Genital Ulcer Syndrome.

1. FACULTY OF HEALTH SCIENCE
HEALTH EXTENSION DEPARTMENT
HE 233 Oral Presentation
Topic: Sexually Transmitted
Infection (STI) Genital Ulcer
Syndrome

2. LEARNING OBJECTIVES
• Definition
• Structures and functions affected
• Causes
• Clinical Manifestation
• Diagnosis
• Management Plan
• Prevention

3. OVERVIEW
What is STIs?
An infection that can be transmitted through sexual contact
with an infected person.
STIs can be transmitted in many different ways, but most can
passed by:
Vaginal sex
Anal Sex
Oral Sex
Skin-to-skin contact
Infected mother to child.
In this presentation we are going to talk about Genital Ulcer
Syndrome mainly Donovanosis, Genital herpes, and Syphilis.

4. CURABLE OR NON CURABLE
Curable
• Donovanosis
• Syphilis
Non Curable
• Genital
Herpes
EXCEPT HERPES DONOVANOSIS AND
SYPHILIS CAN BE CURED WITH
ANTIBIOTIC BUT NOT ALWAYS LONG-TERM
DAMAGES.

5. DONOVANOSIS
• Donovanosis is also known as granular inguinale
and it is a bacterial disease characterize by
ulcerative genital lesions.
• Structures affected are genitals and anal of both
genders
• The disease is caused by a bacteria klebsiella
granulomatis formally known as
calymmatobactrium granulomatis.

6. CONT..
• Signs and symptoms includes;
Sores on anal of both genders
Beefy-red bumps on genitals or around anus
Skin gradually wears away and bumps turn red
Slowly spread and destroy genital tissue
Loss of color around genitals and the skin around them
• With the disease its very difficult to detect in the early
stages, since you may not notice the initial lesions but it will
be detected when ulcers begun to form.

7. CONT..
• The disease is treated with antibiotics like tetracycline and the
macrolide erythromycin. Streptomycin and ampicillin may also
be used. Mostly prescribe for three weeks and on till it is cured.
Complications includes;
 Genital damage and scaring
 Skin color loss in genital area
 Permanent swelling due to scaring
• With the prevention
 Avoid sexual activities often
 The proper use of condoms
 Avoid reuse of clothes
 Faithful to a partner

8. SYPHILIS
• According to Mayo clinic, syphilis is a sexually transmitted
infection caused by bacteria Treponema pallidum. Spread
through direct contact with a syphilis sore (chancre) during any
form of sex, contacted with body fluids, and infected mother to
unborn baby.
Cause
• Syphilis is caused by Treponema pallidum subspecies of pallium,
a motile spirochete bacterium. It enter through penetration via the
skin and mucous membrane through abrasions during sexual
contact or transmitted from infected mother to unborn baby.

9. PRIMARY SYPHILIS
Primary syphilis develops at the site of primary contact. The
chancre is painless and can easily spread without noticing.
Labial Chancre

10. SECONDARY STAGE
Rash on the palms of hands, sole of feet and generalized body
rash
Lymphadenopathy
Malaise
Mucous patches
Condylomata lata
Alopecia

11. TERTIARY SYPHILIS
In this stage it leads to permanent damaged. It affects the central nervous
system, meningovascular (damaged to the blood vessels, brain, & spinal
cord), loss of vision leading to blindness, bone osteoporosis, teeth
deformities & cardiovascular inflammation of the aorta. Clinical
manifestation include gummatous lesions & cardiovascular syphilis
Teeth deformities & Gummatous ulcer

12. DIAGNOSIS
There are three aspects to diagnosis.
1. Clinical History
2. Physical Examination
3. Laboratory Diagnosis
Management Plan
Benzathine penicillin G 2.4 Million units intramuscularly
If allergic to penicillin;
Give Doxycycline 100 mg orally ‘bd’ qd x14/7
Tetracycline 500 mg orally ‘QID’ x14/7

13. PREVENTION
• According to Hawker (2012), syphilis can be prevented by patient
counseling and health education. Educating the patients to get
treatment and follow-up, risk reduction, and transmission.
Educate patient to have only one sex partner and get treatment if
infected. Always screen pregnant mothers at their first prenatal
visit to prevent stillborn & protect baby from infected, neonatal
death, infant disorder, and bone deformities.
IN SUMMARY, SYPHILIS IS CAUSED BY BACTERIA T. PALLIDUM AND IS
TRANSMITTED THROUGH DIRECT CONTACT/PENETRATES THROUGH
BREAKS IN THE SKIN. SIGNS AND SYMPTOMS VARIES ACCORDING TO
THEIR STAGES. IT IS DIAGNOSIS THROUGH HISTORY, EXAMINATION
AND LABORATORY TEST. IT IS CURABLE BUT IF LEFT UNTREATED IT
LEADS TO PERMANENT DAMAGES.

