Sexually transmitted infections and the GI tract Flashcards
How are infections transmitted during “sex”?
Direct inoculation Trauma e.g. blood borne viruses IV drug use Fomites Ingestion Sexual/genital secretions
Which parts of the GI tract can be affected by STIs?
Any part
What GI infection can be transmitted faeco-orally during sex?
Shigella
What is Gonorrhoea often coinfected with?
Chlamydia
How is rectal gonorrhoea spread?
Direct contact of mucosal surfaces.
What are the symptoms of rectal gonorrhoea?
Short incubation period (5-10 days) Low abdominal pain Diarrhoea Rectal bleeding and discharge Tenesmus May have associated symptoms: urethral discharge, dysuria May be asymptomatic
What is seen on proctoscopy?
Inflamed mucosa
Purulent exudate
What are complications of rectal gonorrhoea?
Abscess formation
Increased susceptibility to HIV
Increased infectiousness of HIV
(more likely to acquire HIV if come into contact with it if the mucosa is already inflamed and infected)
How is rectal chlamydia transmitted?
Direct contact of mucosal surfaces.
Which sites should be considered when doing STI screening and testing?
Vagina
Urethra
Throat
Rectum
What are the symptoms of rectal chlamydia?
70% asymptomatic
Milder than gonorrhoea
Anal discomfort/itch and discharge
Associated symptoms
How does primary syphilis present?
A solitary painless ulcer
How does secondary syphilis present?
Mucosal patches and ulcers Mouth, anogenital, rectal Condylomata lata - wart like lesions in warm areas Systemic inflammation Hepatitis
What are symptoms of rectal Herpes simplex 2?
Pain Ulcers Painful defecation Bleeding Mucus Viraemic symptoms
What does HPV infection cause?
Usually causes anal warts which can extend to the rectum