SEXUALLY TRANSMITTED DISEASE

• 1.Syphilis

  Other names:

  -Sy

  -Bad Blood

  -The pox

  -Lues venereal

  -Morbus gallicus
• CAUSATIVE AGENT:

  Treponema pallidum

  (a spirochete)

  
  

  Incubation Period:

  10-90 days (3 months); average of 21 days
• MODE OF TRANSMISSION

  
  

  -Direct contact

  -Transplacental (After AOG of 16 weeks)

  -Through blood transfusion

  -Indirect contact with contaminated articles
• PATHOGNOMONIC SIGN

  Primary stage (4-6 weeks):

  -painless chancre at site of entry of germ with serous exudates

  Tertiary Stage (one to 35 Years):

  -Gumma, Syphilic endocarditis and meningitis
• MANAGEMENT TREATMENT

  Diagnostic test:

  Dark field illumination test

  Fluorescent treponemal antibody absorption test

  -most reliable and sensitive diagnostic test for Syphilis

  VDRL slide test, CSF analysis, Kalm test,

  Wasseman test

  Treatment:

  -Drug of Choice: Penicillin (Tetracycline if resistant to

  Penicillin)
• PREVENTION

  -Abstinence

  -Be faithful

  -Condom
• NOTE:Primary and secondary sores will go even without treatment but the germs continue to spread throughout the body. Latent syphilis mav continue 5 to 2()+ years with NO Latent syphilis ma

  Latent syphilis may continue 5 to 20+ years with NO Latent syphilis may continue 5 to 20+ years with NO symptoms, but the person is NO longer infectious to other people.

  A pregnant mother can transmit the disease to her unborn child (congenital syphilis).
• 2. Gonorrhea

  Other names:

  GC, Clap, Drip, Stain, Gleet, Flores Blancas
• Causative Agent

  Neiserria gonorrhea
• Mode of transmission

  Direct contact- genitals,anus,mouth

  Incubation period

  2-10 days
• Pathognomonic Sign

  Thick purulent yellowish discharge

  Burning sensation upon urination/dysuria
• Management/Treatment

  Diagnostic Test: Culture

  Treatment: Drug of choice- Penicillin
• Prevention

  -Abstinence

  -Be faithful

  -Condom

  Prevention of gonococcal ophthalmia is done through the prophylactic use of ophthalmic preparations with erythromycin or tetracycline
• 3. Trichomoniasis

  Other names:

  • Vaginitis
  • Trich
• Causative Agent

  Trichomonas vaginalis
• MODE OF TRANSMISSION

  Direct contact:

  Incubation Period:

  4 — 20 days; average of 7 days
• PATHOGNOMONIC SIGN

  Females:

  -white or greenish-yellow

  -odorous discharge

  -vaginal itching and soreness

  -painful urination

  Males:

  -Slight itching of penis

  -Painful urination

  -Clear discharge from penis
• MANAGEMEN/TREATMENT

  Diagnostic Test:

  -Culture

  Treatment:

  -Drug Of Choice: Metronidazole (Flagyl)
• PREVENTION

  • Abstinence
  • Be faithful
  • Condom
• 4. Chlamydia

  CAUSATIVE AGENT

  • Chlamydia trachomatis; (a rickettsia)
• MODE OF TRANSMISSION

  • Direct contact

  Incubation Period:

  • 2 to 3 weeks for males: usually no symptoms for females
• PATHOGNOMONIC SIGN

  Females:

  • Asymptomatic
  • Dyspareunia
  • Fishy vaginal discharge

  Males:

  • Burning sensation during urination
  • Burning and itching of urethral opening (urethritis)
• MANAGEMEN/TREATMENT

  Diagnostic Test:

  • Culture

  Treatment:

  • Drug of Choice: Tetracycline
• PREVENTION

  • Abstinence
  • Be faithful
  • Condom
• 5. Candidiasis

  Other names:

  • Moniliasis
  • Candidosis

  CAUSATIVE AGENT

  • Candida albicans
• MODE OF TRANSMISSION

  • Direct contact

  PATHOGNOMONIC SIGN

  • White, cheese-like vaginal discharges
  • Curd like secretions
• MANAGEMEN/TREATMENT

