-IBIS-1.5.0-
tx
reproductive system
venereal disease
diagnoses

definition and etiology

definition:
The five most common venereal diseases, more recently termed "sexually transmitted diseases" or "STDs", have been syphilis, gonorrhea, chancroid, lymphogranuloma inguinale, and granuloma inguinale. Recently, other communicable diseases have been added and are on the rise. These include nonspecific urethritis, trichomonas, chlamydial infections, genital candidiasis (yeast infection), herpes, warts, lice and HPV.

etiology:
The etiology depends upon the disease. All are transmitted (but not exclusively) via sexual contact.

signs and symptoms

signs and symptoms:

candidiasis: (yeast infection):
• intense itching
• pasty discharge in women
• hyphae visible on wet mount

trichomonas:
• heavy, yellow, frothy, discharge
• "flea bitten", "strawberry" cervix
• males often asymptomatic
• often self-limiting in males

gardnerella:
now known as hemophilus vaginalis
• main complaint: odor
• on saline wet mount: fishy smell when mixed with KOH

chlamydia:
• cervicitis
• burning on urination
• an intracellular bacterial parasite; hard to culture; attacks the columnar epithelium

gonorrhea:
• gram (-) diplococci
• females may be asymptomatic
• may lead to PID, pelvic inflammatory disease
• in males affects the prostate, urethra; penile discharge
• painful urination
• female: painful urination; dysmenorrhea, dyspareunia
• may spread to eyes, oropharynx, synovial fluid of joints, rectum
• culture positive (80% accurate)

herpes:
• many small vesicles on penis, cervix, vulva
• itching
• headache
• neuritis in dermatome (i.e. anterior thigh)
• dysuria

syphilis: "to study syphilis is to study medicine"
1° (3 weeks)
• chancre on penis, vagina, cervix, rectum, anus
2° (6 weeks post-primary)
• rash on hands and feet
• fever, sore throat, nausea
• flat-topped growths (condyloma lata)
• arthralgia
• headaches
3° (10-20 years)
• large, destructive lesions in any body system, most notably the nervous system;
• neurosyphilis: affects posterior portion of spinal cord

lab findings:
• culture of lesions or discharge
• Tzanck smear for herpes
• VDRL or RPR for syphilis
• chlamydia antigen staining
• wet prep

course and prognosis

• varies with different conditions; some are minor and heal quickly with appropriate treatment; some, like herpes are lifelong and recurrent; others, like syphilis, have serious sequelae.

differential diagnosis

• Differentiate the causative agents
• Be mindful of septicemia and pelvic inflammatory disease as possible complications.


footnotes