Flashcards in Urethritis/Cervicitis: Ryan Deck (16)
Which three organisms account for 60-80% of STIs with primary symptoms of discharge and dysuria?
Chlamydia trachomatis (Ct) and Neisseria Gonorrhoeae (GC)
Minor player Ureaplasma urelyticum (a mycoplasma)
Can we grow Ct in artificial medium?
No, it is an obligate intracellular organism. Can be grown in tissue culture.
What is the primary VF of Ct?
Ability to cause inflammation via heat shock protein
What is the primary VF or GC?
LPS, invokes inflammatory response
What does it mean when said that GC undergoes antigenic variation?
It has pili that are used to transmit various silent peptide encoding loci into other GC, basically transmitting genetic info and causing genetic rearrangement throughout the course of the infection that adds to antigenic variation and thus, to resistance.
Discuss the possibility of dissemination among Ct and GC.
Ct- no dissemination
GC- may disseminate
Ureaplasma are not susceptible to treatment with this Abx, for this reason.
Beta-lactams; no cell wall. (mycoplasma)
Besides urethritis and cervicitis, what other diseases are caused by Ct or GC or both?
Salpingitis and PID
Perihepatitis (Fitz-Hugh-Curtis Syndr.) - abdominal adhesions
Infant PNA- Ct only
Reiter's syndr.- reactive, non-septic arthritis
Describe what is going on in PID.
How do we treat it?
Inflammatory process involving a variable combination of endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis.
Dull to severe lower abd. pain
Cervical motion tenderness
Serious problem, can lead to infertility.
Tx: Doxy and Cefoxitin (2nd Gen- covers gram -'s)
Describe the disseminated infxns of GC.
Rarely- endocarditis, meningitis
Describe the infantile PNA of Ct.
Repetitive cough with dyspnea
Hyperinflation w/ bilateral infiltrates
Serum IgM raised
Wheezing is rare (diff. from pertussis)
Describe the Dx of Ct and GC
Gram stain (-) for GC
Can't gram stain Ct. If you see poly's but no cocci, probably Ct.
GC can be grown on chocolate agar (Thayer-Martin + Vanc.)
Most common Dx by Nucleic Acid Amplification Test (NAAT)
Sensitive, but expensive
Describe tx for GC and Ct.
GC- Single IM inj. of ceftriaxone due to B-lactam res.
Ct- Azithromycin or Doxy
oral erythromycin for neonates/preg. mothers
Silver nitrate for infants with GC conjunctivitis
What is Lymphogranuloma verereum (LVG)?
More invasive form of STD than urethritis/cervicitis caused by Ct. Invasion of inguinal lymph nodes.
Very rare in the US
What is Trachoma?
Caused by strains of Ct that do NOT cause urethritis/cervicitis. Can be blinding. Prevalent in Asia, ME, Africa.