Sexually Transmitted Diseases

-Classifications:

-Chlamydia

-Gonorrhea

- Bacterial Vaginosis

- Herpes

- Genital Warts

-HIV

-Hepatitis B

-Candidiasis

-Trichomonas Vaginalis

Etiology: Sexually transmitted infections (STIs) or sexually transmitted diseases (STDs) are
typically contracted through intercourse. The bacteria, viruses, fungal, and parasites are
usually transmitted through sexual contact through blood, semen, vaginal or other bodily
fluids. Other than sexual contact, It can also be transmitted to infants during pregnancy or
child birth and can be contracted to blood transfusion or shared needles.

Potential Nursing Diagnoses for STIs

-Readiness for enhanced knowledge would be a priority nursing care plan for someone who
has an STI, or recurring STI, that is treatable.

-Impaired Comfort r/t infection

-Fear r/t altered body function, risk for social isolation, fear of incurable disease

-Ineffective Health Maintenance r/t deficient knowledge regarding transmission, symptoms,

treatment of STD

-Ineffective Sexuality Pattern r/t illness, altered body function

-Social Isolation r/t fear of contracting or spreading disease

-Risk for Infection: spread of infection: Risk Factor: Lack of knowledge concerning
transmission of disease

-Readiness for enhanced knowledge: Seeks information regarding prevention and treatment of
STD’s

-Fear r/t to possible death (HIV/AIDS)

-Ineffective Protection r/t depressed immune system (HIV/AIDS)

Nursing Interventions

-Teach medication regiment, which includes thee name of, administration, side effects, and
action of the prescribed medication.

-Review hygiene before application of topical medications (e.g. wash with soap and water,
wear loose-fitting cotton undergarments).

-Discuss the importance in notifying sexual partners.

-Instruct the female patient regarding the importance of yearly gynecological examination
with Papanicolaou (Pap) smears.

-Encourage male patients to have yearly testicular examinations.

-Instruct patients in the safe methods of preventing STI transmission.

-Instruct in the use of a latex male condom.

-Discuss the benefits of monogamous relationships.

-Provide hope within the parameters of the disease process. Do no give false reassurance.

-Assist the patient in identifying the extent of changes in appearance.

-Refer to support groups.

-Encourage the patient to talk about anxious feelings.

-Identify the availability of support systems for the patient.

-Identify behaviors suggestive of the grieving process.

-Listen and encourage patient to verbalize feelings.

-Discuss the "normal" impact of change on self-esteem. Reassure patient that such changes
often result in a variety of emotional and behavioral responses.
Reference :

Pillitteri, A. (2010). Maternal & Child Health Nursing: Care of the Childbearing &
Childrearing Family. Wolters Kluwer Health/Lippincott Williams & Wilkins.

Mayo Clinic Staff. (2023, September 8). Sexually transmitted diseases (STDs) -
Symptoms and causes. Mayo Clinic. Retrieved April 15, 2024, from
https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/
symptoms-causes/syc-20351240

STD

-Sexually transmitted infections (STIs) are diseases that are spread through sexual contact
with an infected partner. A sexually transmitted infection may pass from person to person in
blood, semen, or vaginal and other bodily fluids.

- STIs have a direct impact on sexual and reproductive health through stigmatization,
infertility, cancers and pregnancy complications and can increase the risk of HIV.

-Sometimes sexually transmitted infections are spread in ways other than sexual contact. For
example, STIs can spread to infants during pregnancy or childbirth. STIs also can spread
through blood transfusions or shared needles.

-STIs don't always cause symptoms. A person can get sexually transmitted infections from
another person who seems healthy and may not even know they have an infection.

Reference:

Dr. Seb. (2024, April 4). Differences between bacterial, viral, fungal and
parasitic sexually transmitted diseases. Psychologists By DRSEB.COM.
Retrieved April 15, 2024, from https://drseb.com/sti/bacterial-viral-parastic-and-
fungal-stis/

-There are 4 primary types of organism causing STIs: Bacterial, Viral, Fungal & Parasitic.

