stds

Views:
 
Category: Entertainment
     
 

Presentation Description

No description available.

Comments

Presentation Transcript

SEXUALLY TRANSMITTED DISEASES:

SEXUALLY TRANSMITTED DISEASES Dr. Ashish J Post Graduate Dept of Microbiology

LEARNING OBJECTIVES:

LEARNING OBJECTIVES Overview Listing the causes Covering bacterial causes of STD Clinical manifestations Diagnosis Treatment

KEY QUESTIONS:

KEY QUESTIONS Most practical, clinically useful diagnostic tests Most appropriate antibiotics for treatment Characteristic lesions

SEXUALLY TRANSMITTED DISEASES OVERVIEW:

SEXUALLY TRANSMITTED DISEASES OVERVIEW

SEXUALLY TRANSMITTED DISEASES OVERVIEW:

SEXUALLY TRANSMITTED DISEASES OVERVIEW Esoterica

Over view:

Over view “ Group of communicable diseases which are transmitted predominantly or entirely by sexual contact.” Most STD contracted by 15-45 year old. Postulated that in some countries 1 in 4 people affected. Target anyone.

PowerPoint Presentation:

Table 124-1 Sexually Transmitted and Sexually Transmissible Microorganisms Bacteria Viruses Other a Transmitted in Adults Predominantly by Sexual Intercourse Neisseria gonorrhoeae Chlamydia trachomatis Treponema pallidum Haemophilus ducreyi Calymmatobacterium granulomatis Ureaplasma urealyticum HIV (types 1 and 2) Human T-cell lymphotropic virus type I Herpes simplex virus type 2 Human papillomavirus (multiple genotypes) Hepatitis B virus b Molluscum contagiosum virus Trichomonas vaginalis Phthirus pubis

PowerPoint Presentation:

Sexual Transmission Repeatedly Described but Not Well Defined or Not the Predominant Mode Mycoplasma hominis Mycoplasma genitalium Gardnerella vaginalis and other vaginal bacteria Mobiluncus spp. Helicobacter cinaedi Helicobacter fennelliae Cytomegalovirus Human T-cell lymphotropic virus type II (?) Hepatitis C, D viruses Herpes simplex virus type 1 (?) Epstein-Barr virus Human herpesvirus type 8 Candida albicans Sarcoptes scabiei

PowerPoint Presentation:

Transmitted by Sexual Contact Involving Oral-Fecal Exposure; of Declining Importance in Homosexual Men Shigella spp. Campylobacter spp. Hepatitis A virus Giardia lamblia Entamoeba histolytica

History taking:

History taking Age group Sexual History Traveling history. On treatment Underlying diseases Mode of onset

Symptoms suggestive:

Symptoms suggestive Abnormal discharge from vagina or penis Pain or burning sensation with urination. Sore or blister which is painful and swollen. Abnormal vaginal bleeding or severe menstrual cramps. Itching in vaginal or rectal area. Pain in lower abdomen especially for women. Pain during sex. Skin rash or mouth lesions.

Morphological characteristics Lesions:

Morphological characteristics Lesions Ulcers: Papules Vaginal Discharge Vesicles and Bullae Diffuse erythema Crusts. Hypertrophic lesions Extragenital manifestations

Major STD syndromes:

Major STD syndromes Male Urethritis Epididymitis Female Urethritis Vulvovaginitis Cervicitis Vulvitis

PowerPoint Presentation:

PID Infertility Ulcerative lesions. Proctitis Proctocolitis or enterocolitis Enteritis Acute arthritis with urogenital infection Genital and anal warts Mononucleosis syndrome Hepatitis Scabies Pubic lice

Lab Diagnosis:

Lab Diagnosis Sample collection Transport Direct Microscopy Culture Biochemical test. Serological Test Direct Detection test. PCR

CHLAMYDIA :

CHLAMYDIA Pathogen - Chlamydia trachomatis Obligate intracellular parasite Can be grown in tissue culture

CHLAMYDIA TRACHOMATIS:

CHLAMYDIA TRACHOMATIS

CHLAMYDIA MICROBIOLOGY:

CHLAMYDIA MICROBIOLOGY Reticular body Elementary body – infectious form

CHLAMYDIA MECHANISMS OF TRANSMISSION:

CHLAMYDIA MECHANISMS OF TRANSMISSION Sexual contact Perinatal

CHLAMYDIA Frequency:

CHLAMYDIA Frequency Most common STD 3 - 5 x as common as gonorrhea Prevalence varies with the population

CHLAMYDIA MANIFESTATIONS IN MEN:

