What Is Venereology?

The traditional concept of venereal disease is a disease transmitted through sexual intercourse. The main disease occurs in the genital area. Including syphilis, gonorrhea, soft chancre, STD lymphogranuloma and groin granuloma. Sexually transmitted diseases are a group of common infectious diseases that are widely spread all over the world, and they are showing a trend of expanding epidemic scope, reducing the age of onset, and increasing the number of resistant strains, especially the sharp increase in AIDS, which has become a serious public health problem. The prevention and treatment of sexually transmitted diseases will be a very difficult and long-term task.

Basic Information

English name: venereal disease
Visiting department: dermatology
Multiple groups: Young adults
Common causes: The infection source is transmitted through sexual contact, blood-borne transmission, etc.

Common symptoms: Different pathogens cause different sexually transmitted diseases, such as syphilis, gonorrhea, genital tract chlamydia trachomatis infection, condyloma acuminatum, genital herpes, etc., have different clinical manifestations
Contagious: Have
way for spreading: Sexual contact

STD Etiology

Common pathogen

(1) The virus can cause genital warts, genital herpes, and AIDS. Common herpes simplex virus, human papilloma virus, molluscum contagiosum virus, cytomegalovirus, EB virus, hepatitis virus, AIDS virus and so on.

(2) Chlamydia can cause STD lymphogranuloma, chlamydia urethritis / cervicitis. Mainly various serotypes of Chlamydia trachomatis.

(3) Mycoplasma can cause non-gonococcal urethritis. Including Mycoplasma urealyticum and Mycoplasma pneumoniae.

(4) Treponema pallidum The pathogenic microorganism that can cause syphilis is Treponema pallidum.

(5) Bacteria can cause gonorrhea and soft chancre. Common are Gonorrhoeae, Haemophilus ducreyi, Capsella granulomatous, Gartnerella, anaerobic bacteria and so on.

(6) Fungi can cause vulvovaginal candidiasis. The pathogenic microorganisms are mainly Candida albicans.

(7) Protozoa and parasites can cause vaginal trichomoniasis, scabies, and pubic lice. These pathogens exist widely in nature and grow and reproduce at appropriate temperatures and become ill.

2. Ways of transmission

(1) Sexual transmission Same-sex or heterosexual intercourse is the main mode of transmission of sexually transmitted diseases. Other sexual acts, such as oral sex, fingering, kissing, touching, etc., can also occur.

(2) Indirect contact transmission Non-sexual contact transmission between people is relatively rare, but certain sexually transmitted diseases, such as gonorrhea, trichomoniasis, and fungal infections, occasionally under certain circumstances Can be spread through towels, bathtubs, clothes and other supplies.

(3) Blood-borne transmission Syphilis, AIDS, and gonorrhea can cause pathogenemia. If the recipient receives such blood, a transmissible infection can occur.

(4) Mother-to-child transmission. Pregnant women with syphilis can infect the fetus through the placenta; pregnant women with gonorrhea can cause fetal infection due to infection in the amniotic cavity. Neonatal gonococcal or chlamydial ophthalmia and chlamydial pneumonia may occur through the birth canal during delivery.

(5) Iatrogenic transmission Medical personnel's protection is not strict enough to infect themselves; medical equipment is not strictly disinfected, pathogens have not been killed, and can infect others when reused; organ transplantation, artificial insemination

(6) Other ways such as vector insects, food and water are not significant in STD transmission.

Clinical manifestations of sexually transmitted diseases

Because STDs is a general term for a group of diseases, their symptoms vary from disease to disease. After infection with STD pathogens, some people have obvious clinical manifestations, but some people do not have any manifestations. The clinical manifestations of different STDs caused by different pathogens are different. The following briefly describes the clinical characteristics of common STDs

Syphilis

(1) The first stage of syphilis is mainly manifested by painless ulcers (hard chancrees) in the genitals, which usually begin to appear 2 to 4 weeks after infection;

(2) Secondary syphilis is mainly manifested as rashes and condyloma acuminata, as well as lesions in bones, joints, eyes, nerves, internal organs, etc.

(3) Tertiary syphilis is mainly manifested as severe damage to nerves and cardiovascular and other major organs.

Gonorrhea

Males often have pus with urethral discharge, conscious urination, urgency, frequent urination, or pruritus; females show itching and burning sensations in the vulva, accompanied by vaginal purulent discharge.

3. Reproductive tract Chlamydia trachomatis infection

There are mainly urethral mucus or mucopurulent discharge, urination pain, lower abdomen pain or pain during intercourse.

4. Condyloma acuminatum

It is mainly manifested as single or multiple nipple-shaped, coronal-shaped, cauliflower-shaped or mass-shaped neoplasms in the vulva, vagina, and cervix.

5. Genital herpes

It begins to manifest as itching or itching of the genitals, thighs or buttocks, and pain. Then, multiple erythema, pimples, and blisters appear in the genitals, buttocks, anus, or other parts of the body. The first onset can be accompanied by systemic symptoms such as fever and headache.

STD check

There are many types of STDs, and each STD has several different laboratory tests. The accuracy of these tests is related to whether the patient can be correctly diagnosed and effectively treated. At present, the common STD testing methods are as follows:

Gonorrhea

(1) Smear method is highly accurate for male acute urethritis, but it is not suitable for female patients. A positive microscopy can make a preliminary diagnosis, but a negative cannot rule out a diagnosis.

