MICROBIOLOGY - Last moment revision

The first person to observe bacteria – Anton von leuwen hock

The earliest discovery of pathogenic micro organism was probably made by –

Augustino Bassi
The development of bacteriology as a scientific discipline date from Louis Pasteur
The kingdom Protista has been divided into two groups – prokaryotes and
Eukaryotes

Bacteria and blue green algae are Prokaryotes while fungi, algae, slime moulds and
protozoa are Eukaryotes.
The types of staining that may be toxic and that which kills bacteria is called
supravital staining.
Bacteria have an affinity to basic dyes due to acidic nature of protoplasm.

Acid fast staining discovered by Ehrlich and modified by Zeil and Neelssen.

According to shape bacteria are classified into

1. Cocci - spherical shaped bacteria
2. Bacilli - rod shaped cells
3. Vibrio - comma shaped cells
4. Spirilla- rigid spiral forms
5. Spirochetes- flexuous spiral forms
6. Actinimycetes - branching filamentous form.
7. Mycoplasma – lacks cell wall. Hence do not possess stable morphology.

Cultural media may be a complex medic if ingredients are added for special purpose
of growth.

IMMUNITY
Refers to resistance exhibited by host towards injury caused by
microorganisms and their products.
Innate immunity is inborn.
Acquired immunity may passive and active immunity.
Active immunity developed by an individual due to antigenic stimulus . once
developed it is long lasting.
In PASSIVE immunity no antigenic stimulus; preformed ontibodies are administered.
An antigen has been defined as any substance when introduced parenterally into the
body stimulates the production of antibodies. The smallest unit of antigenicity is
called an epitope
Antibodies are immunoglobulins

IgG :- this is major serum immunoglobulin. Its level is raised in chronic malaria, kala
azar, or myeloma. IgG is only maternal immunoglobulin that is normally transported
across the placenta and provides natural passive immunity in newborn.
IgA:-it is the second most abundant class of immunoglobulin seen in body fluids such
as colostrums, saliva and tears.

IgM:- is called ‘millionaire” molecule. It is not transported across the placenta hence
presence of IgM in the foetus or newborn indicates diagnosis of congenital infection
such as syphilis, rubella, HIV and toxoplasmosis.

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IgM antibodies are short lived, hence their presence in serum indicates recent
infection.

IgE:- greatly elevated in atopic (Type I allergy) conditions such as asthma, hay
fever, eczema, and also in children having high load of intestinal parasites.

In general
IgM – protects body fluids
IgA – protects body surfaces
IgM – protects blood stream
IgE - mediates reagenic hypersensitivity
Bence jones proteins are abnormal light chain immunoglobulins seen in multiple
myeloma.
Coomb’s test – antiglobulin test- dirct commb’s test is positive in haemolytic disease
of newborn due to Rh incompatibility
Indirect commb’s test is positive in Brucellosis

Wasserman reaction (Serodiagnosis of syphilis) is a complement fixation test

The term hypersensitivity means injurious consequence in sensitized host following
contact with specific antigens. Mainly classified into
Immediate – B-cell or antibody mediated and Delayed – t cell mediated

Immediate hypersensitivity Delayed hypersensitivity

1. Appears rapidly and recedes rapidly
2. Induced by antigens or happens by
any route
3. Circulating antibodies are present and
responsible for reaction
4. So antibody mediated reaction
1. Appears slowly and lasts longer
2. Induced by infection, ingestion of
antigen or happen intradermally
3. Antibodies absent
4. Cell mediated reaction

- In anaphylactoid reactions there is no immunological basis.

- Shwartzan reaction is not an immune reaction but reaction resembles
immune inflammation.
- Auto immunity is a condition in which structural or functional damage is
produced by action of immunologically competent cells or antibodies against
normal components of body.
- Rose water test is used for the detection of rheumatic fever.

STAPHYLOCOCCUS
Gram positive
Occurs in ‘grape like clusters’
Enzyme coagulase present
It causes LOCALISED SUPPURATIVE LESIONS
Common culture media is nutrient ogar and organization shows ‘oil –paint’
appearance in medica. Main exotoxins of S.aureus are cytolytic toxin, enterotoxin
and exfoliative toxins. Entero toxin causes staphylococcal food poisoning (milk
and milk products are responsible for common food items)
Exfoliative toxins causes TSS (toxic shock syndrome)
And SSSS - Staphylococcal scalded skin syndrome- seen in infants – Ritter’s
disease

