Transmission: Sexual contact with an infected partner,
Oral,
Vaginal, or
Anal sex.
Chlamydia trachomatous:
Bacterial,
Coexists with gonorrhea infections.,
Found in the cervix, urethra, rectum, or throat, and
Ascend the genital tract to cause an upper reproductive tract condition called “pelvic inflammatory disease”.
Trichomoniasis:
Caused by a protozoan or parasite,
Found in the urethral tissues and vagina,
May or may not cause symptoms.
Gonorrhea:
Caused by the bacterium Neisseria gonorrhea,
Infects
Throat,
Eyes,
Urethra,
Vagina,
Anus, and
Ascending parts of the female reproductive tract,
Results in pelvic inflammatory disease.
Genital herpes:
Caused by a viral infection.
Two main causes of genital herpes:
Herpes simplex virus type 1, and
Herpes simplex virus type 2.
Caused by oral, anal, and vaginal sex.
Vaginal candidiasis:
Not technically an STD,
Passed from a male with candidiasis of the penis to the female,
Common,
Caused by a fungal organism,
Imbalance in the vaginal flora predisposes to overgrowth of yeast, leading to irritation, swelling, and itching.
Human papillomavirus:
Viral STD,
Several strains of HPV cause genital warts,
Can cause cervical cancer as they infect the cervix and lead to cervical dysplasia.
Incidence and Prevalence:
Not all sexually transmitted diseases are clinically reportable,
Difficult to know the true incidence and prevalence of these diseases.
US: about 1.5 million cases of chlamydia are reported each year to the Center for Disease Control.
About 175 million individuals throughout the world have trichomoniasis
Gonorrhea is reportable to the CDC: 700,000 cases reported each year
Genital herpes affects about one out of every six women between the ages of 14 and 50 years of age.
Most caused by HSV type 2,
HSV type 1 viral infections can also occur.
About 300,000 people in the US present to clinical care with this disease.
Candida species in the vagina is high.
Only about 20 percent of patients will have the symptomatic infection,
80 percent: no signs or symptoms of vulvovaginal candidiasis.
Human papillomavirus or
About 75 percent of people of reproductive age has been exposed to HPV.
Estimated that about 15 percent of women have the HPV virus in their genital tract.
The second most common STD after herpes simplex infections.
Predisposing Factors
Unprotected sex with an individual who already has the disease,
Multiple sex partners,
Not using condoms,
Some STDs can occur even when the patient has used a condom as skin contact outside of the penis can cause certain transmissions (such as herpes and HPV),
Early age at first intercourse and poor socioeconomic,
People with compromised immune systems,
The main risk factors for candidiasis of the vagina:
Antibiotic use (which alters the vaginal flora),
pregnancy,
Diabetes,
Excessive stress, and
Compromised weak immune system.
Signs and Symptoms
Chlamydia:
A high rate of silent infections,
Abdominal pain,
Dysuria,
Yellow vaginal discharge, and
Urinary frequency and urgency are common when the urethra is involved.
Trichomonas:
Seventy percent of people with trichomoniasis: no symptoms,
Mild symptoms: No medical attention,
Vaginal itching,
Foul-smelling, foamy vaginal discharge, and dysuria,
Abdominal pain is uncommon,
Doesn’t usually ascend to the upper reproductive tract.
Gonorrhea:
Could be asymptomatic,
Vaginal discharge that is slightly green in color,
Dysuria,
Increased frequency of urination,
Dyspareunia,
Pelvic pain,
A sore throat (if the throat is involved), and
Fever can develop if a pelvic inflammatory disease is present.
Genital herpes:
May or may not have symptoms,
Starts with a tingling sensation of the skin around the vagina,
Progresses to pain and the presence of small, red vesicles that can spread in a cluster,
Lesions last up to three weeks before breaking open and crusting,
Recurrences are likely but are milder than the initial outbreak.
vaginal candidiasis:
Profuse vaginal itching,
Vulvar swelling,
Dyspareunia,
Vaginal and vulvar redness,
Pain in the perineum, and
Cottage-cheese discharge.
