Sexually transmitted infections Part V

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Sexually transmitted infections: includes human papillomavirus, ectoparasites, hepatitis, enteric diseases

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Sexually transmitted infections Part V

  1. 1. Sexually Transmitted Infections By: Maria Carmela L. Domocmat, RN, MSN Nurse Instructor Northern Luzon Adventist College
  2. 2. 1. Diseases Characterized by 3. Diseases Characterized by Ulcerations Vaginal Discharge Chancroid Bacterial Vaginosis Trichomoniasis Genital HSV Infections Vulvovaginal Candidiasis Granuloma Inguinale (Donovanosis) 4. Human Papillomavirus (HPV) Infection Lymphogranuloma Venereum Genital Warts Syphilis 5. Ectoparasitic Infections2. Diseases Characterized by Scabies Urethritis or Cervicitis Pediculosis Pubis Chlamydial Infections 6. Hepatitis A, B, C Gonococcal Infections 7. Sexually transmitted enteric infections Proctitis, Proctocolitis, and EnteritisOverview Maria Carmela L. Domocmat, RN, MSN
  3. 3. HUMAN PAPILLOMAVIRUS(HPV) INFECTION
  4. 4. GENITAL WARTS(Condyloma Acuminata)
  5. 5. Genital Wartsa group of more than 70 viruses, someof which can lead to cervical cancer.Several strains of HPV cause externalgenital warts.Organism: Human Papilloma Virus HPVInfectivity: people can infect otherswhen they have lesions & sometimeswhen they do not; 66% of people whohave sexual contact with a partner whohas genital warts will develop genitalwarts, usually within 3 months Maria Carmela L. Domocmat, RN, MSN
  6. 6. Genital Warts Incubation: 1 to 20 months; usually about 1-2 months Maria Carmela L. Domocmat, RN, MSN
  7. 7. Maria Carmela L. Domocmat, RN, MSN
  8. 8. warts on genitals, rectum or throat (similar in both sexes) Benign growth, multiple, painless clusters Laryngeal papillomatosis in infant Born vaginally from infected motherSymptoms Maria Carmela L. Domocmat, RN, MSN
  9. 9. Most people with HPV do not develop symptomsor health problems from it.In 90% of cases, the body’s immune systemclears HPV naturally within two years.But, sometimes, HPV infections are not clearedand can cause: Genital warts Rarely, warts in the throat -- a condition called recurrent respiratory papillomatosis, or RRP. When this occurs in children it is called juvenile-onset RRP (JORRP). Cervical cancer and other, less common but serious cancers, including cancers of the vulva, vagina, penis, anus, and oropharynx (back of throat including base of tongue and tonsils). Maria Carmela L. Domocmat, RN, MSN
  10. 10. The types of HPV that can cause genital warts are not the same as the types that can cause cancers. There is no way to know which people who get HPV will go on to develop cancer or other health problems.Note: Maria Carmela L. Domocmat, RN, MSN
  11. 11. genital contact, most often during vaginal andanal sex.oral sex and genital-to-genital contact.can be passed on between straight and same-sexpartners—even when the infected partner has nosigns or symptoms.A person can have HPV even if years havepassed since he or she had sexual contact withan infected person. Most infected persons do not realize they are infected or that they are passing the virus on to a sex partner. It is also possible to get more than one type of HPV.MOT Maria Carmela L. Domocmat, RN, MSN
  12. 12. Rarely, a pregnant woman with genitalHPV can pass HPV to her baby duringdelivery. Very rarely, the child can developjuvenile-onset recurrent respiratorypapillomatosis (JORRP).MOT Maria Carmela L. Domocmat, RN, MSN
  13. 13. Acetic acid Biopsies For subclinical case– Pap smear, colposcopy (vagina and cervical tissue exam with scope)Dx Maria Carmela L. Domocmat, RN, MSN
  14. 14. Five Percent Acetic Acid WashIndicated for Genital Warts or Condylomata Acuminata
  15. 15. 1. After completing all other vaginal specimens, swab the cervix with cotton-tipped applicator that has been soaked in 5% acetic acid. 2.Leave for one minute.Five Percent Acetic Acid Wash Maria Carmela L. Domocmat, RN, MSN
