Introduction:

• most frequently diagnosed

Transmission:

• contact with genital secretions

• results in infection:

  • endocervix

  • urethra

  • rectum

  • occasionaly pharynx and eye

• accurate results obtained 1-2 weeks after potential exposure

• incubation peiord 7-21d

• Swabs taken too soon : false neg

• Vertical transmission may cause conjunctivits/ophthalmia in new born

• within 3w delivery

Symptoms:

• asymptomatic \~70% of people

• Men:

  • urethra discahrge

  • urethral irritation

  • dysuria

  • testicular pain/swelling

• Females:

  • vaginal discharge

  • lower abdominal pain

  • dyspareunia

  • dysuria

  • irregular PV bleeding

  • should be considered with sterile pyuria

  • + breakthorugh bleeding

Testing:

• all sexually active F \<25yo

  • if never been testing

  • annually

    • ≥ 2 partners last 12 mo

    • recent partner change

• M:

  • \<25

  • ≥2 partners

  • co-infection

• STI in past 12 mo

• partner has STI

• increased risk of complciation of STI

  • TOP, IUD

Lymphogranuloma vernerum

• painless genital ulcers

  • sometimes grouping with herpetiform appearance

• susbeqent painful chronic granulomatous inguinal lymphadenopahty

  • + anorectal disease and + chlamydia and not responding: Consider LGV

First line:

• azithromycin 1g stat

  • safe for use in pregnant (B1)

  • better efficacy than alternatives

• (or if not pregnant)

  • doxycyline 100mg bd for 7/7

• repeat sexual health check in 3/12 as reinfection common

• test of cure uncessary

  • except women treated during pregnancy or if non-standard treatment used

    • 5 weeks after

Bpac