Sexually transmitted diseases: Difference between revisions

No edit summary
No edit summary
(40 intermediate revisions by 7 users not shown)
Line 1: Line 1:
==Background==
==Background==
*STD Prevalence: [[Human papillomavirus|HPV]] > [[Human papillomavirus|HSV-2]] > [[Trichomonas]] > [[Chlamydia trachomatis|Chlamydia]] > [[HIV]] > [[HBV]] > [[Neisseria gonorrhoeae|Gonorrhea]] > [[Syphilis]]
*STD New infections: HPV > Chlamydia > Trichomonas > Gonorrhea > HSV-2 > Syphilis > [[HIV]] > HBV <ref>[http://www.cdc.gov/std/stats/sti-estimates-fact-sheet-feb-2013.pdf CDC: STI Fact sheet 2013]</ref>


==Diagnosis==
==Clinical Features==
{{Genital images male}}
{{Genital images male}}
{{Genital images female}}
{{Genital images female}}


==Management==
==Differential Diagnosis==
===Treatment Chart===
{{STD DDX}}


{| style="border-right: medium none; border-top: medium none; border-left: medium none; border-bottom: medium none; border-collapse: collapse" border="1"
==Evaluation==
|-
| style="border-right: windowtext 0.5pt solid; padding-right: 5.4pt; border-top: windowtext 0.5pt solid; padding-left: 5.4pt; padding-bottom: 0in; border-left: windowtext 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: windowtext 0.5pt solid" valign="top" width="82" |
'''Disorder'''


| style="border-right: windowtext 0.5pt solid; padding-right: 5.4pt; border-top: windowtext 0.5pt solid; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: windowtext 0.5pt solid" valign="top" width="108" |
==Management==
'''Clinical'''
*It is important to treat sexual partners for all STDs
 
**See [[Expedited Partner Therapy]]
| style="border-right: windowtext 0.5pt solid; padding-right: 5.4pt; border-top: windowtext 0.5pt solid; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: windowtext 0.5pt solid" valign="top" width="162" |
'''1<sup>st</sup> line'''
 
| style="border-right: windowtext 0.5pt solid; padding-right: 5.4pt; border-top: windowtext 0.5pt solid; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: windowtext 0.5pt solid" valign="top" width="176" |
'''Alternative'''
 
| style="border-right: windowtext 0.5pt solid; padding-right: 5.4pt; border-top: windowtext 0.5pt solid; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: windowtext 0.5pt solid" valign="top" width="90" |
'''Partner'''
 
| style="border-right: windowtext 0.5pt solid; padding-right: 5.4pt; border-top: windowtext 0.5pt solid; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: windowtext 0.5pt solid" valign="top" width="108" |
'''In Pregnancy'''
 
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
''[[N. Gonorrhea]]''
 
[[Urethritis]]/
 
[[Cervicitis]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
M: [[urethritis]] with d/c or simply dysuria;can be asymptomatic
 
F: purulent discharge; can be asymptomatic
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Ceftriaxone]] 250mg IM
 
OR
 
[[Cefixime]] (Suprax) 400mg po x1
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
[[Spectinomycin]] 2g IM x 1
 
OR
 
[[Azithromycin]] 2g po x 1
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" |
Treat and abstinence x 7d after both treated
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
[[Ceftriaxone]] 250mg IM x 1
 
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
''[[N. Gonorrhea]]''
 
[[Gonorrheal Conjunctivitis|Conjunctivitis]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
2-5d after birth
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
Erythromycin ophthalmic 0.5% x1
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
Tetracycline ophthalmic 1% x1
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
''[[N. Gonorrhea]]''
 
Disseminated
 
(DGI)
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Petechial, pustular acral skin lesions,
 
Asymmetrical arthralgias, tenosynovitis,
 
[[Septic Arthritis]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Ceftriaxone]] 1g IM/IV q24
 
-continue x24-48h until improvement
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
[[Cefotax]] 1g IV q8
 
[[Spectinomycin]] 2g IV q12
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
''[[Chlamydia Trachomatis]]''
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
M: [[urethritis]] with d/c or simply dysuria; can be asymptomatic
 
F: purulent discharge or cervical bleeding; can be asymptomatic
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Azithromycin]] 1g po x1
 
OR
 
[[Doxycycline]] 100mg po bid x 7d
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
[[Erythromycin]] base 500mg po qid x 7d OR
 
[[Oflox]] 300mg po bid x 7d
 
OR
 
[[Levoflox]] 500mg po qd x 7days
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" |
Treat and abstinence x 7d after both treated
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
[[Azithromycin]] 1g po x1 or
 
[[Amoxicillin]] 500mg po tid x 7d
 
Or
 
[[Erythro]]
 
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
''[[Chlamydia]]''
 
''Trachomatis''
 
[[Conjunctivitis]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
5-12d after birth; silver nitrate ophthalmic only rx [[gonorrhea]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Erythromycin]] base 50mg/kg/day PO / 4 doses x14days
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
''[[Chlamydia Trachomatis]]''
 
