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Chapter 24 Infections of the Genitourinary System © 2004 Wadsworth – Thomson Learning The Genitourinary System Figure 24.1 © 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% © 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 © 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 © 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 © 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 Figure 24.5 – untreated cases – T-cell immunity--gummus (rubbery mass) © 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 © 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 © 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 © 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 © 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 © 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 © 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 © 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 © 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 © 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 © 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 © 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 © 2004 Wadsworth – Thomson Learning