Transcript Infection of the genital tract

Infection of the genital tract
Done by:
Tasneem abue tailakh
Safaa alijla
Infection of the genital tract
- Bacterial
- Viruses
- Fungi
- parasite
Bacterial
Syphilis
Syphilis is a sexually transmitted disease caused
by the spirochetal bacteria treponema
pallidum subspecies pallidum.
The primary route of transmission of syphilis is
through sexual contact however it may also
be transmitted from mother to fetus during
pregnancy or at birth resulting in conginetal
syphilis.
The signs and symptomes of syphilis vary
depending on which of the four stages it presents
in (primary, secondary, latent, and tertiary).
- The primary stage typically presents with a single
chancre0
- secondary syphilis with a diffuse rash
- latent with little to no symptoms0
- tertiary with gumms, neurological, or cardiac
symptoms.
Treponema pallidum
Treponema pallidum is a species of spirochaete
bacterium with subspecies that cause
treponemal diseases such as syphylis.
It is not seen on a gram stain smear because the
organism has a waxy coat around it that does
not accept the Gram stain.
Chancroid
Chancroid, or soft chancre, is a sexually transmitted disease
caused by Haemophilus ducreyi, a gram-negative bacillus.
It is relatively uncommon in the United States, but is the most
common cause of genital ulcers in Africa.
The incubation period is 3 to 7 days. The lesion begins as a soft,
red papule. Within 1 to 2 days, it becomes pustular, eroded,
and ulcerated.
The ulcer is usually 1 to 2 cm in diameter, painful, and covered
by a yellowish or gray exudates; it bleeds easily when
scraped. The edges of the ulcer are ragged and undermined.
Chancroid
Chancroid does not have a vesicular stage. In males the ulcer is
typically located on the distal penis, but may occasionally
occur in the urethra and anal orifice.
In females, the lesions tend to be localized to the vulva but
can also occur in the vaginal, perianal area, and cervix.
Painful inguinal lymphadenopathy and over-riding erythema is
associated with chancroid in nearly half of all cases in males,
less often in female cases.
The lymph nodes become fluctuant, can spontaneously rupture,
and drain pus. Systemic symptoms can occur but are rare.
Chancroid
Lesion is located in the anogenital area
Lesion is a painful ulcer without eschar
Lesion lacks vesicular stage
Lymphogranuloma Venereum
Lymphogranuloma venereum (LV) is a sexually
transmitted disease caused by chlamydia
organisms.
LV is found most frequently in the tropical and
subtropical parts of the world.
The incubation period ranges from 3 to 12 days.
The primary lesion is a 5- to 8-mm, soft, red,
painless erosion or ulcer.
The ulcer heals spontaneously in a few days. The
secondary stage begins 2 to 6 weeks later and is
characterized by the appearance of tender, inguinal
adenopathy, which develops with overriding erythema and edema.
The lymph nodes coalesce, may fluctuate, and drain
spontaneously. Associated fever, chills, and malaise can
be severe.
The late stage of LV is characterized by anogenital
strictures in untreated or under-treated cases.
Granuloma Inguinale
Granuloma inguinale is a chronic bacterial infection of the
genital region, generally regarded to be sexually
transmitted.
Granuloma inguinale is a relatively rare disease occurring
in people living in tropical and subtropical areas.
It occurs more frequently in males.
In the United States, while homosexuals are at greater
risk, it is relatively rare in heterosexual partners of
those infected.
Granuloma Inguinale
Urethral discharge in males
Discharge from the male urethra has many
causes, but when an adult seeks medical
assistance , the cause is often urethritis
caused by a sexually transmitted infection .
Purulent discharge from the urethra may be
caused by either C.tracomatis (serotypes A-K)
or N.gonorrhoeae .
Although N.gonorrhoeae typically causes a more
obviously purulent discharge ,there is overlap
in the clinical presentation and a high
proportion of dual infection .
The patient may have dysuria but some patients
have urethritis without a clinically evident
discharge .
Vaginal discharge
Bacterial vaginosis :
In bacteria , there is a thin discharge with a
distinctive odour , which the patient may well
notice .
