SYNONYMS

CAUSATIVE AGENTS Neisseria gonorrhoeae

INCUBATIOB PERIOD 3-5 days after contact with an infected partner

MODE OF TRANSMISSION Transmitted through sexual intercourse with an infected partner; via infected birth canal of infected mothers during delivery; indirectly transmitted via contaminated hands, fomites contaminated with purulent discharges; directly also via oral sex

SIGNS AND SYMPTOMS Urethritis among the males, a few days after exposure. Lymphadeniti s (swelling of lymphnodes) Ophtalmia neonatorum Gonorrheal ophthalmia Gonorrheal vulvovaginitis Gonococcal pharyngitis Anal gonorrhoea Dysuria Urethral discharge Prostatitis Inguinal lymphadenitis Pelvic pain Fever

PERIOD OF COMMUNICABILITY The period of communicability may extend for months in untreated individuals.

DIAGNOSTIC TEST *Urine sample *Vaginal and urethral cultures

MEDICAL MANAGEMENT *Ceftriaxone (Suprax) and doxycycline (Vibramycin); oral amoxicillin Aqueous procaine penicillin G given intramuscularly together with probenecid by mouth just before injection for acute genital infection Local application of 0.5% erythromycin ophthalmic ointment or 1% tetracycline to the conjunctiva of the new born for gonococcal ophthalmia Instillation to the affected eyes of 1% silver nitrate or 0.5% erythromycin (CREDEs PROPHYLAXIS) for ophthalmia neonatorum

NURSING MANAGEMENT *Monitor the patient for complications. *Tell the patient that until cultures prove negative, hes still infectious and should avoid unprotected sexual contact. *Urge the patient to inform his sexual partners of his infection so that they can seek treatment. *Advise the partner of an infected person to receive treatment even if she doesnt have positive cultures. *Counsel the patient and his sexual partners to be tested for human immunodeficienc y virus and hepatitis B infection. *Instruct the patient to be careful when coming in contact with his bodily discharges so that he doesnt

COMPLICATIONS Pelvic inflammatory disease, which can lead to a tubal pregnancy that results in a miscarriage and can cause the death of the mother Epididymitis, which is a painful condition of the testicles that can lead to infertility if left untreated.

*STD GONORRHEA

The clap

contaminate his eyes. *Tell the patient to take antiinfective drugs for the length of time prescribed. *To prevent reinfection, tell the patient to avoid sexual contact with anyone suspected of being infected, to use condoms during intercourse, to wash genitalia with soap and water before and after intercourse. HERPES GENITALIS Genital herpes Herpes Simplex Virus 2 3 to 14 days Sexual contact Anal sex Oral sex Vaginal sex as well as Kissing Skin-to-skin contact which transmits HSV-1 and HSV-2 In males, the lesions occur on the glans penis, shaft of the penis or other parts of the genital region, on the inner thigh, buttocks, or anus. In females, lesions appear on or near the pubis, labia, clitoris, vulva, buttocks or anus HSV can be isolated for 2 weeks and up to 7 weeks after the appearance of primary lesions. Both primary and recurrent infection may be asymptomatic. HSV may be shed intermittently from mucosal sites for years and possibly lifelong. Blood Test Viral Cell Culture Test Immune Response Tests Dynamiclear (one application relief) Essential Oils Famvir (Famciclovir) Lysine & other Diet Supplements Medicinal Herbs Oxygen Therapy Valtrex and Acyclovir Educate the patient from: Abstaining from sexual intercourse or limiting intercourse to one partner who is free of sexually transmitted diseases. Not having sex with high-risk partners. Other sexually transmitted infections Newborn infection - This may result in brain damage, blindness or death for the newborn. Bladder problems Meningitis Rectal inflammation (proctitis).

 Other common symptoms include pain, itching, and burning. Less frequent, yet still common, symptoms include discharge from the penis or vagina, fever, headache, muscle pain (myalgia), swollen and enlarged lymph nodes and malaise.Wome n often experience additional symptoms that include painful urination (dysuria) and cervicitis. Herpetic proctitis (inflammation of the anus and rectum) is common for individuals participating in anal intercourse.

