chlamydia trachomatis , mycoplasma , ureaplasma , and other non- gonococcal urethritis:
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Chlamydia trachomatis , Mycoplasma , Ureaplasma , and other Non- Gonococcal urethritis:. Chlamydia trachomatis: Microscopy and culture: Small unicellular round-to-ovoid bacteria that cannot stained by Gram’s stain. - PowerPoint PPT PresentationTRANSCRIPT
Chlamydia trachomatis, Mycoplasma, Ureaplasma, and other Non-Gonococcal urethritis:
Chlamydia trachomatis: Microscopy and culture:
- Small unicellular round-to-ovoid bacteria that cannot
stained by Gram’s stain.- Some inclusion bodies retain Iodine or the counter
stain safranin. - Rigid Cell wall .
- The cell envelope has two lipid bilayers with cell wall
material resembles a gram-negative (but not
peptidoglycan nor muramic acid).
n
- Obligatory intracellular parasite.- It depends on the host cellular energy compounds ATP,
and NAD.- Cultivated in yolk sac of embryonated egg or tissue
culture.
Chlamydia inclusion :R. bodies. Chlamydia inclusion .
Pathogenesis and life cycle:-Transmission: Sexual route.-Infectious part: The elementary body.-The elementary bodies taken by phagocytosis into susceptible host cell.-Once inside the cell, the elementary body prevents fusion of the phagosome and lysosomes.
-It will converted into metabolically active dividing Reticulate body. (non-infectious body).-Inclusion bodies. -After 48 hours, rupture of infected cell to release many elementary bodies.-Host cell death.
Chlamydia life cycle:N
Clinical picture of Chlamydia trachomatis:Annually, more than four million urogenital Chlamydia trachomatis infections occur in the USA in young individuals.1-Nongonococcal urethritis: -Caused by Serovars: D,E, F,.., to K. - In male : Urethritis, infection could extend to epididymitis. and orchitis. - In Female: Pelvic inflammatory disease. Urethritis, Cervicitis, Endometritis, Salpingitis.2-Lymphogranuloma venereum:(LGV): more invasive infection -Caused by Serovars: L1, L2, and L3. -Papules in the external genitalia.(for one to two months). -Painful swelling of inguinal and perirectal lymph nodes.
Clinical picture of Chlamydia trachomatis: N
Clinical picture of Chlamydia trachomatis:
Urethral discharge : (more mucoid with fewer pus cell). Chlamydial Cervicitis.
Laboratory diagnosis: Clinical specimens:Urethral discharge, urine, and Scraping of infected epithelial cells.1- Direct microscopy: A-Immunofluorescent microscopy. B-Electron microscopy.
2-Detection of Chlamydia genetic material by PCR.
3-Serology: Serologic testing for specific antibodies is not helpful except in suspected Lymphogranuloma venereum.
Laboratory diagnosis:
Immunofluorescent staining of inclusion body. Electron microscopy and immuno-electrone microscopy for inclusions.
Mycoplasma hominis and Ureaplasma urealyticum:- The smallest prokaryotic microbe with no peptidoglycan cell
wall.
- Because of their extremely small size(0.1-0.3 micrometer),
Mycoplasma species pass through sterilization filters.
- Lacking cell walls, all species are enclosed instead by lipid
bilayer membrane containing sterols. - Due to the absence of Cell walls:
1-The bacteria are plastic, pleomorphic in nature, and
cannot be classified as either cocci or rods.
2-The bacteria are resistance to penicillin and cephalosporins.
n
- Double-stranded DNA genomes measure less than one million Kilodaltons.
Cultural characteristics and colony morphology: - Facultative anaerobes, and some species are strict anaerobes.- Fastidious for external source of cholesterol (serum).- Given appropriate supplementation, they can be grown in cell-
free media.- Colonies are visualized microscopically by 30 to 100 x
magnification.- Colonies show a characteristics (fried egg) appearance.
Biochemical activities and clinical picture:
-Mycoplasma hominis and Ureaplasma urealyticum grow more rapidly than Mycoplasma pneumoniae.
-They can be distinguished by their carbon utilization patterns; M. hominis degrades arginine. U. urealyticum hydrolyses urea.In female:-The major clinical condition associated with M. hominis is postabortal fever.-M. hominis is recovered locally in cases of Pelvic inflammatory disease.-All M. hominis species are Erythromycin resistance.
n
- The drug of choice for treatment is tetracycline (for M. hominis). - Ureaplasma urealyticum is associated with cases of
Endometritis and vaginitis.
In male:- Ureaplasma urealyticum is associated with cases of Urethritis. - The infection could be disseminated to other tissue in immunocompromised patients.
Candidiasis:
- Most commonly encountered opportunistic mycoses worldwide.
- Cellular immunity protects against mucocutaneous candidiasis,
neutrophils protect against invasive candidiasis
- They are members of the normal flora.
- More than 150 species of Candida known.- Only ten species cause disease in humans.
- The most common species of medical significance are:
1-Candida albicans.
2-Candida tropicalis.
Morphology and cultural characteristics: Candida is thin-walled, small yeasts (4 to 6 microns) that reproduce by budding.Microscopically: Candida albicans is dimorphic, in addition to budding yeast cells, pseudohyphae, it also can produce true hyphae.Asexual Germination of Candida occurs by production of Blastospores or Chlamydiospores.
n
-Macroscopically: on agar media they produce creamy colonies within 24 hours at 37 C or room temperature.
-Candida species produce a small ,white, rounded colonies with feet projection and regular margin.
Germ tube test: -Candida species must be incubated with serum for 90 minutes at 37 C;
-yeast cells of C. albicans will produce true hyphae or germ tube.
Clinical picture of Candida albicans:
- Candida albicans causes almost 100% of cases of
oropharyngeal candidiasis and at least 90% of cases of
Candida vulvovaginitis.
- Vaginal candidiasis presents as itching and burning pain of
the vulva and vagina.
- Thick or thin white discharge.
- Vaginal swab and discharge should be examined for
differential diagnosis.
- Candida albicans can cause urethritis in male.
Trichomoniasis: Trichomonas vaginalis: Classification: urogenital Mastigophora. Morphology:20-30 um ,oval or pyriform in shape ,with short undulating membrane , axostyle and four free flagellae.Transmission: sexual intercourse,and contaminated clothes.
Pathology and Clinical picture: Vaginitis - itching, copious- yellowish offensive discharge. Urethritis in male and female. Prostatitis and seminal vesiculitis in male.
Diagnosis: by finding the trophozoites in smears from vaginal or urethral discharge.
Trichomoniasis:n