SEXUALLY TRANSMITTED DISEASES

GONORRHEA
CAUSATIVE AGENT:
Neisseria Gonorrhea
 Gram (-) diplococci
 Produces an endotoxin
 Pathogenic to humans only

INCUBATION PERIOD:
3 – 5 days

CLINICAL MANIFESTATIONS:
Women: asymptomatic  PID
Men: urethritis and yellowish, greenish discharge and dysuria

DIAGNOSTIC EXAM:
Gram stain

TREATMENT:
3rd Generation Cephalosporin

NURSING INTERVENTION:
All information are confidential
Infants born to mothers positive for gonorrhea should be given crede’s prophylaxis
Case finding
Sex education

HERPES GENITALIA
CAUSATIVE AGENT:
Herpes Simplex Virus 2 (HSV 2)

INCUBATION PERIOD:
3 – 6 days

CLINICAL MANIFESTATIONS:
Vesicles or ulceration on vagina
Vesicles are painful

DIAGNOSTIC EXAM:
Tzanck test
(+) giant cells and inclusion bodies on cells
Serology

TREATMENT:
Acyclovir

NURSING INTERVENTION:
1. Sex education
2. Case finding
3. Prevent secondary bacterial infection

TRICHOMONIASIS
CAUSATIVE AGENT:
Trichomonas Vaginalis
 Does not have a cyst form

INCUBATION PERIOD:
1
4 days to 1 month

CLINICAL MANIFESTATIONS:
Vaginal itching
Burning pain on urination
Yellowish-greenish frothy vaginal discharge

DIAGNOSTIC EXAM:
Demonstration of the protozoa on microscopic examination of discharge

TREATMENT:
Metronidazole

NURSING INTERVENTION:
Sex education
Case finding

MONILIASIS/CANDIDIASIS
CAUSATIVE AGENT:
Candida Albicans

INCUBATION PERIOD:
Variable

CLINICAL MANIFESTATIONS:
Vaginal itching
Thick curd like discharge

DIAGNOSTIC EXAM:
KOH stain to detect presence of hyphae

TREATMENT:
Nystatin vaginal suppositories

NURSING INTERVENTION:
 Prevent secondary bacterial infection
 Identify cause of candidiasis through history taking

CHANCROID
CAUSATIVE AGENT:
Haemophilus Ducreyi
 Gram (-)

INCUBATION PERIOD:
3 – 5 days

CLINICAL MANIFESTATIONS:
Soft chancre
Painful genital ulcers + unilateral swelling of lymph node in the groin (purulent discharge)

DIAGNOSTIC EXAM:
Gram stain

TREATMENT:
Erythromycin
3rd generation cephalosporin

NURSING INTERVENTION:

2
  Instruct to avoid sexual conact until healing is complete (2 weeks)
 Check for drug allergy
 Prevent secondary bacterial infection

LYMPHOGRANULOMA VENEREUM
CAUSATIVE AGENT:
Chlamydia
A, B, C
 Cause trachoma (scarring of the eye)  blindness
D
 Causes non-gonococcal urethritis in males and cervicitis and PID in females
L1, L2, L3
 Cause Lymphogranuloma Venerum
 Painless papule or ulceration

INCUBATION PERIOD:
Variable

CLINICAL MANIFESTATIONS:
Cause trachoma (scarring of the eye)  blindness
Causes non-gonococcal urethritis in males and cervicitis and PID in females
Painless papule or ulceration

DIAGNOSTIC EXAM:
Serology

TREATMENT:
Doxycycline – for adults
Erythromycin – for infants and pregnant women
Azithromycin

NURSING INTERVENTION:
 All patients with other STDs should be treated with Chlamydia
 Check newborns for signs of chlamydial infection
 Sex education

CONDYLOMA ACUMINATUM
CAUSATIVE AGENT:
Papillomavirus (type 6, 7 and 11)

CLINICAL MANIFESTATIONS:
Presence of warts on the genital area

DIAGNOSTIC EXAM:
Biopsy

TREATMENT:
Podophyllin
Liquid nitrogen
Laser ablation

NURSING INTERVENTION:
Sex education

SYPHILIS
CAUSATIVE AGENT:
3
Treponema Pallidum

INCUBATION PERIOD:
Variable

CLINICAL MANIFESTATIONS:
PRIMARY SYPHILIS
 Painless chancre
 Resolve spontaneously over 4 – 6 weeks
 Patient can be asymptomatic for years and then progress to secondary syphilis

SECONDARY SYPHILIS
 Appears 6 weeks after primary chancre has appeared
 T. pallidum has reached the bloodstream
 SYPHILITIC RASH
o (+) generalized rash characterized as flat lesions and can be seen in palms, soles and
mucous membrane
 Condyloma Latum
o Painless ulcer found in the warm moist areas of the body
 Resolve over 6 weeks
 Patient can be asymptomatic for years and then progress to tertiary syphilis

TERTIARY SYPHILIS
 Occur after 3 to 10 years after the primary infection
 Appearance of GUMMAS
o Chronic superficial granulomatous lesions that is solitary
 CV syphilis
o Asymptomatic
o Presence of aneurysm
 Neurosyphilis
o Presence of Tabes Dorsalis
 slow degeneration of the nerve cell and nerve fibers that carry sensory
information to the brain
 Decrease reflexes, paresthesia, unsteady gait
o Argyll Robertson Pupil
 Lesion of the midbrain
 Constrict to near vision but not to light

CONGENITAL SYPHILIS
IN UTERO:
 Miscarriage/Still birth
EARLY:
 Snuffles – runny nose
LATE:
 Deafness
 Saddle nose
 Sabershin
 Bowing of tibia
 Hutchinson’s teeth
 Upper central incisirs are widely separated with a central notch in each tooth
 Mulberry molars
 Too many cusps in the molars

DIAGNOSTIC EXAM:
1. VDRL (Venereal Disease Reaearch Lab)
2. RPR (Rapid Plasma Reagin)
3. Dark Field microscopy

4
TREATMENT:
Penicillin G

NURSING INTERVENTION:
Sex education