Sexually Transmitted Diseases: Types and Symptoms

Sexually transmitted diseases are diseases that spread because of sexual activities. The symptoms like itching, discharge, and burning start occuring around the genital areas. These are highly contagious and proper education should be given to people specially youth regarding STDs so as to prevent the infection.

Syphilis

• It is caused by treponema pallidum. Treponema is a spirochete and it is a thread-like Organism.
• Syphilis can be classified into two types:
•  It can be Congenital or Acquired. Congenital syphilis is transmitted to the fetus from the mother and Acquired syphilis is transmitted through sexual or blood transfusion.

The course of the disease

There is a development of primary Syphilis and a lesion called a chancre within 10 to 90 days of infection. Secondary lesions on the mucocutaneous region and other organ involvement can occur after 2 to 12 weeks. Tertiary syphilis can also occur in some patients after more than two years, cardiovascular problems and neurosyphilis can develop.

Also Read: Leptospirosis: Causes, Phases, Transmission, Symptoms, Risk Factors, Diagnosis, Treatment, Complications and Prevention

Primary Syphilis 

• It is the development of an ulcer in the genital area called a chancre. The Chancre is single, painless, well-defined, indurated lesion and there might be the presence of a significant discharge.
• Extra genital lesions can be present on the trunk, fingers, and mouth, etc.

Also Read: Herpes: Causes, Symptoms, Stages of Herpes, Transmission of Herpes, Diagnosis, Treatment

Secondary Syphilis

• In some patients, the spirochaetes can disseminate to all the tissues via the bloodstream and multiply the tissues and this can lead to secondary syphilis. Its manifestations are observed in skin and mucosa, and there will be the presence of some systemic symptoms.
• The common symptoms will be fever, skin rash, and lymph nodes.
• These secondary syphilitic skin lesions are polymorphic and bilaterally symmetrical but these do not present with vesicles and bulla. 
• These rashes are rose-colored and first appear in secondary syphilis. 
• When syphilis affects the palms and soles hyperpigmented plaques can be seen.
• Some of the lesions are broad and flat and these are called condyloma lata.
• Secondary syphilis can be present in many forms except vesicles and bulla. It can be present with circular patches of alopecia called moth-eaten alopecia.
• Epitrochlear lymphadenopathy.
•  These systemic manifestations involve spleen, CNS manifestations, and kidney problems.

Also Read: Cholera: Causes, Symptoms, Types of Carriers, Risk Factors, Diagnosis, Treatment

Latent Syphilis

Late latent syphilis is known as the non-infective stage of syphilis.

Also Read: Group A Streptococcal Infections : Types, Causes, Symptoms, Diagnosis, Treatment

Tertiary Syphilis

• It is also a known infective stage and it is a hypersensitivity reaction that occurs to the remnants of the spirochetes.
•  It can involve CNS and CVS.
•  In CVS it usually presents with aortitis and aortic aneurysms.
•  In CNS it can cause tabis dorsalis and psychiatric issues. 
• It can lead to enlarged and painless joints called Charcot's joints. The skin lesions of tertiary syphilis are called gumma.
• Saddle nose deformity is seen in tertiary syphilis. 

Also Read: Measles: Causes, Clinical Presentation, Risk Factors, Complications, Diagnosis, Treatment And Vaccinations

Congenital or Prenatal Syphilis

Early congenital syphilis will present as:

1. Wrinkled old age appearance
2. Potbelly or hepato splenomegaly
3. Nasal discharges
4. Hydrops fetalis
5. Rashes 
6. There is a special triad of congenital syphilis called as Hutchinson’s triad it includes 8th nerve deafness, interstitial keratitis and Hutchinson’s teeth. 

Investigations

• By dark ground microscopy, the fluorescent spirochaetes can be observed.
• Chancre smear is taken and observed under a microscope.
• Non-treponemal tests like VDRL and RPR help in monitoring the response to the treatment.
• Treponemal tests like FTA/ABS remain positive even after treatment so these don’t help in regular monitoring.

