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Sexually transmmited
diseases
1
2
STDs:
 Group of communicable diseases
transmitted by sexual contact.
 Caused by a wide range of bacterial, viral
,prot...
1.SYPHILIS
 Causative organism:
caused by spirochaetes-
TREPONEMA PALLIDUM
 Word derived from the name
of the mythologic...
 T.pallidum- a coiled spiral filament 10 µm long that moves
actively in fresh preparations
 The organism is rapidly dest...
Epidemiology
o infected 12 million people in 1999 .
90% of cases in thedeveloping world.
o affects 700,000 - 1.6 million p...
o Due to unsafe sexual practices.
o Syphilis increases the risk of HIV transmission
and co-infection is common.
o Untreate...
IMMUNOLOGYThe pathogenesis of lesions appear to be due to host immune
response.
2 types of serological tests for syphilis:...
3)T.Pallidum passive haemagglutination(TPHA) test
B.Non-treponemal serological test
 these measure non-specific antibodie...
MODE OF TRANSMISSION
• Sexual intercourse resulting in lesions on
glans penis,vulva,vagina & cervix
• Intimate person-to-p...
STAGES OF ACQUIRED SYPHILIS
3 stages depending upon the period after
which the lesions appear and the type of
lesions.
 P...
11
• The canchre heals without scarring
even in the absence of treatment.
• Antibody tests are positive in 1-2
weeks after...
12
• Secondary syphilis
• Patient develops mucocutaneous lesions
and painless lymphadenopathy in 2-3
months after exposure...
Tertiary syphilis
After about 2-3 years following first exposure
tertiary lesions appear.
• much less infective than other...
14
• it is a solitary localised rubbery lession with
central
necrosis seen in organs like liver,testis,bone and
brain.
2.D...
15
 Neurosyphilis may manifest as:
o Meningovascular syphilis affecting chiefly
the meninges.
o Tabes dorsalis affecting ...
CONGENITAL SYPHILIS
 May develop in foetus of more than 16 weeks who
is exposed to maternal blood
 A major cause of stil...
Major morphological features are:
 Saddle shaped nose deformity due to
destruction of bridge of nose
 The characteristic...
18
 Mucocutaneous lesions of acquired
secondary syphilis
 Bony lesions like epiphysitis and
periostitis
 Interstitial k...
19
PREVENTION
 Abstinence from intimate physical contact with an
infected person is effective , as is the proper use of
a la...
GONORRHEA
An acute ,infectious sexually transmitted
disease of mucous membranes of the
genitourinary tract,eyes,rectum & t...
22
Pathogenesis
A venereal disease;name employed by Galen
First step in infection is adhesion of gonococci to
urethra or...
23
 In women the initial infection involves
urethra and cervix uteri.It may extend to
Bartholin’sglands,endometrium&fallo...
 Blood invansion may occur from the
primary site of infection & may lead to
metastatic lesions such as
arthritis,ulcerati...
EPEDEMIOLOGY
 WHO -88 million cases of
gonorrhea occur each year,.
 2010 - 900 deaths down from
1,100 in 1990.
 In UK 1...
 In 2004, the rate of reported gonorrheal
infections was 113.5 per 100,000
persons.
 According to the CDC, "Overall, Afr...
Diagnosis:
Traditionally, gonorrhea was diagnosed
with gram stain and culture;
PCR-based testing methods are becoming
comm...
TREATEMENT
 Antibiotic resistancehas developed to a
number of agents,
including macrolides, clindamycin,
and rifampin.
 ...
29
 CDC reccomendation for
uncomplicated
gonorrhea:
 Ceftriaxone 125mg single IM dose
or
 Ciprofloxacin 500mg single or...
30
CONTROL OF GONORRHEA
Consist of early detection of cases
,contact tracing,health education
and other general measures....
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Syphilis and gonorrhea - Its etiology, pathophysiology, signs and symptoms,diagnosis and prevention

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Discussed about Syphilis and gonorrhea - Its etiology, pathophysiology, signs and symptoms,diagnosis and prevention. Also dicussed about the classifications of both STDs and its diagnostic tests

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Syphilis and gonorrhea - Its etiology, pathophysiology, signs and symptoms,diagnosis and prevention

  1. 1. Sexually transmmited diseases 1
  2. 2. 2 STDs:  Group of communicable diseases transmitted by sexual contact.  Caused by a wide range of bacterial, viral ,protozoal and fungal agents and ectoparasites.  Previously known as veneral diseases.
