Data gathering

  • Red flags – joint aches, fevers, rashes
  • Others – discharge, dysuria
  • Examine – abdominal exam, speculum, vagina/penis, lymph nodes


Clinical management

  • Investigations
    • Endocervical swabs (or vaginal self swab or first void urine) – chlamydia, gonorrhoea
    • Vaginal swab – candida, BV
    • (men – first void urine for chlamydia and gonorrhoea and rectal swabs from MSM)
    • Bloods – HIV, syphilis
  • Explanation
    • gonorrhoea is often without symptoms but it is important to treat as infection can spread in your body and cause serious complications and you can pass it to others. Condoms are the only way to prevent STIs.
  • Treatment
    • Antibiotics e.g. ceftriaxone 500 mg IM single dose + azithromycin 1 g PO single dose
    • Contact tracing
    • Pregnancy test (test for cure of chlamydia treatment if pregnant)
  • Follow-up / Safety-net
    • local sexual health clinic for more detailed screening
    • PIL