UTIs and STIs Key Terms (Gonorrhea, Chlamydia, Trichomoniasis, Syphilis)

Urinary Tract Infections (UTIs)

  • Cause
    • Escherichia coli (most common)
    • Other organisms: Staphylococcus saprophyticus (common in young women), Klebsiella, Proteus
  • Signs & Symptoms
    • Dysuria (burning with urination), frequency, urgency
    • Suprapubic pain
    • Cloudy or foul-smelling urine
    • Pyelonephritis symptoms: fever, flank pain, nausea/vomiting
  • Transmission & Epidemiology
    • Not sexually transmitted, but sex increases risk
    • Women more affected due to shorter urethra
  • Prevention & Treatment
    • Hydration
    • Urinate after intercourse
    • Proper hygiene
    • Antibiotics: nitrofurantoin, trimethoprim-sulfamethoxazole, fosfomycin

Gonorrhea

  • Cause
    • Neisseria gonorrhoeae (gram-negative diplococcus)
  • Signs & Symptoms
    • Men: urethritis with dysuria and purulent discharge
    • Women: cervicitis, pelvic inflammatory disease (PID), infertility risk
    • Can cause pharyngitis, conjunctivitis, disseminated infection (arthritis-dermatitis syndrome)
  • Transmission & Epidemiology
    • Sexual contact (genital, oral, anal)
    • Vertical transmission → neonatal conjunctivitis
  • Prevention & Treatment
    • Condoms, safe sex practices
    • No vaccine
    • Treatment: ceftriaxone (IM) + doxycycline (if chlamydia not excluded)

Chlamydia

  • Cause
    • Chlamydia trachomatis (obligate intracellular bacterium)
  • Signs & Symptoms
    • Often asymptomatic
    • Men: urethritis, epididymitis
    • Women: cervicitis, PID, infertility
    • Can cause conjunctivitis or pneumonia in neonates
  • Transmission & Epidemiology
    • Sexual contact, vertical transmission at birth
    • Most common bacterial STI in the U.S.
  • Prevention & Treatment
    • Condoms, routine screening
    • Treatment: doxycycline (preferred), or azithromycin in pregnancy

Trichomoniasis

  • Cause
    • Protozoan parasite: Trichomonas vaginalis
  • Signs & Symptoms
    • Women: frothy, greenish-yellow discharge, foul odor, vaginal itching/burning, “strawberry cervix”
    • Men: often asymptomatic, sometimes urethritis
  • Transmission & Epidemiology
    • Sexual contact
    • More common in women
  • Prevention & Treatment
    • Condoms, partner treatment
    • Metronidazole or tinidazole (both partners must be treated)

Syphilis

  • Cause
    • Treponema pallidum (spirochete)
  • Signs & Symptoms
    • Primary: painless chancre at infection site
    • Secondary: rash (palms/soles), condyloma lata, systemic symptoms
    • Latent: asymptomatic
    • Tertiary: gummas, neurosyphilis, cardiovascular disease
    • Congenital syphilis: stillbirth, bone deformities, neurologic deficits
  • Transmission & Epidemiology
    • Sexual contact, vertical transmission (transplacental)
  • Prevention & Treatment
    • Safe sex, routine prenatal screening
    • Treatment: penicillin G (all stages, IV for neurosyphilis)