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Bacterial sexually transmitted infections (such as gonorrhea, syphilis and chlamydia) are passed from person to person during sexual intercourse. Pelvic inflammatory disease is among the complications of bacterial STIs such as chlamydia and gonorrhea.
Considering asymptomatic character of bacterial STIs it is highly recommendable to undergo a yearly medical check-up as medical tests are the only reliable method to detect STDs.
Chlamydia is a very common disease that infects cervix, urethra or rectum and can be contracted through sex contact of any type, from mother to baby during childbirth, by carrying the infected liquid on hands to the eyes (rare). Chlamydia often runs asymptomatically which makes it potentially dangerous especially for women’s fertility.
Gonorrhea is very similar to chlamydia in the way it is transmitted and the way it is treated. Pelvic Inflammatory Disease affects only women and comes as a result of bacteria moving from vagina or cervix to the uterus, fallopian tubes, ovaries, or pelvis. Although PID is successfully treated with antibiotics it is crucial to immediately see the doctor after noticing the symptoms as the harmful consequences to the reproductive system can be irreversible.
What is peculiar about our body is that in some cases it can produce antibodies to the infection which reduce the symptoms or even combat the disease completely. Genital herpes is caused by the same virus that results in cold sores around the mouth and has the same signs in the genitals and rectum area. Human Papillomavirus also known as “warts” is a wide-spread disease with about 100 of types detected. Hepatitis B is a sexually transmitted virus spread through the infected blood, semen and vaginal fluids that causes the inflammation of the liver.
Human Immunodeficiency Virus is a virus that can be transmitted through the infected human liquids, through unprotected sex of any type, through the infected needles for drugs injection as well as the instruments for tattooing and from mother to child.
Parasitic STDs are broken down into 5 types: intestinal parasites, pubic lice, scabies, trichomoniasis and vaginitis.
Trichomoniasis is caused by small parasites that can be transmitted from person to person during sex contact or as a result of the contact with the wet clothes, towels and toilet seats where these parasites dwell. Pubic lice are small insects that live in pubic hair, pass from person to person through direct contact or sharing infected objects. One of the most common fungal infections is yeast infection which is not formally an STD but can be contracted through sex contact although a person having yeast infection doesn’t necessarily has sexual life. It is advisable to see the doctor to be diagnosed and treated correctly if any of these symptoms become noticeable. Vaginal yeast is a common fungal infection that results in yeast growth in woman’s vagina and painful urination, vaginal itching and thick white vaginal discharge. In chronic ecto- and endocervicitis, rather dense subepithelial infiltrates of predominantly lymphocytes and plasma cells are found, often accompanied by proliferating capillaries and fibroblasts. Viral infections of the ecto- and endocervix can cause characteristic morphological changes, by which they can be recognized. Infection with HPV usually starts at the basal or parabasal cells and may initiate here a latent infection that remains morphologically inapparent. A koilocyte is a dyskaryotic epithelial cell with a deformed, often angulated, hyper-chromatic nucleus surrounded by a swollen cytoplasm, which shows a clear perinucle-ar halo and a thickened cytoplasmic membrane (Fig. It is important to note that not all HPV infections result in detectable morphological changes (Fuchs et al.
Chlamydial cervicitis is being observed with increasing frequency (Winkler and Crum 1986) and is now the most common sexually transmitted infection in the Western world (Stamm and Holmes 1984). Histologically, severe nonspecific inflammation is typical, but in some cases chronic follicular endocervicitis is observed (Winkler and Crum 1986). It is important to treat the patients as well as their male partners since chlamydial urethritis may be asymptomatic.
Infection with Candida albicans rarely involves the cervix and is secondary to involvement of vulva and vagina. In cervicitis emphysematosa, subepithelial cysts are found as dilated, empty spaces in the connective tissue without epithelial lining. This reactive benign lesion develops at the site of a recent operation and consists of densely packed proliferating mesenchymal spindle cells, capillaries and inflammatory cells. Zewdi FesahayeWhat causes extensive acute inflammatory cell infiltrate at the base of a lesion? After being detected some STDs can be cured even with one dose of antibiotics but for those that require long treatment it is important to comply with the therapy schedule. Sometimes this disease shows up through unusual discharge from the genitals, painful urination and bleeding during or after the intercourse.
