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1L30: Sexually Transmitted InfectionsOutlineA.Overview of recent STI statisticsB.Bacterial STIsa.Chlamydia trachomatisb.Neisseria gonorrheac.Treponema pallidum (syphilis) C.Viral STIsa.Human Papilloma Virus (HPV)b.Herpes Simplex Virus l and ll D.Othera.Trichomonas vaginalisSexually Transmitted Infection (STI) newer terminology for Sexually Transmitted DiseaseRemove stigma of “STD”: many infections are curable and not associated with significant long-term health consequences when treated.All it takes to get an STI is to have sex: vaginal, oral, penile. Many infections are asymptomatic and have no signs of disease ( it is an infection and not a disease!)By strict definition STD only refers to SYMPTOMATIC infection with sexually transmitted organism.Both terminologies (STI and STD) are still being utilized.StatisticsRates of many STIs are increasing in the US: cases of chlamydia, gonorrhea and syphilis have all increased dramatically in past 7 years!In 2018, Louisiana is ranked in top 10 US states for rates of:oSyphilis oGonorrheaoChlamydiaTreatment:antibioticsGonnorhea is developing antibiotic resistance!UNTREATED:increased spread to others, can cause serious health problemsand increase risk of giving and getting HIVExpedited Partner Therapy (EPT): permissible in LouisianaMethod to increase treatment of sex partners of patients diagnosed with STIs (especially chlamydia and gonorrhea) Prescriptions provided to the patient to give to their partner: partner does notneed to be examined by health care providerBACTERIAL STI
2L30: Sexually Transmitted InfectionsChlamydia trachomatisRoute of transmission:vaginal, rectal and oral sex, transmission to newborn during deliveryInfects genital epithelium of both men and womenoWomen most common site of infection: cervix (cervicitis)oMen most common site of infection: urethra (urethritis)oBoth men and women: other sites of infection - epithelial cells of conjunctiva, rectum, pharynxMost cases are ASYMPTOMATIC and therefore can be unknowingly spread (“silent” infection)Gonorrhea (Neisseria gonorrhea)Routes of Transmission: vaginal, rectal and oral sex, mom to newborn during deliveryInfection usually asymptomatic in women (95%), usually symptomatic in men.oSymptoms appear within first two weeks after infectionMen most common site of infection: urethra (urethritis): symptomsoPurulent penile dischargeoPainful and increased frequency urinationoCan lead to epididymitis: testicular/scrotal painWomen most common site of infection: cervix (cervicitis)Both men and women: may have infection at non genital sites: eyes, rectum, throat, mouthUntreated gonorrhea can spread to bloodstream: disseminated gonococcal infection (DGI)Syphilis: Treponema Pallidum (T. Pallidum)Symptomatic:Chlamydia and Gonorrhea in WomenIn those with symptoms: appear within first two weeks after infectionCervicitis: oMucopurulent (mucus + pus) endocervical discharge oCervix bleeds easily with probing
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Sexually Transmitted Infections, Syphilis, Human papillomavirus