Infectious Disease Book

http://www.fpnotebook.com/

Sexually Transmitted Disease

Aka: Sexually Transmitted Disease, STD, Sexually Transmitted Infection, STI
Advertisement
  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. See Genital Ulcers (Mnemonic: CHISEL)
        1. E in CHISEL is drug eruption
      2. Painful Ulcers
        1. Chancroid
        2. Herpes Genitalis
        3. Trichomonas may also cause labial Ulcerations
      3. Non-Painful Ulcers
        1. Granuloma Inguinale
        2. Syphilis (Early)
        3. Lymphogranuloma venereum
    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 BVirus
      9. Parasitic Infection
        1. Pediculosis pubis
        2. Scabies (pruritic genital bumps awaken patient)
  5. Symptoms: Women
    1. Vaginal Discharge
    2. Postcoital spotting
    3. Dyspareunia
  6. Signs: Women
    1. Genital Ulcers
    2. Cervicitis
      1. Erythema of Cervix
        1. GynCervicalColposcopyVaginoCervicitis.jpg
      2. Mucopurulent discharge from Cervical os
  7. Lab: Screening
    1. First-line studies
      1. Chlamydia DNA probe
      2. Gonorrhea DNA probe
      3. Vaginal Wet prep
      4. Consider Urinalysis
    2. Additional studies to consider
      1. HIV Test
      2. Syphilis (RPR)
      3. Hepatitis B Testing (if not immunized)
  8. Lab: 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 181:283-7
  9. Pitfalls
    1. Pharyngeal Gonorrhea in Men who have sex with men
      1. Morris (2006) Clin Infect Dis 43: 1284-9
  10. Management
    1. Emergency department empiric treatment
      1. Initiating empiric treatment for suspected STD prior to results (often delayed days) is appropriate
      2. Despite risk of overtreatment, treating for suspected Chlamydia and Gonorrhea can help further prevent spread and complications
        1. Ceftriaxone 250 mg IM AND
        2. Azithromycin 1 gram orally
    2. Rescreening
      1. Routinely Rescreen positive STD cases in 3 months to identify new STD infections
      2. Peterman (2006) Ann Intern Med 145:654-72
    3. 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 352:676-85
  11. Resources: Patients
    1. CDC National STD Hotline (CDC)
      1. http://www.cdc.gov/std/
      2. Phone: 800-232-4636
    2. Expedited Partner Treatment (CDC)
      1. http://www.cdc.gov/std/ept/
    3. Information from your Family Doctor: Prevent AIDS
      1. http://www.familydoctor.org/healthfacts/005/
  12. References
    1. Workowski (2006) MMWR Recomm Rep 55: 1-94

Sexually Transmitted Diseases (C0036916)

Definition (NCI) A disorder acquired through sexual contact.
Definition (NCI) Any contagious disease acquired during sexual contact; e.g. syphilis, gonorrhea, chancroid.
Definition (MEDLINEPLUS)

Sexually transmitted diseases (STDs) are infections that you can get from having sex with someone who has the infection. The causes of STDs are bacteria, parasites and viruses. There are more than 20 types of STDs, including

Most STDs affect both men and women, but in many cases the health problems they cause can be more severe for women. If a pregnant woman has an STD, it can cause serious health problems for the baby.

If you have an STD caused by bacteria or parasites, your health care provider can treat it with antibiotics or other medicines. If you have an STD caused by a virus, there is no cure. Sometimes medicines can keep the disease under control. Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading STDs.

