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Sexually Transmitted Diseases

. 2. Chlamydia: Urethritis, Lymphogranuloma venereum3. Protozoa: Trichomonas vaginalis4. Fungal: Candida albicans5. Parasite: Acarus scabeii---- Scabeis Phthirus pubis----Pediculosis6. Viruses: HPV------- Genital warts HSV---- Genital herpes simplex

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Sexually Transmitted Diseases

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    1. Sexually Transmitted Diseases Causative Agents: 1.Bacterial: A. Spirochetes: Treponema pallidum B. Nesseria gonorrhea: Gonorrhea C. Haemophilus Ducreys: Chancroid D. Donovan granulomais: Granuloma inguinale

    2. 2. Chlamydia: Urethritis, Lymphogranuloma venereum 3. Protozoa: Trichomonas vaginalis 4. Fungal: Candida albicans 5. Parasite: Acarus scabeii---- Scabeis Phthirus pubis----Pediculosis 6. Viruses: HPV------- Genital warts HSV---- Genital herpes simplex Pox virus ------ Molloscum contagiosum HIV ------- AIDS HBV --------- Hepatitis

    3. Clinical Presentations 1. Itching: scabies, pediculosis, trichomoniasis, candidiasis 2. Genital ulcer: Primary syphilis. Cutaneous manifestations of secondary syphilis. Herpes progenitalis. Chancroid. Gummatous Ulceration of tertiary syphilis. Lymphogranuloma venereum granuloma Inguinale .

    4. 3. Papulonodular lesions: a. venereal warts ”Condylomata accuminata” b. Molloscum contagiosum c- Condylomata lata 4. Discharge: urethral or vaginal discharge 5. Systemic manifestations: Syphilis, Reiters syndrome, AIDS, Hepatitis

    5. Urethral Discharge Gonorrhea Neisseria gonorrhoeae: Gram-negative diplococci - coffee bean The target organs: urethra, cervical mucosa, pharynx, conjuctiva or anorectum Mode of Transmission Incubation Period: 2-5 days

    6. Clinical Features I. Males: Comlications: 1. Tysons gland infection: both sides of freulum of penis 2. Litters gland infection: Periurethral abscess 3. Cowpers glands infection: base of prostate 4. Acute prostatis 5. Chronic prostatis 6. vesiculitis, epidedymitis, epidedymoorchitis 7. Cystitis 8. Disseminated gonococcal infestion

    7. II. Females: Comlications: 1. Skenes glands infection: periurethal abscess or urethral stricture 2. Bartholin gland infection: cyst 3. Pelvic inflammatory disease: infertility

    8. Extragenital Gonorrhea 1. Proctitis 2. Ophthalmia neonatorum 3. Mouth and throat: pharyngitis 4. Disseminated gonococcal infection: arthriris, Tenosynovitis, endocarditis, meningitis, skin lesions

    9. Diagnosis 1. History 2. Urethral or endocervical smear 3. Two- glass urine test 4. Two- catch urine test 5. Culture: "chocolate" agar, Thayer-Martin medium 6. Oxidase test and sugar utilization test

    10. Treatment - treatment of partner - combined infection is common Single-Dose regimen: in uncomplicated gonorrhea Ceftriaxone 125 mg – i.m. injection Cefixime 400 mg- oral Ofloxacin 400 mg- oral Ciprofloxacin 500 mg- oral Levofloxacin 250 mg- oral Spectinomycin- 2gm Kanamycin- 2gm Cefotaxime- 500 mg

    11. In Disseminated gonococcal infection: The above drugs given 2-3 times/days for 3-10 days according to site and response Multiple dose regimen: Tetracycline 250mgX4 for 10 days Doxycycline 100mgX2 for 10 days Metheprim tablets 2X2 for 10 days

    12. Non- Gonococcal urethritis 1. Chlamydia trachomatis 50% 2. Bacteria: E. coli, Klebsiella, Proteus, Haemophilus vaginalis, ureaplasma urealyticum, intraurethaurethral chancre. 3. Viral: intraurethral H. simplex or wart 4. Protozoal: trichomonas vaginalis 5. Fungal: candidiasis 6. Stricture 7. Food and drug allergy 8. Chemical: strong detergents 9. True non- pecific urethritis

    13. Chlamydial urethritis The incubation period Clinical features: 1. in males: shower sign 2. in females: cervicitis or PID Diagnosis: 1. History 2. urethral or cervical smear 3. Culture 4. Serological test

    14. Treatment Azithromycin 1 gm orally as single dose Doxycycline 100 mg twice daily for 7 days Tetracycline 500mg X4 for 7 days Erythromycin 500mg X4 for 7 days

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