Genital tract infections may be classified as endogenous or exogenous. Exogenous infections may be acquired as people engage in sexual activity, and these infections are referred to as sexually transmitted diseases (STDs). In contrast, endogenous infections result from organisms that are members of the patient's normal genital flora.
In the female, genital tract infections can be divided between lower tract (vulva, vagina, and cervix) and upper tract (uterus, fallopian tubes, ovaries, and abdominal cavity) infections.7 Lower tract infections are commonly acquired by sexual or direct contact. Although the organisms that cause lower tract infections are not usually part of the normal genital tract flora, some organisms that are normally present in very low numbers can increase sufficiendy to cause disease. Upper tract infections are frequently an extension of a lower tract infection in which organisms from the vagina or cervix are believed to travel into the uterine cavity and on through the endometrium to the fallopian tubes and ovaries. Similarly, an organism can spread along contiguous mucosal surfaces in the male from a lower genital tract site of infection (i.e., urethra) and cause infection in a reproductive organ such as the epididymis.
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