[[Pneumonia]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
1-3months; afebrile, staccato cough with diffuse infiltrates on CXR; peripheral eosinophilia
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Erythromycin]] base 50mg/kg/day po / 4 doses x14days
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
''[[Trichamonas Vaginalis]]''
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
White, thick discharge
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Metronidazole]] 2g po x 1
 
OR
 
Tinidazole 2g po x 1
 
PLUS
 
[[Azithro]] 1g po x 1
 
-intravag cream not recommended
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
[[Metronidazole]] 500mg bid for 7days; 1-2g po qday x 7d if recurrence
 
OR
 
Topical clotrimazole for metronidazole allergy– not as effective
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" |
[[Metronidazole]] 2g po x 1
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Rx only if symptomatic but rx partner
 
1<sup>st</sup> trimester, Clotrimazole 100mg hs for 7days
 
After 1<sup>st</sup> trimester, [[Metronidazole]] 2g po x 1
 
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
[[Bacterial Vaginosis]]
 
''Lactobacillus''
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
White, fishy discharge
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Metronidazole]] 500mg po bid for 7d
 
OR
 
0.75% Metronidazole gel (one full applicator 5g) intravaginal qd for 5d
 
OR
 
2% Clindamycin cream 5g qd for 7d
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
[[Clindamycin]] 300mg po bid for 7d (recurrence)
 
OR
 
Clindamycin ovules 100mg intravaginally qhs x 3d
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" |
Exam for STD
 
No rx if nl
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
1<sup>st</sup> trimester, metronidazole 250mg po tid x7d
 
After 1<sup>st</sup> trimester, 500mg po bid for 7days or 250mg po tid x7d or Clinda 300mg po bid x 7d
 
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
Candidiasis
 
(''Candida albicans''<span style="font-style: normal">)</span>
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Cottage cheese;
 
[DM] or immunocompromised
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
Butoconazole 2% cream 5g intravaginally for 3d
 
OR
 
Butaconazole-sustained 2% intravag x1
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
Clotrimazole 1%<span> </span>5g cream intravaginally for 7-14d (OTC)
 
OR
 
Clotrimazole 100mg intravag tablet x 7d
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" |
Candicidal cream if dermatitis present
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Avoid fluconazole and ketoconazole.
 
Rx with cream for 7d
 
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
[[Chancroid]]
 
(''[[H. ducreyi]]''<span style="font-style: normal">)</span>
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Painful ulcers with suppurative LAD
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Azithromycin]] 1g PO x 1
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
[[Ceftriaxone]] 250mg IM x1
 
[[Cipro]] 500mg PO bid x 3days
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" |
See CDC
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
[[Ceftriaxone]]
 
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
Granuloma Inguinale (Donvanosis)
 
''Klebsiella granulomatis''
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Painless lesions without LAD
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Doxycycline]] 100mg PO BID x 3wks and until all lesions heald
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
[[Azithromycin]] 1g po q week
 
[[Ciprofloxacin]] 750mg PO bid x 3 weeks
 
[[Bactrim DS]] 1tab PO BID x 3 wks
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" |
same
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
[[Erythromycin]] base 500mg po qid x 3wks
 
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
Lymphogranuloma Venereum (LGV)
 
''C. trach'' <span style="font-style: normal">serovars L1-L3</span>
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Tender, unilateral LAD; can lead to proctitis, fistulas
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Doxycycline]] 100mg po bid x 3 weeks
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
[[Erythromycin]] base 500mg po qid x 3wks
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" |
Treat within 60days of exposure with standard [[Chlamydia]] Rx
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
[[Erythromycin]] base 500mg po qid x 3wks
 
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
Chancre
 
Primary
 
[[Syphilis]]
 
(''[[T. pallidum]]''
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Painless ulcer, [[chancre]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Benzathine Penicillin G]] 1.2million U IM x1
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
[[Doxycycline]] 100mg po bid x 14d
 
[[Tetracycline]] 500mg po qid x 14d
 
[[Ceftriaxone]] 1g IM/IV x 8-10d
 
[[Azithromycin]] 2g po x 1?
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" |
See CDC
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Penicillin; if allergic desensitize
 
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
Secondary [[Syphilis]]
 
(''[[T. pallidum]]''<span style="font-style: normal">)</span>
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Skin rash, mucocutaneous lesions, LAD
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" |
See CDC
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
Latent [[Syphilis]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Seroreactivity without other evidence of disease
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
''Early''
 
''Late''
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
[[Doxycycline]] 100mg po bid x 28d
 
[[Tetracycline]] 500mg po qid x 28d
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" |
See CDC
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
Tertiary [[Syphilis]]
 
