Ceftriaxone 250mg given intramuscularly plus Doxycycline 100mg orally two times a day for 14 days and (optional) Metronidazole 500mg orally two times a day for 14 days. If unable to take Ceftriaxone, the CDC recommends substituting Cefoxitin 2g intramuscularly and Probenecid 1g orally (or a different third-generation cephalosporin as a one-time dose) plus the 14-day oral Doxycycline and Metronidazole (Huether & McCance, 2017). PID is not a required national reportable diagnosis like chlamydia and gonorrhea, but some individual states have the requirement to report (Kreisel et. al., 2017). Each diagnosis of PID comes with an estimated price tag of $3,202 to treat. PID results from an infection of chlamydia and gonorrhea, two of most frequently reported STDs in the US, yet both are completely preventable diseases. Chlamydia averages about 1.5 million cases a year, and gonorrhea accounts for about 400,000 (Kreisel et. al., 2017). The incidence of PID is very high as most infections resulting from chlamydia and gonorrhea in women are without symptoms; therefore, women go untreated and undiagnosed, resulting in a PID diagnosis later. The CDC recommends all women age 25 and under with risk factors get screened for all STDs to decrease their prevalence and the diagnosis of PID (Kreisel et. al., 2017). Human Papillomavirus (HPV) Human papillomavirus (HPV) is the most widespread STD in the US accounting for 14 million new cases each year. It is estimated that 90% of all sexually active people in the US will have some form of HPV in their lifetimes, half of these cases will acquire the cancer-causing type of HPV [ CITATION Nat15 \l 1033 ]. There have been over 200 forms of the HPV virus identified, approximately 40 of these can be easily transmitted by means of the skin and mucous membranes
through vaginal, rectal, and oral contact, from one person to another [ CITATION Nat15 \l 1033 ]. There are two categories of HPV; low-risk, also known as nononcogenic (e.g., HPV types 6 and 11) which are responsible for genital warts and respiratory papillomatosis, and high-risk, also none as oncogenic (e.g., HPV types 16 and 18) which cause cervical, penile, vulvar, vaginal, anal, and oropharyngeal cancers [ CITATION Cen15 \l 1033 ]. In 2009 in the US, HPV infections were responsible for an estimated 34,788 new cancers and at least 355,000 new cases of genital warts [ CITATION Cen15 \l 1033 ]. HPV infection invades epithelial cells that line the inner and outer surface of the skin, throat, genital tract and anus. HPV penetrates the epithelial cell and the virus begins to initiate proteins that encode it. Certain proteins disrupt the normal cell growth function and permit the cell to mutate creating a modification in its genetic makeup. Most often, these abnormal cells are eliminated by the immune system before they can become mutated, but occasionally the transformation is completed which leads to the development of precancerous cells, then progresses into cancer cells, and finally a tumor [ CITATION Nat15 \l 1033 ].
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- Spring '15
- Human papillomavirus