PART 8: Infectious Diseases
SECTION 2 Clinical Syndromes: Community-Acquired Infections
130 Sexually Transmitted Infections: Overview and Clinical Approach
 | Figure 130-1 Percentage of N. gonorrhoeae isolates with intermediate resistance or resistance to -ciprofloxacin, by year: Gonococcal Isolate Surveillance Project, United States, 1990–2008. Intermediate resistance is defined by ciprofloxacin minimal... |
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 | Figure 130-2 Broad-range PCR amplification of 16S rDNA in vaginal fluid from a woman with bacterial vaginosis shows a field of bacteria hybridizing with probes for bacterial vaginosis–associated bacterium 1 (BVAB-1, visible as a thin, curved green rod) and for BVAB-2 (red). The inset shows that BVAB-1 has a morphology similar to that... |
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 | Figure 130-3 Wet mount of vaginal fluid showing typical clue cells from a woman with bacterial vaginosis. Note the obscured epithelial cell margins and the granular appearance attributable to many adherent bacteria (×400). (Photograph provided by Lorna K. Rabe, reprinted with permission from S Hillier et al, in KK... |
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 | Figure 130-4 Organisms detected among female STD clinic patients with mucopurulent cervicitis (n = 167). GC, gonococcus; CT, Chlamydia trachomatis; MG, Mycoplasma genitalium; TV, Trichomonas vaginalis; HSV, herpes simplex virus. (Courtesy of Dr. Lisa Manhart; with... |
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 | Figure 130-5 Chancroid: multiple, painful, punched-out ulcers with -undermined borders on the labia occurring after autoinoculation. |
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 | Figure 130-6 Genital herpes. A relatively mild, superficial ulcer is typically seen in episodic outbreaks. (Courtesy of Michael Remington, University of Washington Virology Research Clinic.) |
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 | Figure 130-7 Lymphogranuloma venereum: striking tender lymphadenopathy occurring at the femoral and inguinal lymph nodes, separated by a groove made by Poupart's ligament. This "sign-of-the-groove" is not considered specific for LGV; for example, lymphomas may present with this sign. |
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 | Figure 130-8 Critical control points for preventive and clinical interventions against sexually transmitted diseases (STDs). [Adapted from HT Waller and MA Piot: Bull World Health Organ 41:75, 1969 and 43:1, 1970; and from "Resource allocation model for public health planning—a case study of tuberculosis control," Bull World Health Organ 48 (Suppl),... |
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