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