Question

A 16-year-old Caucasian female is seen in your office for evaluation of a possible STI. She states that her partner has noted a whitish penile discharge and has burned with urination. When questioned, she states she’s been sexually active, both orally and vaginally, for 2 years and has had four partners. When questioned, she denies using any barrier methods to avoid infection, admits to having a sore throat, and denies vaginal symptoms. 1. What is the presumptive diagnosis? 2. Based on this diagnosis, what is the most appropriate treatment for your patient? 3. Why are the two drugs recommended for treatment? 4. Should your patient’s partner be treated? What about past partners? 5. What is the best way to avoid reinfection?

Answer 1

1) The patient is came up with sore throat and she have multiple sex. Her partner is found to have penile discharge and burning urination.

A sore throat may be the indication of STD like chlamydia, gonorrhoea or syphilis.

It can be diagnosed primarily by physical examination or microscopic examination. Sore or fluid is collected from the infected area and cultured over few days to check the ingectious bacteria or yeast presence.

2) If the test is found to be positive then doctor may recommend antibiotic. Oral sex and intercourses should be avoided at least for 7 days after taking one time antibiotic dose of Azithromycin. Or Doxycycline is recommended twice daily for 7 to 14 days. Infection in throat may lead to many other STI. So treatment should be continued till it is completely normal.

After treatment use barrier methods during sex.

3) Azithromycin and doxycycline are the drug of choice for the infection that patient encounter.

Doxycycline has a huge antibacterial spectrum including intracellular pathogen and bacteria responsible for STI. In antibiotic resistance issues the doxycycline is replaced with azithromycin. With this infection may clear up in a week.

4) partner of the patient should be treated. Because he shows the symptoms like penile discharge and burning urination which is related to STD.

Past partners should be diagnosed for STDs and should proceed with treatment if the teat is positive.