CHLAMYDIA MANIFESTATIONS IN MEN Urethritis Proctitis Epididymitis

CHLAMYDIA MANIFESTATIONS IN WOMEN:

CHLAMYDIA MANIFESTATIONS IN WOMEN Urethritis Endocervicitis Proctitis PID Perihepatitis

FITZ-HUGH-CURTIS SYNDROME:

FITZ-HUGH-CURTIS SYNDROME

CHLAMYDIA SEQUELAE:

CHLAMYDIA SEQUELAE Infertility Ectopic pregnancy Chronic pelvic pain

LGV CLINICAL MANIFESTATIONS:

LGV CLINICAL MANIFESTATIONS

CHLAMYDIA DIAGNOSIS:

CHLAMYDIA DIAGNOSIS Clinical examination Specimen Microscopy: Culture: McCoy and HeLA Cell Culture Nucleic acid probes – PCR Serologic- CFT, Micro IF, ELISA

CHLAMYDIA DIAGNOSIS:

CHLAMYDIA DIAGNOSIS

CHLAMYDIA TREATMENT:

CHLAMYDIA TREATMENT Patient and partner should be treated Drugs of choice Doxycycline Erythromycin AZITHROMYCIN

CHLAMYDIA UNUSUAL PRESENTATIONS:

CHLAMYDIA UNUSUAL PRESENTATIONS Trachoma Inclusion conjunctivitis

TRACHOMA:

TRACHOMA

INCLUSION CONJUNCTIVITS:

INCLUSION CONJUNCTIVITS

GONORRHEA MICROBIOLOGY:

GONORRHEA MICROBIOLOGY Pathogen – Neissseria gonorrhoea Gram-negative diploccus Nutritionally demanding. Always pathogen

GONORRHEA MECHANISMS OF TRANSMISSION:

GONORRHEA MECHANISMS OF TRANSMISSION Sexual contact Perinatal

GONORRHEA FREQUENCY:

GONORRHEA FREQUENCY Less common than chlamydia Prevalence varies with population

GONORRHEA MANIFESTATIONS IN MEN:

GONORRHEA MANIFESTATIONS IN MEN Urethritis Epididymitis Proctitis Pharyngitis

GONORRHEA CLINICAL PRESENTATION:

GONORRHEA CLINICAL PRESENTATION

GONORRHEA MANIFESTATIONS IN WOMEN:

GONORRHEA MANIFESTATIONS IN WOMEN Urethritis Endocervicitis Proctitis PID Pharyngitis

GONORRHEA DISSEMINATED INFECTION:

GONORRHEA DISSEMINATED INFECTION Arthritis- Tenosynovitis Dermatitis Pericarditis and endocarditis Meningitis Perihepatitis

DISSEMINATED GONORRHEA CLINICAL PRESENTATION:

DISSEMINATED GONORRHEA CLINICAL PRESENTATION

GONORRHEA DIAGNOSIS:

GONORRHEA DIAGNOSIS Clinical examination Sample Transport media Gram stain Direct Detection test Culture- 5 types of growth Biochemical reactions Nucleic acid probes

GONORRHEA GRAM STAIN:

GONORRHEA GRAM STAIN

GONORRHEA TREATMENT:

GONORRHEA TREATMENT Patient and partner should be treated Drugs of choice Ceftriaxone – 125 mg i.m . Quinolone – concern with increasing resistance

GONORRHEA SEQUELAE:

GONORRHEA SEQUELAE Infertility Ectopic pregnancy Chronic pelvic pain

SYPHILIS MICROBIOLOGY:

SYPHILIS MICROBIOLOGY Pathogen - Treponema pallidum Cannot be cultivated in vitro 50% escape

SYPHILIS FREQUENCY:

SYPHILIS FREQUENCY Incidence has increased , especially in females aged 15-24 years Highest prevalence – truck drivers, high risk groups

SYPHILIS MECHANISMS OF TRANSMISSION:

SYPHILIS MECHANISMS OF TRANSMISSION Sexual contact Perinatal

CONGENITAL SYPHILIS RISK OF PERINATAL TRANSMISSION:

CONGENITAL SYPHILIS RISK OF PERINATAL TRANSMISSION % Stage of Disease

SYPHILIS DIAGNOSIS:

SYPHILIS DIAGNOSIS Clinical examination Sample collection Gold standard Darkfield microscopy – rarely used Immunofluorescnce Monoclonal antibody Silver Impregenation

PowerPoint Presentation:

Serological test Non treponemal tests- VDRL, RPR Treponemal tests- Using live treponema-TPI Using killed treponema- TPA, TPIA, FTA, FTA-ABS. Using an extract of treponema- TPHA, MHA-TP