PATHOGENESIS

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 - Localized skin lesions including furuncles, styes, boils, abscesses,
carbuncles, impetigo.
- Sepsis in burns and wounds
- Acute osteomyelitis
- Tonsillitis, pharyngitis, pneumonia, especially bronchopneumonia
secondary to some respiratory infections
- Breast abscess in lactating mothers
- Tropical myositis- in young adults of tropics multiple abscess in voluntary
muscles.
- In staphylococcal food poisoning diarrhea and vomiting starts with in 6
hours of taking contaminated food
- Exfoliative diseases such as impetigo, pemphigus neonatorum, Ritter’s
disease, toxic epidermal necrolysis.
- Non pathogenetic staphylococci- staphylococcus epidermitidis

STREPTOCOCCI
Gram positive
It causes SPREADING PYOGENIC INFECTIONS and non suppurative lesions sucj as
rheumatic fever and glomerulonephritis
3 types
Alpha haemolytic s.cocci
Beta haemolytic s.cocci
Gamma haemolytic s.cocci (non haemolytic)
Streptococci form several exotoins and ensumes. The two haemolysins are
haemolysin ‘O’ and ‘S’.
Streptolysin ‘O’ is oxygen labile. Streptolysin regularly appear in sera following
streptococcal infection - ASO tite
Strepto lysine S is not antigenic
Erythrogenic toxin is also called Dick , scarlatinal or pyrogenic toxin.

DICK TEST:- this test is used to identify children susceptible to scarlet fever (scarlet
fever is a type of acute pharyngitis with extensive rash caused by str.pyogens

SCHULRZ CHARTON reaction:- blanching of rash on localinfection convalescent

serum. This is used as a diagnostic test in scarlet fever.
The enzyme sternodornase present in the str.cocci helps to liquefy pus and hence
responsible for serous character of pus.

PATHOGENESIS

- Respiratory infection including sore throat, tonsillitis, pharyngitis

- Extension of infection from throat to surrounding tissues causes ASOM,
mastoiditis , quinsy, Ludwig’s angina, suppurative adenitis
- Skin and subcutaneous infection - Variety of suppurative infection
including infection of wounds or burns.
- 2 typical streptococcus infections are Erysipelas and impetigo (impetigo
are vesicular pin head like infection with exfoliation.)
- Streptococcal subcutaneous infection range from cellulites to necrotizing
fascitis.
- Genital infection including puerperial sepsis and abscess in internal
organs such as brain, kidneys etc.
- Non suppurative leisions such as rheumatic fever and acute
glomerualonephritis.

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 - In rheumatic fever, a connective tissue degeneration of heart valve and
inflammatory myocardial leisions causes Aschoff nodules
- Str. Viridans normally residing in mouth and upper respiratory tract

PNEUMOCOCCI
It is gram positive
Single most prevalent bacterial genera in pneumonia, otitis media, acute sinusitis,
meningitis, and other infectious processes
Cultural characters :- on blood agar draughtsman or carom coin appearance. It
exhibits capsule swelling reaction called quelling reaction.
The toxins are oxygen labile haemolysin and a leucosidin

PATHOGENESIS
-Lobar pneumonia
- Bronchopneumonia following viral infections
- Acute exacerbation of chronic bronchitis (haemophilus influenza also causes this)
- Empyema, pericarditis, ASOM, otitis media, sinusitis, conjunctivitis, suppurative
arthritis

NEISSERIA
Gram negative cocci
N.meningitidis
Causes meningococcal meningitis or cerebrospinal fever
Oval or spherical in shape
Grows only on enriched media such as blood agar, chocolate agar
Modified Thayer-Martin media is a useful selective media

PATHOGENESIS
Cerebrospinal meningitis
Meningococcal septicemia
In meningococcal septicemia there occurs adrenal haemorrhage and shock. This is
Water house – Frederickson syndrome

N. gonorrhoea
Causes veneral disease gonorrhoea. Here also Thayer – Martin media is
used.
PATHOGENESIS
Gonorrhoea is acquired by sexual contact. c/c urethritis lead to stricture
formation. The may spread to periurethral tissue causing abscess and multiple
discharging sinuses. (Water can perineum)
- In women causes Bartholinitis and salpingitis
- Proctitis, conjunctivitis, arthritis, ulcerative endocarditis and meningitis
- Non veneral infection is gonococcal ophthalmia in newborn

NON GONOCOCCAL URETHRITIS (NGU)

Causative organisms are
a. Chlamydia trachomatis
b. Ureaplasma urealyticum
c. Mycoplasma hominis

CORYNE BACTERIA
Gram positive
Non acid fast, non motile rods

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C.diphtheria :- syn. (Loffler’s bacillus)
Having Chinese letter of cuneiform arrangement
Usual media - Loeffler’s serum slope and tellurate blood agar
3 types –
Gravis – most fatal infections
Intermediate
Mitis

Universally used strain is Park william’s strain

PATHOGENESIS
Site of infection
1. Faucial
2. Laryngeal
3. Nasal
4. Otitic
5. Conjunctival
6. Genital
7. Cutaneous

