Flashcards in Week 6.0 - Genital Infections Deck (65)
Why cant you give tetracyclines to children?
-Stains teeth and bones
What is the most common presentation of chlamydia?
What is the most common bacterial STI?
Briefly describe the screening programme for chlamydia
-Targets sexually active under 25s
-Diagnoses 50% of all cases
-At stands or sent in the post
-Urine sample or swab (F) subjected to NAAT
-Dual tests for gonorrhoea
How does herpes simplex virus present?
-Genital herpes -> extensive painful genital ulceration, dysuria, inguinal lymphadenopathy and fever
With which serotype is genital herpes associated?
-HSV2 (HSV1 usually causes coldsores)
Why is herpes a chronic condition?
-Recurrent outbreaks varying from asymptomatic to moderate as the virus remains latent in the dorsal root ganglia
-Outbreaks usually get less severe and further apart
How is herpes diagnosed?
-PCR and vesicle fluid/ulcer base
How is herpes managed?
-Acyclovir for primary outbreak and severe disease
-Can be used as a prophylaxis for frequent recurrences but unpleasant side effects
-Barrier contraception to reduce the risk of transmission
What type of bacterium is n.gonorrhoeae?
-Gram negative intracellular diplococcus
How does gonorrhoea present in males?
-Urethritis with purulent discharge, epididymitis, prostatitis, proctitis, pharyngitis
How does gonorrhoea present in women?
-Most commonly asymptommatic
-Endocervicitis, urethritis, increased vaginal discharge, bleeding between periords, PID
How does disseminated gonococcal infection present?
-Skin and joint lesions
How is gonorrhoea diagnosed?
-Urethral/cervical swab or urine subjected to NAAT
(can do gram stain of pus but requires special culture medium)
How is gonorrhoea treated?
-Intramuscular ceftriaxone and azithromycin for potential chlamydial infection
What type of organism is treponema pallidum?
In which group of the population is syphilis most common?
-Men and MSM
Describe the disease course of syphilis?
1. Indurated, painless ulcer
2. 6-8 weeks later - fever, rash, lymphadenopathy, mucosal lesions
3. Latent infection - symptom free for years
4. Neurosyphilis (slow degeneration of nerves in dorsal spinal cord affecting touch and proprioception). Cardiovascular syphilis (aneurysm formation) and gummas (tumour like balls of inflammation everywhere)
How is syphilis diagnosed?
-Cannot be grown
-Dark field microscopy
-Serology -> ELISA then rapid plasma reagin titre and TP particle agglutination
How is syphilis treated?
-Intramuscular penecilli and 'test of cure' follow up
What is lymphogranuloma venerum?
-Infection of the lymphatics and lymphnodes
-Initial infection occurs as a self-limiting painless genital ulcer which is usually unrecognised
-Secondary infection occurs months later with buboes/abscesses in the inguinal lymph nodes
-Caused by c.trachoma serotypes L1, L2 and L3
What is chancroid?
-Bacterial infection caused by haemophilis ducreyi which presents as painful genital lesions spread by sexual contact
-Can present with painful abscesses (buboes) in the inguinal lymph nodes
What is Donovanosis (granuloma inguinale)?
-Bacterial infection caused by klebsiella granulomatis which is spread by sexual activity
-Characterised by ulcerative genital lesions which are locally destructive to the tissue.
What is trichomonas vaginalis? How does it present?
-A flagellated protozoan which causes bacterial vaginitis (trichomonas vaginitis)
-Presents as a thin, frothy offensive discharge with irritation, dysuria and vaginal inflammation
How is trichomonas diagnosed?
-Vaginal wet preperation and culture enhancement
How is trichomonas vaginitis treated?
What is vulvovaginal candidiasis? How does it present?
-Caused by candida albicans
-Profuse white, curd-like discharge which causes pruritis
How is thrush diagnosed?
-High vaginal smear
How is thrush treated?
-Topical azoles (clotrimazole)