SEXUALLY TRANSMITTED INFECTIONS (STIs)

(Based on Weber & Kelley, 2022)

BACTERIAL STIs

GONORRHEA

 Description: Bacterial infection causing inflammation of mucous membranes in the genitourinary tract.

 Causative Agent: Neisseria gonorrhoeae.

 Other Names: "The clap", "The drip".

 Mode of Transmission: Vaginal, oral, and anal sex; perinatal transmission during childbirth.

 Discharge: Thick, purulent yellow-green discharge from the penis or cervix; may have a foul odor.

 Lesions: Rare; may have urethral redness and swelling.

 Treatment: Antibiotic therapy — ceftriaxone 500 mg IM plus doxycycline 100 mg orally twice daily for 7 days (if chlamydial infection is not excluded).

CHLAMYDIA

 Description: The most commonly reported bacterial STI, often asymptomatic but can lead to pelvic inflammatory disease (PID).

 Causative Agent: Chlamydia trachomatis.

 Other Names: "Silent infection".

 Mode of Transmission: Vaginal, oral, anal sex; childbirth.

 Discharge: Mucoid, purulent discharge; often less noticeable than in gonorrhea.

 Lesions: Cervical inflammation; urethral inflammation in men.

 Treatment: Doxycycline 100 mg orally twice daily for 7 days or Azithromycin 1 g orally once.

SYPHILIS
  Description: A multistage systemic bacterial infection; progresses through primary, secondary, latent, and tertiary stages.

 Causative Agent: Treponema pallidum.

 Other Names: "The great imitator" (due to varied manifestations).

 Mode of Transmission: Direct contact with syphilitic sores during vaginal, anal, or oral sex; from mother to fetus (congenital syphilis).

 Discharge: None specific.

 Lesions: Primary stage — painless chancres (ulcers); Secondary stage — rash on palms/soles, mucous patches.

 Treatment: Benzathine penicillin G 2.4 million units IM in a single dose.

BACTERIAL VAGINOSIS

 Description: Not a true STI but associated with sexual activity; imbalance of normal vaginal flora.

 Causative Agent: Overgrowth of Gardnerella vaginalis and anaerobes.

 Other Names: BV.

 Mode of Transmission: Associated with sexual activity, but not exclusively transmitted sexually.

 Discharge: Thin, grayish-white discharge with a fishy odor.

 Lesions: None.

 Treatment: Metronidazole 500 mg orally twice daily for 7 days.

VIRAL STIs

GENITAL WARTS

 Description: Flesh-colored growths in the genital or anal areas.

 Causative Agent: Human papillomavirus (HPV) types 6 and 11.

 Other Names: Condylomata acuminata.

 Mode of Transmission: Skin-to-skin contact during vaginal, anal, or oral sex.

  Discharge: None.

 Lesions: Cauliflower-like masses, painless.

 Treatment: Topical agents (imiquimod, podofilox); cryotherapy; surgical excision.

HIV

 Description: Virus attacking CD4 T lymphocytes, leading to immunodeficiency.

 Causative Agent: Human Immunodeficiency Virus (HIV-1 and HIV-2).

 Other Names: AIDS virus (if disease progresses).

 Mode of Transmission: Blood, semen, vaginal fluids, breast milk; sexual contact, needle sharing.

 Discharge: None.

 Lesions: Oral thrush, Kaposi's sarcoma lesions (advanced disease).

 Treatment: Lifelong Antiretroviral Therapy (ART) to control virus replication.

GENITAL HERPES

 Description: A recurrent viral infection characterized by painful genital ulcers.

 Causative Agent: Herpes Simplex Virus type 1 (HSV-1) or type 2 (HSV-2).

 Other Names: Herpes.

 Mode of Transmission: Vaginal, oral, or anal sex; skin-to-skin contact.

 Discharge: May accompany secondary infections.

 Lesions: Grouped vesicles on an erythematous base, progressing to ulcers.

 Treatment: Acyclovir, valacyclovir, or famciclovir to reduce symptoms and recurrences.

YEAST INFECTION
CANDIDIASIS

 Description: Fungal infection of mucous membranes.

 Causative Agent: Candida albicans.

 Other Names: Yeast infection.

