TAILIEUCHUNG - Chapter 124. Sexually Transmitted Infections: Overview and Clinical Approach (Part 20) Proctitis,

Chapter 124. Sexually Transmitted Infections: Overview and Clinical Approach (Part 20) Proctitis, Proctocolitis, Enterocolitis, and Enteritis: Treatment Acute proctitis in persons who have practiced receptive anorectal intercourse is usually sexually acquired. Such patients should undergo anoscopy to detect rectal ulcers or vesicles and petechiae after swabbing of the rectal mucosa; to examine rectal exudates for PMNs and gram-negative diplococci; and to obtain rectal swab specimens for testing for rectal gonorrhea, chlamydial infection, herpes, and syphilis. Pending test results, patients with proctitis should receive empirical syndromic treatment—., with ceftriaxone (a single IM dose of 125 mg for gonorrhea) plus doxycycline (100 mg PO. | Chapter 124. Sexually Transmitted Infections Overview and Clinical Approach Part 20 Proctitis Proctocolitis Enterocolitis and Enteritis Treatment Acute proctitis in persons who have practiced receptive anorectal intercourse is usually sexually acquired. Such patients should undergo anoscopy to detect rectal ulcers or vesicles and petechiae after swabbing of the rectal mucosa to examine rectal exudates for PMNs and gram-negative diplococci and to obtain rectal swab specimens for testing for rectal gonorrhea chlamydial infection herpes and syphilis. Pending test results patients with proctitis should receive empirical syndromic treatment . with ceftriaxone a single IM dose of 125 mg for gonorrhea plus doxycycline 100 mg PO twice daily for 7 days for possible chlamydial infection plus treatment for herpes or syphilis if indicated. Prevention and Control of STIs Prevention and control of STIs require the following 1. Reduction of the average rate of sexual exposure to STIs through alteration of sexual risk behaviors and behavioral norms among both susceptible and infected persons in all population groups. The necessary changes include reduction in the total number of sexual partners and the number of concurrent sexual partners. 2. Reduction of the efficiency of transmission through the promotion of safer sexual practices the use of condoms during casual or commercial sex vaccination against HBV and HPV infection male circumcision and a growing number of other approaches . early detection and treatment of other STIs to reduce the efficiency of sexual transmission of HIV . We now know from longitudinal studies over the past decade that consistent condom use is associated with significant protection of both males and females against all STIs that have been examined including HIV HPV and HSV infections as well as gonorrhea and chlamydial infection. The only exceptions are probably sexually transmitted Phthirus pubis and Sarcoptes scabiei infestations. 3. Shortening .

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