micro exam 3 STDs

Top 3 Bacteria STD- chlamydia, gonorrhea, syphilis


Total STD in men and women- 110 million


Vaginosis- disruption of normal microbiota in vaginal tract 


Vaginitis- vaginal inflammation


Lactobacillus- in vagina, produces acidic PH


Chlamydial Urethritis - asymptomatic, chlamydia trachomatis, obligate intracellular parasite 


Reticulate body- no infection


Elementary bodies- causes infection


Chlamydia- “silent epidemic” acquire it though vaginal, anal, or oral sex: symptoms- vaginal bleeding discharge, abdominal pain, fever, painful urination


Salpingitis- complication of chlamydia and gonorrhea, inflammation of fallopian tube and PID (pelvic inflammatory disease )


Ectopic pregnancy- fertilization occurs in degraded vaginal walls, development of fetus outside of uterus 


Conjunctivitis- inflammation of eye 


Pneumonia- chlamydia trachomatis in babies


Chlamydia symptoms in men-  white, cloudy discharge, burning sensation, inflammation around testicles (epididymitis)


Chlamydia treatment - -1 dose Azithromycin -7 days doxycycline, erythromycin 


Gonorrhea- infection of urogenital tract “clappoir” Neisseria gonorrhoeae Gram-negative diplococci 


Female gonorrhea symptoms- 50% asymptomatic 50% vaginitis PID, ectopic pregnancy


Male gonorrhea symptoms- tingling of penis, pain urinating, discharge, swollen lymph nodes


Urethritis- penis shaft (Urethra) normally will get infected first, pus from penis,, burning during urination, red swollen urethra 


Epididymitis- infection spreads to the reproductive tract, Symptoms include: Tender testicles, Become sterile if left untreated. 



Prostatitis- infection may also spread to the prostate gland causing inflammation


Anorectal Gonorrhea- Occurs in men who have anal intercourse, anal itching, painful bowel movement with blood


Gonococcal Pharyngitis- result of oral sex from infected partner 


Gonococcal Conjunctivitis-  normally in infants when mothers have gonorrhea

 

Disseminated Gonococcal Infection DGI- gonorrhea in other parts of body and joints, Bacteria can spread to the bloodstream and infect the joints, heart valves or the brain



Gonorrhea treatment- PPNG (Penicillinase-producing Neisseria gonorrhoeae) makes penicillin useless


Syphilis-  systemic infection caused by Treponema pallidum 


Primary Syphilis-  hard chancre, seep red fluid, healed within 3-6 weeks

Hard chancres- painless circular red ulcers with hard edge 10-90 days 2-4 weeks


Syphilis treatment- penicillin can cure 


Secondary syphilis- weeks later, condyloma lata copper color skin rash appears


Tertiary syphilis- Gummatous syphilis, Neurosyphilis, Cardiovascular syphilis


Gummatous syphilis- lesions that destroy elastic tissue and weaken blood vessel


Neurosyphilis - destroy central nervous system


Cardiovascular syphilis- heart and blood vessels, 10-30 years after)

      Syphylitic aortitis, aortic aneurism

Latent syphilis- No symptoms but the bacteria are continuing their damaging process


Latent syphilis- has orginism without symptoms 


Congenital syphilis- fetus and babies with syphilis 


“Snuffles”- early congenital baby with syphilis rhinitis, mucus and rashes on skin


Late congenital syphilis- hutchinsons triad, interstitial keratitis, teeth abnormality, deafness


Syphilis screening- non specific

Venereal disease research laboratory (VDRL) test. - test if antibodies  react with lipid with blood or spinal fluid 


Rapid plasma reagin (RPR)-VDRL test. - charcoal added to reagent to visualize dots by eye of cholesterol and carbon particles 


TREPONEMA-Specific test syphilis- look for orginism


Enzyme immunoassay (EIA) test-  blood test checks for antibodies to the bacteria that cause syphilis

Fluorescent treponemal antibody absorption (FTA-ABS) test  -test checks for antibodies to the bacteria that cause syphilis and can be used to detect syphilis except during the first 3 to 4 weeks after exposure to syphilis bacteria. Spinal fluid or blood


Treponema pallidum particle agglutination assay (TPPA) -  used to confirm a syphilis infection after another method tests positive for the syphilis bacteria. This test detects antibodies to the bacteria that cause syphilis. This test is not done on spinal fluid.


