Urethritis/Cervicitis/Vaginal Discharge

Question 1

Gonorrhea

Answer 1

Urethritis and Cervicitis
- small Gr- diplococcus, ‘the gonococcus’
- ‘kidney bean’ shaped
- obligate human pathogen
- rapidly killed by drying, sunlight,  moist heat, many disinfectants
- facultative intracellular
- aerobe to facultative anaerobe
- oxidizes glucose
- oxidase +
- many catalase +
Virulence**
- Adhesins 
  - Opa  
  - pili
- LOS
 IgA1 protease
(facultative intracellular)
- outer-membrane blebbing
Labs
- fastidious
- *chocolate or Thayer-Martin

Question 2

Ophthalmia neonatorum

Answer 2

Urethritis and Cervicitis
- small Gr- 
- *obligate intracellular parasite
- ‘lack peptidoglycan’
- causes genital infections, *inclusion conjunctivitis, *trachoma, interstitial pneumonia
Labs
- *elementary body (EB)
   - infectious form, metabolically inactive
- *reticulate body (RB)
   - noninfx, actively reticulating form

Question 3

Chlamydia

Answer 3

Urethritis and Cervicitis
Labs
• PCR dual for chlamydia trachomatis and nisseria gonorrhea
• Tissue culture if 100% accuracy required

Question 4

Trichomonas vaginalis

Answer 4

Vaginal Discharge
• flagellatedPROTOZOAN
• Can occur w/reduction in Lactobacilli (INC pH)
• prevalence coinfection other STIs
- causes trichomoniasis
- undulating membrane
-facultative anaerobe
Diagnosis
- *strawberry cervix
- *NAAT and other molecular tests
- *green, frothy, foul-smelling discharge
Virulence
- proteases, toxins