7.1 Genital tract Non-sexually T INFECTIONS Flashcards
List 8 non-STI infections
- candidiasis
- bacterial vaginosis
- toxic shock syndrome
- group B streptococcus
- STORCH
- post-partum sepsis & other post-partum infection
- UTI
Infection of candidiasis ?
- fungal
- yeast candida albicans most common
What percentage of women will experience at least one episode of a yeast infection in their lifetime?
75%
List some factors that are associated with an increased risk of developing a yeast infection.
- antibiotic use
- local irritants such as soap
- diabetes
- HIV infection
- oral contraceptive pills
- hormone replacement therapy (HRT
Presentation of candidiasis in female and men ?
female:
* vulval/vaginal itching
* sorness
* ‘cheese-like’ vaginal discharge
* dysuria
men:
* redness
* itching on penis
* foreskin sores
* white discharge
How can the use of antibiotics lead to a yeast infection (candida) ?
antibiotics can disrupt the normal balance of bacteria and yeast in the body, allowing Candida albicans to overgrow
management for candidiasis ?
antifungals e.g. fluconazole
Bacterial vaginosis is a …. of the vagina
dysbiosis (imbalance bacterial composition ?)
What is bacterial vaginosis characterised by ?
overgrowth of anaerobes such as gardnerella vaginalis and Prevotella species and a loss of lactobacillii
What changes in vaginal pH are associated with BV?
increased vaginal pH greater than 4.5
Is bacterial vaginosis considered a sexually transmitted infection (STI)?
No, bacterial vaginosis is not considered a sexually transmitted infection, although its prevalence is higher among sexually active women.
What are the typical symptoms of BV?
The typical symptoms of BV include a fishy-smelling, thin, grey discharge.
Unlike yeast infections, BV usually does not cause itching or soreness.
What specific microscopic finding is associated with BV?
The presence of ‘clue cells’ on microscopy is associated with BV.
Clue cells are vaginal epithelial cells coated with bacteria, giving them a stippled appearance.
Which bacteria are commonly overgrown in BV?
overgrowth of anaerobic bacteria such as Gardnerella vaginalis and Prevotella species
What are lactobacilli, and what happens to them in BV?
Lactobacilli are beneficial bacteria that help maintain a healthy vaginal environment by producing lactic acid, which keeps the vaginal pH low.
In BV, there is a loss of lactobacilli, leading to an imbalance and overgrowth of harmful bacteria.
Management for Bacterial vaginosis ?
metronidazole, clindamycin
What makes TSS potentially life-threatening?
TSS is potentially life-threatening due to the severe systemic effects of the bacterial exotoxins, which can lead to multi-organ failure and shock if not treated promptly.
Menstrual TSS mainly associated with ….1….. but may also be seen with …2…
- staphylococcus aureus
- GAS
When tampons are used what permits the access of bacteria into the tissues of vagina ?
bacteria can gain entry into uterus via cervic or through mucosal splits or erosions in the vagina
Symptoms of TSS may include ?
- fever
- headache
- skin rash
- confusion
- vomiting
- diarrhoea
Risk factors for TSS may include ?
tampon use, postpartum period
In what % of healthy women’s reproductive tracts can GBS ( …. or …) be seen ?
35%
Group B streptococcus (sptreptococcus agalactiae)
Group B streptococcus can be transmitted to newborns when ?
at time of birth
Group B streptococcus is primary cause of what ?
neonatal sepsis / meningitis
What can group B streptococcus be associated with ?
- premature labour
- miscarriage
What lowers the risk of transmission of group B streptococcus to the body ?
- screening occurs during pregnancy and receive IV antibiotics during labour
Group B streptococcus in pregnancy management ?
penicillin
What infections does STORCH stand for ?
- congenital infections
S - Syphilis
T - Toxoplasmosis
O - Other infections (parvovirus B19, VZV (varicella zoster virus, varicella = chicken pox), HIV, Hepatitis B etc)
R - Rubella
C - CMV (cytomegalovirus)
H - Herpes simplex
Consequences of STORCH ?
- mild maternal morbidity
- but may have serious foetal consequences
What is a post partum infection ?
bacterial infection of femal repro tract following childbirth or miscarriage
What are the common symptoms of a postpartum infection?
pain in the lower abdomen, fever, and foul-smelling vaginal discharge.
What are some risk factors for developing a postpartum infection?
- type of delivery
- infections
- bacterial vaginosis
- diabetes
- bacterial colonisation
With post-partum infection what should always be assessed for ?
maternal sepsis
management for post-partum infection
depends on infection and severity - always assess for sepsis and empirical antibiotics may be used
List symptoms from UTI’s infections by site - male
- frequency
- urgency
- dysuria (pain)
- haematuria
- nocturia
- cloudy, strong smelling urine
Risk factors for UTI male ?
