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Ch. 14 Genitourinary tract infections

Medical Microbiology. Ch. 14 Genitourinary tract infections. Microbial Diseases of the Urinary and Reproductive Systems. Microbes usually enter the urinary system through the urethra Microbes usually enter the reproductive system through the: Vagina (females) or urethra (males).

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Ch. 14 Genitourinary tract infections

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  1. Medical Microbiology Ch. 14 Genitourinary tract infections

  2. Microbial Diseases of the Urinary and Reproductive Systems • Microbes usually enter the urinary system through the urethra • Microbes usually enter the reproductive system through the: • Vagina (females) or urethra (males)

  3. Female Urinary Organs Figure 26.1

  4. Female Reproductive Organs Figure 26.2a

  5. Male Reproductive & Urinary Organs Figure 26.3

  6. Normal Microbiota • Urinary bladder and upper urinary tract sterile • Lactobacilli predominant in the vagina • >1,000 bacteria/ml or 100 coliforms/ml of urine indicates infection

  7. Cystitis • Usually caused by • E. coli • S. saprophyticus • May also be caused by • Proteus • Klebsiella • Enterococcus • Pseudomonas • E. coli usually causes pyelonephritis • Antibiotic-sensitivity tests may be required before treatment

  8. Leptospirosis • Leptospira interrogans • Reservoir: Dogs and rats • Transmitted by skin/mucosal contact from urine-contaminated water • Diagnosis: Isolating bacteria or serological tests Figure 26.4

  9. Sexually Transmitted Diseases (STDs ) • Prevented by condoms • Treated with antibiotics

  10. Gonorrhea • Neisseria gonorrhoeae • Attaches to oral or urogenital mucosa by fimbriae • Females may be asymptomatic; males have painful urination and pus discharge • Treatment with antibiotics • Untreated may result in • Endocarditis • Meningitis • Arthritis • Ophthalmia neonatorum

  11. Gonorrhea Figure 26.7

  12. Nongonococcal Urethritis • Chlamydia trachomatis • May be transmitted to newborn's eyes • Painful urination and watery discharge • Mycoplasma hominis • Ureaplasma urealyticum

  13. Pelvic Inflammatory Disease • N. gonorrhoeae • C. trachomatis • Can block uterine tubes • Chronic abdominal pain

  14. Syphilis • Treponema pallidum • Invades mucosa or through skin breaks Figure 26.10

  15. Syphilis • Direct diagnosis: • Darkfield microscopic identification of bacteria • Staining with fluorescent-labeled, monoclonal antibodies • Indirect, serological diagnosis: • VDRL, RPR, ELISA test for reagin-type antibodies using cardiolipid (Ag) • FTA-ABS tests for anti-treponemal antibodies

  16. Syphilis Figure 3.6b

  17. Syphilis • Primary stage: chancre at site of infection • Secondary: Skin and mucosal rashes • Latent period: No symptoms • Tertiary: Gummas on many organs • Congenital: Neurological damage • Primary & secondary stages treated with penicillin

  18. Lymphogranuloma Venereum (LGV) • Chlamydia trachomatis • Initial lesion on genitals heals • Bacteria spread through lymph causing enlargement of lymph nodes • Treatment: doxycycline

  19. Chancroid (Soft Chancre) • Haemophilus ducreyi • Ulcer on genitalia • May break through surface • Infection of lymph nodes • Treatment: erythromycin and ceftriaxone

  20. Bacterial Vaginosis • Gardnerella vaginalis • Diagnosis by clue cells • Treatment: metronidazole Figure 26.12

  21. Genital Herpes • Herpes simplex virus 2 (Human herpesvirus 2) or HHV 2 • Neonatal herpes transmitted to fetus or newborns • Recurrences from viruses latent in nerves • Suppression: acyclovir or valacyclovir

  22. Genital Warts • Human papillomaviruses • Treatment: Imiquimod to stimulate interferon • HPV 16 causes cervical cancer and cancer of the penis • DNA test to detect cancer-causing strains • Vaccination against HPV strains

  23. Candidiasis • Candida albicans • Grows on mucosa of mouth, intestinal tract, genitourinary tract • NGU in males • Vulvovaginal candidiasis • Diagnosis by microscopic identification and culture of yeast • Treatment: clotrimazole or miconazole

  24. Trichomoniasis • Trichomonas vaginalis • Found in semen or urine of males carriers • Vaginal infection causes irritation and profuse discharge • Diagnosis by microscopic identification of protozoan • Treatment: metronidazole Figure 26.15

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