Features of syphillis infection
Trepanoma palladum - spirochete bacteria
(potential for TLS type reaction with endotoxin release)
chronic infection can lead to tertiary neurosyphillis
Painless chancre primary presentation - not painful
Treatment of syphillis
IM penicillin
Azithromycin 2g once - effective and no comps
Ciprofloxacin - 3 days - compliance issues
Doxycyclin - 14 days - compliance
New onset seborrheic dermatitis + travel history - what do you think of
HIV
80% prevelance in HIV Vs 1-3%
How is Chlamydia treated?
1 Doxycyclin 7 days - covers rectal infection too
CONTRA PREG
2 Azithromycin 1g once
3 Erythromycin 14 days
4 Ofloxacin 7 days but must be >18
CONTRA PREG
5 Amoxicillin 500 mg three times a day for seven days.
What are complication of chlamydia infection?
Disseminated infection
- PID
- Lymphogranuloma venerum
- Chlamydia trachomonis infects macrophages instead of epithelium resulting in trafficking to LN causing lymphadenopathy and disseminated infection
This will require 21 days treatment minimum with doxycylin
How is recurrent herpes managed?
E.G >6 outbreaks of genital herpes in a year
Qualifies for suppressive therapy
12 months 400mcg aciclovir 400mg BD
- can reactivate post
>2 qualifies again for ongoing management
How is ghonorrhoea treated?
pregnance Ceftriaxone IM and azithromycin
Penicillin
