Sexually Transmitted Infections-1 Flashcards
What is the age group more affected by STI?
Adolescents and young adults
More severe and more frequent for women
What is the most common STI in the US?
Genital herpes
Chancroid more common in urban settings and associated with sex workers
What are the diseases causing genital ulcers?
Genital herpes Syphilis Chancroid Granuloma inguinale Lymphogranuloma venereum (LVG)
How to differentiate the different diseases causing genital ulcers?
Syphilis- solitary hard,painless ulcer
Herpes,chancroid- several to many soft, painful ulcers
Herpes- tender irregular shaped ulcers
Chancroid/syphilis- chancre more uniform in shape
What are the manifestations of genital herpes?
HSV 2 is most common Most infections are asymptomatic Itching sensation Tender painful ulcers Recurrent disease “friend for life” Newborns infected during delivery develop disseminated infections (meningitis, encephalitis) with fatality rate of 60-70%
How is herpes diagnosed?
Clinical diagnosis confirmed with lab testing
Tzanck test
What is the therapy for herpes?
Antiviral agents
Acyclovir- IV for severe disease
How to prevent herpes?
Always use condom
Educate patient about risk of transmission during asymptomatic periods
Risk of congenital infection during labor and delivery should be explained to expectant mother
Treatment is not a cure
What are the manifestations of syphilis?
Caused by treponema pallidum that can’t be grown in vitro
Hard indurated, highly infectious and painless chancre in primary syphilis, may have regional lymphadenopathy
Skin and mucous membrane lesion in Secondary syphilis (6-8 weeks after chancre), generalized lymphadenopathy
What are the manifestations of congenital syphilis?
Early signs: stillborn, osteochondritis , skin lesions on sole, hepatosplenomegaly
Late signs: 60% of survivors have no symptoms
Clutton’s joints, deafness,
Hutchinson’s teeth,mulberry molars
Saddle nose, saber shins
Rhagades
How is syphilis diagnosed?
Screening test is done with nontreponemal tests or reagin test (VDRL and RPR)
Confirmatory test is done with treponemal tests
What is the therapy for syphilis?
Benzathine penicillin G- IM
Treat mother before 16th week prevents congenital syphilis
Post treatment follow up important
Jarisch-Herxheimer reaction- increased bacterial release worsening symptoms can occur
What are the manifestations of chancroid or soft chancre?
Caused by haemophilus ducreyi and almost exclusively transmitted by sexual contact
Prostitution is a major cause of spread
Painful ulcer that lacks induration
Multiple lesions (kissing lesions) can be present
Painful inguinal lymphadenopathy
How is chancroid diagnosed? What is the therapy?
Evaluation of lesion and sexual history
Culture organism for definitive diagnosis
Therapy: azithromycin or ceftriaxone
Aspiration of lymph nodes
Reexamine 3-7 days after start of therapy
What are the manifestations of granuloma inguinale?
Caused by klebsiella granulomatis, gram negative rod with bipolar staining
Ulcerated lesions with rolled border on a beefy red, cobblestone base
Ulcers are painless and bleed easily
Granulomas not in lymph nodes form pseudo-buboes
