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Other Emerging Community Acquired

Sexually Transmitted Diseases
SYPHILIS & GONORRHEA
 SYPHILIS

• A sexually transmitted disease cause by a bacteria,

Treponema pallidum
Spirochetes

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Transmission
• Direct contact with a syphilis sore
during sexual intercourse (vaginal,
oral and anal
• mother-to-baby

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 Stages of Syphilis
• Primary
• Secondary
• Latent
• Tertiary
 Primary
• Spirochetes multiply locally at the site of
entry
 Ulcers will also appear on the site of entry
• Ulcers may appear in 2 – 10 weeks after
infection.
• Can spread to nearby lymph nodes and
reach the blood stream
 Secondary
• Consist of a red maculopapular rash
anywhere in the body including the hands
and feet.
• Appearance of moist, pale papules in the
anogenital region, axilla and mouth
 Secondary
• Symptoms include:
Painless rash that’s not normally itchy
Flat, warty-looking growth on the vulva
or around the anus
White patches on the tongue, cheeks,
or roof of the mouth
Patchy hair loss
 Secondary

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 Latent
• No visible signs or symptoms
• If treatment is stopped, you can
continue to have syphilis for years
 Tertiary
• Characterized by the development
of granulomatous lesions in skin,
bones and liver
• Can have degenerative changes in
the nervous system; or
cardiovascular lesions
 Tertiary

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 Congenital Syphilis
• A pregnant woman can transmit
T. pallidum to fetus through the
placenta in the 10th to 15th weeks of
gestation
 Congenital Syphilis
• If born alive, can develop signs of
congenital syphilis in childhood:
 Interstitial keratitis
Hutchison’s teeth
Saddlenose
Periostitis
 Congenital Syphilis
A B

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Congenital Syphilis

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 Diagnosis
• Specimen of choice
 Tissue fluid
 Serum
• Dark-field Microcopy
• Immunofluorescence
• Serological Testing
 Diagnosis

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 Diagnosis
• Serological testing
 VDRL - Venereal Disease Research Laboratory
 RPR – Rapid Plasma Reagin
 TP-PA – T pallidum-particle agglutination
 TPHA – T pallidum hemagglutination
 MHA – TP – Microhemagglutiation T pallidum
 FTA-ABS – Fluorescent treponemal antibody
absorbed.
 Treatment, Prevention and Control
Control Measures will depend on…
1. Prompt and adequate treatment of all discovered cases
2. Follow-up on source of infection
3. Protected sexual intercourse
Drug of Choice
 Penicillin
 Gonorrhea
• Cause by Neisseria gonorrhoeae, a gram-negative cocci that
usually occurs in pairs
• Causes infection in the genitals,
rectum and throat.
• Common among teens and young
adults
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 Statistics
• In 2016, more than 200,000 were tested
for gonorrhea and more 14,000 tested
positive as shared by the WHO (Rappler)
 Symptoms
• Sore throat
• If in the rectum:
 Itching
 Soreness
 Bleeding
 Painful bowel movements
 Symptoms
• For Female
 Vaginal bleeding
 Pain or burning urination
 Increase vaginal Discharge
• For Male
 Swollen testicles
 Pain or burning urination
 discharge from penis
 Pathogenesis & Pathology
• Gonococci attacks mucous membrane of the
genitourinary track, eye, rectum and throat
 result to acute suppuration
• For infected males..
urethritis, with yellow, creamy pus and
painful urination.
 Urethral infection can be asymptomatic
 Pathogenesis & Pathology
• For infected females..
Primary infection is in the endocervix
and extends to the urethra and vagina
May progress to the uterine tubes,
causing salpingitis
 Pathogenesis & Pathology

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 Diagnosis
• Specimens
 Pus and secretions from urethra, cervix,
rectum, conjunctiva, throat and synovial
fluid
• Blood culture
• Stained Smear
• Culture – modified Thayer-Martin
• Serological Testing – Immunobloting,
Radioimmuno assay, ELISA
 Treatment
• Penicillin
• Tetracycline
• Spectinomycin
• Quinolone
• Cephalosporine
• Ceftriaxone and Azithromycin – Last
recommended DUAL treatment as of today