  16. 16. Normal Finding Abnormal Finding There should be no Rapid acetowhitening or change in the blanching with jagged appearance of the borders (HPV) cervix (HPV) Maria Carmela L. Domocmat, RN, MSN
  17. 17. After application of aceticApparently normal cervix acid Maria Carmela L. Domocmat, RN, MSN
  18. 18. Maria Carmela L. Domocmat, RN, MSN
  19. 19. Maria Carmela L. Domocmat, RN, MSN
  20. 20. There is no cure for HPV, so treatment aims at controlling outbreaks of warts -- if you have a strain that causes visible warts.Treatment Maria Carmela L. Domocmat, RN, MSN
  21. 21. Visible genital warts can be removed by the patient him or herself with prescribed medications. Topical podofilox nd imiquinod cream Contraindicated for pregnant womenTreatment Maria Carmela L. Domocmat, RN, MSN
  22. 22. Visible genital warts They can also be treated by a health care provider. Podophyllin resin in tincture of benzoin or trichloroacetic acid (TCA) or bichloroacetic acid (BCA) Applied topically to warts only Repeated weekly til all lesion disappear and skin healed Contraindicated for pregnant womenTreatment Maria Carmela L. Domocmat, RN, MSN
  23. 23. Some people choose not to treat warts, but to see if they disappear on their own. No one treatment is better than another.Treatment Maria Carmela L. Domocmat, RN, MSN
  24. 24. Extensive genital warts also may be removed using cryotherapy (freezing) – using liquid nitrogen burned off with electrocauterization Surgical excision CO2 lasers In at least 30 percent of treated cases, the warts grow back again.Treatment Maria Carmela L. Domocmat, RN, MSN
  25. 25. Antiviral drug interferon Expensive High rate adverse effectTreatment Maria Carmela L. Domocmat, RN, MSN
  26. 26. Cervical cancer is most treatable when it is diagnosed and treated early. But women who get routine Pap tests and follow up as needed can identify problems before cancer develops. Prevention is always better than treatment.Treatment Maria Carmela L. Domocmat, RN, MSN
  27. 27. Penile Condyloma Maria Carmela L. Domocmat, RN, MSN
  28. 28. Vaccines given in three shots. It is important to get all three doses to get the best protection. most effective when given at 11 or 12 years of age.Prevention Maria Carmela L. Domocmat, RN, MSN
  29. 29. Cervarix and Gardasil Gardasil - also protects against most genital warts, anal, vaginal and vulvar cancers. for 11 and 12 year-old girls, for females 13 through 26 years of age, who did not get any or all of the shots when they were younger. These vaccines can also be given to girls beginning at 9 years of age. It is recommended to get the same vaccine brand for all three doses, whenever possible.Prevention : Girls and women Maria Carmela L. Domocmat, RN, MSN
  30. 30. One available vaccine (Gardasil) protects males against most genital warts and anal cancers. This vaccine is available for boys and men, 9 through 26 years of age.Prevention: Boys and men: Maria Carmela L. Domocmat, RN, MSN
  31. 31. Condoms for those who choose to be sexually active, condoms may lower the risk of HPV. To be most effective, they should be used with every sex act, from start to finish. But HPV can infect areas that are not covered by a condom - so condoms may not fully protect against HPV.Prevention Maria Carmela L. Domocmat, RN, MSN
  32. 32. Preventing RRP: Cesarean delivery is not recommended for women with genital warts to prevent juvenile-onset RRP (JORRP) in their babies. This is because it is not clear that cesarean delivery prevents JORRP in infants and children.Prevention Maria Carmela L. Domocmat, RN, MSN
  33. 33. ComplicationsIf Untreated: both sexes - warts grow& obstruct infected body openings, pre-cancerous lesions of the cervix, vulva, &penis have been linked to some types ofHPV. Maria Carmela L. Domocmat, RN, MSN
  34. 34. Condyloma acuminatumor Genital WartsAnal area Maria Carmela L. Domocmat, RN, MSN
