STD's II Flashcards
(19 cards)
general characteristics of gonorrhea
- caused by Neisseria gonorrhea (gonococcus)
- gram-negative, oxidases positive, and non-capsulated.
- glucose fermenter only
what are the virulence factors of N. gonorrhea?
- pilli (attachment)
- IgA protease (cleave and destroy IgA antibodies)
- endotoxin LOS and OMP (outer membrane protein) allow the exchange of materials
what are the clinical manifestations of gonorrhea in males?
Urethritis:
- infection of the urethra (primary)
- 90% symptomatic
- 2-7 days incubation period
- dysuria, purulent urethral discharge, and blood in semen or urine.
Epididymitis:
- testicular pain and swelling
what are the clinical manifestations of gonorrhea in females?
1- endocervical infection (uncomplicated)
* vaginal discharge by dysuria
* cervical os may be erythematous
2- rectal infections (proctitis)
3- PID
what is PID and where do we see it?
PID (pelvic inflammatory disease) is a term for the inflammation of the uterus, fallopian tube, and ovaries. seen in female patients with gonorrhea.
- give rise to acute salpingitis in the fallopian tube which may lead to sterility and ectopic pregnancy.
what is Ophthalmia neonatorum, where is it seen, and how to treat it?
Ophthalmia neonatorum is seen in neonates with gonorrhea, transmitted to newborns during birth (PERINATAL).
- severe purulent eye discharge with peri-orbital edema, leading to blindness if untreated.
- prevented by using 1% aqueous silver nitrate, treated with topical erythromycin
how to diagnose gonorrhea?
1- gram stain (by swab)
2- culture (chocolate agar)
treatment for gonorrhea
- treat all contacts
- first-line therapy: ceftriaxone or cefixime
- other: cephalosporins & penicillin include fluoroquinolones (e.g. ciprofloxacin), azithromycin, tetracyclines, co-amoxiclav
incubation period of syphilis
2 weeks - 3 months `
primary clinical manifestation of syphilis
- chancre on genitalia, cervix, or the anogenital area (painless pouched-out ulcers)
- usually single
- disappear spontaneously after 3-8 weeks
- highly infectious
- inguinal LN enlargement
- exudate used for diagnosis
what are the secondary clinical manifestations of syphilis?
- 2-16 weeks after chancre disappeared
- Maculopapular & pustular rash on soles and palms, skin and mucous membrane
- Heals spontaneously in 1-3 months
- Early neurosyphilis (CSF positive):
what happens during the latent phase in syphilis?
No lesions, asymptomatic but serological evidence
exists
*What are the clinical manifestations in the tertiary phase of syphilis?
(3-30 years)
– Neurosyphilis: Meningoencephalitis and paralysis
- cardiovascular: aneurysm of ascending aorta, aortitis
- granulomatous lesions in skin and bone
clinical manifestation in congenital syphilis
- intrauterine death, abortion, low birth weight
- Facial abnormalities e.g saddle shape nose, frontal bossing
- Liver, kidneys, eyes, deafness, mouth and tooth abnormalities
what are the methods to diagnose syphilis?
- Detection of the organism in the exudates and lesions using dark field E.M or phase contrast, Immunofluorescent antibodies –
primary syphilis - PCR
- Chest X-ray for aortic aneurysm
- Serology (may be negative in HIV patients)
non-specific antibodies (serology) in syphilis
*may be negative in HIV patient
Non-specific antibodies (1-2 weeks after the primary chancre appears):
- Rapid plasma regain test /VDRL test (Venereal disease research laboratory): detecting anticardiolipin antibodies > sensitive not specific
what tests are used for specific antibody detection in syphilis + congenital?
to confirm a positive non-specific result:
1) ELISA: Detect IgM and IgG
2) FTA-Abs (fluorescent Treponema antibodies-absorption)
3) TPHA (Treponema pallidum Haemagglutinin antibodies)
o Congenital syphilis: testing for IgM and retesting at 6 months of age,
Antibody titers remain elevated in babies with congenital syphilis
* maybe negative in HIV patients
DOC for treating syphilis
Penicillin G 2.4 million units I.M
