GONORRHEA

• Is an infection involving the mucosal

surface of the genitourinary tract, rectum
and pharynx
• Other terms: GC, Clap, Drip, Flores
Blanca, Reloj
• Causative agent: Neisseria gonorrhea
• Incubation Period: usually 2to5 days
 Mode of transmission
• Direct contact from the infectious mucous
membranes
• Sexual contact
• Vaginal delivery
• Caesarean section after rupture of BOW
• Through fomites (rare)
 Signs and symptoms
• Males: burning urination
• Pus discharges
• Females: vaginal discharge
• Mild sore throat
• Infection of the anus, genitals, eyes (rare
in adults)
 Treatment
• Tetracycline
• Ampicillin
• Penicillin G
• Treatment of sexual
partners
 Diagnosis
• Gram staining
• Culture of cervical smear
• Culture of urethral smear
 Complications
• Pelvic inflammatory disease (PID)
• Sterility in both sexes
• Arthritis
• Blindness
• Meningitis
• Heart and kidney damage
• Skin rash
 Complications
• Ectopic pregnancy
• Eye damage in newborns (acquired during
normal delivery)
 Nursing interventions
• Isolation of the patient
• Care of expose person
• Proper diet
• Medication compliance
• Health education
washing of organs and use of condoms
immediate check-up for suspected case
 SYPHILLIS
• Causative agent: Treponema pallidum
• Synonyms: Sy, bad blood, the pox
• Incubation period: 10days to 3months
with average of 21 days
 Signs and symptoms
• Primary stage:
painless chancre
swollen glands

