Sunday, February 14, 2016

The Presentation, Diagnosis, and Treatment of Sexually Transmitted Infections

The reported incidence of sexually transmitted infections (STIs) in Germany is rising. For example, the number of new reported cases of syphilis rose from 3034 in 2010 to 4410 in 2012.

This review is based on pertinent articles retrieved by a selective search in MEDLINE, and on guidelines and systematic reviews from Germany and abroad.

We discuss sexually transmitted infections presenting with genital, anal, perianal, or oral ulcers, urethritis, cervicitis, urethral or vaginal discharge, or genital warts. We also discuss sexually transmitted infection with HIV and the hepatitis C virus (HCV). Acquired sexually transmitted infections elevate the risk of transmission of other sexually transmitted infections; thus, patients presenting for the diagnosis or treatment of any kind of sexually transmitted infection should be evaluated for others as well. For most of these diseases, treatment of the patient’s sexual partner(s) is indicated. Diagnostic nucleic acid amplification techniques are over 90% sensitive and specific and are generally the best way to detect the responsible pathogen. Factors impeding effective treatment include antibiotic resistance (an increasing problem) and the late diagnosis of HIV and HCV infections.

Sexually transmitted infections are common around the world, and any such infection increases the patient’s risk of contracting other types of sexually transmitted infection. Molecular genetic diagnostic techniques should be made widely available.

Below:  Primary infection and secondary stage of syphilis: ulcus durum on the upper lip; maculopapular facial rash

Below:  Acute herpes simplex virus infection in the area of the mons pubis

Full article at:

By:  Florian M.E. Wagenlehner, Prof. Dr. med.,*,1 Norbert H. Brockmeyer, Prof. Dr. med.,2 Thomas Discher, Dr. med.,3Klaus Friese, Prof. Dr. med.,4 and Thomas A. Wichelhaus, Prof. Dr. med.5
1Department of Urology, Pediatric Urology and Andrology, Medical Faculty of the Justus Liebig University Giessen
2Department of Dermatology, Venerology and Allergology, St. Josef-Hospital of the Medical Faculty, Ruhr-University Bochum
3Medizinische Klinik und Poliklinik II, Justus-Liebig-Universität, Giessen
4Department of Obstetrics and Gynecology of the Ludwig-Maximilians-Universität München
5Institute for Medical Microbiology and Infection Control, Goethe University Frankfurt am Main
*Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Universitätsklinikum Giessen und Marburg GmbH, Standort Giessen, Justus-Liebig-Universität Giessen, Rudolf-Buchheim-Str. 7, 35385 Giessen, Germany,  moc.loa@renhelnegaW
Dtsch Arztebl Int. 2016 Jan; 113(1-2): 11–22. Published online 2016 Jan 11. doi:  10.3238/arztebl.2016.0011

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