The Centers for Disease Control and Prevention recommends the maintenance of a low threshold to physicians when diagnosing pelvic inflammation disease because of the lack or absence of significant negative changes. The Center recommends diagnosing women with PID and who experience uterine and adnexal painfulness or cervical tenderness during the examination. Women who have urogenital disease can submit to the nucleic acid amplification text by endocervical or urine sample. Endocervical samples are, however, preferred, a urine samples have lower sensitivity (Miller).
Treatment
The Centers for Disease Control and Prevention revised its guidelines and now recommends the use cephalosporins in the treatment of gonorrhea and PID (Armstrong, 2007). This class of drugs has replaced fluoroquinolones, which have been popularly used since 1993. Fluoroquinolones have been the choice drugs because of their effectiveness, availability and convenient single dose. But resistance to the drugs soon became prevalent in gonorrhea cases, necessitating modifications in the therapy. Incidents were initially reported as occurring in Hawaii, followed by cases in California and the Western States. The resistance trend was first noted among men at 30% in 1994 who have sex with men, then in other groups (Armstrong; Norris, 1999). The incidence persisted and necessitated a change into another regimen. CDC currently recommends a single 125-mg intramuscular shot of ceftriaxone as treatment for uncomplicated urogenita and anorectal gonorrhea. The oral dose is 400 mg of cefixime. Cefixime may be used as an alternative regimen in combination with 1 gram of cefuroxime. CDC also recommends a single intramuscular shot of ceftriaxone for pharyngeal gonorrhea (Armstrong). The list of new class of antibiotics taken orally or given by injection consists of ciprofloxacin, ofloxacin, azithromycin, amoxicillin, doxycycline, and ceftriaxone. Patients who are allergic to penicillin should be treated instead with erhythromycin (Norris).
Alternative treatments include herbs and minerals as supplements (Norris, 1999).
Lactobacillus acidophilus or live-culture yogurts may replenish gastrointestinal flora. Zinc, multivitamins, especially Vitamin C, minerals and garlic help improve the body's immune system. Herbs like kelp, calendula, myrrh, and thuja have demonstrated values on the body's systems. Hot baths also help reduce pain and inflammation. Fasting and juices contribute to cleaning up the urinary and gastrointestinal systems. So do acupressure and acupuncture (Norris).
Prognosis
If the diagnosis is made early and the treatment is correct and complete, the disease can be entirely treated (Norris, 1999). Otherwise, 40% of untreated female patients can develop PID, liver infection and sterility. When the disease spreads throughout the body, the gonococcal infection is likely to cause fever, arthritic joints and skin lesions. The best prevention is still abstinence or exclusive sex with one partner. Infection may also be prevented with the use of contraceptive devices, such as condoms (Norris).
Name of Bacteria: Chlamydia Trachomatis
Disease: Chlamydia or Genital Chlamydia
Body System Involved: Uro-genital System
Taxonomy
Domain - Bacteria
Class - Chlamydiae
Order - Chlamydiales
Family - Chlamydiacea
Genus - Chlamydia
Species - C. Trachomatis
Identification
Chlamydia trachomatis are gram-negative, aerobic, intracellular pathgens (Stephanie, 2008). They are typically coccoid or rod-shaped. They need growing cells to remain alive but can be artificially grown in a suitable medium. They cannot synthesize their own ATP. They were previously believed to be viruses (Stephanie).
The preferred non-culture technique today is the nucleic acid amplification, which have a 85% sensitivity and specificity (Miller, 2006). A Gram stain of mucopurulent discharge from the penis with more than 5 white blood cells per oil-immersion field and no intracellular Gram-negative diplococci can confirm urethritis. The nucleic acid amplification technique can detect and confirm C. trachomatis (Miller). Other tests are cytology, culture, antigen detection, serologic tests, and nucleic acid probes. Because chlamydia are intracellular parasites, swabs of the infected or involved sites, instead of exudates, should be submitted for examination and analysis for accuracy (Mayer, 2007).
Media for Cultivation
Specimens are merged with cultures of susceptible cells (Mayer, 2007). Infected cells are then examined for iodine-staining inclusion bodies, as iodine stains glycogen in these bodies. Their presence confirms C. trachomatis. Other species of the bacterium have no glycogen (Mayer).
Pathogenicity
These organisms are small obligate intracellular parasites (Mayer, 2007). They have their own DNA, RNA and ribosomes and make their own proteins and nucleic acids. They have an inner and outer membrane like gram-negative bacteria. The are unable to make their own ATP and, are, thus energy parasites (Mayer)..
C. trachomatis attacks and infects non-ciliated columnar epithelial cells (Mayer, 2007). They stimulate the infiltration of polymorphonuclear cells and lymphocytes. This leads to the formation of lymphoid follicle and fibrotic changes. Cell destruction follows. The host creates an inflammatory response. Long-lasting immunity is not stimulated by the infection. Re-infection brings on a repeat inflammatory response and resulting tissue damage (Mayer).
Treatment
This depends on the site of the infection, the age of the...
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