Unit 3 NU 545
What is an STI? (affect more than 20 million Americans per year, and 1/2 are younger than 25
years. Hidden epidemic.
STI: is the general term for any disease that can be spread by intimate and/or sexual contact.
Includes systemic diseases such as hepatitis and tuberculosis
Is prevalent in all socioeconomic and racial or ethnic groups
Individuals who have unprotected non monogamous sex have the greatest risk for STI exposure
and infection.
Types of sexually transmitted urogenital infections
Bacterial -(gonorrhea-syphilis-chancroid-granuloma inguinale-bacterial vaginosis)
Viral
Protozoal
Parasitic
Fungal
Gonorrhea (Bacterial infection)
Disseminated gonococcal infection (DGI)
•Rare systemic complication brought about by the spread of infection through the bloodstream
•Life-threatening condition causing a generalized rash and severe joint pain
Perihepatitis
•Spread of N. gonorrhoeae to the liver
Ophthalmia neonatorum
•Gonococcal eye infection in an infant from an infected mother (most states require prophylactic
ophthalmic antibiotics to prevent gonococcal eye infection. Topical antibiotics may not be
effective in eliminating neonatal infection and systemic tx. is indicated for all newborns with
,known exposure. (onset of symptoms 1-12 days) Newborns may also develop gonorrheal
rhinitis.
Gonorrhea (Bacterial infection)
Is caused by Neisseria gonorrhoeae.
Transmission generally requires the contact of epithelial surfaces such as vaginal, oral, or anal
intercourse, and infection in the adults can be in the vagina, rectum, oropharynx, and the
urethra.
Pregnant women can pass gonorrhea to her fetus through infected cervical and vaginal
secretions, and a mother can pass it to her newborn child. Following vertical transmission, the
newborn eyes can be infected and result in blindness if untreated.
Humans are the only natural hosts.
Presence of pili helps N. gonorrhoeae attach to the epithelial cells of mucous membranes.
Why is treatment for gonorrhea becoming more difficult?
because of rapidly developing resistance to antibiotics. CDC and WHO advise dual drug
treatment to treat the infection and staunch increasing resistance.
Antibiotic resistance is most common in those who frequently have oral and anal intercourse
(men with men) CDC says gonorrhea is likely to become resistant to all antibiotics in the near
future.
Common sites/complications of gonorrhea (Bacterial infection)
•Endocervical canal (inner portion of the cervix): most common site for women
•Urethra
•Skene and/or Bartholin glands
•Urethra or rectum: most common site for men
Complications:
,•Pelvic inflammatory disease (PID)
•Sterility
•Disseminated infection
Clinical manifestations of gonorrhea (Bacterial infection)
•Men: sudden onset of painful urination or purulent penile discharge, or both (within a week from
infection)
•Women (within 10 days of exposure or 1-2 days after the next period. More than half are
asymptomatic
Symptoms often do not appear until they have spread to the upper reproductive tract (uterus,
fallopian/uterine tubes, and ovaries)
Dysuria (difficult/painful urination)
Increased vaginal discharge, increased flow or dysmenorrhea, dyspareunia (painful sex) , lower
abdominal and/or pelvic pain
Fever; mucopurulent discharge from the cervical os
treatment for gonorrhea (Bacterial infection)
•Antibiotic (ceftriaxone)
•Multidrug administration to reduce resistance
•Resistant to many antibiotics
•Treatment of partners
•Avoidance of sex until infection resolved, then usage of condoms
What is syphilis? (Bacterial infection)
On the increase from men having sex with men
Treponema pallidum (anaerobic spirochete)
, •Is a corkscrew-shaped, anaerobic bacterium that cannot be cultured in vitro (grow in human
organ or tissue only)
•Infects any body tissue
•Becomes a systemic disease shortly after infection
Maternal-fetal transmission can occur as early as 9 weeks’ gestation.
Tests
•Darkfield microscopy and serologic testing
Where is the bacteria from syphilis present? (Bacterial infection)
exuded from moist mucosal or cutaneous lesions, the spirochete is usually transmitted to others
during the first few years of infection.
Why does untreated early syphilis result in perinatal death (40-70%) during pregnancy?
(Bacterial infection)
Because the spirochete can cross the placental membrane to infect the fetus. However, simple
tx with penicillin is 98% effective at preventing vertical transmission (from mother to baby during
the period immediately before and after birth) .
Therefore, all pregnant women should be screened at their first prenatal visit, and women at risk
should be screened again in the 3rd trimester and at the time of delivery.
The course of untreated syphilis consists of 4 stages:
Stage 1 Primary (usually painless, round, and hard sores)
Secondary
Latent
Tertiary
Primary syphilis: local invasion
What is an STI? (affect more than 20 million Americans per year, and 1/2 are younger than 25
years. Hidden epidemic.
