Sexually transmitted diseases

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  • I just want everyone to know never to give up believing there is someone out there for you even though you have std! We are very happy with each other and that www.Hmeet.net made it possible for us to find each other. Don't pass a good thing, you never know what it may evolve into.Good luck on your search and wish you the best:)
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Sexually transmitted diseases

  1. 1. Sexually transmittedSexually transmitted diseasesdiseases STDSSTDS The term sexually transmitted diseaseThe term sexually transmitted disease applies to infection which specificallyapplies to infection which specifically transmitted by sexual contact.transmitted by sexual contact. 1)1) Syphilis:-Syphilis:- - The causative organism is theThe causative organism is the spirochaete bacterium treponemaspirochaete bacterium treponema pallidum.pallidum. - Mode of infection other than sexualMode of infection other than sexual contact is through blood transfusion andcontact is through blood transfusion and www.doctor.sdwww.doctor.sd
  2. 2. From the pregnant mother to her fetus.From the pregnant mother to her fetus.  Primary syphilis causes a local (usuallyPrimary syphilis causes a local (usually genital) pain less ulcer (chancre) whichgenital) pain less ulcer (chancre) which usually heals in 2- to 6 weeks.usually heals in 2- to 6 weeks. - The inguinal glands are markedlyThe inguinal glands are markedly enlarged firm, but not tender.enlarged firm, but not tender. - The incubation period is from 9 to 90 days.The incubation period is from 9 to 90 days.  Secondary or systemic stageSecondary or systemic stage:-:- - Occurs 6 weeks to 6 months fromOccurs 6 weeks to 6 months from exposure .exposure . - Characterized by fever, malaise,Characterized by fever, malaise, Generalizes.Generalizes. www.doctor.sdwww.doctor.sd
  3. 3. skin rash involving the palms and soles,skin rash involving the palms and soles, mucosal ulceration (snail track), moist wartmucosal ulceration (snail track), moist wart in the genital and anal area calledin the genital and anal area called condylomata lata and generalizedcondylomata lata and generalized lymphadenopathylymphadenopathy  Tertiary syphilis:-Tertiary syphilis:- - May affect the nervous or cardio vascular- May affect the nervous or cardio vascular system with progressive destructivesystem with progressive destructive lesions or gumata.lesions or gumata. Diagnosis:-Diagnosis:- - Is by dark examination under microscopy- Is by dark examination under microscopy to see the spirochaetes in exudate takento see the spirochaetes in exudate taken from the chancre or by serological testsfrom the chancre or by serological testswww.doctor.sdwww.doctor.sd
  4. 4.  Which are positive two weeks afterWhich are positive two weeks after infection.infection.  the VDRL measures antibodies tothe VDRL measures antibodies to treponemal cardiolipin and it is non specifictreponemal cardiolipin and it is non specific to syphilis.to syphilis.  The definitive diagnosis is by fluorescentThe definitive diagnosis is by fluorescent treponemal antibody absorption test (FTA-treponemal antibody absorption test (FTA- ABS) and the treponema pallidumABS) and the treponema pallidum immoblization test (TPI).immoblization test (TPI). Treatment:-Treatment:-  Is with procaine penicillin 600.000 unit I.MIs with procaine penicillin 600.000 unit I.M daily for (10) days.daily for (10) days. www.doctor.sdwww.doctor.sd
  5. 5. www.doctor.sdwww.doctor.sd
