26 - 175 - GONORRHEA, MYCOPLASMA, AND VAGINOSIS Flashcards
most common cause of pelvic inflammatory disease in women.
chlamydia
currently the most common reported STD.
chlamydia
common presenting symptom of STDs in both men and women
Urethritis
causative agent of gonorrhea
Neisseria gonorrhoeae
- gram-negative, aerobic coccus-shaped bacterium found in pairs
- The organisms are usually visualized intracellularly, located** within polymorphonuclear leukocytes**
most common manifestation of gonococcal infection in men
urethritis, characterized by a spontaneous, often profuse, cloudy or purulent discharge from the penile meatus
triad of disseminated gonorrhea
dermatitis, migratory polyarthritis, and tenosynovitis
description of the concurrence of some degree of hemorrhage and necrosis of the cutaneous lesions of disseminated gonoccocal infection
“gun metal gray”
inflammation of the liver capsule, is associated with genitourinary tract infection and may be present in up to one fourth of women with PID caused by either N. gonorrhoeae or C. trachomatis
Fitz-Hugh–Curtis syndrome
Prophylaxis for Gonococcal Infection in Neonates
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considered diagnostic for infection with N. gonorrhoeae in symptomatic men
Gram stain of a urethral specimen that demonstrates polymorphonuclear leukocytes with intracellular gram-negative diplococci
culture medium of N. gonorrhiae
modified Thayer-Martin medium
Treatment of Localized, Uncomplicated Gonococcal Infection of the Cervix, Rectum, Pharynx, or Urethra
Treatment of Disseminated Gonococcal Infection
Treatment of Gonococcal Infection in Neonates
genital mycoplasmal organisms
Mycoplasma spp. and other Ureaplasma spp.
most common cutaneous disease in men with mycoplasma infection
urethritis
most common cutaneous disease in women with mycoplasma infection
cervicitis
adhesion proteins of mycoplasma
M. genitalium (P110 and P140) and M. hominis (P100)
preferred method of testing for mycoplasma
NAAT
- the most sensitive tests available and are almost as specific as culture
- They are approved by the FDA for the diagnosis of urogenital infections caused by C. trachomatis
- noninvasive and easy to perform
- expensive and unable to differentiate among different serovars of C. trachomatis
preferred specimen to submit when the reference laboratory plans to use NAAT
First-voided urine
T/F
Gram stain can be used to detect Mycoplasma spp.
False
Mycoplasma spp. do not possess a cell wall, Gram stain will not detect these organisms.
Treatment of Mycoplasma Urethritis
remains the most frequently reported STI
C. trachomatis
most common manifestations of C. trachomatis infections
Urogenital infections
most common site of chlamydia in men
urethra
- In men, urethritis is the most common manifestation of infection and is characterized by dysuria and a watery or mucoid discharge from the urethra.
- The discharge may be scant, and some patients may only complain of stained underwear.
- In comparison, the discharge in gonococcal urethritis is more purulent and profuse.
most common site of chlamydia in women
urethra and cervix
most common causes of epididymitis in male patients younger than 35 years of age
C. trachomatis and N. gonorrhoeae
overarching clinical presentation encompassing combinations of
endometritis, salpingitis, and peritonitis
- PID is a complication of C. trachomatis infection as well as gonococcal infections.
- patients present with fever; lower abdominal pain; vomiting; and cervical, uterine, and adnexal motion tenderness
C. trachomatis strains that cause** urogenital tract infections**
Serovars D to K
C. trachomatis strains that cause chronic conjunctivitis and trachoma
Serovars A through C
C. trachomatis strains that cause lymphogranuloma venereum
Serovars L1 though L3
first-line treatment of chlamydial infections
doxycycline 100 mg orally twice daily for 7 days or azithromycin given orally as a single 1-g dose
most common vaginal infection in women ages 15 to 44 years
Bacterial vaginosis (BV)
most common risk factors for BV infection
Having sex at an early age and new or multiple sex partners
Amsel criteria for diagnosing BV
- Profuse milky vaginal discharge
- A positive whiff test result (presence of a fishy odor when secretions are exposed to 10% or 20% potassium hydroxide)
- A vaginal fluid pH greater than 4.5
- Presence of clue cells greater than 20% on microscopic examination
squamous epithelial cells covered by coccobacilli that give the cytoplasm a ground-glass appearance and obscure the crisp margins of the cell, leaving ragged borders
Clue cells
the most reliable indicator of BV
presence of clue cells representing at least 20% of the epithelial cells on saline wet mount
Treatment of Bacterial Vaginosis
