Chapter 41 Sexually Transmitted Infections

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Chapter 41Sexually Transmitted Infections


External Infections

• Condylomata

• Herpes

• Chancroid

• Granuloma


Condylomata (Genital Warts)

• Human papillomavirus (HPV)• Transient or persistent• May be asymptomatic• Associated with genital cancers• Vaccine recently developed


Question

Tell whether the following statement is true or false:The HPV vaccine is currently available for both males and

females.


Answer

FalseThe FDA has approved the vaccine for girls (optimal age is

9 to 12 years old). The vaccine is a series of three shots/injections. Clinical trials are currently underway evaluating the efficacy of the vaccine in males, but the vaccine won’t be available for males until the trials are complete and the FDA approves it.


Genital Herpes

• Herpes simplex virus 2 (related to chickenpox and cold sores)

• Causes genital ulcers• Grows in neurons• Can remain dormant in neurons for years• Can reactivate and spread back down neuron


Bacterial Diseases of External Genitalia

• Chancroid

– Haemophilus ducreyi

• Granuloma inguinale (genital ulcers)

– Calymmatobacterium


Vaginal Infections

• Candidiasis

• Trichomoniasis

• Bacterial vaginitis


Normal Bacterial Flora• Many species of bacteria normally live in the vagina• Lactic-acid-producing bacteria dominate

– Acid helps control growth of other bacteria• Species composition of flora varies

– Between individuals– Between ethnic groups

(Zhou, et al., [2004]. Characterization of vaginal microbial communities in adult healthy women using cultivation-independent methods. Microbiology,150, 2565-2573. Retrieved September 22, 2005, from http://mic. sgmjournals.org/cgi/content/full/150/8/2565.0)


Candidiasis• “Yeast infection” or “thrush”• Causes include:

– Decreased normal bacterial flora (antibiotics)– Increased estrogen/progesterone levels– Decreased immune system activity

• Results in:– Inflammation– Thick odorless discharge


Trichomoniasis

• Inflammation• Frothy, malodorous, green or yellow discharge• Associated with tubular infertility or pelvic

inflammatory disease


Bacterial Vaginosis

• Nonspecific: may be caused by many different bacteria

• Imbalance of normal vaginal bacterial flora

• Thin discharge with fishy odor

• Usually treated only if symptomatic or associated with other risk conditions (pregnancy, hysterectomy)


Question

Which vaginal infection is associated with suppressed immune function?

a. Candidiasisb. Trichomoniasisc. Bacterial vaginitisd. Chancroid


Answer

a. Candidiasis Candidiasis (yeast infection/thrush) is associated with

diminished immune function. When the normal flora is decreased, Candida albicans has room to thrive.


Urogenital-Systemic Infections

• Chlamydia

• Gonorrhea

• Syphilis


Chlamydia• Intracellular parasites

– Signs at site of infection: hypertrophy, drainage– Signs of urinary tract infection: urinary frequency,

dysuria, discharge, postcoital bleeding– Signs of upper genital tract infection: irregular uterine

bleeding, abdominal/pelvic discomfort• Complications include infertility and ectopic pregnancy• May cause conjunctivitis


Gonorrhea

• Bacterium Neisseria gonorrhoeae

• May be asymptomatic

• May cause pain and discharge

• May cause conjunctivitis


Syphilis

• Spirochete Treponema pallidum

• Primary syphilis

– Chancre at site of exposure


Syphilis (cont.)• Secondary syphilis

– Disseminates to other organs– Skin rash– Mucosal lesions

• Tertiary syphilis– Gumma lesions develop in organs– CNS and heart often affected


Question

Which of the following STDs may cause conjunctivitis?a. Chlamydiab. Gonorrheac. Syphilisd. a and be. All of the above


Answer

d. a and bCertain STDs affect other body systems - chlamydia

(caused by an intracellular parasite/virus) and gonorrhea (caused by a bacteria) may both result in conjunctivitis.

Syphilis is affects the skin, organs, and CNS.

Chapter 41 Sexually Transmitted Infections

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