Std disease

1. SEXUALLY
TRANSMITTED
INFECTIONS

2. Sexually
transmitted
diseases or
infections
(STDs/STIs)
2
Infections that can be transferred
from one person to another
through unprotected sex (vaginal,
oral , anal ) or through skin-to-skin
genital contact.
Many bacteria, viruses, and fungi
may be sexually transmissible and
may result in disease.
Vertical transmission, Blood, and
contaminated needles are other
mean of transmission such as
Hepatitis C.

3. Common
STI’s
3
Chlamydia
Gonorrhea
Genital Herpes (HSV-2)
HIV and AIDS
Pubic Lice
Syphilis
PID- Trichomonas

4. STI ACQUISITION AND
TRANSMISSION
4
Frequently
changing sexual
partners
Having
unprotected sex
with concurrent
multiple partners
Having
unprotected sex
with sex workers
Homosexuality

5. Role of
Nurse
5
The primary role to teach
about safe sexual practices
Provide information about
disease treatment and referrals
Nurse should be nonjudgmental
Maintain confidentiality

6. Role of
Nurse
6
Establish trusting relationship
History taking and obtain
complete list of sexual partners
Counsel patients on staying
uninfected after treatment.
Encourage them to comply with
treatment,

7. Syphilis

8. Syphilis
8
Caused by bacterium
called Treponema
pallidum
Syphilis develops in
stages, and symptoms
vary with each stage.
(primary, secondary,
latent and late/tertiary)

9. Progression of Syphilis
Primary Syphilis
Secondary Syphilis
Early latent
Syphilis
Late latent
Syphilis
Tertiary
Syphilis
9

11. Primary
Syphilis
• Incubation period is 1 week to
3 months (median 21 days)
• Painless sores appear at the
site of infection (mouth anus,
rectum, vagina or penis).
• These are called chancres.
• The sores heal on their own
after 1 to 3 weeks, but person
still spread syphilis.
• Non tender regional
lymphadenopathy is common.

13. Secondary
Syphilis
• Classic Red or reddish-
brown rash on palms of
hands and soles of feet or
any part of the body
• Occurs 2-8weeks after the
disappearance of chancre.
• These symptoms will go
away, even if no treatment
received but if not treated,
infection will get worse.

14. Cutaneous
Manifestations
Diffused maculopapular rash (Classic)
Mucus patches, gray superficial erosions
or plaques on buccal mucosa or tongue
Split papules: Fissured nodular lesions at
the angle of lips and nasolabial folds
Condylomata lata: Moist heaped up
broad plaques in perianal area, vulva and
inner thighs.
Patchy alopecia or moth-eaten thinning
of hair, eyebrows or beard from
syphilitic involvement of hair follicles

15. 15

18. Latent
Stage
18
Without treatment the secondary syphilis
resolve within few weeks.
Disease enters latent phase characterized
by lack of symptoms and positive
serologic tests.
Not everyone who has syphilis will enter
this phase
Early latent (infection duration less than
1 year)
Late latent (Infection duration greater
than 1 year)

19. Late/Tertiary
syphilis
19
This stage begins when symptoms
from the secondary stage
disappear.
Syphilis isn’t contagious at this
point, but the infection has
started to affect the organs.
This can lead to death. Symptoms
of tertiary syphilis may include:
Neurological problems and
cardiovascular problems

20. Neurological
problems
Syphilis can cause several
problems with nervous
system, including:
• headache, Stroke Meningitis,
Hearing loss
• Visual problems, including
blindness,
• Dementia
• Loss of pain and temperature
sensations
• Sexual dysfunction in men
(impotence), Bladder
incontinence

21. Cardiovascular
problems
• These may include bulging
(aneurysm) and inflammation of
the aorta and of other blood
vessels that can burst. Syphilis
may also damage heart valves.
• Congenital syphilis leads to
deformities in child , and still births
21

23. Prevention
There is no vaccine for syphilis.
To help prevent the spread of syphilis
Abstain or be monogamous.
Use a latex condom.
Avoid recreational drugs
Prenatal screening and treatment
Screening of HIV patients

24. Gonorrhea

25. Gonorrhea
25
Exudative bacterial infection
Causative Agent----Neisseria
gonorrhea.
First described by Neisser in 1879.
One of the oldest disease
It is a very common infection,
especially among young people
ages 15-24 years

26. Clinical
Manifestations
in Males
5-10 percent patients never have
symptoms
Urethritis is most common
Painful urination
Pus-like discharge from the tip of
the penis is classic
Pain or swelling in testicle
Rectal pain, discharge, constipation,
and tenesmus.