  35. 35. Not necessary to evaluate sexual partners Coz treatment is not effective in eradicating infection or its spread Female partner should be referred for Pap smear or when indicated – cervial colposcopy, biopsy Encourage condom useHealth educ Maria Carmela L. Domocmat, RN, MSN
  36. 36. Vaccine-Preventable STDs› Hepatitis A› Hepatitis BHepatitis C Maria Carmela L. Domocmat, RN, MSN
  37. 37. Maria Carmela L. Domocmat, RN, MSN
  38. 38. HEPATITIS
  39. 39. There are five types of hepatitis -- Athrough E -- all of which causeinflammation of the liver.Type D affects only those who also havehepatitis B,Hepatitis E is extremely rare in the UnitedStates. Maria Carmela L. Domocmat, RN, MSN
  40. 40. Type A hepatitis anal-oral contact, by coming in contact with the feces of someone with hepatitis A, or by eating or drinking hepatitis A contaminated food or water.Type B hepatitis infected blood, seminal fluid, vaginal secretions, or contaminated drug needles, including tattoo or body-piercing equipment. It can also be spread from a mother to her newborn.Type C hepatitis not easily spread through sex. more likely through contact with infected blood, contaminated razors, needles, tattoo and body-piercing equipment, or manicure or pedicure tools that havent been properly sanitized, and a mother can pass it to her baby during delivery.Type D hepatitis infected blood, contaminated needles, or by sexual contact with an HIV- infected person.Type E hepatitis in feces, through oral contact, or in water thats been contaminated.MOT Maria Carmela L. Domocmat, RN, MSN
  41. 41. Two weeks to five months, although hepatitis C can remain dormant for 10 years before symptoms crop up.Incubation Period: Maria Carmela L. Domocmat, RN, MSN
  42. 42. mild flu-like symptoms light stools dark urine jaundice Fatigue Fever Hepatitis A symptoms may also include nausea, vomiting, and abdominal pain.Symptoms Maria Carmela L. Domocmat, RN, MSN
  43. 43. All types of hepatitis are diagnosed with a blood test.Testing Maria Carmela L. Domocmat, RN, MSN
  44. 44. Types A and E hepatitis usually resolve over time. If traveling to a country where hepatitis A is prevalent, two doses of a vaccine can prevent the disease. no vaccine for hepatitis E. hepatitis B anti viral medications may help some patients. a vaccine (three doses) can prevent the disease in the first place. the only STD thats preventable with a vaccine, according to Planned Parenthood.) hepatitis C and D interferon and other drugs may help some patients is no vaccine for either type.Treatment: Maria Carmela L. Domocmat, RN, MSN
  45. 45. If are not treated Because types A and E usually go away over time, neither is likely to lead to chronic disease. Types B and C, however, can lead to cirrhosis (scarring of the liver) and liver cancer if not treated; type D can also result in liver cancer.Complications Maria Carmela L. Domocmat, RN, MSN
  46. 46. Maria Carmela L. Domocmat, RN, MSN
  47. 47. HEPATITIS B
  48. 48. Maria Carmela L. Domocmat, RN, MSN
  49. 49. Hepatitis is a disease of the liver.Hepatitis B is transmitted person toperson through blood and body fluids.There is no treatment for the virus afterit has been contracted.The only treatment is prevention:› Abstain from sex› Always use latex condoms› Avoid contact with other people’s blood› Get immunized Maria Carmela L. Domocmat, RN, MSN
  50. 50. Maria Carmela L. Domocmat, RN, MSN
  51. 51. HEPATITIS C
  52. 52. Maria Carmela L. Domocmat, RN, MSN
  53. 53. Maria Carmela L. Domocmat, RN, MSN
  54. 54. Pediculosis PubisScabies Maria Carmela L. Domocmat, RN, MSN
  55. 55. PEDICULOSIS PUBIS
  56. 56. Crab lice, Pthirus pubiswith reddish-brown crab feces. Maria Carmela L. Domocmat, RN, MSN
  57. 57. Crab lice, Pthirus pubis Maria Carmela L. Domocmat, RN, MSN
  58. 58. Tiny insects that live off human blood.Although theyre often found around thegenitals, they can live in any part of thebody with hair. Maria Carmela L. Domocmat, RN, MSN
