Prof Ong Kok Hai’s Notes
Sexually transmitted diseases
Image: treponema pallidum
Image: lymphogranuloma venerum (with lymphodenopathy of inguinal nodes)
Lesions
- syphilis
- treponema pallidum
- Primary: chancre
- Secondary: rash
- Diagnosis
- clinical
- laboratory
- microscopy
- serology (antibody detection)
- VRDL
- RPR
- TPHA
- FTA-Abs
- Routine screening
- antenatal, insurance, blood donors
- Treatment
- penicillin
- herpes
- HSV 1: oral lesions
- HSV 2: genital lesions
- antigen detection
- EIA, immunofluorescence)
- tissue culture
- IgM
- Lymphogranuloma venerum (LGV)
- Chlamydia trachomatis
- A-C: trachoma
- D-K: urethritis, cervicitis, proctitis
- L1-L3: LGV (liver disease, swelling of lymph nodes)
- skin lesions – ulcerating papule
- papules will heal
- lymphadenopathy
- systemic spread
- treatment: tetracycline, erythromycin
- Chandroid
- Haem. ducreyi
- gram –ve rod
- rare
- genital ulcer
- donovanosis
- Calymmatobacterium granulomatis
- gram –ve bacteria
- tropical genital ulcer
- bacteria stains black in Giemsa stain
- within monocytes
- treatment: tetracycline
- genital warts
- condylomata acuminata
- papillomavirus
- 6,11,12,16,18,31
- may not regress for months
- infective period: 1-6 months
- strong association with cervical cancer
- 16,18
- removed by laser
- urethritis
- microbe:
- gonorrhea
- systemic spread
- septicaemia
- septic arthritis
- skin rash/dermatitis
- treatment: penicillin, sulphonamides, spectinomycin
- non-gonococcal urethritis (NGU)
- most common STD
- purulent discharge
- chlamydia
- treatment: tetracycline, erythromycin
- Trichomoniasis
- vaginal discharge foul smelling
- male asymptomatic
- treatment:
- metronidazole
- pus with/without pain on micturition
- symptoms less obvious in females
- vaginitis
- HIV
- hepatitis
- PID
- Mycoplasma
- M. hominis (atypical pneumonia)
- U. urealyticum
- PID
- urethritis
- proctitis
- treatment: tetracycline
Pelvic Inflammatory Disease
- Aetiology
- GC
- NGU
- normal flora
- Complication of gonorrhea & NGU
- asymptomic/mild
- diagnosis
- symptoms
- colposcopy
- high vaginal swab (HVS)
- antigen detection
- treatment
- combination therapy
- chlamydia, gonorrhea, normal flora