SEXUALLY TRANSMITTED INFECTIONS
woman is treated, so is the man)
COMMON STIs
 Chlamydia
 Gonorrhoea
 Syphilis
 Chancroid
 Lymphogranuloma venerum
 Genital mycoplasma
 Group B streptococcus
RISK FACTORS
 Age – sexually active
 Multiple partners
 Oral contraceptives
VULVOVAGINAL CANDIDIASIS
 Candida albicans
 Yeast infection
 Can occur in mouth – oral candidiasis (baby),
vagina, and diaper area of infant
 Clinical Manifestations:
o Thick, curdy vaginal discharge
o Severe itching
o Dysuria – painful urination
o Dyspareunia – painful sex
o White plaques on erythematous base if
found in mouth
o Cottage cheesy discharge, with no smell
 Treatment:
o Intravaginal insertion of Miconazole or
Butoconazole or other topical azole for 7
DAYS
o Clotrimazole suppositories at bedtime for 1
WEEK
o Cream may be prescribed for topical
application to the vulva if necessary
 Use cotton underwear, don’t use
sanitary pads, clean perineal regularly,
use condoms to prevent infection to the
male
o Do not scrape away if in mouth
TRICHOMONIASIS
 Anaerobic Trichomonas vaginalis
 Acquired through sexual intimacy
 Not transmitted across the placental barrier
 Males seldom present any symptoms (but when
 NO NSD when ruptured membrane
 May cause Sepsis Neonaturum (Automatic CS)
 Clinical Manifestations:
o Vulvar or vaginal itching
o “Ping pong” effect – you pass it to your
partner, then he passes it back to you
o Yellow-green frothy discharge (purulent)
o Odorous discharge
o Inflammation of the vagina and cervix
o Dysuria and dyspareunia
o Strawberry-colored cervix
 Treatment:
o Single 2g does of Metronidazole orally or
Flagyl – avoid alcohol because may cause
gh] excessive vomiting
GROUP B STREPTOCOCCUS
 May be considered a normal vaginal flora, if not
pregnant
 GBS may lead to preterm birth, PROM, and
maternal fever higher than 38C
 Treatment:
o Penicillin G or erythromycin (if allergic to
pen G)
BACTERIAL VAGINOSIS
 Gardnerella vaginalis
 Nonspecific vaginitis
 Clinical Manifestations:
o Thin, watery, whitish-gray vaginal discharge
o With a foul fishy oder
 Treatment:
o Oral Metronidazole or oral Clindamycin
(2nd – 3rd trimester because it is teratogenic)
o Clindamycin CREAM or metronidazole
vaginal gel (1st trimester)
CHLAMYDIAL INFECTION
 Chlamydia trachomatis
 Most common STI
 Clinical Manifestations:
o Female:
 No signs and symptoms
© MARY ANDREA G. AGORILLA, UST-CON BATCH 2021 | 1
  But may have yellow purulent discharge  6 weeks – 6 months after, generlozed
or macular, copper colored rash appears
 Painful urination (burning and  Affects the palms of the hand and soles
frequency) of the feet
 Lower abdominal pain o STAGE 3 – TERTIARY
o Male:  Heart is involved
 Non-specific urethritis  CNS – paralysis
 Treatment:  Diagnostic Tests
o Erythromycin or Amoxicillin o Blood tests – VDRL ( positive – will do FTA
o Followed by repeat culture in 3 weeks confirmatory test, negative – no infection)
 If untreated,  Treatment
o Woman may become infertile o P&NP w/ SY less than 1 yr – 2.4 million units
o Infant may develop conjunctivitis of Benzathine Penicillin G IM in single
 CREDE’S PROPHYLAXIS IS VERY dose
IMPORTANT o SY more than 1 yr – 2.4 million units of
Benzathine Penicillin G IM once a week,
for 3 weeks
GONORRHEA (If gonorrhoea (+) so is chlamydia
(+))
HEPATITIS B
 Neisseria gonorrhoeae
 Clinical Manifestations:  Hepa B virus at the blood
o Most women are asymptomatic  Predisposing factors: illegal IV drug users,
