Manifestasi oral pada

infeksi menular
seksual

Hanny Nilasari
Departemen Ilmu Kesehatan kulit dan Kelamin
FKUI/RSCM
Jakarta
Infeksi Menular Seksual

 Infeksi yang ditularkan melalui hubungan

seksual
 Manifestasi lesi : Genital, dan non
genital
 Cara hubungan seksual: genitogenital,
orogenital, anogenital
 Infeksi : gejala klinis : duh tubuh,
vegetasi, ulkus/luka
Chlamydia

 Chlamydia is the most common and fastest-spreading

sexually transmitted disease in the UK. It's caused by a
bacterium, Chlamydia trachomatis.
 Unfortunately, many people (particularly females) have
no symptoms at all.
 Where symptoms do occur, they may include pain in
passing urine and a discharge. They usually appear
approximately 7 to 21 days after infection.
 Chlamydia can also cause a form of conjunctivitis in
adults. Also, this eye infection may occur in the newborn
babies of mothers who have chlamydia.
 Chlamydia can be detected on material
collected by swabbing the cervix during a
traditional examination using a speculum, but
 noninvasive screening tests done on urine or on
self-collected vaginal swabs are less expensive
and sometimes more acceptable to patients.
While culturing of the organism can confirm the
diagnosis, this method is limited to research
laboratories and forensic investigations.
 No data if the infection in the pharynx
Gonorrhoea
 Gonorrhoea is caused by Neisseria gonorrhoeae, a
bacterium that grows and multiplies quickly in moist,
warm areas of the body – such as the cervix, urethra,
mouth, or rectum. The cervix is the most common site of
infection in women.

 Gonorrhoea is most commonly spread during genital

contact, but it can also be passed from the genitals of
one partner to the throat of the other during oral sex.

 Gonorrhoea of the rectum can occur in people who

practice anal sex. In pregnant women, gonorrhoea can
be passed from an infected woman to her newborn infant
during delivery.
 Testing for gonorrhea is done by swabbing the infected site (rectum,
throat, cervix) and’
 identifying the bacteria in the laboratory either through culturing of
the material from the swab (growing the bacteria) or
 identification of the genetic material from the bacteria.

 Sometimes the tests do not show bacteria because of sampling errors

(the sampled area does not contain bacteria) or
 other technical difficulties, even when the woman has an infection.

 Newer tests to diagnose gonorrhea involve the use of DNA probes or

amplification techniques (for example, polymerase chain reaction, or
PCR) to identify the genetic material of the bacteria. These tests are
more expensive than cultures but typically yield more rapid results.
 For uncomplicated gonococcal infections of the
pharynx, the recommended treatment is 125 mg
of ceftriaxone in a single IM dose.

 Treatment should always include medication that

will treat chlamydia [for example, azithromycin
(Zithromax) or doxycycline
herpes
simplex II infection

 It is believed that some thousands of

other people developed herpes but were
not seen at a clinic.
 Genital herpes is a highly contagious viral
condition caused by the herpes simplex virus
(HSV).
 It infects the skin and mucous membranes of the
genitals or rectum, but it can also appear in
areas such as the mouth, particularly the lips.
 Its chief symptom is an outbreak of small
blisters, and these can be very painful.
 It's transmitted primarily through physical and
sexual contact.
 During birth, the presence of herpes simplex
virus in the birth canal is a threat to the infant's
life
 Genital herpes is suspected when multiple painful blisters occur in a
sexually exposed area.

 During the initial outbreak, fluid from the blisters may be sent to the
laboratory to try and culture the virus, but cultures only return a
positive result in about 50% of those infected In other words, a
negative test result from a blister is not as helpful as a positive test
result, because the test may be a false-negative test.

 There are also blood tests that can detect antibodies to the herpes
viruses that can be useful in some situations.

 Other diagnostic tests such as polymerase chain reaction (PCR) to

identify the genetic material of the virus and rapid fluorescent
antibody screening tests are used to identify HSV in some
laboratories.
 Although there is no known cure for herpes, there are
treatments for the outbreaks. There are oral medications,
such as acyclovir (Zovirax), famciclovir (Famvir), or
valacyclovir (Valtrex) that prevent the virus from
multiplying and even shorten the length of the eruption.

