Sexually Transmitted Diseases in Men

Basic male genital tract drawing:A-Urethra ,B-Testicles,C-Scrotum,D-Epidydimis,E-Spermatic Cord,F-Prostate, G-Seminal Vesicle X-Inguinal and femoral lymph nodes (groin lymph nodes)

Genital Herpes 

(caused by Herpes Simplex I and II)

  • Type I is becoming more prevalent cause of genital herpes(less severe & less frequent flare ups)
  • Incubation is 2-7 days
  • Multiple small blisters(pin head) —> turn to ulcers & may turn to larger ulcer
  • Very Painful
  • Mildly swollen inguinal lymph nodes
  • May cause fever
  • Diagnosis: swab (antigen/culture) or blood test (antibodies)
  • Treatment: Antiviral

Syphilis-Chancre

(caused by Treponema Pallidum)

  • 90,000 cases/year in USA
  • Incubation is 10 to 90 days
  • Starts as a bump that ulcerate
  • Painless and hard to touch, has elevated border
  • Lasts 3-6 weeks
  • May cause swollen non tender inguinal lymph nodes
  • Diagnosis: Blood test
  • Treatment: Penicillin IM injection

Chancroid

(chancre like) caused by Haemophilus Ducreyi

  • 2000 cases/year in USA
  • Starts as a bump—>fills with pus—>ulcer
  • Ulcer is soft and very Painful
  • Causes swollen lymph nodes that turn to boils (drain pus)
  • Diagnosis: Stain or culture of pus draining from ulcer or lymph nodes
  • Treatment: Rocephin IM or Cipro orally

Lymphogranuloma Venereum

caused by Chlamydia Trachomatis

  • 600-1000 case/year in USA
  • Incubation is 5-21 days
  • Painless bump that ulcerate
  • May cause tender swollen boils like swollen matted lymph nodes that cause fistulas and sinus tracts complicated by ulcers and scarring
  • May cause inflammation/infection in heart cover,joints,rectum,brain,meninges and eyes
  • Diagnosis: Usually clinical
  • Treatment: Doxycycline for 7 days

Granuloma Inguinale

caused by C.Granulomatis
50 cases / year in USA

  • Causes large soft fleshy cauliflower like lesion
  • Is not associated with swollen inguinal lymph nodes
  • Chief importance is distinction from Syphilis and Chancroid
  • Treatment: Topical podophyllin+- Cryosurgery or Laser resection

Urethritis

  • Most common causes are Chlamydia , Gonorrhea and Mycoplasma Genitalium
  • Trichomonas may cause urethritis but it is less common
  • The usual symptoms are :burning on urination , urethral itching and discharge
  • Diagnosis is made clinically if there is mucoid purulent discharge or by urine test /urethral swab
  • Treatment is usually directed at the common causes (Chlamydia and Gonorrhea) with Rocephin injection and oral Zithromax
  • Sex partner treatment is a must
  • Testing for all other STDs causes is recommended

Epididymitis

  • Most common causes in young sexually active men is Chlamydia and Gonorrhea
  • Older patients may have non STD Epididymitis caused by colonic bacteria just like bladder infections
  • Patient usually presents with one sided Epididymis swelling and pain
  • The infection can spread to the testicle causing testicular infection or “Orchitis”
  • May need scrotum ultrasound to rule out testicular torsion
  • Treatment of STD Epididymitis is similar to Urethritis treatment

Medical Care One is an urgent care and Walk-in clinic in Ypsilanti.  Our Urgent Care provides comprehensive urgent care services so you can avoid the ER. Patient Care is our top priority. We provide high-quality, convenient, and affordable immediate healthcare for patients in the communities we proudly serve. 

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