STI(sexually transmitted infection,性傳染病)題目先看病灶痛不痛、是否有分泌物、是否有水泡或疣。Urethritis/cervicitis(尿道炎/子宮頸炎)最常見要同時想到 N. gonorrhoeae 與 Chlamydia trachomatis,NAAT 是常用診斷概念。Painful vesicles(疼痛性水泡)是 HSV;painless chancre(無痛性下疳)是 primary syphilis(一期梅毒);painful ulcer with tender nodes(疼痛性潰瘍合併壓痛淋巴結)是 chancroid(軟性下疳),但考量流行病學較少見。Condyloma acuminata(尖形濕疣)是 HPV 6/11,癌症風險主要連到 HPV 16/18。
陰道炎三大入口也很常考:Trichomonas 是 strawberry cervix(草莓狀子宮頸)、泡沫分泌物、伴侶同治;Candida 是搔癢、乳酪狀分泌物;bacterial vaginosis(細菌性陰道病)是 fishy odor(魚腥味)、clue cells(線索細胞)。這些不是都歸在細菌章或寄生蟲章,臨床題會一起出現。
| 表現 | 病原 | 重點 |
| Urethritis/cervicitis | N. gonorrhoeae、C. trachomatis | NAAT;常需處理共感染 |
| Painful vesicles | HSV-1/HSV-2 | 潛伏復發、multinucleated giant cells |
| Painless chancre | Treponema pallidum | Primary syphilis;serology |
| Painful ulcer + tender nodes | Haemophilus ducreyi | Chancroid,較少見 |
| Condyloma acuminata | HPV 6/11 | HPV 16/18 與癌症 |
| Vaginitis, strawberry cervix | Trichomonas vaginalis | Motile trophozoite/NAAT;伴侶同治 |
| Curdy discharge | Candida | 糖尿病、抗生素、懷孕 |
| Fishy odor, clue cells | Gardnerella/mixed anaerobes | Bacterial vaginosis |