STI: is the general term for any disease that can be spread by intimate and/or sexual contact.
Includes systemic diseases such as hepatitis and tuberculosis
Is prevalent in all socioeconomic and racial or ethnic groups
Individuals who have unprotected non monogamous sex have the greatest risk for STI exposure
and infection.
Types of sexually transmitted urogenital infections
Bacterial -(gonorrhea-syphilis-chancroid-granuloma inguinale-bacterial vaginosis)
Viral
Protozoal
Parasitic
Fungal
Gonorrhea (Bacterial infection)
Disseminated gonococcal infection (DGI)
•Rare systemic complication brought about by the spread of infection through the bloodstream
•Life-threatening condition causing a generalized rash and severe joint pain
Perihepatitis
•Spread of N. gonorrhoeae to the liver
Ophthalmia neonatorum
•Gonococcal eye infection in an infant from an infected mother (most states require prophylactic
ophthalmic antibiotics to prevent gonococcal eye infection. Topical antibiotics may not be
effective in eliminating neonatal infection and systemic tx. is indicated for all newborns with
,known exposure. (onset of symptoms 1-12 days) Newborns may also develop gonorrheal
rhinitis.
Gonorrhea (Bacterial infection)
Is caused by Neisseria gonorrhoeae.
Transmission generally requires the contact of epithelial surfaces such as vaginal, oral, or anal
intercourse, and infection in the adults can be in the vagina, rectum, oropharynx, and the
urethra.
Pregnant women can pass gonorrhea to her fetus through infected cervical and vaginal
secretions, and a mother can pass it to her newborn child. Following vertical transmission, the
newborn eyes can be infected and result in blindness if untreated.
Humans are the only natural hosts.
Presence of pili helps N. gonorrhoeae attach to the epithelial cells of mucous membranes.
Why is treatment for gonorrhea becoming more difficult?
because of rapidly developing resistance to antibiotics. CDC and WHO advise dual drug
treatment to treat the infection and staunch increasing resistance.
Antibiotic resistance is most common in those who frequently have oral and anal intercourse
(men with men) CDC says gonorrhea is likely to become resistant to all antibiotics in the near
future.
Common sites/complications of gonorrhea (Bacterial infection)
•Endocervical canal (inner portion of the cervix): most common site for women
•Urethra
•Skene and/or Bartholin glands
•Urethra or rectum: most common site for men
Complications:
,•Pelvic inflammatory disease (PID)
•Sterility
•Disseminated infection
Clinical manifestations of gonorrhea (Bacterial infection)
•Men: sudden onset of painful urination or purulent penile discharge, or both (within a week from
infection)
•Women (within 10 days of exposure or 1-2 days after the next period. More than half are
asymptomatic
Symptoms often do not appear until they have spread to the upper reproductive tract (uterus,
fallopian/uterine tubes, and ovaries)
Dysuria (difficult/painful urination)
Increased vaginal discharge, increased flow or dysmenorrhea, dyspareunia (painful sex) , lower
abdominal and/or pelvic pain
Fever; mucopurulent discharge from the cervical os
treatment for gonorrhea (Bacterial infection)
•Antibiotic (ceftriaxone)
•Multidrug administration to reduce resistance
•Resistant to many antibiotics
•Treatment of partners
•Avoidance of sex until infection resolved, then usage of condoms
What is syphilis? (Bacterial infection)
On the increase from men having sex with men
Treponema pallidum (anaerobic spirochete)
, •Is a corkscrew-shaped, anaerobic bacterium that cannot be cultured in vitro (grow in human
organ or tissue only)
•Infects any body tissue
•Becomes a systemic disease shortly after infection
Maternal-fetal transmission can occur as early as 9 weeks’ gestation.
Tests
•Darkfield microscopy and serologic testing
Where is the bacteria from syphilis present? (Bacterial infection)
exuded from moist mucosal or cutaneous lesions, the spirochete is usually transmitted to others
during the first few years of infection.
Why does untreated early syphilis result in perinatal death (40-70%) during pregnancy?
(Bacterial infection)
Because the spirochete can cross the placental membrane to infect the fetus. However, simple
tx with penicillin is 98% effective at preventing vertical transmission (from mother to baby during
the period immediately before and after birth) .
Therefore, all pregnant women should be screened at their first prenatal visit, and women at risk
should be screened again in the 3rd trimester and at the time of delivery.
The course of untreated syphilis consists of 4 stages:
Stage 1 Primary (usually painless, round, and hard sores)
Secondary
Latent
Tertiary
Primary syphilis: local invasion
