Microbiology of genital tract infections Flashcards
What kind of bacteria predominate in the healthy vagina?
Lactobacillus spp
What is the function of lactobacillus spp in the healthy vagina?
To produce lactic acid +/- hydrogen peroxide to suppress the growth of other bacteria
A 24 year old patient presents with and intensly itchy vagina and a white discharge. What is the diagnosis?
Vaginal thrush
A 24 year old patient presents with and intensly itchy vagina and a white discharge. What organism most commonly causes this presentation?
Candida albicans
List the 4 organisms that are part of the vaginal flora?
Lactobacillus
Strep viridans
Group B haemolytic strep
Candida spp
A 24 year old patient presents with and intensly itchy vagina and a white discharge. What is the diagnostic test?
High vaginal swab for culture
A 24 year old patient presents with and intensly itchy vagina and a white discharge. What treatment would you prescribe?
Topical clotrimazole
Oral fluconazole
A patient presents complaining of a fishy smell coming from her vagina and a thin watery discharge. What is the diagnosis?
Bacterial vaginosis
A patient presents complaining of a fishy smell coming from her vagina and a thin watery discharge. What treatment would you prescribe?
Oral metronidazole
A patient presents complaining of a fishy smell coming from her vagina and a thin watery discharge. What are you looking for on culture in the lab?
Clue cells
What are “clue cells” that are seen in bacterial vaginosis?
vaginal epithelial cells that have bacteria adherent to their surfaces
A 22 year old male presents with pain and frequency of micturation. He also has some lower abdominal pain and on examination his prostate is tender.
Acute bacterial prostatitis
What are the common causitive organisms in acute bacterial prosatitis?
Same as UTI (E coli and other coliforms) but also need to check for STI
A 22 year old male presents with pain and frequency of micturation. He also has some lower abdominal pain and on examination his prostate is tender. What is the diagnosis test?
MSSU for culture and sensitivity.
First pass urine for chlamydia and gonorrhoea
How do you get acute bacterial prostatitis?
Rare complication of a UTI or STI
What is the empirical treatment for acute bacterial prostatitis?
Ciprofloxacin fro 28 days
What is the causative bacteria is syphillis?
Treponema pallidum
What does chlamydia trachomatic does stain with a gram stain?
No peptidoglycan in its cell wall
What is the treatment for uncomplicated chlamydia?
Azithromycin 1g oral dose
What kind of bacteria is neisseria gonorrhoeae?
Negative diplococcus
A sexually active male returns from holiday with a purulent discharge from his penis. What is the most likely diagnosis?
Gonorrhoea
A sexually active male returns from holiday with a purulent discharge from his penis. What test would you do to look for STIs?
Combined nucleic acid amplification tests or PCR (looks for gonorrhoea and chlamydia)
Done from first pass urine sample
What kind of swab do you take in a female patient suspected of having chlamydia?
HVS or vulvo vaginal swap which can be self taken.
A sexually active male returns from holiday with a purulent discharge from his penis. What is the treatment?
Gonorrhoeae
IM ceftriaxone + oral azithromycin
What screening tests is done to look for syphillis?
Combined IgG and IgM ELISA
What are the diagnostic tests used in syphillis?
TPPA (trepoma pellidum particle agglutination assay)
This is specific for syphillis but will remain positive for life even once patient has been successfully treated.
What does it mean there is a positive IgM ELISA test for syphillis?
Recent, untreated infection
You suspect someone as having syphillis but the combined IgG and IgM ELISA is negative. What does the result go out as? Do you need more tests?
No more tests needed. Result goes out as negative.
You suspect someone of having syphillis and the combined IgG and IgM ELISA test is positive. What do you do next?
Further tests to confirm whether this is an active infection or not.
- IgM ELISA
- TPPA (active infection)
VDRL
Which two tests will remain positive for life in someone who has had syphillis, even after successful treatment?
IgG, TPPA
Which two tests become negative after treatment for syphillis?
IgM
VDRL
