WHAT ARE SEXUALLY TRANSMITTED DISEASES?
- 1WHAT IS THE MEANING OF SEXUALLY TRANSMITTED DISEASES?
- The spectrum of sexually transmitted diseases (STDs) includes the classic venereal diseases—gonorrhoea, syphilis, chancroid, lymphogranuloma venereum, and granuloma inguinale—as well as a variety of other pathogens known to be spread by sexual contact (Table 1–1). Common clinical syndromes associated with STDs are listed in Table 1–2.
aFor some syndromes, clinical manifestations can be minimal or absent.
bRecurrent herpes infection can manifest as a single lesion.
cost cases of gonococcal pharyngeal infection are asymptomatic.
dSalpingitis increases the risk of subsequent ectopic pregnancy and infertility.
- Neisseria gonorrhoeae is a gram-negative diplococcus estimated to cause over 300,000 new infections per year in the United States. Humans are the only known host of this intracellular parasite.
- 2WHAT ARE THE SIGNS AND SYMPTOMS OF SEXUALLY TRANSMITTED DISEASES?
- Infected individuals may be symptomatic or asymptomatic, have complicated or uncomplicated infections, and have infections involving several anatomical sites.
- The most common clinical features of gonococcal infections are presented in Table 1–3. Approximately 15% of women with gonorrhoea develop pelvic inflammatory disease. Left untreated, pelvic inflammatory disease can be an indirect cause of infertility and ectopic pregnancies.
(MSM, men who have sex with men.)
- In 0.5% to 3% of patients with gonorrhoea, the gonococci invade the bloodstream and produce disseminated disease. The usual clinical manifestations of disseminated gonococcal infection are tender necrotic skin lesions, tenosynovitis, and monoarticular arthritis.
- Diagnosis of gonococcal infections can be made by gram-stained smears, culture (the most reliable method), or newer methods based on the detection of cellular components of the gonococcus (e.g., enzymes, antigens, DNA, or lipopolysaccharide) in clinical specimens.
- Although the culture of infected fluids is not the most sensitive of diagnostic tests for gonorrhoea, it is still the diagnostic test of choice because of the high specificity.
- Alternative methods of diagnosis include enzyme immunoassay, DNA probes, and nucleic acid amplification techniques.