MSHC Treatment Guidelines

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The Melbourne Sexual Health Centre (MSHC) Treatment Guidelines are a guide to assist doctors with the treatment of Sexually Transmissible Infections (STIs). 

The treatment guidelines have been prepared by doctors at MSHC and are currently used within the clinic as a reference for treatment. They have been developed based on the best available evidence but may not necessarily agree with the current Australian Pharmaceutical Benefits Scheme.

 TitleDescription
Bacterial vaginosisBacterial vaginosis (BV) is one of the commonest causes of abnormal vaginal discharge in women.
ChlamydiaChlamydia infections are usually asymptomatic in both men and women. Infection in men can cause urethritis with discharge and dysuria and can lead to epididymo-orchitis. In women infection can cause cervicitis with vaginal discharge and post coita
Epididymo-orchitisEpididymo-orchitis is a clinical syndrome consisting of pain, swelling and inflammation of the epididymii and testes.
GonorrhoeaGonococcal infection can lead to cervicitis, urethritis and proctitis. Pharyngeal, cervical and anorectal infections are often asymptomatic. Men with gonococcal urethritis will usually present with a purulent discharge and dysuria within 2-7 days of expos
HerpesGenital Herpes simplex virus (HSV) infection may be acquired from either symptomatic or asymptomatic partners, and from either genital or oral sexual contact. About 70% is caused by HSV type 2 but an increasing number of genital infections are due to HSV
Lichen SclerosisLichen Sclerosis -Information for Referring Doctors - Sexual Health Factsheet
Lymphogranuloma Venereum (LGV) in MSM LGV is uncommon in developed countries, however, cases have occurred among men who have sex with men (MSM). Most of these men have presented with symptomatic proctitis. Typical symptoms include anorectal pain, discharge, tenesmus, and constipation. Asympt
Molluscum contagiosumMolluscum contagiosum Is due to a poxvirus infection of the skin. It is a benign spontaneously resolving infection lasting months and occasionally up to 2 years. It is common in young children, where lesions occur anywhere on the body (including genital
Mycoplasma genitaliumMycoplasma genitalium (Mg) is a sexually transmitted bacterium that is difficult to culture and detection relies on the use of PCR assays. It is a cause of urethritis in men, cervicitis in women, and rectal infection. In women it can lead to pelvic inflam
Pelvic Inflammatory Disease (PID)Pelvic Inflammatory Disease (PID) comprises a spectrum of inflammatory disorders of the upper female genital tract, including any combination of endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis. PID can lead to infertility...
ProctitisProctitis, or inflammation of the anal canal and distal rectum, can be infective or non infective. Sexually acquired proctitis is commonly asymptomatic but when symptoms are present they usually include pain with or without discharge and bleeding.
Pubic liceHuman lice are responsible for the infestations pediculosis capitis, pediculosis corporis and pediculosis pubis. Transmission is through contact with infested humans, clothing, combs or bed linen.Pubic lice or crab lice (Phthirus pubis) are usually transm
ScabiesScabies is an infestation of the skin by the burrowing mite Sarcoptes scabiei. Infestation is easily spread through direct skin-to-skin contact with sexual partners and household members, and may also occur by sharing clothing, towels and bedding.
STI ScreeningThe type of tests required to screen individuals for STI depends on the sexual history and risk behviour of the individual. The risk of a patient having a particular STI depends on the type of sexual behaviour that has occurred (such as unprotected anal..
SyphilisSyphilis is caused by the spirochaete Treponema pallidum. Syphilis is categorized into early infection (less than 2 years duration), which includes primary, secondary and early latent disease, and late infection (more than 2 years duration)...
Trichomoniasis VaginalisTrichomoniasis in women typically causes a frothy, yellow-green vaginal discharge. It can cause cervical inflammation: “strawberry cervix”. It is an uncommon cause of symptomatic urethritis in men
Urethritis in menSymptoms of urethritis in men include: urethral discomfort, discharge and dysuria. Some men will report only dysuria or discomfort without discharge. Urethritis can be classified as gonococcal and non- gonococcal urethritis (NGU).
Vaginal DischargeVaginal discharge is a common complaint. It can be due to a variety of reasons and may be physiological. A degree of vaginal discharge that changes with the menstrual cycle can be normal, but a change in the nature or volume of the discharge ...
Vulvodynia“ Vulvodynia” is a well-recognised chronic pain condition. There are 2 main subtypes. This guideline focusses on the commonest and most distressing subtype, “Localized Provoked Vestibulodynia “(LPV). It affects the vulval vestibule (around the vaginal
Warts and HPV InfectionGenital infection with Human Papillomavirus virus (HPV) can result in anal or genital warts. Most HPV infection is asymptomatic.

Disclaimer 
The content of these treatment guidelines is for information purposes only. The treatment guidelines are generic in character and should be applied to individuals only as deemed appropriate by the treating practitioner on a case by case basis. Alfred Health, through MSHC, does not accept liability to any person for the information or advice (or the use of such information or advice) which is provided through these treatment guidelines. The information contained within these treatment guidelines is provided on the basis that all persons accessing the treatment guidelines undertake responsibility for assessing the relevance and accuracy of the content and its suitability for a particular patient. Responsible use of these guidelines requires that the prescriber is familiar with contraindications and precautions relevant to the various pharmaceutical agents recommended herein.