Abnormal discharge from vagina or penis

Symptoms and indications: Early symptoms include enlargement of lymph glands and spleen, fever, fatigue, bruising and bleeding easily, Thrush-type infections, diarrhoea and weight loss, dermatitis and respiratory illnesses. Later, a person develops further serious infections or cancers.

These include herpes infections, pneumonia, meningitis, serious gastrointestinal disorders (e.g. salmonella infections), Kaposi's sarcoma and non-Hodgkin's lymphoma. A number of illnesses may occur, some of which are particularly associated with Aids and are known as "Aids indicator conditions".

Treatment: The symptoms of Aids-related infections can be alleviated with appropriate drug treatments, if not entirely cured. other drugs, such as dideoxyinosine and zidovudine, may be helpful, and many other preparations are helpful depending on the nature of the symptoms.

Persons most commonly affected: All age groups and both sexes but affected infants acquire the condition at birth from mothers who have Aids.

GONORRHOEA

Symptoms and indications: In Men: Burning pain on passing urine, which is cloudy and may contain pus, thick yellowish-green discharge from the penis (gleet), enlargement of glands in the groin. If untreated, fibrous tissue may form causing narrowing of the urethra and difficulty in passing urine. There may be pains in the joints and other organs, the bladder, testicles and prostate gland may become inflamed and tender.

In Women: Women may have fewer symptoms than men and these include yellowish-green vaginal discharge (gleet), burning pain on passing urine, which may contain pus. Also the Bartholin's glands (which are sited near the opening of the vagina) often become ulcerated and inflamed. If untreated, the infection and inflammation spreads to the main reproductive organs, the womb, Fallopian tubes and ovaries. The damage is likely to cause infertility and other long-term problems, and occasionally, life threatening peritonitis from an infected Fallopian tube. A person showing any symptoms of gonorrhoea or who has cause for concern should consult a doctor immediately.

Treatment: The patient is usually referred to a hospital clinic specializing in venereal diseases, and diagnosis is confirmed by examination of a sample of the discharge. Treatment is usually very effective through the taking of penicillin, sulphonamides or tetracycline, and can be cured within one or two weeks. The person may need checks for a few more weeks to make sure that the infection has totally cleared. During the course of treatment, the person should refrain from sexual activity, be scrupulous in personal hygiene and not share towels etc. The person should wash the hands frequently and especially avoid rubbing or touching the eyes. Sexual partners should be informed.

Persons most commonly affected: Young adults of both sexes but can affect any age group.

NON-SPECIFIC URETHRITIS (NSU)

Symptoms and indications: Men: Discomfort and pain in the urethra, mild pain on urination, increased frequency of urination and slight or more profuse discharge. The urethra is red and inflamed. Symptoms vary from mild to more severe.

Women: There may be few or no symptoms but, if they do occur, include pain on urination, frequency of urination and pain in the pelvic region. Also vaginal discharge, which may be yellowish and thick, and pain during sexual intercourse.

Treatment: Diagnosis requires bacteriological examination of urethral sample or urine to exclude other causes of infection, such as Gonorrhoea. Treatment is by means of antibiotics including tetracycline, doxycycline or erythromycin, usually for one week, but longer if infection persists or if complications arise. Patients should refrain from sexual intercourse and are usually given a follow-up examination to ensure that the infection has cleared.

Persons most commonly affected: Sexually active adults of both sexes.

VAGINITIS

Symptoms and indications: Symptoms include vaginal discharge that may be thick, discoloured (yellow or greenish) or white and can be foul-smelling. Also, itching of the skin or burning in the region of the vulva, reddening, discomfort and pain. The symptoms may vary in severity, depending upon the cause of the condition. A person with symptoms of vaginitis should seek medical advice.

Treatment: Depends upon the cause, which is established by means of a physical examination and discussion, and may involve obtaining a swab so that infective organisms can be cultured. Treatment for inflammation without infection may be by means of soothing creams or anti-inflammatory preparations such as hydrocortisone. Bacterial infections are treated with appropriate antibiotics such as doxycycline erythromycin and metronidazole, which is also used for infections caused by the parasite Trichomonas. If the cause is Candida, treatment is by means of miconazole or clotrimazole. In older, postmenopausal women, in whom the vaginitis may be atrophic (due to the thinning of tissues, with or without infection) the treatment is usually hormone replacement therapy with oestrogen. The condition can usually be successfully treated.

Persons most commonly affected: Females of all age groups, depending on cause.