A 26 year old female named Anna comes to the clinic one day with complaints of painful and more frequent urination, as well as pain during sexual intercourse, and increased vaginal discharge for the past 5 days. Upon further questioning, Anna tells you that she’s had multiple sexual partners lately. On physical examination, there's purulent vaginal discharge. You obtain a discharge sample with a swab and perform a Gram stain, which reveals the presence of gram-negative diplococci bacteria within neutrophils. You prescribe her a combination of azithromycin and ceftriaxone.
A year later, Anna comes back with similar complaints, but this time she also has a fever; and lower abdominal pain that worsens when she moves. Upon further questioning, Anna reveals that she’s had two more episodes of vaginal infections over the past year, but she didn’t seek medical attention. On physical examination, you notice that Anna has a fever, and when you perform a gynecological exam, movement of the cervix elicits pain.
Now, based on the initial presentation, Anna seems to have vaginitis or cervicitis caused by a sexually transmitted infection, or STI for short. STIs are mainly transmitted from person to person during sexual contact through body fluids, such as vaginal secretions, semen, or blood. The ones most at risk of contracting an STI are sexually active individuals, particularly those who have unprotected sex or multiple sexual partners. But, it’s important to note that sexually transmitted infections can also be transmitted via contact with skin or mucous membranes, including eyes, mouth, throat, and anus. And that’s a high yield fact!
Now, STIs that may cause vaginitis and cervicitis include chlamydia, which is caused by Chlamydia trachomatis; gonorrhea, which is caused by Neisseria gonorrhoeae; and trichomoniasis, caused by Trichomonas vaginalis.