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Chapter 24 Lecture 3 (Sexually Transmitted & Infections (STIs) and…

- - - - Acute inflammation occurs 2-5 days after infection in the urethra of penis
      - Men experience painful urination and a purulent discharge Could lead to sterility due to the formation of scar tissue
      - Women are often asymptomatic (50-80%)
        
        Only when try to get pregnant damage to uterine tubes becomes obvious
        
        Pelvic inflammatory disease my develop (25%)
    - - Caused by Neisseria gonorrhoeae
      - Virulence factors include fimbriae, capsule, and endotoxin
    - - Bacteria attach to epithelial cells of the mucous membranes; the bacteria do not attach themselves to the lining of the vagina---- THEY INFECT THE CERVIX OF THE UTERUS
      - THE FIMBRAE THE BACTERIA CAN ATTACH TO SPERM CELLS AS THEY SWIM PAST– THEY CAN HITCHHIKE TO THE UTERINE TUBES. (PID)
      - Infections outside the reproductive tract also occur.
        
        Anal intercourse can lead to procitis (inflammation of rectum)
        
        Oral sexual intercourse can lead to pharyngitis, and gingivitis
        
        Joints, meninges, or heart- arthritis, meningitis, and endocarditis
      - Babies delivered vaginally by infected mothers can become infected.
    - - Gonorrhea occurs only in humans.
      - Cases in the United States have been declining.
      - Most civilian cases occur in adolescents- southeastern states who have multiple sexual partners
      - Risk increases with frequency of sexual encounters
      - Woman have a 50% chance of becoming infected during a single sexual encounter with an infected man
      - Men have 20% chance of infection with a single encounter with a woman who is infected
      - If a child has it there is strong evidence sexual child abuse
    - - The presence of gram-negative diplococci in pus from an inflamed penis is good enough for dx
        
        Genetic probes are used to diagnose asymptomatic infection
        
        Treated with ceftriaxone and azithromycin
        
        Spread of gonococcal strains resistant to many antimicrobials has complicated treatment
        
        Resistant to PCN tetracycline, erythromycin, aminoglycosides
        
        Recommend dual therapy with ceftriaxone and azithromycin
        
        Prevented with safe sex practices
        
        Give antimicrobial agents to newborn eyes