• Secondary stage: appear 1wk-6mons after the

appearance of chancre
rash
patchy hair loss
sore throat
swollen glands
 Signs and symptoms
• Late stage:
damage to body organs (brain, heart and
liver)
continue 5 to 20 years without symptoms
but the patient is no longer infectious
• Pregnant woman can transmit the disease
to the newborn
 Diagnosis
• Dark field illumination test
• Kalm test
• Serological test
1. Nontreponemal test – using lipid or
cardiolipin antigen
2. Treponemal test – using T.pallidum
 Treatment
• Benzathine Penicillin G IM for 8to10 days
100, 000 units/kg/day for newborn
• Erythromycin 15mg/kg IM for 12to15 days
• Tetracycline HCL 500mg p.o. 4x/day for
14 days
• Topical corticosteroids every 2 hours
 Treatment
• Consult opthalmologist for severe ocular
lesions
• Adequate nutrition
• Blood transfusion for anemia
• Post-treatment follow-up
 Nursing interventions
• Case finding – history of exposure
• Health teaching
• Medication compliance
• Encourage participation in curing oneself
• Routine check-up
• Emphasize hygiene including the patient’s
partner and family
 GRANULOMA INGUINALE
• Chronic inflammatory disease affecting the
skin of the groin, prepuce, perineum
• Appearance of small papule that ruptures
and granulate
• Causative agent: Klebsiella granulomatis
(Donovan body) – a gram negative,
nonmotile, encapsulating spirochete
 GRANULOMA
• Prevalent in tropical areas
• Both males and females are affected
• Common among Negros
• Transmitted by direct contact of skin and
mucous membranes
• Incubation period: from few days to 3
months
 Signs and symptoms
• Papule on the genitals
• Slight purulent discharge
• Pinkish-red granulation tissue affecting the
scrotum and thighs among males, labia,
vagina and cervix among females
• Leukocytosis
 Treatment
• Electrocoagulation under anesthesia –
fulguration of all the edges
• Streptomycin 20 grams for 5 to 10 days
• Oral Chloromycetin 4 grams every 96
hours for three injections
 TRICHOMONIASIS
• Causative agent: Trichomonas vaginalis
• Incubation period: 4 to 20 days with
average of 7 days
• Other name: Trich
• Passed by direct sexual contact or through
contact with wet objects such as towels,
washclothes, douching equipments
 Trichomoniasis
• Incubation period: four to 20 days
• The patient is communicable the entire
duration of the infection
• High incidence among black races
• Prognosis: chronic and difficult to
eradicate
 Signs and symptoms
• Mostly asymptomatic
• Females: white or greenish-yellow
odorous discharge
• Vaginal itching and soreness
• Painful urination
• Males: slight penis itching
• Painful urination
• Clear discharge
 Diagnosis
• Culture test of vaginal discharge – clean
the genitals prior specimen collection
• Microscopic slide of discharge –
identification of motile parasites
 Treatment
1. Thorough cleaning of vagina
2. Maintain low vaginal pH
3. Application of antiseptic agents
• Floraquin tablets – introduce vaginally
• Use of Triva – detergent solution
• chemotherapy
 VENEREAL WARTS
• Small, gray, rough nodules or papillary
projections covered with secretion having
offensive odor
• Synonyms: Verrucae vulgaris, genital
warts, moist warts, condyloma
acuminatum and verruca acuminata
 • appear in the coronal sulcus of penis
or on the labia and around vaginal
orifice
- increase in size during pregnancy
becomes small and disappear after
delivery
- the virus survives a temperature of 50
degrees Celsius for 30 minutes
incubation period: one to 20 months
 Manifestations
• Often associated with gonorrhea
• Warts extend down the inside of both
thighs to axilla and umbilicus even in
perianal area – any warm moist areas of
the body
 Treatment
• Cleaning of affected areas
• Keep the area dry
• Boric acid dusting powder
• Potassium permanganate
• Alum dusting powders
• Salicylic acid
• Electrocautery
• Surgical removal of warts
 Treatment
• Radiotherapy
• IM injection of Bismuth- non-toxic drug
that causes complete disappearance of
venereal warts
• Use of water-soluble salt
• fulguration
 AIDS/HIV
• First occurred in Africa and spread to
Carribean Islands
• Reported in the USA in 1981
• It is currently pandemic
• First case in the Philippines was reported
in 1984
 AIDS/HIV
• Causative agent: Retrovirus – human T-
cell lymphotrophic virus 3 (HTVL-3)
• Mode of transmission:
– Sexual contact
– Blood transfusion
– Use of contaminated syringes, needles etc.
– Direct contact with contaminated blood and
bloody fluids, semen and vaginal discharge
 Signs and symptoms
• Physical: maculo-papular rashes
– Loss of appetite
– Weight loss
– Fever of unknown origin
– Malaise
– Persistent diarrhea
– TB
– Esophageal candidiasis
 Signs and symptoms
• Kaposi’s sarcoma
• Pneumocystis carinii pneumonia
• Gaunt-looking, apprehensive
– Mental: forgetfulness
– Early stage: loss of concentration
» Loss of libido
» Apathy
» Psychomotor retardation
» Withdrawal
 Signs and symptoms
• Late stage
– Confusion
– Disorientation
– Seizures
– Mutism
– Loss of memory
– coma
 Diagnosis
• Enzyme linked immuno sorbent assay
(ELISA)- presumptive test
• Western blot – confirmatory test
 Prevention
• Maintain monogamous relationship
• Avoid promiscuous sexual contact
• Use sterile hospital items
• Proper screening of blood donors
• Thorough examination of blood for transfusion
• Avoid oral, anal contact and swallowing of
semen
• Use of condoms and other protective device
 The 4Cs
• COMPLIANCE
• Follow-up check-up
• medication
• COUNSELLING
• Instruction about treatment
• Disease process
• Guidance on how to avoid the disease
• CONTACT TRACING
• Partner treatment
• CONDOMS
• Promote condoms use
 SARS
• Means Severe Acute Respiratory
Syndrome
• Respiratory illness characterized by fever
and pneumonia rapidly becomes severe
and in some cases may lead to death
• Coronavirus can be found in stool
specimen and body fluids
 SARS
• Causative agent: SARS CoV – unrecognized
corona virus
• Mode of transmission: person to person through
respiratory droplets
• Direct contact with body fluids
• Aerosol transmission
• oro-fecal route
• Incubation period: 2-7 days after exposure
maximum of 10 days
 Diagnosis
• Chest X-ray - normal during prodromal
stage and show infiltrates and progressing
to patchy interstitial infiltrates during
respiratory phase
• Blood cultures
• Sputum gram stain and culture
• Testing for viral respiratory pathogens
 Diagnosis
• Low WBC count
• Low platelet count
• Abnormal liver function
 Prodromal period
• Duration of 2-7 days
• Sudden onset of high fever
• Dry Cough
• Myalgia
• Chills
• Headache
• Body malaise
 Lower respiratory phase
• Severe, dry, non-productive cough
• Shortness of breath after 2 to 7 days
• DOB
• Hypoxemia
• 10 to 20% require mechanical ventilation
• Preventive measures
- no vaccine has been developed
- use of N95 mask
 Prevention
• Eat well-balanced diet, enough sleep,
Exercise to build resistance
• Proper hygiene
• Cover mouth when sneezing or coughing
• Avoid crowded places
• Clean home and environment
• 7 days quarantine for travellers
 Treatment
• Supportive
• Antibiotics against the development of
Pneumonia
• Symptomatic
• Viruses are self-limiting
• Bronchodilators
• Steroids
 JAPANESE ENCEPHALITIS
• Flaviviral neurologic infection
• Common among rural areas spread by
culicine mosquitoes, Culex
Tritaeniorhynchus
• Most common viral encephalitis in Asia
• Incubation period: 4-14 days
 Pathogenesis
• Bite of infected mosquitoes

• Propagates at the site and lymph node

region
• Viremia develops

• Inflammation of the heart, lungs, liver, and

reticuloendothelial system
 Manifestations
• Prodromal phase: fever, headache,
nausea, vomiting and myalgia
• Mild confusion to agitation
• Coma
• Seizures in children
• Meningismus in adult
 Treatment
• Supportive
• Symptomatic
• Antipyretic for fever
• Antiemetic
• anticonvulsant
 Nursing intervention
• Isolation of patient
• Documentation before and after seizure
• Cold packs during fever
• Quiet and dim-lighted room
• Consistent healthcare provider due to
patient’s confusion