STIs and GI Flashcards
How are STIs transmitted?
Direct inoculation Sexual/genital secretions Ingestion Formites- objects which carry infection IVDU Trauma
Who most commonly gets STIs?
~~~
Under 25s
people with multiple sexual partners
No condom use
Men who have sex with men
Past STI history
Large urban areas
Social depravation
Who gets rectal gonnhoroea?
Anal sex
Direct contact of mucosal surfaces with infected secretions spreads it
How does rectal gonorrhoea present ?
Low abdo pain Diarrhoea Rectal bleeding Anal discharge Tenesmus May be asymptomatic
Incubation period of rectal gonorrhoea?
5-10 days
Diagnosis of rectal gonorrhoea?
Examination Gram stain of discharges PCR Gonorrhoea cultures Comprehensive STI testing
Complications of rectal gonorrhoea?
Abscess formation increased
Who gets rectal chlamydia?
Transmitted via direct contact of mucosal surfaces with infected secretions.
Anal sex
How does rectal chlamydia present?
70% asymptomatic Milder than gonorrhoea Anal discharge Anal itch/discomfort Rectal bleeding Change in bowel habit Low abdominal pain Associated genito-urinary symptoms
How is rectal chlamydia diagnosed?
Examination Gram stain of discharges PCR Gonorrhoea cultures Comprehensive STI testing
How is rectal chlamydia treated?
Doxycycline 1 week course
Who gets lymphogranuloma venereum?
Often HIV positive men who have sex with men
Associated with syphillis, Hep C, drug use and group sex
How does lymphogranuloma venereum present?
Ulcer within 1 month
Inguinal syndrome & anorectal syndrome
Strictures, fistulae and genital elephantiasis
How is lymphogranuloma venereum diagnosed?
MSM with haemorrhagic proctitis
HIV + MSM with +ve rectal chlamydia
Suspicious ulcers in MSM
Failed chlamydia test of cure
Presentation of primary syphillis?
Solitary painless ulcer
Presentation of secondary syphillis?
Mucosal patches and ulcers Mouth, anogenital and rectal condylomata lata (warts) Systemic inflammation Hepatitis Procto-colitis
Where does Herpes simplex virus usually effect?
Peri-anal mucosa but can extend to the rectum
How is HSV transmitted?
Ano-genital or oro-anal
How does HSV present?
Pain Ulcers Painful defaecation Bleeding Mucus Viraemic symptoms
HIV and the GI tract?
Gut associated lymphoid tissue (GALT) is largest immune compartment of the body and so is in a state of physiological inflammation
Clinical result of GALT loss?
- Unknown
- HIV enteropathies
- Opportunistic infection
- Persistent immune activation
- Accelerated immunosenescence
