STI, VAGINAL DISCHARGE, PID

Significance
• It is a public health problem (expensive)
• Need of contact tracing/treat partner
• Complications
• Complication on fetus or neonates
• Some cause cancer
• Increases risk of HIV infection
 STI
• Viral infections ( HPV, HIV,HERPES etc )

• Bacterial gonococci, treponema,

• Chlamydia trachomatis

• Fungal candida

• Parasitic tricomonas vaginalis

 Clinical picture
• Asymptomatic
• Vaginal discharge
• Vulval ulceration
• Abdominal pain/ signs of pelvic abscess
 diagnosis
• Laparoscopy
• Culture
• Serology VDRL,RPR TPHA
• Mainly on clinical grounds
• Polymerase chain reaction for chlamydia
 complications
• Cancer of cervix
• Pelvic abscess/ bartholin abscess
• Infertility due to tubal blockage/ risk of
ectopic pregnancy
• Neonatal ophthalmic
• Neonatal encephalitis ,neonatal,
syphilis,stilbirths
• Neurosyphilis+ cardiovascular
 treatments
• Specific for cause
• Chlamydia doxycycline 100mg twice for 7day
• Gonoccocus cefalosporins
• Tricomonas/gardenella metranidazole
• Genital warts podophyllin 20%, cauterisation
• Herpes aciclovir 200mg five times for
5days
 Treatments cont
• Syphilis long term antbiotics
• HIV Conservative, ART, option B+
• Candida clotrimazole, fluconazole
 Key points
• STIs in females are often asymptomatic or non
specific

• STIs often coexist need to screen for others

• Partners must be treated

• Adequate treatment avoids some complications