  6. 6.  Benzathin penicillin 2.4 million unit I.M.Benzathin penicillin 2.4 million unit I.M.  Erythromycin, Cephalosporin andErythromycin, Cephalosporin and Tetracycline are an alternative.Tetracycline are an alternative. 2-2- Gonorrhoea:-Gonorrhoea:- - Is caused by the intracellular gram-Is caused by the intracellular gram- negative diplococcus neisserianegative diplococcus neisseria gonorrhoeae.gonorrhoeae. - It is a world wide problem.It is a world wide problem. - It is highly infective, primarly affect, theIt is highly infective, primarly affect, the urethra endocervix, bartholin gland andurethra endocervix, bartholin gland and rectum and commonly ascends to producerectum and commonly ascends to produce acute pelvic inflammatory disease it mayacute pelvic inflammatory disease it may also cause monarticular arthritis andalso cause monarticular arthritis andwww.doctor.sdwww.doctor.sd
  7. 7. Aphthalmia neonatorum.Aphthalmia neonatorum.  In the female symptoms are often mild orIn the female symptoms are often mild or absent the classical history is urethritis andabsent the classical history is urethritis and vaginal discharge.vaginal discharge.  The incubation period is about two weeksThe incubation period is about two weeks  Diagnosis:-Diagnosis:- - Is by culture of urethral, endocervical and- Is by culture of urethral, endocervical and rectal swabs transported in Stuart'srectal swabs transported in Stuart's enriched medium and incubated in aenriched medium and incubated in a carbon dioxide rich environment.carbon dioxide rich environment. www.doctor.sdwww.doctor.sd
  8. 8.  Treatment:-Treatment:- - The majority of strains are sensitive toThe majority of strains are sensitive to Penicillin –resistant strains respond toPenicillin –resistant strains respond to Cephalosprins and Gentamicin.Cephalosprins and Gentamicin. 3) Chamydia:-3) Chamydia:-  Chlamydia trachomatis is an obligateChlamydia trachomatis is an obligate intracellular organism containing both DNAintracellular organism containing both DNA and RNA and therefore havingand RNA and therefore having characteristic of both bacteria and viruses.characteristic of both bacteria and viruses.  Urogenital infection is caused by subtypesUrogenital infection is caused by subtypes L1,L2, L3.L1,L2, L3.  Infection cause little in the way of symptomsInfection cause little in the way of symptoms www.doctor.sdwww.doctor.sd
  9. 9. Discharge from vagina and cervix, mild pelvicDischarge from vagina and cervix, mild pelvic discomfort or dysuria.discomfort or dysuria.  Infection include trachoma, conjunctivitis,Infection include trachoma, conjunctivitis, non gonococcal urethritis, non specificnon gonococcal urethritis, non specific cervicitis granuloma venereum and probablycervicitis granuloma venereum and probably PIDPID  Diagnosis:-Diagnosis:- - Chalamydia detection in the laporatory hasChalamydia detection in the laporatory has been notoriously difficult.been notoriously difficult. - Tissue culture demonstrate, the intracellularTissue culture demonstrate, the intracellular organism which is the most reliable methodorganism which is the most reliable method www.doctor.sdwww.doctor.sd
  10. 10. - Giemsa stain for urethral, cervical or other- Giemsa stain for urethral, cervical or other discharge shows multinucleated cells withdischarge shows multinucleated cells with intracytoplasmic inclusion bodies.intracytoplasmic inclusion bodies. - Antichamydial antibodies can be detected by- Antichamydial antibodies can be detected by the enzyme linked immunosorbent assaythe enzyme linked immunosorbent assay (ELISA).(ELISA). Treatment :-Treatment :- -drug of choice is Doxycycline alternative are-drug of choice is Doxycycline alternative are Tetracycline or Erythromycin 500mg 1x4x14Tetracycline or Erythromycin 500mg 1x4x14 daysdays www.doctor.sdwww.doctor.sd
  11. 11. www.doctor.sdwww.doctor.sd