Treatment

• Injection benzathine penicillin is given intramuscularly and only one dose is given in case of primary secondary or early latent syphilis.
•  In case of late latent or tertiary syphilis 3 doses at weekly intervals are required.
•  The patient who is allergic to penicillin should be desensitized because penicillin is the most effective drug. If desensitization is not possible then doxycycline is given.

Also Read: Listeriosis : Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention

Hemophilus Ducreyi

• It causes a sexually transmitted infection called Chancroid which is a soft chancre because these are not indurated.
• It presents as:
  • Multiple ulcers
  • Painful
  • Non indurated
  • Greyish
  • Bleeds on touch
  • Suppurative lymphadenopathy will be called a bubo.

Investigations

• Gram stain is done by taking samples from the lesion and gram-negative bacilli will be seen arranged in chains.
• Mueller Hinton Agar supplemented with chocolate horse blood.

Treatment

Azithromycin 1g single dose is given orally or Ceftriaxone 250mg can be given as a single dose Intramuscularly.

Also Read: Brucellosis: Causes, Symptoms, Types, Transmission, Diagnosis, Treatment and Complications

Herpes Genitalis

• It is caused by herpes simplex virus among which type 2 is more common.
• It presents as multiple, painful, and non-indurated vesicles.
• These vesicles can rupture to form coalescing vesicles or polycyclic erosions.
• There is the absence of ulcers
• Bilateral and tender lymphadenopathy will be seen
• The virus can become dormant or latent in the dorsal root ganglion.

Investigations

• Tzanck smear- multinucleated giant cells will be present.
• On serology, glycoprotein can be detected and the test is called ELISA.

Treatment

Acyclovir

Also Read: Pseudomembranous Colitis: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Prevention

Donovanosis

• It is also called Granuloma Inguinale.
• It is caused by Klebsiella granulomatis.
• The patient will present with a beefy red granulomatous ulcer which bleeds easily with touch.
• The ulcers will be single and painless.
• Lymph nodes are not involved

Investigations

• Smear is taken from the ulcer and inside the cell, the bodies are present called Donovan bodies.
• The bacteria will appear as a safety pin.
• Nucleic acid amplification test is done to confirm the diagnosis.

Treatment

• Azithromycin is given for three weeks or until all lesions are completely healed.
• Alternative regimes include doxycycline.

Also Read: Influenza Virus: Causes, Symptoms, Types, Risk Factors, Examination, Diagnosis and Treatment

Lymphogranuloma Venereum

• It is caused by chlamydia trachomatis.
• It has three clinical stages:
  • The primary stage includes transient ulcer and the patient is not present in this stage.
  • The secondary stage is called an inguinal syndrome.
  • The tertiary stage is called Genito acro crural syndrome.

Clinical Features

• Suppurative lymphadenopathy
• The lesions are painful.
• Multilocular
• The ulcer breaks down and leads to the formation of a discharging sinus.

Investigations

• Nucleic acid amplification test
• Complement fixation test
• Treatment- Doxycycline.

Also Read: Mucormycosis : Types, Causes, Risk Factors, Symptoms, Diagnosis and Treatment

Trichomonas Vaginalis

• It is the most common cause of sexually transmitted diseases.
• The main reservoir for this microorganism is the urethra, vagina, and, prostate.
•  It is common in both sexes.
• In men, it can cause urethritis, cystitis, and prostatitis. 
•  In the female, strawberry cervix (red dots are seen) on the cervix, and a greeny discharge can be observed.

Diagnosis

• Discharge can be taken as a sample and a pap smear is done from the cervix.
• Microscopic examination will show the trophozoite on pap smear a pear-shaped Organism is seen with one nucleus and four anterior flagella. The microorganism shows a rotatory type of motility
• Culture- Lash cysteine hydrolysate serum.

                                          Trichomonas

Treatment

Both the sexes are treated with Metronidazole.

Also Read: Actinomycosis Treatment, Symptoms, Causes, Diagnosis & Types

Download the PrepLadder app now and unlock a 24-hour FREE trial of premium high-yield content. Access Video Lectures, digital notes, QBank, and Mock Tests for FREE to ace your NEET PG preparation. Elevate your study experience and gear up for success. Start your journey with PrepLadder today!