This document discusses the syndromic approach for managing sexually transmitted infections (STIs) and pelvic inflammatory disease (PID). It begins by defining STIs and outlining their epidemiology in Ethiopia. The three main diagnostic approaches - etiologic, clinical, and syndromic - are then described. The syndromic approach is recommended, as it allows for treatment of all potential causative pathogens based on symptoms. Common STI syndromes like urethral discharge, genital ulcers, and vaginal discharge are explained in detail. Risk factors, signs, treatment approaches, and complications of each syndrome are outlined. Lower abdominal pain/PID syndrome is also reviewed.
Sexually transmitted infections (STIs) are infections spread through sexual contact that are caused by bacteria, viruses, or parasites. Common STIs include chlamydia, gonorrhea, HIV, herpes, syphilis, and HPV. STIs are transmitted through sexual fluids and can be spread through vaginal, anal, or oral sex. While some bacterial STIs can be cured with antibiotics, viral STIs like HIV and herpes have no cure and can be transmitted for life. Using condoms and having mutually monogamous relationships can help prevent the transmission of STIs.
This document discusses sexually transmitted infections (STIs), including their causes, symptoms, and treatments. It focuses on gonorrhea, caused by Neisseria gonorrhoeae. Gonorrhea symptoms vary between males and females and can include discharge and dysuria. Complications include pelvic inflammatory disease and disseminated gonococcal infection. Treatment involves ceftriaxone or other cephalosporins. The document also briefly outlines Chlamydia trachomatis, lymphogranuloma venereum, syphilis, and neurosyphilis.
STD is an abbreviated form of Sexually transmitted diseases. The meaning of STD disease is that the disease is imparted to others through sexual contact. Apart from sexual transmission, sexually transmitted diseases are also transferred to other persons in various ways. These are- breastfeeding, sharing of infected needles, etc. There are many diseases under the class of STD, and these can be cured by maintaining proper sexual health and hygiene. The mass awareness of sexually transmitted diseases is necessary for preventing them. Social media, newspapers and journals, television broadcasting, internet sources, and medical campaigning are the ways through which the transmission, symptoms, prevention, and prospective cure of STDs are conveyed to the common people. Examples of sexually transmitted diseases are- AIDS, gonorrhea, syphilis, etc.
Sexually Transmitted Diseases and Pelvic Inflammatry diseasesgelaye mandefro
This document outlines clinical information on sexually transmitted diseases (STDs). It begins with an introduction to STDs, noting they are commonly spread diseases that are often asymptomatic. It then covers specific STDs like chlamydia, gonorrhea, herpes, HIV/AIDS, and syphilis. The document discusses the clinical manifestations, diagnosis, and treatment of these diseases. It also provides treatment guidelines for common STD syndromes like genital ulcers, urethral discharge, and abnormal vaginal discharge. Throughout, it includes images to illustrate signs and symptoms of STDs.
This document discusses Chlamydia, a common sexually transmitted infection. It defines Chlamydia, describes its history and etiology as the bacterium Chlamydia trachomatis. It outlines the modes of transmission, typical signs and symptoms, potential complications like pelvic inflammatory disease, and methods for diagnosis and treatment, which usually involves antibiotics. The document emphasizes that Chlamydia can often be asymptomatic but still cause health issues, and stresses the importance of safe sex practices and regular testing to help prevent and identify infections.
This document provides an overview of sexually transmitted diseases (STDs), including:
STDs are passed through sexual contact and can also spread through other means like childbirth or blood transfusions. Common pathogens that cause STDs include bacteria, parasites, and viruses. STDs have an array of symptoms and are diagnosed through tests of blood, urine, or fluid samples. While treatment involves antibiotics or antiviral drugs, prevention relies on screening and reducing risk factors like unprotected sex or multiple partners. The document outlines the types of STDs, their effects on both men and women, risk factors, and resources for further information.
Human papillomavirus (HPV) is a sexually transmitted virus that can cause genital warts and various cancers such as cervical cancer. There are over 100 types of HPV viruses, with some high-risk types being HPV-16, HPV-18 and HPV-31 that are linked to cervical cancer. While most HPV infections cause no symptoms and go away, persistent infections of high-risk HPV types can cause cancers like cervical cancer years later with HPV-
Pelvic Inflammatory Disease (PID) is an infection and inflammation of the upper female genital tract involving the fallopian tubes and ovaries. It is usually caused by ascending infection from the cervix or vagina, often due to bacteria like Neisseria gonorrhoeae or Chlamydia trachomatis. Risk factors include multiple sexual partners and IUD use. Symptoms include lower abdominal pain and tenderness. Diagnosis involves clinical examination and testing for sexually transmitted infections. Treatment aims to cover common causative bacteria with antibiotic regimens. Without treatment, PID can cause long-term complications like infertility or ectopic pregnancy.
Sexually transmitted infections (STIs) are infections spread through sexual contact that are caused by bacteria, viruses, or parasites. Common STIs include chlamydia, gonorrhea, HIV, herpes, syphilis, and HPV. STIs are transmitted through sexual fluids and can be spread through vaginal, anal, or oral sex. While some bacterial STIs can be cured with antibiotics, viral STIs like HIV and herpes have no cure and can be transmitted for life. Using condoms and having mutually monogamous relationships can help prevent the transmission of STIs.
This document discusses sexually transmitted infections (STIs), including their causes, symptoms, and treatments. It focuses on gonorrhea, caused by Neisseria gonorrhoeae. Gonorrhea symptoms vary between males and females and can include discharge and dysuria. Complications include pelvic inflammatory disease and disseminated gonococcal infection. Treatment involves ceftriaxone or other cephalosporins. The document also briefly outlines Chlamydia trachomatis, lymphogranuloma venereum, syphilis, and neurosyphilis.
STD is an abbreviated form of Sexually transmitted diseases. The meaning of STD disease is that the disease is imparted to others through sexual contact. Apart from sexual transmission, sexually transmitted diseases are also transferred to other persons in various ways. These are- breastfeeding, sharing of infected needles, etc. There are many diseases under the class of STD, and these can be cured by maintaining proper sexual health and hygiene. The mass awareness of sexually transmitted diseases is necessary for preventing them. Social media, newspapers and journals, television broadcasting, internet sources, and medical campaigning are the ways through which the transmission, symptoms, prevention, and prospective cure of STDs are conveyed to the common people. Examples of sexually transmitted diseases are- AIDS, gonorrhea, syphilis, etc.
Sexually Transmitted Diseases and Pelvic Inflammatry diseasesgelaye mandefro
This document outlines clinical information on sexually transmitted diseases (STDs). It begins with an introduction to STDs, noting they are commonly spread diseases that are often asymptomatic. It then covers specific STDs like chlamydia, gonorrhea, herpes, HIV/AIDS, and syphilis. The document discusses the clinical manifestations, diagnosis, and treatment of these diseases. It also provides treatment guidelines for common STD syndromes like genital ulcers, urethral discharge, and abnormal vaginal discharge. Throughout, it includes images to illustrate signs and symptoms of STDs.
