Sexually Transmitted Infections (STI) are infections usually acquired during copulation. There are over 30 different organisms that may be transferred during this act. These organisms when transferred usually remain silent for many years hence are called “infections” displacing the old terminology, “disease” (STD). This asymptomatic nature allows this group of infections to contribute to the growing numbers of the epidemic pool thus has become part of the silent epidemic. They are also responsible for causing other disease syndromes not suspected to be STI but rather thought to have unknown causes (idiopathic).
If carriers do develop symptoms, the most common are that of a discharge excreted from the body orifices, (eyes nose and throat, vaginal and urinary tract including anus). Several dermatologic presentations appear, ranging from rashes, ulcerative and raised lesions. Pelvic pain syndrome in both male and female do occur. Systemic manifestations show from septic to neurologic. Reproductive malfunctions and pediatric disorders in addition also take place.
Diagnosis is made by extracting a detailed sexual history from patients. Sexual debut, premarital, extramarital encounters, number of different lifetime sexual exposures, past STI all of this information must be extracted because of the chronic and recurring nature of the disease process. Correct physical examination is a must. Several investigative procedures are essential. Microscopic surveys using several techniques like bright field, phase contrast, dark field, and fluorescence microscopy are all requisites. Culture and DNA methods for etiologic identification if possible should be included. Finally serologic tests done at a proper time to prevent errors of diagnostic windows completes a good problem-solving survey.
Treatment must be on evidence based therapeutic regimen, not on theory or pure logic. Emphasis on test for cure cannot be discounted. Otherwise, a foreboding false sense of security of whether or not one has in fact been cured or simple turned into a silent carrier will prevail.
Finally patient counseling and education cannot be ignored. This part of management is important for the prevention of these diseases and will help in curving down the epidemic curve.