Infected persons should not have sex at all when they have blisters or sores anywhere on the body or in the mouth. Even the use of a condom does not prevent the spread of herpes when someone has genital sores or blisters because not all sores will be covered by the condom. Using latex condoms every time during sex when sores or blisters are not present. Avoiding the use of drugs (particularly cocaine) and alcohol, which can impair good judgment. Having sexual partners tested or treated for herpes before having sexual relations.

SYPHILIS

The great imitator

Treponema pallidum

10 days to 3 months and is usually 3 weeks.

Sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis

*The primary stage classically presents with a single chancre (a firm, painless, non-itchy skin ulceration) *Secondary syphilis with a diffuse rash which frequently involves the palms of the hands and soles of the feet *Latent syphilis with little to no symptoms *Tertiary syphilis with gummas, neurological, or cardiac symptoms. It has, however, been known as "the great imitator" due to its frequent atypical presentations * Congenital syphilis may occur during pregnancy or during birth. Two-thirds of syphilitic infants are born without symptoms.

A case is considered sexually infectious until the end of the early latent period which is approximately two years after infection. Infectious moist mucocutaneous lesions are present in the primary and secondary stages of syphilis and may reoccur intermittently in the early latent period. These lesions may not be apparent to the infected individual.

Blood tests Dark field microscopy or immunofluoresc ence.

Penicillin G or a single dose of oral azithromycin. Doxycycline and tetracycline are alternative choices; however, they cannot be used in pregnant women. Antibiotic resistance has developed to a number of agents, including macrolides, clindamycin, and rifampin. Ceftriaxone, a thirdgeneration cephalosporin antibiotic, may be as effective as penicillinbased treatment.

Assess the history of pain and response to pain Assess the needs that can reduce pain and explain the technique reduces pain and causes pain Create a comfortable environment Reduce unpleasant stimulus Collaboration with physicians in providing analgesic Observation of general condition of the client with vital signs every 2 hours Give antipyretics as recommended by your doctor and monitor the effectiveness of 30-60 minutes later Give a compress on the forehead and arm

Dementia, blindness, or death

Common symptoms that then develop over the first couple years of life include: hepatosplenome galy (70%), rash (70%), fever (40%), neurosyphylis (20%), and pneumonitis (20%). If untreated, late congenital syphilis may occur in 40%, including: saddle nose deformation, Higoumenakis sign, saber shin, or Clutton's joints among others. CANDIDIASIS Thrush Candida albicans 2-5 days (1-14 days) Endogenous spread (part of normal human flora); by contact with excretions of mouth, skin, and feces from patients or carriers; from mother to infant during childbirth; disseminated candidiasis may originate from mucosal lesions, unsterile narcotic Redness, itching and discomfort Symptoms of candidiasis may vary depending on the area affected. Infection of the vagina or vulva may cause severe itching, burning, soreness, irritation, and a whitish or Communicable for duration of lesions Microscopic examination Culturing

Recommend that clients use a thin and loose clothing Give the drink a lot

antimycotics Observe the antifungal standard drugs commonly precautions. used to treat Provide a candidiasis are: nonirritating mouthwash to topical loosen clotrimazole tenacious secretions and topical a soft nystatin, toothbrush to fluconazole avoid irritation. Relieve mouth topical discomfort ketoconazole. with a topical anesthetic,

Fungal scalp infection Fungal throat infection Fungal endocarditis

injections, catheters

whitish-gray cottage cheeselike discharge, often with a curd-like appearance.

such as lidocaine at least 1 hour before meals. Apply cornstarch, nystatin powder, or dry padding in intertriginous areas of obese patients to prevent irritation and candidal growth. Provide appropriate supportive care for patients with systemic infections. Frequently check the vital signs of a patient with systemic infection. If you note a vaginal discharge, document the color and amount.

CHLAMYDIAL INFECTION

Chlamydia trachomatis

7 to 14 days or more

Vaginal, anal, or oral sex, and can be passed from an infected mother to her baby during vaginal childbirth.

Most women with urethral or endocervical chlamydial infection are asymptomatic Clinical manifestation s may include vaginal discharge, dysuria and post-coital or intermenstrua l bleeding. Less frequent manifestation s include urethral syndrome (dysuria and pyuria), bartholinitis, perihepatitis and proctitis. In men, chlamydia shows symptoms of infectious urethritis (inflammation of the urethra) in about 50% of cases. Symptoms that may occur include: a painful or burning sensation

The period of communicability is unknown but may be months to years.

