Micro Flashcards
Organism in gonorrhoea
Neisseria Gonorrhoea
Gram -ve intracellular diplococcus
Presentation of uncomplicated gonorrhoea in males and females
Male: urethritis, epididymitis, proctitis, pharyngitis
Females: Cervicitis, PID, disseminated disease
Complications of Gonorrhoea
Males: epididymitis, strictures
Females: infertility, adhesions
Treatment for gonorrhoea
¥ Ceftriaxone 500 mg IMI or IVI PLUS Azithromycin 1 g
Sequelae of chlamydia in males and females
Males
¥ Urethritis
¥ Epididymitis
- 50% of all cases
¥ ?Prostatitis
¥ Infertility
- CT → premature sperm death
¥ Throat and rectal infections
Females
¥ Infertility
¥ Pelvic Pain
¥ Adhesions
Treatment for chlamydia
Azithromycun and doxycycline
Candidiasis organism, clinical, diagnosis and treatment
C. albicans and C. glabrata
Clinical: pruritis and discharge
Diagnosis: history, pH < 4.5, culture
Treatment: topical imidazoles
Trichomonas organism, clinical, diagnosis and treatment
Diagnosis: nucleic acid
Organism: T vaginalis protozoan
Clinical: frothy discharge pruritis, red inflamed vagina
Treatment: metronidazole, tinidazole
Immediate treatment of new onset low abdominal pain in young women
PID - ceftriaxone and azithromycin
Preconception antenatal screening for immunity
Rubella immunity, HBV sAg, HCV, HIV, syphilis
Immunisation preconception
HBV, VZV, Measles, Mumps, Rubella, Human Papilloma virus (HPV)
Influenza and whooping cough during pregnancy
Post exposure prophylaxis
Ð Zoster (human) Immunoglobulin “ZIG” – Chickenpox
Ð Normal (human) Immunoglobulin – Measles
Ð CMV Immunoglobulin: indications for use? None for postexp
Congenital varicella syndrome
Ð cicatricial scarring, multidermatomal Ð limb hypoplasia Ð neurological defects Ð ocular defects Ð Risk of infant death in first 2 years: ~15%
No risk if infected >20 weeks, max risk week 13-20
Severe neonatal varicella infection
¥ Severe neonatal infection is associated with onset of maternal varicella 5 days before to 5 days after delivery.
¥ Mortality up to 30%
Maternal parvovirus presentation and fetal complications
Maternal:Ð asymptomatic in most
Ð mild respiratory tract illness
Ð arthralgia/arthritis (mainly adults esp female) +/- rash
Ð biphasic illness with rash
Fetal complications
highest risking 2nd trimester
susceptible to aplastic crisis, anaemia, high output cardiac failure
hydrous
Mastitis causative organism and signs
staph aureus, staph epidermis, group B strep
Signs: erythema, oedema, tenderness, fever, malaise
Treatment of mastitis
Avoid milk stasis: continue to breast feed frequently, heat before feeds and massaging during feeds – manual expression or pump
Analgesia: ibuprofen preferred or paracetamol
Antibiotics: usually given if inflammatory symptoms have not resolved over 12-24 hours and patient unwell with systemic symptoms (flucloxacillin or clindamycin if MRSA)
Post partum endometritis
- Uterine or adnexal tenderness
- Purulent and/or offensive lochia
- Fever
Risks for post party genital tract infection
- <10% risk if vaginal delivery
- 40-80% if non elective Caesar in setting of maternal chorioamnionitis
- XS blood loss post op maternal anaemia
- Duration of surgery
- Technique
- Antecedent intra amniotic infection (chorio-amnionitis)
Bacteria in post partum genital infections
Anaerobes
o Peptococcus/peptostreptococcus
o Clostridium species
o Bacteriodes species
Aerobes
o Group B streptococcus
o Group A streptococcus
o Enterococci/enteric gram negative rods
Treatment of post partum genital tract infections
AMOXICILLIN + GENTAMICIN + METRONIDAZOLE
Routine prevention of post partum genital infection
• ROUTINE: antibiotic prophylaxis for ALL caesarean sections
Group B streptococcal infection
Maternal disease: chorioamnionitis, endometritis, bacteraemia & secondary complications (wound infection, mastitis)
• usually Group B streptococci and other organisms
Neonatal disease
Early onset in first week: pneumonia, septicaemia, meningitis (higher mortality)
Late onset: after 1 week - principally meningitis
4 Main methods of GBS infection prevention
¥ Intrapartum chemoprophylaxis to at risk women
¥ Postnatal penicillin prophylaxis to new born babies
¥ Vaginal disinfectants-chlorhexidine (decrease GBS bioburden)
¥ GBS polysaccharide-protein conjugate vaccines
