1. © 2004 Wadsworth – Thomson Learning Chapter 24 Infections of the Genitourinary System

2. © 2004 Wadsworth – Thomson Learning The Genitourinary System Figure 24.1

3. © 2004 Wadsworth – Thomson Learning 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%

4. © 2004 Wadsworth – Thomson Learning 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

5. © 2004 Wadsworth – Thomson Learning 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

6. © 2004 Wadsworth – Thomson Learning 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

7. © 2004 Wadsworth – Thomson Learning 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

8. © 2004 Wadsworth – Thomson Learning 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

9. © 2004 Wadsworth – Thomson Learning 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

10. © 2004 Wadsworth – Thomson Learning Other STDs Nongonococcal urethritis –inflammation of urethra other than N. gonorrhoeae Granuloma Inguinale –Calymmatobacterium granulomatis not highly communicable raised lesions open draining ulcers

11. © 2004 Wadsworth – Thomson Learning 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

12. © 2004 Wadsworth – Thomson Learning 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

13. © 2004 Wadsworth – Thomson Learning 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

14. © 2004 Wadsworth – Thomson Learning 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

15. © 2004 Wadsworth – Thomson Learning Female reproductive tract Pelvic inflammatory disease –infection beyond vagina uterus fallopian tubes ovaries –increased risk if not treated infertility ectopic pregnancy

16. © 2004 Wadsworth – Thomson Learning 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

17. © 2004 Wadsworth – Thomson Learning 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

18. © 2004 Wadsworth – Thomson Learning 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

19. © 2004 Wadsworth – Thomson Learning 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