STIs

• Syphilis

  3rd common Sexually transmitted disease
• Syphilis

  Caused by treponema pallidum
• Primary syphilis

  • Highly infectious with abundant organisms that can be isolated from the ulcer
  • Primary lesion is called "chancre"
  • Starts as hard painless papule that becomes ulcer with smooth or well-delineated border
• Secondary syphilis

  • Flu like symptoms, lymphadenopathy and generalized mucocutaneous rash
  • Lesion is called "condyloma latum" (condyloma lata) - a painless wart like lesion
• Latent syphilis


  • Stage where patient is inactive or asymptomatic
  • May have reactivation of secondary syphilis or may progress to tertiary syphilis
• Tertiary syphilis (late)

  • Characterized by granulomatous skin lesion (gumma) found in bones and other tissues as well organ such as cardiovascular syphilis (Aortic Aneurysm) or CNS involvement (neurosyphilis)
• Early Congenital Syphilis

  • Right after birth with infected newborn
  • Newborn may manifest with runny nose and condylomata lata
• Late Congenital Syphilis

  • 8th nerve deafness with bone and teeth deformities
• Lab diagnosis of syphilis

  • Dark Field microscopy
  • Serology
• Gonorrhea


  Second most common sexually transmitted infection
• Gonorrhea in males

  • Infection is restricted to the urethra and manifests as purulent urethral discharge and dysuria
• Gonorrhea in females

  • Primary infection site is cervix
  • May manifest with purulent vaginal discharge, dysuria and abdominal pain
  • Involving fallopian tubes and ovaries and pelvic inflammatory disease
• Anogenital Herpes Viral Infections (Genital Herpes)

  • In females, lesions appear on the cervix and vulva, with recurrent disease affecting the vulva, perineal skin, legs and buttocks
  • In males, lesions appear on the penis, anus and rectum of those engaging in anal sex
  • Caused by HSV-2 and HSV-1
• Genital Warts (Genital Papillomatosis, Condyloma Acuminamatum)

  • Start as tiny, soft, moist, pink or red swellings, which grows rapidly and may develop stalk
  • Appearance of "small cauliflower" multiple warts on area
  • Occur in men or women who engage in anal sex
  • Caused by papovaviridae family
  • Warts can be malignant
• HIV/AIDS

  • Signs of acute HIV infection usually occur within several weeks to several months after infection with HIV
  • Acute, self-limited mononucleosis-like illness lasting 1 or 2 weeks
  • Persons with AIDS die as a result of overwhelming infections caused by variety of pathogens, often opportunistic pathogens
  • Kaposi's Sarcoma, a previously rare type of cancer, considered to be fatal disease
  • Other signs and symptoms of acute HIV infection include fever, rash, headache, lymphadenopathy, pharyngitis, myalgia (muscle pain), arthralgia (joint pain), aseptic meningitis, retro-orbital pain, weight loss, depression, GI distress, night sweats, and oral or genital ulcers
• Infectious Mononucleosis

  • Also called as "mono" or "kissing disease" is an acute viral disease
  • May be asymptomatic or characterized by fever, sore throat, lymphadenopathy (especially posterior cervical lymph nodes), splenomegaly (enlarged spleen) and fatigue
  • Pathogen is Epstein-Barr virus (EBV), EBV is known as oncogenic (cancer causing), causing or associated with lymphoma, carcinomas (e.g., nasopharyngeal carcinoma and gastric carcinoma), and sarcomas, among other cancers
• Mumps (Infectious Parotitis)

  Acute viral infection characterized by fever and swelling and tenderness of the salivary glands