This document discusses Chlamydia, a common sexually transmitted infection. It defines Chlamydia, describes its history and etiology as the bacterium Chlamydia trachomatis. It outlines the modes of transmission, typical signs and symptoms, potential complications like pelvic inflammatory disease, and methods for diagnosis and treatment, which usually involves antibiotics. The document emphasizes that Chlamydia can often be asymptomatic but still cause health issues, and stresses the importance of safe sex practices and regular testing to help prevent and identify infections.
This document provides an overview of sexually transmitted diseases (STDs), including:
STDs are passed through sexual contact and can also spread through other means like childbirth or blood transfusions. Common pathogens that cause STDs include bacteria, parasites, and viruses. STDs have an array of symptoms and are diagnosed through tests of blood, urine, or fluid samples. While treatment involves antibiotics or antiviral drugs, prevention relies on screening and reducing risk factors like unprotected sex or multiple partners. The document outlines the types of STDs, their effects on both men and women, risk factors, and resources for further information.
Human papillomavirus (HPV) is a sexually transmitted virus that can cause genital warts and various cancers such as cervical cancer. There are over 100 types of HPV viruses, with some high-risk types being HPV-16, HPV-18 and HPV-31 that are linked to cervical cancer. While most HPV infections cause no symptoms and go away, persistent infections of high-risk HPV types can cause cancers like cervical cancer years later with HPV-
Pelvic Inflammatory Disease (PID) is an infection and inflammation of the upper female genital tract involving the fallopian tubes and ovaries. It is usually caused by ascending infection from the cervix or vagina, often due to bacteria like Neisseria gonorrhoeae or Chlamydia trachomatis. Risk factors include multiple sexual partners and IUD use. Symptoms include lower abdominal pain and tenderness. Diagnosis involves clinical examination and testing for sexually transmitted infections. Treatment aims to cover common causative bacteria with antibiotic regimens. Without treatment, PID can cause long-term complications like infertility or ectopic pregnancy.
This document discusses several common genital infections including pediculosis pubis, scabies, molluscum contagiosum, condylomata acuminata, vulvar infections, genital ulcers, mycoplasma genitalium, vaginitis, HIV, chancroid, syphilis, gonorrhea, and chlamydia. For each infection, it provides information on causative agent, clinical features, diagnosis, and treatment. The document serves as a reference for medical students to learn about sexually transmitted infections and genital diseases.
Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae, which commonly infects warm, moist areas of the body. Common symptoms in men include discharge from the penis and pain or swelling in the testicles or penis. In women, symptoms often include vaginal discharge and pain or burning with urination. Left untreated, gonorrhea can spread to other parts of the body and potentially cause infertility and pelvic inflammatory disease.
- HPV (human papillomavirus) is the most common sexually transmitted infection that can sometimes cause serious illnesses like genital warts and cervical cancer.
- HPV is transmitted through skin-to-skin contact and condoms do not fully prevent transmission.
- While HPV often clears on its own, persistent infections can cause abnormal cell growth.
- There is an effective vaccine that protects against the HPV types that cause 70% of cervical cancers and 90% of genital warts. The vaccine is recommended before sexual debut.
- Widespread HPV vaccination combined with screening programs has significantly reduced HPV infections and related cancers.
This document discusses infections in pregnancy, including TORCH infections (toxoplasmosis, other [syphilis], rubella, cytomegalovirus, and herpes simplex virus), as well as HIV in pregnancy. It describes how pregnancy predisposes women to certain infections due to immunocompromise. It provides details on screening, diagnosis, treatment and management of various infections that can affect the mother and fetus, including toxoplasmosis, rubella, cytomegalovirus, syphilis, herpes, and HIV. It also discusses pre-pregnancy, antenatal, intrapartum and postpartum care recommendations for HIV-positive women.
This document provides information about common sexually transmitted infections (STIs), including Chlamydia, Gonorrhea, Genital Herpes, HIV/AIDS, Human Papillomavirus, Syphilis, Bacterial Vaginosis, Trichomoniasis, and Viral Hepatitis. It describes the causes, symptoms, and treatment options for each STI. The document emphasizes that STIs can be transmitted through unprotected sexual contact and sharing needles. It also recommends abstinence, vaccination, reducing sexual partners, and condom use as ways to prevent the transmission of STIs.
This document provides an overview of sexually transmitted infections (STIs), including definitions, common STIs caused by viruses and bacteria, and their symptoms and treatment. It discusses STIs like herpes, HPV, HIV/AIDS, gonorrhea, chlamydia, and syphilis. The conclusion emphasizes practicing safer sex, having mutually monogamous relationships, knowing your limits, not drinking/doing drugs before sex, and getting tested regularly if at higher risk.
Cervical cancer develops from precancerous changes to cervical cells that are caused by human papillomavirus infection. The transformation zone of the cervix, where squamous and columnar cells meet, is most susceptible to HPV infection and precancerous changes. Screening methods like the Pap test, HPV testing, visual inspection with acetic acid, and colposcopy are used to detect precancerous cells early through cervical examinations and biopsies. Vaccines against HPV can prevent infection from high-risk HPV types most commonly associated with cervical cancer.
For pregnant women diagnosed with uncomplicated malaria caused by chloroquine-resistant P. vivax infection, prompt treatment with artemether-lumfantrine (second and third trimesters) or mefloquine (all trimesters) is recommended. Doxycycline and tetracycline are generally not indicated for use in pregnant women
The document discusses human papilloma virus (HPV) including the virus itself, associated diseases, transmission, epidemiology, clinical manifestations, carcinogenic properties, vaccination, and treatment options. HPV is a common virus that can cause genital warts and various cancers like cervical cancer. Vaccination provides high efficacy against HPV types known to cause cancer and genital warts. Treatment depends on the manifestation but may include cryotherapy, laser ablation, or topical medications.
Gonorrhoea is a sexually transmitted disease caused by N. gonorrhoeae. Hippocrates referred to acute gonorrhea as “strangury” obtained from the “pleasures of Venus” in the fourth and fifth centuries B.C. (229). It was not until A.D. 130 that Galen, who mistakenly confused the purulent discharge associated with gonococcal urethritis with semen, introduced the term gonorrhea, i. e., “flow of seed” . N gonorrhoeae is the second most commonly occurring reportable sexually transmitted infection after Chlamydia trachomatis.
This document presents a lecture on sexually transmitted infections (STIs) and their syndromic management approach. It defines STIs and discusses their epidemiology in Ethiopia. Three diagnostic approaches - etiological, clinical and syndromic - are described, with the syndromic approach being most commonly used due to its low cost and simplicity. Common STI syndromes like urethral discharge, genital ulcers and vaginal discharge are outlined, detailing their causes, signs/symptoms, complications, and treatment guidelines. The interaction between STIs and HIV is also reviewed, emphasizing how STIs enhance HIV transmission and affect clinical presentation during co-infection.
Sexually transmitted infections in pregnancymamta rai
This document discusses sexually transmitted infections that can occur during pregnancy. It provides information on how pregnancy can alter the anatomy and microbiome of the genital tract, increasing susceptibility to certain STIs. It then examines several specific infections in detail, including syphilis, gonorrhea, chlamydia, herpes, HPV, and hepatitis B. For each STI, it discusses prevalence in pregnancy, effects on the mother and fetus/newborn, screening and diagnosis guidelines, and recommended treatment approaches.
