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Bacterial and Viral Urogenital Tract Infections and STD's
For 2420 Micro Class.
Terms in this set (43)
-Diagnosis: urinalysis: look for presence of nitrates & proteins in urine
-Symptoms: dysuria (painful urination), frequent urination, cloudy/foul smelling urine, kidney pain, nausea, vomiting, fever
-Prevention: drink lots of water; urinate frequently; drink cranberry juice (2 antiadherence compounds have been isolated); urinate after sexual intercourse; avoid bubble bath, etc. that could irritate urethra; proper hygiene (wipe front to back)
-Treatment: antibiotics; culture to be specific/narrow spectrum
-Common culprits: E. coli, Pseudomonas, Enterococcus, Klebsiella, Proteus, Staphylococcus aureus, Serratia marcescens, Acinetobacter baumannii (nosocomial, catheters)
inflammation of urethra
inflammation of ureter
TSS (Toxic Shock Syndrome) Is Caused By:
TSS (Toxic Shock Syndrome)
-incidence rose sharply in late 1970's; rise associated with new superabsorbent, but abrasive, tampons, which were left in vagina for long periods of time; tampons caused small tears in vaginal wall and provided appropriate conditions for bacteria to multiply
-bacteria enter blood and produce exotoxins; fever, low blood pressure (shock), and a red rash on the trunk (bumps are well separated); deaths are due to shock (vasodilation throughout the body causes a drop in blood pressure).
Bacterial STD's (Sexually Transmitted Diseases)
Bacterial STD's (Sexually Transmitted Diseases)
Bacterial Vaginitis (B.V.) Is Caused By:
Bacterial Vaginitis (B.V.)
-Usually caused by opportunistic organisms that multiply when the normal vaginal microflora are disturbed by antibiotics or other factors (pregnancy, use of contraceptive pills, menopause, douching); has now been shown to also be transmitted sexually.
-Can be potentially dangerous to a fetus, but not to mother
-Diagnosis - clue cells (sloughed vaginal epithelial cells) have bacteria attached to them in distinctive patterns.
Syphilis Is Caused By:
About Treponema pallidum
-spirochete bacterium; difficult to isolate in patient
-can also be transmitted in saliva
-3 disease stages: primary (genital chancres), secondary (rash can look like chicken pox or heat rash), tertiary (damage to all organs, death) - latent stages occur between these disease stages
-has periodic latent stages (no symptoms) that make patients sometimes think that they do not have an STD
-called the "great imitator" because its symptoms mimic those of so many other diseases; heart valves, blood vessels, and meninges can be affected
-mental illness accompanies neural damage
-congenital syphilis occurs when bacteria cross the placenta from mother to baby - infant may show signs such as notched incisors ("Hutchinson's teeth"), a perforated palate, a "saber tibia" (deformed shin bone), an aged face with a saddle-shaped nose
-less common than gonorrhea
-can be cured with antibiotics (penicillin & tetracycline)
Gonorrhea Urethritis [the "clap"] Is Caused By:
About Neisseria gonorrhoeae
-G(-) diplococci; possess pili that allow them to attach to epithelial cells and to sperm; can survive in dried masses of pus for 6-7 weeks
-produce endotoxin that damages the reproductive tract mucosa and produce proteases that destroy IgA antibody
Gonorrhea Urethritis [the "clap"]
-"flow of seed" a Greek physician in 130 AD mistook pus for semen
-some people are asymptomatic; can be a carrier for 5-15 years postinfection
-contraceptive pills alter vaginal conditions in favor of gonococcal growth
-initially caused urethritis - can be confused with a UTI; females can develop PID - pelvic inflammatory disease which can lead to sterility; bacteria infect the endometrium of the uterus and fallopian tubes; leading cause of infertility in the US; can also cause an ectopic pregnancy; in men can cause epididymitis which can lead to sterility.
-can also cause infections of pharynx (from oral sex), rectum (from anal sex), arthritis, blindness; silver nitrate once administered to the eyes of newborns to prevent infections - due to antibiotic resistance, some physicians have returned to this practice.
-treatable with antibiotics (penicillin & cipro); July 2011 strain discovered in Japan that is resistant to all currently available antibiotics - strain has been dubbed H041.
Nongonococcal Urethritis (NGU) Is Caused By:
Nongonococcal Urethritis (NGU)
-"nongonococcal" means symptoms may be similar to gonorrhea, but it's not gonorrhea; symptoms are generally milder.
-prevalence is greater than gonorrhea/syphilis; the most common bacterial std's
-bacteria has an intracellular life cycle (bacteria enter host cells)
-disease may be difficult to detect (80% of women and 10% of men are asymptomatic)
-PID/epididymitis/sterility risk like gonorrhea
-infants can become infected when passing through birth canal; silver nitrate is ineffective
-blindness referred to as trachoma
Genital (Venereal) Warts or Condyloma Are Caused By:
Genital (Venereal) Warts or Condyloma
-all warts are caused by different strains of human papilloma viruses (HPV); researchers have identified >100 strains of HPV; ~60 strains cause plantar warts on hands/feet; ~40 different strains cause genital warts and cancer; not all strains that cause genital warts cause cancer
-HPV causes virtually all cervical cancer, most anal cancer, and some vaginal, vulvar, penile, and oropharyngeal cancers.
