Chapter 26
Urinary system infections
Medgar Evers College
Bio 261
Prof. Santos
Anatomy of Female Urinary system
Normal Microbiota
• The upper urinary tract is void of normal
microbiota.
• The lower urethra is inhabited by certain
microorganisms such as species of
Lactobacillus, Staphylococcus,
Corynebacterium, Haemophilus,
Streptococcus, and Bacteroides.
Women
• Microbiota is influenced by estrogen level.
• After puberty, the level of estrogen
increases. This increase causes an
increase in Lactobacillus that produces
acid by products that lower the pH of the
vagina.
• This low pH keeps other pathogens away.
Urinary system Infections
• Microbes usually enter the reproductive
system through the:
• • Vagina (females) or urethra (males)
Bacterial
Disease
Cause
Sympto
ms
Pathoge treatmen
nesis
t
Bacterial
Cystitis
Cystitis usually
caused by E.
coli & S.
saprophyticus
• May also be
caused by
Proteus,
Klebsiella,
Enterococcus,
Pseudomonas
Burning,
Bacterial
painful, frequent ascends the
urination, foul
urethra.
smell and red
colored urine,
fever, chills,
back pain,
vomiting
Antimicrobial
medication,
hygiene, and
drinking fluids.
Leptospirosis
Disease
Cause
Sympto
ms
Pathoge Treatme
nesis
nt
Leptospirosis
Leptospira
interrogans
Chills, fever,
headache,
muscle
aches
Penetration of
mucous
membrane,
travels via
bloodstream,
and
colonization
throughout
body.
Avoid contact
with animal
urine, An
antibiotics such
as tetracycline.
Genital system diseases
• Sexually transmitted vs. non sexually
transmitted.
Bacterial vaginosis
Disease
Cause
Symptoms
Pathogenesis
treatment
Bacterial
vaginosis
Gardnerella
Vaginalis
A small
aerotolerant,
gram positive
bacteria
Infection
without
inflammation;
thin white
grayish bubbly
vaginal
discharge, fishy
odor,
Diagnosis by
clue cells,
higher vaginal
pH
Treatment:
metronidazole
Normal clue cell of Human Vagina
Infected clue cells
Vulvovaginal Candidiasis
Disease
Cause
Sympto
ms
Pathoge Treatme
nesis
nt
Vulvovaginal
Candidiasis
Candida
albicans
Itching, burning,
thick white
vaginal
discharge,
redness and
swelling
An
inflammatory
response to the
overgrowth of
the yeast
An antifungal
medication
such as
clotrimazole.
Staphylococcal toxic shock
syndrome
Disease
Cause
Symptoms
Pathogenesis
treatment
Staphylococcal
toxic shock
syndrome
S. aureus
fever, diarrhea,
vomiting,
muscle aches,
low blood
pressure, and a
rash.
Toxin (TSST-1)
A superantigen
Antimicrobial
agents,
frequent
change of
tampons by
menstruating
women
Bacterial sexually transmitted
diseases
• Most of these are STD’s (sexually
transmitted diseases)
• Prevented by condoms
• Treated with antibiotics
Bacterial infections include
•
•
•
•
Gonorrhea
Chlamydial Genital System infections
Syphilis
Chancroid
Gonorrhea- most common reported
STD in the United States
Incidence of Gonorrhea on the
USA
USA Distribution of Gonorrhea
Gonorrhea
• agent of infection =Neisseria gonorrhoeae
• Attaches to oral or urogenital mucosa by
fimbriae
• Females may be asymptomatic; males
have painful urination and pus discharge
• Treatment with antibiotics
• Untreated may result in endocarditis,
meningitis, and arthritis and ophthalmia
neonatorum – infant eye infections
Gonorrhea – gram-negative, pairs
of cocci
Pelvic Inflammatory Disease (PID)
• Polymicrobic, usually
– N. gonorrhoeae
– C. trachomatis
• Pelvic inflammatory disease (PID) is an
infection of the female reproductive
organs. It usually occurs when sexually
transmitted bacteria spread from your
vagina to your uterus and upper genital
tract.
Signs and symptoms of pelvic inflammatory
disease may include:
•
•
•
•
•
•
•
•
Pain in your lower abdomen and pelvis
Heavy vaginal discharge with an unpleasant odor
Irregular menstrual bleeding
Pain during intercourse
Low back pain
Fever, fatigue, diarrhea or vomiting
Painful or difficult urination
PID may cause only minor signs and symptoms or none at all.
Asymptomatic PID is especially common when the infection is
due to chlamydia.
Chlamydial genital system
infections
Disease
Cause
Sympto
ms
Pathoge treatmen
nesis
t
Chlamydial
genital system
infections
Chlamydia
trachomatis
Men; whitegray penile
discharge, pain
in the testes
Women; vaginal
discharge and
bleeding and
lower and upper
abdominal pain
Bacteria
attaches to
specific
receptors on
the epithelial
cells,
inflammatory
response and
massive cellular
immune
response
causes damage
Azithromycin
and other
antimicrobial
medications.
The U.S. Incidence of Syphilis
Geographical Distribution of
Syphilis
Syphilis
•Caused by Treponema
pallidum
•Invades mucosa or through
skin breaks
Syphilis
• Primary stage: Chancre at site of infection
• Secondary stage: Skin and mucosal
rashes
• Latent period: No symptoms
• Tertiary stage: Gummas on many organs
• Treatment: Benzathine penicillin
• Congenital: Neurological damage
Lesions of Primary Stage Syphilis
Lesions of Secondary Stage
Syphilis
Lesions of Tertiary Stage Syphilis
Chancroid (Soft Chancre)
• Causative agent: Haemophilus ducreyi
• Symptoms: Painful ulcers of genitals
swollen lymph nodes in groin
• Diagnosis: Culture
• Treatment: Erythromycin; cetriaxone
Viral STD’S
Genital Herpes
• Caused by herpes simplex virus 2 (human
herpesvirus 2, or HSV–2)
• Painful vesicles on genitals
• Neonatal herpes transmitted to fetus or
newborns
• Recurrences from viruses latent in nerves
• Suppression: Acyclovir
Genital Warts
• Human papillomaviruses
• Warts in genital area
• HPV 16 causes cervical cancer and
cancer of the penis
• Treatment: Podofilox; imiquimod
• Prevention: Vaccination against HPV
strains
Male genital warts
AIDS
Disease
Cause
Symptoms
Pathogenesis
treatment
AIDS
Human
immunodeficiency
virus type 1
No symptoms
or flu like
symptoms,
latent period
followed by
other infections
that are
opportunistic
HIV-1 infects
CD+4 t cells
and
macrophages
and destroys
them and thus
weakening the
immune system
Abstinence
from sex,
protection,
antiviral
medications
such as reverse
transcriptase
and protease
inhibitors, and
good life style
Protozoal STD
Trichomoniasis
• Causative agent: Trichomonas vaginalis
• Found in semen or urine of male carriers
• Vaginal infection causes irritation and
profuse foul, greenish yellow frothy
discharge
• pH: 5–8
• Diagnosis: Microscopic identification,
DNA probe
• Treatment: Metronidazole