Venereal disease
Syphilis
• Chronic Infectious diseases
• is caused by the spirochete Treponema pallidum.
• Both females and males become ill
The primary lesion of this
sexually transmitted disease usually occurs
on
• Skin
• Oral mucosa
• Internal organs
• Nervous system
Common localization of chancre are on
• Lips
• Gingiva
• Tongue
• Tonsils
• Palato glossal arches
• Uvula
Forms of syphilisis can be
• Acquired- spreading ways are sexual,dental instruments and etc
• Congenital- a. caused by the transplacental transmission of viable
• T. pallidum into the circulation of the developing fetus.
b. A pregnant patient with primary or secondary syphilis may infect
the developing fetus, resulting in characteristic congenital
abnormalities
Phases of acquired syphilis are
• incubation (period)- last 2-3 weeks
• Primery
• Secondary
• Tertiary
Etiology of syphilis is
• Treponema pallidum
Subjective signs of Primary syphilis are
• Uncomfortable speech and eating process
• General condition is Sufficient
Objective signs of primary siphilis
• Primary suphilis deveolepes at an area where Treponema pallidum
entered in the body
• The primary lesion, chancar, is characterized by the development of a firm
nodule at the site of inoculation
• after a few days it breaks down to leave a painless ulcer with indurated
margins
• Cervical lymph nodes are usually enlarged and rubbery in consistency.
• The chancre is highly infectious
• The lesions of primary syphilis usually resolve within 3–12 weeks without
scarring
Secondary syphilis
• Clinically approximately 6 weeks or longer after the primary infection
• characterized by a macular or papular rash, febrile illness, malaise,
headache, generalized lymphadenopathy, and sore throat. Oral
• Ulceration, described as ‘snail track ulcers’, develops.
• Lesions of secondary syphilis are infective but resolve within 2–6
weeks.
Tertiary syphilis
• Approximately 30% of patients with untreated secondary syphilis
develop the latent form many years after the initial infection
• Two oral lesions are recognized in the tertiary form of syphilis: gumma
in the palate and leukoplakia affecting the dorsal surface of the
tongue
Syphilis is characterized with Hutchinson’s
triad
• interstitial keratitis
• deafness
• Dental abnormalities consisting of notched or screw - driver-shaped
incisors and mulberry molars
DIAGNOSIS
• is supported if dark-field microscopy of a smear taken from either a
primary or a secondary lesion reveals numerous spirochetes in size
and form typical of T. pallidum
• The rapid plasma reagin (RPR) and Venereal Diseases Reference
Laboratory (VDRL) tests, both widely used to screen blood dona -
tions, are inexpensive and fast but are not entirely specific
• Confirmatory testing, such as the T. pallidum hemagglutination
(TPHA) and fluorescent treponemal antibody absorption (FTA-ABS)
tests, are specific but more expensive
MANAGEMENT
• Intramuscular procaine penicillin
• For the penicillin-allergic patient, oral tetracycline, 500 mg four times
daily, oral doxycycline, 100 mg twice daily, or oral erythromycin, 500
m
• The Jarisch-Herxheimer reaction is a well-known reaction to initial
therapy when penicillin is injected into the patient, particularly
secondary syphilis. It results from a massive spirochete kill, which
releases large quantities of antigen into the bloodstream g four times
daily for 14 days, are effective.
Prognosis
• Treponemes have no ability to form resistance to penicillin.
• Patients should be followed up for at least 2 years and serological
examinations repeated over this period.
Gonorrhea stomatitis
• Gonorrhea is a sexually transmitted infection (STI) caused by the
bacteria Neisseria gonorrhoeae.
• It can infect both men and women
typically affects
• urethra
• throat
• rectum
• cervix
Prevelens
• Sexual transmitted infection
• Women who are infected with gonorrhea may also transmit the
bacteria to their newborns during childbirth.
• Gonorrhea infections in babies typically affect their eyes.
Localization
• Lips
• Gingiva
• Floor of the mouth
• Tongue
• Tonsils
In children
Eyes and nasal mucosa
Subjective signs
• Can be temperatureand sore troat
• There can be no clinical manifestetion
Objective signs
• Hyperemic area
• Greeneish,pussy lesion on defected area
• Small sized erosions,ulcers
Diagnosis
• Laboratory test
• Under the microscope reveals gonorrhoeae
• Oral cavity sanation
• To trat lesion with antiseptic 0.05 chlorhecsidine,1%
Iodineol, 3%-hydrojen peroxide
• Antibiotics locally:1.0 %tetracycline
• Antimicrobial medicaments: gengigel
• Laser therapy