  3. 3. 1.SYPHILIS  Causative organism: caused by spirochaetes- TREPONEMA PALLIDUM  Word derived from the name of the mythological handsome boy ,syphilus who was cursed by Greek God Apollo with the disease. 3
  4. 4.  T.pallidum- a coiled spiral filament 10 µm long that moves actively in fresh preparations  The organism is rapidly destroyed by heat,cold,& antiseptics.  The organism cant be stained by the usual methods & can be seen in the exudates & tissues by: • Dark ground illumination in fresh preparations • Fluorescent antibody technique • PCR as a research method 4
  5. 5. Epidemiology o infected 12 million people in 1999 . 90% of cases in thedeveloping world. o affects 700,000 - 1.6 million pregnancies a year. spontaneous abortions, stillbirths, and congenital syphilis. o Sub-Saharan Africa -20% of perinatal deaths. o Since 2000, rates of syphilis have been increasing in the US, UK, Australia and Europe primarily among men who have sex with men.5
  6. 6. o Due to unsafe sexual practices. o Syphilis increases the risk of HIV transmission and co-infection is common. o Untreated it has a mortality of 8% to 58% with a greater death rate in males. o 19th and 20th century-less severe symptoms, due to widespread availability of effective treatment and decreasing virulence of the spirochete. o With early treatment few complications 6
  7. 7. IMMUNOLOGYThe pathogenesis of lesions appear to be due to host immune response. 2 types of serological tests for syphilis: A.Treponemal serological test Measure antibody to T.pallidum antigen & are as under: 1)Fluorescent treponemal antibody-absorbed(FTA-ABS)test. 2)Agglutinin assays eg:microhaemagglutination assay for T.pallidum(MHA-TP) & Serodia TP-PA which is more sensitive 7
  8. 8. 3)T.Pallidum passive haemagglutination(TPHA) test B.Non-treponemal serological test  these measure non-specific antibodies IgM & IgG immunoglobulins directed against cardiolipin-lecithin-cholesterol complex & are more commonly used. These are as under: 1)Reiter protein compliment fixation(RPCF): Test of choice for rapid diagnosis 2)Veneral disease research laboratory(VDRL) test Wassermann described a compliment fixing antibody against antigen of human syphilitic tissue.This antigen is used in VDRL test 8
  9. 9. MODE OF TRANSMISSION • Sexual intercourse resulting in lesions on glans penis,vulva,vagina & cervix • Intimate person-to-person contact with lesions on lips,tongues or fingers • Transfusion of infected blood • Materno-foetal transmission in congenital syphilis if mother is infected 9
  10. 10. STAGES OF ACQUIRED SYPHILIS 3 stages depending upon the period after which the lesions appear and the type of lesions.  Primary syphilis • Chancre appear on genitals or extra genital sites in 2-4 weeks after exposure to infection • Initially the lesion is painless papule which ulcerates in the centre so that the fully developed chancre is an indurated 10
  11. 11. 11 • The canchre heals without scarring even in the absence of treatment. • Antibody tests are positive in 1-2 weeks after the appearance of canchre.
  12. 12. 12 • Secondary syphilis • Patient develops mucocutaneous lesions and painless lymphadenopathy in 2-3 months after exposure • ML may be in the form of mucous patches on mouth,pharynx and vagina. • Antibody tests are always positive at this stage.it is a highly infective stage .Spirochaetes can be easily demonstrated in mucocutaneous lesions
  13. 13. Tertiary syphilis After about 2-3 years following first exposure tertiary lesions appear. • much less infective than other 2 stages and spirochaetes can be demonstrated with great difficulty. • The lesions are of 2 types: 1.syphilitic gumma 13
  14. 14. 14 • it is a solitary localised rubbery lession with central necrosis seen in organs like liver,testis,bone and brain. 2.Diffuse lessions of tertiary syphilis. • the lessions appear following widespread dissemination of spirochaetes in the body.these lesions are as under;  Cardiovascular syphilis • The walls of aorta is weakened and dialated due to syphilitic aortitis and results in aortic aneurysm,incompetence of aortic valve and
  15. 15. 15  Neurosyphilis may manifest as: o Meningovascular syphilis affecting chiefly the meninges. o Tabes dorsalis affecting the spinal cord. o General paresis affecting the brain.
