Infecciones de Transmisión Sexual (ITS)

Epidemiología

• En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 2018, 26 millones de casos nuevos por ITS se diagnosticaron en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum Estados Unidos.
• Grupos de pacientes de alto riesgo:
  • Adolescentes y adultos jóvenes de 15 a 24 años (representaron el 50% de las nuevas ITS en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 2018)
  • Hombres que tienen sexo con hombres (HSH)
  • Minorías raciales y étnicas
• El VHS-2 y la sífilis aumentan el riesgo de infección por el VIH.
• Las ITS pueden tener graves consecuencias reproductivas y efectos adversos para la salud a largo plazo.
• ITS notificables a los LOS Neisseria departamentos de salud estatales:
  • Sífilis
  • Chancroide
  • VIH
  • Gonorrea
  • Clamidia

Etiología

Las infecciones se transmiten principalmente por vía sexual, lo que puede incluir sexo sin protección vaginal, anal u oral.

Bacteriana

• Chancroide ( Haemophilus ducreyi Haemophilus ducreyi A species of Haemophilus that appears to be the pathogen or causative agent of the sexually transmitted disease, chancroid. Haemophilus)
• Clamidia y linfogranuloma venéreo ( Chlamydia trachomatis Chlamydia trachomatis Type species of Chlamydia causing a variety of ocular and urogenital diseases. Chlamydia)
• Gonorrea ( Neisseria gonorrhoeae Neisseria gonorrhoeae A species of gram-negative, aerobic bacteria primarily found in purulent venereal discharges. It is the causative agent of gonorrhea. Neisseria)
• Granuloma inguinal o donovanosis Donovanosis Donovanosis (also known as granuloma inguinale) is an STD caused by Klebsiella granulomatis and is mainly seen in tropical regions. The condition is characterized by chronic, progressive, ulcerating disease mostly affecting the genital region. Donovanosis ( Klebsiella Klebsiella Klebsiella are encapsulated gram-negative, lactose-fermenting bacilli. They form pink colonies on MacConkey agar due to lactose fermentation. The main virulence factor is a polysaccharide capsule. Klebsiella pneumoniae is the most important pathogenic species. Klebsiella granulomatis)
• Mycoplasma genitalium Mycoplasma genitalium A species of gram-negative bacteria originally isolated from urethral specimens of patients with non-gonococcal urethritis. In primates it exists in parasitic association with ciliated epithelial cells in the genital and respiratory tracts. Mycoplasma
• Sífilis ( Treponema pallidum Treponema pallidum The causative agent of venereal and non-venereal syphilis as well as yaws. Treponema)

Viral

• Herpes simple ( virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology del herpes simple, VHS tipos 1 y 2)
• Virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de la hepatitis B Hepatitis B Hepatitis B virus (HBV) is a partially double-stranded DNA virus, which belongs to the Orthohepadnavirus genus and the Hepadnaviridae family. Most individuals with acute HBV infection are asymptomatic or have mild, self-limiting symptoms. Chronic infection can be asymptomatic or create hepatic inflammation, leading to liver cirrhosis and hepatocellular carcinoma (HCC). Hepatitis B Virus:
  • Transmisión sexual
  • Otros modos de transmisión: exposición a sangre/productos sanguíneos, de madre a hijo
• VIH
  • Transmisión sexual
  • Otros modos de transmisión: exposición a sangre/productos sanguíneos, lactancia materna
• VPH
  • La ITS más común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum todo el mundo
  • Verrugas genitales: VPH-6 y 11
  • Lesiones intraepiteliales escamosas anogenitales: asociadas a 15 tipos, siendo el VPH-16 el más común

Parásitos

• Piojos púbicos o ladillas (Phthirus pubis)
• Tricomoniasis ( Trichomonas Trichomonas A genus of parasitic flagellate eukaryotes distinguished by the presence of four anterior flagella, an undulating membrane, and a trailing flagellum. Nitroimidazoles vaginalis)

Presentación Clínica

ITS bacterianas

ITS virales

ITS parasitarias

Diagnóstico

Enfoque diagnóstico

Antecedentes sexuales completos:

• Número de parejas
• Tipos de prácticas sexuales
• Tipos de protección utilizados, si alguno fue usado
• Antecedentes de ITS
• Antecedentes de embarazo
• Historial de vacunación:
  • Hepatitis A Hepatitis A Hepatitis A is caused by the hepatitis A virus (HAV), a nonenveloped virus of the Picornaviridae family with single-stranded RNA. HAV causes an acute, highly contagious hepatitis with unspecific prodromal symptoms such as fever and malaise followed by jaundice and elevated liver transaminases. Hepatitis A Virus/B
  • VPH
• Antecedentes de viajes

Examen físico focalizado:

• Cabeza, ojos, oídos, nariz y garganta (HEENT, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés): examinar la mucosa oral y los LOS Neisseria labios en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum busca de erupciones o úlceras
• Examen abdominopélvico: evaluar si hay sensibilidad abdominal baja o pélvica
• Examen genitourinario:
  • Palpar los LOS Neisseria ganglios linfáticos inguinales en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum busca de nódulos
  • Examen genital para detectar erupciones, úlceras, exudado, verrugas
  • Hombre: examen testicular para evaluar la hinchazón, la sensibilidad

Pruebas específicas

Las muestras para las pruebas se obtienen del lugar o los LOS Neisseria lugares de la infección/lesión, que pueden incluir zonas anogenitales, ganglios linfáticos y zonas orales.