Centers for Disease Control and Prevention

Definition (CSP) diseases due to or propagated by sexual contact.
Definition (MSH) Diseases due to or propagated by sexual contact.
Concepts Disease or Syndrome (T047)
MSH D012749
ICD9 099.9
ICD10 A50-A64.9, A64, A50-A64
SnomedCT 8098009, 187367009, 187348005, 186949002, 154378004, 186831003, 266208003, 276972005
English Disease, Sexually Transmitted, Diseases, Sexually Transmitted, Diseases, Venereal, Sexually Transmitted Disease, Sexually Transmitted Diseases, Venereal Diseases, SEXUALLY TRANSMITTED DISEASE NOS, Disease, Venereal, VD, Venereal disease, NOS, Disea w predom sex mod transm, Infections with a predomin, Infections with a predominantly sexual mode of transmiss, Infections with a predominantly sexual mode of transmission, STD - Sexually transmitted dis, Unspcf sexual transmitd dis, Unspecified sexually transmitted disease, Venereal disease NOS, Venereal disease, unspecified, [X]Infections with a predomin, [X]Infections with a predominantly sexual mode of transmiss, [X]Infections with a predominantly sexual mode of transmission, [X]Unspcf sexual transmitd dis, [X]Unspecified sexually transmitted disease, Sexually transmitted infectious disease, NOS, SEX TRANSM DIS, VENEREAL DIS, Sexually transmitted disease, NOS, sexually transmitted disease (diagnosis), venereal disease, sexually transmitted disease, VD (venereal disease), std, Sexually transmitted infections, Venereal Disease, Sexually transmitted infection, Sexually transmitted disease NOS, SEXUALLY TRANSMITTED DISEASE, [X]Unspecified sexually transmitted disease (disorder), [X]Infections with a predominantly sexual mode of transmission (disorder), Venereal disease NOS (disorder), DISEASE (VD), VENEREAL, VENEREAL DISEASE, VENEREAL DISEASE (VD), VD, VENEREAL DISEASE, Sexually Transmitted Diseases [Disease/Finding], Sexually transmitted diseases, disease sexualli transmit, sexually transmitted diseases, vds, diseases venereal, sexually transmitted diseases (STDs), disease sexually transmit, disease venereal, sexually transmitted disease (STD), Disease;sexually transmitted, venereal diseases, disease sexually transmited, disease sexually transmitted, diseases sexually transmited, diseases sexually transmitted, Infections with a predominantly sexual mode of transmission (A50-A64), Sexually Transmitted Infection, Venereal disease, Disease with a predominantly sexual mode of transmission, STD - Sexually transmitted disease, Sexually transmitted disease, Sexually transmissible disease, Sexually transmitted infectious disease (disorder), Sexually transmitted infectious disease, disease (or disorder); infectious, sexually transmitted, disease (or disorder); sexually transmitted, disease (or disorder); venereal, infectious; disease, sexually transmitted, sexual; transmitted disease, venereal; disease, Venereal diseases, Diseases (Venereal), STD, Sexually Transmitted Disorder, Statutory venereal disease, VD - Venereal disease, Venereal disease (disorder), STDs, Disease;venereal
Italian Malattia sessualmente trasmessa, Malattia venerea non specificata, Malattia sessualmente trasmessa NAS, Malattia venerea NAS, Malattia venerea, Malattie veneree, Malattie sessualmente trasmesse, Infezione trasmessa per via sessuale
Dutch seksueel overdraagbare aandoening NAO, VD, venerische ziekte NAO, geslachtsziekte, niet-gespecificeerd, seksueel overdraagbare infectie, aandoening; infectieus, seksueel overdraagbaar, aandoening; seksueel overdraagbaar, aandoening; venerisch, infectieus; aandoening, seksueel overdraagbaar, seksueel; overdraagbare aandoening, venerisch; aandoening, Niet gespecificeerde seksueel overdraagbare aandoening, seksueel overdraagbare aandoening, Aandoening, seksueel overdraagbare (SOA), Aandoeningen, seksueel overdraagbare (SOA), Geslachtsziekte, SOA, Seksueel overdraagbare aandoening (SOA), Seksueel overdraagbare aandoeningen (SOA)