1) Bacterial - Chlamydia, Gonorrhoea, Bacterial vaginosis

2) Viral - Herpes, HIV, Hepatitis, HPV

3) Fungal - Candidiasis

4) Parasitic - Trichomonas Vaginalis,

Reference:

Henigsman, S. A. (2019, February 1). Chlamydia: Symptoms, Treatments,

Causes, and More. Healthline. Retrieved April 15, 2024, from
https://www.healthline.com/health/std/chlamydia#in-throat

World Health Organization Staff. (2023, July 17). Chlamydia. World Health
Organization (WHO). Retrieved April 15, 2024, from https://www.who.int/news-
room/fact-sheets/detail/chlamydia
BACTERIAL STI: CHLAMYDIA

Etiology

-Chlamydia is a common STD caused by infection with Chlamydia trachomatis. It can

cause cervicitis, urethritis, and proctitis. Chlamydia spreads through vaginal, anal, or oral sex
with someone with the infection.The majority of affected persons are asymptomatic and, thus,
provide an ongoing reservoir for infection.

-Transmission:

-Sex without a condom or other barrier method and oral sex without a barrier method are
the main ways a chlamydia infection can be transmitted.

-Penetration doesn’t have to occur to contract it. Touching genitals together may transmit
the bacteria.

-Pregnant people can give chlamydia to their baby during childbirth. This can cause
ophthalmia neonatorum (conjunctivitis) or pneumonia in some infants. Rectal or genital
infection can persist one year or longer in infants infected at birth

-Chlamydia can also be contracted even in someone who’s had the infection once before
and successfully treated it.

Clinical Signs/Symptoms

Many people with chlamydia have no symptoms or only mild symptoms. If symptoms occur,
they may not appear until up to three weeks after having sex with someone who has
chlamydia.

-In women, common symptoms include

 a change in vaginal discharge

 bleeding between menstrual periods or after sex
 pain or discomfort in the lower abdomen
 burning sensation when urinating.

-Common symptoms in men include

 burning when urinating

 discharge from the penis
 pain or discomfort in the testicles.

-Anal infection in women and men can cause

 pain
 discharge
 bleeding.

-Chlamydia in throat : If you contract chlamydia from oral sex, you may experience no
symptoms. If symptoms are present with chlamydia in the throat, they can include:
  sore throat
 dry throat
 fever
 coughing

-Infants born to mothers with chlamydia may experience eye infections or pneumonia. These
can be treated with antibiotic medications for newborns.

-The LGV type of chlamydia can cause severe inflammation and can lead to genital ulcer,
lymph node enlargement, or inflammation of the anorectal area with discharge, abdominal
cramps, diarrhea, constipation, fever or pain while passing stools.

Diagnosis

 Sexual history taking and risk assessment are crucial before diagnosis. Clinical
examination, speculum examination and palpation can provide important clues to clinical
diagnosis.

 Molecular tests are the gold standard for diagnosing C. trachomatis which can be
performed in the lab or at the point of care using molecular tests. Some rapid diagnostic
tests are available in the market, but currently they perform poorly compared to
molecular tests.

 A urine test. A sample of urine is analyzed in the laboratory for presence of this
infection. This can be done for males and females.

 A swab. A sample from the cervix, vagina, throat or anus is collected on a swab for
testing. From the cervix, a member of your healthcare team collects a sample of the
discharge from the cervix on a swab for testing. This can be done during a routine Pap
test. For a swab from the vagina, either you or the healthcare professional can do the
swab. For males and females, depending on sexual history, a swab may be taken from the
throat or the anus

-You can get tested by a healthcare professional or use a test available without a prescription.
If you've been treated for an initial chlamydia infection, you should be retested in about three
months.

BACTERIAL STI; GONORRHEA

-A sexually transmitted bacterial infection caused by the bacteria Neisseria gonorrhea. It often
affects urethra, rectum or throat.

- It is transmitted by having vaginal, anal, or oral sex with someone who has gonorrhea.

- A pregnant person with gonorrhea can give the infection to their baby during childbirth.

-Transmission ; Direct Sexual Contact only

ETIOLOGY
-In gonorrhea, disease transmission occurs through contact with exudates from the mucous
membranes of infected persons, usually by direct contact. The gonococcus then attaches to
and penetrates columnar epithelium and produces a patchy inflammatory response in the
submucosa.

Clinical Manifestations (S/sx)

Gonorrhea often has no symptoms, but it can cause serious health problems, even without
symptoms.