Microhemagglutination assay (MHA-TP) -  used to confirm a syphilis infection after another method tests positive for the syphilis bacteria (not reliable forfirst 3-4 weeks of infection)


Chancroid- painful genital ulcers, haemophilus ducreyi gram-neg cocci, soft chancre, swollen lymph nodes 


Chancroid treatment - azithromycin, erythromycin, ceftriaxone


Lymphogranuloma venereum- LGV C&S, SE asia, 1000 cases a year primarily in homosexual men 


LGV stage I- 3 weeks, small painless nodule at infection site, heals within a few days, rectal bleeding in males 

LGV stage II- 6 weeks after infection, unilateral or bilateral swelling of lymph nodes in groin, swelling to naked eye, red-blue color


LGV stage III- untreated Jersild syndrome several years, intestinal strictures, fistulas, purulent abscess or lymphatic stasis, swollen genitals


Klebsiella granulomatis- granuloma inguinale “donovanosis”  


granuloma inguinale stage 1- small pimples spread and eat surrounding tissue, tissue turns pink or red and bumps appear, bumps turn into raised red nodules with velvety texture, painless and bleed


granuloma inguinale stage 2- bacteria erodes skin, shallow ulcers spread to inner thighs, lined with granulated tissue and foul smell


granuloma inguinale stage 3- ulcers become deep and morph into scar tissue


granuloma inguinale treatment- tetracyclines 


Gardnerella vaginalis- non-specific vaginitis/ non-gonococcal uretheritis, mild infection of vagina and vulva, foul smelling discharge, gram-stain shows “clue cells” 


Gardnerella vaginalis treatment- tetracycline 


Mycoplasma and ureaplasma- lack cell wall, cause nonchlamydial and nongonococcal uerethritis, treated with tetracycline


Mycoplasma species- not cause vaginitis, may proliferate inpatients with bacteria vaginosis 


M. hominis- isolated from endometria and fallopian tubes of 10% of women with salpingitis 


M. genitalium- involved in pelvic inflammatory disease and cervicitis 


Ureaplasma, urealyticum, ureaplasma parvum- cause placental inflammation and may invade amniotic sac early, persistent infection and adverse pregnancy outcomes, including premature birth



UTIs (urinary tract infections) - sheddinf of epithelial cells, mucus secretion, flushing action of urine, sectretory antibodies


Main indigenous flora facultative- corynebacterium, staphylococcus, streptococcus species

Main indigenous flora anaerobes- bacteriodes, prevotella, porphyromonas, peptostreptococcus species


Urethritis- caused by e coli, chlamydia, trachomatis, mycoplasma, bacteria from large intestine in urethra, sexual intercourse 


Urethritis treatment- drinking plenty of water, urinating, clean genitals, antibiotics


Cystitis- e coli caused, persistent urge to urinate, burning and blood in urine, cloudy foul smelling urine, bacteria from large intestine through urethra to bladder, sexual intercourse


Cystitis,prostatitis, pyelonephtitis  treatment- good hygiene, clean genitals, drinking enough fluid to urinate regularly, antibiotics


Prostatitis- caused by e coli, staphylococcus, proteus, pseudomonas, fever and chills, flu symptoms, pain in prostate gland, lower back and groin, urinary frequency, blood urine, bacteria to bladder from large intestine and sex



Pyelonephritis - e coli, enterococcus, klebsiella, pseudomonas, frequent urination, burning pain when urinating, abdominal pain cloudy, pus or blood filled urine, bacteria in bladder from large intestine or sex


Cutibacterium- acne, chronic inflammation, 85% of adolescents and young adults, starts when a hair follicle become swollen with seum and keratinocytes 


Plugged glands- “comedones”, open- blackheads, closed- whiteheads

Acne treatment- mild soaps, benzoyl peroxide, retin a


Retin A- prevents blockage of folliciles