Infection of the genital tract - PowerPoint Presentation

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Infection of the genital tract

Done by:

Tasneem

abue

tailakh

Safaa

alijla

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Infection of the genital tract

- Bacterial

- Viruses

- Fungi

- parasite

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Bacterial

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Syphilis

Syphilis

is a

sexually transmitted disease caused by the

spirochetal

bacteria

treponema

pallidum

subspecies

pallidum

.

The primary route of transmission of syphilis is through

sexual contact

however it may also be transmitted from mother to fetus during pregnancy or at birth resulting in

conginetal

syphilis.

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The signs and

symptomes of syphilis vary depending on which of the

four stages

it presents in (primary, secondary, latent, and tertiary).

- The

primary stage

typically presents with a single

0

chancre

-

secondary syphilis

with a diffuse rash

0

-

latent

with little to no symptoms

- tertiary

with

gumms

, neurological, or cardiac symptoms.

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Treponema

pallidum

Treponema

pallidum

is a species of

spirochaete

bacterium with subspecies that cause

treponemal

diseases such as

syphylis

.

It is not seen on a gram stain smear because the organism has a waxy coat around it that does not accept the Gram stain.

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Chancroid

Chancroid

, or soft chancre, is a sexually transmitted disease caused by

Haemophilus

ducreyi

, a gram-negative bacillus.

It is relatively uncommon in the United States, but is the most common cause of genital ulcers in Africa.

The incubation period is 3 to 7 days. The lesion begins as a soft, red papule. Within 1 to 2 days, it becomes

pustular

, eroded, and ulcerated.

The ulcer is usually 1 to 2 cm in diameter, painful, and covered by a yellowish or gray exudates; it bleeds easily when scraped. The edges of the ulcer are ragged and undermined.

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Chancroid

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Chancroid

does not have a vesicular stage. In males the ulcer is typically located on the distal penis, but may occasionally occur in the urethra and anal orifice.

In females, the lesions tend to be localized to the vulva but can also occur in the vaginal,

perianal

area, and cervix.

Painful inguinal

lymphadenopathy

and over-riding

erythema

is associated with

chancroid

in nearly half of all cases in males, less often in female cases.

The lymph nodes become fluctuant, can spontaneously rupture, and drain pus. Systemic symptoms can occur but are rare.

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Chancroid

Lesion is located in the

anogenital

area

Lesion is a painful ulcer without

eschar

Lesion lacks vesicular stage

 

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Lymphogranuloma

Venereum

Lymphogranuloma

venereum

(LV) is a sexually transmitted disease caused by

chlamydia

organisms.

LV is found most frequently in the tropical and subtropical parts of the world.

The incubation period ranges from 3 to 12 days.

The primary lesion is a 5- to 8-mm, soft, red, painless erosion or ulcer.

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The ulcer heals spontaneously in a few days. The secondary stage begins 2 to 6 weeks later and is characterized by the appearance of tender, inguinal

adenopathy

, which develops with over-

riding

erythema

and edema.

The lymph nodes coalesce, may fluctuate, and drain spontaneously. Associated fever, chills, and malaise can be severe.

The late stage of LV is characterized by

anogenital

strictures in untreated or under-treated cases.

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Granuloma

Inguinale

Granuloma

inguinale

is a chronic bacterial infection of the genital region, generally regarded to be sexually

transmitted.

Granuloma

inguinale

is a relatively rare disease occurring in people living in tropical and subtropical areas.

It occurs more frequently in males.

In the United States, while homosexuals are at greater risk, it is relatively rare in heterosexual partners of those infected.

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Granuloma

Inguinale

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Urethral discharge in males

Discharge from the male urethra has many causes, but when an adult seeks medical assistance , the cause is often

urethritis

caused by a sexually transmitted infection .

Purulent discharge from the urethra may be caused by either

C.tracomatis

(serotypes A-K) or

N.gonorrhoeae

.

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Although

N.gonorrhoeae

typically causes a more obviously purulent discharge ,there is overlap in the clinical presentation and a high proportion of dual infection .

The patient may have

dysuria

but some patients have

urethritis

without a clinically evident discharge .