Most women with gonorrhea do not have any symptoms. Even when a woman has symptoms,
they are often mild and can be mistaken for a bladder or vaginal infection. Symptoms in
women can include:

 Painful or burning sensation when peeing;

 Increased vaginal discharge; and
 Vaginal bleeding between periods.
Men who do have symptoms may have:

 A burning sensation when peeing;

 A white, yellow, or green discharge from the penis; and
 Painful or swollen testicles (although this is less common).
Rectal infections may either cause no symptoms or cause symptoms in both men and women
that may include:

 Discharge;
 Anal itching;
 Soreness;
 Bleeding; and
 Painful bowel movements.
Diagnosis (Pathop Book & Gonorrhea - Diagnosis and treatment - Mayo Clinic)

To determine whether you have gonorrhea, your healthcare professional will analyze a sample
of cells. Samples can be collected with:

 A urine test. This can help identify bacteria in your urethra.

 A swab of the affected area. A swab of your throat, urethra, vagina or rectum can collect
bacteria that can be identified in a lab.

BACTERIAL STI : BACTERIAL VAGINOSIS

(vagina naturally contains different kinds of bacteria. Usually, your body works to maintain
the perfect balance between different bacteria, preventing specific types from growing out of
control. Once there’s an imbalance in the vaginal flora, or more precisely, when one strain of
bacteria naturally present within the vagina becomes overpopulated due to different factors.
For example, things as simple and trivial as using a new shampoo or shower gel can be
enough to disrupt the balance and bring on the condition.)

-A condition results from an overgrowth of bacteria in the vagina such as Gardnerella

vaginalis. This causes vaginal discharge with foul smell and itching.

-The condition known as bacterial vaginosis (or BV for short) is commonly mistaken for a
sexually transmitted infection
-Bacterial vaginosis is more common among those who are sexually active. Activities such as
unprotected sex and douching raise your risk of having BV and untreated BV may increase
your chance of getting a sexually transmitted infection

Clinical Manifestations (S/Sx)

BV doesn’t always cause symptoms. But when it does, they can include:

 burning sensation when urinating

 gray or white discharge
 fishy-smelling discharge
 itching and pain in vulva

Strong-smelling vaginal discharge is a hallmark symptom of BV. For some, the odor may get
stronger after unprotected sexual intercourse if semen mixes with the discharge.

Diagnosis (Bacterial vaginosis - Diagnosis and treatment - Mayo Clinic, Bacterial

Vaginosis: Symptoms and How to Treat It (healthline.com))

To diagnose bacterial vaginosis, your doctor may:

 Ask questions about your medical history. Your doctor may ask about any vaginal
infections or STIs you've had before.
 Perform a pelvic exam. First, your doctor will look at your vagina for signs of infection.
Next, the doctor will feel your pelvic organs. This is done by inserting two fingers into the
vagina while pressing on the stomach area, also called the abdomen, with the other hand.
 Take a sample of vaginal discharge. This sample will be tested for "clue cells." Clue
cells are vaginal cells covered in bacteria. These are a sign of BV.
 Test your vaginal pH. The acidity of your vagina can be tested with a pH strip. You
place the test strip in your vagina. A vaginal pH of 4.5 or higher is a sign of bacterial
vaginosis.

VIRAL STI STI : HERPES VIRUS INFECTIONS (PATHOPY BOOK)

-2 TYPES: TYPE 1 & TYPE 2

-HSV type 1 is most often associated with herpetic infections above the waist, typically in the
oral cavity and on the lips, but also in the eyes or on the epidermis. HSV type 1 can be
transmitted sexually and can cause genital herpetic infections. It is present in saliva, stool, and
urine. The vesicles resulting from type 1 infection in the oral cavity are commonly referred to
as cold sores or chancres and often affect children younger than 5 years.

-HSV type 2 is implicated in most genital, CHAPTER 34 Sexually Transmitted Infections

693 anal, and perianal herpes and is sometimes referred to as genital herpes for this reason.
Type 2 HSV can also result in oral lesions after sexual contact.. Although type 2 is primarily
transmitted through sexual contact, pregnant mothers can transmit the infection to newborns
during vaginal delivery. Although type 2 is primarily transmitted through sexual contact,
pregnant mothers can transmit the infection to newborns during vaginal delivery.

