Sexually transmitted diseases

1
Sexually transmitted diseases
2
Normal flora

• Urethra Diptheroids, Acinetobacter species and
  enterobacteria.
• Cervix usually sterile.
• Vagian
• From puberty to menopause (acid pH in vagina)
  lactobacilli, anaerobic or microaerophilic
  streptococci, Bacteroides
• Vagina after menopause (alkaline pH)
  Diphtheroids, micrococci, Staphylococcus
  epidermidis, candida albicans.
• Vagina before puberty (alkaline pH)
  Staphylococcus aureus, and diptheroids.

3
Main causative agent

• Syphilis
• Chlamydia
• Neisseria gonorrhoeae
• H. ducreyi
• Ureaplasma

4
Terms

• Nongonococcal urethritis (NGU). Urethritis caused
  by an organism other than N. gonorrhoeae (e.g.,
  C. trachomatis or Ureaplasma urealyticum).
• Sexually transmitted disease (STD).
• Venereal disease (VD).

5
Urethritis

• Inflammation of urethra may occur in men and
  women.
• N. gonorrhoeae and C. trachomatis are common
  causes.
• Ureaplasma urealyticum may cause urethritis in
  men.

6
Cervicitis

• Inflammation of the uterine cervix
• Most common caused by N. gonorrhoeae and C.
  trachomatis.

7
Pelvic Inflammatory Disease (PID)

• Inflammation of the pelvic cavity that may
  include salpingitis (i.e., inflamed fallopin
  tube), endometritis (i.e., inflamed endometrium),
  tubo-ovarian abscesses (i.e., infected fallopian
  tubes and ovaries), and peritonitis (i.e.,
  infected peritoneal cavity).
• PID may be caused by a variety of organisms
  including N. gonorrheae, C. trachomatis, and
  endogenous flora (e.g., Bacteroides, Actinomyces,
  and enterobacteriacae).

8
Genital Ulcers

• Treponema pallidum ulcer is painless and the
  associated adenopathy is bilateral.
• Haemophillus duccreyi is the cause of chancroid.
  Clinically the patients present with a painful
  genital ulcer. Unilateral painful swollen
  inguinal lymph nodes rapidly develop in half of
  infected persons.
• Chlamydia infection by C. trachomatis serotypes
  L1, L2 and L3 causes lymphogranuloma venereum.
  Characterized by swollen inguinal lymph nodes,
  and painless papule on external genitalia which
  then ulcerate.

9
Prostatitis

• Inflamed prostate.
• Caused mainly by member of enterobacteriaceae, N.
  gonorrhoeae, C. trachmatis and S. aureus.

10
Postpartum endometritis

• These infections occur after chidlbirth and may
  be caused by a variety of organisms, including
  Beta-hemolytic streptococci, Gardenerella
  vaginalis, enterococci, mycoplasma hominis, and
  anerobic bacteria.

11
Group B streptococci

• Many women carry group B strepotocci vaginally.