The most frequent agents of STD •Papillomaviruses •Chlamydiae •Yeasts Other common agents of STD: HBV, HCV HIV HSV 2 Mycoplasma & Ureaplasma Gardnerella vaginalis Trichomonas vaginalis Sarcoptes scabiei Phthirus pubis Papillomaviruses The most frequent agent of genital infections Genotypes 6, 11 and many others: both ♂ & ♀: anogenital warts (condylomata accuminata) Genotypes 16, 18 and some other ♀: infection of cervix → Ca Vaccination against carcinogenic types! http://missinglink.ucsf.edu Anogenital warts (condylomata accuminata) Chlamydiae Chlamydia trachomatis serotypes D to K ♂: urethritis ♀: cervicitis Therapy: macrolides and tetracyclines Lab. dg: direct: detection of antigen detection of DNA culture (special cell culture) http://pathmicro.med.sc.edu/mayer/chl-life.jpg The developmental cycle of Chlamydia http://webeye.ophth.uiowa.edu Adult Chlamydial Conjunctivitis Yeasts Candida albicans ♂: balanoposthitis ♀: vaginal mycosis Therapy: topical imidazoles (clotrimazole) systemic triazoles (fluconazole) Lab. dg: microscopy culture (Sabouraud agar) Trichomonas vaginalis http://depts.washington.edu Trichomonads Trichomonas vaginalis (a flagellate) ♂: asymptomatic carriers ♀: vaginitis, cervicitis, urethritis Therapy: metronidazole (both partners) Lab. dg: microscopy (wet mount, Giemsa stained film) & culture on special media Viral agents of STD – HSV 2 Herpes simplex virus 2 ♂ & ♀: herpes genitalis Therapy: acyclovir Lab. dg: •PCR •serology (primary infection) http://www.nlm.nih.gov Hepatitis B, C (VHB, VHC) Hepatitis C virus ♂ & ♀: viral hepatitis C, acute and chronic Lab. dg: - detection of viral RNA - detection of antibodies (anti-HCV) Hepatitis B virus ♂ & ♀: viral hepatitis B, acute and chronic A recombinant vaccine (HBsAg) Lab. dg: markers HBsAg, anti-HBs HBeAg, anti-HBe X anti-HBc HBV DNA 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 + Ag (& confirmation of positive findings) special tests: 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 Jacques-Louis David (1748-1825): Death of Marat (1783) •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)