Genital Herpes

Gonorrhea is caused by a bacterium, which means it can be treated with antibiotics. Having the infection does not mean that the person cannot be infected again. Asymptomatic carriers likely spread the infection through sexual behavior. There is a 20 percent chance of getting gonorrhea from an infected woman after one act of vaginal intercourse, with a higher rate seen in men who have sex with other men. Women, on the other hand, have a 60 to 80 percent chance of contracting the disease after an infected man performs vaginal sex with her.

Gonorrhea used to be assessed with a gram stain and bacterial culture; however, techniques similar to those use to detect chlamydia are now used, which detect bacterial DNA in a swab or other sample. In some cases, both types of tests are done to confirm the disease. Disseminated gonorrhea is detected by swabbing several body areas, including the rectum, mouth, urethra, and cervix. If the joint is involved, this is proven by getting a swab of the joint fluid.

All patients who have a positive test for gonorrhea should also be checked for HIV, syphilis, and chlamydia because the coinfection rate with chlamydia is about 50 percent. There is a lesser link between gonorrhea and other STIs. Screening should be done on all women under 25 as well as men who have sex with men and others who are high risk because of their sexual practices or because of a past infection.

Treatment of gonorrhea involves antibiotic therapy, with ceftriaxone and azithromycin used. There is a high risk of antibiotic resistance, which can affect the antibiotics used. Babies are given erythromycin at birth because of the risk of severe eye infections gotten from congenital gonorrhea. Sexual partners should also be treated, even without an examination. Penicillin was once used to treat gonorrhea but there is just too much antibiotic resistance to the drug to make it helpful.

GENITAL HERPES

Genital herpes is a viral infection passed through sexual contact. Most patients have no symptoms but those that do have tiny blisters that open up to lead to painful ulcerations. In some cases, systemic symptoms like swollen lymph nodes, body aches,

and fever can be present. The lesions last four days after getting exposed and the lesions can last up to a month. Recurrences are common but less severe.

The infection is spread through genital contact with an infected person, usually because of sexual behavior. It does not require actual sores in order to spread the disease. There are two types of herpes simplex, which includes HSV-2 and HSV-1. Most are caused by HIV-2 disease but HSV-1 can also cause the disease. The infection is not curable. Figure 15 shows genital herpes infection:

Figure 15.

Most of the lesions in males are on the glans penis, the penile shaft, and on parts of the genitals, including the anus. Women can get the lesions on the vulva, clitoris, mons pubis, perineum, buttocks, or around the anus. It can be burning, itching, or painful with generalized symptoms usually present with the first infection. About 80 percent will get a reinfection from HSV-2 with 50 percent getting a reinfection from HSV-1. HSV-2 infections recur at 4 to 6 times per year with HSV-1 infections recurring once a year.