STDs in the elderly...

  1. Good morning to you all...
    I apologize in advance, I worked a 12 hr night and I'm sleepy, so forgive any lapses in logic here...

    I had an admission last night. 89 y/o F with h/o Parkinson's disease, admitted for an acute MI and SVT.
    She was a great admission, sweet as pie! Took her to the bathroom and noticed bright blood in the toilet.
    I told her what I saw and she agreed to have me examine her further to identify the source of bleeding.
    She denies scratching, pain, irritation, etc. No hemorrhoids. Alert and oriented x3.
    I found a small, non-painful bleeding ulcer (about the size of a grain of rice?) on her labia..
    looking at the whole picture, it looked like she had others which had healed. She denied tenderness
    or pain while I was cleaning the area. She also denied knowledge of anything unusual going on down there..

    I did order an ET consult, and I communicated this info to the docs... I hope they care enough to check it out or at least ask her PCP to run an STI panel... anyway...

    What do you guys think it could have been? my guesses were HSV and syphilis... except I would expect HSV to cause some type of discomfort... also, she denies being "with" anyone since her husband died over 10 yrs ago, and I doubt late stage or latent syphilis would cause ulcerations... but the parkinsonian neuromuscular issues and the heart disease do fit... or maybe i'm just making connections that aren't there because I'm so amazingly sleepy :-P

    My overactive brain has been pondering this all night...

    Any of you see STI/STDs in your elderly population? This is the first time I've seen this, although I know it's been a pressing issue for the elderly population as of late.

    Thanks. Sorry for the odd topic.

    G'night to the nightshift folk!
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    About acuariaRN

    Joined: Dec '06; Posts: 20; Likes: 14
    staff nurse; from US
    Specialty: Emergency

    10 Comments

  3. by   FireStarterRN
    She could have been exposed to herpes and have it be latent, not knowing that she had it. They say it's very common. It would manifest when ones immunity is compromised, in a time of illness or run down condition.
  4. by   iamablonde1970
    yes, I agree with FireStarterRN, AND STD's are alot more common with the elderly population than many people realize.

    Goodnight Night Shift folks!
  5. by   ktwlpn
    It could also be a cancer-squamos cell ca. of the vulva...
  6. by   pagandeva2000
    Herpes can lay dormant for a long, long time. Some people have very few outbreaks, others are less fortunate and have more. And, yes, for sure, if the body's immune system is down, or under stress, an outbreak can occur. I have not known the herpes leisions to bleed that badly (or at all, actually).

    STDs are alive and well with the elderly. I remember years ago, working as a phlebotomist, coming across patients as old as 70 discovering for the first time that they had the HIV virus. That blew my mind. Many people feel after menopause that because pregnancy is not an issue, are more free to indulge in sexual expression, don't worry about barrier methods of protection as often. Naively, they believe that STDs are for the younger generations, and I also suspect that they also believe that older lovers are less likely to have multiple partners. My theory is that with medications like Viagra/Cialis, many of the elder men have revived their sex lives, thus expose themselves to this the same as the younger folks.
  7. by   mustlovepoodles
    I worked for a short time in a family practice office. We lived in Florida, near a resort town. Every day we treated several over-60s for STDs, mostly gonorhea, HPV, herpes, and genital warts. These folks must have been doing the dirty night and day! And we had frequent flyers! I was always professional, even with the ones who laughed and joked about their STDs like it was a badge of honor. I just wanted to scream," Come on, folks. Walgreens still sells condoms!"
  8. by   Nursebarebari
    In december of last year, one more form was added to our admission forms. It was for hiv testiing, we were to ask and convince all pt on adm. who are a & o x 3 for HIV testing. After we interview the pt and fill out the form, we pass it on to the doctor to get the consent. My first pt was a 81 year old male, his result came out positive HIV. He was so mad and in denial that he signed AMA the next day and left.
    So yes, as others stated, STDs are very common in the elderly.
  9. by   mochabean
    There was a 70 yo old patient who had HIV. I was blown away. I had always heard about elderly people, esp. elderly women, get STDs. It didn't hit me until I saw it for myself.
  10. by   lpnflorida
    I remember reading in our local paper, the highest cases of STD's were occuring in a well known retirement community in Central Florida.

    Rather makes me want to take up knitting when I retire. lol
  11. by   diane227
    The first case I saw was an 86 year old guy who came in with the drip. He wandered in in his plaid shirt and overalls. Doctor took a look at him and sure enough he had a clap. So the doctor started talking to him, trying to determine his number of partners to give the health department some idea of how many people they would need to follow up on. THERE WERE SO MANY, HE COULD NOT REMEMBER. He did have an 18 year old girlfriend at the time. The doctor, who was a resident in training at the time came out of the exam room and was so mad. "Here's this 86 year old guy with so many girlfriends he can't remember them and I can't even get one date!".
  12. by   barefootlady
    STD's are not common in the older population here, but younger people taking advantage of the elderly for their retirement money is growing everyday, so I expect that to change soon. Shameful.

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