Tuesday, November 13, 2007

Once is never enough. Unless.....

If newFNP were to be flippant, she would counsel that if you have to acquire an STI, chlamydia is the way to go. Think about it, 1g of Azithromycin and, if you treat it early, you're likely good to go. This is in contrast to say, Lymphogranuloma venereum, which is, in fact, caused by C. trachomatis but appears to be much, much worse. Or ophthalmic gonorrhea in which your eye tries to kill itself by drowning itself in pus.

OK, enough of that fun mental image and back to chlamydia.

It's no big epidemiological secret that chlamydia is widespread in young sexually active people, much like their legs, newFNP presumes. NewFNP treats it on a fairly regular basis. In addition, she dispenses partner therapy in order to nip that drip in the bud.

So when newFNP diagnosed her new prenatal patient with chlamydia on her routine OB labs, she happily dispensed an extra gram of azithromycin for this young woman to give to her partner. She counseled pelvic rest for at least a week and instructed this woman to come back three weeks later for her routine OB physical and pap.

She returned, and guess what else did?

Where newFNP must have failed was in not dispensing an extra dose to treat her partner's partner. NewFNP will find out tomorrow when her patient returns for a second course of treatment and, perhaps, some frank discussion regarding the asshole who is re-infecting her.


that big girl said...

Is chlamydia a STD that poses dangers to the baby? During pregnancy or during vaginal delivery?

newFNP said...

Chlamydia can lead to chorioamnionitis and there are some data that say preterm rupture of membranes as well. During delivery, the exposed newborn is at risk for conjunctivitis and pneumonia.

Anonymous said...

NewFNP, you are too funny! I love your witty humor. Thanks for sharing your story.

BostonFNP said...

OK, so several issues.
1. Seen the ole' gonorrhea in the eyes from a good old Boston boy who forgot to wash his hands after handling his disgusting drippy wee-wee. Gross, and a clinical first.

2. Did you see the NYT article on the rise of chlamydia this year? Must all be in LA and Boston because I am seeing A LOT of the clap.

3. The whole idea of treating oneself and one's partner and then ABSTAINING for, oh I don't know, at least 48 hours, has been lost on many of BostonFNPs patients. Has anyone heard of antibiotic resistance? MRSA? PID? Infertility? I have one patient who has had 10, count them, 10 STIs in the last 24 months. I feel like a broken record. Please, please for the love of Mike, use a damn condom!!