Lemly Diana, Gupta Nupur
Division of Adolescent and Young Adult Medicine and.
Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA.
Pediatr Rev. 2020 Oct;41(10):522-537. doi: 10.1542/pir.2019-0078.
Sexually transmitted infections (STIs) disproportionately affect young people, with more than half of the infections occurring in youth aged 15 to 25 years. (1)(2) This review, the second in a 2-part series on STIs, focuses on infections that may cause abnormal vaginal or penile discharge, including trichomonas, chlamydia, gonorrhea, and pelvic inflammatory disease (PID). Most infected persons, however, are asymptomatic. Nucleic acid amplification tests are the most sensitive and specific for the detection of chlamydia, gonorrhea, and trichomoniasis, and they can be performed on provider- or patient-collected swabs. Providers should have a low threshold for diagnosing and treating PID because untreated PID can have serious long-term complications for young women. Indications for hospitalization for PID include the presence of a tubo-ovarian abscess, severe illness with systemic symptoms, pregnancy, human immunodeficiency virus infection, and failure to respond to outpatient oral treatment (within 48-72 hours) or inability to tolerate the oral treatment.
性传播感染（STIs）对年轻人的影响尤为严重，超过半数的感染发生在15至25岁的年轻人中。（1）（2）本综述是关于性传播感染的两部分系列中的第二篇，重点关注可能导致阴道或阴茎异常分泌物的感染，包括滴虫、衣原体、淋病和盆腔炎（PID）。然而，大多数感染者没有症状。核酸扩增检测对于衣原体、淋病和滴虫病的检测最为敏感和特异，并且可以使用医疗机构采集或患者自行采集的拭子进行检测。医疗服务提供者对盆腔炎的诊断和治疗阈值应较低，因为未经治疗的盆腔炎可能会给年轻女性带来严重的长期并发症。盆腔炎住院治疗的指征包括存在输卵管卵巢脓肿、伴有全身症状的严重疾病、妊娠、人类免疫缺陷病毒感染，以及对门诊口服治疗无反应（48 - 72小时内）或无法耐受口服治疗。