The patients with chlamydia are almost always prescribed to take medications against gonorrhea and vice versa. Sometimes syphilis is difficult to distinguish as it can imitate the course of other diseases but generally it starts with the sore in the area of penis or vagina. PID can develop as the complication of chlamydia and gonorrhea damaging fallopian tubes and tissues in and near the uterus and ovaries and even leading to infertility in serious untreated cases. Viral infections spread by means of altering human cells and making them produce more viral cells. Several of them can persist for the long time and even for the whole life bringing sometimes irreversible damage for health if left untreated. However only medical tests can show whether the virus is losing its impact and it is necessary to abstain from sex until the active treatment prescribed by the doctor is over.
It is spread though contact with the infected parts of skin mainly during the intercourse but in some cases it can be transmitted from mother to a child during giving birth. It passes from person to person though sex contact and especially through skin-to-skin contact with the infected areas.
It often goes with flu-like symptoms such as nausea, tiredness, loss of appetite and muscle pain and is difficult to treat.
It damages the immune system and may lead to AIDS although people with HIV can also live long without developing AIDS. Some parasites can severely damage the host’s health with toxins leading to parasitic infection, while others have no impact on the body at all.


Trichomoniasis and intestinal parasites are easily cured with prescribed anti-parasitic and antibiotic medications. Trichomoniasis is cured effectively with antibiotics but the treatment of both partners is necessary.
Yeast infection leads to overgrowth of the natural yeast in the organism that changes the normal bacteria balance. Thrush, jock itch and balanitis are among the other fungal infections that can be transmitted during sexual intercourse. A cold sore is a blistering wound usually caused by herpes simplex virus type 1, although few occasions may also be caused by the virus herpes simplex type 2, this characteristic herpetic lesion is commonly known by the name of fire.
70-72) is characterized by vascular congestion, edema, and infiltration of inflammatory cells, mainly neutrophilic granulocytes.
Severe subacute and chronic follicular and ulcerative cervicitis may be misdiagnosed as lymphoma when large lymphoid cells, immunoblasts, and mitoses are found.
The accompanying inflammatory infiltrate may be scant (as with HPV infection) or extensive (as with herpes virus infection).
If the infection changes to the productive phase, strong viral gene expression and production of new virus particles are observed in the intermediate and superficial layers of the epithelium, resulting in characteristic morphological changes that are typical for HPV infections (Middleton et al. Intraepithelial vesicles (bullae) may be seen in the ectocervix in patients with generalized pemphigus vulgaris, or as isolated small cysts (see below). 84) almost always develops from an infection descending from tuberculous salpingitis or endometritis. The most sensitive method to assess the presence of Chlamydia is the examination for chlamydial DNA, either by PCR or with the hybrid capture technique.
Distinction from severe subacute or chronic nonspecific cervicitis is virtually impossible on histological grounds alone. 86) is caused by an ascending infection with Trichomonas vaginalis, a flagellated protozoon most easily recognized in a fresh vaginal smear under phase-contrast microscopy (Stoll 1969). Nonspecific acute and subacute purulent cervicitis, follicular (chlamydial) cervicitis, granuloma inguinale, and lymphogranuloma can be distinguished by detecting the causing agent.
87) may result from infectious trauma from an intrauterine device or surgical procedures (Burkman and Damewood 1985).
Inspissated mucus or groups of autolytic, swollen, endocervi-cal epithelial cells arranged in a radial position may have a very similar appearance.
Chlamydia is effectively treated with the antibiotics but abstention from sex is crucial until the treatment is over.
Blood test is a reliable way to detect this disease and the treatment consists of antibiotics course (mainly penicillin-based).
However, orderly treatment can help keeping the virus under control for a consistent period of time and alleviate the symptoms reducing the impact of the disease on everyday life of the patient.
Although herpes symptoms are easy to treat, there’s no cure against the virus and after the outbreak lasting 2–3 weeks the disease comes into a dormant stage with the infected person remaining a potential transmitter.