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Vaginal discharge

Bacterial

vaginosis

:

In bacteria , there is a thin discharge with a distinctive

odour

, which the patient may well notice .

The condition is caused by a

distutbance

in vaginal flora that results in in an over growth of

commensal

anaerobic , the metabolic products the metabolic products of these include volatile amines , hence the smell.

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Species including

Gardnerella

vaginitis

and

Mobiluncus

sp.

have been implicated as possible causes of condition ,but isolation of the organisms does not help in the clinical management of individual patient.

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cervicitis

Inflammation of the uterine cervix is usually caused by sexually transmitted infection with either

N.gonorroeae

or

C.tracomatis

.

Cervicitis

is the female counterpart of

urethritis

in adult males .

Unfortunately , it is not so easily noticed and a large proportion of cases go undiagnosed .

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The consequence of undiagnosed

cervicitis

is ascending infection of female genital tract ,

endometritis

,

salpingitis

tubo

-ovarian abscess or disseminated

gonococcal

infection (DGI) .

The most important non-infective

sequelae

include infertility or , if the fallopian tubes remain patent, an increased risk of tubal pregnancy .

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Pelvic

infgammatory

diseases

PID is a term used to refer to infection of the female pelvic organs ,it is usually sexually transmitted .

Infection of the fallopian tubes , the

adjasent

structures and abscesses in the pouch of

Douglas usually occur as a result of

assending

sexually transmitted infection from the lower

genetal

tract .

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N.gonorreae

and

C.tracomatis

are prominent causes of PID .

However, many cases are

polymicrobial

and feature other species such as anaerobic bacteria ,

Sreptococci

,

Mycoplasma

and

Ureplasma

spp.

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Intrauterine infection

Infections of the uterus are uncommon and arise in several specific setting .

Endometritis

may

occure

as a consequence of ascending infection with

N.gonorreae

or C.

tracomatis

but is

rarly

diagnosed as

adistinct

entity.

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Infection may arise postpartum or

postabortion

, when bacteria from the vaginal flora gain access and establish an acute

endometritis

.

This process is assisted by the presence of retained products of conception .

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Postpartum ,the patient will have offensive

lochia

and fever .

This was often caused by Streptococcus

pyogen

, but anaerobic and other bacteria may also be implicated .

Extension of infection into the

myometrium

and spread via the

bloodsream

may develop rapidly.

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Pelvic

actinomycosis

Amore insidious

intrauterin

infection is pelvic

actinomycosis

, caused by the bacterium

Actinomyces

isra

.

Infection occurs more commonly in women with IUDs .

These patient may have any of the features of cervical or uterine infection .

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The majority of patients who come to medical attention have

have

had

actinomyces

– like organism noted in cervical smear .

In most cases , these are

commensal

organisms and don’t signify active infection .

Management by removal of IUD ,but

penicilline

treatment is advised .

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Epididymitis

Is an infection of the

epidydimis

caused by

avariety

of bacterial species .

In men under the age of 35 years most cases of

epididymitis

are caused by ascending sexually transmitted infection usually with :

N .

Gonorreae

or

C.tracomatis

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In older men , infection is more often caused by

enterobacteriaceas

,

Staph and

Cornebacteria

spp

The

epididymis

is tender to palpation and

ther

e may be local pain .

If the

infectin

has arisen from ascending ,sexually transmitted infection there may be clinical picture of

urethritis

.

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The condition may be

difficlt

to distinguish from

testiculer

torsion , in which case

cergical

removal is required .

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Thank you

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Safaa

Khalil

Organisms infect the genital tract

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Abnormal vaginal discharge

watery discharge

white discharge

thick white chunky discharge

(like cottage cheese)

swelling of the

vulvar

skin

pain with intercourse

painful urination

redness of the vulva

vaginal and labial itching, burning.

These infections are more common after taking an antibiotic.

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Fungal

Candida

albicans

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Tests

A history and physical exam will be performed

A KOH smear identifies the Candida organism.

Treatment

Treatment

inlcudes

over-the-counter vaginal creams such as

miconazole

clotrimazole

butoconazole

terconazole

. Prescription pills such as

fluconazole

vaginal suppositories, and creams are also available.