(''[[T. pallidum]]''<span style="font-style: normal">)</span>
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Cardiac (aortitis), ophtho (iritis, uveitis), gumma
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Benzathine Penicillin G]] 2.4million U IM qweek x 3
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" |
See CDC
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
Neurosyphilis
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
[[Meningitis]], syphilitic eye disease
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
Aqueous crystalline penicillin G 18-24million units/d administered as 3-4million units IV q4h or continuous infusion x 10-14days
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
[[Procaine penicillin]] 2.4million units IM qday + Probenecid 500mg po qid<span> </span>
 
BOTH for 10-14d
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
[[HSV]] (1<sup>st</sup> episode)
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Vesilcular [[rash]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
Acyclovir 400mg po TID x 7-10day
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
Famciclovir 250mg po TID x 7-10d
 
Valacyclovir 1g PO BID x 7-10d
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
[[HSV]] (suppressive)
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
Acyclovir 400mg PO BID
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
Famciclovir 250mg po BID
 
Valacyclovir 500mg PO qday
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
[[Epididymitis]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Pain, swelling, inflammation of the epididymis
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Ceftriaxone]] 250mg IM + Doxycyline 100mg po bid x 10d
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
Oflox 300mg<span> </span>po bid x 10d + levoflox 500mg po qday x 10d
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
[[Epididymorchitis]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
[[Proctitis]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Inflammation of the rectum (distal 10-12cm)
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
[[Ceftriaxone]] 125mg IM x1 + Doxy 100mg po bid x 7d
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
[[PID]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Sexually active, no other sources and: CMT OR uterine OR adnexal TTP
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
'''Outpt:'''
 
[[Ceftriaxone]] 250mg IM x1
 
OR
 
[[Cefoxitin]] 2g IM in a single dose and probenecid 1g orally administered concurrently in single dose
 
OR
 
Other parenteral 3<sup>rd</sup> gen [[cephalosporin]] (eg. [[ceftizoxime]] or [[cefotaxime]])
 
PLUS
 
[[Doxy]] 100mg po bid x14d
 
+/-
 
[[Metronidazole]] 500mg po bid x 14d
 
 
 
'''Inpt:'''
 
[[Cefotetan]] 2g IV q12h
 
OR
 
[[Cefoxitin]] 2g IV q6h
 
PLUS
 
[[Doxycyline]] 100mg IV or PO q12
 
(''similar bioavailability)''
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
'''Outpt:'''
 
[[Oflox]] 400mg po bid x 14d
 
OR
 
[[Levofloxacin]] 500mg po qday x 14d
 
+/-
 
[[Metronidazole]] 500mg po bid x 14d
 
 
 
'''Inpt:'''
 
[[Clinda]] 900mg IV q8h
 
PLUS
 
[[Gent]] load 2mgkg IV; maintenance 1.5mg/kg q8h; single daily dosing may be substituted
 
+/-
 
[[Metro]] 500mg IVq8h
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
[[Scabies]]
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Crusted rash, intertiginous areas
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
Permethrin 5% cream applied to all areas of body from neck down and rinsed off after 8-14h
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
Ivermectin 200mcg/kg PO, repeated in 2weeks
 
Lindane (1%) 1 ounce of lotion of 30g of cream applied in thin layer all over from neck down x 8 hours then rinse
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|-
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: 0.5pt solid; width: 81.9pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="82" |
Pediculosis Pubis
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" |
Puritic genitalia
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 2.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="162" |
Permethrin 1% cream: apply to affected areas x 10mins then wash off
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 175.5pt; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="176" |
Malathion lotion 0.5% apply x 8-12h then rinse
 
OR
 
Ivermectin<span> </span>250mcg/kg PO repeated in 2 weeks
 
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.25in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="90" | <br>
| style="border-right: 0.5pt solid; padding-right: 5.4pt; border-top: medium none; padding-left: 5.4pt; padding-bottom: 0in; border-left: medium none; width: 1.5in; padding-top: 0in; border-bottom: 0.5pt solid" valign="top" width="108" | <br>
|}


†Test for [[HIV]], [[syphilis]]
==Disposition==


==See Also==
==See Also==
*[[Human Papillomavirus (HPV)]]
*[[Pelvic Inflammatory Disease (PID)]]
*[[Pelvic Inflammatory Disease (PID)]]
*[[Ulcerative STDs]]
*[[Ulcerative STDs]]
*[[Penile diagnoses]]
*[[Pelvic pain]]
*[[Expedited Partner Therapy]]


== Source  ==
==External Links==
DeBonis


Adapted from CDC 2010 Guidelines
==References==
<references/>


[[Category:GU]] [[Category:ID]] [[Category:OB/GYN]]
[[Category:Urology]] [[Category:ID]] [[Category:OBGYN]]

Revision as of 20:10, 10 September 2020

Background

Clinical Features

STD Visual Diagnosis (Male)

STD Visual Diagnosis (Female)

Differential Diagnosis

Sexually transmitted diseases

Evaluation

Management

Disposition

See Also

External Links

References

  1. ↑ CDC: STI Fact sheet 2013
Retrieved from "https://www.wikem.org/w/index.php?title=Sexually_transmitted_diseases&oldid=272670"