A sexually transmitted disease (STD), also known as sexually transmitted infection (STI) or venereal disease (VD), is an illness that has a significant probability of transmission between humans or animals by means of sexual contact, including vaginal - PowerPoint PPT Presentation

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A sexually transmitted disease (STD), also known as sexually transmitted infection (STI) or venereal disease (VD), is an illness that has a significant probability of transmission between humans or animals by means of sexual contact, including vaginal

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Title: A sexually transmitted disease (STD), also known as sexually transmitted infection (STI) or venereal disease (VD), is an illness that has a significant probability of transmission between humans or animals by means of sexual contact, including vaginal


1
Introduction
  • A sexually transmitted disease (STD), also known
    as sexually transmitted infection (STI) or
    venereal disease (VD), is an illness that has a
    significant probability of transmission between
    humans or animals by means of sexual contact,
    including vaginal intercourse, oral sex, and anal
    sex.

2
Sexually Transmitted Infections
  • Yeasts and fungi
  • Candida albicans
  • Candida glabrata
  • Candida tropicalis
  • Parasites
  • Trichomonas vaginalis
  • Entamoeba histolytica
  • Giardia intestinalis
  • Ectoparasites
  • Sarcoptes scabiei
  • Phthirus pubis
  • Bacterial
  • Neisseria gonorrhoeae
  • Treponema pallidum
  • Chlamydia trachomatis
  • Haemophilus ducryei (chancroid)
  • Lymphogranuloma
  • Mycoplasma
  • Viruses
  • Herpes simplex II
  • Hepatitis B
  • Hepatitis C
  • HIV
  • Papillomavirus

3
Genus Trichomonas
  • Its includes a group of flagellated protozoa It
    infect humans and animal
  • Human Trichomonads
  • 3 species of trichomonads found in human.
  • Two are normally harmless.

4
  • Pentatrichomonas hominis
  • T. tenax
  • T. vaginalis which is a serious sexually
    transmitted pathogen.

5
Trichomonas vaginalis
  • It is the etiological agent of trichomoniasis.
  • Trichomoniasis is a common sexually transmitted
    disease with a worldwide distribution.
  • transmittable, sexually and through contact with
    toilet seats and towel.
  • T. vaginalis despite it name, infect both men and
    women.
  • In females the organism inhabits the vagina and
    urethra
  • In males it is found in the urethra, prostate or,
    seminal vesicles.

6
  • The life cycle consist only of a trophozoite
    stage which is transmitted by direct contact
    during sexual intercourse
  • both sexes equally susceptible

7
T. Vaginalis trophozoite
  • Fgflagella
  • Bbbasal body
  • Nunucleus
  • Axaxostyle
  • umundulating membrane
  • Cycytostomal groove
  • Cscosta

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  • (B) T. vaginalis on the surface of a vaginal
    epithelial cell prior to ameboid transformation.

5 µm
10
  • (C) Ameboid morphology of T. vaginalis as seen in
    cell culture.

5 µm
11
Life cycle flagella are found in the genital
tract. Transmission during dealings with
contaminated matters (clothes, cotton..etc.
12
  • Sign and symptoms
  • T. vaginalis causes different manifestation in
    men and women.
  • Women are more likely to exhibit symptoms which
    tend to persist longer
  • Incubation period is 4-28 days.
  • In female ranges from asymptomatic, to mild or
    moderate irritation, to extreme vaginitis
  • 10 - 50 asymptomatic
  • The commonest symptoms vaginal discharge, vulval
    itching, dysuria, or offensive odor , rare
    abdominal discomfort
  • Vaginal discharge up to 70 - varying in
    consistency from thin and scanty to profuse and
    thick the classical discharge of frothy yellow
    occurs in 10-30 of women
  • Extreme cases associated with vulvitis and
    vaginitis
  • 2 strawberry cervix appearance to the naked
    eye.
  • Higher rates are seen on colposcopic examination.
  • 5-15 no abnormalities on examination.
  • In male 50-90 are asymptomatic
  • mild dysuria or pruritus
  • minor urethral discharge

