UGI 3 Flashcards
common site of gonorrhea infection in men and women and associated symptom
men: urethra; purulent urethral discharge
women: cervix; vaginal discharge
clinical presentation of gonorrhea
vaginal and urethral discharge, erosive vesiculobullous lesions, mucopurulent gonococcal cervicitis
features of neisseria gonorrhea
gram neg diplococci, non motile non spore forming, fastidious, oxidase positive,
virulence factor of neisseria gonorrhea
pili, Opa, por protein, LOS, iron binding protein
LIPOP
pathogenesis of neisseria gonorrhea
it binds to columnar epithelial cells of distal cervix or urethra using PILI and outer surface proteins then multiplies
in women gonorrhea spreads to the fallopian tube. how does it spread if its not motile?
uterine or urethral contractions
what can chronic infections of neisseria gonorrhea lead to
scarring and stricture of fallopian tube or urethra
how do you diagnose gonorrhea
- intracellular gram neg diplococci for women only
- non culture lab test
- thayer martin or chocolate agar with oxidase pos colonies
treatment of gonorrhea
250mg single dose of ceftriaxone together with 1g oral azithromycin
-there is resistance to fluoroquinolones so can only see cephalosporin (beta lactamase resistant)
when treating gonorrhea what else do you treat for
chlamydia since a good portion of people have both
increases the transmission of HIV
bacterial vaginosis, trichomoniasis, gonorrhea, chlamydia
most commonly reported notifiable disease
chlamydia
chlamydia trachomatis is associated with what disease
conjunctivitis, infant pneumonia, urogenital disease (D-K) lymphogranuloma venerum (LGV1, 2, 3)
since chlamydia is mostly asymptomatic, it often goes untreated. What could happen if chlamydia goes untreated in women
they can develop PID (pelvic inflammatory disease) which leads to infertility, ectopic pregnancy, chronic pelvic pain
what happens if men have chlamydia that goes untreated (though this is rare)
epididymitis and urethritis
features of chlamydia
- gram neg but atypical bacteria
- infectious form - elementary bodies
- replicative/non infectious form - reticulate bodies
- obligate intracellular
- gains entry via ulceration and laceration
why can’t you view chlamydia with a gram stain although it is gram neg
it is atypical in that it is intracellular
receptors for elementary bodies
– mucous membranes of the urethra
– endocervix, endometrium, fallopian tubes
– anorectum
– respiratory tract and conjunctivae
specimen used for testing in chlamydia
- urine or swab from urethra if male and vagina or endocervix if female
- for those that engage in anal or oral sex, rectum and oropharynx swab
best test for chlamydia
NAAT (like in trichomoniasis)
why are swabs and not exudate used as specimen for chlamydia
because it is an intracellular parasite
treatment for chlamydia
- azithromycin 1g orally, single dose
- doxycycline 100mg orally 2x/day for 7 days
