Sexually Transmitted Diseases

STI

- the general term for any disease that can be spread by intimate and/or sexual contact

- included systemic diseases such as hepatitis and tuberculosis

- is prevalent in all socioeconomic and racial or ethnic groups

- individuals who have unprotected nonmonogamous sex have the greatest risk for STI exposure and infection

- bacterial

- viral

- protozoal

- parasitic

- fungal

What is another name for gonorrhea?

The clap

What bacterium causes gonorrhea?

Neisseria gonorrhoeae

How is gonorrhea primarily transmitted?

Transmission generally requires the contact of epithelial surfaces

Can pregnant females pass gonorrhea to their fetus?

Yes, pregnant females can pass gonorrhea to her fetus and to her newborn child

What is the only natural host for Neisseria gonorrhoeae?

Humans

What structure helps Neisseria gonorrhoeae attach to epithelial cells?

Presence of pili

What are the common sites of gonorrhea infection in women?

Inner portion of cervix, urethra, rectum

What are the common sites of gonorrhea infection in men?

Urethra, rectum

What are some complications of gonorrhea?

Pelvic inflammatory disease (PID), sterility, infection

What are the symptoms of gonorrhea in males?

Sudden onset of painful urination or purulent penile discharge, or both

What are the symptoms of gonorrhea in females?

Asymptomatic, dysuria, increased vaginal discharge, lower abdominal and/or pelvic pain, fever

What is the trend of syphilis cases among men who have sex with men?

Syphilis is on the increase among men having sex with men.

What is the causative agent of syphilis?

Treponema pallidum, a corkscrew-shaped, anaerobic bacterium.

Can Treponema pallidum be cultured in vitro?

No, it cannot be cultured in vitro; it is done in rabbit testes.

What type of disease does Treponema pallidum cause shortly after infection?

It becomes a systemic disease shortly after infection.

When can maternal-fetal transmission of syphilis occur?

As early as 9 weeks gestation.

What are the characteristics of primary syphilis?

Local manifestations with a hard chancre that is eroded, painless, firm, and hard.

When does primary syphilis typically manifest after exposure?

From 12 days to 12 weeks after exposure, with an average duration of 3 weeks.

What are the symptoms of secondary syphilis?

Systemic manifestations including low-grade fever, malaise, and sore throat.

When does secondary syphilis develop after the first appearance of lesions?

It develops 6 weeks after the first appearance of distal lesions.

What is the most contagious stage of syphilis?

Secondary syphilis.

What is latent syphilis?

A stage with medical evidence of infection but asymptomatic individuals.

What is the duration of latent syphilis?

It can last as short as 1 year or as long as a lifetime.

What are the two stages of latent syphilis?

Early and late stages.

What characterizes tertiary syphilis?

It is the most severe stage, appearing after the latent stage, with vasculitis, necrosis, and fibrosis.

What is congenital syphilis?

A form of tertiary syphilis that appears after the latent stage.

What is the scientific name for Chlamydia?

Chlamydia trachomatis

What is the most common STI in the US?

Chlamydia

Is Chlamydia an obligate or facultative organism?

Obligate (needs the host to live)

What type of bacteria is Chlamydia?

Gram-negative

What type of bacterium is Chlamydia in terms of its living conditions?

Intracellular bacterium

What is the elementary body of Chlamydia?

Small, resilient, metabolically inert, able to survive extracellularly

What type of parasite is Chlamydia?

Metabolically active parasite

What are common symptoms of Chlamydia in males?

Clear and puffy ulcers, mucous discharge or mild burning with urination

What are common symptoms of Chlamydia in females?

Leading cause of tubal infertility, acute urethral syndrome, yellow mucopurulent discharge with inflammation of the uterine cervix

What are potential effects of Chlamydia on newborns?

Conjunctivitis (pink eye) and pneumonia

What causes Lymphogranuloma venereum?

C. trachomatis

What type of infection is Lymphogranuloma venereum?

Chronic STI

What is the initial presentation of Lymphogranuloma venereum?

Begins as a skin lesion

How does Lymphogranuloma venereum spread after the initial lesion?

Spreads to lymphatic tissue causing inflammation, necrosis, and abscesses

What is the incubation period for primary lesions of Lymphogranuloma venereum?

5-21 days

Where do male lesions typically occur in Lymphogranuloma venereum?

Penis and scrotum

Where do female lesions typically occur in Lymphogranuloma venereum?

Cervix, vaginal wall, and labia

What are secondary lesions in Lymphogranuloma venereum characterized by?

