Sexually transmitted infections

Abstract

Sexually transmitted infections (STIs) are a threat to health worldwide. An estimated 340 million people are infected each year with chlamydia, gonorrhea, trichomoniasis, or syphilis. 1 In the poorest countries, unsafe sex is second only to malnutrition as the leading risk factor for disease, disability, and death, and in the developed world unsafe sex is the ninth most important risk factor. 2 Symptomatic men present to a range of settings including general practice, genitourinary medicine (GUM) clinics, emergency departments, and urology services. Urethritis (dysuria or urethral discharge) is most often caused by Chlamydia trachomatis, Neisseria gonorrhea, or Mycoplasma genitalium, but also by viruses such as herpes simplex virus (HSV) or adenovirus. Epididymo-orchitis can develop from ascending spread of bacteria and is associated with infertility. Genital ulceration is mostly due to HSV, less commonly to syphilis or lymphogranuloma venereum (LGV), and rarely to chancroid or donovanosis in returning travellers. Genital lumps may be warts or molluscum contagiosum. Itching in the pubic area occurs with scabies or lice.