Q4MBIO | LESSON 6

• Urinary tract infections (UTIs) include infections of the urethra, bladder, and kidneys, and are common causes of urethritis, cystitis, pyelonephritis, and glomerulonephritis. Bacteria are the most common causes of UTIs, especially in the urethra and bladder.

  BACTERIAL INFECTIONS OF THE URINARY SYSTEM
• • Bacterial infection of the bladder, but it can also occur as a reaction to certain treatments or irritants such as radiation treatment, hygiene sprays, or spermicides.
  • Common symptoms of cystitis include dysuria (urination accompanied by burning, discomfort, or pain), pyuria (pus in the urine), hematuria (blood in the urine), and bladder pain.
  • Is commonly treated with fluoroquinolones, nitrofurantoin, cephalosporins, or a combination of trimethoprim and sulfamethoxazole. Pain medications may provide relief for patients with dysuria.

  Bacterial cystitis
• • an inflammation of the kidney, can be caused by bacteria that have spread from other parts of the urinary tract.
  • Common signs and symptoms include back pain (due to the location of the kidneys), fever, and nausea or vomiting.
  • can be treated with either oral or intravenous antibiotics, including penicillins, cephalosporins, vancomycin, fluoroquinolones, carbapenems, and aminoglycosides.

  Pyelonephritis
• • Occurs when the glomeruli of the nephrons are damaged from inflammation.
  • The most well-characterized mechanism of glomerulonephritis is the post-streptococcal sequelae associated with Streptococcus pyogenes throat and skin infections.
  • Can be treated with Blood pressure medicines, Corticosteroids, Diuretics, Diet changes, Dialysis and Kidney transplant

  Glomerulonephritis
• • can produce fever, headache, chills, vomiting, diarrhea, and rash with severe muscular pain. If the disease continues to progress, infection of the kidney, meninges, or liver may occur and may lead to organ failure or meningitis.
  • Treatment for leptospirosis involves broad-spectrum antibiotics such as penicillin and doxycycline. 

  Leptospirosis
• • refers to inflammation of the urethra that is unrelated to N. gonorrhoeae. A mild disease, but can lead to purulent discharge and dysuria.
  • NGU is most commonly treated using tetracyclines (such as doxycycline) and azithromycin; erythromycin is an alternative option. Tetracyclines and fluoroquinolones are most commonly used to treat Ureaplasma urealyticum.

  Nongonococcal Urethritis (NGU)
• In addition to infections of the urinary tract, bacteria commonly infect the reproductive tract. As with the urinary tract, parts of the reproductive system closest to the external environment are the most likely sites of infection. Often, the same microbes are capable of causing urinary tract and reproductive tract infections.

  BACTERIAL INFECTIONS OF THE REPRODUCTIVE SYSTEM
• • Inflammation of the vagina is called vaginitis, often caused by a bacterial infection. It is also possible to have an imbalance in the normal vaginal microbiota without inflammation called bacterial vaginosis (BV).
  • The major causative agent is Gardnerella vaginalis, a gram-variable to gram-negative pleomorphic bacterium. Other causative agents include anaerobic species such as members of the genera Bacteroides and Fusobacterium.


  Bacterial Vaginitis and Vaginosis
• • Presumptive diagnosis of bacterial vaginosis can involve an assessment of clinical symptoms and evaluation of vaginal fluids using Amsel’s diagnostic criteria which include 3 out of 4 of the following characteristics:
  • white to yellow discharge;
  • a fishy odor, most noticeable when 10% KOH is added;
  • pH greater than 4.5;
  • the presence of clue cells.

  Bacterial Vaginitis and Vaginosis
• • Also known as the clap, gonorrhea is a common sexually transmitted disease of the reproductive system that is especially prevalent in individuals between the ages of 15 and 24.
  • Males may develop pain and burning during urination and discharge from the penis that may be yellow, green, or white. Less commonly, the testicles may become swollen or tender. Women may develop pelvic pain, discharge from the vagina, intermenstrual bleeding (i.e., bleeding not associated with normal menstruation), and pain or irritation associated with urination.

  Gonorrhea
• • It is caused by Neisseria gonorrhoeae, often called gonococcus or GC, which have fimbriae that allow the cells to attach to epithelial cells.
  • Gonorrhea can be cured with the right treatment. CDC recommends a single dose of 500 mg of intramuscular ceftriaxone. Alternative regimens are available when ceftriaxone cannot be used to treat urogenital or rectal gonorrhea

  Gonorrhea
• • Common sexually transmitted infection that can occur in both men and women.
  • Chlamydia trachomatis is the causative agent of the STI chlamydia
  • Major cause of nongonococcal urethritis (NGU) and may also cause epididymitis and orchitis in men. In women, chlamydia infections can cause urethritis, salpingitis, and PID.
  • Can be treated using azithromycin or doxycycline (the recommended regimen from the CDC). Erythromycin, levofloxacin, and ofloxacin are alternatives.