  59. 59. Through sexual transmission,skin-to-skin contact,in clothing, bedding,on a toilet seat harboring the insects.MOT Maria Carmela L. Domocmat, RN, MSN
  60. 60. As long as a week if its the first time had pubic lice as little as a day if this is a recurrence.Incubation Period: Maria Carmela L. Domocmat, RN, MSN
  61. 61. Symptoms of crabs are usually noticed around 5 days to 7 weeks after infection and include: Itching in the genital area or any other part of the body with hair. inflammation of the affected area; sometimes visible lice and eggs; spots of blood as lice feed from blood vessels in the skin.Symptoms: Maria Carmela L. Domocmat, RN, MSN
  62. 62. Pubic lice are very small, whitish-gray parasites that look like crabs. insects or their eggs (which are pearl- colored and oval-shaped) in your hair. skin under hair -red and scaly, or there may be small blue spots -- signs of lice bites.Testing: Maria Carmela L. Domocmat, RN, MSN
  63. 63. Over-the-counter lotions that contain the chemical permethrin such as Rid and Nix will get rid of the lice. (Talk to doctor before using any product that contains the chemical lindane, which can be toxic, especially for unborn children.) After washing with the lotion, use a fine-toothed comb to comb out the crabs and their eggs (called nits). sexual partner(s) must be treated as well all clothing or bedding that may be infested must be washed in very hot water or dry-cleaned. In some cases, clothing, towels, or bedding may need to be washed a few times before theyre completely lice-free. It is not necessary to shave pubic hair as this is unlikely to remove all lice.Treatment: Maria Carmela L. Domocmat, RN, MSN
  64. 64. If are not treated: If dont seek treatment youre likely to pass pubic lice on to any sexual partners, or anyone else youre in close contact with.Complication Maria Carmela L. Domocmat, RN, MSN
  65. 65. SCABIES
  66. 66. Molluscum lesions on anarm Maria Carmela L. Domocmat, RN, MSN
  67. 67. A mite that burrows under the skin andlays eggs. Maria Carmela L. Domocmat, RN, MSN
  68. 68. Through close contact or through sleepingin bedding or wearing clothes that areinfested.Rarely, holding or shaking hands cantransmit scabies.MOT Maria Carmela L. Domocmat, RN, MSN
  69. 69. As long as a week if its the first time youve been infested; a day if its a recurrence.Incubation Period Maria Carmela L. Domocmat, RN, MSN
  70. 70. intense itching or small bumps or a rash on the penis, between the fingers, on buttocks, breasts, wrists, thighs, or around the navel.Symptoms Maria Carmela L. Domocmat, RN, MSN
  71. 71. Contagiosum can cause papules to form on theScabies around penis skin.(Credit: E van Herck) Maria Carmela L. Domocmat, RN, MSN
  72. 72. Creams and lotions containing permethrin such as Rid and Nix must be applied to the whole body from the neck down. (As with pubic lice, products containing lindane may be harmful to the fetus if used by a pregnant woman) Change clothing and sleep on freshly laundered sheets after youve applied the lotion. Any bedding or clothing that may have been infested should be washed with very hot water or dry-cleaned.Treatment: Maria Carmela L. Domocmat, RN, MSN
  73. 73. Continued scratching can cause an infection, and if it left untreated, scabies can be transmitted to anyone you come in close contact with.Complications Maria Carmela L. Domocmat, RN, MSN
  74. 74. Maria Carmela L. Domocmat, RN, MSN
  75. 75. CYTOMEGALOVIRUS
  76. 76. Found is saliva, urine, semen, and vaginal secretions symptoms include pharyngitis, malaise, fever and lymphadenopathy, heterophil antibody negative, blood smears may show atypical lymphocytes may be fatal to those patients with AIDSCMV - Cytomegalovirus Maria Carmela L. Domocmat, RN, MSN
  77. 77. Treatment:most resolvespontaneoulsytherapy is oftenrequired forimmunosuppressedpatientsGanciclovirCMV Maria Carmela L. Domocmat, RN, MSN
  78. 78. Maria Carmela L. Domocmat, RN, MSN
  79. 79. Maria Carmela L. Domocmat, RN, MSN

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