STD-Associated Gastrointestinal Infections

Introduction

Introduction to sexually transmitted diseases related gastrointestinal infections Sexually-transient intestinal infection (sexually transmissibleintestinalinfection) refers to a type of gastrointestinal disease caused by bacterial, protozoal and viral infections or opportunistic infections. It mainly includes two aspects: one is the direct transmission of pathogenic microorganisms caused by sexual contact with gastrointestinal infections. On the other hand, after infectious diseases, the body's resistance is reduced, resulting in opportunistic infections of the digestive tract. Diarrhea is one of the main manifestations of AIDS. Sexually transmitted infectious diarrhea is characterized by diarrhea, which can be accompanied by abdominal pain or bloating. Bacterial infections can cause acute onset of fever, nausea, and diarrhea. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of transmission: sexual transmission Complications: diarrhea, malabsorption syndrome, bacteremia

Cause

Sexually transmitted diseases related to gastrointestinal infections

Virus infection factors (85%):

Pathogens causing sexually transmitted diseases include Neisseria gonorrhoeae, Treponema pallidum, HIV (human immunodeficiency virus), hepatitis virus, mycoplasma and chlamydia.

Other infection factors (15%):

Female rectal gonorrhea can be derived from the genitourinary tract, infected by enema or anal thermometer or directly transmitted from the vagina, but most of the rectal gonorrhea is infected by anal sex, syphilis, HIV, hepatitis virus caused by gastrointestinal symptoms mainly secondary In the sexually transmitted diseases themselves, oral and anal contact can spread Salmonella, Shigella, intestinal amebiasis, streptococcus or Campylobacter jejuni, causing digestive symptoms.

Pathogenesis

It is speculated that the possible pathogenesis of AIDS is: when an individual is infected with HIV, in the early stage of infection, the body has an excellent immune response to HIV, high virulence, high expression of HIV clones are inhibited or eliminated, and due to infected cells The number is still small, so there is no significant change in the number of CD4+ T cells, but hidden in lymphocytes, HIV variants and integrated proviruses in mononuclear macrophages are not lurked by immune attack, in the future At the time, after activation of these cells by certain factors, the HIV and provirus that are lurking in the cells begin to transcribe and replicate, and the HIV strains that produce higher virulence are continuously produced, and the above-mentioned mechanism of CD4+ T cell reduction is involved. The rapid reduction and depletion of CD4+ T cells leads to the collapse of the entire immune system and the rapid development of infected individuals into AIDS patients.

Prevention

Sexually transmitted diseases related gastrointestinal infection prevention

Firstly, it should block the blood-borne infection route, strictly prohibit the blood donation of high-risk groups, and strictly prohibit the use of imported freeze-dried plasma human albumin and other blood products, popularize the knowledge of AIDS, prevent its main sexual transmission routes, and actively develop effective AIDS vaccines. It will play an important role in avoiding the spread of AIDS.

Complication

Sexually transmitted diseases related gastrointestinal infection complications Complications, diarrhea, malabsorption syndrome, bacteremia

Esophagitis or esophageal ulcer can cause swallowing pain and post-sternal discomfort. Esophageal ulcer can also produce blood at the same time. Colonitis can cause watery diarrhea. If ulcers are combined, there is a risk of intestinal perforation occurring in the gastrointestinal tract. In bacterial infections, it can cause severe malabsorption and chronic diarrhea, and a small number can induce repeated bacteremia.

Symptom

Sexually transmitted diseases related gastrointestinal infection symptoms Common symptoms swallowing sores herpes abdominal pain watery stool gastrointestinal symptoms nausea mucus diarrhea thin anorexia

Depending on the cause of the disease, sexually transmitted diseases-related gastrointestinal infections have various manifestations.

1. AIDS digestive tract manifestation of diarrhea is one of the main manifestations of AIDS, especially in developing countries and tropical regions, intestinal diarrhea is watery stool, mainly found in the genus Piriformis, Cryptosporidium, etc. In the case of microsporidia infection, the diarrhea caused by Cryptosporidium infection is prone to a chronic process, and the colonic diarrhea is mucus or pus and bloody stool, mainly found in concurrent amoebic, bacillary and giant cells. Viral enteritis, avian branch fungus infection, lesions in the small intestine and rectum, manifested as fever, diarrhea and weight loss; also manifested as Whipple syndrome, more common in men, intermittent diarrhea, feces foamy, volume More, stench, occasional migratory joint pain, purpura, swollen lymph nodes and multiple serositis, anti-tuberculosis drugs and adrenal cortical hormone treatment can alleviate symptoms, intestinal fungal inflammation, frequent diarrhea, stool often green vegetables, Mucus jelly, smear or culture can find fungi, antifungal treatment can temporarily relieve symptoms.