  16. 16. CONGENITAL SYPHILIS  May develop in foetus of more than 16 weeks who is exposed to maternal blood  A major cause of still birth  Pregnancies in women with primary & secondary syphilis often end in spontaneous abortion,perinatal death or a child with congenital syphilis  Antibiotics used to treat are penicillin,doxycycline,and erythromycine 16
  17. 17. Major morphological features are:  Saddle shaped nose deformity due to destruction of bridge of nose  The characteristic Hutchinson’s teeth which are small widely spaced,peg-shaped permanent teeth 17
  18. 18. 18  Mucocutaneous lesions of acquired secondary syphilis  Bony lesions like epiphysitis and periostitis  Interstitial keratitis with corneal opacity  Diffuse fibrosis in liver and interstitial fibrosis of lungs  One of the most serious consequence of congenital syphilis –neurological damage with mental retardation
  19. 19. 19
  20. 20. PREVENTION  Abstinence from intimate physical contact with an infected person is effective , as is the proper use of a latex condom.  Congenital syphilis - by screening mothers during early pregnancy and treating those who are infected  The first-choice treatment for uncomplicated syphilis - single dose of im benzathine penicillin or a single dose of oral azithromycin.  Doxycycline andtetracycline are alternative choices; but not recommended for pregnant women,due to risk of birth defects. 20
  21. 21. GONORRHEA An acute ,infectious sexually transmitted disease of mucous membranes of the genitourinary tract,eyes,rectum & throat. Causative organism Caused by gram-negative oxidase- positive,diplococcus,Neisseria gonorrhoea. 21
  22. 22. 22 Pathogenesis A venereal disease;name employed by Galen First step in infection is adhesion of gonococci to urethra or other mucosal surface.  The incubation period is 2-8 days.  In men, the disease start as an acute urethritis with a discharge containing gonococci in large numbers.infection extends along the urethra to prostrate,seminal vescicle & epididymis
  23. 23. 23  In women the initial infection involves urethra and cervix uteri.It may extend to Bartholin’sglands,endometrium&fallopian tube.pelvic inflamatory disease and salpingitis may lead to sterility.  Conjunctivitis may occur,usually due to autoinoculation by patients fingers
  24. 24.  Blood invansion may occur from the primary site of infection & may lead to metastatic lesions such as arthritis,ulcerative endocarditis.  A non venereal infection is gonococcal opthalmia in newborn - direct infection during passage through birth canal. -controlled by instilling 1% silver nitrate solutio into the eyes of newborn. 24
  25. 25. EPEDEMIOLOGY  WHO -88 million cases of gonorrhea occur each year,.  2010 - 900 deaths down from 1,100 in 1990.  In UK 196 per 100,000 males 20 to 24 years old and 133 per 100,000 females 16 to 19 years old were diagnosed in 2005. 25
  26. 26.  In 2004, the rate of reported gonorrheal infections was 113.5 per 100,000 persons.  According to the CDC, "Overall, African Americans are most affected by gonorrhea. Blacks accounted for 69% of all gonorrhea cases in 2010. 26
  27. 27. Diagnosis: Traditionally, gonorrhea was diagnosed with gram stain and culture; PCR-based testing methods are becoming common. .All people testing positive for gonorrhea should be tested for other sexually transmitted diseases such as chlamydia, syphilis, and human immunodeficiency virus 27
  28. 28. TREATEMENT  Antibiotic resistancehas developed to a number of agents, including macrolides, clindamycin, and rifampin.  Ceftriaxone, a third- generation cephalosporin antibiotic, may be as effective as penicillin-based treatment. 28
  29. 29. 29  CDC reccomendation for uncomplicated gonorrhea:  Ceftriaxone 125mg single IM dose or  Ciprofloxacin 500mg single oral dose plus doxycycline 100mg twice daily for 7 days or  Erythromycine 1g single oral dose.
  30. 30. 30 CONTROL OF GONORRHEA Consist of early detection of cases ,contact tracing,health education and other general measures. As the disease does not confer any immunity vaccination has no place in prophylaxis.
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Discussed about Syphilis and gonorrhea - Its etiology, pathophysiology, signs and symptoms,diagnosis and prevention. Also dicussed about the classifications of both STDs and its diagnostic tests

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