The condition is caused by a distutbance in vaginal
flora that results in in an over growth of
commensal anaerobic , the metabolic products
the metabolic products of these include volatile
amines , hence the smell.
Species including Gardnerella vaginitis and
Mobiluncus sp.
have been implicated as possible causes of
condition ,but isolation of the organisms does
not help in the clinical management of
individual patient.
cervicitis
Inflammation of the uterine cervix is usually caused by
sexually transmitted infection with either
N.gonorroeae or C.tracomatis .
Cervicitis is the female counterpart of urethritis in adult
males .
Unfortunately , it is not so easily noticed and a large
proportion of cases go undiagnosed .
The consequence of undiagnosed cervicitis is ascending
infection of female genital tract , endometritis ,
salpingitis tubo-ovarian abscess or disseminated
gonococcal infection (DGI) .
The most important non-infective sequelae include
infertility or , if the fallopian tubes remain patent, an
increased risk of tubal pregnancy .
Pelvic infgammatory diseases
PID is a term used to refer to infection of the female
pelvic organs ,it is usually sexually transmitted .
Infection of the fallopian tubes , the adjasent structures
Douglas usually and abscesses in the pouch of
occur as a result of assending sexually transmitted
infection from the lower genetal tract .
N.gonorreae and C.tracomatis are prominent causes of
PID .
However, many cases are polymicrobial and feature
other species such as anaerobic bacteria ,Sreptococci
,Mycoplasma and Ureplasma spp.
Intrauterine infection
Infections of the uterus are uncommon and
arise in several specific setting .
Endometritis may occure as a consequence of
ascending infection with N.gonorreae or C.
tracomatis but is rarly diagnosed as adistinct
entity.
Infection may arise postpartum or
postabortion , when bacteria from
the vaginal flora gain access and
establish an acute endometritis .
This process is assisted by the
presence of retained products of
conception .
Postpartum ,the patient will have offensive
lochia and fever .
This was often caused by Streptococcus pyogen
, but anaerobic and other bacteria may also
be implicated .
Extension of infection into the myometrium
and spread via the bloodsream may develop
rapidly.
Pelvic actinomycosis
Amore insidious intrauterin infection is
pelvic actinomycosis , caused by the
bacterium Actinomyces isra .
Infection occurs more commonly in women
with IUDs .
These patient may have any of the features
of cervical or uterine infection .
The majority of patients who come to
medical attention have have had
actinomyces – like organism noted in
cervical smear .
In most cases , these are commensal
organisms and don’t signify active
infection .
Management by removal of IUD ,but
penicilline treatment is advised .
Epididymitis
Is an infection of the epidydimis caused by
avariety of bacterial species .
In men under the age of 35 years most cases
of epididymitis are caused by ascending
sexually transmitted infection usually with :
N . Gonorreae or C.tracomatis
In older men , infection is more often caused
by enterobacteriaceas , Staph and
Cornebacteria spp
The epididymis is tender to palpation and
ther e may be local pain .
If the infectin has arisen from ascending
,sexually transmitted infection there may
be clinical picture of urethritis .
The condition may be difficlt to
distinguish from testiculer
torsion , in which case cergical
removal is required .
Thank you
Safaa Khalil
Organisms infect the genital tract
Abnormal vaginal discharge
watery discharge
white discharge
thick white chunky discharge
(like cottage cheese)
swelling of the vulvar skin
pain with intercourse
painful urination
redness of the vulva
vaginal and labial itching, burning.
These infections are more common after taking an antibiotic.
Fungal
Candida albicans
Tests
A history and physical exam will be performed
A KOH smear identifies the Candida organism.
Treatment
Treatment inlcudes over-the-counter vaginal creams such as
miconazole
clotrimazole
butoconazole
terconazole
. Prescription pills such as fluconazole
vaginal suppositories, and creams are also available.
is a common sexually transmitted disease
that affects both men and women
Features of it include pain, itching and
Painful blisters in genital area.
