Chlamydia
Gonorrhea
Things You Can Get While Having Sex :D
Fun Facts
Symptoms
Diagnostic Testing
Chlamydia
Asymptomatic
Specific culture or
Trachomatis bacteria Can infect cervix,
assay
urethra, rectum,
Screen:
throat, or eye
Sexually
2 days 2 weeks
active <25 yo
after infection
All pregnant
Dysuria, vaginal
Repeat
discharge,
screening 6
intermenstrual
months after
bleeding, abdominal
tx
or pelvic pain
Reportable disease
Obtain contacts
Was in decline, now
rising again
Spread through
unprotected oral,
vaginal, and anal sex
Condoms can reduce
transmission
Infection in cervix,
urethra, rectum or
throat
Asymptomatic
(unlike men who are
asymptomatic)
Dysuria, vaginal
discharge, vaginal
bleeding or pain,
rectal bleeding or
pain
Specific culture or
urine assay (not pap)
Usually together with
chlamydia
Reportable disease
Obtain contacts
Can infect newborn,
can cause complex
disease involving
joints, skin, heart,
brain (Reiters
Syndrome)
Treatment
Azithromycin 1 g x 1
dose
Doxycycline 100 mg
x 7 days
Treat if:
Positive test
Contact of
positive test
Symptoms/sig
ns compatible
If GC+
Can resume
intercourse after one
week
Advise re: reinfection
Preferred:
Ceftriaxone
250 mg IM x 1
dose PLUS
Azithromycin
1 g po x 1
dose
Alternatively:
Cefixime 800
mg po x 1
dose PLUS
Azithromycin
1 G po x 1
dose
Quinolone resistance
Syphillis
Pelvic
Treponema Pallidum
Uncommon but
frequency rising
quickly
900% increase from
1997 2004 (mostly
MSM)
Transmitted by oral,
vagina, or anal sex
Vertical transmission
Condoms can reduce
risk
Infection of upper
Primary
Painless
chancre (1090 days after
infection)
heals in 3-8
weeks
Secondary
3 months later
flu like
symptoms,
military rash,
joint pain
can resolve on
own in 3-12
weeks, can
relapse
Latent
No symptoms
1- 30 years
Tertiary
Major
destruction
(40% of
untreated)
brain, skin,
joints, eyes,
ears,
cardiovascular
Pelvic pain, vaginal
Microscopy of lesion
(darkfield
microscopy) or blood
test (VDRL)
Cervical cultures,
Reinfection common
Can resume sex 1
week after one week
Penicillin G
Can be re-infected
Avoid sex until cure
confirmed
Reportable disease
Dont need to tell
partner
Oral antibiotics (2
Inflammatory
Disease
genital tract (Uterus,
tubes, ovaries)
Need to diagnose
and treat
aggressively
Genital Herpes
HIV
HSV-1 Cold sores
HSV-2 genital
herpes
Now >50% of new
genital infections are
HSV-1
No cure
Recurrent outbreaks
is usually HSV-2
Can still transmit
virus when no
lesions
Skin to skin contact,
condoms less
protective
Vertical transmission
Virus that causes
AIDS
Incurable but
discharge, fever,
dyspareunia,
dysuria, dyschezia
bimanual, exam,
WBC, blood cultures,
ultrasound,
laparoscpopy
Tubo-ovarian
abscess, Firz-Hugh
Curtis (liver capsule
inflammation)
Primary outbreak (220) days after
infection fever and
tingling prodrome,
dysuria, extensive
painful vesicles that
rupture and leave
erosions that heal
without scarring
Viral culture of
blister lesion
Tissue sample
Type specific
serology (HSV-1
70%; HSV-2 25%)
Clinical diagnosis
Oral anti-virals for
suppression and
reduction of
transmission
Often mild
symptoms itch or
tingle
Recurrent outbreaks
often mild
Asymptomatic for
many years
Fatigue, night
wks) if
uncomplicated
Expect multiple
pathogens
IV antibiotics if sick,
tubo-ovarian abcess,
pregnant, unreliable
Laparoscopy to
diagnose/treat
evacuate abscess,
culture
Partner should be
test and treated for
GC/Chlamydia
Supportive and local
care
Oral anti-virals for
acute treatment
Acyclovir
Famcyclovir
Valacyclovir
Not reportable
Blood test
3 month window
between infection
Anti-retrovirals,
reverse trancriptase
inhibitors, protease
Human Papilloma
Virus
treatable
Exchange of body
fluids; oral sex lower
risk
>25% of new
Canadian infections
in women
20% increase in
annual reported
cases between 20002004
100 subtypes
identified, 30
subtypes infect the
genital tract
Vaccination program
in Grade 8 for girls
with Gardasil (Types
6, 11, 16, 18)
Very infectious
60% will get warts
after contact
Skin to skin contact
Can recur later after
clears
Hepatitis B Virus
Very effective
vaccine (Grade 6)
sweats, diarrhea,
infections, weight
loss
AIDS defining illness
Kaposis Sarcoma,
Cervical cancer,
Pneumocystis
jirovecii pneumonia,
mycobacterium
avium complex, _
others
Cauliflower like
growths
condylomata
acuminata
and positive test
(test twice)
Need explicit
consent to test
Reportable disease
inhibitors
Goal is undetectable
viral load
Treat infections
Multi-disciplinary
care
Physical excision,
laser, cryotherapy,
electrosurgery
Immunologic
imiquimod
Chemical
trochloroacetic acid,
podophillin,
podophilox
Not reportable
Sexual or body fluid
transmission
Can clear infection or
become a chronic
carrier
Vertical transmission
Molluscum
contagiosum
Hepatocellular
Carcinoma
DNA pox virus
Pink papules with
umbilication
Many treatments
similar to what you
do with condyloma
Common childhood
infection
Self-limited, can
recur
Skin to skin contact
Trichomoniasis
Unicellular
flagellated parasite
Frothy, green vaginal
discharge
Vaginal sample for
microscopy
Infect vagina,
urethra, bladder,
cervix
Vaginal odour,
pruritus, dysuria,
dyspareunia
Strawberry cervix
due to punctate
hemorrhages rare
Spread by genital
sexual contact
Symptoms occur
usually one week
after contact
Not reportable
Metronidazole 2 g po
x1
OR
Metronidazole 500
mg po bid x 7
Vaginal gel not
effective
Treat partners
Condom reduces risk
50% of women
asymptomatic
Not reportable
Can recur
Pubic Lice (Crabs)
Scabies
Phthirus Pubis
Crab-like, bury at
base of hair to feed
from blood, eggs
(nits) in hairs
Skin to skin contact,
fomites
Tiny mites that
burrow under skin
and lay eggs in
tunnels in the skin
Prefer skin folds
(genitals, under
breasts, between
fingers)
Skin to skin contact,
fomites
Severe pruritus
Can be in other body
hair
Very rarely can
cause PID
Treat with
antiparasitic
shampoo, laundry,
treat partners
Not reportable
disease
Intense pruritus and
rash
Anti-parasitic lotion
for treatment
Not reportable
