REPRODUCTIVE SYSTEM a.

Chlamydia trachomatis
o most common pathogen associated with
BACTERIAL diseases NGU
1. Gonorrhea o Many people suffering from gonorrhea
o Sexually transmitted infection (STI) caused by the are coinfected with C. trachomatis
gram-negative diplococcus Neisseria gonorrhoeae. o Symptoms are often mild in men and in
o Symptoms in men are painful urination and a women it’s usually asymptomatic
discharge of pus-containing material from the o If untreated:
urethra  Men may develop inflammation of the
o Complications can involve the joints, heart epididymis.
(gonorrheal endocarditis), meninges (gonorrheal  Women may develop inflammation of
meningitis), eyes, pharynx, or other parts of the the uterine tubes that may cause
body. scarring, leading to sterility
o Gonorrheal arthritis, which is caused by the growth o For diagnosis, culturing is the most
of the gonococcus in fluids in joints, occurs in about reliable method, but this requires
1% of gonorrhea cases. specialized cultivation methods, takes 24
o Joints commonly affected include the wrist, knee, to 72 hours, and is not always
and ankle. conveniently available
o The symptoms of pharyngeal gonorrhea often o Urine samples can be used, but the
resemble those of the usual septic sore throat. sensitivity is lower than with swabs
o Anal gonorrhea can be painful and accompanied by o Screening is also recommended for other
discharges of pus. 2. higher-risk groups:
o Gonorrhea can be transmitted through sexual  persons who are unmarried
contact  people who have multiple sexual
o Gonorrhea in men is diagnosed by finding gonococci partners
in a stained smear of pus from the urethra.
o Diagnosis of gonorrhea has been aided by the
development of an ELISA test that detects b. Ureaplasma urealyticum
N. gonorrhoeae in urethral pus or on cervical swabs o Pathogen which is a member of the
within about 3 hours with high accuracy. mycoplasma (bacteria without a cell
o Other rapid tests use monoclonal antibodies against wall).
antigens on the surface of the gonococcus.
o Nucleic acid amplification tests are very accurate for c. Mycoplasma hominis
identifying clinical isolates from o commonly inhabits the normal vagina but
suspected cases. can opportunistically cause uterine tube
o For gonorrhea affecting the cervical, urethral, or infection.
rectal tissues, the current recommendation is first to
use cephalosporins such as o Both chlamydia and mycoplasma are sensitive to:
o Ceftriaxone Tetracycline type antibiotics-Doxycycline, or to
o Cefixime Macrolide-type antibiotics- Azithromycin.
o It’s also standard practice to treat sex partners of
patients to decrease the risk of reinfection and to
decrease the incidence of STIs in general. 3. Pelvic Inflammatory Disease (PID)
o a collective term for any extensive bacterial
infection of the female pelvic organs, particularly
the uterus, cervix, uterine tubes, or ovaries.
o Considred to be polymicrobial- a number different
2. Nongonococcal Urethritis (NGU)
pathogens might be the cause, including coinfections
o Also known as nonspecific urethritis (NSU)
o The two most common microbes are N.
o Refers to any inflammation of the urethra not
gonorrhoeae and C. trachomatis
caused by Neisseria gonorrhoeae.
o Women may have serious complications such as
o Symptoms include painful urination and a watery
infertility or chronic pain.
discharge.
o It has fewer initial inflammatory symptoms than
when caused by N. gonorrhoeae.
o However, the damage to the uterine tube may be  There are no symptoms but with
greater with chlamydia, especially with repeated healing of lesion.
infections. d. Tertiary Stage
o The bacteria may attach to sperm cells and be  During this stage, degenerative
transported by them from the cervical region to the lesions called gummas form on the
uterine tubes. skin, bone and nervous system as a
o Women who use barrier contraceptives, especially result of hypersensitivity reactions.
with spermicides, have a significantly lower rate of Other symptoms include mental
PID. retardation, blindness and physical
o Infection of the uterine tubes, or salpingitis, is the instability.
most serious form of PID o Congenital syphilis: Babies born to women
o Salpingitis can result in scarring that may block the have syphilis can become infected through
passage of ova from the ovary to the uterus, possibly placenta or during birth. Most newborns with
causing sterility. Congenital syphilis have no symptoms, although
o A blocked uterine tube may cause ectopic (or tubal) some experience rash on the palms of their
pregnancy hands and the sole of their feet also some
o A diagnosis of PID depends strongly on signs and experience Neurological damage.
symptoms o Neurosyphilis
o The recommended treatment for PID is the -the symptoms of neurosyphilis include severe
simultaneous administration of Doxycycline and head ache, difficulty coordinating muscle
Cefoxitin (a cephalosporin). movements, paralysis, numbness and
o This combination is active against both the dementia.
gonococcus and chlamydia.  Two types of tests used to diagnose syphilis:
 Treponemal test
-this test identifies the antibodies
4. Syphilis to the causative organism. Blood
o It is a sexually transmitted disease that is caused by test can confirm the presence of
the bacteria Treponema pallidum. the antibodies that the body
o It is named after the shepherd Syphilis who is the produce to fight infection.