Warts are highly contagious but even the dormant stage without warps can lead to infecting other person. There’s no cure for Hepatitis B but there’s an effective vaccine which can help prevent this dangerous disease. The symptoms of Hepatitis B and Hepatitis C are very much alike with flu-like signs and jaundice. There’s no medicine or vaccine for HIV but this virus can be controlled by a combination of medications. Parasitic STDs are transmitted from person to person during sexual contacts or non-sexual contacts such as birth or breastfeeding from mother to child, while sharing common objects such as towels, bedding or clothes. Scabies, pubic lice, and certain types of vaginitis can be cured with over-the-counter medical shampoos, lotions and creams. Fungal infections are often triggered by taking antibiotics and birth control pills, using perfumed vaginal washing products or by lack of airflow while wearing tight underwear.
Fungal infections are treated with special creams and lotions that easily fight the disease and reduce the nuisance brought by the symptoms. In popular culture is associated to these lesions with any insect bite or blister caused by any hot object, but what is true, is that this blistering lesion is caused by a virus. In prolonged or severe chronic endocervicitis, lymphoid follicles may develop (follicular endocervicitis, Fig. However, surface ulceration and a polymorphic inflammatory infiltrate with neutrophils and plasma cells are rarely seen in lymphomas, which show instead an extensive, monomorphic infiltrate of lymphoid cells (Fig. Both signs, the atypical degenerating nucleus and the clear, blown-up cytoplasm, are essential features of a true koilocyte.
Samples taken from women between 15 and 50 years of age with normal cytologic smears harbor HR-HPV DNA in about 10% (de Villiers et al.
In the acute stage, the infection can be easily recognized cytologically by the large multinucleated epithelial cells with characteristic intranuclear, ground-glass, viral inclusions (Fig. The tuberculous granulomas can be recognized by aggregates of epitheloid cells and Langhans giant cells surrounded by lymphocytes. They can often be distinguished from tuberculous granulomas by identifying intracytoplasmic inclusions of foreign material in multinucleated giant cells under polarized light. Only in a small number of cases can cytoplasmic inclusions, comprising aggregates of Chlamydia trachomatis organisms,be found in columnar or metaplastic basal cells of smears or sections (Fig. Many of these so-called nonspecific infections actually are unrecognized chlamydial cervicitis, as Paavonen et al. In histological preparations an inflammatory infiltrate is seen, whereby the desquamating epithelial cells reveal nuclear swelling and chromatin clumping. Subacute endocervicitis with intracytoplasmic inclusions of Chlamydia trachomatis in metaplastic epithelial cells.
Rare parasitic infections involving the cervix are: schistosomiasis (endemic in Africa), echinococcosis, and infections with Entamoeba histolytica. Microscopically, a dense inflammatory infiltrate with abscess formation is seen, consisting mainly of neutrophils and histiocytes. Distinction is possible by immunohistochemical detection of Actinomyces organisms (Pine et al.


The nuclei of the glandular epithelial cells are pleomorphic, hyperchromatic and enlarged due to replication of DNA without cell division.
One can contract syphilis during sex of any type with the person infected or as a result of a direct contact with the sore.
There are several ways to treat warts including cryotherapy, laser and electric current treatment but even if the warts no longer occur it is necessary to undergo regular checkups to prevent HPV developing into cancer. The common symptoms of parasitic STDs are reddish irritated and itching skin in the genitals area sometimes with the signs of bites in case of lice or discharge from vagina and penis in case of trichomoniasis. Pregnant women and patients with diabetes are also in the group of risk as well as men ignoring washing under the foreskin. The characteristics of a herpes Labialis are as follows: at the beginning some tingling in the lips, passes the hours area is detected, we can see the appearance of small red dots in the area where the discomfort is felt. Positivity for MIB-1 in parabasal cell layer of squamous epithelium and in lymphocytic infiltrate in stroma. 76), and the overlying columnar epithelium may show polymorphic,hyperchromat-ic, and depolarized nuclei. Infections with LR-HPV types, however, in almost all cases regress spontaneously within several months (Ho et al. An ulcer-ative and necrotizing infection of the cervix may occasionally be caused by Chlamydia trachomatis, or by protozoa, such as Trichomonas vaginalis, or rarely by Entamoeba histolytica.