This document discusses features of pregnancy and childbirth management in women with extragenital pathology. It notes that only 20% of pregnancies proceed without complications, while 30-40% involve extragenital pathology (EGP) such as cardiovascular, kidney, or blood diseases. Pregnancy termination risks are 12% and can affect fetal development. The most common EGP in women ages 21-29 is cardiovascular disease, observed in 7% of cases. Management of pregnancy involves frequent hospitalizations and selecting delivery methods based on the severity of the woman's condition.
This document discusses cervicitis, an inflammation of the cervix. It notes that cervicitis is commonly caused by certain sexually transmitted infections like Chlamydia trachomatis and Neisseria gonorrhoeae. The document outlines the symptoms, signs, diagnosis, and treatment recommendations for cervicitis. It provides treatment guidelines for common causes like chlamydia, gonorrhea, trichomoniasis, and bacterial vaginosis. The document emphasizes the importance of treating sex partners to prevent reinfection.
This document provides information on Pelvic Inflammatory Disease (PID), including its definition, epidemiology, microbiology, pathogenesis, clinical presentation, diagnosis, differential diagnosis, staging, and management. PID is an inflammatory condition of the female upper genital tract that is usually caused by sexually transmitted pathogens like Neisseria gonorrhoeae and Chlamydia trachomatis. It is commonly associated with sexually transmitted infections and can lead to long-term complications if not properly treated. Diagnosis is based on clinical criteria established by the CDC and may involve imaging and laboratory tests. Treatment involves antibiotics according to CDC guidelines.
The document discusses human papillomavirus (HPV) and its role in cervical cancer. It provides a history of HPV research and establishes a causal link between high-risk HPV types and cervical cancer through large epidemiological studies. The document also examines HPV genome structure and how the E6 and E7 oncoproteins interact with host cell proteins to promote oncogenesis and immortalization, ultimately leading to cervical cancer if a persistent infection occurs.
Benign lesions of the cervix, vagina and vulvaNick Harvey
The document discusses benign lesions that can occur on the cervix, vagina, and vulva, describing common conditions such as cervical polyps, Nabothian follicles, vaginitis, vulvar cysts and infections. It provides details on the presentation, causes, diagnosis, and treatment of these various lesions. A wide range of benign gynecological conditions are examined to help clinicians properly identify and manage non-cancerous abnormalities in these areas.
1. Candida albicans causes the majority of fungal infections, accounting for 80-90% of cases, while Candida glabrata is the second most common cause, accounting for 5-15% of cases.
2. The prevalence of non-albicans Candida species, particularly C. glabrata and C. tropicalis, has been increasing in recent years, especially in recurrent cases. These species are more resistant to antifungal treatments.
3. Treatment for uncomplicated Candida vaginitis typically involves topical or short-course oral antifungal azole therapy for 1-7 days. More severe or recurrent cases may require longer treatment courses or maintenance therapy.
This document provides guidelines for urinary tract infections (UTIs) during pregnancy. It discusses that UTIs are the most common medical complications of pregnancy and are associated with risks like preterm delivery. It outlines recommendations for screening, diagnosing, and treating asymptomatic bacteriuria, acute cystitis, and acute pyelonephritis during pregnancy. Treatment is recommended for asymptomatic bacteriuria to reduce risks, and symptomatic UTIs should be promptly treated with appropriate antibiotics based on culture and sensitivity testing. Post-treatment cultures are advised to confirm resolution of infections.
This document discusses sexually transmitted infections (STIs). It begins by defining STIs as infections that can be transmitted through sexual activity, noting they may be caused by bacteria, viruses, fungi or other organisms. It then provides details on specific STIs like chlamydia, gonorrhea, herpes, HIV/AIDS, and HPV. For each STI, it discusses the causative agent, prevalence, transmission, symptoms, potential complications if left untreated, diagnosis, and treatment. The document aims to educate about common STIs by providing an in-depth overview of infectious agents, transmission, clinical presentation, and management.
Syndromic approaches of sexually transmitted diseasesbrightaman
Hello everyone, you will get all materials associated with syndromic approaches of STI including management algorithm and treatment https://www.slideshare.net/brightaman/syndromic-approaches-of-sexually-transmitted-disease
https:/www.YouTube.com/@Bole tube ቦሌ 9297?sub_confirmation=1
Sexually transmitted infections (STIs) are caused by different microbes transmitted sexually. Over 20 microbes can cause STIs. STIs are a major public health problem worldwide, especially in developing countries with limited diagnostic and treatment facilities. Common STIs include those causing urethral discharge, vaginal discharge, genital ulcers, and lower abdominal pain. STIs are usually managed through etiologic or syndromic approaches depending on availability of diagnostic testing. Treatment involves antibiotics targeting likely causative agents. Partner treatment and health education are important for control of STIs.
This document discusses several common genital infections including pediculosis pubis, scabies, molluscum contagiosum, condylomata acuminata, vulvar infections, genital ulcers, mycoplasma genitalium, vaginitis, HIV, chancroid, syphilis, gonorrhea, and chlamydia. For each infection, it provides information on causative agent, clinical features, diagnosis, and treatment. The document serves as a reference for medical students to learn about sexually transmitted infections and genital diseases.
Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae, which commonly infects warm, moist areas of the body. Common symptoms in men include discharge from the penis and pain or swelling in the testicles or penis. In women, symptoms often include vaginal discharge and pain or burning with urination. Left untreated, gonorrhea can spread to other parts of the body and potentially cause infertility and pelvic inflammatory disease.
- HPV (human papillomavirus) is the most common sexually transmitted infection that can sometimes cause serious illnesses like genital warts and cervical cancer.
- HPV is transmitted through skin-to-skin contact and condoms do not fully prevent transmission.
- While HPV often clears on its own, persistent infections can cause abnormal cell growth.
- There is an effective vaccine that protects against the HPV types that cause 70% of cervical cancers and 90% of genital warts. The vaccine is recommended before sexual debut.
- Widespread HPV vaccination combined with screening programs has significantly reduced HPV infections and related cancers.
This document discusses infections in pregnancy, including TORCH infections (toxoplasmosis, other [syphilis], rubella, cytomegalovirus, and herpes simplex virus), as well as HIV in pregnancy. It describes how pregnancy predisposes women to certain infections due to immunocompromise. It provides details on screening, diagnosis, treatment and management of various infections that can affect the mother and fetus, including toxoplasmosis, rubella, cytomegalovirus, syphilis, herpes, and HIV. It also discusses pre-pregnancy, antenatal, intrapartum and postpartum care recommendations for HIV-positive women.
This document provides information about common sexually transmitted infections (STIs), including Chlamydia, Gonorrhea, Genital Herpes, HIV/AIDS, Human Papillomavirus, Syphilis, Bacterial Vaginosis, Trichomoniasis, and Viral Hepatitis. It describes the causes, symptoms, and treatment options for each STI. The document emphasizes that STIs can be transmitted through unprotected sexual contact and sharing needles. It also recommends abstinence, vaccination, reducing sexual partners, and condom use as ways to prevent the transmission of STIs.
