Porth's Essentials of Pathophysiology, 4e

exually transmitted infections (STIs) encompass a broad range of infectious diseases that are spread by sexual contact. 1,2 Although the incidence of syphi- lis and gonorrhea as reported in the professional literature and public health statistics has decreased slightly, the incidence of other STIs is increasing. The actual figures are probably much higher than those reported because many STIs are not reportable or not reported. The agents of infection include bacteria, viruses, fungi, and other microorganisms (see Chapter 14). The initial site of an STI may be the urethra, gen- italia, rectum, or oral pharynx. The organisms that cause these infections tend to be short lived outside the host, so they usually depend on person-to-person spread. The rates of many STIs are highest among adolescents; more common in persons who have more than one sexual partner; and it is not uncommon for a person to be concurrently infected with more than one type of STI. Many factors contribute to the increased prevalence and the continued spread of STIs, including the fact that STIs are frequently asymptomatic, which promotes the spread of infection by persons who are unaware that they are carrying the infection. Furthermore, part- ners of infected persons are often difficult to notify and treat. Condoms could prevent the spread of many STIs, but they often are not used or are used improp- erly. In addition, there currently are no cures for viral STIs (e.g., human immunodeficiency virus [HIV], her- pes simplex virus, and human papilloma virus [HPV]); although there are drugs available that may help to manage the infections, they do not entirely control the spread. Also, drug-resistant microorganisms are rap- idly emerging, making treatment of many STIs more difficult. This chapter discusses the manifestations of STIs in men and women in terms of infections of the external genitalia, vaginal infections, and infections that have genitourinary as well as systemic manifestations. HIV infection is presented in Chapter 16. Sexually Transmitted Infections 41 C h a p t e r S

Infections of the External Genitalia Human Papillomavirus Infection and Genital Warts

Etiology and Pathogenesis Diagnosis and Treatment

Genital Herpes

Etiology and Pathogenesis Diagnosis and Treatment Maternal/Neonatal Transmission Chancroid Lymphogranuloma Venereum Vaginal Infections Candidiasis Trichomoniasis Bacterial Vaginosis Vaginal-Urogenital-Systemic Infections Chlamydial Infections

Etiology and Pathogenesis Diagnosis and Treatment

Gonorrhea

Etiology and Pathogenesis Diagnosis and Treatment

Syphilis

Etiology and Pathogenesis Diagnosis and Treatment

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