Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Systems
- 1 Infective Endocarditis
- 2 Myocarditis and Pericarditis
- 3 Dental and Odontogenic Infections
- 4 Systemic Diseases Causing Fever and Rash
- 5 Otitis Media
- 6 Otitis Externa
- 7 Sinusitis
- 8 Supraglottitis
- 9 Pharyngitis and Tonsillitis
- 10 Deep Neck Space Infections
- 11 Mumps
- 12 Peritonitis
- 13 Viral Hepatitis
- 14 Infectious Biliary Diseases: Cholecystitis and Cholangitis
- 15 Acute Infectious Diarrhea
- 16 Diarrhea in HIV-Infected Patients
- 17 Ulcerative Sexually Transmitted Diseases
- 18 Nonulcerative Sexually Transmitted Diseases
- 19 Vulvovaginitis
- 20 Male Genitourinary Infections
- 21 Adult Septic Arthritis
- 22 Hand Infections: Fight Bite, Purulent Tenosynovitis, Felon, and Paronychia
- 23 Osteomyelitis
- 24 Open Fractures
- 25 Spinal Infections
- 26 Prosthetic Joint Infections
- 27 Diabetic Foot Infections
- 28 Plantar Puncture Wounds
- 29 Periocular Infections
- 30 Conjunctival and Corneal Infections
- 31 Uvea, Vitreous, and Retina Infections
- 32 Community-Acquired Pneumonia
- 33 Tuberculosis
- 34 Influenza
- 35 HIV-Associated Respiratory Infections
- 36 Arthritis in the Acute Care Setting
- 37 Lower Urinary Tract Infection in Adults
- 38 Pyelonephritis in Adults
- 39 Fever and Headache: Meningitis and Encephalitis
- 40 Fever and Focal Cerebral Dysfunction
- 41 Fever and Acute Weakness Localizing to the Spinal Cord
- 42 Altered Mental Status in HIV-Infected Patients
- 43 Bacterial Skin and Soft-Tissue Infections
- Part II Pediatrics
- Part III Special Populations
- Part IV Current Topics
- Part V Overview of Antibiotics
- Part VI Microbiology/Laboratory Tests
- Part VII Infection Control Precautions
- Index
- References
18 - Nonulcerative Sexually Transmitted Diseases
from Part I - Systems
Published online by Cambridge University Press: 15 December 2009
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Systems
- 1 Infective Endocarditis
- 2 Myocarditis and Pericarditis
- 3 Dental and Odontogenic Infections
- 4 Systemic Diseases Causing Fever and Rash
- 5 Otitis Media
- 6 Otitis Externa
- 7 Sinusitis
- 8 Supraglottitis
- 9 Pharyngitis and Tonsillitis
- 10 Deep Neck Space Infections
- 11 Mumps
- 12 Peritonitis
- 13 Viral Hepatitis
- 14 Infectious Biliary Diseases: Cholecystitis and Cholangitis
- 15 Acute Infectious Diarrhea
- 16 Diarrhea in HIV-Infected Patients
- 17 Ulcerative Sexually Transmitted Diseases
- 18 Nonulcerative Sexually Transmitted Diseases
- 19 Vulvovaginitis
- 20 Male Genitourinary Infections
- 21 Adult Septic Arthritis
- 22 Hand Infections: Fight Bite, Purulent Tenosynovitis, Felon, and Paronychia
- 23 Osteomyelitis
- 24 Open Fractures
- 25 Spinal Infections
- 26 Prosthetic Joint Infections
- 27 Diabetic Foot Infections
- 28 Plantar Puncture Wounds
- 29 Periocular Infections
- 30 Conjunctival and Corneal Infections
- 31 Uvea, Vitreous, and Retina Infections
- 32 Community-Acquired Pneumonia
- 33 Tuberculosis
- 34 Influenza
- 35 HIV-Associated Respiratory Infections
- 36 Arthritis in the Acute Care Setting
- 37 Lower Urinary Tract Infection in Adults
- 38 Pyelonephritis in Adults
- 39 Fever and Headache: Meningitis and Encephalitis
- 40 Fever and Focal Cerebral Dysfunction
- 41 Fever and Acute Weakness Localizing to the Spinal Cord
- 42 Altered Mental Status in HIV-Infected Patients
- 43 Bacterial Skin and Soft-Tissue Infections
- Part II Pediatrics
- Part III Special Populations
- Part IV Current Topics
- Part V Overview of Antibiotics
- Part VI Microbiology/Laboratory Tests
- Part VII Infection Control Precautions
- Index
- References
Summary
INTRODUCTION – AGENTS
Sexually transmitted diseases are best divided into two major groups: those that cause ulcerative lesions (see Chapter 17, Ulcerative Sexually Transmitted Diseases) and those that do not. Diseases that fall into this latter group include chlamydial infections, gonococcal infections, nongonococcal urethritis, and human papilloma virus (HPV). Although new tests make diagnosis easier, results are often not available during an acute care visit, and empiric treatment with appropriate follow-up is often the best approach.
CHLAMYDIA
Epidemiology
Chlamydia trachomatis, when sexually transmitted, most commonly causes urethritis in men and cervicitis in women. The incidence of this infection is 3 to 5 million cases annually, making it the most common sexually transmitted infection in the United States.
Clinical Features
In men, C. trachomatis most commonly causes urethritis with dysuria and/or a clear urethral discharge (Table 18.1). Women, in contrast, are asymptomatic in 70–80% of cases, though rare complaints include dysuria, vaginal discharge, and spotting.
Differential Diagnosis
The differential diagnosis for Chlamydia includes:
Urethritis:
Neisseria gonorrhoeae
Mycoplasma genitalium
Ureaplasma urealyticum
adenovirus
herpes simplex virus
Trichomonas vaginalis
Noninfectious causes such as Reiter's syndrome and contact dermatitis from topical preparations or latex condoms should also be considered in the differential diagnosis.
Cervicitis:
C. trachomatis and N. gonorrhoeae are the most common causes of acute cervicitis. As mentioned above, noninfectious causes, including contact dermatitis from douches, scented tampons, vaginal creams, or latex condoms should also be considered.
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- Information
- Emergency Management of Infectious Diseases , pp. 97 - 104Publisher: Cambridge University PressPrint publication year: 2008