Chapter 31: Sexually Transmitted Diseases
AS is a 27-year-old patient with a new diagnosis of a chlamydia infection. The patient is concerned about the infection, the treatment, and complications from the infection. Complications of chlamydia genital infection include which of the following?
a. Granulomatous and cardiovascular diseases
b. Vesicular lesions on the external genitalia
c. Pelvic inflammatory disease and infertility
d. General paresis, dementia, and sensory ataxia
Answer c is correct. Without appropriate and timely treatment for chlamydia, complications such as pelvic inflammatory disease (PID), ectopic pregnancy, premature delivery, and infertility can result.
Answer a is incorrect. Granulomatous and cardiovascular diseases are manifestations of tertiary syphilis and represent some of the long-term complications of syphilis.
Answer b is incorrect. Vesicular lesions on the external genitalia are a manifestation of genital herpes infection.
Answer d is incorrect. General paresis, dementia, and sensory ataxia are clinical manifestations of late neurosyphilis, a form of tertiary syphilis.
TD is 27-year-old man who presents to a local STD clinic with complaints of painful urination and urethral discharge over the past 4 days. He is sexually active, reporting three partners within the past 30 days. He has no known drug allergies. A diagnosis of chlamydia is made. Select the most appropriate therapy for TD.
b. Azithromycin + cefixime
Answer b is correct. This is the most appropriate therapy for TD, which includes treatment for chlamydia and gonorrhea. Because coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae commonly occurs, presumptive therapy for gonorrhea should be considered when treating chlamydia.
Answer a is incorrect. Although doxycycline is a recommended agent for the treatment of chlamydia, this is not the most appropriate answer. Because coinfection with C. trachomatis and N. gonorrhoeae commonly occurs, presumptive therapy for gonorrhea should be considered when treating chlamydia.
Answer c is incorrect. Ceftizoxime is not a recommended therapy for chlamydia, although it is an alternative agent for gonorrhea treatment.
Answer d is incorrect. Acyclovir is an antiviral agent and would not be effective against a chlamydia bacterial infection. Although ofloxacin is an alternative agent for chlamydia treatment, this combination is inappropriate.
Which of the following is a contraindication to doxycycline therapy? Select all that apply.
a. Age younger than 8 years