Sexually Transmitted Infections Flashcards
What are the 7 main types of STIs?
Bacterial: (all notifiable)
- chlamydia
- gonorrhoea
- syphilis
Viral:
- herpes simplex virus (HSV)
- human papilloma virus (HPV)
- HIV (notifiable)
- viral hepatitis (HBV, HCV) (notifiable)
What are the 5 notifiable STIs?
all bacterial:
- chlamydia
- gonorrhoea
- syphiliis
2 viral:
- HIV
- viral hepatitis (B, C)
What are complications of STIs?
- infertility
- ectopic pregnancy
- neonatal morbidity
- pelvic inflammatory disease
- malignancy
What are the genitourinary tract defences against STIs?
Female:
- thick vaginal epitheliuim
- cervical mucous plug
- regular shedding of endometrium
- oestrogen
- lactobacilli in tract
Male:
- prostatic secretions (antimicrobial)
- long urethra
Describe the condition of chlamydia
Bacterial:
- chlamydia trachomoatis bacteria
- acts as an obligate intracellular parasite that lives and multiplies within cells
- 14 day incubation
Incidence:
- most common UTI in Australia
SSX - women:
- affects cervix more than vagina
- vaginal discharge and bleeding
- abdo pain and bloating
- dyspareunia (pain during sex)
SSX - men:
- dysuria
- maybe penilel discharge
Complications - women:
- chronic PID (salpingitis, cervicitis)
- ectopic pregnancy
- infertility
Complications - both sexes:
- secondary infections (proctitis, pharyngitis, conjunctivitis, 8% develop reactive arthritis)
- leading cause of infective blindness
Management:
- antibiotics
- notify partners
Describe the condition of gonnorhea
Bacterial:
- neisseria gonorrhoeae bacteria
- 3-7 day incubation period
SSX - women:
- 60% asymptomatic
- maybe vaginal discharge, spotting, dysuria
Complications - women only:
- PID (salpingitis)
- pelvic infection
- perihepatitis (inflammation of peritoneal covering of liver)
- 3% develop reacive arthritis
SSX - men:
- dysuria
- prurulent discharge
- urinary frequency and urgency
Complications - men only:
- proctitis (rectal pain, tenesmus, anal discharge)
- prostatitis
Complications - both:
- conjunctivis (can cause corneal ulceration and visual deterioration)
- pharyngeal gonorrhea (usually asymptomatic, can cause Cx lymphadenopathy)
- rectal infection (from anal intercourse)
Describe the condition of syphilis
Bacterial:
- treponema pallidum bacterial agent
- 14-28 day incubation period
Stages:
- early / primary
- within 2-4 weeks of infection
- chancres develop (small red lesions) that contain multiple spirochaetes (bacterial pathogens) that can spread easily
- asymptomatic or localized lyphadenopathy) - early / secondary
- 6-8 weeks after chancre development
- SSX last for several months and if untreated, SSX disappear and disease becomes latent
- skin: rash becoming generalied, condylamata lata (warty lesions), silvery grey lesions
- systemic (fever, malaise, anorexia)
- pain (HA, arthralgia, myalgia)
- lymphadenopathy (becoming generalized) - late / tertiary (rare in developed countries)
- previous SSX re-appear
- gummas (caused by granuloma formation)
- neurosyphilis (HA, blurred vision and photophobia, dizziness, meningitis, seizures, paraplegia, psychosis, cognitive decline)
- CVD features (develop within 10-25 years)
What is reactive arthritis?
- a complication of chlamydia (8%) and gonorrhea (3%)
SSX:
- asymmetrical oligoarthritis affecting less than 6 joints
- joints become red, swollen and tender
- affects entheses (causes heel pain, Achilles tendon and plantar fascia)
- joints usually affected: knees, SIJ, interphalangeal, LBP
Describe the condition of genital herpes
Viral
- 70% caused by Herpes Simplex Virus Type 2 (HSV2)
- HSV1 less common
Transmission:
- genital or oral contact
Progression:
- virus is latent when contracted, but becomes infectious 2-3 days per year due to viral shedding
- first attack lasts 2-4/52 before lesions crust and disappear
- recurrences can last for 7-10 days
SSX:
- characteristic painful, grouped lesions that rupture and leave painful erosions
- systemic (fever, lethargy)
- localized lymphadenopathy
- intense burning and stinging
Nerve root involvement:
- HSV can spread up a local sensory nerve to the DRG (and lie latent for lifetime)
- reactivation can produce dermatomal pain, or virus can travel back down nerve and produce new lesions
Management:
- can’t be cured
- oral anti-viral agents and IV anti-viral agents (if immunocompromised) to manage SSX
Describe the condition of genital warts
Viral:
- caused by human papilloma virus (HPV)
Progression:
- transmitted through small abrasions
- incubation period of months
- SSX appear after months and disappear within 1-2 years
SSX:
- microscopic warts affecting skin and mucous membranes
- asymptomatic carriage
Complications:
- increased risk of reproductive cancers (cervical, vulval, anorectal, penile)
Management:
- HPV vaccine dramatically reducing rates
- treatment: topical acids, cryosurgery, surgical excision
Describe the condition of vaginal thrush
Definition:
- not an STI
- overgrowth of fungus (candida albicans)
Aetiology:
- arises from disordered local ecology that allows overgrowth of yeast
Risk factors:
- pregnancy
- diabetes
- antibiotics
- some types of OCP
SSX:
- can be asymptomatic
- itching / pain of vagina and vulva
- redness / swelling
- dyspareunia
- dysuria
- vaginal discharge thick and curdy
Describe the condition of toxic shock syndrome
Definition:
- not an STI
- a form of septic shock (circulatory failure) secondary to bacterial infection and toxin release
Agents:
- staphy
- strep
Aetiology:
- tampon use: provides the opportunity for bacteria to overgrow
SSX:
- sudden onset fever
- sudden onset vomiting and diarrhea
- maybe sore throat, HA, skin rash, myalgia
Complications:
- septic shock: peripheral vasodilation and hypotension
- poor renal perfusion can cause kidney damage
- poor cerebral perfusion can cause confusion, coma, death
