11.infectious disease of genitalia & sexual transmitted infections

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11.infectious disease of genitalia & sexual transmitted infections

  1. 1. Infectious disease of genitalia Sexual Transmitted Infections
  2. 2. Bacterial Vaginosis(vaginitis) • Harmful bacteria: Gardnerella vaginalis, Mycoplasma hominis, • The pH and ecosystem changes, with concomitant symptoms • Sign & Symptom: asymptomatic, Itching, fish like odor, gray-white or watery vaginal discharge • Tx; oral metronidazol or clindamycin cream(if pregnancy metronidazole is contraindicate(PROM tendency), avoid alcohol while using drugs)
  3. 3. Bacterial Vaginosis(vaginitis)
  4. 4. Trichomonas • Etiology: protozoa parasite Trichomonas Vaginalis (most common curable STI) • Sign & symptoms: women; vagina odor 4-20days, thick, yellow-green or gray discharge, genital irritation and iching, painful urination, discomfort after intercourse. men;penis has thin, whitish discharge, painful urination and difficult. • Both sexual partner should receive treatment , avoid sexual intercourse or use condoms 4-6wks after treatment • Tx: Metronidazole(avoid alcohol, alcohol can cause severe nausea & vomiting) • Pregnant woman commonly experience recurrences Result; premature rupture of membranes, preterm birth, low birth weight, genital and lung infection on new born
  5. 5. Trichomonas
  6. 6. Yeast infection(Candidiasis, Moniliasis) • Etiology: Candida albicans • Most common disease especially pregnant woman, about 75% all of women experience at least one symptomatic episode • Over growth of C. albicans follow a disruption of normal vagina echosystem. • Contributing factors: use antibiotics, corticosteroids, diabetes, immunosuppr essive treatment, immunodeficiency, oral contraceptives, perfumed feminine hygiene spray, wearing tight, poorly ventilated cloth or underwear
  7. 7. Yeast infection(Candidiasis, Moniliasis) • Sign & symptoms: itching, burning, irritation of vagina and vulva, cheese like discharge, dysuria and dyspareunia • Dx: culture and microscopic exam of swab sampling from vagina and cervix diagnosis and conform yeast form • Tx: antifungal vaginal medication • Prevention: perineal hygiene is most important, genital area clean and dry
  8. 8. Yeast infection(Candidiasis, Moniliasis)
  9. 9. Perineal hygiene and infection prevention • Nurses should provide women with a teaching plan for perineal hygiene • Goal: prevent organisms(E-coli) from spreading from rectum to the vagina and urethra. • Wash hand s before and after genital contact and after using the restroom. • Women to wipe the perineum from front to back each time they void or defecate as well as during sex and menstruation
  10. 10. Perineal hygiene and infection prevent • Avoid products that may disturb the normal vagina flora(Dödenal bacillus) • Women should not use feminine hygiene(perfum. Spray, tampon and pad, deodorize) • Vagina is normally clean organ and does not need special cleanliness • Women are often at risk for genital infection or vaginitis because of the warm, moist, environment which promote microbial growth. • Wearing cotton underpnts, avoid nylon under ware and tight pants • Shower and perineal wash, avoid douch, buble bath and other bath additive • Perineal and vulva Wash 2 L water + Vinegar 3Tabe spoon
  11. 11. Sexual Transmitted Infection Chlamydia • Causative bacterium: Chlamydia tracomatis • Prevalence group: 15-20yrs old lower scioeconomic group • Transmitted through oral, vagina, anal sexual contact with infected person • Sign & Symptoms: early asymtomatic-purulent mucus discharge from vagina after 1-3wks • Transmitted endocervix endometrium uterine tube peritoneum PID infertility • Rectum urethra inflammation and ulceration
  12. 12. Chlamydia & Gonorrhea • Chlamydia & Gonorrhea can inflame lining of eye. newborn developed blindness from infection chlamydia at birth. • All newborn should be treating antibiotic ointment on eyes • All pregnant women should be test for chlamydia infection • Dx: examination of a specimen from endocervix, vagina, penis • TX: Antibiotics; agitomycin, doxycline, erythromycin, amoxicillin • Avoid sexual intercourse or using condom