PRIMARY SYPHILIS PRINCIPAL CLINICAL FINDING:

PRIMARY SYPHILIS PRINCIPAL CLINICAL FINDING

SECONDARY SYPHILIS PRINCIPAL CLINICAL FINDINGS:

SECONDARY SYPHILIS PRINCIPAL CLINICAL FINDINGS

SECONDARY SYPHILIS PRINCIPAL CLINICAL FINDINGS:

SECONDARY SYPHILIS PRINCIPAL CLINICAL FINDINGS

LATE STAGE SYPHILIS PRINCIPAL CLINICAL MANIFESTATIONS:

LATE STAGE SYPHILIS PRINCIPAL CLINICAL MANIFESTATIONS Destructive gummas Aortic valve injury CNS manifestations Dementia Tabes dorsalis Pupillary abnormalities

ARGYLL-ROBERTSON PUPIL:

ARGYLL-ROBERTSON PUPIL Accommodates but does not react

LATE STAGE SYPHYLIS GUMMAS:

LATE STAGE SYPHYLIS GUMMAS

CONGENITAL SYPHILIS CLINICAL MANIFESTATIONS:

CONGENITAL SYPHILIS CLINICAL MANIFESTATIONS Fetal death Growth restriction Multiple anomalies Immediately apparent at birth Delayed appearance

CONGENITAL SYPHILIS ABNORMAL DENTITION:

CONGENITAL SYPHILIS ABNORMAL DENTITION

CONGENITAL SYPHILIS SABER SHINS:

CONGENITAL SYPHILIS SABER SHINS

SYPHILIS TREATMENT:

SYPHILIS TREATMENT Patient and sexual partner(s) should be treated Antibiotic therapy Penicillin – preferred in pregnancy Doxycycline Tetracycline

STDs CONCLUSIONS:

STDs CONCLUSIONS Infection Diagnosis Treatment Chlamydia PCR Azithromycin Gonorrhea PCR Ceftriaxone Syphilis Serology Penicillin

Haemphilus ducreyi:

Haemphilus ducreyi 1890 Association with HIV Gram -ive coco bacilli School of fish, rail road. Soft chancre Location of lesion normally in genitalia

PowerPoint Presentation:

Lab diagnosis. Collection of specimen Microscopy Culture- Chococlate agar with 1%Iso Vitalex and containing vancomycin. Biochemical inert Rapid diagnostic method Treatment Azithromycin, Erythromycin, Co-trimoxazole, all for 7 days Ceftriaxone Treat partner Treat the nodes

Calymmatobacterium granulomatis:

Calymmatobacterium granulomatis Gram neg cocco bacilli Safety pin appearance Morphologically similar to Klebsiella Poorly defined. Donovan bodies. Donovanosis. Subcutaneous spread. Gross deformities. Link to Ca.

PowerPoint Presentation:

Diagnosis Clinical manifestation Histologic examination of punch biopsy Microscopy examination Indirect immunofluorescence test. Culture- Egg yolk, yolk sac of embryonated hens egg. Treatment Azithromycin, Chloramphenicol, Ceftriaxone,

Gardenella vaginalis:

Gardenella vaginalis Associated with Bacterial vaginosis along with anaerobic bacteria Characterized by vaginal pH>4.5 Presence of clue cells Fishy odour Only normal mucoid discharge Clue cells Treatment is Clindamycin, Vancomycin

Mobiluncus:

Mobiluncus Slightly curved bacilli and occur in single or pairs. Essentially anaerobe Distinct odour Bacterial vaginosis. Lab Diagnosis Clue cells. Treatment for bacterial vaginosis Oral- Metronidazole, Clindamycin, Cephelexin, Cefadoxryl Vaginal- Clindamycin, Metronidazole.

Mycoplasma:

Mycoplasma Mycoplasma hominis- PID, postabortal and post partum fever Mycoplasma genitalium- Non gonococcal urethritis Ureaplasma urealyticum- Non gonococcal urethritis and prostatis

References :

References Koneman- Textbook of microbiology Bailey and Scott- Textbook of diagnostic microbiology Harrison’s textbook of medicine Trees DI, Morse SA. Chancroid and Haemophilus ducreyi: An update. Clin Microbiol Oriel JD. The history of non-gonococcal urethritis. Genitourin Med. Taylor-Robinson. The history of non gonococcal urethritis Larsen B. Vaginal flora in health and disease. Clin Obstet Gynecol. Greenwood- Textbook of microbiology Ananthnarayan and Paniker- Textbook of microbiology

authorStream Live Help