Syphilis Treponema pallidum Fastidious bacterium

Transmission Sexual, MTCT

Pathogenesis

Incidence

Symptoms Primary: Chancres genital sores Secondary: systemic -fever -malaise -lymphadenitis -rash may be anywhere, especially feet soles Latency possibly decades Tertiary: Organ failure nervous system or CV system, lesions on skin gummas Fetus can cause spontaneous abortion or cause congenital syphilis Clap -Genital creamy white discharge -Oral/Anal redness, pain, pus -PID common cause -Neonatal blindness -Genital: cloudy discharge -Oral/Anal: sores PID: most common cause Trachoma (Neonates) inflammation of eyelid scarring and blindness in neonates. -Neonates may be fatal, especially if primary infection at birth. -Health workers ob/gyn, dentist may get sores on hands

Other

Diseases

Vaccine?

Gonorrhea Neisseria gonorrhoeae (gonococcus) the second special coccus)

Sexual, MTCT

Lives in lymphoid tissue under mucosal lining, has complement evasion VFs, survives phagocytosis

Clamydia C. trachomatis Intracellular in epithelia C. pneumoniae relative

Sexual, MTCT

Top STD in U.S.

Herpes simplex 1, 2 (HSV1 (oral) , HSV2 (genital))

Skin= lytic tissue, Trigem/sacral nerves =latent

Latency/reactivation Stress/IC related Primary vs Recurrent primary last longer, more severe (may be fever, pain); recurrent may have no symptoms other than minor sores

Human papillomavirus (HPV) 200+ strains!

Contact

Have genes that make proteins that cause cells to divide. Why? It does not have a gene for DNA dependent DNA polymerase. It must use the host cells replication enzyme, but the cell will only

-Warts: benign tumors: growths, not sores -Genital: cauliflower appearance Elsewhere all warts, anywhere

Screening: Pap smear very effective; reduces cervical cancer rates 90+% where used. Cervical cancer may develop years after sex with transmitting partner has ceased, so exams are regular.

Cervical Cancer: only a few strains cause this- 4 cause 2/3 of all cancers. Others? Oropharyngeal: some evidence of link to prostate cancer

Treatment: Cryotheraphy Vaccine: Gardisil or Cervarix -subunit vaccine against the 4 strains that must often cause cancer, so it is not a guarantee! -Men are transmitters

Bacterial vaginosis (BV)

Cause unknown

produce that enzyme when dividing. Commensals as opportunists when vaginal fluid becomes too acidic.

-irritation -pain -strong odor -discharge not a good indicator

Review Candidiasis- not generally an STI imbalance in hormones that increases alkalinity of vagina or Abx Review Trichonomas