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Chapter 6

Chapter 6. Women’s Health: Commonly Occurring Infections. Bacterial Vaginosis (BV). Overgrowth of normal vaginal flora Thin, watery, white-gray discharge “Fishy” odor Treatment: Flagyl. Clue Cells. Vulvovaginal Candidiasis (VVC). Fungal or yeast infection Thick, white vaginal discharge

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Chapter 6

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  1. Chapter 6 Women’s Health: Commonly Occurring Infections

  2. Bacterial Vaginosis (BV) • Overgrowth of normal vaginal flora • Thin, watery, white-gray discharge • “Fishy” odor • Treatment: Flagyl

  3. Clue Cells

  4. Vulvovaginal Candidiasis (VVC) • Fungal or yeast infection • Thick, white vaginal discharge • Severe itching, dysuria, and dyspareunia • Treatment: miconazole cream, Diflucan

  5. Hyphae-Candida Albicans

  6. Trichomoniasis • Bacterial organism: Trichomonas vaginalis • Transmission: sexual intimacy • Asymptomatic or mild symptoms: • Yellow-green, frothy, odorous discharge • Vulvar itching • Treatment: metronidazole

  7. Trich

  8. Chlamydia • Bacteria organism: Chlamydia trachomatis • Transmission: vaginal sex • Symptoms: 70% of women are asymptomatic. • Treatment: azithromycin or doxycycline

  9. Gonorrhea • Bacterial organism: Neisseria gonorrhoeae • Transmission: vaginal, anal, or oral sex • 80% of women are asymptomatic • Treatment: antibiotic therapy

  10. Herpes Simplex • Viral organism: HSV-1 and HSV-2 • Transmission: • Vaginal, anal, or oral sex • Skin-to-skin contact with an infected site

  11. Herpes Simplex (cont’d) • Symptoms: primary outbreak • Single or multiple blister like vesicles • Difficult urination and urinary retention • Enlargement of inguinal lymph nodes • Flu like symptoms, genital pruritus, or tingling • Treatment: oral acyclovir

  12. Syphilis • Bacterial organism: Treponema pallidum • Transmission: • Vaginal, oral, or anal sex • Exposure to exudate from infected individual • Transplacental • Treatment: penicillin G

  13. Syphilis (cont’d) • Symptoms: early stage • Chancre appears, fever, weight loss, malaise • Symptoms: secondary stage • Condylomata lata on vulva, acute arthritis • Enlargement of liver and spleen, enlarged lymph nodes • Chronic sore throat with hoarseness

  14. Genital Warts • Viral organism: human papilloma virus (HPV) • Transmission: vaginal, oral, or anal sex • Symptoms: • Painless genital warts • Pruritus • Treatment: client or provider therapies for wart removal

  15. Condylomata acuminata

  16. Pediculosis Pubis • Parasite: Phthirus • Transmission: intimate sexual contact, shared towels and bed linens • Symptoms: • Itching in pubic area • Treatment: 1% permethrin cream; wash and dry linens, towels, and clothing

  17. Scabies • Parasite: Sarcoptes scabiei • Transmission: intimate sexual contact in adults • Symptoms: • Itching and erythematous, papular lesions or furrows • Treatment: 5% permethrin cream; wash and dry linens, towels, and clothing

  18. Health Strategies to Prevent STIs • ????

  19. Health Teaching • Planning ahead and developing strategies to say no to sex • Limiting the number of sexual contacts and practicing monogamy • Using a condom and negotiating condom use with a partner • Reducing high-risk behaviors such as used of alcohol and recreational drugs

  20. Health Teaching (cont’d) • Refraining from oral sex if partner has active sores in mouth, vagina, anus, or on penis • Seeking care as soon as symptoms are noticed • Understanding that disappearance of symptoms does not mean treatment is unnecessary • Taking all prescribed medications completely • Having more frequent Pap screening for certain genital infections

  21. Expedited Partner Therapy EPT • The practice of treating the sex partners of persons with STIs without an intervening medical evaluation or professional prevention counseling. • May significantly reduce overall transmission • Be aware of individual state legal requirements when considering initiation of EPT

  22. Pelvic Inflammatory Disease PID • Inflammation of upper female genital tract • Chlamydia trachomatis and Neisseria gonorrhoea • Post infection tubal damage associates with infertility • Treatment: - IV fluids, pain medication, IV antibiotics

  23. Symptoms of PID • Bilateral sharp, cramping pain in the lower quadrants • Fever greater than 101oF, chills • Mucopurulent cervical or vaginal discharge • Irregular bleeding • Cervical motion tenderness during intercourse • Malaise, nausea, and vomiting

  24. Cystitis: Risk Factors • Sexual intercourse • Use of a diaphragm and a spermicide • Delayed postcoital micturition • Pregnancy • History of a recent UTI

  25. Cystitis • Symptoms: • Dysuria, urgency, and frequency • Suprapubic or low-back pain • Low-grade fever • Hematuria • Treatment: antibiotic therapy

  26. Pyelonephritis: Symptoms • Sudden onset with chills, high temperature, and costovertebral angle tenderness or flank pain • Nausea, vomiting, and malaise • Frequency, urgency, and burning with urination • Decreased urinary output • Severe colicky pain, vomiting, dehydration, and ileus of the large bowel

  27. Pyelonephritis: Treatment • IV antibiotics • IV hydration • Urinary analgesics such as Pyridium • Pain management and medication to manage fever

  28. Hepatitis A • Transmission: fecal-oral, contaminated food or water • Incubation: 15–50 days • Not chronic • Immunization available

  29. Hepatitis B • Transmission: blood/body fluids • Incubation: 45–160 days • Chronic • Immunization available

  30. Hepatitis C • Transmission: blood/blood products • Incubation: 14–180 days • Chronic • Immunization not available

  31. Hepatitis D • Transmission: blood/body fluids • Incubation: 45–160 days • Chronic • Immunization not available

  32. Hepatitis E • Transmission: fecal-oral • Incubation: 15–60 days • Not chronic • Immunization not available

  33. Resources • Center for Disease ControlThis site provides screening, treatment, and prevention guidelines for sexually transmitted infections. Also included are presentation slides available for downloading. • Healthy Devil OnlineOperated by Duke University, this site offers guidelines for safer sex, a risk assessment profile, and information on the various sexually transmitted infections.

  34. Resources • I Wanna KnowProvides information related to teen sexual health including puberty, sexually transmitted infections and sexuality. • American Social Health AssociationEasy-to-understand information is provided about sexually transmitted infections including statistics, transmission methods, symptoms, diagnosis, treatment and prevention. A glossary is also included.

  35. Resources • Safe Sex and HIV PreventionThis site offers AIDS information on prevention, treatment, policy, and activism, and continuing education for patients and health professionals. • Urinary Tract InfectionsBasic facts are provided about symptoms, treatment, and prevention of UTIs. The site content is reviewed by a medical doctor.

  36. Resources • The Urology ChannelThis site provides a wide range of detailed information about a variety of urology conditions including traditional medical treatment and naturopathic treatment.

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