  13. 13. Gonorrhea • Bacterium: Neisseria gonorrhea • Infected Batholin’s gland, rectum cervix urethra(as like as chlamydia infection) • Sign & symptoms: asymtomatic purulent discharge, dysuria and urinary frequency, urethral dischage, cervicitis • Dx: specimen culture from cervix, rectum urethra discharge • Tx: antibiotics; cefixime, ceftriaxone,
  14. 14. Syphilis • Bacterium: Treponema pallidum • Transmitted through sexual intercourse • Initial infection is localized ulcer systemic damage fetal • Maternal-fetal transmission(4070%) congenital syphilis, stillbirth, neonatal death • Congenital syphilis baby; skin ulcer, rashes, fever, Hoarse crying sounds, mental and physical handicaps 2-3month after birth
  15. 15. Syphilis • 4 stage of syphilis - Primary syphilis; painless ulcer or chancre cervix, tongue, lips, 26wks of exposure - Secondary syphilis: chronic stage, skin rash and brown sores 3-6wks after initial ulcer, mild fever, fatigue, headache, sore throat, hair loss, swollen lymph gland occur over 1-2yrs - Latent syphilis: no symptoms - Tertiary syphilis: final stage, spreads to many body systems(heart, eye, brain nerve system bone and joint mental illness, blindness, neurologic problem, heart problems death • Dx: microscopic identification of bacterium and exam. of blood sample(serology test) • TX: penicillin, tetracycline, doxcycline • Disease preventions as the ultimate goal • Pregnant women should be screening and instruction
  16. 16. Genital Herpes • • • • • • • • • • Herpes simplex virus type 2(HSV 2) HSV-1: cold sore lips, nose, HSV-2: genital infection Sign & symptoms: itching and burning Virus incubates 7days, 12days until healing but recurrent frequently Associated factors: sexual intercourse, stress, hormonal change, menstruation, climatic changes Dx: rectal cultures, clinical exam. Tx: acyclovir(Zovirax) Woman should maintain cleanliness and dryness Transmitted mother to infant cesarean birth indicated
  17. 17. Genital Herpes
  18. 18. Human Papillomavirus(HPV) Genital warts • HPV is more than 100 virus group • Genital warts(Condylomata): oral, vaginal, anal sex with infected people. 75% no Sx. • Sign& Symptoms: developed condylomata(warts) vulva, cervix, anus. • Warts vary size, appear flat and flash colored cauliflower look. • High risk HPV cause abnormal result on Pap smear and lead to cervical cancer. • Different diagnosis can be made using vinegar-like solution applied to the suspected area. This solution causes the warts to turn white. • Tx: Podophyllin and podofilox solution, Trichloroacetic acid(TCA), cryosurgery, electrocautery • Safe sex, avoid sex until tx. Finish all medications sex paterner to be tested and treated
  19. 19. Human Papillomavirus(HPV) Genital warts
  20. 20. Human Immunodeficiency Virus(HIV) • Acquired immunodeficiency syndrome(AIDS) is an infectious disorder that profoundly weakness the immune system by Human Immunodeficiency virus(HIV) • 10 yrs longer for an initial infection with HIV develop in to AIDS • Infected people can give HIV to other through sexual contact, pregnancy, breast feeding, organ transplants, sperm donation, IV drug use, blood transfusion
  21. 21. Human Immunodeficiency Virus(HIV) • HIV kills CD4cells(helperT cells), which help the body fight off infection and disease. • CD4 cells in an infected person decrease as number of HIV-infected cells increase. • Dx: positive HIV antibody by test for ELISA(enzyme-linked immuno-sorbent assay) T4/T8 ratio=T lymphocyte(T4 cell 200/mm₃↓)indicate AIDS • Tx: antiretroviral medication, adjust immune enhancing drugs, supportive care
  22. 22. Human Immunodeficiency Virus(HIV) • Opportunistic infection: consquence of weakened immunity that is secondary to HIV/AIDS  pneumocystis carinii pneumonia, cytomegalo virus infection • HIV is longterm not treatable disease AIDS is fetal disease • Prevention and test is most important • Safe sex, needle, blood not exchange

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