Most of these inclusions are double refractile under polarized light (such as talcum crystals or suture material). The causative agent, Chlamydia trachomatis, is sexually transmitted and has an affinity for cervical columnar cells or basal (reserve) cells.
Characteristic gram-positive rods arranged in a radial fashion, and located in the center of the abscess, are diagnostic. In the cytoplasm, damage of various organelles and destruction of lysosomal membranes may result in vacuolation.
Infections are generally easy to treat with antibiotics, however bacterial STIs often show no symptoms and are left untreated which can cause serious damage to health of the person infected. Syphilis runs through several stages and when left untreated it can lead to damage and breakdown of various systems of the organism.
These initial lesions begin to fill with liquid in its interior, formed painful blisters until they burst alone and become very painful. With more severe inflammation, the epithelium is destroyed, sloughed off, leading to an erosive or ulcerative ectocervicitis (Fig. When detected in cervical smears, such reactive nuclear changes may be misinterpreted by the screening cytologist and lead to false-positive readings.
For example, clear cells with ballooned cytoplasm and a normal nucleus may be seen after a gestagen-predominant hormonal stimulation, whereby glycogen accumulates in the cytoplasm (Fig.
The percentage of HPV-positive women with normal cytologic smears depends significantly on the women's age. On histological examination, small or larger vesicles may be found within the ectocervical epithelium containing such giant cells with intranuclear viral inclusions (Fig. Since similar granulomatous lesions of other causes may occur here, and some of them are even more common, the diagnosis of tuberculosis has to be verified by the demonstration of acid-fast mycobacteria (tuberculosis), with the Ziehl-Neelsen stain, or a modification of it. Infectious granulomas such as lues, lymphogranuloma venereum, granuloma inguinale, schistosomiasis, and sarcoidosis must be distinguished from tuberculosis by using special stains or bacteriological and immunological methods, since individual morphological features are often lacking. Concomitant infection of other tissues leads to urethritis, endometritis, salpingitis, and proctitis, which are common.
Recognition in vaginal PAP smears is difficult, since many degenerative cytoplasmic inclusions occurring in metaplastic epithelial cells closely resemble the various developmental stages of chlamydial inclusions. Distinction from gonorrhea is possible bacteriologically, from trichomonal infection by vital cytology under phase-contrast microscopy (see below).
Similar cellular changes may be observed in the ectocervical epithelium resulting in postirradiation dysplasia. In general the percentage of younger women with a HR-HPV-positive test result is significantly greater than that of older women (Schiff-man and Kjaer 2003).
The cytoplasmic chlamydial inclusions can best be detected immunohistochemically; the most sensitive method to assess the presence of Chlamydia is the examination for chlamydial DNA, either by polymerase chain reaction (PCR) or with the hybrid capture technique.
These wounds tend to heal themselves, so it is sometimes necessary to do anything to try to heal them, already that we can accidentally spread the virus to another part of our body. Because of these cellular and nuclear alterations, they have to be classified as mild (reversible) dysplasia (CIN i,see p. For a detailed description of the taxonomy and the epidemiological distribution of HPV infection, the reader is referred to de Villiers et al. These vesicles ultimately burst, forming confluent ulcers surrounded by cellular debris and dense inflammatory infiltrates (Figs. The motile protozoa are most readily identified in fresh native smears under phase-contrast microscopy. But we must bear in mind that this lesion can return to appear, usually in the same area in which appeared for the first time, since the virus attacks on average 4 times per year, although depending on our immune system, episodes may be more or less frequent. A degenerative vacuolation of the cytoplasm may occur in other nonspecific inflammatory lesions. Itself, we must take into account what was mentioned, to know what is a cold sore?, since ignorance can do that we can infect us near someone, since we do not know that these wounds are highly contagious, it is for this reason that we must avoid all direct and indirect contact with them. During pregnancy, infection of the fetus or placenta may cause spontaneous abortion (Corey 1984).
Discover how I could remove outbreaks of genital herpes using a very curious method by clicking here. Viral DNA is reproduced in the nuclei of koilocytes, and in the cytoplasm viral particles are accumulated.



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