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Questions and Answers
What type of microbes primarily cause specific sexually transmitted diseases?
Which of the following is NOT a common symptom of sexually transmitted diseases?
Which bacterium is identified as the cause of gonorrhea?
What is the incubation period for males infected with gonorrhea?
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How do gonococci primarily attach to host cells?
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Which of the following statements about STD-causing microbes is true?
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What symptom might indicate an infection in females with gonorrhea?
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What is the nature of the infection caused by Neisseria gonorrhoeae?
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What characterizes the primary phase of LGV?
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What is a common symptom during the secondary phase of LGV?
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Which treatment is appropriate for the early phases of LGV?
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What significant consequence can arise from untreated LGV in its late phase?
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What is the primary cause of Nongonococcal Urethritis (NGU)?
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What symptom might males experience due to Nongonococcal Urethritis?
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What serious risk is associated with chlamydial infections during pregnancy?
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Which of the following is a recommended method for controlling LGV?
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What is required for the diagnosis of non-gonococcal urethritis (NGU)?
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Which organism is responsible for causing venereal syphilis?
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What is the initial symptom of the primary stage of syphilis?
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During which stage of syphilis are 100% of individuals serologically positive?
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What is a key characteristic of the tertiary stage of syphilis?
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What symptom may occur due to central nervous system involvement in tertiary syphilis?
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What is a common diagnostic method for syphilis?
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What happens during the latent period of syphilis?
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What is a major consequence of gonococcal pelvic inflammatory disease (PID) in females?
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During which physiological event are gonococci most likely to disseminate?
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What is the recommended treatment for a gonococcal infection according to health authorities?
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What is one of the leading causes of blindness in newborns stemming from gonococcal infections?
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What method is most effective for controlling the spread of gonorrhea?
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Why do repeated gonococcal infections occur frequently?
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What is the primary complication of untreated disseminated gonococcal infection?
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Which strains of gonococci present a challenge to treatment?
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What is the primary causative agent of syphilis?
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During which age range is the incidence of syphilis highest?
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What is the recommended treatment for early-stage syphilis?
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Which of the following is NOT a method for the prevention and control of syphilis?
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What symptom is characteristic of a Trichomonas vaginalis infection?
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What is a common consequence of Trichomonas vaginalis infections during pregnancy?
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How is the diagnosis of syphilis made?
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What is the incubation period for the infection caused by Haemophilus ducreyi?
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Study Notes
Sexually Transmitted Diseases (STDs)/Venereal Diseases
- STDs are infections transmitted through sexual contact and can be caused by bacteria, viruses, or parasites.
- Non-specific STDs are often caused by a range of microbes, like staphylococci, streptococci, and coliform bacteria.
- Specific STDs are caused by sexually transmitted microbes, including: Bacterial vaginosis, Chancroid, Gonorrhea, Lymphogranuloma venereum (LGV), Nongonococcal Urethritis, and Syphilis.
- STDs are unable to survive outside the body for extended periods and require direct intimate contact for transmission.
- STDs often produce lesions in the genital area that discharge infecting microbes.
- Common symptoms of STDs include unusual discharge from the penis or vagina, warts or lesions on the genital area, burning while urinating, and anal itching, redness, soreness, and sometimes bleeding.
Gonorrhea
- Gonorrhea is an acute, infectious, sexually transmitted disease of the mucous membranes of the genitourinary tract, eye, rectum, and throat.
- It is caused by the gram-negative bacterium Neisseria gonorrhoeae.
- Neisseria gonorrhoeae are also referred to as gonococci and have a worldwide distribution.
- Neisseria gonorrhoeae attach to mucosal cells by means of pili and protein II, preventing them from being washed away by normal discharges or urine flow.
- Neisseria gonorrhoeae are then phagocytosed by mucosal cells and can be transported through cells to intercellular spaces and sub-epithelial tissue.
- The host's defenses have little effect on this bacteria.
- In males, the incubation period is 2 to 8 days, often resulting in a urethral discharge of yellow, creamy pus, and frequent, painful urination with burning sensation.
- In females, the cervix is the primary site infected. Symptoms may begin 7 to 21 days after infection, and some vaginal discharge may occur.
- Neisseria gonorrhoeae can infect the Fallopian tubes and surrounding tissues, leading to pelvic inflammatory disease (PID) in 10 to 20% of infected females.
- Gonococcal PID is a major cause of sterility and ectopic pregnancies due to scar formation in the Fallopian tubes.
- Neisseria gonorrhoeae dissemination is more common during menstruation due to an increased concentration of free iron available to the bacteria.
- Disseminated gonococcal infection with bacteremia can occur in both genders, leading to involvement of the joints (gonorrheal arthritis), heart (gonorrheal endocarditis), or pharynx (gonorrheal pharyngitis).
- Eye infections can occur in newborns passing through an infected birth canal, resulting in a condition called ophthalmia neonatorum, or conjunctivitis of the newborn. This was formerly a leading cause of blindness.
- Tetracycline, erythromycin, povidone-iodine, or silver nitrate in dilute solution are used to prevent ophthalmia neonatorum.
- Neisseria gonorrhoeae are very sensitive to environmental conditions and survive poorly outside the body.
- The Centers for Disease Control and Prevention recommends five single doses of cefixime, ceftriaxone, ciprofloxacin, ofloxacin, and levofloxacin to eradicate the infection.
- Penicillin-resistant strains of Neisseria gonorrhoeae occur worldwide, often carrying a plasmid that directs the formation of penicillinase, a ß-lactamase enzyme that inactivates penicillin G and ampicillin.
- Public education, diagnosing and treating asymptomatic patients, barrier protection, and quick treatment of infected individuals are crucial for controlling gonorrhea's spread.
- More than 60% of gonorrhea cases occur in the 15- to 24-year-old age group.
