Infections of the Urgogenital Tract & STD's Flashcards
Toxic Shock Syndrome
Staphylococcus aureus
- not considered STD; urogenital disease
- super absorbent tampons would cause small tears in vaginal wall, providing appropriate conditions for bacteria to multiply.
- bacteria enter blood & produce exotoxins
- fever, low blood pressure, red rash on the trunk; deaths were due to shock
Bacterial Vaginitis
Gardnerella vaginalis
- usually caused by opportunistic organisms that multiply when normal vaginal flora is disturbed (by pregnancy, the pill, menopause, douching)
- can be potentially dangerous to a fetus, but not to mother
- CLUE CELLS (sloughed vaginal epithelial cells) have bacteria attached to them in distinctive patterns.
Syphilis
Treponema pallidum
- spirochete bacterium; difficult to isolate in patient
- can be transmitted in saliva
- 3 Stages:
1. primary - genital chancres
2. secondary - rash can look like chicken pox or heat rash (on hands & feet)
3. tertiary - damage to all organs, death
Latent stages occur between these stages.
- called “Great Imitator” b/c symptoms mimic so many other diseases
- mental illness accompanies neural damage
- CONGENITAL SYPHILIS occurs when bacteria cross the placenta (notched incisors; perforated palate, deformed shin bone; aged face w/saddle-shaped nose)
- PYROTHERAPY - used to treat by giving patients malaria; would cause high fever (kill the bacteria); treat for malaria - patients OK. Did this until penicillin came along.
- one shot of penicillin clears it.
Gonorrhea (the clap)
Neisseria gonorrhoeae
G(-) diplococci; posses pili that allow them to attach to epithelial cells & sperm.
- produce endotoxin that damages the reproductive tract mucosa & produce proteases that destroy IgA antibody.
- some people asymptomatic, can be carrier 5-15 years.
- silver nitrate drops in newborns’ eyes as preventative
-treatable w/antibiotics (penicillin & cirpo), but resistant strain found in Japan (H041)
Nongonococcal Urethritis (NGU)
Chlamydia trachomatis
- “nongonococcal” means may be similar to gonorrhea, but it’s not gonorrhea
- prevalence is greater than gonorrhea/syphilis
- most common bacterial std
- PID/epididymitis/sterility risk like gonorrhea
- infants can become infected when born; silver nitrate is ineffective
- blindness referred to as trachoma
AIDS (Acquired Immune Deficiency Syndrome)
HIV (Human Immunodeficiency Virus)
- retrovirus
- HIV targets & destroys T cells
ARC (AIDS Related Complex) is a condition in which antibody tests are positive for HIV. Show mild symptoms of HIV infection (fatigue, enlarged lymph nodes, night sweats, weight loss, diarrhea). Most patients develop KARPOSI’S SARCOMA (caused by herpes virus, tumors of blood vessels are seen as purplish spots on skin)
- Transmission - sexual contact, sharing of needles, blood transfusions
- Vaccine difficult due to high mutation of virus
Hepatitis B
Hepatitis B virus
partially double stranded DNA virus
- called AIDS twin & serum hepatitis
- transmission same as AIDS
- cannot donate blood/organs; not fecal-oral
- Acute infection is cleared, but chronic infections are treated with antivirals & interferon.
- FULMINANT HEPATITIS - a condition of total liver failure
- has been linked to liver cancer
- Vaccine - part of routine infant vaccination (genetically engineered vaccine)
Hepatitis D
Hepatitis D virus (HDV)
RNA virus
- HDV is considered to be a SUBVIRAL SATELLITE - can only propagate in presence of Hepatitis B virus. Uses the HBV surface antigen to form a capsid
- transmission can occur either
1. simultaneous w/HBV (coinfection)
2. superimposed on chronic HepB or HepB carrier state (superinfection)
- Co-infection withHDV increases risk of liver cirrhosis & cancer w/HBV. In combo w/HBV, HDV has the higher mortality rate of all hep infections.
Hepatitis C
Hep C virus
RNA virus
- not ID until 1989; blood & products not screened until 1992, so were a source of infection until then.
- the MOST COMMON blood-borne infection in US
- CDC urges people born between 1945-1965 to be tested (silent epidemic”)
- usually spread thru contact w/blood, needle sharing, body piercing, tattoos
- NOT spread thru sexual transmission; vertical trans. to fetus possible
- acute infection: 2 wks - 6 mos. after infection. Symptoms may be mild; classic hep symptoms; jaundice
- chronic: about 80% who become infected develop a chronic infect.
- Most common reason for liver transplant in US
Herpes
Herpes virus
Simplex Type 1 - oral; fever blisters, cold sores
Simplex Type 2 - genital
- one of the most common STD’s
- oral can become genital & genital can become oral
- LATENCY is a hallmark of herpes infections; can be triggered by fever, UV, stress, hormone imbalance, menstrual bleeding, trauma, diet
- when reactivated, virus moves along neuron to epithelial cells where it replicates & causes lesions
- Neonatal herpes - infected in birth canal
- HERPETIC WHITLOW - a lesion on a finger
- cannot eradicate virus, but ACYCLOVIR can reduce occurrence of lesions
Cytomegalic Inclusion Disease
Human cytomegalovirus (HCMV or just CMV)
- a Herpesviridae (aka Human Herpesvirus 5)
- establishes a latent/chronic infection that can be reactivated.
- infects 50-80% of adults in US
- virus interferes with antigen presentation
- spreads thru body fluids; horizontal transmission (std); teratogen (C in TORCH)
- asymptomatic in healthy; illness resembles mononucleosis
- immunocompromised: blindness, pneumonia, diarrhea, digestive tract ulcers, hepatitis, encephalitis, can be fatal.
- congenital: jaundice, purple skin blotches, low birth weight, splenomegaly, hepatomegaly, pneumonia, seizures, hearing & vision loss
Ebola
Ebola virus
RNA enveloped “thread” virus; 5 strains
- causes a severe hemorrhagic viral fever
- first recognized in 1976 in Zaire, Africa
- transmission: direct contact w/body fluids, possible respiratory, nosocomial trans is dangerous, monkeys a probably reservoir
- IP: 2-21 days
- no cure or treatments
- Zaire strain has 88% mortality rate
