Sexually transmitted diseases!

Men with urethritis (gonorrhea) characteristically complain of urethral discharge and burning on urination. The most important pathogens causing sexually transmitted diseases are bacteria such as Neisseria gonorrhoeae and Chlamydia trachomatis. Sexually transmitted diseases seen in women and men are generally urethritis, cervicitis, epididymitis, genital ulcers and warts (condyloma), HIV. Complications of urethritis in men are epididymitis, urethral stricture, disseminated urinary tract infection, and Reiter’s syndrome.

Gram stain of the urethra swab for gram (-) intracellular diplococci is examined microscopically and a Neisseria gonorrhea culture is performed in a male patient who presents with urethral discharge (green, yellowish, gray colored, …) and dysuria findings after a suspicious sexual intercourse. However, due to the fact that diagnostic tests are not available in all settings and the importance of early treatment in these diseases, empirical antibiotic therapy is performed in order to correct the patient’s obvious complaints. The most common cause of nongonococcal urethritis is C. trochomatis. It is very important in the treatment whether the disease is complicated or whether it recurs and it is planned accordingly. In uncomplicated urethritis, cervicitis and rectal infections, a single oral dose of 1 g azithromycin or 100 mg doxycycline twice daily for 7 days is administered together with cefixime tb 400 mg or ceftriaxone im 125 mg once daily, while nongonococcal urethritis (chlamydia) is administered as a single dose. oral azithromycin or doxycycline 100 mg twice daily for 7 days.

In patients with recurrent or incomplete urethritis, we give a single dose of 2 g metronidazole together with 500 mg oral erythromycin 4 times a day for 7 days. If patients with resistant or recurrent urethritis did not comply adequately with the initial treatment or re-infection from an untreated person, the same treatment can be applied again. Other patients should receive treatment for both T.vaginalis and genital mycoplasmas. Treatment of genital herpes virus infections is antiviral drugs, penicillin in syphilis, penicillin in chancroid, doxycycline in lenagranuloma venereum and TMP-SMX or doxycycline in granuloma inguinale. Genital warts are caused by the human papillomavirus and most HPV infections are asymptomatic. Visible warts can be painful and itchy, depending on their size and location. Most are caused by HPV types 6 and 11. HPV 16, 18, 31, 35 is associated with dysplasia and squamous cell cancer. The aim of the treatment is to remove the lesions and cauterization, podofilox solution, cryotherapy, surgical excision can be applied.

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