Adolescent- Male Sexually Transmitted Infections (STIs)


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Today we’ll be covering Male Sexually Transmitted Infections (STIs), going along with this month’s theme, Adolescent Medicine. If you haven’t listened to our podcast before, each week we have a case-based discussion about a medical topic to help you study for the pediatric medicine board exam. Episodes are released every weekend, and the case is then reviewed and reinforced on social media throughout the week.

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This month we are also joined by our wonderful guest host, Dr. Nimisha Bajaj! She created all of the cases for this month, and we are so happy to have her join us! Feel free to check her social media for more thought-provoking and insightful content, @NimishaBajaj2 (

Today’s Case:

A 17 year old previously healthy male presents for an annual physical exam. When examining his genitals, you notice a small ulcer on his penis that he had not seen before. It is painless, and he denies other symptoms, including fever, dysuria, and penile discharge. It is a solitary ulcer with smooth, firm borders and no underlying erythema or skin color changes. He also has no inguinal lymphadenopathy. He reports unprotected penile-vaginal intercourse with 2 separate partners in the last few weeks, but he is unsure about their STI status. You send the appropriate diagnostic studies, which are pending. Given his symptoms and the most likely diagnosis, what is the next best step to treat this adolescent?

  1. 400 mg oral Acyclovir 3 times per day for 7 days
  2. 1g oral Azithromycin in a single dose
  3. 250 mg IM Ceftriaxone in a single dose with 1g oral Azithromycin in a single dose
  4. 4 million units IM Penicillin G
  5. Initiate antiretroviral therapy

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