hero of a poem, Syphilis, sive morbus Gallicus.
o Dark field microscopic is the best method to identify  Non-treponemal test
the bacteria also by staining with fluorescent- -this identifies the body’s response
labelled, monoclonal antibodies. to the infection.
o There are three stages of syphilis: o Primary and secondary stages are treated with
a. Primary Stage penicillin
 During this stage, there is a small,
hard-based chancre at the site of
infection, it could be found at the 5. Bacterial Vaginosis
genital area of the male. The sore o It is also referred to as nonspecific vaginitis, a
usually lasts 3 to 6 weeks and heals vaginal condition that can produce vaginal discharge
regardless of whether or not there and results from overgrowth of certain kinds of
was a treatment received. bacteria in the vagina.
b. Secondary Stage o It was called Gardnerella vaginitis after the bacteria
 On this stage, skin and mucosal that were thought to cause the condition which is
rashes are widely disseminated. Gardnerella vaginalis.
The rash can look like rough,
reddish brown spots on the palms o Signs and symptoms
and bottoms of the feet. Other  An abnormal amount of vaginal discharge
symptoms may include fever,  The vaginal discharge is thin and Grayish
swollen lymph glands, sore throat, white
patchy hair loss, headaches, weight  Vaginal odor ( foul-smelling or unpleasant
loss, muscle aches and fatigue. fishy odor)
 The vaginal discharge and odor are often
c. Latent period
more noticeable after sexual intercourse
  Pain with sexual intercourse or urination 1. Genital Herpes
o The term vaginosis refers to a vaginal abnormality -Herpes simplex virus 2 (Human herpesvirus 2 or
therefore men cannot get bacterial vaginosis. HHV 2)
However, female sex partners of women with - It is a common sexually transmitted disease (STD)
bacterial vaginosis may want to consider being caused by an infection with herpes simplex virus
evaluated because it can spread to female partners. (HSV). There are two types of herpes simplex virus.
o Transmission
- Multiple or new sexual partners increases a a. HSV-1 is most commonly associated with
woman’s risk of developing bacterial blisters and ulcers around the mouth known as
vaginosis. cold sores.
- IUDs (intrauterine devices) for birth control b. HSV-2 is associated with blistering lesions in
- Vaginal douching genital areas that are exposed during sexual
- It is not possible to contract bacterial duct.
vaginosis from toilet seats, swimming pools o Signs and symptoms
and hot tubs, or from touching - Neonatal herpes transmitted to fetus or
contaminated objects. newborns
o Diagnosis - Typically painful blisters (that may appear
- The doctor will perform a pelvic exam. like “pimples”) around genital area
During the exam, the doctor notes the - Blisters around the anal area
appearance of the vaginal lining and cervix. - Ulcer formation after the blisters break
The doctor will also perform a manual exam open
of the ovaries and the uterus. - Recurrences from viruses latent in nerves
- The doctor may collect samples to check for (80%)
Chlamydia or gonorrhoea infection. - Blisters take 2 to 4 weeks to heal.
- Examining the vaginal discharge under a - With the first outbreak of genital herpes, a
microscope can help distinguish bacterial person may also experience flu-like
vaginosis from infections such as yeast symptoms including:
vaginitis.  Fever
- A sign of bacterial vaginosis under the  Chills
microscope is a vaginal cell called a clue  Body aches
cell. Clue cells are vaginal cells covered with  Swollen lymph nodes
bacteria and are believed to be the most - Immediately prior to an outbreak, there
reliable diagnostic sign bacterial vaginosis. may be an itching, burning, or tingling
- A vaginal pH greater than 4.5 is also sensation of the skin.
suggestive of bacterial vaginosis - In women, genital herpes usually causes
o Treatment blistering lesions on the vulva and around
- Antibiotics are the recommended the vaginal opening that progress to ulcer
treatment for bacterial vaginosis. A few formation. The infection spreads to involve
antibiotic remedies are routinely used and cervix in most cases, leading to cervicitis or
include: inflammation of cervix.
 Metronidazole (Flagyl) taken by o Transmission
either oral (pili) form or vaginal - Herpes simplex virus is transmitted by the
metronidazole gel (metrogel) it is direct person-to-person contact.
believed to be the most effective - Genital herpes is acquired through sexual
treatment contact with genital areas.
 Vaginal clindamycin cream - Genital herpes can be caused by mouth to
(cleocin) genital contact with a person who has cold
 Tinidazole (tindamax)n is an sores or herpes infection in mouth
antibiotic that appears to be - Transmissions from an infected male to
effective in treating bacterial female partner are more likely than
vaginosis, and may have fewer side transmission from an infected woman to a
effects than metronidazole. male partner.
