Chapter 24 Lecture 2
Streptococcal Acute Glomerulonephritis
Some antibody-antigen complexes against group A streptococci strains are not removed from the body
Complexes are deposited in the glomeruli of the kidneys
Cause inflammation of the glomeruli and nephrons
Obstructs blood flow through the kidneys which leads to …
Hypertension and low urine output
Urine will contain blood & proteins.
Irreversible kidney damage can occur in adults while young pts may recover fully
Nonvenereal Diseases of the Reproductive Systems
Staphylococcal Toxic Shock Syndrome
Docs first described TSS in the late 1920s, but in the 1980s the condition was an epidemic in the US
Signs and symptoms
Sudden-onset fever, chills, vomiting, diarrhea, low blood pressure, confusion, and severe red rash
Individuals go into shock if untreated
Untreated TSS is fatal
Pathogen and virulence factors
Caused by some strains of S. aureus
Remember that Staph is normally part of the skin and mucous membrane biome
These strains produce toxic shock syndrome toxin
Strains of S. aureus that cause TSS make certain exotoxins called TSST
Staphylococcal Toxic Shock Syndrome
Pathogenesis and epidemiology
Absorption of toxin TSST into blood triggers toxic shock syndrome
Most cases occur in menstruating females who are using super absorbent tampons
Doctors found that S aureus grows exceeding well on super absorbent tampons, especially when blood soaked tampons, especially for a prolonged period.
Diagnosis, treatment, and prevention
Diagnosis is based on signs and symptoms
It can occur in males too
Considered medical emergency (incubation period is 2-3 days)
Requires removal of foreign material (tampon, sponge, and drainage of infected area) and antimicrobial drugs. Supportive care IV fluid, dialysis, and medication
Avoiding tampons or using less absorbent tampons reduces risk (which in 1980, the FDA ordered certain tampons off the market, in 1982 there was a reduction in the absorbency and then mandated educational material on packaging).
Bacterial Vaginosis
Bacteria can contaminate the warm, moist vaginal lining- There is no inflammation so we do not call it vaginitis
Signs and symptoms
White vaginal discharge with a “fishy” odor
Some itching & irritation of the vaginal opening
Up to 50% of cases report no symptoms
Pathogens
Normal bacteria (lactobacilli) are replaced with a large number of anaerobic bacteria (Gardnerella vaginalis)
Pathogenesis and epidemiology
‘pH in vagina is higher than the normal 4.5
Associated with multiple sexual partners and vaginal douching
Diagnosis, treatment, and prevention
Diagnosed is based on signs and symptoms, including odor, pH, and the presence of clue cells
Treated with oral or vaginal metronidazole
No absolute way to prevent but abstinence and refraining from douching are beneficial
Nonvenereal Diseases of the Reproductive Systems
Vaginal Candidiasis- describes any variety of opportunistic yeast infections and diseased cause by Candida albicans
Involve any mucous membrane
Normally lives in GI tract and vagina in competition with lactobacilli.
Signs and symptoms
Severe vaginal itching and burning and will intensify with urination, relations can be painful and you can pass this on to a partner
White plaques on the affected tissue
Pathogen
Most commonly caused by Candida albicans
Normal microbiota of skin and mucous membranes
Pathogenesis and epidemiology
Candida overgrows if vaginal pH becomes alkaline or normal microbial populations are reduced
Can become systemic in immunocompromised people
Diagnosis, treatment, and prevention
Identification of Candida and presence of symptoms are diagnostic
Treated with azole or fluconazole
Prevent by avoiding persistent moisture in genital area