Sexually Transmitted Infections

1. Describe the prevalence, clinical features, diagnosis, treatment and possible complications of Chlamydia Trachomatis in a woman of childbearing age.
Chlamydia is the commonest sexually transmitted disease in the United States caused by a bacterium. Chlamydia Trachomatis causes this disease and has an estimated prevalence of 4 million infections annually. About 75 percent of the infected women (Sexually Transmitted disease. CDC Fact sheet) do not have any symptoms. Symptoms include abnormal vaginal discharge, lower abdominal pain, lower back pain and burning sensation when urinating. Nausea, pain during intercourse, fever and bleeding between periods may also be seen. It is diagnosed by laboratory tests using culture or non culture techniques such as nucleic acid amplification test on samples from the endocervix or urine (Miller, 2006). Treatment is with azithromycin (single, 1g dose) or doxycycline (100mg twice daily for a week). A possible complication includes pelvic inflammatory disease (PID). This may lead to chronic pelvic pain, ectopic pregnancy and infertility.
2. Compare and contrast Treponema Pallidum and Neisseria Gonorrhoeae infection in terms of a) clinical features, b) diagnosis c) treatment and d) complications.
Treponema Pallidum and Neisseria Gonorrhoeae are both infections caused by a bacterium. While the infection with T. Pallidium (syphilis) manifests in the form of painless ulcers on the sites of infection, infection with N. Gonorrhoea (gonorrhea) presents in the form of painful urination, bleeding between periods and discharge from the vagina in women and discharge from the penis and painful, swollen testicles in men. Both infections may be passed from mother to baby. Syphilis may cause anomalies in babies (Syphilis, 2006). Both are diagnosed by detecting the bacterium in scrapings and samples. Syphilis may be diagnosed by detecting antibodies too. Both are treated with antibiotics. Both organisms can pass through blood to other organs. Complications of syphilis mainly involve the cardiovascular system and brain. Gonorrhoea causes PID. This in turn may lead to chronic pelvic pain, ectopic pregnancy and infertility. Both infections make the sufferer more susceptible to acquire HIV and if not treated, both may lead to death.
3. Briefly discuss advice you would give to a young adult who is experiencing the first episode of HSV2 infection.
I will explain that HSV2 infection is caused by HSV2 virus and that it is a contagious disease often transmitted sexually, which may recur and often difficult to cure completely. So, he / she have to be cautious so as not to spread this virus to his / her sexual partners. I will emphasize the compulsory use of condoms for two main reasons.
1. Firstly, to prevent the transmission of the HSV2 virus.
2. Secondly, because people with HSV2 infection are at a higher risk of getting HIV. (Rebbapragada et al., 2007)
Also, I will tell that care should be taken to ensure others do not touch the blisters and ulcers or the fluid oozed from them. and if he / she experience a recurrence, he / she should seek medical help.
References.
Miller KE (April 15, 2006) Diagnosis and Treatment of Chlamydia Trachomatis infection. American Family Physician.Retrieved on March 25, 2008 from http://www.aafp.org/afp/20060415/1411.html
Rebbapragada A, Wachihi C, Pettengell C, Sunderji S, Huibner S, Jaoko W, Ball B, Fowke K, Mazzulli T, Plummer FA, Kaul R. (2007) Negative mucosal synergy between Herpes simplex type 2 and HIV in the female genital tract. AIDS, 21(5), 589-98
Sexually Transmitted Diseases. Chlamydia – CDC Fact Sheet. Retrieved on March 25, 2008 from http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm#moreinfo
Syphilis ( October 27, 2006) Retrieved on March 25, 2008 from http://www.mayoclinic.com/print/syphilis/DS00374/DSECTION=all&amp.METHOD=print
2. Compare and contrast Treponema Pallidum and Neisseria Gonorrhoeae infection in terms of a) clinical features, b) diagnosis c) treatment and d) complications.
Treponema Pallidum
Neisseria Gonorrhoea
Clinical Features
Causes the disease
Syphilis
Gonorrhoea
Organism
Bacteria
Bacteria
Has single or multiple painless sores
Yes
No
Draining lymph nodes enlarged
May be
May be
Non-itchy skin rash
Present in secondary stage
Absent
Involvement of other organs
Present in the late stages (may involve brain, heart, liver, eyes, bones, joints and blood)
Mainly involves the joints
Fever and sore throat
May be
May be
Painful urination
Absent
Present
Discharge from penis
Absent
White, yellow or green coloured discharge
Painful, swollen testicles
No
Sometimes
Increased vaginal discharge
No
Yes
Bleeding between periods
No
Yes
Discharge, anal itching, soreness, bleeding or painful bowel movements.
No
Yes (in rectal infection)
Can pass from mother to baby
Yes
Yes
Can cause anomalies of the baby
Yes
No
Diagnosis
Detecting the presence of bacterium in scrapings and samples.
Yes
Yes
Detecting antibodies to the bacterium
Yes
No
Treatment
Antibiotics (In the early phases, treatment is with a single injection of Penicillin or two weeks of antibiotics such as doxycycline, tetracycline or erythromycin. Later phases require more aggressive treatment with IV antibiotics.)
Antibiotics
Complications
Main complications
Cardiovascular syphilis and neuro syphilis.
In females, PID leading to chronic pelvic pain, ectopic pregnancy and infertility.
In males, epididymitis leading to infertility.
Anomalies in babies
Bone and teeth deformities, swollen joints, vision and hearing problems. (Syphilis, 2006)
Not seen
Can spread to blood
Yes
Yes
More susceptible to HIV infection
Yes
Yes
If not treated may die
Yes
Yes