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Candidiasis: The genus candida encompasses more than 150 species ubiquitous in
nature these organisms are found on inanimate objects in foods and on animals and are
normal commensals of human. Candida is a small this walled, ovoid yeast that measures
4-6 mm in diameter and reproduces by budding organisms occur in three.
The human pathogens are C albicans, C guithermondii, C Krusei, C glabrate and few
other. They vitamin the gastrointestinal tract, the female genital tract and the skin.
Etiologic Agent: Candida is a small this walled, ovoid yeast that measures 4-6 mm in
diameter and reproduces by budding. The organism of this genus occurs in three forms
in lessue as blastospores, psendo hyphen and hyphen.
Pathogenesis: In the most serious form of Candida infection the organism¶s disseniate
homogenously and form micro abscesses in organs
Mccourtaveous: The chemical manifestations are mostly thrust and vulvo vaginal
candidacies. The influence of reproductive harmones in adolescents cause vast changes
in the tissues and increase susceptibility of infection.
A white scanty, vaginal discharge in the form of white plagnes or cotton cherse like
curds adherent loosely to vaginal mucosa. C albicans accounts for nearly all cases of
vaginal candidiasis. Volvovaginal candidiasis occure in women with mentrolled diabetes,
pregnancy debilitation and immune suppression.
To a drop of the suspension of vaginal discharge in saline on a slide, add or drop of 10%
KOH sohetion and examinine under microscope.
Gram stained smeas of vaginal discharge shous ± oval budding yeast calls.
Culture ± on saborauds metimom reveals rounded oroval shaped colomies 1-2mm in
diameter within 48-72
Wel preparation technique: The swab is agitated in 0.9% saline and a drop of this is
observed under wet mount microscopy. Motile pear shaped organism is seen in positive
specimens. Culture is the gold standard technique with a sensitivity of more than 70%
but takes upto 7days for results to be obtained.
Grams stained smear of vaginal discharge shows ± clue cells with bacilli, gram negative
roads of gram which are gardeneralla vaginalts and plcomorphic bacteria¶s which include
other anaerobic bacteria.
Mucopurulent cervicits refers to inflammation of the columnas epithelwon and
subepithlivrn of the endocervix and contigons columner epithetium that exposed an
epithetium position on the exocercix.
The terms pelvic inflammatory disease usually refers to infection that ascends from revix
or vagine to involve the endometrial and/ or fallopian tubes. Infection can extend
beyond the reproduction treet to cause peritonitis, perihepathis, pewsplenitis or pelvic
abscess.
The agents most after implicated in PID include the primary causes of endocercities ±
Nisseria gnorrhoeae and Chlamydia trachmetis.
c
Neisseria gonorrhea is a gram negative non motile, non- spore forming organism that
grows singly and in pairs. Neisseria gonorrhoeae other species by their ability grow on
selective medva.
Physical examination way reveal a prulent discharge (Mucopus) from the cervical os
Polymorphonuclear leucocylee (Poly morphe Nucholytes) (PMNS) are often seen an the
endocervix on grams stain vaginal discharge should be inocluted on to a plate of Thayer
± martin medium for culture.
Nucleic acid pro be tests are sometimes substituted for culture for alirect defection of N.
Gonorrhoeae in urogential specimens.
Chlamydia are obhigate intracellular bacteria that are classified in order Chlamydiales
Chlamydia possess both DNA and RNA, have a cell wall and ribosomes similar to those of
gram negative bacteria.
c
Unique feature of all Chlamydia is their complex reproductive cycle. Two forms of
microorganism the extra cellular elementary body (EB) and the intracellular reticulate
body (RB). EBs attaché to susceptible target cells and enter the cells inside a
phagosome and reorganize into RBS which are adapted to intracellular survival and
multiplication.
Laboratory diagnosis
Isolation of organism in cell cultures Direct immune fluorescent antibody slide test by
straining with fluorescein ± conjected monoclonate antibody for Chlamydial antigens ±
Observation of fluorescing EBs confirms the diagnosis.
NAAT can defect Chlamydia genes in forst void urine samples and vaginal discharge
swabs.
The spirochaetales include three genera that are pathogenic for humans.
Leptospira which causes human leptospirosis Borrelia which causes ± Lyme disease.
Actiologic Agent
Primary syphilis: Primary chancre is a single painless papule that rapidly crodes and
becomes indurated with a characteristic cartilaginous consistency a palpation of the edge
and base of the ulcer. Common sites of occurrence are cerix and labia in women.
Typical skin rash consisting of macular, popular, papulo squmous and pustalar lesions
muconspatches. Papules enlarge to produces condylomata late.
Typical mucons pateh is a painless siluverygrey erosion evith a red periphery. Latent
syphilis ± Positive serologic tests for syphilis and absence of clinical manifestations.
Dark field microscopy and immunoflooure antibody and training are done to identify
spirochete in most lesions.
a) Non treponemal tests RPR and VDRL tests measure JgG and JgM directed against a
cardiolip lecithic ± cholesterol antigen complex.
± !!" #
c
The genome of Herpes Simplex Virus is a linear double strand DNA molecule that
encodes more than 90 transcription units.
The viral genome is packaged is a regular icosahedra protein shall composed of 162
copsomeres. The onter covering of the virus is a lipid containing member are acquired as
DNA containing eapsid buds through the inner nuclear membrane of the bost cell
Pathogenesis: Exposure to HSV at nucosal surfaces or abrabled skin sites permits entey
of virus and initiation of its replication in cells of epidermis and dermis.
Lab diagnosis: Staining of scrapings from the base of lesions with weights, Giemsa¶s
Tzank preparation, or paparicolovn¶s stain to defect gaint cells or intranceclear inchisions
of herpes virus infection.
±#!! #
Human papillma viruses selectively infect the epithlim of skin and mucous membranss.
These infections may be symptomatic, produce warts and are associated with a variety
of being and mehignant neoplarms.
Etiologic Agent papilloma viruses are members of the family pabillomaviride. They are
non evveloped, measure ± 50.55mm in diameter, have icosahedral capsids compsed of
72 capsoneres and contain a double. Strand circular DNA genome of 7900 base pairs.
HPV-6 causes anogental warts and GPV = 16 infection can produce cervical dysplasia
and inverine cervical cancer.
Pathogenesis: The incubation period of HPV disease is usually 3-4 months and may
range from 1 month ot 2 years. All types of squamous epithelium can be infected by
HPV.
Episomal HPV DNA is present in the nuclei of infected cells in benign lessons caused
HPV. HPV infection also elicits a detectable serologic response in many patients.