Common viral stis genital herpes simplex hsv ii or i

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
o Cytomegalovirus
o Epstein Barr Virus
o Kaposi’s Sarcoma-associated (HHV 8)
Common Protozoal and Insectal STIs
• Protozoan = Trichomoniasis
• Insecta =
o Pediculosis pubis (louse, crabs)
o Sarcoptes scabiei (burrowing mite, scabies)
Common Syndromes of STIs:
• Mucocitis (cervicitis, urethritis, proctitis, conjunctivitis)
o gonorrhea
o chlamydia
• Genital (skin or mucosa) ulcer(s) / lymphadenopathy
o Herpes simplex I and II,
o primary syphilis,
o lymphogranuloma venereum ( Chlamydia trachomatis ),
o Chancroid ( Hemophilus ducrei )
• Vaginitis / vaginal discharge
o Trichomonas
o Bacterial vaginosis
o Candidiasis (thrush) (not an STI but can feel like one)
• Gastroenteritis/hepatitis (bacterial, protozoal and viral infections from
fecal-oral exposures)
o Bacteria - shigella, salmonella, campylobacter
o Protozoa - giardia and entamoeba
o Viruses – hepatitis A, rotavirus, enteroviruses
Genital Exam and Labs:
• Gather vaginal and cervical samples for immediate microscopy:
o Wet mount for trichomonas
o Gram stain for gonococci and bacterial vaginosis
o KOH for candida
• Submit samples of cervical secretions to lab for
o Pap smear for HPV-induced neoplastic cells
o DNA testing for gonococci and chlamydia
Trichomoniasis : Protazoa
• Trichomonas vaginalis = sexually transmitted flagellated protozoan of
genital tract
• Infection exclusively of the genitalia
• Probably most common STD in the world
• Highly associated with other STIs
• Sx in women:
o Vaginal and labial itching, irritation, redness, dysuria, but ~5%
asymptomatic
o Usually have yellow-green frothy discharge, but may have only
nodular cervical (“strawberry cervix”)
o Complications unusual but can promote rupture of membranes and
premature delivery during pregnancy
• Sx in men: Most asymptomatic
o Mild urethritis in minority
o Ascending disease in prostate or epididymis is rare
• Trich Transmission:
o Heterosexual contact (bidirectional)
o Female to female with contaminated fomites “sex toys”
o Rarely if ever transmitted male to male through oral or anal sex
• Treatment:
o Single dose metronidazole (Flagyl)
o Sexual contacts for the past 2 months
o No alcohol with medication
o SE: Can cause violent nausea or vomiting
Mucocutaneous Bacterial STIs : Gonorrhea and chlamydia
• Causes overlapping syndromes including conjunctivitis
• All gonorrhea patients are treated for chlamydia and vice-versa
• Both GC and Chlam diagnosed in same sample by nucleic acid detection
o (urethra>conjunctiva>oral>rectal)
o GC: one of the most common causes of monoarticular arthritis
 i.e. swelling of a joint
Epidemiology of Chlamydia trachomatis:
• Most commonly reporte disease in US
• Obligate intracellular growth makes culture impractical
• Detection in asymptomatic men and women has greatly increased by
widespread screening using DNA based techniques
o