micro chap 23

-urine is a good growth medium for many microorganisms
-reduced urine flow or accidental introduction of bacteria into the bladder can result in cystitis
-if the infection also affects the kidneys it is called pyelonephritis
-an infection only in the urethra: urethritis

*sudden onset of symptoms
-pain in the pubic area
-frequent urges to urinate even when the bladder is empty
-burning pain accompanying urination (dysuria)
-cloudy urine
-orange tinge to the urine (hematuria)
-fever and nausea
-back pain indicated kidneys may also by involved

-zoonosis associated with wild animals and domesticated animals
-can affect the kidneys, liver, brain, and eyes
-major effects on the kidneys and is shed onto the environment through animal urine
-two phases:
*early (leptospiremic) phase
-sudden high fever, chills, headache, muscle aches, conjunctivitis, and vomiting
*second phase (immune phase)
-milder fever, headache, Weil's syndrome (kidney invasion), hepatic disease, jaundice, anemia, and neurological disturbances

-Schistosoma haematobium lodges in the blood vessels of the bladder
-may or may not result in symptoms
-if symptoms occur: itchiness in the area where the worm enters the body, fever, chills, diarrhea, and cough
-urinary tract symptoms occur later which may include blood in the urine and bladder obstruction

-inflammation of the vagina
-vaginal itching to some degree
-burning and sometimes a discharge occurs
-symptoms depend on the etiologic agent

-normal biota living in low numbers
-if grows rapidly and causes a yeast infection, white vaginal discharge occurs

-infection called vaginosis rather than vaginitis because inflammatino in the vagina does not occur
-vaginal discharge with a very fishy odor, especially after sex
-itching is common

-asymptomatic infections in approximately 50% of females and males
-some people experience long-term negative effects

-inflammation of the prostate gland
-acute or chronic
-pain in the pelvic area, lower back, or genital area; frequent urge to urinate; blood in the urine; and/or painful ejaculation

-N. gonorrhoeae is the etiologic agent- also known as the gonococcus
-symptoms in the male
*urethritits, painful urination and a yellowish discharge
*can occasionally spread from the urethra to the prostate gland and epididymus
*scar tissue in the spermatic ducts during healing can render a man infertile (rare)
-symptoms in the female
*likely that both urinary and genital tracts will be infected
*mucopurulent or bloody vaginal discharge
*painful urination if urethra is affected
*major complications occur when the infection ascends from the vagina and cervix to higher reproductive structures
-salpingitis
-pelvic inflammatory disease

-most common reportable infectious disease in the US
-majority of cases are asymptomatic
-symptoms in males:
*inflammation of the urethra
*symptoms mimicking gonorrhea
*untreated infections may lead to epdidymitis
-symptoms in female
*cervicitis
*discharge
*salpingitis
*may lead to PID
-certain strains can invade the lymphatic tissues, resulting in lymphagranuloma venereum
*headache, fever, muscle aches
*lymph nodes fill with granuloma cells and become enlarged and tender
-babies born to mothers with infections can develop eye infections and pneumonia

-three common infectious conditions resulting in lesions on a person's genitals
-syphilis, chancroid, and genital herpes
-having one of these diseases increases the chances of infection with HIV because of the open lesions

-three distinct clinical stages: primary, secondary, and tertiary
-latent periods of varying duration also occur
-transmissible during the early latency period between secondary and tertiary
-largely non-transmissible during late latent and tertiary stages

-appearance of a hard chancre at the site of entry of the pathogen (after an incubation period of 9 days to 3 months)
-lymph nodes draining the affected region become enlarged and firm
-chancre filled with spirochetes
-chancre heals spontaneously in 3-6 weeks but by then the spirochete has moved into the circulation

-3 weeks to 6 months after the chancre heals
-many systems have been invaded
-fever, headache, sore throat, followed by lymphadenopathy and a red or brown rash that breaks out on all skin surfaces
-hair often falls out
-lesions contain viable spirochetes and disappear spontaneously in a few weeks
-major complications occur in bones, hair follicles, joints, liver, eyes, and brain

-highly varied latent period, can last for 20 years or longer
-rare because of the use of antibiotics
-major complications occur by this stage
-cardiovascular syphilis: weakens the arteries in the aortic wall
-gummas develop in the tissues such as the liver, skin, bone, and cartilage

-from a pregnant woman's circulation into the placenta and fetal tissues
-inhibits fetal growth
-disrupts critical periods of development

-no system-wide effects
-infection usually begins as a soft papule at the point of contact
-develops into a soft chancre (painful in men, but may be unnoticed in women)
-inguinal lymph nodes can become swollen and tender

-caused by herpes simples viruses (HSVs)
-multiple presentations
*no symptoms, or single of multiple vescicles on the genitalia, perineum, thigh, and buttocks
*lesions from initial infection can be accompanied by malaise, anorexia, fever, and bilateral swelling and tenderness of the groin
*occasionally meningitis or encephalitis can develop
-after recovery from initial infection, may have recurrent episodes of lesions; generally less severe
-in the neonate and fetus, HSV infections are very destructive and can be fatal

*causative agents of genital warts
*an individual can be infected with HPV without having warts, however

-unclassified virus in the pox family
-can take the form of skin lesions
-wart-like growths on the mucous membranes or skin of the genital area

-10%-40% of women in the US are colonized asymptomatically
-when these women become pregnant, about half of their infants become colonized by the bacterium during passage through the birth canal
-small percentage of infected infants experience life-threatening bloodstream infections, meningitis, or pneumonia