Sec 32 Sexually Transmitted Diseases Flashcards
Etiologic agent: Syphilis
Treponema pallidum pallidum
Etiologic agent: Chancroid
Haemophilus ducreyi
Etiologic agent: Lymphogranuloma venereum
Chlamydia trachomatis
Etiologic agent: Granuloma inguinale
Klebsiella granulomatis
Etiologic agent: Gonorrhea
Neisseria gonorrheae
Etiologic agent: Chlamydia
Chlamydia trachomatis
Etiologic agent: Genital mycoplasma
Mycoplasma sp.
Ureaplasma sp.
Etiologic agent: Trichomoniasis
Trichomonas vaginalis
Etiologic agent: Bacterial vaginosis
Polymicrobial
Characterized by one or more chancres in presence of laboratory evidence
Primary syphilis
Starts as a dusky red macule that evolves into a papule then to a round-to-oval ulcer with sharply demarcated regular, raised borders that are indurated giving a cartilaginous feel
Chancre
Retraction of the foreskin when a chancre is present on the underside causes foreskin to flip suddenly
Dory flap
Unilateral labial swelling with rubbery consistency and intact surface indicative of deep-seated chancre
Edema induratum
Characterized by localized or diffuse mucocutaneous lesions, often with generalized lymphadenopathy in the presence of laboratory evidence from tissues or sera
Secondary syphilis
Lesions of secondary syphilis that erupts 3-12 weeks after the chancre erupts
Syphilids
Erythematous macules in secondary syphilis
Roseola syphilitica
A white scaly ring on the surface of papulosquamous lesions in secondary syphilis
Biette’s collarette
Seborrheic dermatitis-like lesions around the hairline in secondary syphilis
Crown of Venus
corona veneris
Plantar lesions mistaken for calluses in secondary syphilis
Clavi syphilitici
Confluence of mucous patches on the tongue in secondary syphilis
Plaques fauches en prairie
Rare manifestation that presents as crusted or scaly papules and plaques that can ulcerate or become necrotic with lesions described as rupioid
Malignant lues
Without treatment, the secondary stage recedes in
4-12 weeks
Hallmark of late benign syphilis
Gumma
Nontender pink to dusky red granulomatous nodular lesion with variable central necrosis which commonly affect skin or mucous membranes common in scalp, forehead, buttocks, presternal, supraclavicular or pretibial areas
Gumma
Two syndromes commonly associated with late neurosyphilis
- Dementia paralytica
2. Tabes dorsalis
Presents with sensory ataxia and bowel & bladder dysfunction resulting from damage to the posterior columns of the spinal cord which can be accompanied by an Argyll-Robertson pupil (accommodates but does not react to light)
Tabes dorsalis
Presents as a rapidly progressive dementia accompanied by personality changes in late tertiary syphilis
Dementia paralytica
Treatment: Primary or Secondary or Early latent syphilis
Benzathine penicillin G 2.4 M units IM single dose (both HIV-uninfected and -infected)
Alt - Doxycycline 100mg orally BID for 14 days
Etiologic agent: Pinta
Treponema carateum
Etiologic agent: Yaws
Treponema pallidum pertenue
Etiologic agent: Bejel or Endemic syphilis
Treponema pallidum endemicum
Treatment: Nonvenereal treponematoses
Benzathine penicillin G 1.2 M units IM single dose (>10 years old
Benzathine penicillin G 0.6 M units IM single dose(<10 years old)
Treatment: Chancroid
Azithromycin 1g orally single dose
Ceftriaxone 250mg IM single dose
Ciprofloxacin 500mg orally BID for 3 days
Erythromycin 500mg orally QID for 7 days
Treatment: Lymphogranuloma venereum
Doxycycline 100mg orally BID for 3 weeks (1st line)
Erythromycin 500mg orally QID for 3 weeks (2nd line)
Azithromycin 1g orally once weekly for 3 weeks (3rd line)
Treatment: Granuloma inguinale
Doxycycline 100 BID orally for 3 weeks or until lesions heal (CDC)
Azithromycin 1g on Day 1 then 500mg OD for 3 weeks or until lesions heal (WHO)
Treatment: Uncomplicated Gonococcal infection
Ceftriaxone 125mg IM single dose or
Cefixime 400mg PO single dose
Treatment: Disseminated Gonococcal infection
Ceftriaxone 1g IM or IV every 24 hours until improvement noted
Treatment: Gonococcal infection in Neonates
Ceftriaxone 25-50 mkday IV or IM OD for 7 days (10-14 days if with meningitis)
Treatment: Chlamydia
Azithromycin 1g PO single dose or
Doxycycline 100mg PO BID for 7 days
Treatment: Trichomoniasis
Metronidazole 2g PO single dose or
Tinidazole 2g PO single dose
Treatment: Bacterial vaginosis
Metronidazole 500mg PO BID for 7 days
or
Metronidazole gel 0.75% 5g intravaginal OD for 5 days
or
Clindamycin cream 5% 5g intravaginal OD for 7 days
Ranges in diameter from a few millimeters to 2 cm and is sharply demarcated with regular, raised borders that are indurated, giving the lesion a cartilaginous feel; base is usually clean, and is classically not painful
Hunterian chancre or “ulcus durum” (hard
ulcer)
Relapses of primary syphilis
Monorecidive syphilis or chancre redux
Present as moist, flat, well-demarcated papules or plaques with macerated or eroded surfaces in intertriginous areas, commonly in the labial folds in females or in the perianal region in all patients
Condyloma lata
Pigmentary changes in Syphilis from inhibition of melanogenesis
Leukoderma colli syphiliticum or, if on the neck, “necklace of Venus”
A type of mucous patch of secondary syphilis that can be present at the angle of the mouth, with a characteristic slit traversing its center
Split papule
An asymptomatic stage with no clinical findings, with seroreactivity by definition the only evidence of infection; which is a diagnosis of exclusion
Latent syphilis
Refers to a solitary gumma of the penis
Pseudochancre redux
Responsible for most deaths caused by syphilis
Cardiovascular manifestations:
Syphilitic aortitis leading to aortic regurgitation
Coronaryostial stenosis
Saccular aneurysm
Any stage of infection and a reactive CSF-VDRL
Confirmed Neurosyphilis