Reproductive system; grade 3
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This document discusses several important sexually transmitted infections (STDs). It begins with an introduction to STDs, noting that over 20 have been identified. Important facts provided include that STDs often have no symptoms but people can still transmit them, and some STDs can cause infertility, ectopic pregnancy, or increase HIV risk. Common and important STDs are then discussed in more detail, including chlamydia, gonorrhea, genital herpes, HPV, and syphilis. Diagnostic methods and clinical presentations are summarized for each infection.
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Reproductive system; grade 3
- 1. Introduction. Important facts Important STDs Discussion about common & important STDs.
- 2. STDs, once called venereal diseases, also known as Sexually transmitted infections or STI. Defined as the infections that can be transferred from one person to another through sexual contact More than 20 STDs have now been identified. Introduction
- 3. 1. They affect men & women of all backgrounds & economic levels, being most prevalent among teenagers & young adults, nearly two-thirds occur in people <25 yrs. 2. The incidence is rising- young people become sexually active earlier, have multiple sex partners. 3. STDs may be asymptomatic, even then infected person is capable of transmitting the disease to partner. Important Facts about STDs
- 4. 4. Some STD can spread into the uterus, tubes & ovaries to cause PID,which in turn is a major cause of infertility & ectopic pregnancy. 5. In female some STD may be associated with cervical cancer. e.g.HPV 6. STD can be transmitted vertically from mother to baby before, during or immediately after birth. 7. When diagnosed & treated early, many STD can be treated effectively. 8. Having STD increases the risk for infection with HIV. 5 Facts (contd….)
- 5. 1. Chlamydial infection 2. Gonorrhea 3. Genital Herpes. 4. HPV & genital warts. 5. Syphilis 6. HIV/AIDS. 7. Trichomoniasis 8. Hepatitis B 9. Chancroid 10. Bacterial vaginosis 11. Granuloma inguinale (donovanosis). 12. Lymphogranuloma venereum 13. Molluscum contagiosum 14. Pubic lice 15. Scabies 16. Vaginal candidiasis. Important STDs
- 6. 5
- 7. Chlamydia are very small bacteria , obligate intracellular bacteria that grow within cytoplasmic vacuoles, stain poorly with Gram-stain but have the typical LPS of Gram – ve bact.
- 8. Three species for Chlamydia - C. trachomatis. Resp. T new genus - C. psittaci chlamydophila - C. pneumoniae
- 9. Enter through minute abrasions in the mucosal surface. Specific receptors endocytosis C. t vesicle inhibite Lysozyme fusion ( unknown mechanism ) After formation of metabolically RBs (binary fission ) 10 hs fresh progeny (within 20hs ) release of new EBs to the extracellular environment. Pathogenesis
- 10. The lifecycle of Chlamydia. (EB, elementary body; RB, reticulate body.)
- 11. Clinical syndromes and complications caused by C. trachomatis, serotypes D-K.
- 12. Chlamydial inclusion bodies stained dark brown with iodine
- 13. Direct fluorescent antibody test for Chlamydia trachomatis. Elementary bodies can be seen as bright yellow-green dots under the ultraviolet microscope
- 14. - The genus Neisseria contains two important human pathogens. N . meningitides (meningococus ) N .gonorrhoeae (gonococcus )
- 15. They are Gram – ve diplococci Obligate human pathogen . Found inside polymorph or pus of the inflammatory exudates. - It is exclusively a human pathogen
- 16. Gonos (seed ) Rhoie ( flow ) - It is classical venereal dis . - Spread almost by sexual contact. - Having a short incubation period. - Easy to diagnose and treat. - It is the 2nd infection in UK , with highest rates are seen in ♂ ( 20 – 24 ys) and ♀ ( 16 – 19 ys ).
- 17. • Cervix • Urethra • Rectum • Pharynx • Conjunctiva Infection is generally limited to ; superficial mucosal surface ẃ is lines é columnar epith.
- 18. Squamous epith . ẃ lines the adult vagina is not susceptible . The prepubertal vaginal epith. ẃ has not been keratinized under the influenz of estrogen may be infected. → as vulvovaginitis NB.
- 19. The spread of Neisseria gonorrhoeae is facilitated by various virulence factors. Changes in the surface structure of the gonococcus render the organism avirulent
- 20. Local and systemic spread of gonococcal infection and complications
- 21. - Gram staining of a smear ( 95% sensitive ). - It is a fastidious microbe , - Requiring humidity ( 5-7% co2 )and - Complex media for growth………. combination of oxidase + ve colonies and Gram- ve diplococci provides a presumptive diagnosis . Fluorescent – antibody staining NB.
- 22. -Co – agglutination -Specific biochemical tests ,glucose.oxidase -DNA probes may be used for confirmation - PCR based methods are available in some specified lab -Blood culture for DGI
- 23. - Rapid diagnosis. - Use of effective antibiotics. - Tracing , examination and treatment of contacts. – No vaccine till now ; -antigenic variation of the pilli. - outer memb. Ptns are antigenically variable. - lack of suitable animal models. NB.