This document provides an overview of sexually transmitted infections (STIs), including definitions, common STIs caused by viruses and bacteria, and their symptoms and treatment. It discusses STIs like herpes, HPV, HIV/AIDS, gonorrhea, chlamydia, and syphilis. The conclusion emphasizes practicing safer sex, having mutually monogamous relationships, knowing your limits, not drinking/doing drugs before sex, and getting tested regularly if at higher risk.
Cervical cancer develops from precancerous changes to cervical cells that are caused by human papillomavirus infection. The transformation zone of the cervix, where squamous and columnar cells meet, is most susceptible to HPV infection and precancerous changes. Screening methods like the Pap test, HPV testing, visual inspection with acetic acid, and colposcopy are used to detect precancerous cells early through cervical examinations and biopsies. Vaccines against HPV can prevent infection from high-risk HPV types most commonly associated with cervical cancer.
For pregnant women diagnosed with uncomplicated malaria caused by chloroquine-resistant P. vivax infection, prompt treatment with artemether-lumfantrine (second and third trimesters) or mefloquine (all trimesters) is recommended. Doxycycline and tetracycline are generally not indicated for use in pregnant women
The document discusses human papilloma virus (HPV) including the virus itself, associated diseases, transmission, epidemiology, clinical manifestations, carcinogenic properties, vaccination, and treatment options. HPV is a common virus that can cause genital warts and various cancers like cervical cancer. Vaccination provides high efficacy against HPV types known to cause cancer and genital warts. Treatment depends on the manifestation but may include cryotherapy, laser ablation, or topical medications.
Gonorrhoea is a sexually transmitted disease caused by N. gonorrhoeae. Hippocrates referred to acute gonorrhea as “strangury” obtained from the “pleasures of Venus” in the fourth and fifth centuries B.C. (229). It was not until A.D. 130 that Galen, who mistakenly confused the purulent discharge associated with gonococcal urethritis with semen, introduced the term gonorrhea, i. e., “flow of seed” . N gonorrhoeae is the second most commonly occurring reportable sexually transmitted infection after Chlamydia trachomatis.
This document presents a lecture on sexually transmitted infections (STIs) and their syndromic management approach. It defines STIs and discusses their epidemiology in Ethiopia. Three diagnostic approaches - etiological, clinical and syndromic - are described, with the syndromic approach being most commonly used due to its low cost and simplicity. Common STI syndromes like urethral discharge, genital ulcers and vaginal discharge are outlined, detailing their causes, signs/symptoms, complications, and treatment guidelines. The interaction between STIs and HIV is also reviewed, emphasizing how STIs enhance HIV transmission and affect clinical presentation during co-infection.
Sexually transmitted infections in pregnancymamta rai
This document discusses sexually transmitted infections that can occur during pregnancy. It provides information on how pregnancy can alter the anatomy and microbiome of the genital tract, increasing susceptibility to certain STIs. It then examines several specific infections in detail, including syphilis, gonorrhea, chlamydia, herpes, HPV, and hepatitis B. For each STI, it discusses prevalence in pregnancy, effects on the mother and fetus/newborn, screening and diagnosis guidelines, and recommended treatment approaches.
This document discusses features of pregnancy and childbirth management in women with extragenital pathology. It notes that only 20% of pregnancies proceed without complications, while 30-40% involve extragenital pathology (EGP) such as cardiovascular, kidney, or blood diseases. Pregnancy termination risks are 12% and can affect fetal development. The most common EGP in women ages 21-29 is cardiovascular disease, observed in 7% of cases. Management of pregnancy involves frequent hospitalizations and selecting delivery methods based on the severity of the woman's condition.
This document discusses cervicitis, an inflammation of the cervix. It notes that cervicitis is commonly caused by certain sexually transmitted infections like Chlamydia trachomatis and Neisseria gonorrhoeae. The document outlines the symptoms, signs, diagnosis, and treatment recommendations for cervicitis. It provides treatment guidelines for common causes like chlamydia, gonorrhea, trichomoniasis, and bacterial vaginosis. The document emphasizes the importance of treating sex partners to prevent reinfection.
This document provides information on Pelvic Inflammatory Disease (PID), including its definition, epidemiology, microbiology, pathogenesis, clinical presentation, diagnosis, differential diagnosis, staging, and management. PID is an inflammatory condition of the female upper genital tract that is usually caused by sexually transmitted pathogens like Neisseria gonorrhoeae and Chlamydia trachomatis. It is commonly associated with sexually transmitted infections and can lead to long-term complications if not properly treated. Diagnosis is based on clinical criteria established by the CDC and may involve imaging and laboratory tests. Treatment involves antibiotics according to CDC guidelines.
The document discusses human papillomavirus (HPV) and its role in cervical cancer. It provides a history of HPV research and establishes a causal link between high-risk HPV types and cervical cancer through large epidemiological studies. The document also examines HPV genome structure and how the E6 and E7 oncoproteins interact with host cell proteins to promote oncogenesis and immortalization, ultimately leading to cervical cancer if a persistent infection occurs.
Benign lesions of the cervix, vagina and vulvaNick Harvey
The document discusses benign lesions that can occur on the cervix, vagina, and vulva, describing common conditions such as cervical polyps, Nabothian follicles, vaginitis, vulvar cysts and infections. It provides details on the presentation, causes, diagnosis, and treatment of these various lesions. A wide range of benign gynecological conditions are examined to help clinicians properly identify and manage non-cancerous abnormalities in these areas.
1. Candida albicans causes the majority of fungal infections, accounting for 80-90% of cases, while Candida glabrata is the second most common cause, accounting for 5-15% of cases.
2. The prevalence of non-albicans Candida species, particularly C. glabrata and C. tropicalis, has been increasing in recent years, especially in recurrent cases. These species are more resistant to antifungal treatments.
3. Treatment for uncomplicated Candida vaginitis typically involves topical or short-course oral antifungal azole therapy for 1-7 days. More severe or recurrent cases may require longer treatment courses or maintenance therapy.
This document provides guidelines for urinary tract infections (UTIs) during pregnancy. It discusses that UTIs are the most common medical complications of pregnancy and are associated with risks like preterm delivery. It outlines recommendations for screening, diagnosing, and treating asymptomatic bacteriuria, acute cystitis, and acute pyelonephritis during pregnancy. Treatment is recommended for asymptomatic bacteriuria to reduce risks, and symptomatic UTIs should be promptly treated with appropriate antibiotics based on culture and sensitivity testing. Post-treatment cultures are advised to confirm resolution of infections.
This document discusses sexually transmitted infections (STIs). It begins by defining STIs as infections that can be transmitted through sexual activity, noting they may be caused by bacteria, viruses, fungi or other organisms. It then provides details on specific STIs like chlamydia, gonorrhea, herpes, HIV/AIDS, and HPV. For each STI, it discusses the causative agent, prevalence, transmission, symptoms, potential complications if left untreated, diagnosis, and treatment. The document aims to educate about common STIs by providing an in-depth overview of infectious agents, transmission, clinical presentation, and management.
