STI/RTI SYNDROMIC CASE MANAGEMENT

Urethral Discharge Cervical Discharge Painful Scrotal Swelling Vaginal Discharge Genital Ulcer-Non Herpetic Genital Ulcer - Herpetic Lower Abdominal Pain (LAP) Inguinal Bubo (IB)

n Urethral Discharge (Pus or n Nature and type of discharge n Swelling and pain in the n Nature and type of discharge n Genital ulcer, single or multiple, painful or painless n Genital ulcer or vesicles, n Lower Abdominal Pain n Swelling in inguinal region
muco-purulent) (quantity, color and odor) scrotal region (quantity, color and odor) single or multiple, painful, n Fever which may be painful
n Pain or burning while passing n Burning while passing urine, n Pain or burning while passing n Burning while passing urine, n Burning sensation in the genital area recurrent n Vaginal Discharge

urine increased frequency urine increased frequency n Menstrual irregularities like

n Preceding history of genital
n Increased frequency of n Genital complaints by sexual n Systemic symptoms like n Genital complaints by sexual n Enlarged lymph nodes n Burning sensation in the heavy, irregular vaginal bleeding ulcer or discharge
urination partners malaise, fever partners genital area n Dysmenorrhoea, dysparenunia,

n Systemic symptoms like n Low backache n History of urethral discharge n Low backache dysuria, tenesmus
malaise, fever (Take menstrual history to rule out (Take menstrual history to rule out n Systemic symptoms like
n Lower backache
pregnancy) pregnancy) malaise, fever etc
n Cervical motion tenderness

Tab. Azithromycin 1 gm Tab. Azithromycin 1 gm Tab. Azithromycin 1 gm Tab. Secnidazole 2 g Inj. Benzathine penicillin If allergic to Inj. Penicillin: Tab. Acyclovir 400 mg Tab. Cefixime 400 mg OD stat + Tab. Azithromycin 1 gm
OD Stat + OD Stat + OD Stat + OD Stat + (2.4 MU) - 1 vial Doxycycline 100 MG Tab. Metronidazole 400 mg OD Stat +
Tab. Cefixime 400 mg Tab. Cefixime 400 mg Tab. Cefixime 400 mg Cap. Fluconazole 150 mg Tab. Azithromycin (1 gm) - (Bid for 15 days) TDS for 7 days BD X 14 days + Tab. Doxycycline 100 mg
Single dose Azithromycin 1GM (Single dose)
OD Stat OD Stat OD Stat OD Stat Doxycycline 100 mg BD X 14 days BD for 21 days
KIT 1/Grey KIT 1/Grey KIT 1/Grey KIT 2/Green KIT 3/White KIT 4/Blue KIT 5/Red Kit 6/Yellow Kit 7/Black

Treat all recent partners Treat partners when symptomatic Treat all recent partners Treat partners when symptomatic Treat all sexual partners for past 3 months No partner treatment Treat male partners with Kit 1 Treat all sexual partners for past 3 weeks

IMPORTANT CONSIDERATIONS FOR MANAGEMENT OF ALL STI/RTI

l Educate and counsel client and sexual partner/s regarding STI/RTI, safer sex practices and importance of taking complete treatment
l Treat partner/s
India’s voice against AIDS
l Advise sexual abstinence or condom use during the course of treatment
l Provide condoms, educate about correct and consistent use
l Refer all patients to ICTC
l Follow up after 7 days for all STI, 3rd, 7th, and 14th day for LAP and 7th, 14th, and 21st day for IB
l If symptoms persist, assess whether it is due to re-infection and advise prompt referral
l Consider immunization against Hepatitis B