  Chlamydia
• • Common sexually transmitted infection that can occur in both men and women.
  • The recommended treatment for syphilis is parenteral penicillin G (especially long-acting benzathine penicillin, although the exact choice depends on the stage of disease). Other options include tetracycline and doxycycline.

  Syphilis
• • Characterized by soft chancres on the genitals or other areas associated with sexual contact, such as the mouth and anus. Unlike the hard chancres associated with syphilis, soft chancres develop into painful, open sores that may bleed or produce fluid that is highly contagious.
  • Recommended treatments for chancroid include antibiotics such as azithromycin, ciprofloxacin, erythromycin and ceftriaxone. Resistance to ciprofloxacin and erythromycin has been reported.

  Chancroid
• • Caused by the gram-negative rod Haemophilus ducreyi.
  • Symptoms include:
  • Raised and painful bumps on the skin of your genitals.
  • Ulcers with ragged soft edges that develop from these bumps.
  • Reddened and shiny skin on the sores.
  • Leakage of pus and infectious fluid.
  • Spreading and connecting of these sores into larger areas.

  Chancroid
• VIRAL INFECTIONS OF THE REPRODUCTIVE SYSTEM

  Several viruses can cause serious problems for the human reproductive system. Most of these viral infections are incurable, increasing the risk of persistent sexual transmission.
• • Common infection that can cause painful blisters or ulcers.
  • Common condition caused by the herpes simplex virus, an enveloped, double-stranded DNA virus that is classified into two distinct types.
  • Many infected individuals do not develop symptoms, and thus do not realize that they carry the virus. However, in some infected individuals, fever, chills, malaise, swollen lymph nodes, and pain precede the development of fluid-filled vesicles that may be irritating and uncomfortable.

  Genital herpes
• • Are generally transmitted from the mother to the neonate during childbirth, when the child is exposed to pathogens in the birth canal.
  • Some symptoms include:
  • Irritability
  • blisters anywhere on her body
  • trouble breathing
  • Grunting
  • blue appearance (cyanosis)
  • rapid breathing
  • short periods of no breathing
  • Jaundice
  • bleeding easily

  Neonatal Herpes
• • expectant mothers are screened for HSV infection during the first trimester of pregnancy as part of the TORCH panel of prenatal tests (see How Pathogens Cause Disease). Systemic acyclovir treatment is recommended to treat newborns with neonatal herpes.

  Neonatal Herpes
• • Produces epithelial tumors of the skin and mucous membranes.
  • Warts of all types are caused by a variety of strains of human papillomavirus (HPV)
  • Condylomata acuminata, more commonly called genital warts or venereal warts are an extremely prevalent STI caused by certain strains of HPV.
  • Topical medications such as imiquimod (which stimulates the production of interferon), podofilox, or sinecatechins, may be effective. Warts can also be removed using cryotherapy or surgery, but these approaches are less effective for genital warts than for other types of warts.

  Human Papilomas
• Fungal Infections of the Reproductive System

  1. CANDIDIASIS
  2. TRICHOMONIASIS
• • A condition characterized by vaginitis and commonly known as a yeast infection.
  • Immunosuppression can also play a role, and the severe immunosuppression associated with HIV infection often allows Candida to thrive.

  CANDIDIASIS
• • When a yeast infection develops, inflammation occurs along with symptoms of pruritus (itching), a thick white or yellow discharge, and odor.
  • Topical antifungal medications for vaginal candidiasis include butoconazole, miconazole, clotrimazole, tioconazole, and nystatin. Oral treatment with fluconazole can be used. There are often no clear precipitating factors for infection, so prevention is difficult.

  CANDIDIASIS
• • Commonly found in the normal microbiota of the vagina. As with other vaginal pathogens, it can cause vaginitis when there is disruption to the normal microbiota. It is found only as a trophozoite and does not form cysts.
  • Most common nonviral STI and is caused by a flagellated protozoan Trichomonas vaginalis.
  • The recommended treatment for trichomoniasis is oral metronidazole or tinidazole. Sexual partners should be treated as well.

  TRICHOMONIASIS
• • When symptoms do occur, they are characteristic of urethritis. Men experience itching, irritation, discharge from the penis, and burning after urination or ejaculation. Women experience dysuria; itching, burning, redness, and soreness of the genitalia; and vaginal discharge. The infection may also spread to the cervix.

  TRICHOMONIASIS