1. Leucocytospermia (Pyospermia)
Case of the week
Leucocytospermia (Pyospermia)

2. White blood cells in semen If their number are more than one million in each milliliter of the ejaculate , this means asymptomatic sexually transmitted diseases ( Mycoplasma, ureaplasma & chlamydia). Semen culture should be done.

3. A case of azoospermia with multiple white cells in semen analysis

6. Leukocytospermia (pyospermia)& its effect on sperms ROS: reactive oxygen species ; GPx: glutathione perioxidase ; SOD: superoxide dismutase, GR: present on Y chromosome ; NADH, NASDPH diaphorase are correlated with sperm motility.
helping
helping

7. I. Mycoplasma genitalium Unicellular gram negative, non motile prokarytes which lack distinct cell wall. It can cause non gonoccoal urethritis (NSU)

8. Mycoplasma fermentans It inects human in genital tract & necrotizing tissue. It is also linked with rheumatoid arthritis. It causes chronic fatigue in patients . It causes severe respiratory infections.

9. Mycoplasma fermentans It attacks B cells causing inflammatory reaction
Mycoplasma fermentans It attacks B cells causing inflammatory reaction. It enhance HIV replication.

11. Gram negative Mycoplasma hominis. Smallest free living organism known
Gram negative Mycoplasma hominis. Smallest free living organism known. They have no cell wall& therefore do not gram stain. Tetracycline & erythromycin can treat both mycoplasma & uroplasma

12. Mycoplasma hominis M. H. are often present in vaginas
Mycoplasma hominis M. H. are often present in vaginas. It colonize frequently in the genital tract of sexually active men & women. Growth of fried egg colonies on glucose agar medium within 24 – 48 hours is a characteristic of Mycoplasma hominis. It can cause pyelonephritis, pelvic inflammatory disease, post partum infection.

13. II. Ureaplasma urealyticum It is a normal genital flora of both men and women. It is also associated with a number of diseases in human: non specific urethritis (NSU), infertility, chorioamnionitis, still birth, premature birth, pneumonia, meningitis.

14. Urogenital culture: M. hominis & uroplasma urealyticum specimens work up.

15. III. Chlamydia trachomatis
It is an obligate intercellular human pathogen. It is gram negative bacteria. It can appear as coccoid or rod shape. There are three types of this prokaryotic ( without a membrane bound nucleus) organism:
1. Serovars Ab, B, Ba or C which cause trachoma
2. Serovars D – K which urethritis ( non gonococcal epididymitis proctatitis in men. In women it can cervicitis pelvic inflammatory disease ectopic Perihepatitis (Fitz- Hugh – Curtis syndrome) where is inflammation of liver capsule as a part of pelvic inflammatory disease. It can also Reiter’s syndrome or reactive arthritis ( arthritis, conjunctivitis , urethritis & ulceration of the skin and mouth).
3. Serovars L1 & L2: which cause lymphogranuloma venerum.
Chlamydia trachoatis is the major cause of infertility

17. Life cycle of chlamydia trachomatis EB : elementary body ; RB: reticulate body

21. Chlamydia trachomatis A : complete genome

22. Trachoma The world lead preventable blindness

23. Chlamydial urethritis ( NSU) Swab of the discharge showed no growth in culture but was positive for polymerase chain reaction to C. trachomatis

25. Infection of female genital tract with chlamydia trachomatis The elementary bodies infect the columnar epithelial cells of cervix, endometrium, & fallopian tubers causing pelvic inflammatory disease , salpinigitis, infertility or ectopic pregnancy.

26. Cytological smear of trichomonaus vaginalis : the organism is pear shaped with a diameter of 15 – 3Omicrons . The nucleus is vesicular , eccentric but cytoplasm contain eosinophilic granules. Trichomanides are also seen in in the smear (H. & E)

27. Chlamydia trachomatis inclusion bodies in a Mc Cay cell culture

28. Chlamedia salpingitis : H. E. & immune staining

29. Fitz – Huge- Curtis syndrome Laparoscopy shows the classic “ violin strings” adhesions between anterior liver capsule and anterior abdominal wall or diaphragm.

30. Fitz- Hugh –Coup syndrome “Violin- string “ adhesions can be seen
Fitz- Hugh –Coup syndrome “Violin- string “ adhesions can be seen. This is spread of inflammation in pelvic inflammatory disease.

31. CT scan of right abdominal quadrant & pelvis in Fitz – Huge- Curtis syndrome

32. Fitz – Hugh – Curtis syndrome

33. Reiter’s syndrome It is an auto-immune condition that develop in response to inflammation of other part of the body: genitourinary or gastrointestinal infections. It is associated with HLA-B 27 gene on chromosome 6
Circinate balanitis
Reactive arthritis
Aphthous stomatitis
Geographic tongue

34. Keratoderma blanorrhagicum Feet - Reiter syndrome

35. Ankylosing spondolytis Reiter’s syndrome is considered a precursor of other joint condition including ankylosing spondolytis