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STD2

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Deekshitha Madduri
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8 views55 pages

STD2

Uploaded by

Deekshitha Madduri
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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STD

DR.BHARGAVI M.S OBG


SENIOR RESIDENT
SVIMS,TPTY
BACTERIAL VIRAL FUNGAL PARASITIC

TUBERCULO HSV CANDIDI ISOSPORI

SIS ASIS ASIS

CRYPTOSPORI
CMV CRYPTOC
DIOSIS
OCCOSIS

BACTERIAL HHV 8 PENICILLI TOXOPLAS

RESPIRATO OSIS MOSIS

RY
3 genera have human
pathogens
Treponema, Borrelia, leptospira

Treponema (25 species)-


Relatively short, slender, fine spirals.
Associated with venereal and non venereal
diseases, some are non pathogenic
Treponema pallidum causes syphilis-
venereal disease- STD.
Syphilis - T. pallidum

 History- ancient disease, Columbus crew


 Reservoir- humans only known natural
host.
 Name syphilis from a poem describing a
shepherd boy
 Transmission- sexual route- venereal
 Syphilis is not very contagious; a
person has 1/10 chance of becoming
infected after contact with an infected
person
 In some stages, it is less contagious
 Syphilis is conventionally divided into
following stages:
Primary, Secondary, Latent, Tertiary
Staging has prognostic and
therapeutic implications.
Primary syphilis

 5 to 80 days after contact (sexual), a


chancre develops at point of contact-
external genitalia
 Chancre is an inflammatory lesion
containing spirochetes & lymphocytes.
 It is painless, well circumscribed,
indurated, heals spontaneously after ~10 –
40 days leaving a thin scar.(also called hard
chancre)
 Regional lymph nodes are enlarged and non
tender.
 Even before appearance of chancre,
treponema spread from site of entry via
blood/lymph.
 Multiple chancre may be seen in
immunodefficient patients.
 Once this heals patient remains
asymptomatic till secondary stage
Secondary syphilis

 2 - 12 weeks after primary lesion


heals, generalized symptoms of
disseminated infection occur due to
multiplication and dissemination of
treponemes
 Fever, headache, sore throat and
enlarged lymph nodes develop
 Papular skin rash develops on body
and lesions appear on palms and
soles of feet also
 Abundant spirochetes in skin lesions- most
infectious stage
 Intensity of lesions in secondary syphilis
varies
 Can Heal spontaneously in months to years
 Variable course
spontaneous cure
latent stage
go to 3rd stage
Latent Syphilis

 Absence of clinical symptoms


 3 possible outcomes

Persist for life


Tertiary syphilis
Cure
Tertiary syphilis

 2-20 years later


 Steady tissue destruction- Chronic
granulomata formation- Gumma, lesions
contain very few treponema
 Cardiovascular system/CNS
 ~1/3 die
Late tertiary or quaternary syphilis-

 Tabes dorsalis- dorsal column of


spinal cord
 GPI- dementia
Congenital Syphilis
 Fetus susceptible after 4th month IU life
 40% fetal death

 Hutchinson's Triad

peg teeth
interstitial keratitis
8th nerve destruction- deafness
Treponema pallidum
bacteria
 It is slender and tightly coiled,
measuring 5 to 15 µm long by
0.09 to 0.18µm wide
 They have a characteristic motility
on dark field microscopy- cork
screw
 This is due to axial fibrils, similar
to flagella, varying numbers
 T. pallidum has not been cultured in
vivo.
 It is rapidly inactivated by:
Drying, Heat, Cold
 Transmission is by direct contact or
congenitally
Diagnosis

Clinical- based on symptoms, history


Laboratory
 Darkfield examination

Wear gloves, Clean the lesion with


saline gauze, press it gently and
collect exudate on a slide and
examine in darkground microscope.
Serologic tests
Non Specific/Non treponemal

 A reactive material from beef heart


called cardiolipin is used as
antigen
 It reacts with “reagin” antibodies that
develop in syphilis
 Also called Standard test for Syphilis
(STS)
VDRL
 This is a slide flocculation test to
detect antibodies in patients serum
using cardiolipin as antigen

1o 1/3 +
2o 95% +
latent +/-
Other Non treponemal
tests
 Kahn’s- Tube flocculation test
 Wasserman test- Complement

fixation
 RPR- rapid plasma reagin test

Biological false positives- BFP


 Acute infections, major trauma,

autoimmune conditions like SLE,


 Leprosy, malaria
Specific - treponemal tests
Using T. pallidum antigen to detect antibodies
in patients serum
 Treponema pallidum immobilization- TPI
 Fluorescent treponemal Antibody (FTA)
 T pallidum haemagglutination (TPHA)

1o 80% +
2o & 3o >95% +
latent >99% +
Treatment
 Penicillin is drug of choice
 Duration of tretment varies
according to clinical stage of
disease
 If allergic to penicillin-
Ceftriaxone

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