ETIOLOGY

-HSV types 1 and 2 have certain characteristics in common. Both produce an initial infection
that is self-limiting. The lesions produced by this infection heal, but HSV continues to be
present in the body. Recurrence of the lesions, usually in the area of the initial infection, may
take place as the virus is reactivated. Recurrence of either type may be triggered by an
infectious disease, emotional stress, or immunosuppression. The exact mechanism for
reactivation of the virus is presently unknown, but it is thought that ganglion neurons may
contain latent forms of the virus and then receive a trigger to stimulate replication of the virus
under certain conditions.

Clinial Manifestations (S/Sx)

Most people infected with HSV don't know they have it. They may have no symptoms or
have very mild symptoms. Symptoms start about 2 to 12 days after exposure to the virus.

They may include:

 Pain or itching around the genitals

 Small bumps or blisters around the genitals, anus or mouth
 Painful ulcers that form when blisters rupture and ooze or bleed
 Scabs that form as the ulcers heal
 Painful urination
 Discharge from the urethra, the tube that releases urine from the body
 Discharge from the vagina
During the first outbreak, you may commonly have flu-like symptoms such as:

 Fever
 Headache
 Body aches
 Swollen lymph nodes in the groin

DIAGNOSIS

HSV-1 and HSV-2 are both diagnosed in the same way and with the same tools. The tests are
commonly used to:8

Centers for Disease Control and Prevention. Genital herpes – CDC detailed fact sheet.

 Determine whether sores on your mouth or genitals are caused by HSV.

 Diagnose herpes during pregnancy (to prevent transmission of the virus to the fetus).
 Find out if a newborn has herpes.

Types of Tests

Herpes testing is usually done as a swab test, a blood test, or a lumbar puncture (spinal tap).
The test you get will depend on the type of symptoms you have:

 Swab tests are used in symptomatic people to collect fluids and cells from a herpes
sore. They can differentiate HSV-1 from HSV-2 based on their genetic material using
a technology called polymerase chain reaction (PCR). This is the gold standard for
herpes testing.
 Blood tests can be used in symptomatic or asymptomatic people. These include PCR
tests and antibody-based tests (which detect immune proteins produced in response to
the virus rather than the virus itself). Some antibody tests can differentiate HSV-1 and
HSV-2, while others cannot. Testing too early in asymptomatic people can lead to
a false-negative result, which claims a person does not have the infection when they
actually do.
  Lumbar puncture is used when herpes is suspected to have spread to the brain and
spinal cord, causing encephalitis. This is a rare complication mostly seen
in immunocompromised people, such as those with advanced HIV (human
immunodeficiency virus). The PCR test screens cerebrospinal fluid

HSV blood testing may be useful if:8

 Your sex partner has genital herpes, and you want to know if you acquired it.

 You are pregnant, and you and your partner have had genital herpes in the past or
currently have genital herpes )

References:

VIRAL STI: HUMAN PAPILLOMAVIRUS

-The human papillomavirus (HPV) causes fibrous tissue over growth (sometime called genital
warts) on the external vulva, vagina, or cervix (condyloma acuminatum).(But some types of
genital HPV can cause cancer of the lower part of the uterus that connects to the vagina
(cervix). Other types of cancers, including cancers of the anus, penis, vagina, vulva and back
of the throat (oropharyngeal), have been linked to HPV infection.)

-These infections are often transmitted sexually or through other skin-to-skin contact.

ETIOLOGY

-Human papilloma virus (HPV) infections cause epithelial lesions of the anogenital region.
Also called genital warts or condylomata acuminata, HPV is predominantly transmitted
sexually in young adults, with the highest prevalence in the 16- to 25-year-old age group. The
risk of contracting the disease by sexual contact with an infected person is high; lesions will
develop in up to two thirds of the sexual contacts of affected persons. Nonsexual transmission
has also been documented, and lesions have been found in infants. The period of
communicability is unknown, but is thought to last as long as the lesions persist, and perhaps
even after they are clinically removed.