  Diagnostic Test:

  • Culture
  • Gram staining

  Treatment:

  • Nystatin: for oral thrush
  • Cotrimazole, fluconazole for mucous membrane and vaginal infection
  • Fluconazole or amphotericin for systemic infection

  PREVENTION

  • Abstinence
  • Be faithful
  • Condom
• 6. Acquired immune deficiency syndrome

  (AIDS)

  CAUSATIVE AGENT

  • Retrovi (Human T-cell lymphotrophic virus 3 or HITS' 3)

  Attacks the T4 cells: T-helper cells: T-lymphocytes, and CD4
• MODE OF TRANSMISSION

  • Direct contact
  • Blood and body fluids
  • Transplacental

  Incubation period:

  3-6 months to 8-10 years Variable. Although the

  time from infection to the development of detectable antibodies is generally 1-3 months, the time from HIV infection to diagnosis of AIDS has an observed range of less than I year to 15 years or longer.
• PATHOGNOMONIC SIGN

  l. Window Phase

  2. Acute Primary HIV Infection

  3. Asymptomatic HIV Infection

  4. ARC (AIDS Related Complex)

  5. AIDS
• MANAGEMEN/TREATMENT

  Diagnostic tests:

  • Enzyme-Linked Assay (ELISA)

  -presumptive test

  • Western Blot

  -Confirmatory test

  Treatment:

  1. Treatment of opportunistic infection

  2. Nutritional rehabilitation

  3. AZT (Zidovudine) — retards the replication of retrovirus

  4. PK 1614 - mutagen
• PREVENTION

  • Abstinence
  • Be faithful
  • Condom
  • Sterilize needles, syringes, and instruments used for cutting operations
  • Proper screening of blood donors
  • Rigid examination of blood and other blood products
  • Avoid oral, anal contact and swallowing Of semen
  • Avoid promiscuous sexual contact

  HIV/AIDS Prevention and

  Control Program:

  Goal: Contain the transmission of HIV /AIDS and other reproductive tract infections and mitigate their impact
• Pathognomonic Signs in-depth

  I. Window Phase

  a.initial infection

  b. lasts 4 weeks to 6 months

  c. not observed by present laboratory test (test should be repeated after 6 months)

  2. Acute Primary HIV Infections

  a.short, symptomatic

  b. flu-like symptoms

  c. ideal time to undergo screening test (ELISA)
• 3. Asymptomatic HIV Infection

  a.with antibodies against HIV but not protective

  b. lasts for 1-20 years depending upon factors

  4. ARC (AIDS Related Complex)

  a.a group of symptoms indicating the disease is likely to progress to AIDS

  b. fever of unknown origin

  c. night sweats

  d. chronic intermittent diarrhea

  e. lymphadenopathy

  f. 10% body weight loss
• 5. AIDS

  a.manifestation of severe

  immunosuppression

  b. CD4 Count: <200/dL

  C. presence Of variety Of infections at one time:

  • oral candidiasis
  • leukoplakia
  • AIDS dementia complex
  • Acute encephalopathy
  • Diarrhea, hepatitis
  • Anorectal disease
  • Cytomegalovirus
  • Pneumonocystis carinii
  • pneumonia (fungal)
  • Kaposi's sarcoma (skin cancer; bilateral purplish patches)
  • Herpes simplex
  • Pseudomonas infection
  • Blindness
  • Deafness
• THINGS TO NOTE!!!

  Lecture Discussion:

  • Best method to use in teaching about sex

  Priority intervention when caring for AIDS patient: Use disposable gloves when in contact with non-intact skin

  Major Signs of Pediatric AIDS

  • Chronic Diarrhea >1 month
  • Prolonged Fever >1 month
  • Weight loss or abnormally slow growth

  Breastmilk is important in preventing intercurrent infection in HIV infected infants and children
• NOTE CONTINUATION:

  The Care of HIV patients is similar to the routine care given to cases of other diseases

  Not everybody is in danger of becoming infected with HIV through SEX

  Never give live attenuated (weakened) vaccines e.g. oral polio vaccine

  HIV Positive pregnant women and their partner must be informed of the potential risk of the fetus