Which is the most commonly reported bacterial infection in STI clinic?
chlamydia
What % of people are asymptomatic in chlamydia?
WOMEN: 70-80% MEN: 50%
Which STI stains as a gram negative intracellular diplococcus?
gonorrhoea
Give some complications of chlamydia
-PID (affects 9% of women) - tubal disease - chronic pelvic pain - transmission to neonates - Reiter’s: conjunctivitis, reactive arthritis and urethritis
How does chlamydia present in females?
How do men present with chlamydia?
What are the complications of PID?
It increases the risk of ectopic pregnancy by 10x and carries a 15-20% risk of tubal factor infertility
When can you test chlamydia?
14 days post sexual
How do you test chlamydia and gonorrhoea?
female- HVS or vulvovaginal swab
male - first void urine also: rectal, throat, and eye swabs
Can you culture chlamydia?
no
By which method are chlamydia and gonorrhoea test samples tested?
NAAT - nucleic acid amplification testing
How to treat chlamydia?
1st line = doxycycline 100mg BD for 7 days
azithromycin 1g
When is test for cure done in chlamydia?
pregnancy
How long should patients abstain from sex after completing their treatment for chlamydia?
1 week (once course has finished)
Which serotypes of chlamydia are associated with lymphogranuloma venereum infection in MSM?
Serotypes L1,L2 &L3
What % of people with gonorrhoea are asymptomatic?
men - 10% women - 50%
How does gonorrhoea present in men?
mucopurulent urethral discharge, dysuria
How does gonorrhoea present in women?
inc/altered vaginal discharge, dysuria, pelvic pain
How do you treat gonorrhoea?
ceftriaxone 500mg IM and test for cure at 2 weeks
Which sub-species of herpes simplex is more likely to cause genital herpes?
HSV-2 - also has higher viral shedding so more likely to be transmitted
Describe symptoms of primary genital herpes
up to 3 weeks of blistering and ulceration of external genitalia + pain + external dysuria + discharge + local tender lymph nodes + fever + myalgia
How long does a secondary genital herpes attack tend to last?
5-7 days
How do we treat genital herpes?
Antiviral PO eg aciciclovir 400mg 3x/day for 5 days
What is the most common viral STI?
HPV