Sexually transmitted infections: Nursing pathophysiology

Sexually transmitted infections or ST S are infections spread by sexual contact. These infections are sometimes also called sexually transmitted diseases or STD S and were formerly known as venereal diseases.

Now TI S can be bacterial like chlamydia, gonorrhea and syphilis viral such as herpes simplex virus or HSV, human papillomavirus or HPV, hepatitis and human immunodeficiency virus or HIV or parasitic such as in trichomoniasis.

They're spread through direct contact including direct sexual contact, like vaginal oral or anal intercourse, contact with infected blood or other bodily fluids and even through close body contact.

Additionally, some ST is such as chlamydia, gonorrhea, syphilis and HIV can be spread through vertical transmission, meaning the infection passes from mother to fetus during pregnancy or to the infant during a vaginal birth.

In other cases, infections can be transmitted by sharing personal items such as toothbrushes or razors or by sharing needles during IV drug use.

Risk factors for ST is include having multiple sexual partners, especially without an effective barrier, such as a condom being an uncircumcised biological male and being the receptive partner during intercourse.

Also, biological females are at a higher risk for infection, partly because the vaginal lining is relatively thin and more easily invaded by pathogens.

Additionally, inadequate screening, lack of access to healthcare or inadequate risk assessment by healthcare providers all increase the risk that an infected individual unknowingly transmits an sti I to another individual.

Lastly ST is can occur at any age but they're most prevalent in young adults. Ok.

So the pathophysiology of ST is depends on the specific infectious agent and site. So as an example, a common ST I is Neisseria gonorrhea, a gram negative bacterium that causes gonorrhea.

The bacteria have hair like extensions on their surfaces called py, which help the bacteria attach to the mucosal epithelial cells of structures like the vagina, urethra rectum or oropharynx.

Once the bacteria have attached to the cells, they can then invade the cell triggering an inflammatory reaction which results in tissue damage.

Another common sti is chlamydia trachomatis that causes chlamydia. It's a gram negative obligate intracellular bacterium, meaning that it can't reproduce without infecting a host cell.

It exists outside a host cell as a small form called an elementary body. After exposure, it attaches itself to a cell and enters by endocytosis.

Now, once inside the cell, it begins reproducing until the cell eventually bursts, releasing a lot of new elementary bodies in the surrounding fluids where they attach to other cells to repeat the cycle over and over.

This inflammatory reaction caused by this infection can result in permanent scarring of tissues. Now, in biological females, both gonorrhea and chlamydia can eventually ascend to the upper reproductive structures like the uterus, fallopian tubes and ovaries where they can cause a condition called pelvic inflammatory disease or P ID.

This involves significant inflammation and production of purulent exudate along with adhesions, scarring and damage to the reproductive organs.

Now, STIs can sometimes be asymptomatic but they can also present with clinical manifestations related to the inflammatory response to the infection.

These include unusual discharge from the vagina or penis dysuria or pain or burning during urination, itching, soreness or redness in the genital or anal area, painful swelling like with orchitis, which is inflammation of the testicles and lower abdominal or pelvic pain.

Other systemic signs and symptoms can include swollen lymph nodes and fever. Some STIs such as genital herpes and primary stage syphilis can produce sores on genitalia while certain infections of the oropharynx can result in pharyngitis and tonsillitis.

Now, other infections can cause severe complications like PID, which can ultimately result in infertility or ectopic pregnancy.

Infection with oncogenic serotypes of HPV can cause anogenital and oropharyngeal cancers. The hepatitis B virus or HBV can cause liver damage and liver cancer and syphilis can result in neurological defects and damage to skin bone and soft tissues.

All right. As a quick recap sts are infections transmitted through sexual contact.

They can be bacterial, viral or parasitic. Common clinical manifestations include an unusual vaginal or penile discharge, dysuria, itching, soreness or redness in the genital or anal area and lower abdominal or pelvic pain.