PHRM 514 STD's Fall 2012 (1)

Gonorrhea 2010 statistics n 309341 reported cases n

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Gonorrhea 2010 Statistics n 309,341 reported cases n 100.8 cases/100,000 people § Women 106.5 cases/100,000 § Men 94.1 cases/100,000 n Increased 2.8% since 2009 Centers for Disease Control and Prevention.  Sexually Transmitted Disease Surveillance 2010.  Atlanta: U.S. Department of Health and Human Services; 2011.
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Gonorrhea:  Microbiology n Caused by  Neisseria gonorhoeae n Gram negative diplococcus n Grows best in warm, mucus secreting epithelia Knodel, LC.  Sexually transmitted diseases.  In:  DiPiro JT, Talbert RL, Yee GC, et al., editors.  Pharmacotherapy a  pathophysiologic approach.  8th ed.  New York:  McGraw Hill Medical; 2011:2011-2028. Mehring, PM.  Sexually transmitted diseases.  In:  Porth, CM, editor.  Pathophysiology Concepts of Altered Health  States.   7th Ed.  Philadelphia:  Porth Lippincott Williams and Wilkins; 2005:1101-1110.
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Gonorrhea:  Pathophysiology 1. Gonococci attach to cell membranes  of  mucosal epithelium by surface pili 2. N. gonorrhoeae  penetrates through epithelial  cells to submucosal tissue 3. Mucosal damage occurs (sloughing of  epithelium) 4. Polymorphonuclear (PMN) leukocytes invade  the tissue 5. Submucosal abscesses form and purulent  exudates (pus) are secreted Knodel, LC.  Sexually transmitted diseases.  In:  DiPiro JT, Talbert RL, Yee GC, et al., editors.  Pharmacotherapy a  pathophysiologic approach.  8th ed.  New York:  McGraw Hill Medical; 2011:2011-2028. Honeywell MS, Thompson MD.  Sexually transmitted infections.  In:  Chisholm-Burns M, Schwinghammer T, Wells B,  et al.  Pharmacotherapy Principles and Practice.  2nd ed.  New York:  McGraw Hill Medical;2010:1317-1335.
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Gonorrhea:  Clinical Presentation Males Females Incubation  Period 1-14 days 1-14 days Symptom Onset 2-8 days 10 days Most Common  Site of Infection Urethra Endocervical  canal Other Sites of  Infection Rectum, eye,  oropharynx Urethra, eye,  rectum,  oropharynx Knodel, LC.  Sexually transmitted diseases.  In:  DiPiro JT, Talbert RL, Yee GC, et al., editors.  Pharmacotherapy a  pathophysiologic approach.  8th ed.  New York:  McGraw Hill Medical; 2011:2011-2028.
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Gonorrhea:  Clinical Presentation Males Females Symptoms Urethral infection   –  dysuria, urinary frequency Anorectal infection   –  severe rectal pain Pharyngeal infection   –  mild pharyngitis Endocervical infection   –  asymptomatic to mildly  symptomatic Urethral infection   –  dysuria, urinary frequency Anorectal and  pharyngeal infection   –  same as for males Signs Purulent urethral or rectal  discharge (scant to profuse) Anorectal  – pruritus,  mucopurulent discharge,  Abnormal vaginal  discharge, uterine  bleeding, purulent urethral  or rectal discharge (scant  Knodel, LC.  Sexually transmitted diseases.  In:  DiPiro JT, Talbert RL, Yee GC, et al., editors.  Pharmacotherapy a 
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