13
Focus on pathogen T. vaginalis
  • females get a disintegration of vaginal
    epithelial lining. Natural flora (bacteria ) keep
    the pH of the vagina at 4-4.5 and ordinarily this
    discourages infections.
  • T. vaginalis can survive at a low pH.
  • Once established it causes a shift toward
    alkalinity (pH 5-6) which further encourages its
    growth. There is a tendency to explain
    stillbirths, spontaneous abortions, morbidity to
    women who have vaginitis.
  • Induces vaginal pH change, erosion of normal
    mucosa in women

14
Physical Examination
  • Pelvic examination
  • Inspection of external genitalia.
  • Speculum examination
  • insertion and visualization of vagina and cervix,
    obtaining swabs and slide specimens.

15
Vaginitis - Trichomoniasis
  • Profuse, frothy discharge,
  • yellow-greenish in color
  • foul odor, vulvar pruritus
  • Patchy vaginal erythema and
  • (strawberry cervix)

16
  • Diagnosis
  • 1-Specimens
  • vaginal discharge
  • urine sediment
  • prostatic secretion
  • 1.Vaginal pH
  • 2. Whiff test
  • 3.Wet mount
  • 4. Pap smear
  • 5. Culture
  • 6. Direct immunoflouresence assay
  • 7. Polymerase chain reaction
  • 8. Evaluation for other STDs

17
  • Potassium hydroxide amine test (Whiff test)

Upon application of 10 potassium hydroxide (KOH)
to a vaginal swab sample, a fishy odor is
released, which can suggest trichomoniasis or
bacterial vaginitis.
Whiff test 10 KOH
18
  • Phylum Ciliophora
  • Possess cilia simple cilia or compound ciliary
    organelles during some part of their life cycle
  • Most species have 2 kinds of nuclei macronuclei
    and micronuclei
  • Some members of the phylum engage in sexual
    reproduction, involving conjugation, autogamy,
    and ctyogamy
  • Most ciliates are free-living however, a few
    groups are commensals or parasitic

19
  • Family Balantidiidae, which includes only one
    genus and species (Balantidium coli) are found
    in the intestinal tract of arthropods and some
    vertebrates, including mammals
  • Pathogens of humans, dogs and monkeys
  • Swine are non-pathogenic carrier
  • Mostly infect at Cecum,large intestine
  • Balantidium coli cause Balantidiosis Ciliary
    dysentery
  • Balantidiosis is most often found in tropical
    regions throughout the world
  • It is not a common human disease the infection
    rate is less than 1
  • Pigs are a good source of infection for humans
    in areas where they share habitation
  • Cyst transmission (fecal oral)

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  • Balantidium trophozite

23
Balantidium coli cyst
24
Life Cycle
  • Both asexual and sexual reproduction present
  • Asexual by binary fission
  • Sexual by conjugation
  • Conjugation two opposite mating types pair
    exchange genetic material

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Pathogenesis
  • Balantidium coli produces proteolytic enzymes
    that break down and digest the intestinal
    epithelium.Colon ulceration develops which
    allows for infiltration by lymphocytes and
    leukocytes.Hemorrhaging and secondary bacterial
    infections will develop next.Perforation of the
    large intestine and appendix will occur.

27
  • Clinical Signs
  • Mild infections occur with diarrhea,
  • Abdominal pain
  • Alternating periods of constipation
  • Ulceration of the gut wall
  • Diagnosis
  • Cysts-formed stools
  • Active trophs-diarrheic stools

28
Control
  • Eradication of fecal contamination of food and
    water.
  • Cysts killed by boiling
  • Resistant to low doses chlorine (halide tablets)
  • Avoid practices that allow fecal-oral contact
  • Improved sanitation in institutions.
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