Table: STI worksheet
STI: bacterial or viral
Organism
Transmission
Incubation
Clinical manifestations
Diagnosis & Treatment
Complications
Fetal
Gonorrhea
2
nd
most frequent
Risk:
Neisseria. gonorrhoeae
Gram negative
diplococcus
Vaginal, anal, or oral
sex: men and women
Direct physical contact
with infected host.
3-8 days
No immunity, can
reinfect
Women: asymptomatic
or minor symptoms
that are often
overlooked. If noted
Redness, swelling
at site of contact
(usually cervix and
urethra
Green/yellow
purulent exudate
dysuria
Men:
Urethritis
Dysuria
Profuse, purulent
drainage
Painful/swollen
testes
Culture
Gram negative smear of
discharge for men
History of contact
RX: start before culture
results: cephalosporin
antibiotics
Ceftriaxone
(Rocephin)
250 mg
IM once or
Cefixime (Suprax)
orally AND
Azithromycin 1 g po
once
or
doxycycline if
chlamydial
infection not ruled
out
All sexual contacts must
be evaluated and
treated. No alcohol or
sexual intercourse
during treatment
Male: prostatitis,
urethral stricture,
Sterility from orchitis or
epididymitis
Female: PID, Bartholin’s
gland abscess, ectopic
pregnancy, infertility
Gonococcal infection
during delivery from an
infected 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.
Syphilis
Co infection with HIV
due to lesions on genital
enhance HIV
transmission. This
increases risk
for CNS
involvement
Treponema pallidum
A spirochete
Enters the body
through very small
breaks in the skin or
mucous membranes.
Entry is facilitated by
the minor abrasions
that often occur during
sexual intercourse.
Contact with infectious
Initial 10-90 days
Average 21 days
Short period of
antibiotic production
after infection but
antibx level decreases
and can be reinfected
Primary:
chancre at site of
contact
genital ulcers
regional
lymphadenopathy
exudate highly
infectious; blood
infectious; most
Sexual history
Exam
Confirmed by
spirochete on dark field
microscopy 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 of
aortic valve.
Neurosyphilis with
Infected after 10
th
week
gestation, increased
rate of stillborn or
neonatal death. All
pregnant women
screened on 1
st
prenatal visit
Congential syphilis
Table: STI worksheet
Risks:
lesions and sharing
needles.
