Infections of the Urinary and Reproductive Systems

What are the components of the urinary system?

Kidneys, ureters, urinary bladder, and urethra.

What mechanisms help prevent urinary tract infections?

Valves that prevent backflow to kidneys, acidity of urine, and mechanical flushing.

What is cystitis?

An inflammation of the urinary bladder. (more common in women)

What is urethritis?

An inflammation of the urethra.

What is pyelonephritis?

An inflammation of one or both kidneys.

What is the most common causative agent of urinary tract infections?

Escherichia coli.

Symptoms of pyelonephritis

fever, back or flank pain (generally results in bacteremia)

Treatment of pyelonephritis

cephalosporin

causative agents of cystitis

E. coli and S. saprophyticus

What are the symptoms of cystitis?

Dysuria (painful urination) and pyuria (pus in urine).

How is pyelonephritis diagnosed?

>100,000 CFUs/ml of a single species and a positive leukocyte esterase test.

What is leptospirosis and its causative agent?

caused by Leptospira interrogans, a spirochete; obligate aerobe

What are the symptoms of leptospirosis?

Headaches, muscular aches, fever, kidney failure (Weil's disease), and pulmonary hemorrhagic syndrome.

what are the reservoirs for leptospirosis

dogs, cats, and rats

how is leptospirosis transmitted

skin/mucosal contact from urine contaminated water from domestic or wild animals

What is the treatment for leptospirosis?

Doxycycline.

how is leptospirosis diagnosed

serological test

what is predominant in the vagina and what does it produce

lactobacilli produce H2O2 and lactic acid

What are sexually transmitted infections (STIs)?

Infections that often have no signs or symptoms and include over 30 types. (between 15-24 year olds)

How can STIs be prevented?

condoms

What are the pros of at-home testing for STIs?

More cases diagnosed, better access for patients, and quicker treatment.

What are the cons of at-home testing for STIs?

Cost, privacy concerns, and concerns about accuracy.

What is the causative agent of gonorrhea?

Neisseria gonorrhoeae, a gram-negative diplococcus.

What are the symptoms of gonorrhea in men?

Painful urination and discharge of pus; may also cause epididymitis.

What are the symptoms of gonorrhea in women?

Fewer symptoms; may lead to pelvic inflammatory disease.

if gonorrhea is left untreated it may

disseminate and become systemic endocarditis, meningitis, arthritis

ophthalmia neonatorum

infant blindness due to a gonorrheal infection of the eyes

What is the diagnosis method for gonorrhea?

Gram stain, ELISA, or PCR.

What is the treatment for gonorrhea?

Cephalosporins, such as ceftriaxone and azithromycin.

What is nongonococcal urethritis (NGU)?

An infection caused by Chlamydia trachomatis, Mycoplasma hominis, or Ureaplasma urealyticum.

symptoms of Nongonoccal urethritis

painful urination and watery discharge; (women =possible complications, PID)

diagnosis of Nongonoccal urethritis

culture, PCR

treatment for Nongonoccal urethritis

doxycycline and azithromycin

causative agent of Pelvic inflammatory disease (PID)

Polymicrobic; usually N. gonorrhoeae and C. trachnomatis

What are the symptoms of pelvic inflammatory disease (PID)?

Chronic abdominal pain and potential infertility due to scarring.

salpingitis

infection of uterine tubes; scarring an cause infertility or ectopic pregnancy

treatment for Pelvic inflammatory disease

doxycycline and cefoxitin

What is the causative agent of syphilis?

Treponema pallidum, a gram-negative spirochete.

transmission of syphilis

invades the mucosa or through skin breaks and enters the bloodstream; induces inflammatory response

yaws

skin disease that is not sexually transmitted

What occurs during the primary stage of syphilis?

A painless chancre appears at the site of infection about 3 weeks after exposure

What are the symptoms of secondary syphilis?

Skin and mucosal rashes, especially on the palms and soles; due to inflammatory responses

latent period of syphilis

has no symptoms

What is the tertiary stage of syphilis?

Symptoms appear years after latency, including gummatous syphilis, cardiovascular syphilis, and neurosyphilis

Congenital Spyhilis

neurological damage to the fetus

What is the treatment for syphilis?

Benzathine penicillin.

What is lymphogranuloma venereum (LGV)?

An infection caused by Chlamydia trachomatis, characterized by swelling in lymph nodes.

symptoms of lymphogranuloma venereum

initial lesion on genitals heals, bacteria spread through lymph, swelling in lymph nodes in groin

diagnosis of lymphogranuloma venereum

microscopic identification and culture

treatment for lymphogranuloma venereum

doxycycline

What is genital herpes and its causative agent?

caused by herpes simplex virus type 2 (HSV-2).

What are the symptoms of genital herpes?

Painful vesicles on the genitals and painful urination. (heals within 2 weeks)

What is the treatment for genital herpes?

no cure; uses Acyclovir, famciclovir, and valacyclovir for management/suppression

What causes genital warts?

Human papillomaviruses (HPV), particularly serotypes 6 and 11.

diagnosis of genital warts

via culture or PCR

what serotypes of genital warts cause visible warts

serotypes 6 and 11

what serotypes of genital warts cause cervical cancer

serotypes 16 and 18 (kills 4,000 women annually in US)

treatment for genital warts

removal of warts; podofilox and imiquimod

prevention of genital warts

quadrivalent or nine-valent HPV vaccines

What is candidiasis?

An overgrowth of Candida albicans, causing yeasty discharge and vaginitis.

where does candidiasis grow

on the mucosa of the mouth, the intestinal tract, and the genitourinary tract

oral candidiasis

thrush; white patches or plaques on the tongue & other oral mucous membranes

vulvovaginal candidiasis

vaginitis. yeasty, thick, yellow discharge

treatment for candidiasis

clotrimazole or fluconazole

What is Trichomoniasis and its causative agent?

caused by Trichomonas vaginalis, leading to irritation and foul discharge.

when does Trichomoniasis grow

when normal acidity of the vagina is disturbed

symptoms of Trichomoniasis

irritation and a profuse, frothy, greenish yellow, foul odor discharge

diagnosis and treatment for Trichomoniasis