Viral Diseases
o Diagnosis - Rarely, bleeding or urinary obstruction may
- In most cases in which the characteristic be the initial problem when the wart
signs and symptoms are present, they are involves the urethral opening (the opening
sufficient to establish in a diagnosis of where urine exits the body)
genital herpes infection. Laboratory test, - There may be a history of previous or
such as viral culture and nucleic acid concurrent sexually transmitted disease.
amplification (polymerase chain reaction o Transmission
PCR) tests to detect the genetic material of - The virus that causes genital warts is easily
the virus, are also available. Immunologic passed from one person to another through
tests to identify antibodies to genital herpes sexual contact. Anyone who’s sexually
are other possible tests to establish active can get the virus and pass it on,
whether infection has occurred. o Diagnosis
o Treatments A. PAP test
- Antiviral medications are available that can - For women, it is important to have regular
help manage the severity and duration of exams and Pap test, which can help detect
outbreaks, if taken immediately prior to vagina cervical. During pap test, the doctor
(when there are tingling or unusual skin will use a devise called speculum,
sensations but no blisters) or within 24 B. HPV test
hours of an outbreak. The medications - HPV 16 causes cervical cancer and cancer in
typically used are the penis
 Acyclovir (Zovirax) - Only a few types of genital HPV have been
 Famciclovir ( Famvir) linked, to cervical cancer. A sample of
 Valacyclovir ( Valtrex) cervical cells, taken during a PAP test , can
- In severe cases of viral infection, antiviral be tested for cancer-causing HPV strains
medications may be given intravenously, - Theses test is reserved for women ages 30
but this is not usually needed for genital and older. It is not as useful for younger
herpes. women because their immune systems
2. Genital Warts usually can kill even Cancer-causing
- Genital warts are common and are caused varieties of genital HPV without treatment
by certain types of HPV. Genital warts can C. DNA testing
be annoying, but they’re treatable and - This test can detect cancer-causing strains
aren’t dangerous.
- Genital warts are caused by HPV, it shows o Treatment
up on the skin around the genitalia and - Vaccination against HPV strains
anus. They are caused by certain types of - Vaccine used is the Gardasil
human papillomavirus (HPV). It may be - Doctors may prescribe topical wart
most common STD in USA treatments that might include:
- In men, genital warts can infect the urethra,
 Inquimod (aldara)
penis, scrotum, and rectal area. Warts may
 Podophyllin and podoflox
appear as soft raised masses with surface
that can be smooth. (Condylox)
- In women, genital warts have similar  Trichoacetic acid (TCA)
appearance and usually occur in the moist - If visible warts do not go away with
areas of labia minora and vaginal opening, time, it may require surgery to remove
lesions visisble on the outer genitals. them. The warts can be removed
o Signs and Symptoms through:
- Although genital warts are painless, they  Electroautery, or burning warts
may be bothersome because of their
with electric currents
location, size, or due to itching.
 Cryosurgery, or freezing warts
- The size may range from less than one
millimetre  Laser treatments
- Men and women with genital warts will  Excision, or cutting off warts
often complain of painless bumps, itching,  Interferon injections
and discharge
FUNGAL Disease
1. Candidiasis PROTOZOAN Disease
- Vaginal infections by yeast like
fungi of the genus Candida 1. Trichomoniasis
- Candida albicans - Infection caused by
o is the most common species, Trichomonas vaginalis
causing 85–90% of cases. o anaerobic protozoan
o often grows on mucous o frequently a normal inhabitant
membranes of the mouth, intestinal of the vagina in women and of the
tract, and genitourinary tract urethra in many men.
o opportunistic pathogen o can also be found in semen or
o cause of oral candidiasis, or urine of male carriers.
thrush o causes trichomoniasis when the
o responsible for occasional cases pH of the vagina increases.
of NGU in men and for vulvovaginal - It’s usually sexually transmitted.
candidiasis, which is the most common - The infection is often
cause of Vaginitis. accompanied by a coinfection with
- Infections are usually a result of gonorrhea.
opportunistic overgrowth when the - The incidence of trichomoniasis
competing microbiota are suppressed is higher than that of gonorrhea or
by antibiotics or other factors. chlamydia, but it is considered relatively
- -The lesions of vulvovaginal benign and is not a reportable disease.
candidiasis resemble those of thrush - cause preterm delivery and
but produce more irritation: severe associated problems, such as low birth
itching; a thick, yellow, cheesy weight.
discharge; and yeasty or no odor. - In response to the protozoan
- Predisposing conditions include infection, the body accumulates
the use of oral contraceptives and leukocytes at the infection site.
pregnancy, which cause an increase of - The resulting discharge is
glycogen in the vagina. profuse, greenish yellow, and
- Yeast infections are a frequent characterized by a foul odor.
symptom in women suffering from - This discharge is accompanied
uncontrolled diabetes. by irritation and itching
- A yeast infection is diagnosed - Diagnosis is usually made by
by microscopic identification of the microscopic examination and
fungus in scrapings of lesions and by identification of the organisms in the
isolation of the fungus in culture. discharge.
- Treatment usually consists of - New rapid tests making use of
topical application of nonprescription DNA probes and monoclonal antibodies
antifungal drugs such as clotrimazole - Treatment is by oral
and miconazole. metronidazole, administered to both
- An alternative treatment is a sex partners, which readily clears the
single dose of oral fluconazole or other infection.
azole-type antifungal.