Syndromic approaches of sexually transmitted diseasesbrightaman
Hello everyone, you will get all materials associated with syndromic approaches of STI including management algorithm and treatment https://www.slideshare.net/brightaman/syndromic-approaches-of-sexually-transmitted-disease
https:/www.YouTube.com/@Bole tube ቦሌ 9297?sub_confirmation=1
Sexually transmitted infections (STIs) are caused by different microbes transmitted sexually. Over 20 microbes can cause STIs. STIs are a major public health problem worldwide, especially in developing countries with limited diagnostic and treatment facilities. Common STIs include those causing urethral discharge, vaginal discharge, genital ulcers, and lower abdominal pain. STIs are usually managed through etiologic or syndromic approaches depending on availability of diagnostic testing. Treatment involves antibiotics targeting likely causative agents. Partner treatment and health education are important for control of STIs.
This document discusses sexually transmitted infections (STIs) and provides information on commonly encountered STIs, their symptoms, treatments, and links to HIV transmission. It describes how STIs like chlamydia, gonorrhea, and syphilis can increase the risk of HIV transmission by 2 to 9 times. The document outlines syndromic approaches and recommended treatments for various STI syndromes like urethral discharge, vaginal discharge, genital ulcers, lower abdominal pain, scrotal swelling, inguinal bubo, and neonatal conjunctivitis. It emphasizes that STIs and HIV infection often affect the same populations and share similar risk factors.
Trichomoniasis is a common sexually transmitted infection caused by the protozoan Trichomonas vaginalis. It primarily infects the urogenital tract of females and males. Symptoms can range from an acute inflammatory infection with symptoms like abnormal discharge to an asymptomatic infection. Diagnosis is made through nucleic acid amplification tests or visualizing the motile trichomonads on a wet mount sample. Treatment involves oral metronidazole or tinidazole to cure the infection. Prevention focuses on limiting sexual partners, condom use, and treatment of infected individuals to reduce transmission.
This document provides an overview of genitourinary tract infections for a microbiology course. It discusses various genitourinary infections including gonorrhea, chlamydia, human papillomavirus, HIV/AIDS, and trichomoniasis. For each infection, it covers the causative agent, signs and symptoms, risk factors, complications, and treatments. The objectives are for students to learn about defining and classifying genitourinary infections as well as their clinical implications.
Melioidosis is an infectious disease caused by the environmental bacterium Burkholderia pseudomallei, found in soil and water in Southeast Asia and northern Australia. It presents as acute or chronic localized infection or sepsis. Risk factors include diabetes, chronic lung or kidney disease. Diagnosis involves culture of blood, sputum or lesions. Treatment consists of intravenous antibiotics like ceftazidime or meropenem followed by long-term oral co-trimoxazole or co-amoxiclav. Prognosis depends on presence of comorbidities, with mortality over 50% in severe cases without intensive care facilities. Prevention involves avoiding contact with contaminated soil and water.
This document provides an overview of trachoma, including its epidemiology, etiology, pathogenesis, clinical features, classification, diagnosis, and prevention and treatment. Trachoma is caused by Chlamydia trachomatis and is the leading infectious cause of preventable blindness worldwide, primarily affecting poor, rural areas with limited access to clean water and sanitation. The WHO's SAFE strategy of surgery, antibiotics, facial cleanliness, and environmental improvement is the recommended approach to control and eliminate trachoma as a public health problem.
This document discusses pelvic inflammatory disease (PID), including:
1. PID is inflammation of the female reproductive organs that can be caused by several bacteria and results from infection spreading from the vagina or cervix.
2. Risk factors include young age, multiple sexual partners, douching, and IUD use. Symptoms are often mild or absent.
3. Complications of PID include infertility, ectopic pregnancy, chronic pelvic pain, and preterm delivery. Screening and treatment of cervical infections can prevent PID.
This document provides an overview of pelvic inflammatory disease (PID). It defines PID as an inflammatory disorder of the upper female genital tract caused by infectious microorganisms, most commonly sexually transmitted diseases like gonorrhea and chlamydia. Risk factors include prior STDs, younger age of first intercourse, and multiple sexual partners. Symptoms can include lower abdominal pain and abnormal vaginal discharge. Treatment involves antibiotics to treat the underlying infection. Left untreated, PID can lead to long-term complications like infertility, ectopic pregnancy, and chronic pelvic pain. Prevention emphasizes sexual health education and barrier methods to reduce sexually transmitted infections.
This document discusses infections associated with patients in intensive care units (ICUs). It notes that ICU patients are at high risk for infections due to their critical illness and invasive treatments like ventilators and catheters. Nosocomial infections are a major problem in ICUs, with ventilator-associated pneumonia, central line-associated bloodstream infections, and catheter-associated urinary tract infections being most common. The document provides strategies to prevent infections, including strict hand hygiene, prudent antibiotic use, aseptic technique, environmental cleaning, and education. It focuses on preventing central line-associated bloodstream infections through strategies like chlorhexidine skin antisepsis and avoiding unnecessary catheter replacements.
This document discusses sexually transmitted infections and gynaecologic infections. It begins by defining lower genital tract infections and outlining their causes and management. Specific infections discussed include trichomoniasis, candidiasis, gonorrhea, chlamydia, bacterial vaginosis, herpes, HIV, and pelvic inflammatory disease. The document emphasizes the importance of screening, case management using a syndromic approach, and targeted interventions to control sexually transmitted infections.
Genital infections are a common reason for women of all ages to seek medical care. The most frequent infections are vulvovaginal candidiasis and bacterial vaginosis. These infections can be asymptomatic but sometimes lead to serious complications like tubal infection and damage that impact fertility. Proper diagnosis and treatment are important to relieve symptoms and prevent long term issues. A thorough history, exam, and laboratory testing are needed to make an accurate diagnosis before treatment.
This webinar is organized by MyICID and Institute for Clinical Research (ICR), NIH, Ministry of Health in conjunction with Neglected Tropical Disease Day 2022. The purpose of this webinar is to refresh and update our knowledge on Dengue fever, which has been overshadowed by COVID-19 since the beginning of the pandemic.
Presenter: Dr Ong Hang Cheng, Infectious Disease Physician at University Malaya Medical Center
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This document provides guidelines for the treatment of endocervicitis (mucopurulent cervicitis). It describes the signs and symptoms of endocervicitis as well as its typical causative organisms. It recommends presumptive treatment with cefixime and azithromycin or ceftriaxone and doxycycline. It stresses educating and treating patients and partners, promoting condom use, and follow up after one week to ensure compliance and check test results. For recurrent or persistent cervicitis, it recommends reevaluating for possible reexposure or infection and considering alternative treatment courses.
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Sexually transmitted infections
1. DEBRE BIRHAN UNIVERSITY
COLLEGE OF MEDICINE
Syndromic approach for
management of STI
and PID
Presenter - Zelalem Mekonnen
Modulator- Dr. Adissu (Gynecologist & Obstetrician)
February 2013 E.C
2/24/2021
1
2. Objectives
Define Sexually transmitted diseases
Recognize approaches to STI Case Management
Understand the syndromic approach for the
management of different STIs syndromes
2/24/2021
2
3. Sexually transmitted infections
Is diverse group of infections, caused by different types of
microbial agents, that are frequently transmitted by sexual
contact.
