1. Mucopurulent discharge
1.1. Neisseria
1.1.1. Morphology
1.1.1.1. Gram-neg diplococci
1.1.1.2. "Coffee bean shapped" (2 bacteria together)
1.1.2. Culture
1.1.2.1. Fastideous
1.1.2.1.1. Require enriched growth medium
1.1.2.1.2. Needs increased CO2 concentration
1.1.2.2. Oxidase pos (aerobic)
1.1.2.3. Produce weak acidic products on cystine trypticase agar
1.1.3. 3 types
1.1.3.1. N. meningitidis
1.1.3.2. Moraxella catarrhalis
1.1.3.3. N. gonnorhoeae
1.1.3.3.1. Clinical presentations
1.1.3.3.2. Epidemiology
1.1.3.3.3. Virulence factors
1.1.3.3.4. Pathogenesis
1.1.3.3.5. Dx
1.1.3.3.6. Immunity
1.1.3.3.7. Tx
1.2. Chlamydia
1.2.1. General
1.2.1.1. Obligate intracellular parasites
1.2.1.1.1. Can't make ATP
1.2.1.1.2. Resemble G- bacteria
1.2.1.2. Exist in 2 forms
1.2.1.2.1. Elementary = infectious
1.2.1.2.2. Reticulate = noninfections
1.2.1.3. Classification
1.2.1.3.1. Serotype A,B,C
1.2.1.3.2. D-K
1.2.1.3.3. L1, L, L3
1.2.2. Pathogenesis
1.2.2.1. 1) attach to cells and are phagocytized
1.2.2.2. 2) Change from non-replicating elementary bodies to metabolically active reticulate bodies
1.2.2.3. 3) Replicate and develop into elementary bodies
1.2.2.4. 4) E. bodies lyse host cell and invade new one
2. Bacterial Vaginitis
2.1. Dx
2.1.1. Vaginal pH > 5
2.1.2. Thin, homogenous vaginal discharge
2.1.3. Release of amine-like odor when mixed with 10% KOH
2.1.4. Clue cells on gram stain
2.2. Etiology
2.2.1. Gardnerella vaginalis
2.2.2. Mobiluncus sp.
2.2.2.1. Curved anaerobic G- rod
2.2.3. Trichomonas vaginalis
2.2.3.1. Presentation: malodorous, frothy discharge w/ burning, itching, chafing
2.2.3.2. Diffuse vaginal erythema
2.3. NOT STDs!!! Don't need to Tx partner
3. Genital Ulcers
3.1. Treponema
3.1.1. General
3.1.1.1. Long, thin, helical bacteria
3.1.1.2. Rototary motility
3.1.1.3. G- wall (w/ NO endotoxin!)
3.1.2. Classification
3.1.2.1. All not STDs
3.1.2.1.1. T. pertenue (Yaws)
3.1.2.1.2. T. carateum (Pinta)
3.1.2.1.3. T. endemicum (Bejel)
3.1.2.2. STD: T. pallidum (Syphilus)
3.1.2.2.1. Epidemiology
3.1.2.2.2. Clinical
3.1.2.2.3. Lab Dx
3.1.2.2.4. Tx
3.2. Chancroid (haemophilus ducreyi)
3.2.1. Clinical
3.2.1.1. "Soft chancre"
3.2.1.1.1. Painful, sloughy and purulent edges
3.2.1.1.2. Bleed easily
3.2.2. Lab Dx
3.2.2.1. Culture requires special media
3.2.2.2. Slow growing
4. Ectoparasitic Sx
4.1. Phthirus public (pubic lice)
4.1.1. Lab Dx
4.1.1.1. Examine hair follicles for nits and adult lice
4.2. Sarcoptes scabiei (scabies
4.2.1. Lab Dx
4.2.1.1. Skin scraping w/ KOH wet mount
4.2.2. Clinical
4.2.2.1. Itchy reddish papules around groin, axilla, waist, and elbows