STD
1. Gonorrhea : 가장 흔함
1) cause : postpartum infection, ophthalmia neonatrum(cunjunctivitis➝blind)
2) Sx. :➀ M➝ dysuria, frequency, purulent urethral discharge
➁ F➝ purulent viginal discharge (60%➝ asymptomatic)
3) Dx. : Gram stain or Cx.(Blood test로는 ✓안됨)
4) Complication : prostatitis, epididymitis, PID, infertility, arthritis, sepsis, peumonia
5) Tx. : penicillin & probenecid(penicillin의 효과를 배가시킴)➝산도통과 전 치료한다.
6) Transmitted : sexual contact
2. Herpes : 최악질
1) Sx. : ➀ active lesions : painful vesicle➝cervix, vaginal wall, vulva, thigh(➝ 태아에게 감염됨) : 전염력 가장↑
➁ fever, headache, general adenopathy
remission: vaginal delivery가능
exacerbation: c/s
2) Dx. : ➀ tissue Cx.(isolation of virus)
➁ microscopic exam.(multinucleated giant cells)
3) Tx. : ➀ lidocaine
➁ clean & dry (습하면 더 아프다.)➝ shower후 warm air blower, wear loose clothing
➂ dysuria ➝ voiding in warm water
➃ acyclovir(Zovirax)➝ IV or oral (7~10일간)
4) Transmitted :➀ through birth canal➝ 산도통과시 wound에 접촉
➁ intrapartum➝ ascending or direct contact
3. Syphilis(=Lues) : 가장위험
1) cause : Treponema pallidum
2) Sx. : ➀ primary (3wks후) : painless, red skin lesion이 rectal, genital, lip, perineal, thigh에 생김(Chancre)
➝치료안해도 없어지나 균(+)➝most infectious stage➝치료안하고 출산 시 돌이킬 수 없는 CNS, hearing loss, jaundice등의 damage..
➁ secondary(1~3m) : cutaneous, nonpruritic, diffuse lesions on face, trunk or extremities.
➂ Tertiary(10~30yrs후) : cardiac & neurologic destruction
3) Dx. : VDRL, RPR, FTA
4) Tx. : penicillin & probenecid or erythromycin➝16주 이전에 치료받으면 기형예방 가능.
5) complication : late abortion, still birth, prematurity, severe anemia, congenital syphilis
6) Transmitted : ➀ sexual contact ➁ open wound
➂ blood ➃ trans-placenta(16주이후에 태반통과)
4. Trichomoniasis : may be the most frequently
1) Sx. :➀ greenish-gray(yellow-greenish) vaginal discharge
➁ foul-smelling, frothy vaginal discharge
➂ 분비물의 양 多
2) Tx. : Flagyl
5. Candidiasis
1) cause : ➀ fungus(candida albicans)
➁ not associated with sexual transmission
➂ pregnancy
➃ birth control pill use
➄ nonsexual sources( ex, 공중목욕탕, 화장실)
➅ early indication of diabetes in girls & women
(어린아이가 sexually active하지 않은데 계속 candida생기면 DM의심➝ 소변의 당이 묻어 viginal에 fungus자람)
2) Sx. : ➀ edematous, erythematous, pruritic vulva, itching
➁ thick, white, cottage cheese like discharge(odorless)
➂ pain
➃ fetus➝ may contact thrush
3) Tx. : ➀ Nystatin(Mycostatin) ➁ Lotrimin
6. Scabies : 원충이 신체의 hair에 기생
1) Sx. : genital itching
2) Dx. : microscopic examination of shave excision lesion
3) Tx. : ➀ gamma benzene hexachloride lotion(Kwell) ➝ 5세 이하에게는 사용✗
➁ 온 가족이 함께 치료받는다.
➂ 전염력 ➝ contact isolation
➃ A-zoo Pyrinate, RID
7. Chlamydia : gonorrhea와 비슷
1) Sx.: ➀ major cause of nongonococcal urethritis in men(frequency, dysuria)
➁ PID
➂ delivery동안 new-born에게 전염된다.
➃ many women ➝ asymptomatic ➝ frequency, dysuria, urgency
➄ vaginal discharge : thick, acidic odor
2) Dx. : identification of organism through culture
3) Tx. : oral erythromycin(14일)
Report cause of gonorrhea, syphilis to health department.
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