-Faucial diphtheria is the commonest type. Classified into malignant or hyper toxic
diphtheria in which there is sever toxaemia with marked adenitis – bull neck. Death
occurs due to circulatory failure.
-Septic- which leads to ulceration, cellulitis, gangrene
- Haemorrhagic – characterized by bleeding from edge of membranes

Common complication – asphyxia, acute circulatory failure, post diphtheritic paralysis

SHICK TEST- susceptibility test for diphtheria

BACILLUS
Rod shaped bacteria
2 types
Aerobic bacilli and anaerobic bacillus
Gram positive

B.anthracis :- first pathogenic bacteria observed under microscope and it is the first
bacillus to be isolated in pure culture and first bacterium used for preparation of
attenuated vaccine.
M-Fayden’s reaction:- used for presumptive diagnosis of anthrax in animals

Culture media:- on agar media frosted glass appearance with locks of matted hair
called medusa head appearance, on gelatin slab having ‘inverted fir tree’ appearance
when grown on solid media ‘ strings of pearl reaction’.

ANTRAX is a zoonosis
3 types
1. Cutaneous 2. Pulmonary 3. Intestinal
All types leads to fatal septicemia.
Cutaneous anthrax
Follows infection through skin. Leisions are called ‘malignant pustule’ or black eschar
Disease is common in dock workers carrying loads of hides and skins on bare back.
Hence called hide porter’s disease.-

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PULMONARY ANTHRAX:-
Wool sorter’s disease due to inhalation of dust from infected wool. There is
haemorrhagic pneumonia. Haemorrhagic meningitis is a complication.

Intestinal anthrax is rare. Occurs mainly in primitive communities which uses

undercooked meat.
Lab diagnosis is by immunofluoroscence

Bacillus cereus – causes food borne disease characterized by diarrhea and abdominal
pain associated with consumption of cooked rice, usually fried rice from Chinese
restaurant.

CLOSTRIDIUM
Gram positive
Anaerobic sphere forming bacilli
Genus responsible for 3 major diseases
1. Gas gangrene. 2. Food poisoning 3. Tetanus
Spores may be central or equatorial. Eg. Cl. Bifermingens

Oval or terminal Tennis racket eg. Cl. Tertian

Spherical and terminal – drum stick appearance eg. Cl. Tetani

Useful media
Robertson’s cooked meat broth
cl. perfingens - Gas gangrene (malignant oedema)
Wound contamination
Septic abortion
Anaerobic myositis
Food poisoning and
Necrotizing enteritis
In litmus reaction fermentation of lactose causes stormy fermentation
cl. perfingens show ‘Nagler reaction’ due to specific lecithinase effect

Food poisoning starts between 8-24 hours – self limiting illness

cl.noviji (cl.oedematiens)
Also causes gangrene characterized by high mortality and large amount of
oedema fluid with little or no observable gas.

Clostridium tetani
Drumstick appearance
Media: robertson’s cooked meat broth
2 toxins: tetanolysin which is haemolysin and tetanospasmin which is a powerful
neurotoxin

Tetanus toxins block synaptic inhibitors in spinal cord. While strychnine acts post
synaptically.
Abolition of spinal inhibition causes uncontrolled spread of impulses initiated any
where in CNS. This results in muscle rigidity and spasm.
Sometimes tetanus may be due to local suppuration called otogenic tetanus.

Clostridium botulinum

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 Causes food poisoning – exotoxin is responsible for pathogenicity. It acts by
blocking acetylcholine at synapse and neuromuscular junction. Hence onset
marked by diplopia, dysphagia and dysarthria
Botulinum – 3 type
1. Food borne botulism
2. Wound botulism
3. Infantile botulism

Food borne botulism- 12- 36 hours after ingestion

Vomiting, thirst, constipation, ocular paresis, difficulty in swallowing,
speaking, breathing, coma or delirium
Death is due to respiratory failure.
Wound botulism – Rare. Symptoms similar to food borne botulism except GIT
symptoms
Infant botulism - Infants less than 6 months are affected. Manifestations are
constipation, poor feeding, lethargy, weakness, pooled oral secretion, weak or
altered cry, loss of head control.

NON SPORING ANAEROBS

Enterobacteria – proteus
Mc conkeney’s medium

E coli- pathogenesis
Neonatal meningitis
Septicemia
Clinical features:
1. UTI
2. Pylonephritis and hypertension in pregnant women
For diagnosis - Mid stream urinalysis

3. Diarrhea – traveller’s diarrhea

4. Enterohaemorrhagic colitis – frank dysentery
5. Pyogenic infection and septicemia

KLEBSIELLA (fried –landler’s bacillus)

-Pneumonia, UTI, septicemia and rarely diarrhea

ENTEROBACTERIA
Shigella causes bbacillary dysentery
Short incubation period – 1-7 days; usually 48 hours

Enterobacteria - Salmonella
Salmonella typhi:- causes typhoid fever.

