Sexually transmitted disease

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Sexually transmitted disease Microchapters

Patient Information

Overview

Classification

Chlamydia
Gonorrhea
Human Immunodeficiency Virus (HIV)
Human papillomavirus (HPV)
Herpes Simplex Virus (HSV)
Mycoplasma genitalium
Syphilis
Trichomonas vaginalis
Zika Virus
Hepatitis B
Hepatitis C
Bacterial vaginosis

Differential Diagnosis

Treatment

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Carla Vorsatz, M.D.[2]; Associate Editor(s)-in-Chief: Tarek Nafee, M.D. [3]

Synonyms and Keywords: Sexually transmissible disease; STD; VD; STI; sexually transmitted infection; venereal disease.

Overview

Sexually transmitted diseases (or STDs) are bacterial, viral, fungal, or protozoal infections that are transmitted via sexual contact. Sexual contact may entail non-penetrative contact of the genitalia, performing or receiving oral sex (cunnilingus, anilingus, or fellatio), and insertive or receptive vaginal or anal sexual intercourse. Sexually transmitted infections may have a variety of clinical presentations including dermatological manifestations, generalized symptoms, or urogenital tract symptoms such as discharge and dysuria. Some infectious agents may be transmitted primarily through sexual contact while others may less frequently be transmitted sexually.

The CDC reported updated Surveillance data on sexually transmitted diseases from 2018 in the United States, which included chlamydia, gonorrhea, and syphilis.[1] Complications of STDs depend on the causative pathogen and may range from genital or oral pruritis and discomfort to more serious complications such as pelvic inflammatory disease, primary CNS lymphoma, cervical cancer, as well as cardiac and neurological complications. If left untreated, some STDs may progress to septic shock and death.

Most STDs have well-established risk factors and preventative measures. If followed appropriately, most STD transmissions can be avoided.

Classification

Table below provides a concise comparison of various sexually transmitted diseases:[1]

Transmission Clinical Presentation Disease Diagnosis Mother to Child Transmission Most Serious Complications
Laboratory Studies Clinical Diagnosis Vertical Transmission Trans-vaginal Transmission
Primarily sexually transmitted Genital Dermatological Manifestation
(e.g., ulcers, chancre, vesicles, warts, balanitis etc.)
HPV Cervical Cancer
''Herpes simplex'' 1 and 2 Moderate to severe pruritis/discomfort, superinfection
Syphilis
Scabies Moderate to severe pruritis/discomfort
Pubic lice Moderate to severe pruritis/discomfort
Candidiasis
(in males)
Mild to moderate pruritis/discomfort
Generalized Symptoms
(e.g., constitutional symptoms)
HIV
Syphilis
Urogenital infections
(e.g., Vaginitis, Urethritis, Cervicitis, and PID)
Gonorrhea PID
Chlamydia PID
Syphilis
Mycoplasma genitalium unknown unknown PID
''Trichomonas vaginalis'' PID
Less frequently sexually transmitted Generalized Symptoms
(e.g., constitutional symptoms)
Zika Virus Vertical transmission and congenital abnormalities
Hepatitis B Hepatocellular Carcinoma
Hepatitis C Liver cirrhosis, Hepatocellular Carcinoma
Urogenital Infections
(e.g., Vaginitis, Urethritis, Cervicitis, and PID)
''Gardnerella vaginalis'' Moderate to severe discomfort
Candidiasis
(in females)
Moderate to severe pruritis/discomfort
Ureaplasma urealyticum Moderate to severe pruritis/discomfort

Differential Diagnosis

Table below provides differential diagnosis of sexually transmitted diseases:[1]

Disease Symptoms
Discharge Dysuria Vaginal odor Dyspareunia Genital skin lesion Genital pruritis Fever Lymphadenopathy Other symptoms
Chlamydia Cough, shortness of breath, red eye with discharge (neonate), joint pain
Gonorrhea Sore throat, polyarthralgia, tenosynovitis, rash, eye discharge (neonates)
HIV Fever, lymphadenopathy, rash, fatigue, myalgia, arthritic pain, headache
Herpes simplex Fatigue, myalgia, painful oral ulcers
HPV Weight loss, hoarseness (adults), altered cry, stridor (infants)
Hepatitis B Fever, fatigue, nausea, vomiting, loss of appetite, abdominal pain, dark urine, clay-colored stools, joint pain, yellowish discoloration of the eyes and skin, skin rash, muscle pain
Hepatitis C Fever, fatigue, anorexia, arthralgia, nausea, vomiting
Bacterial vaginosis None
Mycoplasma genitalium None
Zika virus Conjunctivitis, rash, joint pain, myalgia

Treatment

References

  1. 1.0 1.1 1.2 CDC Sexually Transmitted Disease Surveillance 2018 STDs in the United States. The Centers for Disease Control and Prevention. https://www.cdc.gov/std/stats18/toc.htm Accessed on January 25, 2020.