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119 Cards in this Set

  • Front
  • Back
Kinds of STDs
Bacterial
Viral
Parasitic
Other
Bacterial STDs
Syphilis
Gonorrhea
Chancroid
Lymphogranuloma Venereum
Granuloma Inguinale
Chlamydia
Mycoplasma and Ureaplama Infections
CHANCROID
Infection of: genital skin or m.membranes
Caused by: Haemophilus ducreyi
Characterized by: painful ulcers&suppuration of linguinal lymph nodes
Dx: clinical (it's difficult to culture the organism)
Tx: Macrolide, Ceftriaxone, Ciprofloxacin, Erythromycin
Suppuration
AKA - purulent
Something that causes pus
Macrolide
Used to treat respiratory tract infections and soft tissue infections. Their antimicrobial spectrum is slightly wider than that of penicillin, and therefore are a common substitute for patients with a penicillin allergy.
Where do you see Chancroid?
Developing Countries
Since it is an ulceration, what else do you see with this disease?
HIV
Signs and Sxes
Small, painful, papules 3-7 d
Then Shallow, soft, painful ulcers
Infected linguinal lymph nodes which form a bubo
Possibly phimosis, urethral stricture and urethral fistula
Bubo
Swelling of the lymph nodes, found in an infection
Phimosis
When the foreskin of the penis of an uncircumcised male cannot be fully retracted
Why would you aspirate the bubo?
1.
symptomatic relief
2.
diagnosis from pus-will see H. ducreyi
Chlamydia trachomatis
Mycoplasma genitalium
Ureaplasma urealyticum
Infections?
Urethritis
Cervicitis
Proctitis
Pharyngitis
Dx for these infections?
By culture
Immunoassay for antigens
Genetics
Tx for these infections?
Azithromycin
Ofloxacin
Levofloxacin
Erythromycin
Tetracycline
Chlamydia causes what?
Lymphogranuloma venereum (LGV)
Salpingitis
Epididymis
Perihepatitis
Neonatal conjunctivitis
Infant pneumonia
STD's
Pneumonias
There are 3 species of Chlamydia...
1. Chlamydia trachomatus
2. Chlamydophila pneumoniae
3. Chlamydophila psittaci
What is the most common bacterial cause of STD's in the US?
Chlamydia trachomatis
What are these most common dzes?
MEN
Urethritis
Epididymitis
WOMEN
Cervicitis
Urethritis
PID
BOTH
Proctitis
LGV
Reactive arthritis (Reiter's Syndrome)
C. trachomatis from mom
Neonatal conjuctivitis
Infant pneumonia
C. pneumoniae
Pneumonia (community acquired)
C. psittaci
Psittacosis
Transmitted from psittacine birds...causing a disseminated dz characterized by pneumonitis
Chlamydia Dx...
Presumptive
Try to r/o gonorrhea
Culture C. trachomatis
NAAT(nucleic acid amplification tests)-genital samples
Chlamydia Tx...
Azithromycin
Doxycycline
Fluoroquinolones
Mycoplasma pneumoniae
pneumonia (community-acquired)
M. genitalium and U. urealyticum
Nongonococcal urethritis
Above 2 plus M. hominis
Other urogenital infections
IE
Vaginitis
Cervicitis
Pyelonephritis
PID
Mycoplasmas Dx...
Difficult to culture
Mostly Clinical
DNA probes
Detection of Abs or Ags
Mycoplasmas Tx...
Macrolides
Fluoroquinolones
Tetracyclines
Signs and Sxes of Mycoplasma Infections
MEN
Symptomatic urethritis
Mild dysuria, discomfort in the urethra, discharge
Signs and Sxes of Mycoplasma Infections
WOMEN
Generally Asymptomatic
May have vaginal discharge, dysuria, frequency, pelvic pain, pharyngitis, cervicitis, salpingitis
Fitz-Hugh-Curtis Syndrome
"Perihepatitis"
Can occur w/Mycoplasma Infections
RUQ pain
fever
Vomitting
Reactive arthritis
"Reiter's Syndrome"
Complication of chlamydial infections
Causes skin and eye lesions and noninfectious recurrent urethritis
Suspect these 3 infections with what?
Urethritis
Salpingitis
Cervicitis
Proctitis
pharyngitis
Lower UTI's
What are the tests for these 3 infections?
Urine samples
Urethral exudate samples
ELISA
Nucleic acid probes(Chlamydia)
Genital Warts
(Condylomata acuminata)
Caused by?
HPV
Genital Warts from HPV
causes what?
Pedunculated Lesions on gentials
Flat, precancerous endocervical or anal lesions
Genital Warts Dx?
Clinical
Px of Genital Warts?
Resolve in immunocompetent pts
Persists in pts with decreased cell-mediated immunity (IE-HIV)
Signs and Sxes of Genital Warts
Anogenital warts(cauliflower)
Where are the genital warts in men?
