Microbiology a systems approach 2 nd ed
Sponsored Links
This presentation is the property of its rightful owner.
1 / 64

Microbiology: A Systems Approach, 2 nd ed. PowerPoint PPT Presentation

  • Uploaded on
  • Presentation posted in: General

Microbiology: A Systems Approach, 2 nd ed. Chapter 23: Infectious Diseases Affecting the Genitourinary System. 23.1 The Genitourinary Tract and Its Defenses.

Download Presentation

Microbiology: A Systems Approach, 2 nd ed.

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript

Microbiology: A Systems Approach, 2nd ed.

Chapter 23: Infectious Diseases Affecting the Genitourinary System

23.1 The Genitourinary Tract and Its Defenses

  • Urinary tract: removes substances from the blood, regulates certain body processes, and forms urine and transports it out of the body

    • Includes the kidneys, ureters, bladder, and urethra

    • Defenses

      • Flushing action of urine

      • Desquamation of the epithelial cells

      • Acidity of urine

      • Antibacterial proteins in urine

      • SecretoryIgA

Genital System

  • Genital system: reproduction , aka the reproductive system

    • Male reproductive system includes the testes, epididymis, vas deferens, prostate gland, scrotum, and penis

      • Defenses: flushing action of urine

    • Female reproductive system includes the uterus, fallopian tubes, ovaries, and vagina

      • Defenses vary over the lifetime of the woman

        • Childhood and after menopause: mucous is the major defense with secretoryIgA antibodies

        • During reproductive years: changes in pH

Figure 23.1

Figure 23.2

Figure 23.3

23.2 Normal Biota of the Urinary Tract

  • Outer region of the urethra harbors some normal biota

  • Nonhemolytic streptococci, staphylocci, corynebacteria, and some lactobacilli

  • Normal Biota of the Male Genital Tract

    • Same as described for urethra, since the urethra is the terminal “tube”

  • Normal Biota of the Female Genital Tract

    • The vagina harbors a normal population of microbes

      • Lactobacillusi species

      • Candida albicans at low levels

23.3 Urinary Tract Diseases Caused by Microorganisms

  • Urinary Tract Infections (UTIs)

    • Urine is a good growth medium for many microorganisms

    • Reduced urine flow or accidental introduction of bacteria into the bladder can result in cystitis

    • If the infection also affects the kidneys it is called pyelonephritis

    • An infection only in the urethra: urethritis


  • Cystitis: sudden onset of symptoms

    • Pain in the pubic area

    • Frequent urges to urinate even when the bladder is empty

    • Burning pain accompanying urination (dysuria)

    • Cloudy urine

    • Orange tinge to the urine (hematuria)

    • Fever and nausea

    • Back pain indicates kidneys may also be involved


  • Zoonosis associated with wild animals and domesticated animals

  • Can affect the kidneys, liver, brain, and eyes

  • Major effects on the kidneys and is shed into the environment through animal urine

  • Two phases

    • Early (leptospiremic) phase

      • Sudden high fever, chills, headache, muscle aches, conjunctivitis, and vomiting

    • Second phase (immune phase)

      • Milder fever, headache, Weil’s syndrome (kidney invasion, hepatic disease, jaundice, anemia, and neurological disturbances)

Figure 23.4

Urinary Schistosomiasis

  • Schistosomahaematobium lodges in to the blood vessels of the bladder

  • May or may not result in symptoms

  • If symptoms occur: itchiness in the area where the worm enters the body, fever, chills, diarrhea, and cough

  • Urinary tract symptoms occur later which may include blood in the urine and bladder obstruction

23.4 Reproductive Tract Diseases Caused by Microorganisms

  • Many are transmitted through sexual contact, but not all are

  • Three broad categories of sexually transmitted diseases

    • Discharge diseases

    • Ulcer diseases

    • Wart diseases

Vaginitis and Vaginosis

  • Inflammation of the vagina

  • Vaginal itching to some degree

  • Burning and sometimes a discharge occurs

  • Symptoms depend on the etiologic agent

Candida albicans

  • Normal biota living in low numbers

  • If grows rapidly and causes a yeast infection, white vaginal discharge occurs

Figure 23.5

Gardnerella species

  • Infection called vaginosis rather than vaginitis because inflammation in the vagina does not occur

  • Vaginal discharge with a very fishy odor, especially fater sex

  • Itching is common

Trichomonas vaginalis

  • Asymptomatic infections in approximately 50% of females and males

  • Some people experience long-term negative effects

Figure 23.7


  • Inflammation of the prostate gland

  • Acute or chronic

  • Pain in the pelvic area, lower back, or genital area; frequent urge to urinate; blood in the urine; and/or painful ejaculation