Other modes of transmission include: mother-to-child, blood
transfusions, or other contact with blood or fomites
STIs have public health importance because of their
magnitude, potential complications and their interaction
with HIV/AIDS.
2/24/2021
3
4. Epidemiology of STIs
According to 2016 EDHS 4% of women and men
age 15-49 reported having an STI and/or
symptoms of an STI in the past 12 months
Among men, the percentage was 6% in Oromiya,
and 5% in Harari compared to less than 1% in the
Tigray and Benishangul-Gumuz.
2/24/2021
4
5. Interaction of STIs and HIV
STIs enhance the sexual transmission of HIV
through
I. primarily cause ulcers disrupt the integrity of the skin
barrier
II. Cause inflammation (gonorrhea, trichomoniasis, and
chlamydial infections)
III. Increase viral shedding & increase susceptibility to
HIV
2/24/2021
5
6. CONT…
HIV infection affects STIs through
1. HIV alters susceptibility of STI pathogens to
antibiotics
2. Increased susceptibility to STIs among
immune suppressed individuals
3. The clinical features of various types of STIs
are influenced when there is co-infection
with HIV.
2/24/2021
6
7. Approaches to STI Case
Management
Three diagnostic approaches:
Etiologic approach.
Clinical approach
Syndromic approach
2/24/2021
7
8. 1. Etiologic approach
Identifying the causative agent using laboratory tests
& giving treatment targeting to the pathogen identified.
2. Clinical approach
Uses clinical experience to identify symptoms which
are typical for a specific STI, then giving treatment
targeted, to the suspected pathogen
3. Syndromic approach
Identification of clinical syndrome and giving
treatment targeting all the locally known pathogens
which can cause the syndrome
2/24/2021
8
9. Etiologic approach
Advantages
Accurate diagnosis, accurate
treatment,
Proper use of antibiotics
Decreases over treatment and
antibiotic resistance).
Better way to diagnose and treat
asymptomatic infections
Disadvantages
Needs lab support and
expertise
Expensive and it is time
consuming
2/24/2021
9
10. Clinical approach
Advantages
Saves time for
patients
Reduces lab
expenses
Disadvantages
Requires high clinical skill
Mixed infections often
overlooked
Doesn’t identify
asymptomatic STIs
2/24/2021
10
11. Syndromic approach
Advantages
Complete STI care
offered at first visit
Simple, rapid and
inexpensive
Patients treated for
possible mixed infections
Accessible to a broad
range of health workers
Disadvantages
Over treatment with
antibiotics,
There is risk of creating
antibiotic resistance
Decreased compliance
There is also increased
cost of drugs.
Moreover asymptomatic
infection missed.
2/24/2021
11
12. Cont..
Health care providers should undertake the
following measures besides treating individual
patients
i. Partner notification and management
ii. Condom promotion and supply
iii. Health education and risk reduction counseling
iv. Linkage with HIV counseling and testing
v. Follow-up visits for patients with STI
2/24/2021
12
14. 1. Urethral discharge syndrome
is the presence of abnormal secretions from the distal
part of the urethra
it is the characteristic manifestation of urethritis
urethral discharge is accompanied by burning
sensations (dysuria) during micturition.
Person with urethral discharge can also have increased
frequency and urgency of urination and itching
sensation of urethra.
The appearance of the discharge can be purulent or
mucoid, clear, white, or yellowish-green
2/24/2021
14
15. Etiology
Neisseria gonorrhea (81%)
Chlamydia trachomatis (36.8%).
other causative micro-organisms are mycoplasma
genitalium,Trichomonas vaginalis, and
Ureaplasma urealyticum.
Most of the time urethral discharge is due to
mixed infection of Neisseria gonorrhea and
Chlamydia trachomatis
2/24/2021
15
16. Clinical manifestations
N. gonorrhea has usually an acute onset with profuse and
purulent discharge
C. trachomatis has sub-acute onset with scant
mucopurulent discharge.
Common signs and symptoms are burning sensation during
micturition, urgency and frequency of urination with itching
sensation of the urethra.
2/24/2021
16
17. The signs and symptoms of complications of the
syndrome are testicular pain and swelling, arthritis,
polyarthralgia, tenosynovitis, skin lesions and
constitutional symptoms.
2/24/2021
17
18. CONT..
Acute complications
i. Disseminated gonococci syndrome
ii. Perihepatitis
iii. Acute epididymo-orchitis
Chronic complications
1. Urethral stricture
2. Infertility
3. Reiter’s syndrome (arthritis, conjunctivitis, and
nonspecific urethritis)
2/24/2021
18
19. TREATMENT
Ceftriaxone 250mg IM stat/ Spectinomycin 2 gm IM
stat
Plus
Azithromycin 1gm po stat/Doxycycline 100 mg po Bid
for 7 days/Tetracycline 500 mg po Qid for 7
days/Erythromycin 500 mg po Qid for 7 days in cases of
contraindications for Tetracycline (children and
pregnancy)
The preferred regimen is Ceftriaxone 250mg IM stat
plus Azithromycin 1gm po stat
2/24/2021
19
20. 2. Genital ulcer syndrome
is an open sore or a break in the continuity of the
skin or mucous membrane of the genitalia
ETIOLOGY
Herpes simplex virus, (HSV-1 and HSV-2)
Treponema pallidum
Haemophilius ducreyia
Chlamydia trachomatis
Klebsiella granulomatis (donovanosis)
2/24/2021
20
22. Common sites in male are glance penis, prepuce and
penile shaft
In women are vulva, perineum, vagina and cervix and can
cause occasionally severe vulvo- vaginitis and necrotizing
cervicitis
2/24/2021
22
23. complications of genital ulcer syndrome
Granulomatous lesions (Gummas) on the skin,
liver, bones, or other organs
Tabes dorsalis and dementia, often with paranoid
features
Aortic aneurysm and aortic valve insufficiency
Phimosis in men
Destruction of the penis or auto amputation
2/24/2021
23
24. TREATMENT
1. Treatment for Non- Vesicular Genital Ulcer
Benzathine penicillin 2.4 million units IM stat /Doxycycline(in penicillin allergy) 100mg
bid for 14 days plus
Ciprofloxacin 500mg bid orally for 3 days /Erythromycin 500mg tab qid for 7 days
plus
Acyclovir 400mg Tid orally for 10 days (or 200mg five times per day of 10 day)
2. Treatment for Vesicular, multiple or recurrent genital ulcer
Acyclovir 200 mg five times per day for 10 days
Or
Acyclovir 400 mg tid for 7 days
3. Treatment for recurrent infection: Acyclovir 400 mg tid for 7 days
2/24/2021
24
25. 3. Vaginal discharge syndrome
Normal vaginal discharge is white mucoid, odor
less &nonirritant, thin or thick based on menstrual
cycle.
