妇产科之性传播疾病.ppt

妇产科学第19章 性传播疾病 【教学目标】了解淋病、梅毒及病毒和沙眼衣原体感染的生殖道炎症的发病原因、传播途径、临床表现及诊断治疗和预防措施。 【教学重点】淋病、梅毒及病毒和沙眼衣原体感染的生殖道炎症的传播途径、临床表现及诊断治疗和预防措施。 【教学难点】淋病、梅毒及病毒和沙眼衣原体感染的生殖道炎症的发病原因、传播途径。 Sexually Transmitted Diseases Bacterial infections: Chlamydia trachomatis Neisseria gonorrhoeae (GO) Syphilis Viral infections: Herpes genitalis Human papillomavirus (HPV) Human immunodeficency virus (HIV) Chlamydia vaginitis [E] Chlamydia trachomatis? Salpingitis (Peritonitis, infertility, etopic pregnancy , premature labor , stillbirth possible) [S] Often symptom free,associated with other pathogens of vaginitis (GO, vaginosis), Dysuria, pollakisuria, white glassing discharge. Chlamydia should be suspected in any patient with acute PID, possible GO or trichomonas vaginitis [D] Intracelluar inclusion, immunology with monoclonal antibody. [T] Azithromycin 1g oral, single dose Doxycycline 100mg bid for 7 d, Minocine? Gonorrhea (GO) [E] Gramnegative gonococci (Diplococci ), Optimal pH 7.2 , incubation time :ca.1 w. [S] 50-80% women with GO are asyptomatic. Acute infection in urethra, cervix, Skne’s glands, Bartholin’s glands, evtl rectum. Confined in the mucosa only Profuse purulent urethral and vaginal discharge,urethral burning, dysuria, bladder irritability, inflammation of urethra, cervix, Skene’s and Bartholin’s glands. If treatment of the acute phase delayed or inadequate, GO via ascending surface spreading usually toward the end or after the next menstrual period ? Acute salpingitis and pelvic peritonitis. Accompany symptom: Condylomata acuminata. [D] History of exposure, microscopy, culture, PCR ELISA. . Syphilis [E] Treponema pallidum by direct genital or oral- genital contact with an actively infected sexual partner . Following transfusion with blood from an infect