o Purulent, greenish yellow vaginal discharge homosexuals, prostitutes, multiple sex partners,
o Dysuria and urinary frequency occupational exposure to the blood
o Inflammation and swelling of the vulva  Treatment:
o More discharge than chlamydia o Hepa B immune globulin soon after birth
o Inflammation and painful Bartholin’s gland (newborn)
 Treatment:
o NP – Cefixime orally or Cefixime IM +
Doxycycline TOXOPLASMOSIS
o P – Deftriaxone IM or Cefixime orally with
Erythromycin or Azithromycin  Toxoplasma gandii
 May cause OPTHALMIA NEONATORUM in the  Etiology:
newborn (treated with erythromycin) o Eating raw or undercooked meat (medium
rare)
o Drinking unpasteurized goat’s milk
SYPHILLIS o Contact with feces of infected cats
 Risks
 Treponema pallidum o Fetal: inflammation of the retina, blindness,
 Clinical Manifestations: deafness, severe retardation, severe=
o STAGE 1 – PRIMARY convulsions, coma, microcephaly,
 Painless chancre appears hydrocephalus
 Slight fever  Diagnostics:
 Weight loss o IgG and IgM fluorescent antibody tests
 Malaise o Indirect hemaggluitination test
 Lymphadenopathy that cannot be o Sabin-fieldman dye test
noticed o Ultrasound to detect fetal infection
o STAGE 2 – SECONDARY  Treatment:
 Condylomata lata o Mom: combination of antiparasitic drugs –
 Acute arthritis Sulfadiazinei and Pyrimethamine,
 Enlargement of liver and spleen Spiramycin in Europe
© MARY ANDREA G. AGORILLA, UST-CON BATCH 2021 | 2
 o Baby: combination of Sulfadiazine,  Severe infection – microcephaly,
Pyrimethmine, Leucovotin for 1 year mental retardation, seizures, retinal
dysplasia, apnea, coma
 Infant is infected and often asuptomatic
RUBELLA (German measles)
at birth but develops - fever or
 Best to be prevented by getting a vaccine hypothermia, jaundice, seizures, poor
 Clinical Manifestations feeding aftern an incubation period of 2-
o High grade fever 12 days
o Upper respiratory tract infection o Treatment:
o Lymphadenopthay  Acyclovir, Valacyclovir, Famciclovir
o Itchy rash  Sitz bath – to remove or reduce pain
 Diagnostic: o Mode of delivery: NSD (if no evidence of
o Hemagglutination inhibition test genital infection, CSD (active genital lesions
 Positive titer 1:16 or greater – evidence or presence of prodromal symptoms of
of immunity infection
 Negative titer less than 1:8 indicates
susceptibility to rubella
 Risks: HIV/ AIDS
o Baby: first trimester, congenital cataracts,
 Attacks the immune system (cell-mediated)
sensorineural deafness, congenital heart
 May or may not be transmitted sexually
defects (PDA), mental retardation, cerebral
 Transmitted via blood and other fluids
palsy
 Infants may be infected in utero during delivery,
 Treatment
or through breastfeeding
o Increase fluid intake
 30% chance of transmission to the baby
o Vitamin C
o Gamma globulin during pregnancy

CYTOMEGALOVIRUS (CMV)

 Belongs to the herpes virus group and causes

both congenital and acquired infections referred
to as cytomegalic inclusion disease (CID)
 Transmission:
o Placenta, cervical route during birth, through
body fluids (blood or urine), between human
by any close contact (e.g. kissing,
breastfeeding, and sexual intercourse)
 Diagnostics (for pregnant women)
o Depends on presence og CMV in the urine,
rise in IgM levels and identification of the
CMV antibodies with in the serum IgM
fraction
HERPLEX SIMPLEX VIRUS (HSV-1 or HSV-2)

 Risks:
o Baby:
 Primary infection – spontaneous
abortion, LBW, preterm birth

© MARY ANDREA G. AGORILLA, UST-CON BATCH 2021 | 3