- 24. Gonococcal skin lesion: an intensely inflamed.
- 25. Gonococcal arthritis affecting the ankle 1 week after contact with a new sexual partner
- 26. Gram stain of N.gonorrhoea
- 27. - Over 120 different types of papilloma virus can infect humans . - Widely distributed in nature . -papilloma viruses are 55 nm diameter , icosahedral , ds DNA viruses and cause skin papillomas (warts ) and tumors . - species specific , can be distinct from animal papilloma viruses .
- 28. - They show adaptation to definite sites on the body , - At least 40 types including HPV6 , 11 , 16 and 18 can infect the anogenital tract and other mucosal areas ( sexually transmitted ). - HPV1 and 4 tend to cause plantar warts. - HPV2 , 3 and 10 to cause warts on the knees and fingers. - Direct and indirect transmission . - DELETE
- 29. HPV2 , HPV3 &HPV10 cause warts on the knees and fingers. HPV1 &HPV4 tend to cause plantar warts 40 types( HPV6 ,11,16&18) infect the anogenital tract and other mucosal areas (sexually transmitted) They show adaptation to definite sites on the body .
- 30. - Diagnosis: viruses cannot be cultivated in the lab. , and at present serologic tests are neither useful nor available - DNA detection methods
- 31. Types of genital herpes: Herpes simplex virus type 1 (oral herpes) Characterized by lesions or blisters found on the mouth or lips. Herpes simplex virus 2 (genital herpes) Characterized by lesions found on and around the genital area. Viral Infections
- 32. Genital herpes is generally transmitted by sexual contact. Direct contact with infected genitals can cause transmission via sexual intercourse, oral-genital contact, anal intercourse, Other protected areas of skin can become infected if there is a cut, rash, or sore so that infections of the fingers, thighs, or other areas of the body are also possible. Viral Infections: Genital Herpes
- 33. The risk of developing genital herpes in a woman exposed to a symptomatic man is between 80-90%. A man’s risk of developing genital herpes from a single sexual encounter with an infected woman is about 50%. Problem: Herpes can spread when an infected individual displays no symptoms! Viral Infections: Genital Herpes
- 34. Oral Herpes Herpes Simplex Oralis
- 35. The treponemas that infect man are obligate human parasites No other natural hosts are known .
- 36. Non – venereal diseases ( yaws , bejel and pinta ) Venereal disease ( Syphilis )
- 37. -Intimate physical contact - contact é infectious body fluids or - in same instances by fomites
- 38. -are slender unicellular helical a spiral rods, motile,é several flagella which do not protrude into the surrounding medium but enclosed within bacterial outer membrane . -Treponemal flagella are complex , comprising a sheath and core .
- 39. -It has a worldwide distribution. It is the 3rd most frequent STDs in USA In UK ↑ed 15 – 20 % -Very sensitive to dryning , heat and disinfectants i–e the organism does not survive well outside the body . -Sexual contact . -Most active age group 15-30 y olds . -Congenital S ( vertical ) in utero or during delivery . -S has been rarely acquired by transfusion of infected fresh human blood .
- 40. - Outer memb. Ptns are associated é adherence to the surface of host cells. -Produce hyaluronidase ẃ may facilitate perivascular infiltration . -Spirochetes are coated é host cell fibronectin ẃ can protect against phagocytosis . -The cell surface rich in lipid and the antigen are covered , therefore T.P. can survive in the body for many years despite avagorous immune response . - Tissue damage is mostly due to the host response.
- 41. -Penetration of intact mucosa or through abraded skin → local multiplication ( very slow by av.3w ) infiltration of plasma cells , polymorph and macrophage. é endarteritis . Spread by lymphatics and blood to any organ . NB.
- 42. Congenital Syphilis – perforation of palate
- 43. Secondary Syphilis: Papulo squamous rash
- 44. Adv. Screening. Low cost , Technical simplicity , Monitor the efficacy of the treatment. Disadv. False + ve ( acute viral , bacterial infection ...) VDRL RPR Cardiolipin (Ag) + sera → floccultion 1st (70%) 2nd ( 100%) late ( 0% )
- 45. Fluorescent treponemal antibody absorption ( FTA – Abs ) test. Heated treated serum is 1st absorbed é a suspension of a non-pathogenic treponema ( ẃ removes non- specific cross-reactive Abs that may be detected against commensal spirochates . 1st ( 80% ) 2nd ( 100% ) late ( 95% ) Remains + ve following successful therapy. NB.
- 46. - T.P. haemagglutination assay ( TPHA ) Sera are pre-absorbed. Remain + ve for life . Important for neuro S. 1st ( 65 ) 2nd ( 100 ) late ( 95 ) . - T.P. particle agglutination test ( TPPA ). use colored gelatin particles. - ELISA or western blot for IgM in cong.syphilis . - Recently available kits for rapid detection.