Abnormal in color, odor and amount accompanied
by pruritus- pathological
2/24/2021
25
26. Etiology
The most common causes of vaginal discharge syndrome are
Neisseria gonorrhea
Chlamydia trachomatis
Candida albicans
Trichomonas vaginalis
Gardnerella vaginalis
Bacterial vaginosis (Gardnerella vaginalis) is the leading
cause of vaginal discharge in Ethiopia followed by
candidiasis, trichomoniasis, gonococcal and chlamydia
cervicitis
2/24/2021
26
27. CLINICAL MANIFESTATIONS
Thin, homogenous whitish discharge with fishy
odor
Thick, profuse, malodorous, yellow-green, frothy
itchy
Purulent exudate from the cervical Os
White , thick and curd like discharge coating the
walls of the vagina
Vulvo-vaginal pruritus, irritation of vulva,
dyspareunia, dysuria, and frequency of urination.
2/24/2021
27
28. Physical examination
Dry congestion of the vulva with discharge.
Signs of cervicitis during speculum examination
which are redness and contact bleeding from the
cervix, spotting and endo cervical discharge
2/24/2021
28
29. COMPLICATIONS
Pelvic Inflammatory Disease (PID)
Peritonitis and intra-abdominal abscess
Adhesions and intestinal obstruction
Ectopic pregnancy
Premature Rupture of Membrane (PROM)
2/24/2021
29
31. CONT..
Common risk factors for development of vaginal
discharge syndrome secondary to cervicitis:
The presences of one or more risk factor suggest
cervicitis
• Multiple sexual partners in the last 3 month
• New sexual partner in the last 3 month
• Ever traded sex
• Age below 25 years
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32. Risk Assessment Positive Risk Assessment Negative
Ceftriaxone 250mg IM stat/ Spectinomycin
2gm IM stat
Plus
Azithromycin 1gm po stat/Doxycycline 100 mg
po Bid for 7 days
Plus
Metronidazole 500 mg Bid for 7 days
If discharge is white or curd-like add
Clotrimazole vaginal pessary 200 mg at bed
time for 3 days
Note: The preferred regimen is Ceftriaxone
250mg IM stat plus Azithromycin 1gm po stat
plus Metronidazole 500 mg bid for 7 days.
Metronidazole 500 mg bid for 7
days
If discharge is white or curd-like
add Clotrimazole vaginal pessary
200 mg at bed time for 3 days
2/24/2021
32
33. 4. Lower abdominal pain/ (PID)
Clinical syndrome resulting from ascending infection
from the cervix and/or vagina.
Inflammatory disorders of the upper female genital
tract, including endometritis, salpingitis, tubo-ovarian
abscess and pelvic peritonitis.
The inflammation may also spread to the liver, spleen
or appendix.
2/24/2021
33
34. CONT..
The vast majority of PID with or without pelvic
abscess improves with antibiotics alone and the fever
usually subsides in less than 72 hours.
Failure to improve within 72 hours after antibiotic
treatment indicates failure of medical treatment and the
patient should be referred for surgical evaluation and
treatment.
2/24/2021
34
35. ETIOLOGY
PID is frequently poly-microbial.
The commonest pathogens associated with PID, which are
transmitted sexually, are C. trachomatis & N. gonorrhea.
Other causes which may or may not be transmitted sexually
include:
Mycoplasma genitalium
E. coli
H. influenza
Streptococcus
2/24/2021
35
36. Risk factors
AGE
Adolescent girls are at significant risk for development of
acute salpingitis
The incidence of acute PID decreases with advancing age.
Due to greater endocervical exposure in the
ectocervix of adolescents
2/24/2021
36
37. IUCD
Multiple case-controlled studies have shown an
increased risk of acute PID in women who used an
IUD.
It has been estimated that IUCD users have a
threefold to fivefold increased risk for
development of acute PID
2/24/2021
37
38. Surgical procedures of the female genital
tract
About 15% of pelvic infections occur after
procedures that break the cervical mucous barrier.
UGTI associated with first-trimester
abortions is about 1 in 200 cases
2/24/2021
38
39. Previous acute PID
Due to the sexual habits of the woman involved,
such as reinfection from an untreated male partner
or genital tract damage from the initial infection.
may be the loss of natural protective mechanisms
of the fallopian tube lining against
microorganisms.
2/24/2021
39
40. Frequent sexual activity,
early onset of sexual activity,
multiple sex partners, and a
recent new sex partner are associated with risk for
developing PID.
2/24/2021
40
41. PID protective factors
OCP
Mechanism of protection- probably due to:
cervical mucus thickening
short menstrual flow period- shorter interval for
bacterial invasion
ovulation inhibition no nidus for abscess
formation on ovary
Barrier contraceptives ( mechanical and
chemical)- 60% decrease with consistent use
2/24/2021
41
42. Hegar criteria for the Diagnosis
if one major plus two minor or
Two major criteria.
Major criteria
1. Cervical motion tenderness
2. Uterine tenderness
3.Adnexal tenderness.
2/24/2021
42
43. Minor criteria
One or more of minor criteria can be used to
diagnosis of PID:
• oral temperature >101°F (>38.3°C);
• abnormal cervical mucopurulent discharge
• presence of abundant numbers of WBC on saline
microscopy of vaginal fluid;
• elevated erythrocyte sedimentation rate;
• elevated C-reactive protein; and
• laboratory documentation of cervical infection
with N. gonorrhoeae or C. trachomatis.
2/24/2021
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47. Fitz-Hugh-Curtis syndrome
Perihepatic inflammation and adhesions, develop in 1% -
10%
RUQ pain,pleuritic pain,& RUQ tenderness.
Mistakenly diagnosed as either acute cholecystitis or
pneumonia
Due to vascular or transperitoneal dissemination of either N.
gonorrhoeae or C. trachomatis to produce the perihepatic
inflammation.
2/24/2021
47
48. For outpatient For inpatient
Ceftriaxone 250 mg IM stat
/Spectinomycin 2gm i.m stat
Plus
Azithromycin 1gmpo stat/Doxycycline
100 mg po b.i.d for 14 days
Plus
Metronidazole 500 mg po b.i.d for 14
days
Admit if there is no improvement
within 72 hours
Note : The preferred regimen is
Ceftriaxone 250mg IM stat plus
Azithromycin 1gm po stat plus
Metronidazole 500 mg bid for 14 days
Ceftriaxone 250 mg i.m/i.v
/Spectinomycin 2 gm i.m bid
Plus
Azithromycin 1gm po daily
/Doxycycline 100 mg po b.i.d for 14
days
Plus
Metronidazole 500 mg po b.i.d for
14 days
2/24/2021
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49. Hospitalization of patients with acute PID
should be seriously considered when:
surgical emergencies such as appendicitis
and ectopic pregnancy cannot be exclude
pelvic abscess is suspected
severe illness precludes management on an
outpatient basis
CONT..
2/24/2021
49
50. CONT..
The patient is pregnant
The patient is unable to follow or tolerate an
outpatient regimen
Patient has failed to respond to outpatient therapy.
PID in HIV patients
2/24/2021
50
52. Tubo-ovarian Abscess
Tubo-ovarian abscess (a mass consisting primarily of an
abscess cavity within an anatomically defined structure
such as the ovary), pyosalpinx
TOA is diagnosed when a patient with PID has a pelvic
mass that is palpable during bimanual examination.
