micro ch 23

Escherichia coli accounts for 90% of the 7 million cases. most potent of all the pathogens that cause UTIs

• Urine
• Requires collection of a clean voided stream

• from external environment
• from blood passing throgught the renal artery
• normally flushed out during urination
• They are more common in males the first few months of life but by preschool its more prevalent in women.

• alpha hemolysins
• specialized pili- P pili
• - binds to receptor cells of urinary tract
• causes successful colonization
• In 90% of patients UTIs are identified as pyuria
• - more than 10 WBCs per cubic millimeter of urine
• - presence of WBC casts in the urine

• A gram stain of urine sample
• 1 bacterium per oil-immersion field indicates infection

UTI occuring in urethra

UTI occurs in bladder

UTI occurs in kidneys

UTi of the prostate

STDs

• most often affect women
• more sexual promiscuity= more likely to contract an STD

• Urethritis
• cervicitis
• prostatis
• pharyngitits (10-15 year olds most common location for STD)
• Pelvic inflamatory Disease (PID)

• Urethritis
• Cervicitis
• Prostatis
• Pharyngitis
• PIV
• Disseminated gonococcal infection

• Non-gonococcal urethritis
• Epididymitis
• Cervicitis
• Aalpingitis
• Lymphogranuloma Venereum

Syphillis

Non-Gonococcal urethritis

AIDS, AIDS related complex

Primary and recurrent gential herpes

Genital wars and association with cervical carcinoma

Vulvovaginitis and penile candidiassis

Trichomonoal vaginitis

• Causitive agent: Teponema pallidum
• Primary: Presence of chancre, (painless hard lesion)
• Secondary: widspread rash, sore throat, headace, mild fever, malaise, myalgia
• Latent: no clinical sign
• Tertiary: gummas, dementia, blindness, paralysis, heart failure--- you see this stage 20-30 years after initial infection

• gummus= granulosis lesion either bones, organs, skin
• Syphillis has very sensitive growing conditions

• causative agent: Nisseria Gonorrhorea
• can have very mild of no symptoms
• discharge, dysuria
• PID
• disseminated gonococcal infection
• tx: one dose of cephalosporins

• Has a unique replication cycle that involves two forms of bacterium
• These are the elementary body and the reticular body
• The replication cycle begins when an EB attaches to receptors on the plasma memebrane of the host cell and enters through endocytosis
• While in the endocytotic vesile, the EB converts to an RB.
• Instead of fusing with lysosomes, the vesicles fuse with other vesicles carrying the same pathogen.
• As the number of chlamydia in each vacuole increases, the endosome membrane expands by fusin gwith the lipids of the golgi aparatus to from a large inclusion body.
• AFter 24-72 hours, the process reverses and te RB form reorganizes and condenses to the EB form.
• The endosome membrane then either disintregrates or fuses with the host cell membrane releasing the EBs, which go on to infect new tarets.

• Females: most are asymptomatic → PID
• males: painful urination, pus discharge from penis
• lymphogranuloma venereum- severe form of disease characterized by a transient genitial lesion and a bubo in the groin

bubo= huge swelling of a lymphnode

• Elementary bodies- inefective form
• Reticulate bodies- reproductive form

Chlamydia

• diagnosed by demonstration of chlamydial DNA following PCR amplification
• tx’s w/ antimicrobial drugs
• prevented by abstience or mutual monogamy

genital herpes quadruples the risk of HIV infection

• diagnosis made based on chacteristics lesions
• tx requires administration of acyclovir or other antiviral agents to lessen symptoms
• prevention can be acheived through abstience or mutual monogamy
• condoms often provide little protection

caused by trichomonas vaginalis

• women- foul smelling, yellow-green baginal discharge and vaginal irritation
• males- typically asymptomatic

• Transmission primarily via sex
• most common currable STD in women
• individuals w/ multiple sex partners or infected w/ other veneral diseases are at higher risk for the disease

• caused by hemophilus ducreyi
• prodcues a toxin tht kills epethelial cells

E. Coli

Non-gonococccal Urethritis

D. All

D. Non-gonococal urethritis