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Lecture 08 - STIs

Lecture 08 - STIs - L ectu re 08 S T Is Syphilis Chancroid...

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Lecture 08 - STIs: Syphilis, Chancroid, Chlamydia, and Gonorrhoeae. Transmission of STIs: **majority the patient is asymptomatic Mucous membrane contact (oral, vaginal, or anal sex) Skin to skin contact (sexual or not) Perinatal (maternal to neonate) Parenteral (blood) Moral of the story: “Don’t touch anyone ever” Common Bacterial STIs Gonorrhea Chlamydia Syphilis Methacillin-resistant Staphlococcus aureus (?) MRSA (large outbreak in SD) This can be in the gym and lots of areas but most common in STI clinics Common Viral STIs Genital herpes simplex (HSV II or I) Human papilloma virus Hepatitis viruses B > A > C Human Immunodeficiency Viruses (HIV I and II) Other Herpesviruses Cytomegalovirus Epstein Barr Virus Kaposi’s Sarcoma-associated (HHV 8) Common Protozoal and Insectal STIs Protozoan = Trichomoniasis Insecta = Pediculosis pubis (louse, crabs) Sarcoptes scabiei (burrowing mite, scabies) à hands Not necessarily STI, close contact Common Syndromes of STIs Mucocitis (cervicitis, urethritis, proctitis, conjunctivitis) gonorrhea chlamydia Genital (skin or mucosa) ulcer(s) / lymphadenopathy Herpes simplex I and II, primary syphilis, lymphogranuloma venereum ( Chlamydia trachomatis ), chlamydia Chancroid ( Hemophilus ducrei ) Vaginitis / vaginal discharge Trichomonas Bacterial vaginosis Candidiasis (thrush) (not an STI but can feel like one) à must be differentiated Gastroenteritis/hepatitis (bacterial, protozoal and viral infections from fecal-oral exposures) Bacteria - shigella, salmonella, campylobacter Protozoa - giardia and entamoeba Viruses – hepatitis A, rotavirus, enteroviruses Genital Exam and Labs Inspect perineum and use vaginal speculum to assess signs of infection: redness, odor, and discharge from cervix Gather vaginal and cervical samples for immediate microscopy: Wet mount for trichomonas Gram stain for gonococci and bacterial vaginosis KOH for candida Submit samples of cervical secretions to lab for Pap smear for HPV-induced neoplastic cells DNA testing for gonococci and chlamydia Differential Diagnosis of Vaginal Discharge Vaginitis / Vaginosis Syndromes STIs trichomoniasis bacterial vaginosis (unlikely) Non-STI with similar symptoms candidiasis (thrush) Cervicitis (inflammation) à more likely gonorrhea chlamydia Trichomoniasis: Trichomonas vaginalis = sexually transmitted flagellated protozoan of genital tract Infection exclusively of the genitalia
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Probably one of the most common STD in the world US: 3 million women annually Highly associated with other STIs Probably same number of (nearly) asymptomatic men who act as vectors
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