妇产科之性传播疾病.ppt

妇产科学第19章性传播疾病
【教学目标】了解淋病、梅毒及病毒和沙眼衣原体感染的生殖道炎症的发病原因、传播途径、临床表现及诊断治疗和预防措施。
【教学重点】淋病、梅毒及病毒和沙眼衣原体感染的生殖道炎症的传播途径、临床表现及诊断治疗和预防措施。
【教学难点】淋病、梅毒及病毒和沙眼衣原体感染的生殖道炎症的发病原因、传播途径。
Sexually Transmitted Diseases
Bacterial infections:
Chlamydia trachomatis
Neisseria gonorrhoeae (GO)
Syphilis
Viral infections:
Herpes genitalis
Human papillomavirus (HPV)
Human immunodeficency virus (HIV)
Chlamydia vaginitis
[E] Chlamydia trachomatis Salpingitis (Peritonitis,
infertility, etopic pregnancy , premature labor , stillbirth possible)
[S] Often symptom free,associated with other
pathogens of vaginitis (GO, vaginosis),
Dysuria, pollakisuria, white glassing discharge.
Chlamydia should be suspected in any patient with
acute PID, possible GO or trichomonas vaginitis
[D] Intracelluar inclusion, immunology with
monoclonal antibody.
[T] Azithromycin 1g oral, single dose
Doxycycline 100mg bid for 7 d, Minocine?
Ofloxacin 100 mg tid for 7 d Erythromycin 500 mg qid for 7 d. for
pregnant patients
Gonorrhea (GO)
[E] Gramnegative i (i ),
Optimal pH , incubation time : w.
[S] 50-80% women with GO are asyptomatic.
Acute infection in urethra, cervix, Skne’s
glands, Bartholin’s glands, evtl rectum.
Confined in the mucosa only
Profuse purulent urethral and vaginal
discharge,urethral burning, dysuria, bladder
irritability, inflammation of urethra, cervix,
Skene’s and Bartholin’s glands.
Co-infection with other STD mon.
Causing recurrent PID, chronic pelvic pain
or infertility due to tubal damage or hydrosalpinx formation.
Women with a history of salpingitis  7~10 X ectopic pregnancy
If treatment of the acute phase delayed or
inadequate, GO via ascending surface
spreading usually toward the end or after the
next menstrual period  Acute salpingitis
and pelvic peritonitis.
pany symptom: Condylomata acuminata.
[D] History of exposure, microscopy, culture, PCR
ELISA.
.
[T] Ceftriaxone 1g iv + Doxycycline 100 mg bid for 7 d.
Failure is rare and a follow up cul