Lect 21 Flashcards
Chlamydia Trachomatis can cause what 4 infections
- trachoma
- lymphogranuloma venereum
- inclusion conjunctivitis
- NGU (nongonococcal urethritis)
Chlamydia Trachomatis
- gram status
- requirements
- obligate intracellular bacteria, require host derived ATP
- gram negative
Chlamydia Trachomatis exists in what 2 forms
- elementary body: infectious
- reticulate body: intracellular
list the 3 main causes of nongonococcal urethritis
- Chlamydia Trachomatis
- ureaplasma urealyticum
- mycoplasma genitalium
main reservoir of ureaplasma urealyticum and mycoplasma genitalium
genital tract of sexually active person
NGU from C. trachomatis has highest prevalence in what patient population
- teenagers
ascension of C. trachomatis in females can cause
- salpingitis
- PID
presentation of NGU C. trachomatis in males
- urethritis and epididymitis
- water, odorless discharge
toxin of C. trachomatis
- toxin similar to Toxin B in C. Diff
- causes
- chronic inflammation
- sloughing of mucosal cells
- causes
how is C. trachomatis diagnosed
- isolation of cell culture: gold standard
- nucleic acid probes
Tx: C. trachomatis
azithromycin or tetracycline
Trichomonas vaginalis
- in what form does it exist
- exists as a trophozoite
- flagellated protozoan
- extracellular anaerobe
how is Trichomonas vaginalis transmitted
sexual intercourse
clinical presentation
- males: asymptomatic, scant, clear to mucupurulent d/c
- females: profuse vaginal d/c, frothy and malodorous
Trichomonas vaginalis
Trichomonas vaginalis in women can lead to what co-condition
bacterial vaginosis
how is Trichomonas vaginalis diagnosed
- wet mount exam
- culture
tx Trichomonas vaginalis
metronidazole
what is bacterial vaginosis
- not an STI
- caused by overgrowth of opportunistic pathogen in vagina due to changes in pH
differentiate between vaginal pH in normal vs vaginosis
- normal: PH < 4.5
- vaginosis: pH: 5-6
List the criteria that are present to diagnose bacterial vaginosis
- presence of CLUE CELLS
- fishy odor when 10% KOH added
- pH > 4.5
where are Candidiasis spp normally found
- normal flora of skin and mucous membranes
- opportunistic fungal infections
vulvovaginal candidiasis is normally caused by what species
candida albicans
clinical presentation
- thick, white, frothy d/c in women (no odor)
- itching, irritation
- burning sensation with intercourse or urination
- vaginal pain
vulvovaginal candidiasis
candida albican parent yeast can turn into what 3 forms
- budding yeast
- pseudohypha
- germ tube -> hypha
which form of candida albican is the most adhesive
germ tube
how is candida albican diagnosed
- direct microscopic exam
- large G+ cells (will stain purple)
- yeast cells, true hyphae, pseudohyphae
- Culture -> chromagar
tx of vulvovaginal candidiasis
- topical cream: miconazole
- oral fluconazole
Haemophilus
- gram status
- motile
- gram negative
- non motile
Haemophilus Ducreyi leads to formation of what lesion
chancroid
clinical presentation
- develops 3-5 days post infection
- vesicle or papule that quickly progresses to pustulation and ulceration
- lesion: tender papule on genitalia that lacks induration, bleeds readily,
soft chancre of chancroid -> Haemophilus Ducreyi
how is Haemophilus Ducreyi diagnosed
- required identification of Haemophilus Ducreyi from genital ulcer or swollen lymph node
- PCR
tx: Haemophilus Ducreyi
3rd gen cephalosporin
**needs susceptibility testing
Pelvic inflammatory disease is usually caused by what two pathogens
- Neisseria gonorrhoeae
- chlamydia trachomatic
what increases risk of developing PID
- STD present
- prior episode of PID
- sexuall active adolescent
- mult sex partners
- frequent douching
clinical presentation
- low abd pain
- abnormal vaginal discharge
- painful intercourse
- increased pain with menstruation
- scarring
- irregular menstruation
- fever and chills
PID
how is PID diagnosed
- clinically
- evidence of inflammation
- fever, leukocytosis, elevated ESR