Clinical Manifestations(S/Sx) (HPV infection - Symptoms & causes - Mayo Clinic)

In most cases, your body's immune system defeats an HPV infection before it creates warts.
When warts do appear, they vary in appearance depending on which kind of HPV is involved:
 Genital warts. These appear as flat lesions, small cauliflower-like bumps or tiny
stemlike protrusions. In women, genital warts appear mostly on the vulva but can also
occur near the anus, on the cervix or in the vagina. In men, genital warts appear on the
penis and scrotum or around the anus. Genital warts rarely cause discomfort or pain,
though they may itch or feel tender.
 Common warts. Common warts appear as rough, raised bumps and usually occur on the
hands and fingers. In most cases, common warts are simply unsightly, but they can also
be painful or susceptible to injury or bleeding.
 Plantar warts. Plantar warts are hard, grainy growths that usually appear on the heels or
balls of your feet. These warts might cause discomfort.
 Flat warts. Flat warts are flat-topped, slightly raised lesions. They can appear anywhere,
but children usually get them on the face and men tend to get them in the beard area.
Women tend to get them on the legs.

DIAGNOSIS (HPV infection - Diagnosis & treatment - Mayo Clinic )

 Your doctor might be able to diagnose human papillomavirus (HPV) infection by looking at
your warts.

If genital warts aren't visible, you'll need one or more of the following tests:

 Vinegar (acetic acid) solution test. A vinegar solution applied to HPV-infected genital areas
turns them white. This may help in identifying difficult-to-see flat lesions.
 Pap test. Your doctor collects a sample of cells from your cervix or vagina to send for
laboratory analysis. Pap tests can reveal abnormalities that can lead to cancer.
 DNA test. This test, conducted on cells from your cervix, can recognize the DNA of the high-
risk varieties of HPV that have been linked to genital cancers. It's recommended for women
30 and older in addition to the Pap test.

VIRAL STI: HIV (HIV/AIDS - Symptoms and causes - Mayo Clinic)

-Human Immunodeficiency Virus (HIV) a virus that damages the immune system so that
the body is less able to fight infection and disease. If HIV isn't treated, it can take years before
it weakens the immune system enough to become AIDS.

-Transmission:
-HIV is spread through contact with genitals, such as during sex without a condom.

-HIV is transmitted through bodily fluids that include: blood, semen, vaginal and rectal
fluids, breast milk

ETIOLOGY (HIV and AIDS: Symptoms, Causes, Treatments, and More (healthline.com))

-HIV destroys white blood cells called CD4 T cells. These cells play a large role in helping
the body fight disease. The fewer CD4 T cells you have, the weaker your immune system
becomes. (Healthy adults generally have a CD4 count of 500 to 1,600 per cubic millimeter. A
person with HIV whose CD4 count falls below 200 per cubic millimeter will be diagnosed
with AIDS)

Clinical Manifestations (S/Sx) (HIV/AIDS - Symptoms and causes - Mayo Clinic)

Primary infection, also called acute HIV

(Some people infected by HIV get a flu-like illness within 2 to 4 weeks after the virus enters
the body. This stage may last a few days to several weeks. Some people have no symptoms
during this stage.)

Possible symptoms include:

 Fever.
 Headache.
 Muscle aches and joint pain.
 Rash.
 Sore throat and painful mouth sores.
 Swollen lymph glands, also called nodes, mainly on the neck.
 Diarrhea.
 Weight loss.
 Cough.
 Night sweats.
(These symptoms can be so mild that you might not notice them. However, the amount of
virus in your bloodstream, called viral load, is high at this time. As a result, the infection
spreads to others more easily during primary infection than during the next stage.)

Clinical latent infection, also called chronic HIV

In this stage of infection, HIV is still in the body and cells of the immune system, called white
blood cells. But during this time, many people don't have symptoms or the infections
that HIV can cause.

This stage can last for many years for people who aren't getting antiretroviral therapy, also
called ART. Some people get more-severe disease much sooner.

Symptomatic HIV infection

As the virus continues to multiply and destroy immune cells, you may get mild infections or
long-term symptoms such as:

 Fever.
 Fatigue.
 Swollen lymph glands, which are often one of the first symptoms of HIV infection.
 Diarrhea.
 Weight loss.
 Oral yeast infection, also called thrush.
 Shingles, also called herpes zoster.
 Pneumonia.

