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Case of the week

Case of the week. Leucocytospermia (Pyospermia). White blood cells in semen If their number are more than one million in each milliliter of the ejaculate , this means asymptomatic sexually transmitted diseases ( Mycoplasma, ureaplasma & chlamydia). Semen culture should be done.

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Case of the week

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  1. Case of the week Leucocytospermia (Pyospermia)

  2. White blood cells in semenIf their number are more than one million in each milliliter of the ejaculate , this means asymptomatic sexually transmitted diseases ( Mycoplasma, ureaplasma & chlamydia). Semen culture should be done.

  3. A case of azoospermia with multiple white cellsin semen analysis

  4. Leukocytospermia (pyospermia)& its effect on spermsROS: reactive oxygen species ; GPx: glutathione perioxidase ; SOD: superoxide dismutase, GR: present on Y chromosome ; NADH, NASDPH diaphorase are correlated with sperm motility. helping helping

  5. I. Mycoplasma genitaliumUnicellular gram negative, non motile prokarytes which lack distinct cell wall. It can cause non gonoccoal urethritis (NSU)

  6. Mycoplasma fermentansIt inects human in genital tract & necrotizing tissue. It is also linked with rheumatoid arthritis. It causes chronic fatigue in patients . It causes severe respiratory infections.

  7. Mycoplasma fermentansIt attacks B cells causing inflammatory reaction. It enhance HIV replication.

  8. Gram negative Mycoplasma hominis.Smallest free living organism known. They have no cell wall& therefore do not gram stain. Tetracycline & erythromycin can treat both mycoplasma & uroplasma

  9. Mycoplasma hominisM. H. are often present in vaginas. It colonize frequently in the genital tract of sexually active men & women. Growth of fried egg colonies on glucose agar medium within 24 – 48 hours is a characteristic of Mycoplasma hominis. It can cause pyelonephritis, pelvic inflammatory disease, post partum infection.

  10. II. Ureaplasma urealyticumIt is a normal genital flora of both men and women. It is also associated with a number of diseases in human: non specific urethritis (NSU), infertility, chorioamnionitis, still birth, premature birth, pneumonia, meningitis.

  11. Urogenital culture: M. hominis & uroplasma urealyticum specimens work up.

  12. III. Chlamydia trachomatis • It is an obligate intercellular human pathogen. It is gram negative bacteria. It can appear as coccoid or rod shape. There are three types of this prokaryotic ( without a membrane bound nucleus) organism: • 1. Serovars Ab, B, Ba or C which cause trachoma • 2. Serovars D – K which cause @ urethritis ( non gonococcal urethritis), @ prostatitis, @ epididymitis , @ infertility& @ proctatitis in men. In women it can cause @ cervicitis , @ pelvic inflammatory disease & @ ectopic pregnancy. @ Perihepatitis (Fitz- Hugh – Curtis syndrome) where is inflammation of liver capsule as a part of pelvic inflammatory disease. It can also cause @ Reiter’s syndrome or reactive arthritis ( arthritis, conjunctivitis , urethritis & ulceration of the skin and mouth). • 3. Serovars L1 & L2: which cause lymphogranuloma venerum. • Chlamydia trachoatis is the major cause of infertility

  13. Life cycle of chlamydia trachomatisEB : elementary body ; RB: reticulate body

  14. Chlamydia trachomatis A : complete genome

  15. TrachomaThe world lead preventable blindness

  16. Chlamydial urethritis ( NSU)Swab of the discharge showed no growth in culture but was positive for polymerase chain reaction to C. trachomatis

  17. Infection of female genital tractwith chlamydia trachomatisThe elementary bodies infect the columnar epithelial cells of cervix, endometrium, & fallopian tubers causing pelvic inflammatory disease , salpinigitis, infertility or ectopic pregnancy.

  18. Cytological smear of trichomonaus vaginalis : the organism is pear shaped with a diameter of 15 – 3Omicrons . The nucleus is vesicular , eccentric but cytoplasm contain eosinophilic granules. Trichomanides are also seen in in the smear (H. & E)

  19. Chlamydia trachomatis inclusion bodies in a Mc Cay cell culture

  20. Chlamedia salpingitis : H. E. & immune staining

  21. Fitz- Hugh –Coup syndrome“Violin- string “ adhesions can be seen. This is spread of inflammation in pelvic inflammatory disease.

  22. CT scan of right abdominal quadrant & pelvis in Fitz – Huge- Curtis syndrome

  23. Fitz – Hugh – Curtissyndrome

  24. Reiter’s syndromeIt is an auto-immune condition that develop in response to inflammation of other part of the body: genitourinary or gastrointestinal infections. It is associated with HLA-B 27 gene on chromosome 6 Circinate balanitis Reactive arthritis Aphthous stomatitis Geographic tongue

  25. Keratoderma blanorrhagicumFeet - Reiter syndrome

  26. Ankylosing spondolytisReiter’s syndrome is considered a precursor of other joint condition including ankylosing spondolytis

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