Sexually Transmitted Infections

Common symptoms of sexually transmitted infections:

  • Itching, pain or burning in the genital area
  • Discharge from the penis or vagina
  • Sores, blisters or rash in the genital area
  • Warts in the genital area
  • Pain or bleeding during intercourse
  • Pain or burning sensation when urinating

Sexually transmitted infections can also mimic symptoms of a general infection including:

  • Flu-like symptoms (body aches, fever, fatigue)
  • Swollen lymph nodes
  • General malaise or fatigue

Teaching Moment: Many people may be infected with a sexually transmitted disease, but not show symptoms. It is best to always use a condom even if your partner has no outward signs of infection, if you do not know your or their HIV or STI status.

How to prevent sexually transmitted infections:

  • Use a condom
  • Limit sex to one uninfected partner (monogamous relationship)
  • Hepatitis B Vaccine prevents hepatitis B infection
  • The HPV vaccine prevents infection with HPV (and cervical cancers caused by HPV)
  • Male circumcision (reduces the risk of men acquiring HIV by 60%)

Teaching Moment: Sexually transmitted infections (STIs) are infections that spread through sexual contact. These infections are most often transmitted through oral, vaginal or anal sex, but can also be transmitted from mother to child during pregnancy and childbirth. They are NOT spread through contact with objects an infected person has touched (like dishes or toilet seats) and they do not spread through the air or through insect bites from mosquitos or ticks.

Symptoms and syndromes with clinical signs, underlying causes and differential diagnoses

Presenting Complaint (Symptoms) Signs Pathogens / Causes Differential Diagnoses Syndrome
Ulcers or sores on the penis, scrotum, labia, vagina, cervix and/or rectum Ulcers (visible break in the skin), blisters or sores on the genitals, With or without Bubo Herpes simplex virus, Treponema pallidum (Syphilis), Haemophilus ducreyi (Chancroid), Calymatobacterium granulom atis(Granuloma inguinale), Chlamydia trachomatis biovar LGV (Lymphogranuloma venereum) None Genital ulcer disease
Urethral Discharge with or without dysuria (pain on passing urine) Discharge from meatus urethrae with or without ‘milking’/ expressing Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis None Urethral Discharge
Pain in the lower abdomen in a woman with or without abnormal vaginal discharge Fever, Lower abdominal tenderness on palpation, Vaginal discharge / bleeding, Cervical excitation tenderness, Pelvic mass, Rebound tenderness /Guarding Neisseria gonorrhoea, Chlamydia trachomatis, Other bacteroides species Ectopic pregnancy, Incomplete abortion, Appendicitis Pelvic Inflammatory Disease
Abnormal vaginal discharge, Vulval itching, Vulval swelling Abnormal vaginal discharge, Vaginal or vulval inflammation, Inflammation of the cervix, Pain on cervical movement Trichomonas vaginalis, Candida albicans, Bacterial Vaginosis, Neisseria gonorrhoeae, Chlamydia trachomatis None Abnormal Vaginal Discharge
Painful testes, With or without swelling, With or without urethral discharge Swollen / tender scrotum, Redness of the scrotum, Urethral discharge, Fever Neisseria gonorrhoeae, Chlamydia trachomatis Trauma, Torsion of the testes Mumps Scrotal Swelling
Swelling and pain in the groin Swollen inguinal lymph nodes, With or without ulceration or sinuses H. ducreyi (Chancroid), C. granulomatis Infected wound in lower limb, Tuberculosis Inguinal Bubo
Itching and pain of the glans penis Redness on the glans penis, Discharge on the glans penis Candida albicans, Trichomonas vaginalis None Balanitis or Balanoprosthitis
Discharging, swollen eyes Red, swollen eyes N. gonorrhoeae, C. trachomatis None Neonatal Conjunctivitis

Complications of STIs

  • Increased risk of HIV acquisition
  • Stillbirth
  • Neonatal death
  • Low birth weight and prematurity
  • Congenital deformities
  • Severe infection-sepsis
  • Infertility

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