STD AND RTI

SYPHILIS Syphilis is a sexually transmitted disease caused by the spirochete bacterium Treponema pallidum

CLINICAL FEATURES PRIMARY STAGE Small red spot is noticed on the penis 3 – 4 weeks after sexual intercourse Painless develop to a well defined hard sore or hard chancre A painless bubo in the groin Glands in neck,axilla and epitrochlear region SECONDARY STAGE Sore throat,anemia,skin rashes,enlargement of glands Pain and swelling in bones and joints Soft warty condylomata are seen on the moist surface Ulcer in throat White mucous patch inside the cheeks

CAUSATIVE AGENT TREPONEMA PALLIDUM Dies rapidly outside the body It is killed by drying,heating,ordinary antiseptics

SOURCE OF INFECTION Saliva Urine Broken and ulcerating gum in throat Skin may be infective

MODE OF TRANSMISSION Sexual intercourse Rarely by kissing Saliva Semen Blood Vaginal discharges Congenital syphilis Extragenital infection

PERIOD OF COMMUNICABILITY As long as primary sore,condylomata,mucous patches or ulcerating gummata are not healed

SUSCEPTIBILITY AND RESISTANCE Susceptibility in general No natural immunity

INCUBATION PERIOD 10 days to 10 weeks Average 3 weeks

METHOD OF CONTROL…Contd PREVENTIVE MEASURES Congenital syphilis Serological examination and treatment Acquired syphilis Health and sex education Personal prophylaxis before, during and after exposure Control of prostitution Early diagnosis and treatment

METHOD OF CONTROL CONTROL OF PATIENTS,CONTACTS AND THE IMMEDIATE ENVIRONMENT Report to health authority Isolation Contacts Congenital syphilis ( All immediate family members) Primary syphilis (sexual contact preceding 3 months) Secondary syphilis (sexual contact preceding 6 months) Specific treatment Acquired syphilis (Benzathine penicillin G) Congenital syphilis (Procaine penicillin ) In case of pencillin allergy erythromycin or tetracycline is given

GONORRHOEA Gonorrhea is a sexually transmitted disease caused by the bacteria Neisseria Gonorrhoeae or Gonococcus

CLINICAL FEATURES MALE Inflammation of urethra Acute burning sensation with pain and pus discharge while passing urine Infection spread to prostate, seminal vesicles,bladder,renal pelvis or rectum FEMALE Infection spread to uterus,tubes,peritoneum and bartholin glands INFECTION MAY SPREAD THROUGH BLOOD TO HEART,MENINGES,JOINTS ,MUSCLES,TENDONS AND EYE

COMPLICATIONS Urethral stricture in males PID in females Infertility

DIAGNOSIS It is a gram negative diplococci Male urethral smear Female smear from cervix and uterus No reliable serological test are available

CAUSATIVE AGENT Neisseria Gonorrhoeae Kidney shaped diplococci

SOURCE OF INFECTIONPERIOD OF INFECTIVITY Untreated cases are infective for months Women form largest reservoir

MODE OF SPREAD Sexual intercourse Oropharyngeal gonorrhea due to orogenital sexual contact Infected towels Purulent conjunctivitis Ophthalmia neonatorum due to infection in the birth canal

INCUBATION PERIOD 2 – 7 days

METHOD OF CONTROL PREVENTIVE MEASURES TREATMENT Procaine pencillin G Pencillin allergy tetracycline or erythromycin Sex partner should be treated OPTHALMIA NEONATORUM Pencillin injection Pencillin eye drop

TRICHOMONAL VAGINITIS AND URETHRITIS Trichomonal vaginitis is a protozoal infection of the vagina and the urethra caused by a flagellate parasite – Trichomonas vaginalis

CAUSATIVE ORGANISM Trichomonas vaginalis The parasite lives in the vagina and urethra of females And in male urethra

DIAGNOSIS By detecting parasite in vaginal and urethral discharge

CLINICAL MANIFESTATION MALE Mucoid discharge Slight irritation FEMALE Vulvar irritation Frothy yellowish discharge Putrid odour of discharge

TREATMENT Metronidazole 200mg thrice daily for 7 days

CHANCROID (SOFT SORE) FEATURES Small red lesion appear on the genitals as a papule or vesicle which becomes a pustule and ulcerated Ulcers multiple and painful Soft bleeding surface Ragged undermined edges Lymph glands are enlarged, tender and matted Suppuration of lymph glands Phimosis in male Extragenital lesions on the lips,tongue,chin,breast and umbilicus

CHANCROID (SOFT SORE) EPIDEMIOLOGY CAUSATIVE AGENT Duncrey bacillus (H.duncrey) Abrasions,cut and wound predispose to infection PERIOD OF INFECTIVITY Person remains infective till the lesions are healed INCUBATION PERIOD 2-5 days ,24 hrs if there is abrasion TREATMENT Sulphadimidine 4gm daily for 10-15 days in divided doses Tetracycline 0.5gm four times a day for 10 days

LYMPHOGRANULOMA VENEREUM LGV is a sexually transmitted disease caused by the organism Chlamydia trachomatis It is more common in South India

LYMPHOGRANULOMA VENEREUM CAUSATIVE ORGANISM Chlamydia trachomatis ROUTE OF ENTRY Breaks in the skin It can cross epithelial cell layer of the mucous membranes INCUBATION PERIOD 3 – 30 days

LYMPHOGRANULOMA VENEREUM CLINICAL FEATURES Primarily an infection of the lymphatics and lymph nodes Climatic bubo Iguinal glands are enlarged and matted, forming tender mass and which may burst Discharging sinuses Ano rectal stricture Urethral lesions with fistulae Fever Body aches

LYMPHOGRANULOMA VENEREUM DIAGNOSIS Serological testing TREATMENT Surgical correction of deformity Doxycycline, Erythromycin and Tetracycline

GRANULOMA INGUINALE(DONOVANOSIS) CAUSATIVE ORGANISM Calymmatobacterium granulomatis (Donovanis granulomatis) MODE OF TRANSMISSION Contact with lesions INCUBATION PERIOD 8 – 80 days SPECIFIC TREATMENT Tetracycline 500mg four times daily for 10 days Clotrimoxazole and chloramphenicol

GRANULOMA INGUINALE(DONOVANOSIS) CLINICAL FEATURES Lesions appear on the genitals as a hard papule or vesicles that are ulcerated Floor of the ulcer is painless with red velvety granulation Extra genital lesions occur in the warm and moist area (scrotum,labia and vagina)