Transcript Document

TORTORA  FUNKE  CASE
ninth edition
MICROBIOLOGY
an introduction
26
Microbial Diseases
of the Urinary and
Reproductive Systems
PowerPoint® Lecture Slide Presentation prepared by Christine L. Case
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Microbial Diseases of the Urinary
and Reproductive Systems
 Microbes usually enter the urinary system through
the urethra.
 Microbes usually enter the reproductive system through
the vagina (in females) or urethra (in males).
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Female Urinary Organs
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Figure 26.1
Female Reproductive Organs
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Figure 26.2a
Male Reproductive & Urinary Organs
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Figure 26.3
Normal Microbiota
 Urinary bladder and upper urinary tract sterile
 Lactobacilli predominant in the vagina
 >1,000 bacteria/ml or 100 coliforms/ml of urine
indicates infection
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Cystitis
 Usually caused by
 E. coli
 S. saprophyticus
 May also be caused by
 Proteus
 Klebsiella
 Enterococcus
 Pseudomonas
 E. coli usually causes pyelonephritis.
 Antibiotic-sensitivity tests may be required before treatment.
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Leptospirosis
 Leptospira interrogans
 Reservoir: Dogs and rats
 Transmitted by
skin/mucosal contact
from urine-contaminated
water
 Diagnosis: Isolating
bacteria or serological
tests
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Figure 26.4
Sexually Transmitted Diseases (STDs )
 Prevented by condoms
 Treated with antibiotics
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Gonorrhea
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Figure 26.5a
Gonorrhea
 Neisseria gonorrhoeae
 Attaches to oral or urogenital mucosa by fimbriae.
 Females may be asymptomatic; males have painful
urination and pus discharge.
 Treatment is with antibiotics.
 If left untreated, may result in
 Endocarditis
 Meningitis
 Arthritis
 Ophthalmia neonatorum
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Gonorrhea
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Figure 26.7
Gonorrhea
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UN 26.1
Nongonococcal Urethritis
 Chlamydia trachomatis
 May be transmitted to a newborn's eyes
 Painful urination and watery discharge
 Mycoplasma hominis
 Ureaplasma urealyticum
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Pelvic Inflammatory Disease
 N. gonorrhoeae
 C. trachomatis
 Can block uterine tubes
 Chronic abdominal pain
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Syphilis
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Figure 26.9a
Syphilis
 Treponema pallidum
 Invades mucosa or through skin breaks.
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Figure 26.10
Syphilis
 Direct diagnosis
 Darkfield microscopic identification of bacteria
 Staining with fluorescent-labeled, monoclonal
antibodies
 Indirect, serological diagnosis
 VDRL, RPR, ELISA test for reagin-type antibodies
using cardiolipid (Ag)
 FTA-ABS tests for anti-treponemal antibodies
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Syphilis
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Figure 3.6b
Syphilis
 Primary stage: Chancre at site of infection
 Secondary: Skin and mucosal rashes
 Latent period: No symptoms
 Tertiary: Gummas on many organs
 Congenital: Neurological damage
 Primary and secondary stages treated with penicillin
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Lymphogranuloma Venereum (LGV)
 Chlamydia trachomatis
 Initial lesion on genitals heals
 Bacteria spread through lymph causing enlargement
of lymph nodes
 Treatment: Doxycycline
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Chancroid (Soft Chancre)
 Haemophilus ducreyi
 Ulcer on genitalia
 May break through surface
 Infection of lymph nodes
 Treatment: Erythromycin and ceftriaxone
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Bacterial Vaginosis
 Gardnerella
vaginalis
 Diagnosis by
clue cells
 Treatment:
Metronidazole
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Figure 26.12
Genital Herpes
 Herpes simplex virus 2 (Human herpesvirus 2 or
HHV–2)
 Neonatal herpes transmitted to fetus or newborns
 Recurrences from viruses latent in nerves
 Suppression: Acyclovir or valacyclovir
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Genital Warts
 Human papillomaviruses
 Treatment: Imiquimod to stimulate interferon
 HPV 16 causes cervical cancer and cancer of the
penis.
 DNA test is needed to detect cancer-causing strains.
 Vaccination against HPV strains
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Candidiasis
 Candida albicans
 Grows on mucosa of mouth, intestinal tract, and
genitourinary tract.
 NGU in males
 Vulvovaginal candidiasis
 Diagnosis is by microscopic identification and culture
of yeast.
 Treatment: Clotrimazole or miconazole.
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Trichomoniasis
 Trichomonas vaginalis
 Found in semen or urine of
male carriers
 Vaginal infection causes
irritation and profuse
discharge.
 Diagnosis is by microscopic
identification of protozoan.
 Treatment: Metronidazole.
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Figure 26.15
Vaginitis and Vaginosis
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Table UN 26.1