Genital Urinary and Circulatory Lymph Diseases - Micro

Micro

Neisseria gonorrhoeae

• A culture of the cervical specimen should be ordered

• Assuming the patient has PID, they acquired the disease through direct sexual contact.

• Symptoms: Abdominal pain, fever

• Asymptomatic infection with the disease is common in women, and symptoms may only manifest when PID develops.

• The disease prevents immunity due to its ability to vary its surface antigens, preventing the host from developing lasting protective immunity. This allows for repeated infections.

Herpes simplex virus (HSV)

• leads to recurrent genital ulcers

• As a physician, you should recommend that a patient modify their sexual activity to reduce transmission risk. This includes consistent and correct condom use, and discussing her diagnosis with sexual partners.

• Treatment: Antiviral medications can effectively manage symptoms, reduce the frequency and severity of outbreaks, and decrease the risk of transmission.

• Long-term risk: potential for transmission to sexual partners or, if she becomes pregnant, vertical transmission of the virus to her fetus or neonate, which can cause severe fetal/neonatal infections.

Escherichia coli (E. coli)

• Site of infection: Kidneys, infections of this organ is called pyelonephritis.

• Characteristics: gram-negative bacilli, growth on MacConkey’s agar, and the fact that this disease is a common cause of UTIs and pyelonephritis.

• Test for diagnosis: urine culture and sensitivity testing should be ordered.

• Women are more commonly affected by this condition than men primarily because their urethra is shorter, making it easier for microbes from gastrointestinal tract to ascend to the bladder. Additionally, prostatic secretions in men have antibacterial properties that offer protection. Sexual activity in women can also “force” organisms into the urethra.

Enterococcus spp.

• Endocarditis

• Organisms that frequently cause endocarditis in intravenous drug users (IVDUs) include S. aureus and Enterococcus spp. The organism causing this patients infection is Enterococcus spp.

• Symptoms: fevers, chills, dizziness

• Intravenous drug use predisposes the patient to this type of infection by directly introducing bacteria from contaminated needles, skin flora, or the drug itself into the bloodstream.

• Pathogenicity: bacteria adhering to damaged or abnormal heart valves, forming vegetations that are protected from immune defenses. Other organs may be secondarily infected due to the dissemination of bacteria or septic emboli from the heart vegetation through the bloodstream.

• When considering antimicrobial therapy, a general strategy of prolonged intravenous antibiotics therapy is employed, often with a combination of bactericidal drugs, to ensure eradication of the bacteria within the vegetation.

• Vancomycin-resistant enterococci (VRE) has recently emerged involving Enterococcus spp.

• Prevention: strict infection control measures, such as hand hygiene, contact precautions, and environmental disinfection.

Plasmodium spp. (specifically P. falciparum)

• Symptoms: fevers, chills, cough, and myalgias

• Two complications associated with his organism, with pertinent clinical findings:

  • Severe Anemia: The patient presented with a hematocrit of 25% and later 23%, and received packed red blood cells. This is due to the parasites’s destruction of red blood cells during its life cycle.

  • Cerebral Malaria/Mental Status Changes & Disseminated Intravascular Coagulation (DIC): The patient developed mental status changes, became comatose, and exhibited oozing blood from orifices and catheter sites with prolonged bleeding times and low platelet count, consistent with DIC. Plasmodium falciparum has a unique characteristic of causing infected red blood cells to adhere to endothelial cells in capillaries, particularly in the brain, leading to microvascular obstruction, tissue hypoxia, and organ dysfunction, including cerebral malaria and contributing to DIC.

• Exchange transfusion was used as a therapeutic strategy to rapidly reduce the parasitic load and remove infected red blood cells, as well as toxic metabolites, thereby mitigating the severe complications of the infection.

• Problems associated with chemotherapy for this diseases infection include increasing drug resistance, which necessitates combination therapies. Additionally, severe cases require immediate and aggressive treatment due to rapid progression and high mortality if untreated or inadequately treated.

Rickettsia prowazekii

• Form of transmission: lice or ticks to humans

• Reservoir: Humans Vector: Lice/Ticks (human louse)

• Symptoms: bleeding under the skin (leading to the rash)

• Symptoms caused by invading and damaging the endothelial cells lining the blood vessels, leading to vasculitis, increased vascular permeability, and hemorrhage.

• Treatment: antibiotics, primarily tetracyclines, as rickettsial organisms are obligate intracellular bacteria that are susceptible to these drugs.

• The disease would be most common in higher altitudes of eastern Africa due to colder temperatures. Colder climates favor the conditions that lead to louse infestations, such as less frequent bathing and wearing multiple layers of clothing, facilitating the spread of lice and the pathogen they carry.

• Transmission: crowded and unsanitary conditions, common in jails, facilitate the rapid spread of body lice, which are the vectors of Rickettsia prowazekii.