Infectious Disease Book

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Sexually Transmitted DiseaseAka: STD

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  1. See Also
    1. Postexposure Prophylaxis for HIV
    2. Postexposure Prophylaxis for Hepatitis B
    3. Rape Management
  2. Risk Factors: High Risk Groups for STD
    1. Adolescents
      1. Multiple partners
      2. Sequential monogamy
      3. Unconcerned
      4. Uniformity
    2. Racial or ethnically skewed
      1. Black: Chlamydia more common
    3. Homosexual men or women
    4. Coasts or Ports of entry
    5. Prostitutes
    6. Teenage runaways
    7. Immigrants
  3. Pathophysiology: Transmission
    1. Contact
      1. Secretions
      2. Mucus membrane
      3. Skin abrasion
    2. Intercourse not necessary for STD transmission
      1. Herpes Simplex Virus
      2. Condyloma
      3. Gonorrhea
      4. Chlamydia
  4. Causes
    1. Sexually Transmitted Disease Genital Ulcers
      1. Painful Ulcers
        1. Herpes Genitalis
        2. Chancroid
      2. Non-Painful Ulcers
        1. Granuloma inguinale
        2. Lymphogranuloma venereum
        3. Syphilis (Early)
    2. Sexually Transmitted Disease Non-ulcerative
      1. Non-Gonococcal Urethritis
      2. Pelvic Inflammatory Disease
      3. Gonorrhea
      4. Chlamydia
      5. Syphilis (Secondary or tertiary)
      6. Human Papillomavirus (HPV) and Cervical Dysplasia
      7. Human Immunodeficiency Virus (HIV)
      8. Hepatitis B Virus
      9. Parasitic Infection
        1. Pediculosis pubis
        2. Scabies (pruritic genital bumps awaken patient)
  5. Screening: Wet Mount microscopic exam of cervical swab
    1. Positive: Polymorphonuclear Leukocytes (PMNs) >10/hpf
    2. Positive test should be followed by specific testing
      1. Chlamydia trachomatis
      2. Neisseria gonorrhoeae
    3. Efficacy
      1. Test Sensitivity: 90%
      2. Test Specificity: 87%
    4. Reference
      1. Bohmer (1999) Am J Obstet Gynecol 181:283
  6. Symptoms: Women
    1. Vaginal Discharge
    2. Postcoital spotting
    3. Dyspareunia
  7. Signs: Women
    1. Genital Ulcers
    2. Cervicitis
      1. Erythema of cervix
        1. GynCervicalColposcopyVaginoCervicitis.jpg
      2. Mucopurulent discharge from Cervical os
  8. Pitfalls
    1. Pharyngeal Gonorrhea in Men who have sex with men
      1. Morris (2006) Clin Infect Dis 43:1284
  9. Management
    1. Rescreening
      1. Routinely Rescreen positive STD cases in 3 months to identify new STD infections
      2. Peterman (2006) Ann Intern Med 145:654
    2. Expedited Partner Treatment
      1. Precaution: Legality of Expedited Partner Treatment varies by State in the United States
      2. Ideally sexual partners are seen for their own medical evaluations
        1. However: Delaying their treatment until evaluation risks re-exposing treated patients
      3. CDC asks physicians to consider treating sexual partners of STD patients without a visit
        1. Employ in cases where sexual partner is unlikely to present for medical care
        2. Prescription for sexual partner's STD treatment is given to the patient being treated
      4. References
        1. Golden (2005) N Engl J Med 352:676
  10. Resources for Patients
    1. STD Hotline: (800) 227-8922
    2. Information from your Family Doctor: Prevent AIDS
      1. http://www.familydoctor.org/healthfacts/005/
  11. References
    1. Workowski (2006) MMWR Recomm Rep 55:1

Sexually Transmitted Diseases (C0036916)

Definition (MSH)Diseases due to or propagated by sexual contact.
Definition (CSP)diseases due to or propagated by sexual contact.
Definition (NCI)Any contagious disease acquired during sexual contact; e.g. syphilis, gonorrhea, chancroid.
Definition (NCI)A disorder acquired through sexual contact. --2004
ConceptsDisease or Syndrome (T047)
ICD9099.9
EnglishDisease with a predominantly sexual mode of transmission, SEX TRANSM DIS, Sexually transmissible disease, Sexually transmitted disease, Sexually transmitted diseases, Sexually Transmitted Disorder, Sexually transmitted infectious disease, Statutory venereal disease, STD, STDs, VD, VENEREAL DIS, venereal disease, Venereal diseases
Spanishenfermedad de transmisión sexual, enfermedad de transmision sexual, enfermedad infecciosa transmitida por vía sexual, enfermedad infecciosa transmitida por via sexual, enfermedad infecciosa transmitida sexualmente, enfermedad venérea, enfermedad venerea
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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