate highly infectious; blood infectious; most Sexual historyExamConfirmed by spirochete on dark fieldmicroscopy and direct fluorescent antibody.Serology: VDRL & RPR: look for nonspecific Occur mostly in late syphilis:Damage to bone, liver, or skin. CV with aneurysm, with possible rupture, scarring ofaortic valve. Neurosyphilis with Infected after 10thweekgestation, increased rate of stillborn or neonatal death. All pregnant women screened on 1stprenatal visitCongential syphilis
Table: STI worksheetRisks: lesions and sharing needles.