INFLAMMATION
Infection of the
reproductive system may be classified as:
1. Non-specific, usually caused by
a mixture of microbes, e.g Staphylococci, streptococci, coliform bateria, Clostridium perfringens
2. Specific, caused by sexually transmitted microbes, the most common of which is Neisseria gonorrhoeae, Trichomonas vaginalis, chlamydia, herpes viruses, human immundeficiency virus.
PELVIC INFLAMMATORY DISEASE (PID)
This
infection may be specific or non-specific. It begins as vulvovaginitis, including the vulvar glans, then it may spread to the cervix, uterus, uterine tubes and ovaries. Upward spread is most common when microbes are present in the vagina before a surgical procedure, parturition or abortion, especially if some of the products of conception are retained.
Complication Of PID include:
1. Infertility due to obstruction of uterine tubes
2. Peritionitis
3. Intestinal obstruction due to adhesions between the bowel and the uterus and/ or uterine tubes
4. Bacteraemia which may lead to meningitis, endocarditis, suppurative arthritis
5. Bartholin's gland abscess or cyst formation if the duct is blocked
SPECIFIC INFECTIONS (Venereal diseases)
In general, the microbes that cause sexually transmitted disease
1. Are unable to survive outside the body for long periods
2. Have no intermediate host
3. Produce lesions in the genital area which discharge the infecting microbes
GONORRHOEA
This is the most commonly occuring venereal disease and affects men and women. It is caused by Neisseria gonorrhoea. In the male, suppurative urethritis occurs and the infection may spread to the prostate gland, epididymis and testes. In the female infection may spread from vulvar glands,vagina and cervic to the body of the uterus, uterine tubes, ovaries and peritoneum. Healing by fibrosis in the female may cause obstruction of the uterine tubes, leading to infertility. In the male it may cause urethral stricture. Non-venereal transmission of gonorrhoea may cause neonatal ophthalmia in babies born to infected mothers. The eyes are infected as the baby passes through the vagina.
SYPHILIS
this disease is caused by Treponema pallidum. There are three clearly marked stages although the third is now rarely seen in Britain. After an incubation period of several weeks, the primary sore (chancre) appears at the site of infection, e.g, the vulva, vagina, perineum, penis, round the mouth. After several weeks the chancre subsides sponstaneously. Secondary lesions appear 3 to 4 months after infection. They consist of skin rashes and raised papules (condylomata lata) on the external genitalia and vaginal walls. These subside after several months and are followed by a latent period of a variable number of years. Tertiary lesions (gumma) develop in many organs and in a few cases the nervous system in involved, leading to general paralysis.
Sexual transmittion occurs during the primary and secondary stages when discharge from lesions contains microbes. Congenital transmittion occurs when microbes from an infected mother cross the placenta to the fetus. Accidental spread of infection may occur by blood transfusion if a donor's blood is taken during the incubation period after microbes have spread to the blood from the site of infection.