Enfermedad bacteriana:

• Chancroide:
  • Cultivo a partir de úlceras genitales
  • Descartar las etiologías comunes de las úlceras genitales: herpes y sífilis
• Clamidia:
  • Prueba de elección: prueba de amplificación de ácidos nucléicos (NAAT, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) (la PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR) es un método común).
  • El cultivo tiene un uso limitado.
• Gonorrea:
  • Prueba de elección: NAAT
  • Tinción de Gram (microscopía)
  • Cultivos (uretral, vaginal, faríngeo, rectal)
• Granuloma inguinal ( donovanosis Donovanosis Donovanosis (also known as granuloma inguinale) is an STD caused by Klebsiella granulomatis and is mainly seen in tropical regions. The condition is characterized by chronic, progressive, ulcerating disease mostly affecting the genital region. Donovanosis):
  • Muestra de biopsia de tejido
  • La patología mostraría cuerpos de Donovan (cuerpos de inclusión citoplasmáticos de tinción bipolar Bipolar Nervous System: Histology).
• Linfogranuloma venéreo: NAAT
• Mycoplasma genitalium Mycoplasma genitalium A species of gram-negative bacteria originally isolated from urethral specimens of patients with non-gonococcal urethritis. In primates it exists in parasitic association with ciliated epithelial cells in the genital and respiratory tracts. Mycoplasma: NAAT
• Sífilis:
  • Pruebas no treponémicas: reagina plasmática rápida y prueba de enfermedades venéreas de laboratorios de investigación ( VDRL VDRL Treponema, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés)
  • Prueba de confirmación: absorción de anticuerpos treponémicos fluorescentes (FTA-ABS, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés)

Enfermedad viral:

• VHS-1 y 2:
  • Prueba de elección: PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR)
  • Serología
  • Cultivo viral
• VIH:
  • Tamizaje: inmunoensayo que detecta los LOS Neisseria anticuerpos contra el VIH-1 y el VIH-2 y el antígeno p24 del VIH-1
  • Pruebas de confirmación: muestras con inmunoensayo de antígeno/anticuerpo reactivo
  • Infección aguda: carga viral del ARN del VIH
• VPH:
  • Detectado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum una muestra de cuello uterino (como parte del tamizaje de cáncer de cuello uterino)
  • También se comprueba en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la biopsia orofaríngea
• Hepatitis B Hepatitis B Hepatitis B virus (HBV) is a partially double-stranded DNA virus, which belongs to the Orthohepadnavirus genus and the Hepadnaviridae family. Most individuals with acute HBV infection are asymptomatic or have mild, self-limiting symptoms. Chronic infection can be asymptomatic or create hepatic inflammation, leading to liver cirrhosis and hepatocellular carcinoma (HCC). Hepatitis B Virus:
  • Marcadores serológicos (e.g., antígeno de superficie y anticuerpos de la hepatitis B Hepatitis B Hepatitis B virus (HBV) is a partially double-stranded DNA virus, which belongs to the Orthohepadnavirus genus and the Hepadnaviridae family. Most individuals with acute HBV infection are asymptomatic or have mild, self-limiting symptoms. Chronic infection can be asymptomatic or create hepatic inflammation, leading to liver cirrhosis and hepatocellular carcinoma (HCC). Hepatitis B Virus)
  • PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR) (ADN del HBV HBV Hepatitis B virus (HBV) is a partially double-stranded DNA virus, which belongs to the Orthohepadnavirus genus and the Hepadnaviridae family. Hepatitis B virus is transmitted by exposure to infectious blood or body fluids. Examples of types of exposure include sexual intercourse, IV drug use, and childbirth. Hepatitis B Virus)

Enfermedad parasitaria:

• Trichomonas Trichomonas A genus of parasitic flagellate eukaryotes distinguished by the presence of four anterior flagella, an undulating membrane, and a trailing flagellum. Nitroimidazoles vaginalis:
  • La microscopía (montaje húmedo) muestra tricomonas móviles.
  • PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR)
  • Cultivo vaginal
  • Citología cervical
• Pthirus pubis:
  • Demostración de la presencia de piojos o liendres (huevos de piojo) mediante el examen directo o microscópico de los LOS Neisseria tallos del cabello

Tratamiento

ITS bacterianas

ITS virales

ITS parasitarias

Prevención

• Tamizaje de ITS
• Asesoramiento sobre prácticas sexuales seguras:
  • Educar sobre los LOS Neisseria comportamientos que aumentan los LOS Neisseria riesgos de las ITS
  • Medidas preventivas (e.g., uso del preservativo)
  • Importancia de tratar a las parejas
• Vacunación:
  • Hepatitis B Hepatitis B Hepatitis B virus (HBV) is a partially double-stranded DNA virus, which belongs to the Orthohepadnavirus genus and the Hepadnaviridae family. Most individuals with acute HBV infection are asymptomatic or have mild, self-limiting symptoms. Chronic infection can be asymptomatic or create hepatic inflammation, leading to liver cirrhosis and hepatocellular carcinoma (HCC). Hepatitis B Virus
  • VPH
• Profilaxis:
  • Profilaxis antirretroviral de preexposición contra el VIH (PrEP, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés)
  • Profilaxis antirretroviral postexposición contra el VIH (administrada en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum un plazo de 72 horas)
• La terapia supresora del VHS reduce la transmisión de la infección a la pareja no infectada.