Sexually Transmitted Diseases

Sexually Transmitted Diseases

Definition The spectrum of sexually transmitted diseases includes the classic venereal diseases – gonorrhea, syphilis, chancroid, lymphogranuloma venereum, and granuloma inguinale – as well as a variety of other pathogens known to be spread by sexual contact (Table Sexually Transmitted Diseases). Common clinical syndromes associated with sexually transmitted diseases are listed in Table Selected Syndromes Associated with Common Sexually Transmitted Pathogens. The most current information on epidemiology, diagnosis, and treatment of sexually transmitted diseases provided by the Centers for Disease Control and Prevention  can be found at http://www.cdc.gov. TABLE. Sexually Transmitted Diseases Disease Associated Pathogens Bacterial Gonorrhea Neisseria gonorrhoeae Syphilis Treponema pallidum Chancroid Hemophilus ducreyi Granuloma inguinale Calymmatobacterium granulomatis Enteric disease …

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Gonorrhea

Neisseria gonorrhoeae is a gram-negative diplococcus estimated to cause up to 600,000 infections per year in the United States. Clinical presentation Infected individuals may be symptomatic or asymptomatic, have complicated or uncomplicated infections, and have infections involving several anatomic sites. Approximately 15% of women with gonorrhea develop pelvic inflammatory disease. Left untreated, pelvic inflammatory disease can be an indirect cause of infertility and ectopic pregnancies. In 0.5% to 3.0% of patients with gonorrhea, the gonococci invade the bloodstream and produce disseminated disease. The usual clinical manifestations of disseminated gonnococcal infection are tender necrotic skin lesions, tenosynovitis, and monoarticular arthritis. Diagnosis Diagnosis of gonococcal infections can be made by gram-stained smears, culture …

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Syphilis

The causative organism of syphilis is Treponema pallidum, a spirochete. Syphilis is usually acquired by sexual contact with infected mucous membranes or cutaneous lesions, although on rare occasions it can be acquired by nonsexual personal contact, accidental inoculation, or blood transfusion. Clinical presentation The clinical presentation of syphilis is varied, with progression through multiple stages possible in untreated or inadequately treat patients (Table Presentation of Syphilis Infections). Primary Syphilis Primary syphilis is characterized by the appearance of a chancre on cutaneous or mucocutaneous tissue. Chancres persist only for 1 to 8 weeks before spontaneously disappearing. TABLE. Treatment of Gonorrhea Type of Infection Recommended Regimensa Alternative Regimensb Uncomplicated infections of the cervix, …

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Chlamydia

Infections caused by C. trachomatis are believed to be the most common STD in the United States that has more than doubled in the past 10 years. Clinical presentation In comparison with gonorrhea, chlamydial genital infections are more frequently asymptomatic, and when present, symptoms tend to be less noticeable. Table Presentation of Chlamydia Infections summarizes the usual clinical presentation of chlamydial infections. Similar to gonorrhea, chlamydia may be transmitted to an infant during contact with infected cervicovaginal secretions. Nearly two thirds of infants acquire chlamydial infection after endocervical exposure, with the primary morbidity associated with seeding of the infant’s eyes, nasopharynx, rectum, or vagina. Diagnosis Culture of endocervical or urethral epithelial …

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Genital herpes

The term herpes is used to describe two distinct but antigenically related serotypes of herpes simplex virus. Herpes simplex virus type 1 (Herpes Simplex Virus-1) is most commonly associated with oropharyngeal disease; type 2 (Herpes Simplex Virus-2) is most closely associated with genital disease. Diagnosis A presumptive diagnosis of genital herpes commonly is made on the basis of the presence of dark-field-negative, vesicular, or ulcerative genital lesions. A history of similar lesions or recent sexual contact with an individual with similar lesions also is useful in making the diagnosis. Tissue culture is the most specific (100%) and sensitive method (80% to 90%) of confirming the diagnosis of first-episode genital herpes. Treatment …

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Chancroid

Description of Medical Condition A sexually transmitted disease characterized by painful genital ulcerations and inflammatory inguinal adenopathy. It is uncommon in the United States but found worldwide. Chancroid is endemic in developing countries and a cofactor for HIV transmission. System(s) affected: Reproductive, Skin/Exocrine Genetics: N/A Incidence/Prevalence in USA: Fewer than 100 cases reported to the CDC in 2000-2002. Actual numbers felt to be greater due to underreporting of cases. Predominant age: Teenagers and adults Predominant sex: Male > Female Medical Symptoms and Signs of Disease • Tender genital papule that ulcerates after 24 hours • Irregular edged, painful ulcer(s) • Ulcers may be 1 mm to 5 cm in size • …

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Chlamydial sexually transmitted diseases

Description of Medical Condition An obligate intracellular membrane-bound prokaryotic organism, chlamydia trachomatis causes an estimated 3 million new sexually transmitted infections in the US each year. The estimated cost of chlamydia STDs in 1994 was $2 billion per year in the U.S., largely due to costly complications such as PID, infertility, and ectopic pregnancy. Studies indicate that 75-90% of women and 50-90% of men with chlamydial STD are asymptomatic. Persons with asymptomatic infection can remain infectious for years. Currently many more women than men are screened, leaving a large male reservoir of infection. System(s) affected: Reproductive Genetics: Unknown Incidence/Prevalence in USA: 3-5% general medical population, 5-15% of teens and young adults, …

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