-warts are more common in women
-genital warts are one of the most common STD's; many people are asymptomatic, but can still transmit the virus
-usually transmitted by direct contact (skin to skin)
-many HPV infections can be cleared by the body, but some are chronic
-no cure for the infected, but warts can be removed - treated with cryotherapy (freezing) or caustic chemical agents
-pathogenicity: virus is lysogenic; viral DNA inserts into the host cell's chromosome and alters the DNA so that the host cell divides out of control
-Gardasil vaccine (genetically engineered) - includes 4 HPV strains: 6, 11, 16, 18
AIDS (Acquired Immune Deficiency Syndrome) Caused By:
HIV (Human Immunodeficiency Virus)
About the virus:
This virus is called a retrovirus (retro means backward). AZT (azidothymidine), which is used against HIV, helps stop reverse transcription by targeting the enzyme reverse transcriptase. There are 3 major groups of HIV and 10 subtypes; most cases in U.S. caused by type I.
-Symptoms: infection typically causes flu-like symptoms, followed by an asymptomatic period of months or years during whitch the patient can transmit the disease; specifically targets and destroys T helper cells and macrophages, thus affecting both the B cell and cytotoxic T cell responses, so person can die of a secondary infection; most patients develop Kaposi's sarcoma (caused by a herpes virus; tumors of blood vessels are seen as purplish spots on skin, but occur throughout the body)
-ARC (AIDS Related Complex) is a condition in which antibody tests are positive for HIV. Patients with ARC show the mild symptoms of HIV infection, which include enlarged lymph nodes, fatigue, night sweats, weight loss, and diarrhea.
-Transmission: sexual contact (all forms), sharing of needles, blood transfusions, mother to infant; development of a vaccine is difficult due to high mutation rate of virus
-AIDS has become the 5th leading cause of death among 25 to 44 yr. olds!
-In 2000, AIDS associated illness caused the death of 3 million people worldwide; common infections include herpes, CMV, Toxoplasma (protistan), Crytptococcus (fungus), Cryptosporidium (protistan), Candida (fungus).
Hepatitis B Cused By:
Hepatitis B Virus (HBV)
About Hepatitis B Virus (HBV)
-Partially double stranded DNA virus
-Discovered in 1965; blood screening began in 1969
-Called "AIDS' Twin" and "serum hepatitis"
-Transmission: same as with HIV (body fluids); sexual contact, blood transfusions, re-use of contaminated needles & syringes, body piercings & tattoos, and vertical transmission from mother to child during childbirth
-can't ever donate blood/organs. Not transmitted through food/water like Hep A & E.
-With acute infection, infection is cleared spontaneously. Chronic infections are treated with antivirals and interferon. With chronic infections, treatment relieves some symptoms, but does not cure disease; some patients required a liver transplant if damage is severe. Some patients develop fulminant hepatitis, a condition of total liver failure. Has been linked to liver cancer (increases chances of developing liver cancer by as much as 300 times)
-Symptoms: abdominal pain, nausea/vomiting, loss of appetite, abdominal distension, jaundice, dark urine, clay colored stools, hepatomegaly, chronic inflammation -} cirrhosis (scarring); about half of infected people are asymptomatic
-now part of routine infant vaccination (genetically engineered vaccine)
Hepatitis D (HDV)
-HDV is considered to a subviral satellite because it can propagate only in the presence of the hepatitis B virus (HBV). HDV uses the HBV surface antigen to form a capsid.
-Transmission of HDV can occur either via simultaneous infection with HBV (coinfection) or superimposed on chronic hepatitis B or hepatitis B carrier state (superinfection).
-Co-infection with HDV increases the risk of liver cirrhosis and liver cancer associated with HBV. In combination with hepatitis B virus, hepatitis D has the highest mortality rate of all the hepatitis infections.
Hepatitis C Caused By:
Hepatitis C Virus (HCV)
Hepatitis C Virus (HCV)
-not identified until 1989; blood, blood products (plasma, platelets, antibody), & organs not screened until 1992, so were a major source of infection prior to this time
-the most common blood-borne infection in the United States, affecting at least 4 million people
-The Centers for Disease Control and Prevention urges people born between 1945 and 1965 to be tested, noting that roughly 75 percent of people with the disease are baby boomers. The number of baby boomers dying from a "silent epidemic" of hepatitis C infections is increasing so rapidly that federal officials are planning a new nationwide push for widespread testing.
Transmission of Hepatitis C
-HCV usually spreads through contact with blood, most commonly by sharing needles and other equipment used to inject illegal drugs, but also through blood/organ donations, body piercing and tattoos; health care workers face a risk (although low, less than 2%) of infection from accidental needle sticks and other occupational exposures; can also be spread from using same tooth brush, razor, etc.