Under the foreskin
Coronal sulcus
urethral meatus
penile shaft
anus/rectum
Where are the genital warts in women?
Vulva
Vaginal Wall
Cervix
Perineum
Genital Wart Dx
Clinically-visually
Differentiate from condyloma lata of secondary syphilis w/serologic tests
Biopsy of wart
Colposcopy
Nucleic Acid Amplification Assays
Genital Warts Tx
Someimes No Treatment=may resolve themselves
Removal with cryotherapy, electrocauterization, laser, surgery
What prevents recurrences of genital warts in men?
Circumcision
What causes Gonorrhea?
Neisseria gonorrheae
What does Gonorrhea affect?
Urethra, cervix, rectum, pharynx, eyes
how do you Dx gonorrhea?
Culture
Genetic methods
How do you treat gonorrhea?
Antibiotics
How is gonorrhea transmitted?
Sexual Contact
Urethral
Endocervical
Pharynx
Rectum
Or during birth to newborns
What are the Signs and Sxes of gonorrhea?
Can often be Asymptomatic
Male urethritis
Epididymitis
Cervicitis
PID
Fitz-Hugh-Curtis Syndrome (perihepatitis)
Rectal gonorrhea
Disseminated Gonococcal Infection
Tenosynovitis
Skin lesions
What gonorrheal infection can cause a sore throat?
Gonococcal pharyngitis
What other organism has to be distinguished from N. gonorrheae?
N. meningitidis
(also carried in the throat)
What is Granuloma Inguinale or Donovanosis?
A progressive infection of gential skin
What is Granuloma Inguinale caused by?
Calymmatobacterium granulomatis
How do you Dx Granuloma Inguinale?
Clinical-skin lesions: beety red, raised, ulcerated, Donovan bodies from edge of lesions
Biopsy
No cultures can be used
What are the signs and Sxes of Granuloma Inguinale?
Lesions
In men: penis, scrotum, groin thighs
In women: vulva, vagina, perineum
Both: face
How do you Tx Granuloma Inguinale?
Antibiotics
Tetracycline, macrolides
Lymphogranuloma Venerum
(LGV)is what kind of dz?
Chlamydial
LGV is characterized by what?
Transitory primary skin lesion + lymph problems
LGV Dx?
Clinical-genital ulcers+inguinal adenitis
Serologic testing
Immunofluorescent testing
ELISA
LGV Tx?
Tetracycline
Erythromycin
Azithromycin
LGV signs and Sxes?
Quick vesicle formation, ulceration and healing
Enlarged inguinal lymph nodes
Fever, malaise, h/a, joint pains, anorexia, vomiting
Sexually Transmitted Enteric Infections
Bacterial-Shigella, Camphylobacter, Salmonella
Viral-Hep A,B,C
Parasitic-Giardia, amebiasis
Syphilis
What is this caused by?
What is it?
Treponema pallidum
Systemic Dz with 3 clinical stages(1,2,3) and periods of latency btwn them
Syphilis
Signs and Sxes
Genital Ulcers
Skin Lesions
Meningitis
aortic dz
neuro syndromes
Syphilis
Dx
Serologic tests
Adjunctive studies (baased on the stage of the dz)
Syphilis
Tx
Penecillin
How long is a person infective?
Through the primary and secondary stages
What can accelerate syphilis?
HIV
See notes...slide 66...page 11
for the graph on classification of syphilis
Primary Syphilis
3-4 wk incubation period
Chancre develops @ site of inoculation
Erodes to form an ulcer that exudes a clear serum containing spirochetes
Lymph nodes are firm
Secondary Syphilis
Bacteremia with widespread dissemination
Generalized mucocutaneous lesions
Adenopathy
Syphilic dermatitis
Condyloma lata
Systemic Sxes-fever, malaise, anorexia, nausea, fatigability, h/a, bone pain
Condyloma lata
hypertrophic, flattened, dull pink or gray papules at mucocutaneous junctions or moist areas
Trichomoniasis
Caused by what organism?
Causes what?
Trichomonas vaginalis
Infection of vagina or male genital tract (seen more in women)
Trichomoniasis
Signs and Sxes
Can be asymptomatic (esp with men)
Urethritis-transient, frothy, purulent discharge, dysuria and frequency
Vaginitis-copious, yellow/green, frothy discharge, soreness of vulva and perineum, dyspareunia, dysuria
Cystitis-occasionally
Epididymitis-rare
Prostatitis-rare
Trichomoniasis
Dx
Cultures of urine urethra
Microscopy of vagina or prostate secretions
Trichomoniasis
Tx
Metronidazole
Side effects of metronidazole
Leukopenia, rxns to alcohol, candidal superinfections, early pregnancy
Spirochetes
Can only be seen with darkfield microscopy
Spirochetes
3 types
Treponema
Leptospira
Borrelia
Bejel, Pinta and Yaws
(Endemic treponematoses)
What infections are these?