Nucleic acid amplification tests (NAAT), such as polymerase chain reaction (PCR) transcription mediated amplification (TMA) the DNA strand displacement amplification (SDA)

Azithromycin Doxycycline Erythromycin or Ofloxacin. Agents recommended for pregnant women include erythromycin or amoxicillin.

Advice abstinence from sexual intercourse until treatment has been completed. No follow-up culture is necessary to ensure cure; however, rescreening is recommended 3 to 4 months after treatment to detect reinfection, particularly in adolescents and young women. Ensure that the partner is treated at the same time; recent partners should receive treatment despite lack of symptoms and negative Chlamydia result. Report case to local public health department (Chlamydia is a reportable infectious disease).

Females: Chronic pelvic pain, infertility and ectopic pregnancy Males: Epididymitis, infertility, Reiters syndrome and conjunctivitis

when urinating, an unusual discharge from the penis, swollen or tender testicles, or fever. Discharge, or the purulent exudate, is generally less viscous and lighter in color than for gonorrhea. Chlamydia conjunctivitis or trachoma was once the most important cause of blindness worldwide

Ensure that the patient begins treatment and will have access to prescription follow up. Explain mode of transmission, complications, and the risk for other STDs. Teach about all STDs and their symptoms. Explain the treatment regimen to patient and advise her of adverse effects. Encourage abstinence, monogamy, or safer sex methods, such as female or male condom. Stress the importance of follow-up examination and testing to eradication of infection. Recurrence rates are highest in young patients.

*G.I Fatigue Fever Abdominal pain Nausea Appetite loss Jaundice, a yellowing of the skin or whites of the eyes Bile is removed from blood stream and excreted in urine, giving it a dark amber colour Clay-coloured feces Hepatitis A Always wash Vaccine your hands Immunoglobulin thoroughly after using the restroom and when you come in contact with an infected person's blood, stools, or other bodily fluid. Avoid unclean food and water. Avoid raw or undercooked meat and fish. Beware of sliced fruit that may have been washed in contaminated water. Travelers should peel all fresh fruits and vegetables themselves. Do not buy food from street vendors. Heated food should be hot to the touch and eaten right away.

HEPA A

Infectious hepatitis Epidemical virus

Hepatitis A virus

2 and 6 weeks and the average incubation period is 28 days

Usually spread the fecal-oral route; transmitted person-to-person by ingestion of contaminated food or water or through direct contact with an infectious person

14 days before and 7 days after the onset of jaundice, or if jaundice does not occur, 7 days before and 14 days after the onset of symptoms.

Anti-HAV IgM

 If no water is available, boiling water is the best method for eliminating hepatitis A. Bringing the water to a full boil for at least 1 minute generally makes it safe to drink. TYPHOID FEVER Gastric fever Abdominal typhus Infantile remittant fever Slow fever Nervous fever Pythogenic fever Salmonella enterica Typhoid fever is usually 8-14 days but this depends on the infective dose and can vary from three days to one month Transmitted by the ingestion of food or water contaminated with the feces of an infected person, which contain the bacterium Salmonella enterica, serovar Typhi Abdominal tenderness Agitation Bloody stools Chills Confusion Difficulty paying attention (attention deficit) Delirium Fluctuating mood Hallucinations Nosebleeds Severe fatigue Slow, sluggish, lethargic feeling Weakness It is communicable as Complete blood long as typhoid or count (CBC) paratyphoid bacilli Blood culture arepresent in excreta. ELISA urine Some patients become test to look for permanent carriers. the bacteria that cause Typhoid fever Fluorescent antibody study to look for substances that are specific to Typhoid bacteria Platelet count (platelet count will be low) Stool culture Antibiotic therapy may include one or more to the following agents: ciprofloxacin, ceftriaxone, chloramphenicol, amoxycillin or co-trimoxazole Tell the patient to wear thin and absorbs sweat. Restrict visitors. Observation of vital signs every 4 hours. Tell the patient to drink a lot, drink a lot of fluid intake. Collaboration with doctor in the provision of antibiotics and antipyretic therapy. Intestinal hemorrhage (severe GI bleeding) Intestinal perforation Kidney failure Peritonitis

