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REGUB Micro - STIs (ii) (HIV (risk factors (sexual contact (hetero or…
REGUB Micro - STIs (ii)
HSV
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primary attack: genital ulceration, dysuria (maybe even urinary retention), ILI
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neonatal HSV
generalised infection - skin, brain, mucous membranes
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Tx: acyclovir, famiclovir, valayclovir
if frequent attacks (@ least once a month) give acyclovir for 1 yr - gives patient a chance to build-up immunity
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Chlamydia
cervicitis
can ascend to PID (chronic pelvic pain, infertility, ectopic pregnancy), esp with repeat attacks
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Reiter's syndrome
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classic triad of conjunctivitis, urethritis, arthritis
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CDC recommendation
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screening of older women with risk factors (new partner, multiple partners)
trichomonas vaginalis
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vaginal discharge, vulval itching, dysuria, 10-50% asymp
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a/w PROM, low birth weight
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Chancroid
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ulcer, tender inguinal lymphadenopathy, suppuration, adenitis, sinus formation
dDx: syphilis, herpes, LGV
Dx: microscopy, culture, NAAT
Tx
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antibiotics depend on geography (resistance patterns) - azithromycin, ceftriaxone, ciprofloxacin, erythromycin
HIV
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prevention
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vertical transmission
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no breastfeeding, or prophylaxis while doing so
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oral disease: candidiasis, oral hairy leukoplakia
Cut disease: HSV, fungal infections
GIT disease: Candida/HSV oesophagitis, cryptosporidium
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neuro disease: cryptococcal meningitis, cerebral toxoplasmosis, HIV neuropathy
malignancies: Kaposi's sarc, non-Hodgkin's lymphoma, Hodgkin's disease, cervical cancer
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