Infectious Disease( gonorrhoea and syphilis)

Gonorrhoea is caused by Nesseria Gonorrhoea.
Syphilis is a sexually transmitted systemic bacterial infection .

1. GONORRHOEA AND SYPHILIS Presented By Mokshada.R.Bhirud . B.Pharm

2. GONORRHOEA Defination :- A sexually transmitted bacterial infection also called a sexually transmitted disease, caused by bacteria.( Neisseria gonorrhoeae).a gram-negative bacterium .   Gonorrhea bacteria can infect the urethra, rectum, female reproductive tract, mouth, throat or eyes. Gonorrhea is most commonly spread during vaginal, oral or anal sexual activity. But babies can get the infection during childbirth. In babies, gonorrhea most commonly affects the eyes.

3. Mode of transmission :- Vaginal Interecourse . Oral Intercourse. Anal Intercourse. Gonorrhorea found in younger people ( age 15-30)who has multiple sex partner presentation title 3

4. Clinical Manifestation :- ► In Women : 1) Cervicitis. 2) Increased vaginal discharge that can be strong smelling, thin and watery/ thick and yellow green. 3) Vulval itching or burning. 4) Dyspareunia (Dyspareunia is persistent or recurrent genital pain that occurs just before, during or after sex ). 5) Abnormal vaginal bleeding such as after vaginal intercourse 6) Abdominal pain with nausea 7) Pelvic inflammatory disease (PID )

5. ♦ In men : ● Urethritis ● Pus-like discharge from the tip of the penis. ●Epididymitis (scrotal pain). ●Inflammation in prostate gland. ►symptoms can occur in both men and women: ●Dysuria (painful urination) ●Proctitis - Irritation or discharge from the anus ●Pharyngitis - A sore throat and swollen lymph nodes in the neck ●Arthritis , pustular skin lesions, and tenosynovitis presentation title 5

6. Pathophysiology presentation title 6 Neisseria gonorrhea Get attached to pili to columnar epithelial cells of urethra Produce marked polymorphonuclear response in the submucosa Leucocytes exudates fill up the anterior urethra Inflammatory process extends to the posterior urethra Granular tissue formed in mucosa and submucosa Urethral discharge

7. ► Diagnostic :- presentation title 7 ●A urine test .   ●A swab of the affected area . ●Gram stain. ●Synovial fluid in disseminated infection ► Treatment :- Non-pharmacological Management ● Use a condom if you have sex. ● Limit your number of sex partners. ● Be sure you and your partner are tested for sexually transmitted infections . ● Don't have sex with someone who appears to have a sexually transmitted infection . ● Consider regular gonorrhea screening.Regular screening is also recommended for men who have sex with men, as well as ther partners . ● To avoid getting gonorrhea again, abstain from sex until after you and your sex partner have completed treatment and after symptoms are gone.

8. presentation title 8 ●Antibiotics : ceftriaxone ( cephalosporins ), penicillin. ●For severe infection: CDC recommended ●Ceftriaxone-125 mg + Doxycycline-100mg+ Ciprofloxacin-500 mg. ●Erythromycin : 1 gm oral Pharmacological Treatment :

9. SYPHILIS

10. presentation title 10 syphilis is a bacterial infection usually spread by sexual contact.The disease start as a painless sore typically on the genitals, rectum, mouth. ● Deffination :- “ It is a chronic infections disease caused by a spirochete Treponema pallidum , usually transmitted throught sexual intercourse and affecting almost any organ and tissue in the body.” ● Mode of transmission :- ● Sexual contact ● Contact with infected blood or body fluid ● Shared needles ● Vertical transmission:mother to infant via breast feeding. Syphilis

11. Pathophysiology ● Gumma , CVS involvement, Neurological complications Treponema pallidum Infection (Bacteria spread to various organs and even CNS) 10 to 90 Days Primary Syphilis (Chancre) After 2 to 12 weeks Secondary Syphilis Recurrence of Secondary Syphilis Latent Syphilis 72%Asymptomatic 28%Tertiary Syphilis ● Chancre last 3 to 6 weeks & heals without treatment. ● Single sore is Chancre, it is firm round, small and painless. ● Lymphadenopathy ● Spread of the disease. ● Generalizedenlargement of lymph nodes. ● Low grade fever,malaise , sore throat. ● Cutaneous and mucosal rashes. ● 25 % CSF abnormal

12. presentation title 12 ● Enlarge lymph node ● Painless sore (Chancre) ● Alopecia ● Extreme tiredness ● Fever ● Malaise (discomfort, illness, or unease) ● Sore throat ● Skin rash (reddish-brown sores) ● Weight loss Clinical Manifestation

13. presentation title 13 Risk factors :- ● Sexual contact with a known case of syphilis ● Unprotected sexual activity ● Sex worker ● Diagnosed with other sexually transmitted diseases ● Multiple sexual partners Prevention :- ●Avoid sharing needles if using injected drugs . ●Sexual contacts should also be treated ●Consistent and correct usage of condoms ●Sexual abstinence ●Practice safe sex . ●Get screened for STDs.Syphilis .

14. presentation title 14 Stages of Acquired Syphilis :- ► Primary syphilis (first stage) : ⚫ usually lasts around 21 days a round, painless, usually hard sore (chancre) appears on the genitals, anus or elsewhere ●the chancre may not be noticed and will heal in 13 - 10 days progresses to the second stage if untreated . ► Secondary syphilis : ● includes a non-itchy rash, usually on the palms and soles of the feet ● white or grey lesions appear in warm and moist areas, such as the labia or anus, at the site of the chancre ● symptoms will go away without treatment . ► Latent syphilis : ● often has no symptoms ● progresses to the third and final stage of syphilis (tertiary) after years if untreated ● tertiary syphilis can lead to brain and cardiovascular diseases, among other conditions.

15. Treatment of Syphilis :- ● parenteral penicillin ( benzathine Penicillin G) is the first-line treatment for all syphilis infections including during pregnancy . ● Penicillin should be administered after the infection has been confirmed . ● Treatment with adequate penicillin ends infectivity within 24-48 hours. ● Oral penicillin preparations are not effective for the treatment of syphilis . ● Primary , secondary, or early latent syphilis (< 1 year's duration): Benzathine penicillin G 2.4 million units (1.8g) IM in a single dose . ● Late latent syphilis (> 1 year's duration) or latent syphilis of unknown duration: Benzathine penicillin G 2.4 million units (1.8g) IM once a week for three successive weeks. ● Neurosyphilis : Aqueous crystalline penicillin G 18-24 million units IV ( 3 - 4 million units every 4 hours or by continuous infusion) for 10 - 14 days or aqueous procaine penicillin G 2.4 million units IM daily plus probenecid 500 mg oral four times daily for 0 - 14 days . G 50,000 units/kg IM daily for 10 days.ycline 100 mg oral

16. ● Primary, secondary, or early latent syphilis (< 1 year's duration): Doxycycline 100 mg oral bid for 14 days or tetracycline 500 mg oral qid for 14 days or ceftriaxone 1 g IM or IV daily for 8 - 10 days . ●L ate latent syphilis (> 1 year's duration) or latent syphilis of unknown duration: Doxycycline 100 mg oral bid for 28 days or tetracycline 500 mg oral qid for 28 days. Penicilin Allergic Patient :-

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