Episode 55 HIV/AIDS
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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025
Outro Music: Leap in the Dark by Alex Grohl
Courtesy of Pixabay under Creative Commons non-commercial use.
Produced by: Todd Fredricks DO MSS
Edited by: Todd Fredricks DO MSS
Answers for Episode 54 STI
Question 1: Gonorrhea treatment and AMR
A 22-year-old man presents with dysuria and purulent urethral discharge after unprotected sex. NAAT for Neisseria gonorrhoeae is positive and Chlamydia trachomatis NAAT is negative. He has no drug allergies and no signs of disseminated infection. According to current evidence in the review, which is the preferred first-line regimen for uncomplicated urogenital gonorrhea?
A. Ceftriaxone monotherapy
Question 2: Syphilis diagnostic algorithm
A 28-year-old pregnant patient at her first prenatal visit has risk factors for sexually transmitted infections but no symptoms. You plan screening for syphilis. Which testing strategy best aligns with the diagnostic approach in the review?
A. Screen with a nontreponemal test (VDRL or RPR) and confirm positives with a treponemal test (TPPA or FTA‑ABS)
Question 3: Persistent NGU and Mycoplasma genitalium
A 30-year-old man is treated for presumed non-gonococcal urethritis (NGU) with azithromycin and returns 2 weeks later with persistent dysuria and urethral discharge. Repeat NAATs for C. trachomatis and N. gonorrhoeae are negative. Which next step is most consistent with the review’s recommendations?
C. Order NAAT for Mycoplasma genitalium with resistance testing and treat with a resistance‑guided or two‑step regimen
Paper for Next Week:
Dähne T, Jaki L, Gosert R, Fuchs J, Krumbholz A, Nägele K, Pletz MW, Khanna N, Leuzinger K, Panning M. Herpes simplex virus and drug resistance—comprehensive update on resistance mutations and implications for clinical management: a narrative review. Clinical Microbiology and Infection. 2025 Sep;31(9):1484-1490
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