Hosts: Jake Lancaster MD, Chief Medical Information Officer and Amanda Comer DNP, System Director, Advanced Practice Providers
Guest: Alex Yoby, Pharmacist
CME Credit Info:
Contact CEOD@bmhcc.org if you have any questions about claiming credit.
CDC’s Sexually Transmitted Infections (STI) Treatment
Guidelines, 2021
Notable updates:
These guidelines discuss 1) updated recommendations for
treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and
Trichomonas vaginalis; 2) addition of metronidazole to the recommended
treatment regimen for pelvic inflammatory disease; 3) alternative treatment
options for bacterial vaginosis; 4) management of Mycoplasma genitalium;
5) human papillomavirus vaccine recommendations and counseling messages; 6) expanded risk factors for syphilis testing
among pregnant women; 7) one-time testing for hepatitis C infection; 8)
evaluation of men who have sex with men after sexual assault; and 9) two-step
testing for serologic diagnosis of genital herpes simplex virus
Syphilis
Lore
It is postulated that syphilis came to Europe in the 1490s when Columbus
arrived in Italy from America. After Italy surrendered to the invading French
in 1495, this new disease rapidly spread across Europe. The name
"syphilis" comes from the work of Girolamo Fracastoro, a noted poet
and physician in Verona, Italy. In 1530, he wrote about a shepherd named
Syphilus who angered Apollo, causing the god to curse the entire population
with the affliction that we now know as syphilis
T. pallidum
Syphilis is a systemic, bacterial infection caused by
Treponema pallidum. Treponema are thin,
Gram-negative, slowly metabolizing spirochetal bacterium, requiring an average
of 30 hours to multiply. It is microaerophilic and cannot grow on standard
culture media. Treponema pallidum’s outer membrane lacks lipopolysaccharides
and has few surface-exposed unique proteins, making it difficult for the immune
system to fight the infection. Because of this characteristic, T
pallidum is labeled as a stealth pathogen. T. pallidum is the
only Treponema species that causes sexually transmitted disease.
Syphilis is characterized by a wide range of variable
clinical symptoms that can resemble other diseases, which make it difficult to
diagnose without a test, therefore, it is often referred to as “The Great
Imitator”. The infection progresses through multiple stages (primary,
secondary, latent, and tertiary) and can affect virtually every organ system in
the body, even many years or even decades after the original infection.
Infected people are contagious during the primary and secondary stages of
syphilis.
Stages of syphilis
Primary syphilis: Primary syphilisclassically
presents as a single painless ulcer or chancre at the site of infection but can
also present with multiple, atypical, or painful lesions. A chancre is defined
as a firm, round, painless ulcer at the...