DIAGNOSIS (HIV/AIDS - Diagnosis and treatment - Mayo Clinic)

HIV can be diagnosed through blood or saliva testing. Tests include:

 Antigen-antibody tests. These tests most often use blood from a vein. Antigens are
substances on the HIV virus itself. They most often show up in the blood within a few
weeks after being exposed to HIV.
 The immune system makes antibodies when it's exposed to HIV. It can take weeks to
months for antibodies to show up in blood. You may not show a positive result on an
antigen-antibody test until 2 to 6 weeks after exposure to HIV.
 Antibody tests. These tests look for antibodies to HIV in blood or saliva. Most
rapid HIV tests are antibody tests. This includes self-tests done at home. You may not
show a positive result on an antibody test until 3 to 12 weeks after you've been exposed
to HIV.
 Nucleic acid tests (NATs). These tests look for the virus in your blood, called viral load.
They use blood from a vein.

VIRAL STI: HEPATITIS B (Hepatitis B - Symptoms and causes - Mayo Clinic)

-Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV)

-Transmission:
(Common ways that HBV can spread are)

 Sexual contact. You may get hepatitis B if you have unprotected sex with someone who
is infected. The virus can pass to you if the person's blood, saliva, semen or vaginal
secretions enter your body.
 Sharing of needles. HBV easily spreads through needles and syringes contaminated with
infected blood. Sharing IV drug paraphernalia puts you at high risk of hepatitis B.
 Accidental needle sticks. Hepatitis B is a concern for health care workers and anyone
else who comes in contact with human blood.
 Mother to child. Pregnant women infected with HBV can pass the virus to their babies
during childbirth. However, the newborn can be vaccinated to avoid getting infected in
almost all cases. Talk to your provider about being tested for hepatitis B if you are
pregnant or want to become pregnant.
Acute vs. chronic hepatitis B

Hepatitis B infection may be short-lived, also called acute. Or it might last a long time, also
known as chronic.

 Acute hepatitis B infection lasts less than six months. Your immune system likely can
clear acute hepatitis B from your body, and you should recover completely within a few
months. Most people who get hepatitis B as adults have an acute infection, but it can lead
to chronic infection.
 Chronic hepatitis B infection lasts six months or longer. It lingers because your immune
system can't fight off the infection. Chronic hepatitis B infection may last a lifetime,
possibly leading to serious illnesses such as cirrhosis and liver cancer. Some people with
chronic hepatitis B may have no symptoms at all. Some may have ongoing fatigue and
mild symptoms of acute hepatitis.

Cllinical Manifestations (Hepatitis B - Symptoms and causes - Mayo Clinic)

Symptoms of acute hepatitis B range from mild to severe. They usually appear about 1 to 4
months after you've been infected, although you could see them as early as two weeks after
you're infected. Some people, usually young children, may not have any symptoms.

Hepatitis B signs and symptoms may include:

 Abdominal pain
 Dark urine
 Fever
 Joint pain
 Loss of appetite
 Nausea and vomiting
 Weakness and fatigue
 Yellowing of the skin and the whites of the eyes, also called jaundice

DIAGNOSIS (Hepatitis B - Diagnosis and treatment - Mayo Clinic)

Your health care provider will examine you and look for signs of liver damage, such as
yellowing skin or belly pain. Tests that can help diagnose hepatitis B or its complications are:

 Blood tests. Blood tests can detect signs of the hepatitis B virus in your body and tell your
provider whether it's acute or chronic. A simple blood test can also determine if you're
immune to the condition.
 Liver ultrasound. A special ultrasound called transient elastography can show the
amount of liver damage.
 Liver biopsy. Your provider might remove a small sample of your liver for testing to
check for liver damage. This is called a liver biopsy. During this test, your provider inserts
a thin needle through your skin and into your liver and removes a tissue sample for
laboratory analysis.
 FUNGAL STI: CANDIDIASIS

-Candidiasis is a fungal infection caused by an overgrowth of a type of yeast that lives on

your body (Candida albicans). A candidiasis infection often appears on your skin, vagina or
mouth, where Candida naturally lives in small amounts.

