-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