Consideration of sexually transmitted infections in the differential diagnosis: Case studies

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.