HPV:
Presence of fleshy or verrucous lesions on the genitalia
Cervical HPV will often have no symptoms until they develop cervical cancer from prolonged infections with certain strains of the virus.
Clinical Presentation:
General:
Vaginal burning pain,
Itching,
Vaginal discharge,
Dyspareunia, and
Vulvar swelling.
Complicated gonorrheal and chlamydial infections
Fever,
Abdominal pain, and
Pelvic pain (associated with or without vaginal complaints).
Herpes simplex infections
Genital pain and lesions they cannot explain.
Vaginal candidiasis
Vaginal itching,
vaginal discharge.
HPV infections: Noted on a Pap test:
Abnormal HPV-infected cells are noted on the evaluation.
Human papillomavirus lesions/genital warts in the genital area.
Etiology
Chlamydia:
Chlamydia trachomatis bacterium
Affect any part of the woman’s genital tract as well as the rectum and urethra, or the throat.
Sexual contact with an infected person can cause the infection.
Trichomoniasis:
protozoan known as Trichomonas vaginalis, a flagellated organism.
Gonorrhea:
Neisseria gonorrhoeae,
Affect the genital tract of a woman along with the mucous membranes of the eyes, rectum, throat, and mouth.
Herpes simplex types 1 and 2
Both can be sexually-transmitted with direct contact of the lesions from one person to another.
Vaginal candidiasis:
Sexually transmitted.
Candida albicans, which is a normal part of the vaginal flora but, under certain circumstances, there can be an overgrowth of the yeast organism and an active infection.
Pathology
Chlamydia:
Cultured,
Blood tests to identify the antibodies to Chlamydia, and
Genetic material from the organism itself. (NAAT): Nucleic acid amplification test or NAAT: Swabbing the vagina or doing a urinalysis looking for the organism’s DNA.
Trichomoniasis
Vaginal or urethral discharge:
Looking for the organisms under the microscope: Pear-shaped organisms with obvious flagella that cannot be seen by the naked eye.
Gonorrhea
A culture of the vaginal discharge or infected urine,
Can be seen on a slide or smear of the vaginal or urethral discharge,
Culture can be obtained of either the blood or vaginal secretions.
Herpes simplex
The clinical picture of lesions and pain that are generally only seen in herpes simplex infections.
Viral cultures: which type of herpes simplex he patient has.
Candidiasis:
KOH smear in which a sampling of the vaginal secretions is looked at under the microscope. Potassium hydroxide (KOH) is added to the slide and this kills the cells, leaving the fungal organisms easy to see. Fungal cultures are not usually done.
HPV:
clinical diagnosis,
however, testing to identify which strain of the many types of viruses that can cause genital warts.
Treatment and Management
Chlamydia:
Antibiotics:
Azithromycin
Doxycycline: for seven days.
The sexual partners also need to be treated, even if they have no symptoms.
Trichomoniasis
Metronidazole
Gonorrhea:
A single injection of ceftriaxone or a single dose of azithromycin,
Chlamydia and gonorrhea often go together, a longer course of azithromycin is recommended.
Herpes simplex infections:
Antiviral agents
Oral acyclovir,
valacyclovir, and
famciclovir
HPV infections:
Electrocautery,
Excision, or
Cryotherapy to remove warts, which cuts down on the spread of warts.
Vaginal candidiasis:
Butoconazole,
Miconazole,
Terconazole,
Monistat, and
Complications
Chlamydia and gonorrhea:
Pelvic inflammatory disease,
Fitz-Hugh-Curtis (perihepatitis) syndrome and infertility.
Chlamydia and gonorrhea can be passed from mother to child at birth, leading to infections in the child and preterm birth.
Trichomoniasis:
Not many complications.
Contagious
Genital herpes infection is a
High risk of pregnancy complications. The virus can be transmitted from mother to child at birth, leading to serious neonatal viral disease.
Rarely, herpes simplex can affect the unborn fetus.
HPV can be passed from mother to infant during the birth process.
The main maternal complication of an HPV infection is the chance of getting cervical cancer from certain strains of the virus.
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