Current Approaches in the Diagnosis and Treatment of Sexually Transmitted Diseases

Abstract

The term sexually transmitted infection includes various diseases caused by pathogens transmitted through sexual activity. The diseases can be acute or chronic, resulting in lesions with varying characteristics as well as infertility, weakness or even death. While some sexually transmitted diseases progress with ulcers, some of them can present with discharge or both clinical presentations. Syphilis, genital herpes infection, chancroid, granuloma inguinale and lymphogranuloma venereum usually progress with ulcers while gonococcal and chlamydia infections, bacterial vaginosis, trichomonas vaginalis and vulvovaginal candidiasis usually progress with discharge.

While culture is successful in diagnosis for some diseases, the diagnosis of others are based on clinical criteria. In many of the diseases, direct microscopic examination of the exudate taken from the tissue or lesion, nucleic acid amplification tests and serological tests are more successful.

The goals of treatment are to eliminate the pathogen, to eliminate lesions and symptoms, to reduce the risk of contagiousness and recurrent infection, and to eliminate complications that may occur in the late period. Along with appropriate antimicrobial therapy, partner treatment and management is also very important.

Keywords

• Sexually transmitted infection
• ulcer
• discharge
• culture
• nucleic acid amplification test
• serological test

CİNSEL YOLLA BULAŞAN HASTALIKLARIN TANI VE TEDAVİSİNDE GÜNCEL YAKLAŞIMLAR

Abstract

Cinsel yolla bulaşan enfeksiyon terimi, cinsel aktivite yoluyla bulaşan patojenlerin neden olduğu, akut ya da kronik olabilen, değişik özelliklerde lezyonlarla seyreden, infertilite, düşkünlük hatta ölümle sonuçlanabilen çeşitli hastalıkları kapsamaktadır. Cinsel yolla bulaşan enfeksiyonların bir kısmı döküntü ve ülserle seyrederken, bir kısmı da akıntı ya da her iki klinik tablo ile birlikte görülebilmektedir. Sifilis, genital herpes enfeksiyonu, şankroid, granuloma inguinale ve lenfogranuloma venereum genellikle ülser ile seyrederken; gonokok ve klamidya enfeksiyonları, bakteriyel vajinozis, trikomonas vajinalis ve vulvovajinal kandidiazis gibi bazı hastalıklar genellikle akıntı ile seyretmektedir.

Tanı için bir kısım hastalıkta kültür altın standart iken, bir kısmının tanısı klinik kriterlere dayanmakta, birçoğunda ise doku veya lezyondaki eksudanın direkt mikroskopik incelemesi, nükleik asit amplifikasyon testleri ve serolojik testler (antijen veya antikor tarama) öne çıkmaktadır.

Tedavinin amaçları patojenin elimine edilmesi, lezyon ve semptomların ortadan kalkması, bulaştırıcılık ve rekürren enfeksiyon riskinin azaltılması ile geç dönemde görülebilecek komplikasyonların ortadan kalkmasıdır. Uygun antimikrobiyal tedavi ile birlikte partner tedavisi ve yönetimi de kür için önemlidir.  

Keywords

• Cinsel yolla bulaşan enfeksiyon
• ülser
• akıntı
• kültür
• nükleik asit amplifikasyon testi
• serolojik test

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