2. Sexually transmitted infectious diarrhea protozoal infections have no specific gastrointestinal symptoms, manifested as diarrhea, may be associated with abdominal pain or bloating; bacterial infections can be acute onset, fever, nausea and diarrhea.

3. Gonorrhea: Most oropharyngeal gonorrhea has no clinical symptoms, only a few cases of sore throat, patients may have suppurative tonsillitis, stomatitis, tongue and buccal mucosal ulcers. There are no specific symptoms of rectal gonorrhea. Some patients have a burning sensation of the rectum, itching of the anus, bloody stools or mucus, and even diarrhea.

4. Syphilis: Oral lesions are most common in the lips, but also in the tongue, oral mucosa and tonsils, which are characterized by painless round ulcer lesions, ie, diarrhea. In addition, the anorectal rectum can also be seen in the lower jaw, after 2 to 4 weeks. The primary lesion can be self-healing. After 3 weeks to 3 months, secondary syphilis can occur. The gastric mucosa can be widely affected. Clinically, abdominal pain can occur, without nausea and vomiting and non-anaesthetic weight loss.

5. Viral infection: common herpes simplex virus, cytomegalovirus and hepatitis virus infection, type I herpes simplex virus mainly affects the oral cavity, manifested as swallowing pain, anorexia and fever, type II herpes simplex virus mainly involves the anus, It is characterized by anorectal pain with secretions, diarrhea or constipation, and sexual activity in contact with the surface of the intestinal mucosa can spread a variety of viruses, including hepatitis virus. Hepatitis A is more common in male homosexuality, type B and type C. Hepatitis can be transmitted through a variety of sexual behaviors.

Examine

Sexually transmitted diseases related gastrointestinal infections

1. HIV pathogen examination.

2. Diagnosis of immunodeficiency test.

3. Pathogenic diagnosis of opportunistic infections.

Clinically suspected sexually transmitted infectious diarrhea should be checked for stool routine, parasites and feces culture. For patients with proctitis, anal secretions or colonoscopy should be taken for gonococcal, herpes simplex virus, mycoplasma or chlamydia isolation and culture, serum The experiment can be used for the diagnosis of syphilis, chlamydia and viral hepatitis.

According to the symptoms of digestive system symptoms and signs, the corresponding endoscopic examination, imaging examination, ultrasound examination and biopsy pathological examination and other experimental diagnostic techniques have practical significance for the diagnosis of the site or nature of the digestive system and the diagnosis of the tumor.

Diagnosis

Diagnosis and identification of sexually transmitted diseases related gastrointestinal infections

Combined with the symptoms and signs of the digestive system, detailed inquiry about sexual behaviors is conducive to clinical judgment and selection of appropriate laboratory tests. The diagnosis of AIDS (acquired immunodeficiency syndrome) should be combined with medical history, physical examination and laboratory data synthesis. analysis.

Differential diagnosis

1. Crohn's disease: This disease may have nausea, vomiting, abdominal pain, diarrhea, especially when the X-ray shows mucosal edema, thickening of the intestinal wall is ileocolitis, should be differentiated from Crohn's disease, peripheral blood Eosinophilia suggests eosinophilic gastroenteritis, fever, pus and bloody stools, fistula in the intestine, presence of stenosis or secondary manifestations of intestinal inflammatory disease (stomatitis, arthritis, etc.) suggesting Crohn's disease (see Inflammatory bowel disease).

2. High eosinophilic syndrome: high eosinophilic syndrome, except for increased eosinophils in the peripheral blood, accompanied by multiple systems and multiple organ involvement, such as heart, brain, kidney, lung and skin, can also be involved In the gastrointestinal tract, a wide range of gastrointestinal eosinophilic infiltration occurs, and the course of the disease is short and the prognosis is poor. Therefore, if there is obvious clinical manifestation of organ involvement other than the gastrointestinal tract, the syndrome should be considered.

3. Radiation enteritis: In addition to ulcers and erosions, the chronic lesions of the rectum, the residual gland hyperplasia, the goblet cells are large and increased, can cause mucus and bloody stools, cancer can occur in the late stage, but rare.

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