French Maladie vénérienne SAI, Maladie vénérienne, non précisée, MV, Maladie sexuellement transmissible SAI, Infection sexuellement transmissible, Maladie sexuellement transmissible, MST, Maladies sexuellement transmissibles, Maladies vénériennes, Maladies sexuellement transmises
German Geschlechtskrankheit NNB, VD, Geschlechtskrankheit, unspezifisch, Sexuell übertragbare Erkrankungen, STD (Sexuell übertragbare Krankheiten), Durch Geschlechtsverkehr uebertragene Krankheiten, nicht naeher bezeichnet, sexuell uebertragene Infektion, Geschlechtskrankheit, Geschlechtskrankheiten, Venerische Krankheiten, Sexuell übertragbare Krankheiten
Portuguese Doença transmitida sexualmente NE, Doença venérea, Doença venérea NE, DST, IST, Infecção sexualmente transmissível, Doenças trasmitidas por via sexual, Doenças Sexualmente Transmissíveis, Doenças Venéreas, Doenças Sexualmente Transmitidas, DSTs, Doenças de Transmissão Sexual, Infecções Sexualmente Transmissíevis, Infecções Sexualmente Transmitidas
Spanish Enfermedad venérea no especificada, Enfermedad de transmisión sexual NEOM, EV, Enfermedad venérea NEOM, enfermedad venérea (trastorno), enfermedad venérea, Venereal diseases, Syphilis and other venereal diseases, Sexually transmitted diseases, [X]enfermedad de transmisión sexual no especificada, [X]enfermedad de transmisión sexual no especificada (trastorno), [X]infecciones con modo de transmisión predominantemente sexual, [X]infecciones con modo de transmisión predominantemente sexual (trastorno), [X]infecciones de transmisión predominantemente sexual (trastorno), [X]infecciones de transmisión predominantemente sexual, enfermedad de transmisión sexual, enfermedad infecciosa transmitida por vía sexual (trastorno), enfermedad infecciosa transmitida por vía sexual, enfermedad venérea, SAI (trastorno), enfermedad venérea, SAI, Enfermedad de transmisión sexual, enfermedad infecciosa transmitida sexualmente, Enfermedades Sexualmente Transmisibles, Enfermedades Venéreas, Enfermedades Venereas, ETSs, ETS, Enfermedades Sexualmente Transmitidas, Enfermedades de Transmision Sexual, Enfermedades de Transmisión Sexual, ITS, Infecciones Sexualmente Transmitidas, Infecciones de Transmision Sexual, Infecciones de Transmisión Sexual
Japanese 性行為感染症NOS, 性病、詳細不明, 性病NOS, セイコウイカンセンショウ, セイビョウショウサイフメイ, セイコウイカンセンショウNOS, セイビョウNOS, セイビョウ, 性行為感染症, 性感染症, 性病, 性的感染症
Swedish Könssjukdomar
Czech sexuálně přenosné nemoci, pohlavní nemoci, Pohlavní nemoc, Pohlavně přenosné onemocnění, Pohlavně přenosné onemocnění NOS, Pohlavní nemoc, blíže neurčená, Pohlavní nemoc NOS, Sexuálně přenosné choroby
Finnish Sukupuolitaudit
Russian POLOVYM PUTEM PEREDAVAEMYE BOLEZNI, VENERICHESKIE BOLEZNI, ВЕНЕРИЧЕСКИЕ БОЛЕЗНИ, ПОЛОВЫМ ПУТЕМ ПЕРЕДАВАЕМЫЕ БОЛЕЗНИ
Korean 상세불명의 성행위로 전파되는 질환
Croatian SPOLNE BOLESTI
Polish Choroby przenoszone drogą płciową, Choroby weneryczne
Hungarian szexuálisan átvitt betegség, Szexuálisan közvetített fertőzés, nemibetegség, nem meghatározott, Nemibetegség k.m.n., szexuálisan átvitt betegség k.m.n., VD
Sources
Derived from the NIH UMLS (Unified Medical Language System)


You are currently viewing the original 'fpnotebook.com\legacy' version of this website. Internet Explorer 8.0 and older will automatically be redirected to this legacy version.

If you are using a modern web browser, you may instead navigate to the newer desktop version of fpnotebook. Another, mobile version is also available which should function on both newer and older web browsers.

Please Contact Me as you run across problems with any of these versions on the website.

Navigation Tree