Chapter 26
Microbial Diseases of the
Urinary and Reproductive Systems

Urinary System- consists of organs that regulate the chemical composition of the
blood and excrete waste products

Reproductive System- consists of organs that produce gametes for reproduction of
the species or support the developing embryo

Urinary System - Structure/Function
Consists of:
1. kidneys- remove impurities from the blood and concentrate it in the urine
2. ureters- tubules used to remove urine from the kidneys
3. urinary bladder- saclike structure that stores urine
4. urethra- tube through which urine leaves the body; also transports semen

Reproductive System - Structure/Function
Consists of:
Female
1. ovaries- produce the ova (eggs)
2. fallopian tubes- tube for transporting the ova from the ovaries to the uterus
3. uterus- where the embryo/fetus develops
4. vagina- where contents of the uterus exit
Male
1. testes- produces sperm
2. ducts for transporting seminal fluid and sperm
3. penis

Normal Microbiota of the Urinary and Reproductive Systems
-acid-forming lactobacilli, corynebacteria, bacilli, and cocci

Diseases of the Urinary System - Bacterial
Clinical Syndromes
-opportunistic infections
-urethritis- inflammation of the urethra
-cystitis- inflammation of the bladder
-ureteritis- inflammation of the ureter
*Cystitis
-more common in females
-caused by E. coli or Staphylococcus saprophyticus
-Symptoms: dysuria(difficult, urgent urination), pyuria (leucocytes in the urine)
*Pyelonephritis
-inflammation of the kidneys
-scar tissue forms and impairs kidney function
-caused by E. coli - 75%
*Leptospirosis
-caused by Leptospira interrogans - spirochete
-Symptoms: fever, chills, headache
-localization of organism in the kidney = jaundice and possible kidney failure
-mainly a disease of animals that excrete the organism in their urine
-Transmission to humans: contact with urine-contaminated water

Diseases of the Reproductive System - Bacterial
-Diseases of the reproductive system transmitted by sexual activity are called
sexually transmitted diseases (STDs).
*Gonorrhea
-most common reportable communicable disease in the US
-caused by Neissereia gonorrhoeae - gram (-) diplococcus
-attaches to the epithelial wall of the urethra by fimbriae = infective
-invades oral-pharyngeal area, cervix, eyes, and rectum
-Symptoms: Males: painful urination, discharge of pus from the urethra
Complication: possible sterility from blockage of reproductive ducts
from scarring
Females: unaware of infection, pain (uterus and uterine tube infection)
-Complications: gonorrheal endocarditis (heart), gonorrheal meningitis
(meninges), gonorrheal arthritis (joints), ophthalmia neonatorum
(infection of eyes as infant passes through the birth canal/prevention:
antibiotics at birth), gonorrhea can be transferred by hand contact,
any area of sexual contact, pharyngeal gonorrhea ( resembles sore
throat symptoms), anal gonorrhea (painful with discharge of pus)
-Treatment: no immunity. Tetracycline
*Nongonococcal Urethritis (NGU) - nonspecific urethritis
-caused by Ureaplasma urealyticum or Mycoplasma hominis, chlamydias,
obligate intracellular parasites that are not easily cultured
-common STD in the US, but is not reported
-Treatment: tetracycline
*Pelvic Inflammatory Disease (PID) - any extensive bacterial infection of the
female pelvic organs
-caused by Neisseria gonorrhoeae; frequently coinfected with chlamydial
bacteria
-Salpingitis(infection of the uterine tubes) most serious kind of PID; causes scarring
which blocks passage of ova from the ovary to the uterus - results in ectopic (tubal)
pregnancy(fetus develops in the uterine tube
*Syphilis
-caused by Treponema pallidum- gram (-) spirochete
-Transmission: sexual contact
-Incubation: 3 weeks
-Symptoms:
Primary stage -chancre or sore at site of infection
-fluid from chancre is highly infectious
Secondary stage - rash occurs on the skin and mucous membranes
-lesions are highly infectious
-Transmission: nonsexual (kissing, dental work, etc.)
Latent stage
-lasts for years after 2ndary infection
Tertiary stage -(< than 1/2 the cases) disease reappears after many
years; production of gummas (lesions) causes
extensive tissue damage
-Congenital syphilis- causes damage to an infant's mental development
-Treatment: benzathine penicillin
*Lymphogranuloma Venereum
-caused by Chlamydia trachomatis
-disease associated with regions of the tropical world and the southeastern US
-Symptoms: regional lymph nodes become enlarged and tender
-Complications: scarring of lymph drainage ducts = enlargement of male
genetalia and rectal narrowing in females
*Chancroid (Soft Chancre)
-mainly a tropical disease
-cases in the US are associated with drug users
-formation of a painful ulcer on the genitalia with spreading to lymph nodes
-caused by Haemophilus ducreyi
*Bacterial Vaginosis
Vaginitis- infections of the vagina; caused by Candida albicans (fungus)
Trichomonas vaginalis (protozoan), Gardnerella vaginalis
(bacterium)
-C. albicans - acts as an opportunist
-T. vaginalis and G. vaginalis are sexually transmitted
-Diagnosis: fishy odor, vaginal pH > 5, "clue cells" - sloughed off vaginal
epithelial cells covered with bacteria
-Treatment: metronidazole
Viral Diseases of the Reproductive System
*Genital Herpes
-caused by herpes simplex virus type-2; enters a latent stage in nerve cells and
reappears at intervals
-Symptoms: lesions with burning sensation and vesicles
-lesions are infectious to an infant at birth -neonatal herpes (fatal or
neurological damage)
-Treatment: acyclovir
*Genital Warts
-caused by papillomaviruses - also causes cervical cancer
*AIDS
-viral disease transmitted by sexual contact
Fungal Diseases of the Reproductive System
*Candidiasis
-caused by Candida albicans - yeastlike fungus that grows on mucous
membranes
-vulvovaginal candidiasis- infection of the mucous membrane of the vagina
-Symptoms: irritation, sever itching, yellow,cheesy discharge, yeasty odor
-Predisposing conditions: pregnancy, diabetes, tumors, immunosuppressive
drugs or antibiotics
-Treatment: clotrimazole and miconazole
Protozoan Diseases of the Reproductive System
*Trichomoniasis
-caused by Trichomonas vaginalis
-results when the acidity of the vagina is disturbed and the protozoa outgrow
the normal microbiota
-Symptoms: Males: none
Females: purulent discharge, odor, irritation, itching
-Treatment: metronidazole