Infectious Diseases Manifesting in the Genitourinary System Flashcards

E.coli, staphylococcus saprophyticus, enterococcus

opportunism: transfer from GI tract (community-acquired) or environment or GI tract (via catheter)

usually culture-based; antimicrobial susceptibilities always checked

hygiene practices; in case of CA-UTIs, limit catheter usage

adhesions, motility

usually nitrofurantoin

usually nitrofurantoin

causes 90% of community UTIs and 50-70% of CA-UTIs

causes small percentage of community UTIs and even lower percentage of CA-UTIs

based on susceptibility testing; vancomycin-resistant enterococcus is in serious threat category in CDC antibiotic resistance report

frequent cause of CA-UTIs

leptospira interrogans

vehicle: contaminated soil or water

adhesions, invasion proteins

slide agglutination test of patient's blood for antibodies; in the US, CDC will culture specimens

avoiding contaminated vehicles

doxycycline, penicillin G, or ceftriaxone

US: 100 to 200 cases per year, half in Hawaii; internationally: 80% of people in tropical areas are seropositive

schistosoma haematobium

vehicle; contaminated water

antigenic "cloaking," induction of granulomatous response

identification of eggs in urine, PCR methods

avoiding contaminated vehicles

praziquantel

endemic in africa, middle east, india, and turkey, in sub-saharan african: 120 million infected

candida albicans and trichomonas vaginalis

opportunism

wet prep or gram stain

topical or oral azole drugs, some over-the-counter drugs

white, curd-like discharge

US: causes 20% of all vaginitis cases; 75% women reported to have had at least one infection in their lifetimes

direct contact (STI)

protozoa seen on pap smear or gram stain; culture is the gold standard

barrier use during intercourse

discharge may be greenish

7 to 8 million women infected per year

mixed infection

opportunism or STI

visual exam of vagina or clue cells seen in pap smear or other smear

metronidazole or clindamycin

discharge may have fishy smell

US: estimated 7.4 million new cases per year; internationally: prevalence rates vary by country from 20% to 51%

GI tract biota

endogenous transfer from GI tract; otherwise unknown

various

digital rectal exam to examine prostate; culture or urine or semen

antibiotics, muscle relaxers, alpha blockers

pain in genital area and or/back, difficulty urinating

US: 50% of men experience during lifetime

neisseria gonorrhoeae

direct contact (STI), also vertical

fimbrial adhesins, antigenic vvariation, IgA protease, membrane blebs/endotoxin

gram stain in males, rapid tests (PCR, ELISA) for females, culture on thayer-martin agar

avoid contact; condom use

coinfection by gonorrhea and chlamydia should be assumed; treat with ceftriaxone + azithromycin; antibiotic-resistant strains on urgent threat list from CDC

rare complications include arthritis, meningitis, and endocarditis

eye infections, blindness

US: increased 56% since 2015; internationally: 26 million cases

chlamydia tranchomatis

direct contract (STI), vertical

intracellular growth resulting in avoiding immune system and cytokine release, unusual cell wall preventing phagolysosome fusion

PCR or ELISA, can be followed by cell culture

avoid contact; condom use

coinfecction by chlamydia and gonorrhea should be assumed; treat with doxycycline or azithromycin

more commonly asymptomatic than gonorrhea

eye infections, pneumonia

US: 92% increase since 2009; internationally: eye infection (trachoma) has 90% prevalence rate in developing world

treponema pallidum

direct contact and vertical

lipoproteins

direct tests, blood tests for treponemal and nontreponemal antibodies, PCR

antibiotic treatment of all possible contacts, avoiding contact

penicillin G

three stages of disease plus latent period, possibly fatal

congenital syphilis

US: estimated 120,000 new cases per year; internationally; estimated 12 million new infections per year

haemophilus ducreyi

direct contact (vertical transmission not documented)

hemolysin (exotoxin)

rule out other ulcer diseases

avoiding contact

ceftriaxone or azithromycin

no systemic effects

none

US: no more than a handful per year; internationally: estimated 7 million cases annually

herpes simplex 1 and 2

direct contact, vertical

latency

clinical presentation, PCR, Ab tests, growth of virus in cell culture

avoiding contact, antivirals can reduce recurrences

acyclovir and derivatives

ranges from asymptomatic to frequent recurrences

blindness, disseminated herpes infection

US: 25% prevalence in adults; internationally: estimated 536 million infected in 15-49 age group

HPV and molluscum contagiosum

human papillomaviruses

direct contact (STI), also auto inoculation, indirect contact

oncogenes (in the case of malignant types of HPV)

PCR tests for certain HPV types, clinical diagnosis; pap smear

vaccine available; avoid direct contact and prevent cancer by screening cervix

warts or precancerous tissue can be removed; virus not treatable

infection may or may not results in warts; infection may result in malignancy

may cause laryngeal warts

US: estimated 6 million new infections per year, 12,000 new cases of HPV-associated cervical cancer

poxvirus, sometimes called the molluscum contagiosum virus (MCV)

direct contact (STI), also indirect and autoinoculation

clinical diagnosis, also histology, PCR

avoid detection contact

warts can be removed; virus not treatable

wart-like growths are only known consequence of infection

US: affects 2-10% of children annually

vertical

culture of mother's genital tract

treat mother with penicillin/ampicillin

US: vaginal carriage rates 15%-45%, neonatal sepsis due to this occurs in 1.8-3.2 per 1,000 live births; internationally: vaginal carriage rates 12%-27%

saphylococcus saprophyticus

group b stretococcus

E. coli

enterococcus

leptospira interrogans

neisseria gonorrhoeae

chlamydia trachomatis

treponema pallidum

haemophilus ducreyi

herpes simplex viruses 1 and 2

human papillomaviruses

pox viruses

candida albicans

trichomonas vaginalis

schistosoma haematobium