The most frequent agents of STD

•                 Papillomaviruses

•                 Chlamydiae

•                 Yeasts

Other common agents of STD:

        HBV

        HCV

        HIV

        HSV 2



        Mycoplasma & Ureaplasma

        Gardnerella vaginalis

        Klebsiella granulomatis



        Trichomonas vaginalis

        Sarcoptes scabiei

        Phthirus pubis



                                         Papillomaviruses

The most frequent agent of genital infections

Genotypes 6, 11 and many other:                  both ♂ & ♀: anogenital warts  (condylomata
accuminata)



Genotypes 16, 18 and some other                   ♀: infection of cervix → Ca



Vaccination against carcinogenic types!

Culture impossible – diagnostics performed using molecular methods





                                            Chlamydiae

The second most frequent agent of genital inf.



Chlamydia trachomatis serotypes D to K            ♂: nongonococcal & postgonococcal

           urethritis

      ♀: cervicitis → blenorrhoea neonatorum



Therapy: macrolides and tetracyclines



Lab. dg: direct: detection of antigen

                           detection of DNA

                           culture (special cell culture)

                           indirect (serology): not very useful









                                              Yeasts



Candida albicans  (rarely other candidae) ♂: balanoposthitis                                    ♀:
vaginal mycosis (candidosis, vulvovaginitis)



Therapy: topical imidazoles (clotrimazole)

                systemic triazoles (fluconazole)



Lab. dg: microscopy

               culture (Sabouraud agar)



                                           Trichomonads

Trichomonas vaginalis (a flagellate)

♂: 0 (rarely urethritis, usually

         asymptomatic carriers)

♀: vaginitis, cervicitis, urethritis



Therapy: metronidazole (both partners must be treated)



Lab. dg: direct only – microscopy (wet mount, Giemsa stained film) & culture on special media

                                            Mycoplasmas

Mycoplasma hominis

Ureaplasma  urealyticum





♂ & ♀: urethritis

♀: postpartum fever,  PID?

Therapy: macrolides and tetracyclines

Lab. dg: direct only – culture on special media

                                           Gardnerellae

Gardnerella vaginalis

♂: 0

♀: bacterial vaginosis

Therapy: metronidazole

Lab. dg: direct only –

              fish odour test

                        microscopy (clue cells)

                        culture on special agar

                                    Viral agents of STD – HSV 2

Herpes simplex virus 2



♂ & ♀: herpes genitalis primary                                      recurrent



Therapy: acyclovir



Lab. dg:

•         isolation on a cell culture

•         detection of DNA by PCR

•         serology (useful in primary                                infection)





Hepatitis C virus

(sexual transmission not excluded)

♂ & ♀: viral hepatitis C, acute and chronic



Therapy:

interferon + ribavirin



Lab. dg:

- detection of viral RNA

- detection of antibodies (anti-HCV)

                                     Viral agents of STD – HIV

Human immunodeficiency virus (HIV-1 and HIV-2)

♂ & ♀: AIDS (acquired immunodeficiency syndrome)



Therapy: combination of antiretrovirotics (HAART = highly active antiretroviral treatment)



Lab. dg: detection of antibodies (& confirmation of positive findings)

            special tests: detection of antigens

                                       determination of viral load







                                      Parasitic agents of STD

Sarcoptes scabiei (itch mite)

♂ & ♀: scabies (mange)

Therapy: antiscabiotics (permethrine, lindane)

Lab. dg: microscopy from skin



Phthirus pubis (pubic louse, crab louse)

♂ & ♀:  pediculosis pubis (phthiriasis)

Therapy: lindane

Lab. dg: demonstration of lice or eggs



                                    Homework 5       – solution



Jacques-Louis David

(1748-1825):

Death of Marat (1783)



What is the connection between this painting and medicine?

•         Jean Paul Marat, murdered by Charlotte Corday in 1793, was initially a physician

•         He was run through when taking a bath for treatment  his skin disorder (probably
dermatitis herpetiformis Dühring)



                                            Homework 6
                    Who is the author    of this painting and what is its name?