- catheterisation
- > 50y
- BPH (Benign Prostatic Hyperplasia - common condition older men where prostate enlarges)
- urine obstruction
What is the most common bacterial cause of urinary tract infections? (most common non STI)
Escherichia coli (E.coli)
Prostatitis is infection of the ..1… accompanied by infection of the …2..
- prostate
- urinary tract
What are 3 common symtpoms of a UTI ?
- dysuria (painful urination)
- frequency
- urgency
How might prostatitis manifest in terms of pain ?
- penile pain
- rectal pain
- lower back pain
- pain on ejaculation
During a physical examination, what finding might suggest prostatitis ?
tender, swollen prostate
Infection causes of prostatitis
- E.coli
- pseudomonas aeruginosa
- Klebsiella
- Chlamydia
- Gonorrhoea
Characteristics of E.coli prostatitis
- BPH, previous UTI, catheterisation
Characteristics of prostatitis caused by Chlamydia / gonorrhoea
- uncommon high risk sexual behaviour
- anal receptive intercourse
Urethritis signs and symptoms
signs: balanoposthitis (inflammation of the head of your penis and foreskin)
symptoms: penile irritation, urethral discomfort, urethral discharge, dysuria
Urethritis often split into ?
NGU and gonococcal urethritis
Causative organisms of urethritis ?
- Neisseria gonorrhoeae
- chlamydia
- mycoplasma genitalium
- ureaplasma urealyticum
- trichomonas vaginalis
Neisseria gonorrohoea is a bacteria that’s:
1. gram staining ?
2. intra/extra cellular shape ?
3. seen on ?
- GN
- intracellular diplococci
- urethral smear
What is NGU ?
Non-Gonococcal Urethritis
Chlamydia …
mycoplasma genitalium…
ureaplasma urealyticum…
trichomonas vaginalis …
What’s balanitis ?
redness and swelling of the glans penis
symptoms of balanitis ?
penile discomfort , itch, bleeding
characteristic symptom of balanitis infection with candida albicans ?
blotchy redness
characteristic symptom of balanitis infection with chlamydia ?
circinate balanitis
characteristic symptom of balanitis infection with gardnerella ?
foul smelling, inflammation ,oedema , mucoid discharge
Epidiymo-orchitis …
symptoms of epidiymp-orchitis ? [change Q are some of these signs ?]
- scrotal pain
- swelling
- erythema
- sometimes urethral discharge
- oedema of the scrotum
- pyrexia (fever)
Characteristics of epidiymo-orchitis with infection chlamydia / gonorrhoea ? [change Q]
Characteristics of epidiymo-orchitis with infection gram negative enteric organisms e.g. E.coli ? [change Q]
Characteristics of epidiymo-orchitis with infection paramyxovirus (mumps)? [change Q]
Women’s urethra length and positioning compared to men ?
shorter and opening closer to the anus
Symptoms of UTI in females ?
- dysuria
- nocturia
- frequency
- cloudy urine
- suprapubic pain
In femal UTI, the most commonly identified causative uropathogen is …. , it’s identified in up to 77% of cases
Escherichia coli (E.coli)
Risk factors of female UTI ?
- sexual intercourse
- new sexual partner
vulvovaginitis characteristic signs and symptoms ?
- vaginal dryness
- vaginal discharge
- itchy, sore vagina
- pain on urination
Characteristic symptoms of vulvovaginitis in candidiasis infection
white, odourless discharge
Characteristic symptoms of trichomoniasis in candidiasis infection
‘fishy smelling’ frothy discharge
Characteristic symptoms of vulvovaginitis in BV (bacterial vaginosis) infection
- thin smelly discharge
- no itching / soreness
Characteristic symptoms of vulvovaginitis in gonorrhoea/chlamydia infection
- no itching
- associated with pain and purulent discharge
Characteristic signs and symptoms of cervicitis ?
- cervical discharge
- cervical erythema
- intermenstrual bleeding
- post-coital bleeding
- dyspareunia
characteristic symptoms of cervicitis in chlamydia/gonorrhoea infection ?
easily induced cervical bleeding
mucopurulent discharge
characteristic symptoms of cervicitis in HSV infection ?
vesicular or ulcerative lesions on the cervix
characteristic symptoms of cervicitis in M. genitalium (mycoplasma genitalium) infection ?
- post-coital bleeding
- mucopurulent discharge
Symptoms of pelvic inflammatory disease ?
- Lower abdominal pain
- Unexplained vaginal discharge
- Irregular bleeding
- Dyspareunia
- Dysuria
Signs for Pelvic inflammatory disease ?
- Cervical motion tenderness
- Uterine tenderness
- Adnexal tenderness
- Fever
- Nausea, vomiting
characteristic symptoms of PID in M. genitalium (mycoplasma genitalium) infection ?
signs and symptoms similar to C. trachomatis
characteristic symptoms of PID in Chlamydia/gonorrhoea infection ?
- mucopurulent discharge
- cervicitis
characteristic of PID in gardnerella vaginalis infection ?
associated with BV
characteristic of PID in enteric pathogens e.g. E.coli infection
cercivitis less likely
