2. Bacterial Vaginosis(vaginitis)
• Harmful bacteria: Gardnerella vaginalis,
Mycoplasma hominis,
• The pH and ecosystem changes, with
concomitant symptoms
• Sign & Symptom: asymptomatic,
Itching, fish like odor, gray-white or watery
vaginal discharge
• Tx; oral metronidazol or clindamycin cream(if
pregnancy metronidazole is
contraindicate(PROM tendency), avoid
alcohol while using drugs)
4. Trichomonas
• Etiology: protozoa parasite Trichomonas Vaginalis (most
common curable STI)
• Sign & symptoms: women; vagina odor 4-20days, thick,
yellow-green or gray discharge, genital irritation and iching,
painful urination, discomfort after intercourse. men;penis has
thin, whitish discharge, painful urination and difficult.
• Both sexual partner should receive treatment , avoid sexual
intercourse or use condoms 4-6wks after treatment
• Tx: Metronidazole(avoid alcohol, alcohol can cause severe
nausea & vomiting)
• Pregnant woman commonly experience recurrences
Result; premature rupture of membranes, preterm birth, low
birth weight, genital and lung infection on new born
6. Yeast
infection(Candidiasis, Moniliasis)
• Etiology: Candida albicans
• Most common disease especially pregnant
woman, about 75% all of women experience at
least one symptomatic episode
• Over growth of C. albicans follow a disruption of
normal vagina echosystem.
• Contributing factors: use
antibiotics, corticosteroids, diabetes, immunosuppr
essive treatment, immunodeficiency, oral
contraceptives, perfumed feminine hygiene
spray, wearing tight, poorly ventilated cloth or
underwear
7. Yeast
infection(Candidiasis, Moniliasis)
• Sign & symptoms: itching, burning,
irritation of vagina and vulva, cheese like
discharge, dysuria and dyspareunia
• Dx: culture and microscopic exam of swab
sampling from vagina and cervix diagnosis
and conform yeast form
• Tx: antifungal vaginal medication
• Prevention: perineal hygiene is most
important, genital area clean and dry
9. Perineal hygiene and infection
prevention
• Nurses should provide women with a
teaching plan for perineal hygiene
• Goal: prevent organisms(E-coli) from
spreading from rectum to the vagina and
urethra.
• Wash hand s before and after genital contact
and after using the restroom.
• Women to wipe the perineum from front to
back each time they void or defecate as well
as during sex and menstruation
10. Perineal hygiene and infection
prevent
• Avoid products that may disturb the normal vagina
flora(Dödenal bacillus)
• Women should not use feminine hygiene(perfum. Spray,
tampon and pad, deodorize)
• Vagina is normally clean organ and does not need special
cleanliness
• Women are often at risk for genital infection or vaginitis
because of the warm, moist, environment which promote
microbial growth.
• Wearing cotton underpnts, avoid nylon under ware and tight
pants
• Shower and perineal wash, avoid douch, buble bath and other
bath additive
• Perineal and vulva Wash 2 L water + Vinegar 3Tabe spoon
11. Sexual Transmitted Infection
Chlamydia
• Causative bacterium: Chlamydia tracomatis
• Prevalence group: 15-20yrs old lower
scioeconomic group
• Transmitted through oral, vagina, anal sexual
contact with infected person
• Sign & Symptoms: early asymtomatic-purulent
mucus discharge from vagina after 1-3wks
• Transmitted endocervix endometrium uterine
tube peritoneum PID infertility
• Rectum urethra inflammation and ulceration
12. Chlamydia & Gonorrhea
• Chlamydia & Gonorrhea can inflame lining of eye.
newborn developed blindness from infection
chlamydia at birth.