-Sexual transmission of HCV is considered to be an inefficient and rare mode of transmission. However, concurrent HIV infection results in increased HCV RNA levels (viral load), which are thought to increase infectiousness of HCV acquired through sexual contact. Of further concern among persons who are coinfected is that HIV accelerates HCV disease progression, even in its early stages. A recent report suggests high-risk sexual behavior as a cause of HCV transmission among HIV-infected MSM in New York City. Unprotected receptive anal intercourse with ejaculation and sex while high on methamphetamine were the most important predictors of HCV infection. Any sexual practices that involve higher levels of trauma to anogenital mucosa ("rough sex") can increase risk
-Vertical transmission to the fetus is possible
-Blood, blood products (plasma, platelets, antibody), & organs not screened until 1992, so were a source of infection prior to this time
-Not transmitted through food/water like Hep A & E.
Acute and Chronic Infection of Hepatitis C
-Acute Infection: occurs 2 weeks to 6 months after infection, usually is so mild that most people don't know they are sick. Older children and adults may develop some mild symptoms, such as fatigue, sore muscles, headache, widespread abdominal pain or pain that is concentrated in the upper right quadrant of the abdomen; nausea, dark urine, light (clay-colored) stools, loss of appetite or weight loss, aversion to some foods, particularly those that are fatty or fried or high in protein, jaundice.
-Chronic Infection: About 80% of people who become infected with HCV develop a chronic infection, which they often have for the rest of their lives. However, the majority of people with chronic HCV infection will not develop severe liver damage. Although it may take many years, up to 20% of people who have chronic HCV infection develop liver scarring (cirrhosis). Of these people, 1-4% also develop liver cancer. HCV infection is the most common reason for liver transplantation in the United States. In 2007, deaths from the disease surpassed those linked to HIV, and the numbers of fatalities are expected to continue increasing, researchers reported. Disease is severe in immunocompromised patients. Most people, especially young children, have no symptoms. If symptoms do develop, they may include:
• Constant tiredness (fatigue)
• A general sense of not feeling well (malaise)
• Mild abdominal pain
Herpes Caused By:
herpes simplex type 1
oral herpes; causes fever blisters or cold sores
herpes simplex type 2
Babies become infected when passing through birth canal; rare, but can become infected in utero; infected neonates usually have central nervous system damage and die within 10 days.
-Oral can become genital and genital can become oral (usually due to oral sex).
-Latency is a hallmark of herpes infections. More than 80% of the adult population worldwide harbors these viruses, but only a small proportion experience recurrent infections. Within 2 weeks of an active infection, viruses travel via sensory neurons to ganglia, where they become latent. They can be activated by fever, UV, stress, hormone imbalance, menstrual bleeding, trauma, diet, etc. When reactivated, virus moves along neuron to the epithelial cells, where it replicates and causes lesion.
-Disease can affect mucous membranes of mouth, eyes, lungs (herpes pneumonia); can also affect skin in places other than the mouth and genitals; a herpetic whitlow is a lesion on a finger that can result from exposure to oral, ocular, or genital herpes lesions.
-Treatment: cannot eradicate virus, but acyclovir can reduce reoccurrence of lesions.
Cytomegalic Inclusion Disease Is Caused By:
Human cytomegalovirus (HCMV or just CMV)
About Human cytomegalovirus (HCMV or just CMV)
-virus is a member Herpesviridae [also known as Human Herpesvirus 5]; establishes a latent (chronic) infection that can be reactivated
-infects between 50% and 80% of adults in the United States as indicated by the presence of antibodies in much of the general population
-virus interferes with Ag presentation
Cytomegalic Inclusion Disease
-infected cells swell and develop "owl eye" inclusion bodies (concentration of viral capsid proteins in cell)
-spreads through body fluids (saliva, blood, breast milk, etc.); horizontal transmission (std); teratogen [C in TORCH is for CMV]
-infection in adults & healthy children is usually asymptomatic; illness resembling mononucleosis can occur
-symptoms in immunocompromised (HIV patients, organ transplant recipients, newborns): blindness, pneumonia, diarrhea, digestive tract ulcers, hepatitis, encephalitis; can be fatal
-symptoms of congenital CMV: jaundice, purple skin splotches, low birth weight, splenomegaly, hepatomegaly, pneumonia, seizures, hearing and vision loss
Ebola Hemorrhagic Fever Is Caused By:
-RNA enveloped "thread" virus; 5 subtypes (strains)
-Causes a severe hemorrhagic viral fever
-First recognized in 1976 in Zaire, Africa
Ebola Hemorrhagic Fever
-Transmission: direct contact with body fluids; possible respiratory transmission; nosocomial transmission dangerous; monkeys a probable reservoir; transmission as an std rare, but possible.
-ID50 is less than 10 in primates
-IP: 2-21 days
-No cure or treatments
-Ebola Zaire strain has an 88% mortality rate
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