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Unformatted text preview: 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 I I or I) • Human papilloma virus • Hepatitis viruses B > A > C • Human Immunodeficiency Viruses (HIV I and I I) • Other Herpesviruses • Cytomegalovirus • Epstein Barr Virus • Kaposi’s Sarcoma-associated (HHV 8) Common Protozoal and I nsectal 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 I I, • 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 t richomonas • 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 • t richomoniasis • 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 • 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)...
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This note was uploaded on 09/14/2011 for the course PHARM mb taught by Professor Staff during the Spring '11 term at UCSD.
- Spring '11