7.1 Genital tract infection Flashcards
What is female reproductive system composed of ?
- 2 ovaries
- 2 fallopian tubes
- a uterus
- a mucous membrane lined vagina
- external genitalia
external genitalia of femal repro system consists of what 3 structures ?
- clitoris
- labia
- opening of the vagina
Microorganisms can invade the female reproductive system via what ?
moist mucous membrane of the vagina
male repro system consists of what structures ?
- 2 testes located within the scrotum a system of ducts
- accessory glands
- the penis
- foreskin (hood of skin) covers the penis
Microorganisms can invade male repro system via ?
urethra or skin of the penis
Name 4 common sites of infection of male
- urethra
- testes
- prostate
- epididymis
Name 4 common sites of infection of female
- vulva
- vagina
- cervix
- fallopian tubes
Urogenital tract infections includes infections transmitted how ?
sexually and non-sexually
In urogenital tract infections due to close proximity often what can also be affected ?
urinary tract
In urogenital tract infections why do infections differ between males and females ?
different urogenital anatomy
In both men and women which organ is sterile
kidneys
In women which organs contain normal microbiota ?
distal 1/3 urethra & vagina
In men which part and which organ may contain skin microbiota ?
distal urethra
What does cervix maintain in Upper fem repro tract ?
sterility
cervix and all structures superior to it are …. ?
sterile
related to action & seen / felt
List general signs & symptoms of urogenital tract infections
Burning sensation when urinating
Frequent urination
Blood in semen / urine
Discharge
Pain during intercourse
Abdominal pain
Ulcerations, blisters
Swelling, redness and warm skin
Foul odour
causes leading to urogenital tract infection ?
- sexual transmission
- pregnancy
- menopause hormone changes
- close proximity of anus and urethra
General risk factors for STIs:
- < 25 yrs
- sexual partner + for STI
- previous STI
- co-existent STI
- 2 or more sexual partners in the preceding year
- recent change in sexual partner
- early age of 1st sexual intercourse
- unprotected sexual intercourse:
-> non-barrier contraception
-> low socioeconomic status
-> drug use
-> commercial sex work
Name 15 sexually transmitted infections
- chlamydia
- gonorrhoea
- trichomoniasis
- herpes simplex
- genital warts
- syphilis
- mycoplasm genitalium (Mgen)
- molluscum contagiousum
- Mpox (monkeypox)
- lymphogranuloma venereum
- HPV (16&18)
- pubic lice
- scabies
- HIV
- hepatitis B
What are the most commonly diagnosed STIs in England ?
- chlamydia (49%)
- first episode genital warts (13%)
- gonorrhoea (13%)
- first episode genital herpes (8%)
Management of all patients with an STI should include :
- referral to a GUM clinic
- partner notification
- testing for other STIs
- advice re-safe sex practices
- support, counselling and education as required
Management of chlamydia
doxycycline
Management of gonorrhoea
ceftriaxone IM
Management of Trichomonas vaginalis
metronidazole
Management of genital herpes
acyclovir
Management of genital warts
surgical excision, cyrotherapy
Management of syphilis
benzylpenicillin IM
Management of public lice/scabies
permethrin cream
Management of Mgen
doxycycline, azithromycin
Prevention of STI
- protected sexual intercourse using barrier contraception e.g condom
- regular screening
- vaccination e.g. HPV, hepatitis B
- notification and treatment of partners
- contact tracing
non-sexually-transmitted infections
- candidiasis
- bacterial vaginosis
- toxic shock syndrome
- group B streptococcus
- STORCH
- post-partum sepsis, other post-partum infection
- urinary tract infection
management of candidiasis
antifungals e.g. fluconazole
management of BV (bacterial vaginosis)
metronidazole, clindamycin
management of group B streptococcus in pregnancy
penicillin
management of post-partum infection
depends on infection and severity - always assess for sepsis and empirical antibiotics may be used
Examples of infections by site for males ?
- prostatitis
- urethritis
- balanitis
- epidiymo-orchitis
Examples of infections by site for females ?
- vulvovaginitis
- cervicitis
- pelvic inflammatory disease
samples for male anatomy taken how ?
- Penile swab of discharge, ulcer, skin
- Urethral swab (Amies/ charcoal)
- First- void Urine sample
- Rectal swab
samples for female anatomy taken how ?
- High vaginal swab (Amies/ charcoal)
- Vulvovaginal swab (NAAT)
- Endocervical (Amies/ charcoal)
- Urine dipstick testing (not for bacteria but nitrates, leukocytes, blood)
Laboratory tests used for genital tract infections ?
- NAAT - detect and amplify either RNA or DNA
- microscopy, culture and sensitivity
- PCR
- serological testing
What infections can be detected using NAAT ?
- chlamydia
- gonorrhoea
- mycoplasma genitalium
- trichomonas vaginalis
What infections can be detected using microscopy,culture and sensitivity ?
- gonorrhoea
- candida
- bacterial vaginosis
- trichomonas vaginalis
What infections can be detected using PCR ?
HSV = herpes simplex virus
MPV = Monkeypox
What infections can be detected using serological testing ?
- syphilis
- HIV
- Hep B/C
what should be considered if a child presents with dysuria, bleeding or ano-genital discomfort without a medical explanation ?
sexual abuse
sexual abuse should be considered if a child present with what ?
- dysuria
- bleeding
- ano-genital discomfort
When should sexual abuse be considered in a child younger than 13 with an STI ?
if there is no clear evidence of mother-to-child transmission or non-sexual transmission
what action should be taken in cases of suspected sexual abuse in children ?
concerns should be discussed with a named or designated professional for safeguarding children
what does the Sexual Offences Act 2003 state about sexual intercourse with a child younger than 16 years ?
any sexual intercourse with a child younger than 16 years is unlawful