  12. 12. (4)(4) Lymphogranuloma venerum:-Lymphogranuloma venerum:- - Caused by chlamydia trachomatis sub typeCaused by chlamydia trachomatis sub type L1,L2,L3 .L1,L2,L3 . - Incubation period is about 7 to 14 days.Incubation period is about 7 to 14 days. - The infection starts with small vulval papuleThe infection starts with small vulval papule which breaks down to form painless ulcer.which breaks down to form painless ulcer. - The infection spread by lymphatics toThe infection spread by lymphatics to involve the whole vulva and perineal area,involve the whole vulva and perineal area, the inguinal glands are enlarged and maythe inguinal glands are enlarged and may form abscesses. There is much sepsisform abscesses. There is much sepsis leading to scarring and fibrosis, someleading to scarring and fibrosis, some times.times. www.doctor.sdwww.doctor.sd
  13. 13.  Fistula and lymphatic blockage leads toFistula and lymphatic blockage leads to elephantiasis of the vulva.elephantiasis of the vulva.  Diagnosis:-Diagnosis:- - Like chlomydia- Like chlomydia  Treatment :-Treatment :- - Tetracycline or Erythromycin 500 mgTetracycline or Erythromycin 500 mg 1x4x21 days.1x4x21 days. 5)Genital Herpes:-5)Genital Herpes:- - The DNA virus herpes simplex has twoThe DNA virus herpes simplex has two main subtypes 1 and 2 both of which maymain subtypes 1 and 2 both of which may infect the genital tract the majority of casesinfect the genital tract the majority of cases being HSV2being HSV2 www.doctor.sdwww.doctor.sd
  14. 14.  The primary attack causes tingling andThe primary attack causes tingling and burning sensations in the infected areaburning sensations in the infected area followed by the appearance of smallfollowed by the appearance of small vesicles on the cervix, vagina orvesicles on the cervix, vagina or surrounding skin, which break down intosurrounding skin, which break down into multiple small painful ulcers which slowlymultiple small painful ulcers which slowly resolves (10 days) and the virus migratesresolves (10 days) and the virus migrates via sensory nerve to the sacral gangliavia sensory nerve to the sacral ganglia where it remains quiescent until reactivationwhere it remains quiescent until reactivation occur. Inguinal and sometimes femoraloccur. Inguinal and sometimes femoral lymph nodes are enlarged and tenderlymph nodes are enlarged and tender  Recurrent attacks are generally milderRecurrent attacks are generally milder  Complications are rare and includeComplications are rare and include www.doctor.sdwww.doctor.sd
  15. 15. Meningitis proctitis and pharyngitis .Meningitis proctitis and pharyngitis .  Diagnosis:-Diagnosis:- - Usually clinical aided by isolation of virus in- Usually clinical aided by isolation of virus in tissue culture.tissue culture.  Treatment :-Treatment :- i with acycloviri with acyclovir o One tablet 200mg “5” times daily for(5)One tablet 200mg “5” times daily for(5) days.days. o Local cream in mild and recurrent infection.Local cream in mild and recurrent infection. o 5 mg/kg body weigh “8” hourly for 5days5 mg/kg body weigh “8” hourly for 5days intravenously in severe infection.intravenously in severe infection. www.doctor.sdwww.doctor.sd
  16. 16. 6)6) Genital warts (condylomataGenital warts (condylomata Acuminata):-Acuminata):- - Are cause by a small DNA virus, the humanAre cause by a small DNA virus, the human papilloma virus of which there are manypapilloma virus of which there are many subtypes. Type 6.11 and 18 are commonlysubtypes. Type 6.11 and 18 are commonly associated with genital warts.associated with genital warts. - The condylomata may be exophytic softThe condylomata may be exophytic soft fleshy projection usually present in clustersfleshy projection usually present in clusters and rarely single or endophytic or flat.and rarely single or endophytic or flat. - Warts may regress spontaneously or mayWarts may regress spontaneously or may enlarge significantly commonly inenlarge significantly commonly in pregnancy.pregnancy. www.doctor.sdwww.doctor.sd
