Fast Five Quiz: Common STDs

Michael Stuart Bronze, MD

Disclosures

January 17, 2019

The symptoms of DGI vary greatly from patient to patient. By the time the symptoms of DGI appear, many patients no longer have any localized symptoms of mucosal infection. The classic presentation of DGI is an arthritis-dermatitis (tenosynovitis) syndrome. Joint or tendon pain is the most common presenting symptom in the early stage of infection. About 25% of patients with DGI experience pain in a single joint, but many other patients describe migratory polyarthralgia, especially of the knees, elbows, and more distal joints. Patients may also have tenosynovitis; the early tenosynovitis most commonly affects the flexor tendon sheaths of the wrist or the Achilles tendon ("lovers' heels").

The risk for transmission of N gonorrhoeae from an infected woman to the urethra of her male partner is approximately 20% per episode of vaginal intercourse and rises to 60%-80% after four or more exposures. In contrast, the risk for male-to-female transmission approximates 50%-70% per contact, with little evidence of increased risk with more sexual exposures.

The incubation period for gonorrhea is usually 2-7 days after exposure to an infected partner. In all patients who present with a possible STD, the history should include the following:

  • Past history of STDs (including HIV infection and viral hepatitis)

  • Treatment history for known STDs

  • Known symptoms of STDs in current or past sexual partners

  • Type of contraception used

  • Any history of sexual assault

The most common site of gonococcal infection in women is the endocervix (80%-90%), followed by the urethra (80%), rectum (40%), and pharynx (10%-20%). If symptoms develop, they often manifest within 10 days of infection.

For more on DGI, read here.

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