Sexually transmitted diseases
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Key Information
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Appropriate Tests
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Don’t forget the importance of contact tracing to identify infected contacts and to break the chain of infection
All of these conditions are nationally notifiable
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More than one infection can be transmitted at the same time.
A patient with vaginitis or urethritis should be tested for gonorrhoea, Chlamydia trachomatis, Trichomonas vaginalis, syphilis and HIV infection.
Consideration should also be given to testing for Mycoplasma genitalium in persistent disease
Testing for hepatitis B and hepatitis C should be included if the patient is at increased risk of acquiring these infections. See Hepatitis B virus infection, Hepatitis C virus infection and their association with co-infections.
Tests for HIV, Syphilis, Hepatitis B serology and Hepatitis C serology should be repeated at appropriate intervals, in view of their long incubation periods and their association with co-infections.
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Chlamydia trachomatis infection
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PCR of first catch urine or genital/urethral/cervical swab.
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Herpes simplex virus infection
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PCR of swab of a lesion in viral transport medium.
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Trichomonas vaginalis infection
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Aspirate of fluid from the posterior fornix or swab in bacterial transport medium for direct microscopy, and or culture. If PCR is required a dry swab should be collected after discussion with the testing laboratory.
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Human papillomavirus infection
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Gonorrhoea
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PCR of first catch urine and consider collecting a genital swab for culture to obtain antibiotic sensitivity results.
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Syphilis
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Swab of lesion for PCR (discuss with the testing laboratory).
Serum for testing for syphilis antibodies.
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HIV infection
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Serum for HIV antibodies
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Hepatitis B virus infection
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Serum for a panel of HBV antigen and antibody tests
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Hepatitis C virus infection
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Serum for HCV antibody tests.
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Granuloma inguinale
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PCR of a lesion swab. If culture is required discuss with testing laboratory.
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Lymphogranuloma venereum
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PCR of genital swab.
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Chancroid (rare)
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See Chancroid.
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