Transcript Genitourinary

Chapter 24
Infections of the Genitourinary
System
© 2004 Wadsworth – Thomson Learning
The Genitourinary System
Figure 24.1
© 2004 Wadsworth – Thomson Learning
Urinary Tract Infections
• Urinary tract infection (UTI)
– any or all parts of urinary tract
– Cystitis: common bladder inflammation
• E. coli--most common
– Urethritis: urethra
• many organisms
– Pyelonephritis: kidneys
• E. coli 75%
© 2004 Wadsworth – Thomson Learning
Leptospirosis
• Leptospira interrogans
– spirochete
• kidney or liver disease
– Weil’s syndrome
• animals to humans
– urine contaminated water
– entrance
• mucous membrane
• break in skin
• difficult to diagnose
– small cells
– special media for culturing
© 2004 Wadsworth – Thomson Learning
Sexually Transmissible Diseases
• Increase in STDs
– antibiotic
resistance
– newly
recognized
pathogens
– multiple sexual
partners
Two sexual partners
per month
Three sexual
partners per month
Figure 24.3
© 2004 Wadsworth – Thomson Learning
Gonorrhea
• N. gonorrhoeae
–
–
–
–
sexually transmitted disease: urethra
300,000 cases/60% age 15-24
males--80% symptoms: urination/discharge
females--asymptomatic
• leads to pelvic inflammatory disease
– potential for systemic infection
• gonorrheal endocarditis
• gonorrheal meningitis
• gonorrheal arthritis
– infants: ophthalmia neonatorum
© 2004 Wadsworth – Thomson Learning
Syphilis
• Treponema pallidum
– spirochete
• Primary stage: several weeks
– hard based chancre
– infectious serous exudate
• Secondary stage: 6-8 weeks
– skin rash
– loss of hair
– malaise, mild fever
• Latent period
• Tertiary phase: years later
Figure 24.5
– untreated cases
– T-cell immunity--gummus (rubbery mass)
© 2004 Wadsworth – Thomson Learning
Chlamydia
• Chlamydia trachomatis
– coinfection with N. gonorrhoeae
– most prevalent STD
– many cases go untreated
• leading cause
– infertility
– ectopic pregnancy
• transmit to infant at birth
– neonatal eye infection
© 2004 Wadsworth – Thomson Learning
Other STDs
• Lymphogranuloma venereum (LGV)
– Chlamydia trachomatis
• invasive strain
• infects lymphoid tissue
• tropical regions
• Chancroid
– Haemophilus ducreyi
• tropical areas
– Africa, Asia, Latin American
– becoming more common in US
– linked to crack cocaine epidemic
• ulcer on genitals
© 2004 Wadsworth – Thomson Learning
Other STDs
• Nongonococcal urethritis
– inflammation of urethra
• other than N. gonorrhoeae
• Granuloma Inguinale
– Calymmatobacterium granulomatis
• not highly communicable
• raised lesions
• open draining ulcers
© 2004 Wadsworth – Thomson Learning
Viral STDs
• Genital herpes
– Herpes simplex virus
– HSV-2: normally genital tract
– HSV-1: normally mouth and face
• cold sores, fever blisters
– latency
• moves from nerve ending to nerve ganglion
• reactivates to epithelial tissue
– Neonatal herpes
• brain and internal organs
• lifelong disabilities
– No cure--treatment with acyclovir
© 2004 Wadsworth – Thomson Learning
Viral STDs
• Genital warts
• Papilloma virus
– Over 65 types--based on DNA
• Diseases
– benign wart
– cervical carcinoma
• Replication
– proliferation of cells
– basal layer of epithelium
• no progeny virus in these cells
– cells differentiate
• virus replicates in later cells--shed from surface
© 2004 Wadsworth – Thomson Learning
Female reproductive tract
• Vaginitis
– vaginal secretion
– Gardnerella vaginalis
• decrease in lactobacilli
• increase in pH
• fishy-smelling discharge
– diagnosis
• vaginal wet mount
• Gram stain
– absence of other bacteria
© 2004 Wadsworth – Thomson Learning
Female reproductive tract
• Toxic Shock Syndrome
– strains of Staphylococcus aureus
• produce toxin
• toxic shock syndrome-associated toxin (TSST)
• bacteria reproduce
– tampons
• enters bloodstream causing symptoms
© 2004 Wadsworth – Thomson Learning
Female reproductive tract
• Pelvic inflammatory disease
– infection beyond vagina
• uterus
• fallopian tubes
• ovaries
– increased risk if not treated
• infertility
• ectopic pregnancy
© 2004 Wadsworth – Thomson Learning
Female reproductive tract
• Candidiasis
– Candida albicans
• yeast infection
– thick white vaginal discharge
– severe vaginal itching
– predisposition
• changes in hormone levels
• broad-spectrum antibiotic therapy
– alter normal microbiota
– treatment
• nystatin or terconazole
© 2004 Wadsworth – Thomson Learning
Female reproductive tract
• Trichomoniasis
– Trichomonas vaginalis
– flagellate protozoan
• copious vaginal discharge
• estimated 25% women in US
– diagnosis
• microscopic analysis of
vaginal discharge
Figure 24.15
© 2004 Wadsworth – Thomson Learning
Infections of newborns
• Listeriosis
– Listeria moncytogenes
– infect placenta or during
birth
– meningitis
– septicemia
– endocarditis
• Group B streptococcal
infection
–
–
–
–
–
Streptococcus agalactiae
transmitted during birth
pneumonia
meningitis
sepsis
© 2004 Wadsworth – Thomson Learning
Infections of newborns
• Cytomegalic Inclusion Disease
– Cytomegalovirus
• herpesvirus family
– Transmission
• close contact, saliva, blood
– Symptoms
• healthy children and adults
– asymptomatic or brief mononucleosislike illness
• prenatal infections
– spontaneous abortion, stillbirth, severe birth defects
© 2004 Wadsworth – Thomson Learning