Sexually Transmitted Diseases: Microbiology

Question 0

N. Gonorrhoea symptoms

Answer 0

Opthalmic disease in newborns
Can be initially asymptomatic
Abnormal vaginal discharge and bleeding after sex
-> developes in to pelvic inflam disease
Painful Purulent urethral discharge in males

Question 1

N. Gonorrhoea

Answer 1

Gonococcal disease is defined by demonstration of N. Gonorrhoeal in clinical samples
Infects mucosal surfaces-> ophthalmia neotorum, urethritis, pharyngitis, cervicitis, vulvovsginalis, proctitis
-> urethritis-> prostatitis, vesiculitis, epididymitis
-> cervicitis-> edometritis, salpingitis, pelvic peritonitis
Amplifies HIV infection
Spread via contact with infected exudate
Reservoir is humans

Question 2

Gonorrhoea diagnosis

Answer 2

NAA test on urine
Urethral swab in males
Speculum examination in females
Gram stained and cultured

Question 3

Gonococcal treatment

Answer 3

Resistant to penicillin, tetracycline and fluroquinines
3rd generation cephalosporins now used-> resistance is increasing
Uncomplicated us ceftriaxone 250mg IV/IM
Or ciproflaxacin 500mg

Question 4

Chlamydia trachomatis

Answer 4

Adapted to exist as obligate intra cellular parasites of eukaryotic cells
Inert extra cellular body cycling with an intra cellular reproductive particle called a reticulate body
Infects epithelial membranes
Serotypes:
L1,2,3-> LGV, cervicitis, proctitis
A,B,Ba,C-> ocular trachoma
D-K-> occulogenital disease

Question 5

Chlamydia symptoms

Answer 5

Women-> genital infection 
Cervicitis
Dysuris-polyuria syndrome-> urethritis
Pelvic inflam disease
Perinepatitis
Pregnancy complications 
Men-> urogential infection
Proctitis 
Reactive arthritis
Urethritis
Epididymitis
Prostatitis
Both-> conjunctivitis, trachoma, pharyngitis, genital lymphoma, venerum
Majority of people asymptomatic

Question 6

Diagnosis of chlamydia

Answer 6

Culture is gold standard as highly sensitive and specific
Antigen detection or hybridisation
PCR
Serology

Question 7

Treatment of chlamidyia

Answer 7

Doxycycline
Azithromycin
Erythromycin

Question 8

Pelvic inflammatory disease

Answer 8

Pelvic and abdo pain, fever, vagianl discharge, cervical tenderness
Gonococcus or chlamidyia
-> infertility and ectopic pregnancy
Doxycycline or ceftriaxone and metronidazole
Or with clarithromycin if severe

Question 9

T. Palladium

Answer 9

Spiral bacteria
Obligate human parasite
Limited reproductive ability 
Syphalis
Acquired:
->early-> primary, secondary or early latent ( late-> late latent >2 years

Question 10

Primary syphilis

Answer 10

Characterised by an ulcer
Regional lymphadenopathy
Incubation 9-90 days

Question 11

Secondary syphilis

Answer 11

Multi system involvement
Usually within 8 weeks of infection
Skin lesions most common
Anterior uveitis, meningitis, cranial nerve palsy, glomerular nephritis

Question 12

Latent syphilis

Answer 12

30% untreated individuals will develop symptomatic late syphilis
Neurosyphilis
Cardiovascular syphilis
Gummatous symphysis

Question 13

Diagnosis

Answer 13

DFM
Serology
Treponemal-> specific
EIA for IgG/M
positive results of specific and non specific required to smoke diagnosis
Lumbar puncture for suspected neurosyphilsis

Question 14

Syphilis treatment

Answer 14

Early disease-> procaine penicillin
Late disease-> procaine penicillin or benzanthine or doxycycline
Neurosyphilsis-> procaine penicillin IM