- Repeated infections are common, and protective immunity to reinfection does not arise because of antigenic variation in the strain that changes its pilin gene.
Lymphogranuloma Venereum (LGV)
- LGV is a sexually transmitted disease caused by Chlamydia trachomatis serotypes L1-L3.
- It is more common in tropical climates.
- LGV progresses through three phases:
- Primary phase: A small ulcer appears several days to several weeks after exposure, healing quickly without scarring.
- Secondary phase: The chlamydiae infect lymphoid cells, causing regional lymph nodes to become enlarged and tender (buboes). Systemic symptoms like fever, chills, and anorexia are common.
- Late phase: Fibrotic changes and abnormal lymphatic drainage lead to urethral or rectal strictures (decrease in size) and potential fluid accumulation in the penis, scrotum, or vaginal area.
- LGV is detected by staining infected cells with iodine, culturing chlamydiae from a bubo, nucleic acid probes, or through the detection of high antibody titers to C. trachomatis.
- Treatment in early phases involves bubo aspiration and administration of azithromycin, ceftriaxone, erythromycin, or ciprofloxacin.
- Late-stage LGV may require surgery.
- Controlling LGV involves abstinence, barrier protection, early diagnosis, and treatment of infected individuals.
Nongonococcal Urethritis (NGU)
- NGU is inflammation of the urethra not caused by the bacterium Neisseria gonorrhoeae.
- NGU can result from non-microbial factors like catheters and drugs, as well as infectious microorganisms.
- Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Trichomonas vaginalis, Candida albicans, and herpes simplex viruses are significant causative agents.
- Most NGU infections are acquired sexually.
- Males may experience few or no symptoms, but complications like urethral discharge, itching, and inflammation of the male reproductive structures can occur.
- Females can be asymptomatic or experience severe infections leading to PID, often resulting in sterility.
- Chlamydial infection in pregnant females is especially serious, as it is linked to miscarriage, stillbirth, inclusion conjunctivitis, and infant pneumonia.
- Diagnosing NGU involves demonstrating a leukocyte exudate and excluding urethral gonorrhea through Gram stain and culture.
Syphilis
- Venereal syphilis is a contagious, sexually transmitted disease caused by the spirochete Treponema pallidum subsp. pallidum.
- Congenital syphilis is acquired in utero from the mother.
- T. pallidum enters the body through mucous membranes or minor breaks or abrasions in the skin, migrating to regional lymph nodes and spreading rapidly throughout the body.
- Syphilis has three recognizable stages:
- Primary stage: After an incubation period of 10 days to 3 weeks or more, a small, painless, reddened ulcer (chancre) with a hard ridge appears at the infection site, containing spirochetes.
- Secondary stage: A highly variable skin rash develops with 100% of individuals becoming serologically positive. Other symptoms include hair loss, malaise, and fever. Both chancres and rash lesions are infectious.
- Latent period: The disease is usually not infectious, except for potential transmission from mother to fetus.
- Tertiary stage: After years, degenerative lesions called gummas form in the skin, bone, and nervous system due to hypersensitivity reactions. This stage is characterized by a reduced number of spirochetes.
- Central nervous system involvement: Tissue loss can lead to cognitive deficits, blindness, a "shuffle" walk (tabes), or insanity.
- Diagnosis of syphilis involves clinical history, physical examination, and dark-field and immunofluorescence examination of lesion fluids for spirochetes.
- Serological tests are informative, as humans respond to T. pallidum with anti-treponemal antibodies and a complement-fixing reagin.
- Prevention and control of syphilis involves:
- Public education
- Prompt and adequate treatment of all new cases
- Follow-up on sources of infection and contacts for treatment
- Prophylaxis (barrier protection) to prevent exposure.
- The incidence of syphilis, along with other STDs, is increasing globally.
- The highest incidence is among those 20 to 39 years of age.
- Early-stage treatment is effective with long-acting benzathine penicillin G or aqueous procaine penicillin.
- Later stages are more difficult to treat with drugs, requiring larger doses over extended periods.
- Treponemes sometimes survive drug treatment for neurosyphilis.
- Immunity to syphilis is not complete, and subsequent infections can occur.
Chancroid
- Chancroid is caused by the bacterium Haemophilus ducreyi.
- The bacterium enters the skin through a break in the epithelium.
- The incubation period is 4-7 days.
- Chancroid is most prevalent in tropical areas.
- It is difficult to diagnose and underreported.
- Chancroid is very common in Asia, Africa, and Latin America.
- Symptoms include a swollen, painful ulcer on the genitals, infection of the lymph nodes, infected lymph nodes that break and discharge pus to the surface, and lesions that serve as a transmission factor for HIV.
- Lesions can also occur on the tongue and lips.
- Diagnosis involves isolating bacteria from ulcers.
- Treatment includes Azithromycin or Ceftriaxone.
Trichomoniasis
- Trichomoniasis is caused by the protozoan Trichomonas vaginalis, a normal inhabitant of the vagina in females and the urethra in males.
- It is usually sexually transmitted.
- Trichomonas vaginalis can overgrow the normal microbial population in the genital area if the vagina's acidity is disturbed, causing Trichomoniasis.
- The body accumulates leukocytes at the site of infection, resulting in a profuse, greenish-yellow discharge with a foul odor.
- The discharge is often accompanied by itching and irritation.
- Trichomoniasis is not a reportable case and is considered relatively benign.
- It can cause preterm delivery and associated problems like low birth weight.
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Description
Explore the critical aspects of sexually transmitted diseases (STDs), including their transmission, symptoms, and specific types like Gonorrhea. This quiz covers various bacterial and viral infections, highlighting their effects on health and the importance of awareness. Test your knowledge on STDs and understand their impact on public health.