  17. 17. - there is association between warts andthere is association between warts and  Cervical and vulval cancer.Cervical and vulval cancer. Diagnosis:-Diagnosis:- - Is by clinical grounds or by histological- Is by clinical grounds or by histological examination of biopsy.examination of biopsy.  Treatment:-Treatment:- - Is by podophyllin a local cytotoxic agent- Is by podophyllin a local cytotoxic agent which can be applied to the affected areawhich can be applied to the affected area “contraindicated in pregnancy ”or by local“contraindicated in pregnancy ”or by local ablation with laser, cryocautary orablation with laser, cryocautary or diathermy.diathermy. ** www.doctor.sdwww.doctor.sd
  18. 18.  www.doctor.sdwww.doctor.sd
  19. 19. 7)Granuloma venrum:-7)Granuloma venrum:- caused by gram negative bacilli whichcaused by gram negative bacilli which .. www.doctor.sdwww.doctor.sd
  20. 20. appears as intracellular bodies calledappears as intracellular bodies called Donovan bodies.Donovan bodies. • The lesion starts as a red papule whichThe lesion starts as a red papule which develop into a beefy red ulcerated mass ofdevelop into a beefy red ulcerated mass of granulation tissue- inguinal glands enlargegranulation tissue- inguinal glands enlarge but donot suppurate .but donot suppurate .  Diagnosis :-Diagnosis :- • By showing Donovan bodies in sampleBy showing Donovan bodies in sample taken from the edge of the ulcer.taken from the edge of the ulcer.  Treatment:-Treatment:- • Tetracycline or Erythromyin 500mg”6”Tetracycline or Erythromyin 500mg”6” hourly for 21 dayshourly for 21 days www.doctor.sdwww.doctor.sd
  21. 21. 8)8) Chancroid (soft sore):-Chancroid (soft sore):- • A genital ulcer accompanied byA genital ulcer accompanied by suppurative lymphadenopathy.suppurative lymphadenopathy. • Incubation period 2-7 days.Incubation period 2-7 days. • The ulcers are usually multiple and painful.The ulcers are usually multiple and painful. • The causative organism is a gram-The causative organism is a gram- negative bacillus haemophililus ducreyi.negative bacillus haemophililus ducreyi. • Diagnosis:-Diagnosis:- • By demonstration of the organism in theBy demonstration of the organism in the discharge obtained from the ulcer or lymphdischarge obtained from the ulcer or lymph node stained by gram stain ornode stained by gram stain or immunoflurosent stain .immunoflurosent stain . www.doctor.sdwww.doctor.sd
  22. 22.  Treatment:-Treatment:- - Sulfamethoxazole 1 mg “4” times daily forSulfamethoxazole 1 mg “4” times daily for 21 days.21 days. 9) Trichomonas vaginitis:-9) Trichomonas vaginitis:- • Flagellate protozoan with flour anteriorFlagellate protozoan with flour anterior flagella, undulating membrane and a longflagella, undulating membrane and a long tail. It is ovoid or pear shape slightly largertail. It is ovoid or pear shape slightly larger than a leucocyte.than a leucocyte. • Causes 1/3 of all cases of vulvo. Vaginitis.Causes 1/3 of all cases of vulvo. Vaginitis. • The main presentation is vaginal discharge,The main presentation is vaginal discharge, pain and soreness of the vulva and itchingpain and soreness of the vulva and itchingwww.doctor.sdwww.doctor.sd
  23. 23.  The discharge is classically profuse,The discharge is classically profuse, greenish, frothy malodorous (fishy).greenish, frothy malodorous (fishy).  The vaginal wall may shows smallThe vaginal wall may shows small strawberry spots.strawberry spots.  The presence of the organism isThe presence of the organism is conformed by simple microscopy 1 drop ofconformed by simple microscopy 1 drop of Discharge + 1 drop of Saline.Discharge + 1 drop of Saline.  Treatment:-Treatment:- - With metronidazole (200mg three times- With metronidazole (200mg three times daily for “7”day, or a single dose of 2gm)fordaily for “7”day, or a single dose of 2gm)for both partners.both partners. www.doctor.sdwww.doctor.sd