14. GENITAL HERPES
It is a common viral sexually transmitted infection of the genitalia
and mucous membrane linings of the human body.
Causes
Caused by two herpes simplex virus (HSV). HSV type-1 and HSV-
type-2
Structures affected by this condition
 blisters come up on the glens penis and scrotum of males and
female’s labias, cervix, vaginal opening and in both genders it
affects the rectum, perineal areas, mouth and lips and thus affecting
normal sexual activities of a sexually active person.

15. CLINICAL MANIFESTATIONS
Takes 11-12days before a sign or symptom to occur or remain
asymptomatic for months or years
 local symptoms include swollen glands, stinging itching
blisters of red sores on the buttocks, anus, perineum areas
and genitals of both males and females
Diagnosis
Laboratory testing confirms the diagnosis as signs and
symptoms may disappear or recur and includes,
Virologic tests with viral cultures of HSV-1 and HSV-2
Polymerase Chain Reaction (PCR) with HSV DNA replication
Type-Specific Serological test for HSV-1 and HSV-2 antibodies
from serum or blood

16. MANAGEMENT PLAN
• Systemic antiviral drugs are used after positive test results to
control genital herpes
• The antivirals don’t cure the condition but rather suppress the
spread and limits it from progressing and further transmission
• The antivirals include; Acyclovir, Valacyclovir and Famciclovir
• The antivirals are typically administered orally or if severe it can
be given intravenously or intramuscularly to the infected patient

17. COMPLICATION AND
PREVENTION
 neonatal herpes from pregnant mother with genital herpes
 painful urinating (dysuria)
 oral herpes
 vaginal or urethral discharge from blister like ulcers
• Counseling at local clinics and other STI centers is the most important
management way to address genital herpes
• Management of sexual partners who are infected and abstaining from sexual
intercourse
• Antiviral treatment for infected pregnant mothers before birth
• Use condoms and prevent unsafe sex with multiple sexual partners

18. SUMMARY
• To summarize, STIs are disease related to sexual contact
through different forms of sex and contacting body fluids from
infected person to uninfected person and also from mother to
unborn baby during pregnancy.
• Bacterial diseases can be easily treated but if left untreated, it
leads to permanent damages to the body while genital herpes is
non curable but can be prevented.
• They are all genital ulcer syndrome related to STIs and the only
100% effective prevention is to abstain from sexual intercourse.

19. REFERENCE
Ballard RC. Klebsiella granulomatis (Donovanosis, Granuloma Inguinale). In: Mandell GL, Bennett JE, Dolin R,
eds. Principles and Practice of Infectious Diseases . 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone;
2009:chap 236.
Carol, D. T. & Marica, A. L. (2012). Disease of the human body (5th ed.) (pp. 463-464).
Philadelphia: Davis Publication.
Centers for Disease Control and Prevention. (2015). 2015 Sexually Transmitted
Diseases Treatment Guidelines. Retrieved March 10th, 2017, from
http://www.cdc.gov/std/tg2015/herpes.htm
Collier, L., Kellam, P., & Oxford, J. 2011. Human Virology.,4th edition. Oxford:
oxford University Press
Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, HIV
infections. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology . 5th ed.
Philadelphia, Pa: Mosby Elsevier; 2007:chap 22.
Haker, J. (2012). Communicable disease control and health protection handbook (3rd ed.) (pp.
42-43). London: John Wesley Publication.
Schull, C.R.1999. Common Medical Problems in the Tropics., 2nd edition. Oxford:
Macmillan Publishers Ltd.
Workowski KA, Berman SM. Centers for Disease Control and Prevention. Sexually transmitted diseases
treatment guidelines 2010. MMWR Recomm Rep . 2010 Dec 17:59:1-110

20. GROUP MEMBERS
1. Newman Taekali (Introduction and Summary)
2. Dickson Hosea (Donovanosis)
3. Philipai Nagah (Syphilis)
4. Andrian Timothy (Genital Herpes)
All prepared by Health Extension Students names mentioned
above and carried forward by Philipai Philip Nagah