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Sexually Transmitted Infections: Difference between revisions

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== UrologySchool.com Summary of Sexually Transmitted Infections ==
== UrologySchool.com Summary of Sexually Transmitted Infections ==
{| class="wikitable"
{| class="wikitable"
|'''Disease'''
|'''<span style="color:#ff0000">Disease'''
|'''Infectious agent'''
|'''<span style="color:#ff0000">Infectious agent'''
|'''Lesions'''
|'''<span style="color:#ff0000">Lesions'''


'''(Painful x2)'''
'''(Painful x2)'''
|'''Lymphadenopathy'''
|'''<span style="color:#ff0000">Lymphadenopathy'''


'''(Tender x3)'''
'''(Tender x3)'''
|'''Systemic symptoms'''
|'''<span style="color:#ff0000">Systemic symptoms'''
|'''Testing'''
|'''<span style="color:#ff0000">Testing'''
|'''Treatment'''
|'''<span style="color:#ff0000">Treatment'''
|-
|-
|'''Genital herpes'''
|'''<span style="color:#ff0000">Genital herpes'''
|'''HSV-1, HSV-2'''
|'''HSV-1, HSV-2'''
|'''PAINFUL vesicles, shallow, usually multiple'''
|'''PAINFUL vesicles, shallow, usually multiple'''
|'''Tender, bilateral inguinal lymphadenopathy'''
|'''Tender, bilateral inguinal lymphadenopathy'''
|'''Present during primary'''
|'''Present during primary infection'''
 
'''infection'''
|'''NAAT or cell culture, serology for HSV subtype'''
|'''NAAT or cell culture, serology for HSV subtype'''
|'''-cyclovir'''
|'''-cyclovir'''
|-
|-
|'''Primary syphilis/chancre'''
|'''<span style="color:#ff0000">Primary syphilis/chancre'''
|'''Treponema pallidum'''
|'''Treponema pallidum'''
|'''PAINLESS, indurated, with a clean base, usually singular'''
|'''PAINLESS, indurated, with a clean base, usually singular'''
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|'''Benzathine penicillin G'''
|'''Benzathine penicillin G'''
|-
|-
|'''Chancroid'''
|'''<span style="color:#ff0000">Chancroid'''
|'''H. ducreyi'''
|'''H. ducreyi'''
|'''Painful papule, then undermined purulent ulcer, single or multiple'''
|'''Painful papule, then undermined purulent ulcer, single or multiple'''
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|'''Azithromycin'''
|'''Azithromycin'''
|-
|-
|'''Lymphogranuloma venereum'''
|'''<span style="color:#ff0000">Lymphogranuloma venereum'''
|'''Chlamydia'''
|'''Chlamydia'''
|'''Small, PAINLESS, singular, vesicle or papule progresses to an ulcer'''
|'''Small, PAINLESS, singular, vesicle or papule progresses to an ulcer'''
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|'''Doxycycline'''
|'''Doxycycline'''
|-
|-
|'''Donovanosis/Granuloma inguinale'''
|'''<span style="color:#ff0000">Donovanosis/Granuloma inguinale'''
|'''Klebsiella'''
|'''Klebsiella'''
|'''PAINLESS, multiple''' '''slowly progressive ulcers on the genitals and perineum'''
|'''PAINLESS, multiple''' '''slowly progressive ulcers on the genitals and perineum'''
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** '''Treatment is guided by wart size, number, and location, and patient preference.'''
** '''Treatment is guided by wart size, number, and location, and patient preference.'''
* '''Options classified as patient-applied vs. provider-administered modalities'''
* '''Options classified as patient-applied vs. provider-administered modalities'''
** '''Patient-applied (3):'''
** '''Patient-applied (3):[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6620174/table/t1-cuaj-6-s2/?report=objectonly §]'''
**# '''Imiquimod cream'''
**# '''Imiquimod cream, 3.75 or 5%, should be applied for 8 hrs daily for 2 weeks'''
**# '''Podofilox cream'''
**##'''Maximum of 8 weeks for 3.75% vs. 16 weeks every other day for 5% imiquimod'''
**# '''Sinecatechins ointment'''
**# '''Podofilox cream, 0.5%, applied twice daily for 3 consecutive days each week, can repeat up to 4 weeks with at least 4 days in between'''
**# '''Sinecatechins ointment, 15%, applied 3 times daily for up to 16 weeks'''
** '''Provider-administered (4):'''
** '''Provider-administered (4):'''
**# '''Podophyllin''' (less refined form of podofilox)
**# '''Podophyllin''' (less refined form of podofilox)
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**# '''Cryotherapy'''
**# '''Cryotherapy'''
**# '''Surgical therapy including direct excision with scissors, tangential shave excision, curettage, or laser therapy using a CO2 laser'''
**# '''Surgical therapy including direct excision with scissors, tangential shave excision, curettage, or laser therapy using a CO2 laser'''
** See Table 1 from 2019 CUAJ Penile Lesions Review
* '''HPV vaccine'''
* '''HPV vaccine'''
** '''Designed to prevent infection and are not effective in clearing an infection once established'''
** '''Designed to prevent infection and are not effective in clearing an infection once established'''
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=== Scabies ===
=== Scabies ===
* '''Skin infection caused by the mite Sarcoptes scabiei'''
* '''Skin infection caused by the mite Sarcoptes scabiei'''
* Pathogenesis
 
** The female lays eggs in the skin, and transmission is by person-to-person skin-to-skin contact with passage of pregnant female mites.
==== Pathogenesis ====
** Incubation period: 2-6 weeks
* The female lays eggs in the skin, and transmission is by person-to-person skin-to-skin contact with passage of pregnant female mites.
* Diagnosis and Evaluation
* Incubation period: 2-6 weeks
** History and Physical Exam
 
*** Most common symptoms are skin rash and '''itching, especially at night''', from an allergic reaction to the mite proteins.
==== Diagnosis and Evaluation ====
** Other
* History and Physical Exam
*** Microscopic examination of a skin scraping to assess for mites, mite eggs, or fecal matter (scybala)
** Most common symptoms are skin rash and '''itching, especially at night''', from an allergic reaction to the mite proteins.
* '''Management'''
* Other
** '''Permethrin cream''' or ivermectin 200 μg/kg orally
** Microscopic examination of a skin scraping to assess for mites, mite eggs, or fecal matter (scybala)
 
==== Management ====
* '''Permethrin cream''' or ivermectin 200 μg/kg orally


=== Pediculosis Pubis (Phthirus pubis): Pubic or Crab Louse ===
=== Pediculosis Pubis (Phthirus pubis): Pubic or Crab Louse ===
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