Discharge Diseases with Major Manifestation in the Genitourinary Tract

  • Increase in fluid discharge in male and female reproductive tracts

  • Includes trichomoniasis, HIV, gonorrhea, and Chlamydia infection


  • N. gonorrhoeae is the etiologic agent- also known as the gonococcus

  • Symptoms in the male

    • Urethritis, painful urination and a yellowish discharge

    • Can occasionally spread from the urethra to the prostate gland and epididymis

    • Scar tissue in the spermatic ducts during healing can render a man infertile (rare)

Symptoms in the Female

  • Likely that both urinary and genital tracts will be infected

  • Mucopurulent or bloody vaginal discharge

  • Painful urination if urethra is affected

  • Major complications occur when the infection ascends from the vagina and cervix to higher reproductive structures

    • Salpingitis

    • Pelvic inflammatory disease

Figure 23.8

Figure 23.9

Figure 23.10

Figure 23.11


  • Most common reportable infectious disease in the U.S.

  • Majority of cases are asymptomatic

  • Symptoms in males

    • Inflammation of the urethra

    • Symptoms mimicking gonorrhea

    • Untreated infections may lead to epididymitis

  • Symptoms in females

    • Cervicitis

    • Discharge

    • Salpingitis

    • May lead to PID

  • Certain strains can invade the lymphatic tissues, resulting in lymphogranuloma venereum

    • Headache, fever, muscle aches

    • Lymph nodes fill with granuloma cells and become enlarged and tender

  • Babies born to mothers with infections can develop eye infections and pneumonia

Figure 23.12

Figure 23.13

Genital Ulcer Diseases

  • Three common infectious conditions resulting in lesions on a person’s genitals

  • Syphilis, chancroid, and genital herpes

  • Having one of these diseases increases the chances of infection with HIV because of the open lesions


  • Three distinct clinical stages: primary, secondary, and tertiary

  • Latent periods of varying duration also occur

  • Transmissible during the primary and secondary stages, and the early latency period between secondary and tertiary

  • Largely nontransmissible during late latent and tertiary stages

Primary Syphilis

  • Appearance of a hard chancre at the site of entry of the pathogen (after an incubation period of 9 days to 3 months)

  • Lymph nodes draining the affected region become enlarged and firm

  • Chancre filled with spirochetes

  • Chancre heals spontaneously in 3 to 6 weeks but by then the spirochete has moved into the circulation

Secondary Syphilis

  • 3 weeks to 6 months after the chancre heals

  • Many systems have been invaded

  • Fever, headache, sore throat, followed by lymphadenopathy and a red or brown rash that breaks out on all skin surfaces

  • Hair often falls out

  • Lesions contain viable spirochetes and disappear spontaneously in a few weeks

  • Major complications occur in bones, hair follicles, joints, liver, eyes, and brain

Figure 23.14

Latency and Tertiary Syphilis

  • Highly varied latent period, can last for 20 years or longer

  • Tertiary syphilis is rare because of the use of antibiotics

  • Major complications occur by this stage

  • Cardiovascular syphilis- weakens the arteries in the aortic wall

  • Gummas develop in tissues such as the liver, skin, bone, and cartilage

Figure 23.15

Congenital Syphilis

  • From a pregnant woman’s circulation into the placenta and fetal tissues

  • Inhibits fetal growth

  • Disrupts critical periods of development

Figure 23.16

Figure 23.17

Figure 23.18


  • No systemwide effects

  • Infection usually begins as a soft papule at the point of contact

  • Develops into a soft chancre (painful in men, but may be unnoticed in women)

  • Inguinal lymph nodes can become swollen and tender

Genital Herpes

  • Caused by herpes simplex viruses (HSVs)

  • Multiple presentations

    • No symptoms, or single or multiple vesicles on the genitalia, perineum, thigh, and buttocks

    • Lesions from initial infection can be accompanied by malaise, anorexia, fever, and bilateral swelling and tenderness of the groin

    • Occasionally meningitis or encephalitis can develojp

  • After recovery from initial infection, may have recurrent episodes of lesions; generally less severe

  • In the neonate and fetus, HSV infections are very destructive and can be fatal

Figure 23.19

Figure 23.20

Figure 23.21

Figure 23.22

Figure 23.23

Wart Diseases

  • Human papillomavirus (HPV)

    • Causative agents of genital warts

    • An individual can be infected with HPV without having warts, however

  • MolluscumContagiosum

    • Unclassified virus in the pox family

    • Can take the form of skin lesions

    • Wartlike growths on the mucous membranes or skin of the genital area

Group B Streptococcus “Colonization”- Neonatal Disease

  • 10% to 40% of women in the U.S. are colonized asymptomatically by group B Streptococcus

  • When these women become pregnant, about half of their infants become colonized by the bacterium during passage through the birth canal

  • Small percentage of infected infants experience life-threatening bloodstream infections, meningitis, or pneumonia

Figure 23.24a

Figure 23.24b

  • Login