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LEARNING ABOUT VENEREAL DISEASES: GRANULOMA INGUINALE
A chronic ulcerative venereal disease of the skin and mucous membranes, caused by a germ known technically as the Donovania granulomatis, is called granuloma inguinale. This condition is spread all over the world but is seen most widely in tropical and semitropical countries. Although the condition is generally believed to be transmitted by sexual contact, the condition is not especially infectious and is not seen nearly as frequently as are other venereal diseases.
The condition is suspected when the characteristic symptoms occur but, of course, has again to be differentiated from other similar venereal diseases, and particularly from syphilis.
Fortunately, granuloma inguinale heals rapidly when the patient is treated with streptomycin, chloromycetin, aureomycin, or terramycin. The drug is given in adequate dosage by injection over a period of seven to ten days, with a good result.
The patient is studied carefully again and again to make certain that he has not any other venereal disease. If there are secondary infections with pus germs, these are treated with penicillin.
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SEXUALLY TRANSMITTED DISEASES: TREATMENT OF URETHRITIS
Treatment of Gonococcal Urethritis
Because of resistance, the CDC does not recommend the use of fluoroquinolones for infections acquired in Asia or the Pacific (including Hawaii). In addition, the CDC has stated that it is "probably inadvisable" to use fluoroquinolones for infections acquired in California. Antibiotics for the treatment of gonococcal infection include cefixime (Suprax), ceftriaxone (Rocephin), ciprofloxacin (Cipro), levofloxacin (Levaquin), and ofloxacin (Floxin).
Alternative antibiotics for N. gonorrhoeae infection include spectinomycin, ceftizoxime, cefoxitin (with probenicid), cefotaxime, gatifloxacin, norfloxacin, and lomefloxacin. Since co-infection with C. trachomatis occurs in 10% to 30% of gonococcal urethritis cases, treatment for both infections should be provided. A single 2 g dose of azithromycin treats both gonococcal and chlamydial infection, but this is not recommended by the CDC, presumably because of the significant gastrointestinal side effects. Instead, the CDC recommends combining the regimens for gonococcal and nongonoccal urethrits.
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