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© 2004 Wadsworth – Thomson Learning
Chapter 24Chapter 24Infections of the Genitourinary Infections of the Genitourinary
SystemSystem
© 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– untreated cases
– T-cell immunity--gummus (rubbery mass)
Figure 24.5
© 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