1.

INFECTION OF THE BREAST

MASTITIS

Inflammation of the breast that can be

accompanied by infection or not, primarily
caused by Staphylococcus aureus bacteria
through wounds on the nipple or through the
bloodstream.
The initial phase of infection characterized by
inflammation.
The next stage of the infection can cause
complications in the form of mastitis and breast
abscesses local collection of pus in the breast.

Based on the occurrence of mastitis

place is divided into:

Mastitis which causes abscesses under the

areola.
Mastitis which causes abscess in the
middle of the breast.
Mastitis at the bottom of the dorsal gland
tissue that cause abscesses between the
breast and the underlying muscles.

By the time it happened, mastitis is

divided into:

lactation mastitis
Nonlaktation mastitis

LACTATION MASTITIS

Occurs when breastfeeding or stopping

breastfeeding at the time, the most
common in two to three weeks post
partum.
The main cause milk production
unreleased milk secreted unreleased
is a good medium for the growth of
bacteria.
The cause is the entry of bacteria
through wounds during breastfeeding.

NONLACTATION MASTITIS

Not occur during lactation

The cause is an infection of the skin
around the areola and nipple eg
sebaceous cyst and hidradenitis
suppurative

2. PELVIC INFLAMMATORY DISEASE

PID refers to infection of the uterus,

fallopian tubes, and other
reproductive organs that causes
symptoms such as lower abdominal
pain.

PID can lead to serious consequences

including infertility, ectopic
pregnancy, chronic pelvic pain.

HOW DO WOMEN GET PID?

Occurs when bacteria move upward

from a womans vagina or cervix into
her upper reproductive organs.

Many different organisms can cause

PID, but many cases are associated
with gonorrhea and chlamydia, two
most common causes for Sexual
Transmitted Disease.

Such as :
endometritis, salphyngitis, etc.

Diagnosis of PID
anamnesis, physical examination, lab.
Examination, radiology examination
(transvaginal USG, MRI), Laparoscope

3. INFECTIONS OF THE FEMALE

REPRODUCTIVE ORGANS (BACTERIA,
VIRUSES, PARASITES)

BACTERIAL INFECTIONS

inflammation of the vagina (vaginitis)

- Bacterial vaginosis
whiteness: a thin, homogeneous, white gray and smelled
fishy
- candida
not a sexually transmitted infection
whiteness: milk white, odorless, erythema of the vulva and
vaginal walls.
- Chlamydia trachomatis
vaginal discharge, red spots, or bleeding pascasanggama.

VIRUS INFECTION

HERPES SIMPLEX VIRUS ( HSV )

Affinity to the skin , mucous membranes , and nervous

system
100 virus subtypes that have been identified - > 8 viruses
that infect humans ( HSV - 1 and HSV - 2 )
HSV - 1 lesions on the face , lips , mouth , and possibly
also in the genital area
HSV - 2 genital lesions
HSV can not be cured
HSV is spread through direct contact of the virus with
mucosal or skin damage
HSV has the ability to vary the invasion se , need not
endocytosis

Future infections : active and latent

Period of active infection : the virus
invades a host cell multiply rapidly
destroy the host cell lots of virion
release infect surrounding cells or
spread via the lymphatics to the lymph
nodes lymphadenopathy
Latency period : virus entry into the
sensory cells that innervate the area of
infection migration along axons
hidden in the ganglion radiksdorsalis
not generate cytotoxic asymptomatic

Infectious virions in active or latent

phase
Women are more vulnerable because
her genitalia mucosal surface area is
larger and micro damage in the
mucosa during intercourse
Seropositive HSV - 1 partial
immunity to HSV- 2

HUMAN PAPILLOMA VIRUS (HPV)

remains unknown because of the HPV life cycle has not

been successfully bred with cell culture
100 subtypes, 33 infect the genital tract
able to bind to various cells, and certain subtypes have
specific tissue tropism
HPV-16 and HPV-18 is oncogenic (Lombard, 1998)
mostly through sexual contact, can also autoinoculation
the majority of HPV infections are not detected 2 years
post-infection still not clear whether the virus has
disappeared / subclinical
type-specific immunity

Symptoms and Signs

Most of subclinical not detected
5% showed the presence of genital warts
American medical asociation, 1998
1. Condyloma acuminata
Lesion exophytic cauliflower-like soft, partial
keratinization
2. Papular warts
Dome-shaped lesions on the skin with a full
keratinization
3. Keratotic warts
Like ordinary skin warts, full keratinization
4. Flat papules
Or macular lesions appear as elevated total or partial
keratinization

4. EXAMINATION IN THE DIAGNOSIS

OF INFECTIONS OF THE
REPRODUCTIVE ORGANS AND
BREASTS

examination of the genital organs

procedure:
1. patient in the lithotomy position
2. examiner wash hands and wear sterile handscoon
3. use a bright spotlight towards the genetalia
inspection:
1. give information that the inspection will begin
2. note the labia majora, labia minora, clitoris, perineum, and
see if there are any signs of infection or discharge
3. note its surface to see if there are differences in the color
of skin trauma scars, cysts, or dilation of the blood vessels

palpation:
1. separate the labia majora with two fingers and then see the labia minora,
clitoris, urethral opening, and vaginal
2. palpation of the labia minora with the thumb and index finger and see if
there are any signs of infection, discharge, ulceration, or tumor
3. do checks on Skene glands and urethral opening by inserting a finger into
the vagina and press the right towards the front slowly and firmly.
4. see whether there was pressure discharge or not. if no then do laboratory
tests
5. Bartholin gland palpation of the right side of the left, the bottom edge of
the mouth of the vagina with your thumb and forefinger slowly and firmly.
6. ask whether the patient is experiencing interference during urination or
defecation
7. palpate the front and rear walls of the vagina
8. ask the patient straining, and see whether or not there is a decrease in
cervical

speculum examination
goals:
see vaginal discharge, infection, ulceration, or cervical
lesions and perform specimen for examination or pap
smear infection

procedure:
1. patient in the lithotomy position
2. examiner wash hands and wear sterile handscoon
3. speculum select the appropriate size of the vagina
4. tool show and explain steps to be taken
5. before inserting the speculum order to help the patient
breathe vaginal relaxation
6. left hand finger to open the mouth of the vagina labia
majora appear
7. insert the speculum with posterior oblique position to
the top of the vagina, and then turn the handle until the
handle slowly speculum speculum in position and lock
diposterior speculum, speculum to open the cervix looks
fine
8. see if there is discharge, inflammation, or lesions
9. when there is a suspected lesion then give the
information that will be followed by a biopsy examination

5. TREATMENT OF INFECTION IN THE FEMALE

REPRODUCTIVE ORGANS