 Mode of Transmission: Not strictly sexually transmitted; associated with antibiotic use, diabetes, pregnancy.

 Discharge: Thick, white, curd-like ("cottage cheese") discharge, usually odorless.

 Lesions: Redness, excoriation, and edema of vulva or penis.

 Treatment: Fluconazole 150 mg orally single dose or topical antifungals.

PARASITIC STI

TRICHOMONIASIS

 Description: Protozoal infection of the vagina, urethra, or prostate.

 Causative Agent: Trichomonas vaginalis.

 Other Names: Trich.

 Mode of Transmission: Sexual intercourse.

 Discharge: Frothy, yellow-green discharge with a foul odor.

 Lesions: Vulvar and vaginal erythema.

 Treatment: Metronidazole 2 g orally in a single dose or Tinidazole.

GENITOURINARY EXAMINATION FINDINGS

(from Weber & Kelley, 2022)

MALE GENITALIA - INSPECTION AND PALPATION

AREA NORMAL FINDINGS ABNORMAL FINDINGS CONDITIONS

Pubic Hair Even distribution; coarse, curly hair Infestation (lice), sparse hair Pediculosis pubis, hormonal deficiency

Shaft Smooth, no lesions Lesions, tenderness, nodules Herpes, Peyronie's disease

Foreskin Retractable (if uncircumcised) Phimosis, paraphimosis Phimosis, Paraphimosis

Glans Smooth, pink Ulcers, inflammation Syphilis, Herpes

Urinary Meatus Central opening, no discharge Hypospadias, discharge Gonorrhea, Chlamydia

Scrotum Asymmetrical (left lower), rugated skin Swelling, masses Hydrocele, Varicocele

Scrotal Skin Rugated, no redness Edema, lesions Scrotal cellulitis

Inguinal and Femoral Areas No bulges Hernias, lymphadenopathy Inguinal hernia, infection

FEMALE GENITALIA - INSPECTION AND PALPATION

AREA NORMAL FINDINGS ABNORMAL FINDINGS CONDITIONS

External Genitalia Symmetrical, moist, no lesions Ulcers, swelling Herpes, Bartholin cyst

Mons Pubis Hair-covered, soft Lesions, swelling Folliculitis, Abscess

Pubic Hair Coarse, evenly distributed Lice infestation, patchy hair Pediculosis pubis

Inguinal Nodes Nonpalpable Enlarged, tender nodes Infection, malignancy

Labia Majora and Perineum Full, symmetrical Swelling, inflammation Trauma, Bartholin gland infection

Labia Minora, Clitoris, Urethral Meatus, Vaginal Opening Pink, moist, no discharge Redness, discharge, ulceration Vaginitis, STI

Vaginal Wall Rugated, pink, moist Atrophic, dry, inflamed Menopause, infections

Cervix Smooth, pink, midline Redness, erosions, discharge Cervicitis, Cancer

Uterus Size Normal (small, non-enlarged) Enlarged Pregnancy, fibroids

Cervix Palpation Firm, smooth Tender, friable PID, Cervical cancer

Uterus Palpation Mobile, non-tender Fixed, tender Endometriosis, malignancy

AREA NORMAL FINDINGS ABNORMAL FINDINGS CONDITIONS

ANUS (MALE AND FEMALE)

AREA NORMAL FINDINGS ABNORMAL FINDINGS CONDITIONS

Sacroccocygeal Area Smooth, no lesions Pilonidal cyst, sinus Pilonidal disease

Anal Mucosa Pink, moist Fissures, hemorrhoids Hemorrhoids, Anal fissure

Anal Sphincter Palpation Good tone Decreased tone Neurologic disorder

Rectum Smooth walls Masses, tenderness Tumors, Polyps

Peritoneal Cavity (Men) No masses Nodules or masses Prostate cancer, metastasis

Prostate (Men) Smooth, firm, median sulcus Nodules, asymmetry Prostatitis, Cancer

Stool Brown, soft Black (melena), blood-streaked GI bleeding, hemorrhoids

APA 7th Edition Reference

Weber, J. R., & Kelley, J. H. (2022). Health assessment in nursing (7th ed.). Wolters Kluwer.