frenkle tl, p. j. (2011). wein : campbell-walsh urology, 10th. ed. e. saunders. md consult

Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult.

• Condition:• Symptoms:• Treatment:• Reportable to the CDC?

Genital Herpes Simplex Virus InfectionEpidemiology: Prevalence - 50 million people in USCause: Virus, HSV-2 (85-90%) and HSV-1 (10-15%)Clinical findings: Ulcer disease, recurrent, multiple, painful vesiclesTest: Viral CultureFirst Treatment: Valacyclovir 1g BID for 7-10 daysRecurrence: Valacyclovir 500mg BID for 3 days Suppression: Valacyclovir 500mg SIDReportable? No

Adapted from Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2010. MMWR 2010;59(RR-12):21–2.


Condition:Symptoms:Treatment:Reportable to the CDC?

Lymphogranuloma Venereum Epidemiology: Rare in US, most common in Africa, Asia, South America, CarribbeanCause: Bacteria, Chlamydia trachomatis L1,2,3Clinical findings: Ulcer disease, painless vesicle then ulcer, location penis, anus, vulvovaginal areaTest: Culture of lesion Treatment: Doxycycline 100mg BID for 3 weeks

Reportable? No


Primary Syphilis Epidemiology: 7.8 cases per 100,000 in men; 1.4 cases per 100,000 in women Cause: Spirochete, Treponema pallidumClinical findings: Ulcer disease, painless, indurated, singular ulcer, bilateral lymphadenopathyTest: Darkfield microscopy of specimens from lesion; serumVDRL or RPR Treatment: Benzathine penicillin G 2.4 mU IM x 1

Reportable? YesAdapted from Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2010. MMWR 2010;59(RR-12):21–2.

Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult.DeCherney AH, Nathan L. Current Diagnosis and Treatment Obstetrics and Gynecology, 10 th edition. McGraw Hill Companies.


Chancroid Epidemiology: Incidence – 28 US cases in 2009, but most common ulcer STI in the worldCause: Bacteria, Haemophilus ducreyiClinical findings: Ulcer disease, painful ulcer, involves penis or vulvovaginal area, unilateral inguinal adenopathyLab: Difficult, but gram stain and culture lesionTreatment: Azithromycin 1g PO x 1Reportable? Yes




Vaginal Discharge

pH WBC Microscopy Symptoms

Normal White, thick, smooth

≤4.5 Absent Lactobacilli None

Candidiasis White, thick, curdlike

≥4.5 Absent Mycelia Vulvar pruritus, external or superficial dysuria

Trichomoniasis Frothy or purulent

≥4.5 Present Mobile trichomonads present; Amine odor

Vulvar erythema and edema, punctate strawberry lesions on cervix

Neisseria gonorrhoeae infection

None or mucopurulent discharge from cervicitis

≥4.5 Present Gram-negative diplococci within or adjacent to polymorphonuclear leukocytes on Gram stain

Vaginal and pelvic discomfort, dysuria, most often asymptomatic

Chlamydia trachomatis infection


≥4.5 Present Organisms not visualized Vaginal and pelvic discomfort, dysuria, most often asymptomatic

Bacterial vaginosis

Thin, white homogeneous

≥4.5 Absent Absent Paucity of lactobacilli; Amine odor; Clue cells

Fishy odor and increased vaginal discharge

Chlamydial urethritis/cervicitis Epidemiology: Incidence – 1.2 million cases in 2009Cause: Bacteria, Chlamydia trachomatisClinical findings: Asymptomatic. Lower urinary tract symptoms in men. Mucopurulent discharge and PID in women.Screen: Yes, annually for sexually active women <26 Test: Urethral, endocervical culture or urine cultureTreatment: Azithromycin 1g PO x 1 Reportable? Yes




Vaginal Discharge
















Bacterial vaginosis




GonorrheaEpidemiology: Prevalence - 50 million people in USCause: Bacteria, Neisseria gonorrheaClinical findings: Men- Lower urinary tract symptoms, Women – mucopurlent endocervical dischargeTest: Urethral, cervical swab for cultureTreatment: Ceftriaxone 250mg x 1 IM

Reportable? Yes



Condition:Treatment:Reportable to the CDC?

Vaginal Discharge
















Bacterial vaginosis




TrichomoniasisEpidemiology: Prevalence – 174 million cases worldwide in 1999Cause: Protozoan, Trichomonas vaginalisClinical findings: Asymptomatic in men; frothy white or green, malodorous discharge; strawberry cervixTreatment: Metronidazole 2gm x1 POReportable? No


Frenkle TL, P. J. (2011). Wein: Campbell-Walsh Urology, 10th. ed. E. Saunders. MD Consult.Habif (2009). Clinical Dermatology, 5th Edition. Elsevier. MD Consult.


ScabiesEpidemiology: Treat entire household, not just sexual partnersCause: Mite, Sarcoptes scabieiClinical findings: Wavy, elongated papules, eruption with pruritisTesting: Microscopic evidence of mite or eggsTreatment: Permethrin cream (5%) all over, wash off after 8-14 hoursReportable? No


HPV, Genital WartsEpidemiology: Prevalence – 20 million, 80% of women by age 50 will have had the infectionCause: Human Papilloma Virus, various subtypesHPV 6 & 11 - wartsHPV 16 & 18 – 99% of cervical cancersClinical findings: recurrent vesicular lesionsTreatment: Podofilox 0.5% gel q12h application x 3 daysReportable? No


frenkle tl, p. j. (2011). wein : campbell-walsh urology, 10th. ed. e. saunders. md consult

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