CHANCROID

Soft Chancre,Soft Sore,Sulcus mole

• Sexually transmitted diseasecharacterized

by painful genital ulcers and inguinal
adenitis.more in males.

Agent : Haemophilus ducreyi

I.P : 1 to 14 days (average 3 to 5 days)

.
Lession are confined to genital areas
traumatized during the sexual
intercourse
Papule sorrounded by erythema
Sharply circumscribed ulcer with granulation
PICTURE
REMOVED
• S and Sx :
Small lesion on the penis
Small lesion in the vulva,vagina and cervix

Ulcerates,painful,soft and malodorous

Bleeds easily and produce pus PICTURE
REMOVED

Inguinal adenitis develops

Rupture of ulcer or boboes

Phinosis (may develop during heaing stage)

Diagnosis:
Biopsy
Darkfield examination and serologic test
Gram stain of ulcer exudates
Treatment:
Azithromycin,Erythromycin,Ceftriaxone
Nursing management:
Wash genetalia with soap and water
Abstain from sexual intercourse until completely healed
Check for drug allergy
Standard precaution
lotion or cream applied to lesions
Preventions:
Condom,wash genitalia after S.I.,Avoid S.I with infected
person
 VENERIAL DISEASE
• CANDIDIASIS:
Moniliasis/Candidosis
Mild superficial fungal infection
Infects nails( Onchomycosis)
Diaper rush
Trush ( Oropharynx)
Moniliasis(Vagina)
Esophagus
GIT
 Recall
Candidiasis Creamcheese like discharge
Agent: Candida albicans

Part of the normal flora(GIT,mouthvagina,skin)

Rise in glucose
Lowered resistance
With radiation,HIV or with aging
Estrogen rise in pregnant patient
Introduction by urinary catheter,
hyperalimentation or surgery
broad expectrum antibiotics
wth pruritus
S and Sx :
Nails: red and swollen,darkened,purulent
Skin: scaly,erythematous,papular rush
(breas,axilla,groin)
Oropharyngeal(Trush)
cream colored bluish white
patches,with bloody engorgement when
scrapped
Vagina : White or yellow vaginal discharge
Eyes: blurred vision
Brain : headache,nuchal rigidity,seizures
Pulmonary : Hemoptysis
Renal system : Fever,flank pain

Diagnosis: Gram staining of vaginal discharge,

skin scrapping
Stool culture
Nursing management:
Meticulous mouth care
Proper disposal of oral secretions
Avoid sharing utensils
candidiasis:
Management :
Nystatin for oral trush
Fluconazole ,Ketokonasole for mucous
membrane and vaginal infection
Amphotericin,Fluconasole for Systemic
infection

Prevention:
Check high risk patients
Check vaginal discharge, note for color,odor and
amount
 SYPHILIS
(Lues Venereal/Morbus Gallicus)
• Chronic infectious sexually transmitted
disease,begins in the mucous membrane and
quiklybecomes systemic
• Agent:
Treponema pallidum
Source : Discharges from lesions ,semen,blood,
I.C : 10 to 90 days.Average is 3 weeks
MoT : Direct
Indirect
Congenital by placental transfer
carelessly handling diapers by the nurse
 PICTURE
Clinical manifestation: REMOVED

PRIMARY :
Presence of painless chancre
SECONDARY :
(+) mucocutaneous lesions and generalized lynphadenopathy.
(+) Rashes
(+) Condyloma lata =eroding lesions > pinkish to
grayish-white lesions
(+) headache,weiht loss,
nausea,vomiting..
alopecia,brittle nails

LATENT : No clinical symptoms but + for serologic tests

LATE SYPHILIS: Tertiary syphilis
(+) Gumma = solitary asymmetric,painless
,endurated crhonic nodule.
1 To 10 years after infection
liver >> affected> epigastric pain,tenderness
and enlarge spleen.
Respiratory tract : Perforation of the nasal
septum or palate
destruction of bones,other organs > death
Cardiovascular > aortic regurgitation,ANEURYSM
• Congenital syphilis
Death> miscarriage,stillbirth
Manifestation: macerated appearance with
collapsed skull and collapse abdomen
Livid red color with bullae with
hemorrhagic fluid
Early congenital Syphilis
(+) Syphilitic Pemphigus: Bullous Rash
(+) “old man look”
(+) Syphilitic nonychia
(+) Muco purulent nasal discharges
Late Congenital syphilis
(+) Interstitial Keratitis : corneal scarring
> blindness
• Complications:
Heart disease ,heart damage,Death in
newborn
Labs :
Darkfield illumination
VDRL slide test ,Rapid plasma reagentest
CSF anlysis
Flourescent Treponemal antiboby absorption test
Treatment :
Benzathine Penicillin G
Tetracycline or Doxycycline
• Nursing management:
Complete the treatment Keep the lesion dry
Universal precaution Repeat diagnostic labs
Partners should be tested HIV testing
NURSING DIAGNOSIS:
Self esteem distubance Social isolation
Altered sexual pattern Knowlege deficit
Impaired skin integrity Anxiety
Prevention and control:
Proper sex education control prostitution
Case finding Report cases to DOH
Regular check up for sex workers