ID - sexually transmitted infections Flashcards
Which stage of syphilis is infectious?
Which is not infectious?
EARLY stage is INFECTIOUS!
LATE stage is not infectious
In which stage of syphilis are there high numbers of spirochetes in the lesions?
In which stage are there low numbers of spirochetes in the lesions?
EARLY stage = abundant spirochetes
Late stage = lesions contain few demonstrable spirochetes
What are the primary lesions of syphilis?
chancre (at infection site) & regional lymphadenopathy
What are the secondary lesions of syphilis?
skin: nonpruritic macular, papular, pustular or follicular (NOT vesicular). Palms & soles common
mucous membranes: highly infectious mucous patches
What is the timeline of untreated syphilis?
- sexual exposure to partner with syphilis
- 3-4 weeks later: an initial small erosion that quickly becomes a painless superficial ulcer (at site of inoculation); also, enlargement of regional lymph nodes
- a few weeks to 6 months later: distant skin & mucosal lesions; condyloma lata
- Then, a LATENT stage, may last a few months to a lifetime: no physical signs; positive serologic tests for syphilis
- Late/tertiary syphilis: gummatous lesions (anywhere, but skin & bone common); CVD, ocular problems, respiratory problems, GI problems
What is the specific secondary lesion of syphilis?
CONDYLOMA LATA
fused, weeping papules of skin/mucous membranes, sometimes mistaken for genital warts
Which phase does neurosyphilis occur in?
Neurosyphilis can occur AT ANY TIME
What is the treatment for syphilis?
PENICILLIN, PENICILLIN, PENICILLIN
What organism causes syphilis?
Treponema pallidum, a spirochete
What organism causes gonorrhea?
Neisseria gonorrhoeae, a gram-negative diplococcus
Likes to live in polymorphonuclear cells
What organism causes genital herpes?
HSV-2
What lab tests do you do for herpes?
Tzanck smear (large multinucleated cells)
PCR
Direct fluorescent antibody test
Where do genital herpes lesions occur?
penile shaft, labia, perianal, buttocks
What organism causes granuloma inguinale?
Calymmatobacterium (Donovania) granulomatis (CURRENT)
Klebsiella granulomatis (lecturer)
What is the pathognomonic cell of granuloma inguinale?
Large, contains intracytoplasmic cysts filled with bodies (Donovan bodies) that stain deeply with Wright stain
How is granuloma inguinale treated?
doxycycline
azithromycin
ciprofloxacin
Name 2 STIs with PAINFUL ulcers.
genital herpes (HSV-2) chancroid (H. ducreyi)
Name 2 STIs with PAINLESS ulcers.
syphilis (T. pallidum) granuloma inguinale (C. or K. granulomatis)
Name 2 STIs with DISCHARGE.
gonorrhea (N. gonorrhoeae)
chlamydia (C. trachomatis)
What causes condyloma acuminata?
HPV
What organism causes chlamydia (non-gonoccocal urethritis/cervicitis)?
Chlamydia trachomatis
Which is more painful and has more purulent, thicker discharge, gonorrhea or chlamydia?
Chlamydia is less painful and has less purulent, more watery discharge than gonorrhea.
How is chlamydia diagnosed?
A patient with urethritis or cervicitis and absence of gram-negative diplococci on gram stain and of N. gonorrhoeae on culture is assumed to have chlamydial infection until proven otherwise.
Treatment for chlamydia?
azithromycin
doxycycline
levofloxacin
