1. STD AND RTI

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

4. 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

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

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

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

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

9. SUSCEPTIBILITY AND RESISTANCE
Susceptibility in general
No natural immunity

10. INCUBATION PERIOD
10 days to 10 weeks
Average 3 weeks

11. 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

12. 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

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

14. 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

15. COMPLICATIONS
Urethral stricture in males
PID in females
Infertility

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

17. CAUSATIVE AGENT
Neisseria Gonorrhoeae
Kidney shaped diplococci

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

19. 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

20. INCUBATION PERIOD
2 – 7 days

21. 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

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

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

24. DIAGNOSIS
By detecting parasite in vaginal and urethral discharge

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

26. TREATMENT
Metronidazole 200mg thrice daily for 7 days

27. 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

28. 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 days in divided doses
Tetracycline 0.5gm four times a day for 10 days

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

30. 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

31. 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

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

33. 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

34. 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)