The most frequent agents of STD
•Papillomaviruses
•Chlamydiae
•Yeasts
Other common agents of STD:
HBV
HCV
HIV
HSV 2
Mycoplasma & Ureaplasma
Gardnerella vaginalis
Klebsiella granulomatis
        Trichomonas vaginalis
Sarcoptes scabiei
Phthirus pubis

Papillomaviruses
The most frequent agent of genital infections
Genotypes 6, 11 and many others:                  both ♂ & ♀: anogenital warts  (condylomata
accuminata)
Genotypes 16, 18 and some other                   ♀: infection of cervix → Ca
Vaccination against carcinogenic types!
Culture impossible – diagnostics performed using molecular methods

http://missinglink.ucsf.edu
Anogenital warts  (condylomata accuminata)


Chlamydiae
The second most frequent agent of genital inf.
Chlamydia trachomatis serotypes D to K            ♂: nongonococcal & postgonococcal
           urethritis
      ♀: cervicitis → blenorrhoea neonatorum
Therapy: macrolides and tetracyclines
Lab. dg: direct: detection of antigen
                           detection of DNA
                           culture (special cell culture)
                           indirect (serology): not very useful

http://pathmicro.med.sc.edu/mayer/chl-life.jpg
The developmental cycle of Chlamydia





http://webeye.ophth.uiowa.edu
Adult Chlamydial Conjunctivitis





Yeasts
Candida albicans (rarely other candidae) ♂: balanoposthitis                                    ♀:
vaginal mycosis (candidosis, vulvovaginitis)
Therapy: topical imidazoles (clotrimazole)
                systemic triazoles (fluconazole)
Lab. dg: microscopy
               culture (Sabouraud agar)

Trichomonas vaginalis
http://depts.washington.edu


Trichomonads
Trichomonas vaginalis (a flagellate)
♂: 0 (rarely urethritis, usually
         asymptomatic carriers)
♀: vaginitis, cervicitis, urethritis
Therapy: metronidazole (both partners)
Lab. dg: direct only – microscopy (wet mount, Giemsa stained film) & culture on special media

Mycoplasmas
Mycoplasma hominis
Ureaplasma urealyticum

♂ & ♀: urethritis
♀: postpartum fever,  PID?
Therapy: macrolides and tetracyclines
Lab. dg: direct only – culture on special media
M. fermentans: www.microbeworld.org

Gardnerellae
Gardnerella vaginalis
♂: 0
♀: bacterial vaginosis
Therapy: metronidazole
Lab. dg: direct only –
fish odour test
                        microscopy (clue cells)
                        culture on special agar
http://www.atsu.edu

Viral agents of STD – HSV 2
Herpes simplex virus 2
♂ & ♀: herpes genitalis primary                                      recurrent
Therapy: acyclovir
Lab. dg:
•isolation on a cell culture
•detection of DNA by PCR
•serology (useful in primary                                infection)

http://www.nlm.nih.gov
Hepatitis B, C  (VHB, VHC)


Hepatitis C virus
(sexual transmission not excluded)
♂ & ♀: viral hepatitis C, acute and chronic
Therapy:
interferon + ribavirin
Lab. dg:
- detection of viral RNA
- detection of antibodies (anti-HCV)
Hepatitis B virus
♂ & ♀: viral hepatitis B, acute and chronic
A recombinant vaccine (HBsAg)
Therapy: acute VHB: no medication, rest & diet
    chronic VHB: interferon
Lab. dg: detection of laboratory markers
HBsAg, anti-HBs
HBeAg, anti-HBe
anti-HBc
HBV DNA

Viral agents of STD – HIV
Human immunodeficiency virus (HIV-1 and HIV-2)
♂ & ♀: AIDS (acquired immunodeficiency syndrome)
Therapy: combination of antiretrovirotics (HAART = highly active antiretroviral treatment)
Lab. dg: detection of antibodies + Ag                                 (& confirmation of positive
findings)
          special tests: viral load




Parasitic agents of STD
Sarcoptes scabiei (itch mite)
♂ & ♀: scabies (mange)
Therapy: antiscabiotics (permethrine, lindane)
Lab. dg: microscopy from skin
Phthirus pubis (pubic louse, crab louse)
♂ & ♀: pediculosis pubis (phthiriasis)
Therapy: lindane
Lab. dg: demonstration of lice or eggs

Sarcoptes scabiei




Jacques-Louis David
(1748-1825):
Death of Marat (1783)
•Jean Paul Marat, murdered by Charlotte Corday in 1793, was initially a physician
•He was run through when taking a bath for treatment  his skin disorder (probably  dermatitis
herpetiformis Dühring)