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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:
4 days to 1 month

1
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:
• Instruct to avoid sexual conact until healing is complete (2 weeks)
• Check for drug allergy
• Prevent secondary bacterial infection

2
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:
Treponema Pallidum

INCUBATION PERIOD:
Variable

CLINICAL MANIFESTATIONS:
PRIMARY SYPHILIS
3
• 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

TREATMENT:
Penicillin G

NURSING INTERVENTION:
Sex education