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Chapter 24Chapter 24Infections of the Genitourinary Infections of the Genitourinary

SystemSystem

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The Genitourinary System

Figure 24.1

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Urinary Tract Infections• Urinary tract infection (UTI)

– any or all parts of urinary tract– Cystitis: common bladder inflammation

• E. coli--most common

– Urethritis: urethra• many organisms

– Pyelonephritis: kidneys• E. coli 75%

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Leptospirosis• Leptospira interrogans

– spirochete

• kidney or liver disease– Weil’s syndrome

• animals to humans– urine contaminated water– entrance

• mucous membrane• break in skin

• difficult to diagnose– small cells– special media for culturing

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Sexually Transmissible Diseases• Increase in STDs

– antibiotic resistance

– newly recognized pathogens

– multiple sexual partners

Two sexual partners per month

Three sexual partners per month

Figure 24.3

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Gonorrhea• N. gonorrhoeae

– sexually transmitted disease: urethra– 300,000 cases/60% age 15-24– males--80% symptoms: urination/discharge– females--asymptomatic

• leads to pelvic inflammatory disease

– potential for systemic infection• gonorrheal endocarditis• gonorrheal meningitis• gonorrheal arthritis

– infants: ophthalmia neonatorum

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Syphilis• Treponema pallidum

– spirochete

• Primary stage: several weeks– hard based chancre

– infectious serous exudate

• Secondary stage: 6-8 weeks– skin rash

– loss of hair

– malaise, mild fever

• Latent period

• Tertiary phase: years later– untreated cases

– T-cell immunity--gummus (rubbery mass)

Figure 24.5

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Chlamydia

• Chlamydia trachomatis– coinfection with N. gonorrhoeae– most prevalent STD– many cases go untreated

• leading cause– infertility– ectopic pregnancy

• transmit to infant at birth– neonatal eye infection

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Other STDs• Lymphogranuloma venereum (LGV)

– Chlamydia trachomatis• invasive strain• infects lymphoid tissue• tropical regions

• Chancroid– Haemophilus ducreyi

• tropical areas– Africa, Asia, Latin American

– becoming more common in US

– linked to crack cocaine epidemic

• ulcer on genitals

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Other STDs

• Nongonococcal urethritis– inflammation of urethra

• other than N. gonorrhoeae

• Granuloma Inguinale– Calymmatobacterium granulomatis

• not highly communicable• raised lesions• open draining ulcers

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Viral STDs• Genital herpes

– Herpes simplex virus– HSV-2: normally genital tract– HSV-1: normally mouth and face

• cold sores, fever blisters

– latency• moves from nerve ending to nerve ganglion• reactivates to epithelial tissue

– Neonatal herpes• brain and internal organs• lifelong disabilities

– No cure--treatment with acyclovir

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Viral STDs• Genital warts• Papilloma virus

– Over 65 types--based on DNA

• Diseases– benign wart– cervical carcinoma

• Replication– proliferation of cells– basal layer of epithelium

• no progeny virus in these cells

– cells differentiate• virus replicates in later cells--shed from surface

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Female reproductive tract

• Vaginitis– vaginal secretion– Gardnerella vaginalis

• decrease in lactobacilli• increase in pH• fishy-smelling discharge

– diagnosis• vaginal wet mount• Gram stain

– absence of other bacteria

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Female reproductive tract

• Toxic Shock Syndrome– strains of Staphylococcus aureus

• produce toxin• toxic shock syndrome-associated toxin (TSST)• bacteria reproduce

– tampons

• enters bloodstream causing symptoms

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Female reproductive tract

• Pelvic inflammatory disease– infection beyond vagina

• uterus• fallopian tubes• ovaries

– increased risk if not treated• infertility• ectopic pregnancy

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Female reproductive tract• Candidiasis

– Candida albicans• yeast infection

– thick white vaginal discharge– severe vaginal itching– predisposition

• changes in hormone levels• broad-spectrum antibiotic therapy

– alter normal microbiota

– treatment• nystatin or terconazole

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Female reproductive tract

• Trichomoniasis– Trichomonas vaginalis– flagellate protozoan

• copious vaginal discharge• estimated 25% women in US

– diagnosis• microscopic analysis of

vaginal discharge

Figure 24.15

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Infections of newborns• Listeriosis

– Listeria moncytogenes– infect placenta or during

birth– meningitis– septicemia– endocarditis

• Group B streptococcal infection– Streptococcus agalactiae– transmitted during birth– pneumonia– meningitis– sepsis

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Infections of newborns

• Cytomegalic Inclusion Disease– Cytomegalovirus

• herpesvirus family

– Transmission• close contact, saliva, blood

– Symptoms• healthy children and adults

– asymptomatic or brief mononucleosislike illness

• prenatal infections– spontaneous abortion, stillbirth, severe birth defects