Skip to Main Content

Instructors can request access to the Casebook Instructor's Guide on AccessPharmacy. Email User Services (userservices@mhprofessional.com) for more information.

LEARNING OBJECTIVES

After completing this case study, the reader should be able to:

  • Identify relevant information from patient history, physical examination, and laboratory data suggestive of the diagnosis of a sexually transmitted infection (STI).

  • List major complications of STIs and appropriate strategies for prevention and/or treatment.

  • Discuss other health issues that may be present in patients referred for treatment of STIs, including immunization needs and risk reduction.

  • Provide appropriate treatment plans for patients with STIs, including drug(s), dosage form, doses, route of administration, frequency, duration, and monitoring.

  • Compare and contrast criteria and options for ambulatory and inpatient treatment of women with pelvic inflammatory disease (PID).

  • Recognize opportunities and provide appropriate recommendations for immunizations, including human papillomavirus (HPV) vaccine.

  • Develop patient counseling strategies regarding drug treatment and possible adverse effects.

PATIENT PRESENTATION 1

Chief Complaint

“My lady and I don’t feel good.”

HPI

Frankie Mason is a 20-year-old man who presents to a health clinic with complaints of 5 days of painful urination and increasing amounts of discolored urethral discharge. Today, he noted four painful blisters on the penis. He is single, heterosexual, sexually active with two to three concurrent partners, and admits to unprotected sex “at least once” in the past 2 weeks. He does not know the sexual histories of his current or past sexual partners or their sexual partners and he admits to over 15 lifetime sexual partners. He denies oral or rectal intercourse.

PMH

History of genital herpes 2 years ago. He has not undergone testing for HIV. He has been immunized against hepatitis B but has not been immunized against HPV as “it’s only for women.” He is unaware of hepatitis A or C as infectious diseases, asking “Do you get that from sex or restaurant food?” No active medical problems.

FH

Noncontributory

SH

Denies IV drug and cigarette use; has two to four beers “on weekends”; may be unreliable in keeping follow-up appointments because he states, “I don’t like doctors.”

Meds

None

All

Ciprofloxacin (“makes me dizzy”)

ROS

Occasional headaches; denies stomach pain, constipation, vision problems, night sweats, weight loss, or fatigue

Physical Examination

Gen

Patient is a well-developed male in NAD, very talkative

VS

BP 104/80, HR 72, RR 12, T 37.6°C; Wt 78 kg

Skin

No rashes or other lesions seen

HEENT

...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.