  24. 24. 10) Gardnerella vaginalis:-10) Gardnerella vaginalis:-  Is a gram negative facultative anaerobicIs a gram negative facultative anaerobic bacillus.bacillus.  Cause a frothy, grey, malodorous dischargeCause a frothy, grey, malodorous discharge the odour increase if the smear is treatedthe odour increase if the smear is treated with 10% koh.with 10% koh.  epithelial cells with bacilli attached to theepithelial cells with bacilli attached to the surface (clue cells) are characteristic.surface (clue cells) are characteristic.  Treatment:-Treatment:- - By Metronidazole- By Metronidazole www.doctor.sdwww.doctor.sd
  25. 25. 11) Acquired immuno deficiency syndrome:-11) Acquired immuno deficiency syndrome:-  Caused by human immuno-deficiency virusCaused by human immuno-deficiency virus (HIV) which is a retro virus(HIV) which is a retro virus  Mode of infectionMode of infection - Both homosexual and hetrosexualBoth homosexual and hetrosexual transmissiontransmission - Blood and blood product, transfusionBlood and blood product, transfusion - Vertical transmission from mother to herVertical transmission from mother to her baby in utero or during delivery or duringbaby in utero or during delivery or during lactation (breast milk).lactation (breast milk).  HIV attack the cells which hasHIV attack the cells which has www.doctor.sdwww.doctor.sd
  26. 26. surface specific receptors known as CD4, thesurface specific receptors known as CD4, the chief target cells for this virus are T4 helperchief target cells for this virus are T4 helper lymphocytes. Their depletion leads tolymphocytes. Their depletion leads to profound effect on cellular immunity. Theprofound effect on cellular immunity. The virus also attack macrophage andvirus also attack macrophage and monocytes.monocytes.  The virus makes a DNA copy of the RNAThe virus makes a DNA copy of the RNA genome( proviral ) which integrates in hostgenome( proviral ) which integrates in host cell DNA.cell DNA.  Some patient have symptoms of acuteSome patient have symptoms of acute infection (fever, malaise, myalgia,infection (fever, malaise, myalgia, lymphadenopathy, pharyngitis, rash) otherlymphadenopathy, pharyngitis, rash) other do not.do not. www.doctor.sdwww.doctor.sd
  27. 27.  Chronic infection is largely asymptomatic,Chronic infection is largely asymptomatic, but intermittent constitutional symptomsbut intermittent constitutional symptoms may occur (fever, night sweats, diarrhoea,may occur (fever, night sweats, diarrhoea, weight loss). During this period the patient isweight loss). During this period the patient is infective.infective.  After a latency of 2 to 5 yrs 6-30% of chronicAfter a latency of 2 to 5 yrs 6-30% of chronic HIV infected patient progress to AIDS.HIV infected patient progress to AIDS.  AIDS patient present with:-AIDS patient present with:- - tumours( Kaposi sarcoma, non Hodgkin’stumours( Kaposi sarcoma, non Hodgkin’s lymphoma, mouth and ano rectal squamouslymphoma, mouth and ano rectal squamous carcinoma.carcinoma. - Opportunistic infection with viruses.Opportunistic infection with viruses. www.doctor.sdwww.doctor.sd
  28. 28. bacteria, fungi and protozoa (pneumocystisbacteria, fungi and protozoa (pneumocystis carinii).carinii).  diagnosis :-diagnosis :- - elisa if positive, it should be repeated to- elisa if positive, it should be repeated to decrease the false positive reaction whichdecrease the false positive reaction which is about 4:1.is about 4:1. - Western blot test must be done forWestern blot test must be done for confirmation .confirmation . - the onset of Aids my be delayed and thethe onset of Aids my be delayed and the severity reduced by combination of antiseverity reduced by combination of anti retroviral treatment (zidovudine indinavir)retroviral treatment (zidovudine indinavir) but there is no cure.but there is no cure. www.doctor.sdwww.doctor.sd
  29. 29. - surveillance, health education, screening- surveillance, health education, screening and counseling are important.and counseling are important. www.doctor.sdwww.doctor.sd

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