About 75% of women with tubo-ovarian abscess respond to
antimicrobial therapy alone
Failure of medical therapy suggests the need for drainage of
the abscess
2/24/2021
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53. Evaluation
Laparoscopy
limited as a method of diagnosing the early stages of
PID,
It is important to R/O non-PID surgical emergencies,
such as appendicitis, endometriosis
Laparoscopy strongly indicated for patients who are not
responding to therapy to
confirm the diagnosis,
obtain cultures from the cul-de-sac or
fallopian tubes, and drain pus if necessary
2/24/2021
53
54. Ultrasonography
Ultrasound is helpful in distinguishing an adnexal
mass, especially in patients who demonstrate a
lack of response to antimicrobial therapy in the
initial 48 to 72 hours of therapy.
2/24/2021
54
55. 5. Scrotal swelling syndrome
Caused by trauma, tumor, and torsion of the testis or
inflammation of the epididymis.
Mostly the inflammation of the epididymis is caused
by STD.
Among patients who are younger than 35 years, the
swelling is likely to be caused by sexually transmitted
infection.
2/24/2021
55
56. ETIOLOGY SCROTAL SWELLING
SYNDROME
Infectious scrotal swelling caused by:
N. gonorrhea
C. trachomatis
T. pallidum
Mumps virus
Filarial disease
Non-infectious cause
Testicular torsion,
trauma,
Incarcerated inguinal hernia
2/24/2021
56
57. CLINICAL MANIFESTATIONS
OF SCROTAL SWELLING
Pain and swelling of the scrotum
Tender and hot scrotum on palpation
Edema and erythema of the scrotum
Dysuria
frequency and urethral discharge
2/24/2021
57
58. COMPLICATIONS OF SCROTAL
SWELLING SYNDROME
• Destruction and scarring of testicular tissues
• Infertility
• Impotence
• Prostatitis
2/24/2021
58
60. 6. Inguinal bubo syndrome
(Swollen glands)
Is swelling of inguinal lymph nodes as a result of
STIs
ETIOLOGY
Chlamydia trachomatis (L1, L2 and L3)
Treponema pallidum
Haemophilius ducreyi
Klebsiella granulomatis (donovanosis)
2/24/2021
60
61. CLINICAL MANIFESTATIONS
Constitutional symptoms of fever, headache
Tender unilateral or bilateral lymphadenopathy
forms a classical “groove sign” in the inguinal area
Fluctuant abscess formation which form coalesce
mass (bubo)
2/24/2021
61
63. COMPLICATIONS
Fistula or sinus formation
Multiple draining sinus
Extensive ulceration of genitalia
Extensive scarring
Chronic untreated LGV may result in
lymphatic obstruction, elephantiasis of the
genitalia.
Note: surgical incisions are contraindicated; instead
aspirate pus with needle through the health skin.
2/24/2021
63
65. 7. NEONATAL CONJUNCTIVITIS
Ocular redness, swelling and drainage which may be
purulent due to pathogenic agents or irritant chemicals in
infants less than 4 weeks of age.
Common etiologic causes of neonatal conjunctivitis are:
N. gonorrhea
C. trachomatis
S. pneumoniae
H. influenzae
S. aureus
2/24/2021
65
66. COMMON RISK FACTORS OF NEONATAL
CONJUNCTIVITIS
I. Maternal infection with STI
II. Exposure of the infant to infectious organisms
III. Inadequacy of ocular prophylaxis immediately after birth
IV. Premature rupture of membrane
V. Ocular trauma during delivery
VI. Prematurity
2/24/2021
66
67. CLINICAL MANIFESTATIONS
Red and edematous conjunctiva
Edematous eye lead
Discharge which may be purulent
Orbital cellulitis in more serious cases
2/24/2021
67
69. PREVENTION OF NEONATAL CONJUNCTIVITIS
1. Wiping the baby’s both eyes with dry and clean
cotton cloth as soon as the baby is born.
2. Apply 1% tetracycline eye ointment into the eyes
of the newborn infant.
3. Properly open the eye of the infant and place the
ointment on the lower conjunctival sacs.
2/24/2021
69
71. Syphilis in pregnancy
is a systemic infection caused by the spirochete
Treponema pallidum, which is of particular
concern during pregnancy because of the risk of
transplacental infection of the fetus.
2/24/2021
71
72. In Ethiopia, syphilis prevalence among ANC follow
up in 2012 was 1%, indicating a low prevalence of
syphilis in pregnant women
RPR >5% indicates high prevalence.
All pregnant women: screen at the first prenatal
encounter
Women at high risk of infection: repeat screening at
28 to 32 weeks and at delivery
2/24/2021
72
73. The stage of syphilis is clinically important
because it impacts the treatment regimen and the
risk of vertical transmission
1. Primary syphilis
Papule, painless, at the site of inoculation.
Ulcerates to produce the classic chancre of primary
syphilis, a 1 to 2 cm painless ulcer
Associated with mild to moderate regional
lymphadenopathy that is often bilateral.
2/24/2021
73
74. Cont.
Chancres heal within 3 to 6wk, even in the absence
of treatment.
The primary stage of syphilis missed in women b/c
the lesion is on vaginal or cervical mucosa
2/24/2021
74
75. 2. Secondary syphilis
Disseminated begins 6wk to 6 months after the
appearance of the chancre
A generalized maculopapular skin rash palms, soles
& mucous membranes
Sparing the face, is characteristic of this stage of the
infection.
Generalized lymphadenopathy accompanies the skin
rash..
2/24/2021
75
78. Cont.
fever, pharyngitis, weight loss, and large genital
lesions called condylomata lata..
The rash typically resolves within 2 to 6wks
Secondary syphilis is commonly the stage when
women present to a health care provider
2/24/2021
78
79. 3. Latent syphilis
asymptomatic.
untreated, patients will have signs & symptoms of
secondary or late syphilis.
latent syphilis may transmit the infection to the
fetus
early latency -the first year following secondary
syphilis
late latency - >1 years
2/24/2021
79
80. 4. Tertiary (late) syphilis
one-third of untreated patients
Tertiary syphilis is characterized by slowly
progressive signs and symptoms
Gumma formation & cardiovascular disease.
5 to 20 years after the disease has become latent.
2/24/2021
80
81. Laboratory
I. Dark field microscopy
II. Nontreponemal
RPR (rapid plasma reagin) test
standard VDRL slide test
2/24/2021
81
83. Preferred regimen
I. A single dose of benzathine penicillin G 2.4 million
units intramuscularly for women with primary,
secondary, or early latent disease
II. Late latent, tertiary, and disease of unknown duration,
three doses of benzathine penicillin G 2.4 million
unit intramuscularly at weekly
If a dose is missed for more than 14 days, the full
three-dose course of therapy should be started again
2/24/2021
83
84. References
1. Ethiopian National guidelines for the management
of sexually transmitted infections using the
syndromic approach ;February, 2015
2. Te Lindes operative gynecology 11th edition
3. Up-todate 17.1
2/24/2021
84