-Types of Candidiasis:

Since yeast naturally lives in your body, there are different types of candidiasis based on the
location of the infection. Types of candidiasis include:

 Vaginal candidiasis (vaginitis): A common infection that causes burning, itching,

redness and discharge from your vagina.
 Cutaneous candidiasis: An infection on your skin that creates a raised, red patch
with small, itchy bumps that form in folds of your skin, like in your underarms, under
your breasts and near your buttocks (diaper rash) or groin.
 Oral candidiasis (thrush): An infection that causes white sores in your mouth,
throat, esophagus, or tongue.
 Candida granuloma: A severe, chronic infection that targets your skin, scalp, mouth
or fingernails.
 Invasive candidiasis (systemic candidiasis): A serious infection that occurs
throughout your body, often in your bloodstream or on the membrane lining of your
heart or skull, as a result of an immune deficiency.

ETIOLOGY

-Candida is a ubiquitous yeast that resides harmlessly on skin and mucous membranes until
dampness, heat, and impaired local and systemic defenses provide a fertile environment for it
to grow.

-Candida is a group of about 150 yeast species. C. albicans is responsible for about 70 to 80% of
all candidal infections.

It shows the major, less common and rare species which are implicated in human infections
 Clinical Manifstations (S/Sx) (Candidiasis Fungal Infection: Causes & Treatment
(clevelandclinic.org))

Symptoms of candidiasis vary depending on the location of the infection. Symptoms of

candidiasis include:

 Red patch of skin (rash) with small, raised bumps (pustules).

 Itching.
 Burning sensation.
 Vaginal discharge (white or yellow).
 White patches or sores in your mouth that cause loss of taste or pain when eating or
swallowing.
 Swelling (inflammation).

DIAGNOSIS (Candidiasis: Cutaneous, Oral, And Other Types (verywellhealth.com))

-a healthcare provider will perform a physical examination of the infected area and possibly
take a swab or scraping that's sent to a lab and examined under a microscope. Candida is easy
to identify this way.

-A culture test identifies the type of yeast and bacteria in your infection. For this test, your
healthcare provider will swab the infected area with sterile cotton, then examine the sample
under a microscope.

-Blood test - If your healthcare provider suspects invasive candidiasis, they may draw a
sample of your blood to examine whether or not yeast and bacteria spread into your
bloodstream.

PARASITIC STI : TRICHOMONIASIS

-Trichomoniasis or “trich” is a common and curable sexually transmitted infection (STI).

Trich spreads during sexual intercourse — in semen (cum) and vaginal fluids. Its name comes
from the parasite Trichomonas vaginalis, which causes the infection.

-It spreads through sexual intercourse and doesn't typically cause symptoms.

Clinical Manifestations (Trichomoniasis - Symptoms & causes - Mayo Clinic)

Symptoms

Most people with trichomoniasis have no signs or symptoms. However, symptoms may
develop over time. When signs and symptoms develop, they are different for men and
women.

In women, trichomoniasis signs and symptoms include:

 A large amount of a thin, often foul-smelling discharge from the vagina — which might be
clear, white, gray, yellow or green
 Genital redness, burning and itching
 Pain with urination or sex
 Discomfort over the lower stomach area
 In men, trichomoniasis rarely causes symptoms. When men do have signs and symptoms,
however, they might include:

 Itching or irritation inside the penis

 Burning with urination or after ejaculation
 Discharge from the penis

ETIOLOGY (Trichomoniasis - StatPearls - NCBI Bookshelf (nih.gov))

Trichomoniasis is an infection that is sexually transmitted and is acquired by direct sexual
contact. It can live for a few hours in moist environments, but virtually all cases are due to the
venereal transmission of the organism. Risk factors include:
History of STIs
New sex parter or multiple partners
Contact with an infected partner
Abusing IV drugs
Not using any type of barrier contraception

DIAGNOSIS (Trichomoniasis: Causes, Symptoms, Testing & Treatment

(clevelandclinic.org))

Your healthcare provider may perform the following tests to diagnose trich:

 Physical exam: Your provider will examine your genitals and discuss any symptoms
you’re having. For people AFAB, it may include a pelvic exam. Often, your provider
will get a sample of your discharge using a cotton swab during this exam. Your
provider may notice your cervix looks like a strawberry. A "strawberry cervix" is an
indication for trich.
 Lab test: Your healthcare provider examines a sample of your vaginal or penile
discharge under a microscope to check for signs of infection. They may send the
swab to the lab for further testing if they don’t see trichomonads under the
microscope.

PATHOPYSIOLOGY BOOK CHAPTER 34 PAGE 689-697

ADELE PILLITERRI BOOK CHAPTER 47 PAGE 1402-1410