STIs
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Swab/Urine
- Chlamydia: usually asymptomatic. Screen routinely. Can cause infertility/PID and Fitz-hugh-curtis. Treat with Azithro x1
- Gonorrhea: often asymptomatic. Screen routinely. Can cause infertility/PID. Treat with Ceftriaxone and Azithromycin
- Trich: frothy/watery discharge. “Strawberry cervix” Can see trich moving on wet mount. Treat Flagyl 2g PO once.
- HPV: Cervical dysplasia/cancer and Genital warts. Topical treatments as needed.
Serum
- Syphilis: Painless chancre followed by latent, then secondary with palmar/plantar rash. If unsure stage, treat as if latent, PCN IM x3
- HIV: Universal screening. PREP if high risk. Referral to ID and counseling if positive.
- Hep B: Treatable, not curable. Routine serum screening.
No Routine Screening, diagnose if lesion
- HSV: Antivirals as needed for outbreaks, can prophylax if frequent outbreaks/immunosuppressed. Valacyclovir or acyclovir are most common.