Sexually Transmitted Disease

Case Study

J.C., a 23-year-old male naval officer recently stationed in the Philippines, complains of dysuria, meatal pain, and a profuse yellow urethral discharge for 2 days. He admits to extramarital sex with a prostitute over the past week. He states that his wife, B.C is 8 weeks pregnant, but she is asymptomatic. Intracellular Gram-negative diplococci were seen on the Gram’s stain of J.C.’s urethral exudates. J.C tells you that if this is a sexually transmitted disease then he does not want the wife to know about this diagnosis and the extramarital affair.
Use the questions below to formulate your answers, reflect and solve the health issue and ethical dilemma.
1. 1. What are your differential diagnoses? What is the primary diagnosis?
2. 2. What is the CDC’s drug of choice for treating this condition and what are some alternates?
3. 2. What additional therapy should be included and why?
4. 3.Why has CDC removed amoxicillin and procaine penicillin from their recommended drugs?
5. 4.J.C. tells you that he does not want the wife to know about this diagnosis; what is the best answer to this request?
6. 4. Should B.C. (J.C.’s pregnant wife) be treated? If so, with what?
7. 6. Is this a reportable disease to public health? If so, how best can you report this?

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