Systemic symptom including fever &
myalgia
Genital herpes
Herpes simplex virus
1&2
Tests
A history and physical exam will be performed.
direct fluorescent antibody (DFA) test can be done to
establish the diagnosis Culture of a genital lesion may be
done.
Treatment
Treatment includes suppression with medical therapy
(acyclovir, famciclovir)
pain medications acetaminophen
nonsteroidal anti-inflammatory medications/NSAIDs
(ibuprofen/Motrin or Advil, naproxen/Naprosyn).
The most common sexually transmitted disease
There are many types that can infect the genital areas of
males and females, and some can also infect the mouth and
throat
Unfortunately most people do not know they are infected
with the it since the initial symptoms can be minor. In
90% of people the …. is cleared from the body without any
treatment.
appear as a small bump or groups of bumps in the
genital area.
They can be small or large, raised or flat, or shaped like
a cauliflower.
They appear within weeks or months after sexual
contact with an infected partner.
.
Cervical cancer usually does not have symptoms until it
is advanced and difficult to treat.
Symptoms of advanced cervical cancer include vaginal
pain, abnormal vaginal intercourse, painful
intercourse, and vaginal fullness
(VIN)
penile intraepithelial neoplasia (PIN)
and/or
anal intraepithelial neoplasia (AIN).
Genital warts
HPV
Tests
A history and physical exam will be done.
HPV is diagnosed by the appearance of the genital warts or through a
PAP smear for women.
Treatment
There is no treatment for the virus itself, but there are treatments for
the problems that HPV can cause.
Most genital warts will go away on their own. Healthcare providers
can provide medication or remove the warts directly.
There is a vaccine against HPV which can help prevent
acquiring the disease.
Condoms during sexual intercourse are also
recommended to protect against HPV and other
sexually transmitted diseases (STDs).
Diarrhea
fatigue
fever
frequent vaginal yeast infections
headache
mouth sores
including candidal infection
muscular stiffness or aching rash of various types
including seborrheic dermatitis
sore throat
swollen lymph glands
Other symptoms may occur when a patient becomes infected with other
bacteria or fungi
Infection is a life threatening disease
The condition gradually destroys the immune system,
preventing the body from fighting off infections.
Most patients die of an overwhelming infection.
There is no cure or vaccine but special anti-viral
medications can keep the virus under control.
The HIV ELISA/Western blot test is used to detect
antibodies to the HIV virus.
It is often spread through sexual contact.
Men can become infected as well.
Both sexual partners need to be treated to
eradicate the infection.
.
Women
painful sexual intercourse, vaginal itching, vaginal
discharge (greenish-yellow, frothy or foamy),
foul smelling discharge, labial swelling, itching
of the inner thighs.
Men
burning after urination, burning after
ejaculation, itching of urethra, slight
discharge from urethra.
Trichomoniasis
Trichomonas vaginalis
A history and physical exam will be performed
A wet prep of the vaginal secretions is done revealing
the organisms.
Treatment
(metronidazole/Flagyl)
and the treatment of all sexual partners to prevent
recurrence.
One must avoid alcohol while taking metronidazole to
prevent severe nausea and vomiting.
Intense itching that is worse at night
Thin pencil mark lines (burrows) that appear between
fingers, in arm pits, at the waist, on inner elbows, on
bottom of feet, around wrists, on buttocks, on
shoulders, on knees, and around breasts
A contagious skin disease caused by a
small mite called
Sarcoptes scabiei
The infection can be easily spread through close contact
amongst families, schools, child care centers or
nursing homes.
Tests
A history and physical exam will be performed.
The diagnosis may be made by the appearance of the rash
Treatment
involves using a prescription medicated cream.
The two most common are permethrin and crotamiton
Almost anyone with it will have itching in the area
covered by pubic hair (often gets worse at night).
This itching may start soon after getting infected with
it, or it may not start for up to 2 to 4 weeks after
contact.
Other symptoms:
Skin reaction that is bluish-gray in color
Sores (lesions) in the genital area due to bites and
scratching
Pthirus pubis
Tratment
is with malathion or an alternative insecticide
Thanks