 Although topical (applied directly on the lesions) agents

exist, they are generally less effective than other
medications and are not routinely used. Medication that
is taken by mouth, or in severe cases intravenously, is
more effective. It is important to remember that there is
still no cure for genital herpes and that these treatments
only reduce the severity and duration of outbreaks.
HIV and AIDS

 Some of those who are HIV-positive will go on to develop AIDS.

 AIDS is a potentially lethal disease, which is caused by the HIV
virus.
 HIV means 'human immunodeficiency virus'.
 HIV invades and destroys the immune system, which protects
the body from infection. This means that a person who carries
the HIV virus is prone to many different illnesses and may die
from diseases that are harmless to healthy people.
 In some countries, particularly those located in Sub-Saharan
Africa, the HIV rates are very high.
 For instance, in the Republic of South Africa it's estimated that
about 11 per cent of the population is HIV-positive.
Genital warts

 At the present time, British GUM clinics see about 91,000

new cases of genital warts a year. Many other people
develop warts, but they are not seen at clinics.
 Warts, or condylomata acuminata, are caused by the
human papilloma virus (HPV).
 Many months can pass from the time of infection to the
actual development of warts, so it may be very difficult to
determine who you got them from.
 In women, HPV can lead to microscopic changes in the
cervix and to the development of cervical cancer.
 HPV is now thought to be associated with various other
cancers, including carcinoma of the anus and possibly of
the throat and adjoining regions.
 A typical appearance of a genital lesion may
prompt the physician to treat without further
testing, especially in someone who has had prior
outbreaks of genital warts.

 Genital warts usually appear as small, fleshy,

raised bumps, but they can sometimes be
extensive and have a cauliflower-like
appearance.
 Remove the lesion best choice
 With electrocauterization or caustic
topical agent
 Syphilis
 If left untreated, syphilis is a dangerous and life-threatening disease.
 It's caused by a corkscrew-shaped germ called Treponema
pallidum.
 It's passed on by intercourse or by almost any other form of sexual
interaction.

 The first symptom appears between 9 and 90 days after exposure to

the germ that causes it. A small lump develops at the infection site,
and this soon breaks down to form a painless ulcer.
 Later, there is a secondary stage (characterised by fever, rashes
and throat ulcers),

 and eventually a tertiary stage (in which the germ may attack the
brain, spinal cord and other organs).
 Formation of an ulcer (chancre) is the
first stage. The chancre develops any
time from 10 to 90 days after infection,
with an average time of 21 days
following infection until the first
symptoms develop.
 Syphilis is highly contagious when the
ulcer is present.
ulkus
Aphtae in 2nd syphilis
 Syphilis can be diagnosed by scraping the base of the
ulcer and looking under a special type of microscope
(dark field microscope)

 Special blood tests can also be used to diagnose

syphilis. The standard screening blood tests for syphilis
are called the Venereal Disease Research Laboratory
(VDRL) and Rapid Plasminogen Reagent (RPR) tests.

 Any positive non-treponemal test must be confirmed by a

treponemal test specific for the organism causing
syphilis, such as

 the microhemagglutination assay for T. pallidum (MHA-

TP) and the fluorescent treponemal antibody absorbed
test (FTA-ABS). These treponemal tests directly detect
the body's response to Treponema pallidum.
Treatment of syphilis

 Depending on the stage of disease and the clinical manifestations, the

treatment options for syphilis vary.
 Long-acting penicillin injections have been very effective in treating both
early and late stage syphilis.

 The treatment of neurosyphilis requires the intravenous administration

of penicillin. Alternative treatments include oral doxycycline or
tetracycline.

 Women who are infected during pregnancy can pass on the infection to
the fetus through the placenta.

 Penicillin must be used in pregnant patients with syphilis since other

antibiotics do not effectively cross the placenta to treat the infected
fetus. Left untreated, syphilis can lead to blindness or even death of the
infant.
THANK YOU