DYSENTERY

Flux or the bloody flux

There are two main types of dysentery: Dysentery caused by shigella bacteria (bacillary dysentery or shigellosis) Dysentery caused by an amoeba (a singlecelled parasite) called Entamoeba histolytica (amoebic dysentery or amoebiasis)

1 to 7 days but more commonly it is only 1 to 3 days. The illness may last for only a day or continue for one or two weeks

Putting anything into the mouth that has touched the feces of a person with Dysentery such as toilet seat, flush handles, taps, toys etc. (Fecal-oral route) Direct contact with a person who has dysentery.

Mild stomach pains Frequent passage of feces Temporary lactose intolerance can occur Vomiting of blood Severe abdominal pain Fever Shock Delirium ABDOMINAL CRAMPING BLOODY MUCOID STOOL TENESMUSfeeling of incomplete defecation

4 weeks, but may persist

Stool sample

Oral rehydration therapy Ciprofloxacin or TMP-SMX (Bactrim) Metronidazole (Flagyl)

Not allowing anyone in the household who has been diagnosed with amebic or bacillary dysentery to prepare food or pour water for others until their doctor confirms that they are no longer carrying the disease agent. Avoiding anal sex or oralgenital contacts. Washing the hands carefully with soap and water after using the bathroom, and supervising the hand-washing of children in day care centers or those at home who are not completely toilet-trained. When traveling, drinking only boiled or treated water, and eating only cooked hot foods.

AMOEBIASIS

Entamoeba histolytica

The incubation period in severe infection is three days. In subacute and chronic form it lasts for several months. In average cases the incubation period varies from 3 to 4 weeks

Fecal-oral transmission Direct contact

Slight attack of diarrhea, altered with periods of constipation and often accompanied by tenesmus. Diarrhea, watery and foul smelling stool often containing blood-streaked mucus Colic and gaseous distension of the lower abdomen Nausea, flatulence, abdomnal distension and tenderness in the right iliac region over the colon Pain at the upper right quadrant with tenderness of the liver Abscess may break through the lungs, patient coughs anchovysauce sputum Jaundice Intermittent fever Loss of weight or anorexia

The microorganism is communicable for the entire duration of the illness.

Stool samples ELISA ( Enzyme-linked immunosorben t assay) RIA

Metronidazole (Flagyl) 800mg TID X 5 days Tetracyline 250 mg every 6 hours Ampicillin, quinolones sulfadiazine Streptomycin SO4, Chloramphenic ol Lost fluid and electrolytes should be replaced

Observe isolation and enteric precaution Provide health education and instruct patient to -Boil water for drinking or use purified water -Avoid washing food from open drum or pail -Cover leftover food -Wash hands after defacation and before eating -Avoid ground vegetables (lettuce, carrots, and the like)

Amebic colitis -Fulminant or necrotizing colitis -Toxic megacolon -Ameboma -Rectovaginal fistulas Amebic liver abscess -Intrathoracic or intraperitoneal rupture with or without secondary bacterial infection -Direct extension to pleura or pericardium Brain abscess

CHOLERA

Asiatic or epidemic cholera

Vibrio cholerae

Few hours to five days. It is usually two to three days.

Drinking or eating Abdominal water or food that cramps has been Dry mucus contaminated membranes or mouth Dry skin Excessive thirst Glassy or sunken eyes Lack of tears Lethargy Low urine output Nausea Rapid dehydration Rapid pulse (heart rate) Sunken "soft spots" (fontanelles) in infants Unusual sleepiness or tiredness Vomiting Watery diarrhea that starts suddenly and has a "fishy" odor

Persons are infectious during the acute stage and for a few days after recovery.

Blood culture Stool culture

Oral rehydration solution (ORS) to replace water and electrolytes

Medical septic protective care must be provided. Enteric isolation must be observed. Vital signs must be recorded accurately. Intake and output must be be accurately measured. A thorough and careful personal hygiene must be provided. Excreta must be properly disposed of. Concurrent disinfection must be applied. Food must be properly prepared. Environmental sanitation must be observed.

Severe dehydration Death