• All newborn should be treating antibiotic ointment
on eyes
• All pregnant women should be test for chlamydia
infection
• Dx: examination of a specimen from
endocervix, vagina, penis
• TX: Antibiotics;
agitomycin, doxycline, erythromycin, amoxicillin
• Avoid sexual intercourse or using condom
14. Syphilis
• Bacterium: Treponema
pallidum
• Transmitted through sexual
intercourse
• Initial infection is localized
ulcer systemic damage
fetal
• Maternal-fetal transmission(4070%) congenital
syphilis, stillbirth, neonatal
death
• Congenital syphilis baby; skin
ulcer, rashes, fever, Hoarse
crying sounds, mental and
physical handicaps 2-3month
after birth
15. Syphilis
• 4 stage of syphilis
- Primary syphilis; painless ulcer or chancre cervix, tongue, lips, 26wks of exposure
- Secondary syphilis: chronic stage, skin rash and brown sores 3-6wks
after initial ulcer, mild fever, fatigue, headache, sore throat, hair
loss, swollen lymph gland occur over 1-2yrs
- Latent syphilis: no symptoms
- Tertiary syphilis: final stage, spreads to many body
systems(heart, eye, brain nerve system bone and joint mental
illness, blindness, neurologic problem, heart problems death
• Dx: microscopic identification of bacterium and exam. of blood
sample(serology test)
• TX: penicillin, tetracycline, doxcycline
• Disease preventions as the ultimate goal
• Pregnant women should be screening and instruction
16. Genital Herpes
•
•
•
•
•
•
•
•
•
•
Herpes simplex virus type 2(HSV 2)
HSV-1: cold sore lips, nose,
HSV-2: genital infection
Sign & symptoms: itching and burning
Virus incubates 7days, 12days until healing but recurrent
frequently
Associated factors: sexual intercourse, stress, hormonal
change, menstruation, climatic changes
Dx: rectal cultures, clinical exam.
Tx: acyclovir(Zovirax)
Woman should maintain cleanliness and dryness
Transmitted mother to infant cesarean birth indicated
18. Human Papillomavirus(HPV)
Genital warts
• HPV is more than 100 virus group
• Genital warts(Condylomata): oral, vaginal, anal sex with infected
people. 75% no Sx.
• Sign& Symptoms: developed condylomata(warts) vulva, cervix, anus.
• Warts vary size, appear flat and flash colored cauliflower look.
• High risk HPV cause abnormal result on Pap smear and lead to
cervical cancer.
• Different diagnosis can be made using vinegar-like solution applied
to the suspected area. This solution causes the warts to turn white.
• Tx: Podophyllin and podofilox solution, Trichloroacetic acid(TCA),
cryosurgery, electrocautery
• Safe sex, avoid sex until tx. Finish all medications sex paterner to
be tested and treated
20. Human Immunodeficiency
Virus(HIV)
• Acquired immunodeficiency syndrome(AIDS)
is an infectious disorder that profoundly
weakness the immune system by Human
Immunodeficiency virus(HIV)
• 10 yrs longer for an initial infection with HIV
develop in to AIDS
• Infected people can give HIV to other through
sexual contact, pregnancy, breast
feeding, organ transplants, sperm
donation, IV drug use, blood transfusion
21. Human Immunodeficiency
Virus(HIV)
• HIV kills CD4cells(helperT cells), which help
the body fight off infection and disease.
• CD4 cells in an infected person decrease as
number of HIV-infected cells increase.
• Dx: positive HIV antibody by test for
ELISA(enzyme-linked immuno-sorbent
assay) T4/T8 ratio=T lymphocyte(T4 cell
200/mm₃↓)indicate AIDS
• Tx: antiretroviral medication, adjust immune
enhancing drugs, supportive care
22. Human Immunodeficiency
Virus(HIV)
• Opportunistic infection: consquence of
weakened immunity that is secondary to
HIV/AIDS pneumocystis carinii
pneumonia, cytomegalo virus infection
• HIV is longterm not treatable disease AIDS
is fetal disease
• Prevention and test is most important
• Safe sex, needle, blood not exchange