27. Clinical
Manifestations
in Females
Mostly asymptomatic
Cervical disease (cervicitis)
Increased vaginal discharge
Painful urination
Vaginal bleeding between periods,
and after vaginal intercourse
Abdominal or pelvic pain

28. Diagnostic Tests
Gram staining – Gram negative diplococci
NAAT (Nucleic Acid Amplification Test)
• First catch of urine in men
• Vaginal or cervical swabs in women

29. Complications
29
Infertility in men and women
Ophthalmia Neonatrum can lead
to blindness in newborns who is
born through vaginal delivery

31. Treatment of
gonorrhea
CDC recommends a single dose
of 250mg of intramuscular
ceftriaxone AND 1g of oral
azithromycin.
Although medication will stop
the infection, it will not repair
any permanent damage done by
the disease

32. Chlamydia
It is bacterial infection caused by chlamydia
Trachomatis and Most common STI

33. Global Statistics
World health organization (WHO) estimates that globally
approximately 127 million new cases of chlamydia occur
annually.

34. Clinical
Manifestat
ions in
women
Mostly asymptomatic
Vaginal discharge in women
Painful sexual intercourse in
women
Bleeding between periods and
after sex in women
Painful burning micturition

35. Clinical
Manifestations
in Men
Urethra
• Painful urination
• Meatal itching or itching
• Discharge from the penis in men
Upper Genital tract
• Testicular pain in men
• Swelling and pain in scrotum
• Epididymitis

36. 1. Urethral
discharge
2. Ependymitis
36

37. Diagnosis
37
NAAT (Nucleic Acid
Amplification Test )
In men the specimen
is first catch urine
In women preferably
cervical swab

38. Complications
If not treated lead to pelvic
inflammatory disease, ectopic
pregnancy, chronic lower
abdominal pain , reactive
arthritis and infertility

39. Treatment
Azithromycin 1 g single dose
(pregnant and non pregnant )
Doxycycline 100 mg BD for 7
days (only non-pregnant)

40. Prevention
Use condoms
Limit number
of sex partners
Get regular
screenings

41. Herpes Simplex

42. Herpes
simplex
42
There are two types of the herpes
simplex virus.
HSV-1 primarily causes oral herpes
and is generally responsible for fever
blisters around the mouth and on the
face.
HSV-2 primarily causes genital herpes

43. Herpes simplex II and I
43

44. Genital
Herpes
Genital herpes is a STI caused by
a herpes simplex virus (HSV II).
Person can get it from having vaginal,
anal, or oral sex with someone who
has it.
The virus can spread even when sores
are not present.
Mothers can also infect their babies
during childbirth and can lead to skin
or systemic herpes leading to brain
damage, breathing problems or fits in
babies.

45. Manifestation
of Herpes
genitals
Primary episode
• occurs within 2 to 12 days.
• Clusters of painful vesicles the
lesion progresses to form
pustules then shallow ulcers
• New lesions form while older
one's crust over
• Lesions can occur on genitals,
buttocks, upper thighs and
perineal regions.
• Local tender
lymphadenopathy, cervicitis,
proctitis

46. Manifestation
of Herpes
genitals
Recurrent Episodes
• Itching, tingling or pain in the
lesions.
• More frequently with HSV2
• Milder and shorter than primary
(4-7days on average)
• Always be considered when
evaluating lower abdomen,
lower back, thigh or buttock
sores.

48. Diagnostic
Test
48
Serology: Type specific
serologic testing identifies
IgG antibodies specific to
viral glycoprotein G.
PCR is most sensitive.
Swab vesicle fluid or ulcer
base to obtain specimen

49. Preventing
HSV 1
Don’t share any items
that can pass the virus
around, such as cups,
towels, clothing,
makeup, or lip balm.
Don’t participate in
oral sex, kissing, or any
other type of sexual
activity during
infection

50. Preventing
HSV 2
avoid any type of sexual activity with
other people during an outbreak.
If the person is not experiencing
symptoms but has been diagnosed with
the virus, a condom should be used
during intercourse.
Women who are pregnant and infected
may have to take medication to prevent
the virus from infecting their unborn
babies.
No vaginal delivery –C Section is
performed

51. Treatment
Most people are treated with an
antiviral medicine. An antiviral
cream or ointment can relieve the
burning, itching, or tingling.
Acyclovir
Famciclovir
Valacyclovir