Chapter 26, Problem 1R

coli to cause cystitis. Do the same for pyelonephritis. Diagram the pathway taken by Neisseria gonorrhoeae to cause PID.

Summary Introduction

To draw:

Pathway taken by E. coli to cause cystitis and pyelonephritis. Pathway taken by Neisseria gonorrhoeae to cause PID

Pictorial representation:

Concept introduction:

Cystitis is a urinary tract infection, mostly caused by E coli. Bacterial growth in the urothelium of the bladder through rectum, urethra, perineum and vagina causes cystitis. Pyelonephritis is an inflammatory disease of kidneys, mostly caused by E coli. Bacteria can reach kidney through lower urinary tract and bloodstream. Pelvic inflammatory disease or PID is a severe bacterial infection of pelvic organs of women, mostly caused by N gonorrhoeae.

Explanation of Solution

Cystitis is a common urinary tract infection, caused by Escherichia coli (E coli) bacteria. Nearly 70-95% of the urinary tract infections are caused by E coli. It is a gram-negative, anaerobic, rod-shaped bacteria. It is commonly found in environment, skin and intestines of animal and human. Mostly they are harmless and help in digestion, and sometimes they can cause serious health problems like diarrhea, cystitis (urinary tract infections), respiratory problem, pneumonia, food poison and others. Cystitis is primarily caused by Escherichia coli and also by Staphylococcus saprophyticus, Klebsiella species, Proteus species and Enterobacter species.  E coli covers the lining of the bladder and causes irritation and inflammation which leads to cystitis. Cystitis affects people in all age groups, however, it is more common in women than men due to the short urethra, which is less than 2 inches. The female urethra is very close to anal opening, hence it may lead to intestinal bacterial contamination. It can be prevented by drinking plenty of water which can flush bacteria and also with personal hygiene. Cystitis can be treated with antibiotics such as nitrofurantoin, trimethoprim - sulfamethoxazole, fluoroquinolone and ampicillin.

Pyelonephritis is an inflammatory disease of kidneys, caused by bacterial infection. It is a life-threatening disease which severely damages one or both kidneys and causes renal scarring. More than 70% of pyelonephritis is caused by E coli and rarely by Enterococcus faecalis, Pseudomonas aeruginosa and Klebsiella species. Bacteria can reach kidney through lower urinary tract and bloodstream. Initially, it infects bladder and move to kidney and severely damage one or both kidneys. Lower urinary tract infection is very vulnerable for kidney damage and pyelonephritis. Pyelonephritis is more common in women than men due to short urethra, which is less than 2 inches. The female urethra is very close to anal opening, hence it may lead to intestinal bacterial contaminations. Second or third generation cephalosporin is used to treat pyelonephritis.

Pelvic inflammatory disease or PID is a severe bacterial infection of pelvic organs such as uterus, cervix, uterine tubes or ovaries in female. N gonorrhoeae and C trachomatis are common microorganisms mostly responsible for PID. Uterine tubes infection or salpingitis by N gonorrhoeae leads to scarring which blocks ovary. The uterine block may cause ectopic pregnancy. Salpingitis causes10-15% infertility in women. PID can be treated with doxycycline and cefoxitin.

Conclusion

Cystitis is a urinary tract infection, majorly caused by E. coli leads to irritation and inflammation of the urinary bladder. Pyelonephritis is an inflammatory disease of the kidney caused by E coli. PID is an inflammatory diseases of female pelvic organ caused by N gonorrhoeae.