(2) The culture method is the most accurate, especially suitable for female patients. Positive culture can confirm the diagnosis.

2. Non-gonococcal urethritis

(1) Smear method It is simple to check neutrophils in urethral or cervical secretions, but the pathogen cannot be determined.

(2) Chlamydia trachomatis antigen detection method The CC method is short, which is simple, but the stability is slightly poor. Positive results combined with clinical can confirm Chlamydia trachomatis infection, which can not be completely ruled out when negative, and can be determined by cell culture.

(3) Mycoplasma culture is more reliable, but the interpretation of the results should be cautious and should be combined with clinical, because normal people may also culture positive.

3. Syphilis

(1) Dark-field microscopy is suitable for patients with hard chancre damage.

(2) Serological tests for non-spirochondrial antigens, such as rapid plasma reagin test (RPR): This is a preliminary screening test and may have a false positive. The titer measurement is helpful to determine the condition and efficacy.

(3) Treponema antigen serological test, such as Treponema pallidum particle agglutination test (TPPA), is a confirmatory test for syphilis, but the titer measurement cannot be used to judge the efficacy and follow-up.

4. Condyloma acuminatum

Diagnosis is usually based on clinical manifestations, if necessary, 5% vinegar test and histopathological examination.

5. Genital herpes

Diagnosis is usually based on clinical manifestations, and herpes simplex virus antigen tests are performed when necessary.

6. AIDS

(1) HIV testing Including virus isolation and culture, antibody testing, antigen testing, viral nucleic acid testing, and viral load testing.

(2) Monitoring of T-lymphocyte subsets in immunodeficiency testing ; CBC cell classification; platelet count, etc.

STD diagnosis

Diagnosis can usually be made based on medical history, clinical manifestations, and laboratory tests. Attention should be paid to non-infectious diseases of the genital area (Behcet syndrome, contact dermatitis, erythema polymorpha, fixed drug rash), other infectious diseases (foreskin balanitis, acute vulvar ulcer, chancroid pustular disease, Vestibular adenitis), skin tumors (Bow-like papules), and so on.

STD Treatment

There are many types of sexually transmitted diseases, and the types of pathogens that cause sexually transmitted diseases are different. Therefore, it is necessary to formulate a targeted treatment plan based on the patient's condition and etiology, and use comprehensive measures such as internal medicine, external medicine, and physical therapy. The following aspects should be noted during treatment:

Formal treatment

Strictly follow the doctor's order to avoid random medication and irregular treatment. Many patients stop treatment once their symptoms are relieved or disappear, do not complete the full course of treatment, or blindly use medicine, which makes the treatment incomplete and brings difficulties to further treatment.

2. Track sexual partners and couples

Failure to treat your spouse / sex partner in a timely manner can cause repeated infections on both sides, leading to long-lasting illness. Therefore, it is emphasized that husbands and wives investigate and rule together in order to eliminate the source of infection and prevent circular transmission.

3. Prohibit sex during treatment

Sexually transmitted disease patients should be prohibited from sexual life before being cured, at least they should also use condoms to have safe sex to prevent further spread of the disease.

4. Periodic review

For example, syphilis serological tests for non-treponegium antigens should be performed every 3 months and 6 months in the second year after completing regular treatment of syphilis; do it around 7-10 days and 14 days after regular treatment of gonorrhea Gonorrhea tests, etc., to evaluate treatment effects and prevent recurrence.

5. Set your mentality right

Some patients are overwhelmed with psychological burdens and worry all day long. Even though they have been cured, they still feel various discomforts.

STD Prognosis

There are many types of STDs, some are easy to cure, and some are not easy to cure. Curable or easily curable sexually transmitted diseases are usually caused by pathogens such as bacteria, chlamydia, mycoplasma, and spirochaedia, such as gonorrhea, non-gonococcal urethritis, syphilis (early syphilis), and soft chancre. These STDs can be treated clinically and etiologically with appropriate antibiotics. Incurable or incurable sexually transmitted diseases are mainly caused by viral infections, such as genital herpes, genital warts, and AIDS. However, the "incurable" mentioned here refers to the inability to achieve etiological cure for a considerable period of time, and these diseases can achieve clinical cure through treatment. Current antiviral drugs generally can only inhibit the viruses that cause these STDs, and they cannot be completely removed in the short term. Therefore, although these STDs can be clinically cured, the virus may still be latent in the human body. This is why Genital herpes or genital warts are easy to relapse in some patients. However, the human body can gradually develop a stronger immunity to these viruses, suppress the virus and no longer harm the human body.

STD prevention

Social prevention

Ban prostitution, drug abuse and drug trafficking, and strengthen health education so that people have a correct understanding of sexually transmitted diseases and sexual behaviors, and promote self-love.

2. Personal prevention

Improve cultural literacy, cleanse yourself, and prevent unclean sex; adopt safe sex; use condoms with reliable quality; pay attention to personal hygiene, do not use drugs, and share syringes with others; try not to transfusion, try not to inject blood products, there are When there are suspicious symptoms of genitals, go to a regular hospital for treatment in time so that early detection and treatment can be found. Spouses who have sexually transmitted diseases should go to the hospital for inspection in time. It is best to avoid sex during the treatment and use condoms when necessary. Contamination of clothing and other daily necessities.