Sexual Transmitted Diseases PDF

Sexual transmitted diseases Urethral discharge Diagnostic methods Mrs. Baraa AL-Qarem  Bacterial infections (sexual transmitted)  Neisseria gonorrhoeae: Gonorrhoea A  Chlamydia trachomatis :Chlamydial Infection , Lymphogranuloma Venereum  Treponema pallid...

Sexual transmitted diseases Urethral discharge Diagnostic methods Mrs. Baraa AL-Qarem  Bacterial infections (sexual transmitted)  Neisseria gonorrhoeae: Gonorrhoea A  Chlamydia trachomatis :Chlamydial Infection , Lymphogranuloma Venereum  Treponema pallidum: syphilis  Haemophilus ducreyi.: Chancroid  Mycoplasma genitalium:  Men: urethral discharge (nongonococcal urethritis).  Women: cervicitis, endometritis, probably pelvic inflammatory disease.  STDs Fungal infections Protozoal infections Candida albicans Trichomonas vaginalis CANDIDIASIS Trichomoniasis Men: superficial infection of Men: urethral discharge the glans penis (nongonococcal urethritis); Women: vulvo-vaginitis with often asymptomatic thick curd-like vaginal Women: vaginosis with discharge, vulval itching, or profuse, frothy vaginal Burning. discharge; preterm birth, low-birth-weight babies.  Method of collection of the specimen In men a) Urethral swab Collect specimen at least 2 hours after urination as voiding decreases the amount of exudates. Retract the prepuce, clean the tip of the meatus with normal saline and collect the pus directly onto a glass slide or sterile swab in case of frank urethral discharge. If no discharge is obtained, insert a sterile cotton tipped or thin calcium alginate swab with a flexible wire shaft or a bacteriological loop 2-3 cm into the urethra and rotate for 5-10 seconds b) Urine The first 10-15 ml of the early morning first void urine is collected in a sterile plastic container with a wide mouth and processed immediately. In women: Vaginal Swab Specimen Collection  TRANSPORT MEDIA FOR CULTURE Transport must be as rapid as possible, avoiding excesses of temperature. Chlamydia (sucrose phosphate transport media in cryo vials) is 4°C. N. gonorrhoeae (nutritive media containing carbon dioxide- Transgrow/Jembec or nonnutritive media-Stuarts/Amies). Susceptible to cool temp. Trichomonas vaginalis (diamond medium ).  Gonococci  Gram-negative, aerobic, capnophilic non-flagellated, non- sporulating, and oxidase- and catalase-producing cocci, which that typically appear in pairs (diplococci) with the opposing sides flattened.  In microscopy they appear in a characteristic kidney or coffee bean morphology. N. gonorrhoeae is fastidious and requires complex nutritionally enriched culture medium for in vitro growth.  N. gonorrhoae Clinical sample Urethral swap, endocervical swap, eye swap ,throat swap, rectal swap and urine. Culture medium: Chocolate agar with 5-10% CO2. Selective media of gonococci: Thayer martin media Modified Thayer martin media Neisseria on culture plate: small, Raised, translucent colonies.  Gonorrhoeae GRAM STAIN  Biochemical test 1. Catalase positive 2. Oxidase positive 3. Carbohydrate fermentation done to specify Neisseria group. 4. API NH (Neisseria-Haemophilus) identification kit demonstrating the profile of N. gonorrhoeae Carbohydrates test to differentiates between Neisseria spp. N. gonorrhoeae : produce acid from its utilization of glucose. N. meningitides, utilizes glucose and maltose. N. gonorrhoeae  Rapid biochemical test: API Test. The API NH strip Consists of 10 microtubes containing dehydrated substrates, which enable the performance of 12 identification tests (enzymatic reactions or sugar fermentations). Trichomonas. Vaginalis  Trichomonas vaginalis Single celled pathogenic protozoa, don’t form cysts, flagellated facultative anaerobic parasite. Only trophozoites form.  Diagnostic test wet mount examination Short undulating membrane only in T. vaginalis Pap smear: specimens for examination may best to obtained through a vaginal speculum.  Chlamydia trachomatis Have infectious particles (EB), with high affinity for host’s EP cells and rapidly enter(Receptors, adhesion molecules…etc.) Receptor mediated endocytosis. Inhibition of lysosomal activity inside the host cells.  Chlamydia trachomatis The second stage inside the cells EB RB. Grow and multiply by binary fission. Liberation from the host cell to infect other cells. The cycle takes 24-48 hrs.  Diagnosis Gram stain is not useful to detect chlamydia (gram variable), similar to gram negative but have different peptidoglycan layer. EBs stain purple with Giemsa’s stain, in contrast to the blue of host cells cytoplasm. RBs stain blue with Giemsas reaction. Also, only C. Trachomatis Inclusions give brown color with iodine solution(presence of high amount of glycogen). Inclusion bodies near the nucleus Only in C. Trichromatic Candida albicans Germ tube  Treponema palladium spirochaete bacterium with various subspecies that cause the diseases syphilis. It is transmitted only among humans. It is a helically coiled microorganism. Thin, helical, motile with endoflagellum. Have cardiolipin which found in normal tissues.  Diagnostic tests This organism cannot be cultured in the lab  Diagnostic test Specimens: pus or tissue fluid from lesions: (look for motile spirochetes) Blood serum: serological test Dark field microscopy. Immunofluorescence. SEM- Treponema palladium Haemophilus ducreyi painful, superficial ulcers  Diagnosis  Amies transport media  Rapid culturing required on chocolate agar.  Differentiated from Neisseria using special biochemical tests. Gram-negative, rod-shaped, facultatively anaerobic, non-motile, pathogenic bacillus This fastidious, Gram-negative coccobacilli dies rapidly outside the human host, making diagnostic testing using culture methods difficult.