Sexually Transmitted Infections Flashcards
which 3 STIs are characterized by cervicitis?
- gonorrhea
- chlamydia
- trichomoniasis
where do HSV-1 and HSV-2 lay dormant, and which is more common?
HSV-2: 90% of genital lesions, more likely to recur
HSV-1: 10% of genital lesions, less likely to recur
latent HSV ascends peripheral sensory nerves to lay dormant in dorsal root ganglia
how will genital lesions caused by HSV1/2 present?
painful vulvar bumps which later crust over
how will genital lesions caused by (primary) syphilis present?
painless vulvar ulcers (chancres) which last 3-6 weeks before healing spontaneously without scarring
chancres are highly infectious due to high viral load
(caused by treponema pallidum)
what are the dermatological findings associated with secondary syphilis?
primary syphilis —> painless chancres
secondary syphilis (result of bacteremia) —> condylomata lata and maculopapular rash
non-treponemal tests for syphilis are based on response to ______
cardiolipin-cholesterol-lecithin antigen
not very specific tests and may become negative with time, while treponemal tests will be positive for life
how do genital lesions caused by molluscum contageosum (pox virus) present?
asymptomatic bumps on the vulva and peri-anal region which last 6-9 months
1-5mm domed papule with umbilicated center
how do genital lesions caused by low risk HPV (6, 11) present?
painless bumps after new sexual contact (condylomata)
HPV - most common viral STD in the US
contrast infection of phthirus pubis to sarcoptes scabiei
phthirus pubis = crabs: infects hair, feed on blood
sarcoptes scabiei = scabies: infects skin, female burrows into epidermis and lays eggs
both are sexually transmitted and present with itchiness in the groin area
how will genital infection with trichomonas (flagellated protozoan) present?
frothy vaginal discharge, strawberry cervix, high vaginal pH (5-5.5)
no itching or dysuria
how will genital infection with gonorrhea present?
purulent discharge
N. gonorrhoeae: gram negative coccus, infection can ascend to urogenital organs
how does genital infection with chlamydia present?
most common bacterial cause of STI - majority are asymptomatic
may have vaginal bleeding or discharge (neonatal conjunctivitis and pneumonia can occur via infection during birth)
Pt is a 17yo F presenting to the ED with bilateral pelvic pain lasting 6 days and worse with moving, as well as fever. PE is notable for yellow vaginal discharge and bilateral lower abdominal tenderness. Pt has 2 sexual partners. What is the most likely diagnosis?
pelvic inflammatory disease, aka salpingitis: infection of upper genital tract in women
most often sexually transmitted, can also be caused by vaginal flora
where would a Bartholin gland abscess be found?
Bartholin glands secretes lubrication and are located adjacent to the posterior end of the vulva
abscess due to infection
how do chancroids caused by hemophilus ducreyi present?
hemophilus ducreyi: intracellular gram negative anaerobic bacillus, most prevalent in tropics
cause highly contagious, painful genital ulcers
may also cause “buboes” - inguinal lymphadenitis which can rupture and release pus
Pt is a 36yo M returning from a tropical vacation, presenting with painful genital ulcers. Culture reveals a gram negative anaerobic bacillus that is found within macrophages and neutrophils. What is the most likely causative agent?
hemophilus ducreyi: intracellular gram negative anaerobic bacillus, most prevalent in tropics
cause highly contagious, painful genital ulcers
may also cause “buboes” - inguinal lymphadenitis which can rupture and release pus
how does granuloma inguinale present?
chronic ulcerative granulomatous infection causing painless ulcer with beefy red base and clear sharp edges - produces malodorous discharge and may bleed easily
caused by Klebsiella granulomatis - intracellular gram negative bacteria
what is the causative agent of granuloma inguinale?
chronic ulcerative granulomatous infection causing painless ulcer with beefy red base and clear sharp edges - produces malodorous discharge and may bleed easily
caused by Klebsiella granulomatis - intracellular gram negative bacteria
Pt from South Africa present with chronic painless ulcer with beefy red base and clear sharp edges, which produces malodorous discharge and bleeds easily. Tissue biopsy reveals bacteria encapsulated in mononuclear leukocytes. What is the likely diagnosis?
granuloma inguinale caused by Klebsiella granulomatis - intracellular gram negative bacteria
Donovan body (bacteria encapsulated in mononuclear leukocytes) is pathognomonic
what tissue biopsy finding is pathognomonic of granuloma inguinale caused by Klebsiella?
Donovan body: bacteria encapsulated in mononuclear leukocytes
Klebsiella granulomatis - intracellular gram negative bacteria