Chronic, tropical, nonvenereal, spirochetal inf spread by body contact
Bejel
Sxes?
Caused by what organism?
Occurs where?
How?
M. membrane and mucocutaneous lesions, skin and bone gummas
Treponema pallidum subsp endemicum
Arid countries
Mouth to mouth contact
Yaws
Sxes?
Caused by what organism?
Occurs where?
How?
Periostitis & Dermal Lesions
Treponema pallidum subsp pertenue
Humid equatorial countries
Scanty clothing skin trauma
Pinta
Sxes?
Caused by what organism?
Occurs where?
How?
Lesions of dermis
T. carateum
Mexico, Central America, South America
Contact with broken skin
Bejel, Pinta and Yaws
Tx?
Penicillin
Leptospirosis
(Spirochete infection)
What does this include?
All infections caused by Leptospira
Including infectious jaundice and canicola fever
Leptospirosis
Sx?
Biphasic
1st phase/septicemic-4-9 days, acute febrile episodes, h/a, mm pains, chills
2nd phase/immune-6-12 days, see Abs in serum, acute febrile episodes, hepatic, renal and meningeal involvement
Leptospirosis
Dx?
Dark Field Microscopy
Culture
Serology
Leptospirosis
Tx?
Doxycycline
Penicillin
Leptospirosis
Sources?
Urine of domestic and wild animals
Lyme's Dz
Caused by what organism?
How is it transmitted?
Lyme's Dz is caused by Borrelia burgdorferi which is carried by Ixodes scapularis (deer tick)
Lyme's Dz
Sxes?
erythema migrans rash, neuro, cardiac and joint abnormalities
Lyme's Dz
Dx?
Clinical
Acute and convalescent Ab titers may be helpful
Lyme's Dz
Tx?
Doxycycline
Ceftriaxone
Lyme's Dz
Read slides 101-115...pp 17-20
Too much info to put on cards
Annoying
Relapsing Fever
What is it?
Recurring febrile dz with h/a, myalgia and vomiting for 3-5 days
Relapsing Fever
Caused by?
Borrelia spp and transmitted by lice or ticks
Relapsing Fever
Dx?
Clinical
Confirm with staining of peripheral blood smears
Relapsing Fever
Tx?
Tetracycline
Erythromycin
Relapsing Fever
Insect Vector?
Soft ticks-Ornithodoros-Americas, Africa, Asia and Europe
Body louse-rare in the US, in Africa
Relapsing Fever
How is the Borrelia spread via louse?
Louse is infected by feeding on a febrile pt, it can be crushed on a new host, borrelia are released and enter via broken skin (intact lice do not transmit dz)
Relapsing Fever
How is Borrelia spread via ticks?
From rodent reservoirs to human reservoirs...tick bites
Relapsing Fever
Tx?
Can be self-limiting as pt develops immunity
Ticks-Tetracycline or erythromycin or doxycycline
Relapsing Fever
Dx?
Clinical-recurrent fever
Confirmed by visualization of spirochetes in the blood during a febrile episode
Dark Field Microscopy
Neisseriaceae
All pathogenic aerobic gram-negative cocci belong to this family
This includes: Acinetobacter, Kingella, Moraxella, Neisseria and Oligella
Neisseriaceae
Which ones are the most important human pathogens?
N. miningitidis and N. gonorrhoeae
Neisseriaceae
How are these 2 infections spread?
Person to person
Neisseriaceae
These 2 organisms can exist in asymptomatic carrier states which are important b/c of their asso with epidemics
Moraxella and Kingella
Both can cause infs in the CNS, respiratory tract, urinary tract, endocardium, bones, joints
Moraxella catarrhalis-otitis media in children and sinusitis
Acinetobacter
Causes what?
Suppurative infections in any organ system
Opportunists in hospitalized pts
Acinetobacter
Ubiquitous
Can survive on dry surfaces for days
Acinetobacter
Risk Factors
Hospital stays
Alcoholism
Smoking
Chronic Lung Dz
DM
Residence in tropical developing community
Acinetobacter
Common site for infection?
Lungs
Acinetobacter
Tx?
Resistant to many antimicrobials
Use combo therapy
Meningococcal Dzes
Cause what?
Meningitis
Septicemia
Meningococcal Dzes
Sxes?
Severe
H/A, N/V, photophobia, lethargy, rash, multiple organ failure, shock, DIC
Meningococcal Dzes
Dx?
Clinical
Confirmed by culture
Meningococcal Dzes
Tx?
Penicillin
3rd Generation Cephalosporin
Meningococcal Dzes
Caused by what organisms?
N. meningitidis