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is a common sexually transmitted disease that affects both men and women

Features of it include pain, itching and Painful blisters in genital area.

Systemic symptom including fever &

myalgia

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Genital herpes

Herpes simplex virus

1&2

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Tests

A history and physical exam will be performed.

direct fluorescent antibody (DFA) test can be done to establish the diagnosis Culture of a genital lesion may be done.

Treatment

Treatment includes suppression with medical therapy (acyclovir,

famciclovir

)

pain medications acetaminophen

nonsteroidal

anti-inflammatory medications/NSAIDs (ibuprofen/Motrin or Advil, naproxen/

Naprosyn

).

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The most common sexually transmitted disease

There are many types that can infect the genital areas of males and females, and some can also infect the mouth and throat

Unfortunately most people do not know they are infected with the it since the initial symptoms can be minor. In 90% of people the …. is cleared from the body without any treatment.

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appear as a small bump or groups of bumps in the genital area.

They can be small or large, raised or flat, or shaped like a cauliflower.

They appear within weeks or months after sexual contact with an infected partner.

.

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Cervical cancer usually does not have symptoms until it is advanced and difficult to treat.

Symptoms of advanced cervical cancer include vaginal pain, abnormal vaginal intercourse, painful intercourse, and vaginal fullness

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(VIN)

penile intraepithelial

neoplasia

(PIN)

and/or

anal intraepithelial

neoplasia

(AIN).

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Genital warts

HPV

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Tests

A history and physical exam will be done.

HPV is diagnosed by the appearance of the genital warts or through a PAP smear for women.

Treatment

There is no treatment for the virus itself, but there are treatments for the problems that HPV can cause.

Most genital warts will go away on their own. Healthcare providers can provide medication or remove the warts directly.

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There is a vaccine against HPV which can help prevent acquiring the disease.

Condoms during sexual intercourse are also recommended to protect against HPV and other sexually transmitted diseases (STDs).

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Diarrhea

fatigue

fever

frequent vaginal yeast infections

headache

mouth sores

including

candidal

infection

muscular stiffness or aching rash of various types

including

seborrheic

dermatitis

sore throat

swollen lymph glands

Other symptoms may occur when a patient becomes infected with other bacteria or fungi

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Infection is a life threatening disease

The condition gradually destroys the immune system, preventing the body from fighting off infections. Most patients die of an overwhelming infection.

There is no cure or vaccine but special anti-viral medications can keep the virus under control.

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The HIV ELISA/Western blot test is used to detect antibodies to the HIV virus.

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It is often spread through sexual contact.

Men can become infected as well.

Both sexual partners need to be treated to eradicate the infection.

.

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Women

painful sexual intercourse, vaginal itching, vaginal discharge (greenish-yellow, frothy or foamy), foul smelling discharge, labial swelling, itching of the inner thighs.

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Men

burning after urination, burning after ejaculation, itching of urethra, slight discharge from urethra.

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Trichomoniasis

Trichomonas

vaginalis

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A history and physical exam will be performed

A wet prep of the vaginal secretions is done revealing the organisms.

Treatment

(

metronidazole

/

Flagyl

)

and the treatment of all sexual partners to prevent recurrence.

One must avoid alcohol while taking

metronidazole

to prevent severe nausea and vomiting.

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Intense itching that is worse at night

Thin pencil mark lines (burrows) that appear between fingers, in arm pits, at the waist, on inner elbows, on bottom of feet, around wrists, on buttocks, on shoulders, on knees, and around breasts

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A contagious skin disease caused by a small mite called

Sarcoptes

scabiei

The infection can be easily spread through close contact amongst families, schools, child care centers or nursing homes.

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Tests

A history and physical exam will be performed.

The diagnosis may be made by the appearance of the rash

Treatment

involves using a prescription medicated cream.

The two most common are

permethrin

and

crotamiton

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Almost anyone with it will have itching in the area covered by pubic hair (often gets worse at night).

This itching may start soon after getting infected with it, or it may not start for up to 2 to 4 weeks after contact.

Other symptoms:

Skin reaction that is bluish-gray in color

Sores (lesions) in the genital area due to bites and scratching

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Pthirus

pubis

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Tratment

is with

malathion

or an alternative insecticide

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Thanks