bacterial sexually transmitted infections Flashcards
(31 cards)
chlamydia
what is unique about it?
what bacteria causes it?
what does it cause?
special: classified as bacteria BUT replicate ONLY within cells as it can’t make it’s own ATP and lack peptidoglycan (but have gram - like envelope-can’t detect with gram stain)
caused by- chlamydia trachomatis
cause- genital infections and conjunctivitis, infant pneumonia, trachoma (roughing of inner surface of eyelids), lymphogranuloma venereum
what are the life stages of chlamydia and chlamydophila
elementary bodies- infectious form-rigid cell wall for extracellular survival
reticulate form- replicative form-has fragile cell wall and is intracellular
what’s the main form of chlamydia found to cause disease
chlamydia trachomatis
what are biovars and what are the two associated with c. trachomatis
- biovars are forms of c/ trachomatis that have different biochemistry
- trachoma( urogenital problems) and LGV (most invasive
what are c. trachomatis tropisms
-nonciliated columnar cuboidal and transitional epithelial cells like urogenital and conjunctival places
pathogenesis of chlamydia
-c. trachomatis causes destruction of epithelia and proinflammatory cytokine response that can, without treatment, lead to fibrosis and infertility
what do these serovars cause?
a, b, Ba, and C -
D-K-
L1, L2, L2a, L2b, L3-
a, b, Ba, and C -trachoma
D-K- urogenital tract disease
L1, L2, L2a, L2b, L3- lymphogranuloma venereum
what is trachoma caused by and how is it transmitted?
- c. trachomatis
- it is a chronic conjunctivitis that is transmitted eye-to-eye by droplets, hands, clothing, and flies (especially where there’s a shortage of water or numerous flies present)
- leading cause of preventable blindness in the world
what is a tell-tail sign of adult conjunctivitis? neonatal?
adult- mucopurulent discharge, keratitis, corneal infiltrates
neonatal- incubate up to 12 days post birth and then have swelling of eyelids and discharge
what are symptoms of chlamydia in men vs women
men
- most are symptomatic
- mucopurulent discharge
- dysuria
- epidymitis, prostatitis and may progress reiter syndrome- urethritis, conjunctivitis, polyarthritis (CUP)
women
- often asymptomatic- reservoir
- mucopurulent discharge
- pelvic inflammatory disease- inflam of reproductive organs
- abdominal pain
- can cause scarring and sterility or ectopic pregnancy
reiter syndrome
cup
conjunctivitis, urethritis, polyarthritis
in men with chlamydia
-caused by prolonged chlamydia
lymphogranuloma vernereum (LGV)
- caused by serovars L1-3 of chlamydia trachomatis
- invasive
- prevalent in Africa, asia, south America- recently traveled sexually active individual
- patient presents with lesion that is painless
- get swelling and inflammation of lymph nodes that drain the site of initial infection = called INGUINAL LYMPHADENOPATHY
- nodes can become supurative and rupture forming fistulas
- proctitis can also result
diagnosis and treatment of c. trachomatis
- diagnosis-
scraping of cervix or urethra or conjunctiva
1) stain with IODINE -identifies GLYCOGEN IN RETICULAR BODIES
-also see cytoplasmic inclusions of elementary bodies and reticular bodies
2) can also immunoflores elementary bodies with elisa
*3) PCR nucleic acid amplification test from urine or urethral discharge are considered test of choice
treatment for c trachomatis
doxcyline and macrolides
prevention for c trachomatis
- control re-infection- infections doesn’t confer immunity
- safe sex, early detection and treatment of symptomatic patients with their sex partners
would you prescribe a beta lactam to a chlamydia pt?
no because c. trachomatis does not have peptidoglycan
how do macrolides and doxycline work
inhibit protein synthesis
type of bacteria that causes gonorrhea and it’s features
-Neisseria gonorrhoeae
-gram negative, anaerobic, free living, diplococci
catalase pos
non spore forming
looks like kidney bean
how do you tell the difference between N. meningitides and n. gonorrhoeae
- can’t distinguish under microscope
- see how they react to sugars and look at sites of primary infection
- N. meningitides ferments maltose and N gonorrhoeae does NOT
- N gonnorrhoeae doesn’t have a capsule
what type of virulence factors does N. gonorrhoeae have?
- PILIN (ATTACHMENT)
- porin- promotes intracellular survival
- opa protein that attaches to surface of eurkaryotic cells
- LOS- LIPOLIGOSACCHARIDE- LIKE LPS IN GONORRHEA
- IgA protease
- BETA LACTAMASE
LOS- lipooligosaccharide
- LOS changes the way it looks to allow it to escape immune defense
when is a patient more at risk for dissemated infections of N. gonnorhoeae
when the patient has deficiencies in late components of complement c5b-9 (membrane attack complex)
pathogenesis of gonorrhea
- gonococci attach to mucosal cells (via pili, porB or opa)
- penetrate cells and multiply
- pass thru cells to subepithelial space where infection is established -usually cervix for women
- LOS stimulates inflammation- chemokines and TNF alpha (proinflammatory cytokine) which is responsible for symptoms
symptoms of gonorrhea
- MUCOPURULENT DISCHARGE at involved site, urethra, epididymis, cervix, anus
- DYSURIA after 2-5 days
- most men have acute symptoms/women can be asymptomatic
- men- epididymitis, prostatitis, periurethral abscesses
- women- salpingitis (inflame of fallopian tubes), tubovarian absesses, PID (pelvic inflammatory disease)
- pharyngitis, conjunctivitis in neonates obtained during birth
