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Consideration of sexually transmitted infections in the differential diagnosis

Case studies

O'Byrne, Patrick RN-EC, PhD (Associate Professor, Nurse Practitioner)1,2,3; MacPherson, Paul MD, PhD (Infectious Disease Specialist, Scientist)4,5; Kitson, Cynthia RN-EC, PhD (Candidate) (Nurse Practitioner)1,6; Bourgault, Andree RN-EC, MScN (Nurse Practitioner)2

Journal of the American Association of Nurse Practitioners: January 2019 - Volume 31 - Issue 1 - p 65–71
doi: 10.1097/JXX.0000000000000103
Clinical and Case Study Article
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Background and Purpose: The rates of many sexually transmitted infections (STIs) have increased in recent years. Many health care professionals miss these potential diagnoses in clinical practice.

Methods: Two case studies are presented, one an adult female with dysuria; the other an adult male with a rash. Appropriate differential diagnoses and relevant history, examination, and investigation details are discussed.

Conclusions: Not all dysuria signifies a urinary tract infection. Although most rashes are not syphilis or HIV, it is important to rule out these etiologies for rashes in adults without a previous history of similar dermatologic conditions.

Implications for Practice: Due to increased rates of many STI and HIV, it is important for nurse practitioners who work in primary care to consider these infections in patients who present with dysuria and rashes. Similarly, nurse practitioners who work in STI clinic settings should consider non-STI diagnoses in their work. In both cases, a perspective that includes both STI and non-STI etiologies is essential.

1School of Nursing, University of Ottawa, Ottawa, Ontario, Canada,

2Ottawa Public Health, Sexual Health Centre, Ottawa Ontario, Canada,

3Centretown Community Health Centre, Ottawa, Ontario, Canada,

4The Ottawa Hospital, Ottawa, Ontario, Canada,

5Ottawa Hospital Research Institute, Ottawa, Ontario, Canada,

6Ottawa Inner City Health, Mission Clinic, Ottawa, Ottawa, Canada

Correspondence: Patrick O'Byrne, RN-EC, PhD, University of Ottawa, School of Nursing, 451 Smyth Road, Ottawa, ON K1N 6N5, Canada. Phone: +1.613.562.5800; E-mail: pjobyrne@uottawa.ca

Competing interests: The authors report no conflicts of interest.

Received May 02, 2018

Received in revised form June 07, 2018

Accepted June 11, 2018

© 2019 American Association of Nurse Practitioners
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