Inflammation and swelling of the lymph nodes; formation of large ulcerative lesions that can rupture and drain

What is Anorectal lympogranuloma venereum (LGV)?

Direct inoculation during anal intercourse; may be a chronic or late manifestation of lymphatic spread from the inguinal area

What is chancroid?

A rare acute infectious disease caused by Haemophilus ducreyi.

What type of bacteria causes chancroid?

Haemophilus ducreyi, which is a gram-negative bacillus.

Where is chancroid mostly found?

In tropical settings.

What are the symptoms of chancroid in females?

Asymptomatic but can have vaginal discharge, pain on defecation, or rectal bleeding.

What are the symptoms of chancroid in males?

Unilateral, painful genital ulcers.

What is the treatment for chancroid?

Single- or multiple-dose antibiotics; treatment of partners; condom use.

What are the characteristics of ulcers/lesions caused by chancroid?

They are painful, tender, soft, and large.

bacterial vaginosis

- sexually associated conditions; not always an STI

- cause: Gardnerella vaginalis and other anaerobes

- gray vaginal discharge -- elevation in vaginal pH

- treatment: Flagyl or other antibiotics; treatment of partners not necessary

What are the two serotypes of genital herpes?

Herpes simplex virus (HSV) type 1 and HSV type 2

How is genital herpes transmitted?

Through contact with a person who is shedding the virus

Can genital herpes be transmitted during childbirth?

Yes, from mother to baby through contact with blood and vaginal secretions

Where does initial virus replication of genital herpes occur?

Locally at the site of infection

How does the genital herpes virus spread in the body?

It spreads to contiguous cells and into sensory nerves

Where is the genital herpes virus transported after initial infection?

To the dorsal root via intraaxonal transport

What happens to the genital herpes virus after it is transported to the dorsal root?

It remains latent until reactivated

What do lesions from genital herpes initially appear as?

Groups of vesicles that progress to ulceration with pain, lymphadenopathy, and fever

Is there a cure for genital herpes?

No, there is only management of symptoms

What characterizes a first-episode primary genital infection of HSV?

No antibodies, small vesicular lesions with fever and malaise

What characterizes a first-episode nonprimary HSV infection?

Preexisting antibodies, systemic symptoms are fewer

What are the symptoms of recurrent genital herpes infections?

Mild local symptoms

What types of infections can genital herpes cause in newborns?

Local infection of eyes, skin, or mucous membranes to severe disseminated infection with CNS involvement

How many different types of Human papillomavirus (HPV) are there?

120 different types

What are the two categories of HPV types?

High-risk and low-risk serotypes

What type of vaccine is available for HPV?

Three-dose vaccine

To which family does HPV belong?

Papovaviridae family

How is HPV primarily transmitted?

Sexual contact

What condition is HPV associated with?

Cervical dysplasia and cancer

What test is used to screen for HPV-related cervical issues?

Papanicolaou test (Pap smear)

What are genital warts?

Soft, skin-colored, whitish pink-to-reddish brown benign cauliflower painless growths

How is the treatment for genital warts classified?

Considered cosmetic, not curative

What causes scabies?

Sarcoptes scabiei, the adult female itch mite

How is scabies transmitted?

Prolonged and close skin-to-skin contact, typically among family members or between sexual partners

What is a classic symptom of scabies?

Intense pruritus (itching)

What is the treatment for scabies?

Topical application; treatment for partners and family members; treatment of clothing and beddings

What is another name for Pediculosis pubis?

Crabs

What is the cause of Pediculosis pubis?

Phthirus pubis, the crab louse

How is Pediculosis pubis transmitted?

Intimate sexual contact or contact with infected bed linens or clothing

What is the life cycle duration of a crab louse?

25-30 days

What are the stages of the crab louse's life cycle?

Egg or nit, three nymphal stages, and an adult stage

What are the symptoms of Pediculosis pubis?

Mild-to-severe itching, allergic sensitization, and secondary infections from scratching

Systemic disease known to be sexual transmitted

- Acquired immunodeficiency syndrome (AIDS)

- Cytomegalovirus

- Epstein-Barr virus

Can Hepatitis B virus be sexually transmitted?

Yes

What are the methods of transmission for Hepatitis B virus?

Needle puncture, blood transfusion, cuts or abrasions in the skin, and absorption by mucosal surfaces

What is the risk of perinatal transmission of Hepatitis B virus?

High for babies of HBV-infected mothers unless they receive immunoglobulin and vaccination