Genital tract infections

25. Genital tract infections




Questions


image Which genital tract infections are common?

image Which are the infectious agents of urethritis?

image Which are the infectious agents of genital ulcers?


Host susceptibility and epidemiology


Genital tract infections includes a number of sexually transmitted diseases (STDs), as well as some infections that do not require sexual activity for transmission. The STDs where the main symptoms occur outside the genital tract (e.g. HIV and hepatitis B) are considered elsewhere. In the male, with the exception of the distal 2–3 cm, the normal urethra is sterile, protected by mucus, prostatic secretions and periodic flushing with urine. The commensal flora of the vagina offers some protective effect, as does the mucus within the cervix and uterine cell turnover through menstruation. STDs require intimate contact for transmission. Contact tracing is undertaken following diagnosis to reduce transmission within the community; GPs will often refer patients to the local genitourinary clinic where all the facilities are available. Chlamydial and human papillomavirus infections are highly endemic among 16–24 year olds (Fig. 3.25.1)


image

Fig. 3.25.1 Sexually transmitted infections in 2006 in the UK among 16–24 year olds. LVG, lymphogranuloma venereum.



The clinical syndromes


There are few clinical presentations: skin infections present in both sexes in the same way, whereas other genital infections manifest in different organs depending on gender (Fig. 3.25.2). Table 3.25.1 gives the methods of diagnosis and treatments.


image

Fig. 3.25.2 A. Genital warts (human papilloma virus) found around the anus, vagina, vulva or cervix and on the penis shaft. B. Gential herpes (herpes simplex type 2). C. Syphilitic chancre (T. pallidum).


(courtesy of Dr R. Nadarajan, Frimley park Hospital, Frimley, UK.)

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Jul 3, 2016 | Posted by in MUSCULOSKELETAL MEDICINE | Comments Off on Genital tract infections
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