Enteric fever :- typhoid and paratyphoid fever- salmonella paratyphi A,B,C

Widal reacton
Leucopenia
Diazo test of urine

Slamonella gastroenteritis
Poultry, meat, milk, cream and eggs

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Short incubation period – less than 24 hours

VIBRIO
Gram negative; comma shaped

Described by Koch as ‘fish in stream’ vibrio colonies are identified by ‘string test’
Biochemical reaction- cholera rod reaction
In cholera – watery diarrhea, vomiting with hypovolumic shock and death in less
than 2 hours

Stool has fishy odour and it is described as ‘rice watery’ stool.

PSEUDOMONAS
Bacillus pyocyanius
Gram negative
Pyocyanis forms blue pus ; self limiting illness - shanghai fever

YERSINIA, PASTEURELLA, FRANCISCILLA

Yersinia safety pin appearance

On nutrient agar - stalactile growth
Yersinia causes plague
Pandemic plague causes black death due to extensice cutaneous
haemorrhage and gangrene.
3 forms
Bubonic, pneumonic and septicemic
Vector is rat flea – xenophilla cheopis

HAEMOPHILUS INFLUENZAE
Gram negative bacillus
Cultural media is blood agar and shows Satelletism in media

Pathogenesis

Meningitis
Otitis media
Pneumonia
Arthritis
Endocarditis, pericarditis
Bronchitis
Haemophilus ducreyi
Cause chancroid or soft sore. Veneral disease. Bacilli are arranged in groups called
school of fish or rail road track appearance
BORDETELLA PERTUSIS ( bordet- gengou glycerine –potatoe blood agar
‘Bisected pearls’ or mercury drops’ with ‘aluminium paint’ appearance
Pathogenesis: Pertusis or whooping cough.

BRUCELLA
Acute brucellosis ; undulant fever
Malta fever
Relapsing fever
Caused by B. melitensis – Brucellosis is primarily a disease of reticuloendothelial
system

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Lab investigation:- castinada method of blood culture.

MYCOBACTERIUM TUBERCULOSIS
Gram positive
Acid fast bacillus

In children it causes primary complex.

Ghon’s focus :- subpleural focus of tuberculous pneumonia in lung parenchyma

Adult type TB is due to reactivation of primary infection.

In mantoux test 0.1 ml. purified protein derivative is injected intracutaneously on
flexor aspect of forearm. Site is examined after 48-72 hours
If induration of diameter 10mm or more – positive mantoux test
If induration is 5 mm. or less than 5mm. – negative
If induration is between 6-9 mm it is doubtful case.

LEPROSY
Caused by gram positive mycobacterium leprae. Organism is arranged in
parallel rows are having ‘cigar bundle’ appearance. Masses of bacilli are called globi.
The globi appear in virchow’s lepra cell or foamy cell

Leprosy is a chronic granulomatous disease.

4 types
1. Lepromatous
2. Tuberuloid
3. Dimorphous
4. Indeterminate

Lepromatous variety is most infectious type. Lepromin test is negative in

lepromatous leprosy due to deficient cell mediated immunity.
In Tuberculoid leprosy patient is having high resistance. Good prognosis. Lepromin
test is positive. Few skin lesions but neurological symptoms are more and deformity
occurs early.

The term borderline or dimorphous refers to lesions possessing characteristic of both

tuberculoid and lepromatous type.

The indeterminate type is early unstable tissue response to the microorganism.

Lesions undergo spontaneous healing.
Classification according to Reiding & jopteng scale of classification
Lepromin test is described by metsuda
Biphasic events
First phase - early reaction - Fernandes reaction. Ie. Erythema and induration
developing in 24-48 hours.
Late phase - Mitsuda reaction - starting 1 or 2 weeks later. It consists of indurated
skin nodule which may ulcerate.
Lepromin test is positive in Tuberculoid leprosy
Lepromin test is negative in lepromatous leprosy
Lepromin test is variable in dimorphous and indeterminate varieties

SPIROCHAETES
Treponema pallidum causing syphilis

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 Treponema pertenue causes yaws
Treponema carateum causes pinta
Staining reaction is silver impregnation method
Syphilis is a veneral disease
Primary lesion is chancre
Lymph nodes are characteristically rubbery in consistency
Secondary syphilis starts after 2-6 weeks, characterized by roseolar skin rashes
After secondary syphilis there is a stage of latent syphilis. During this period
diagnosis is possible by serological test. There occurs cardiovascular lesions including
aneurysm.
Tertiary syphilis – delayed hypersensitivity reaction mainly tabes dorsalis and
general paralysis of insane.

Serological test for diagnosing syphilis

A. Reagin test
B. Kahn test (floaculation test)
C. VDRL test (veneral disease research laboratory test)
D. Rapid plasma regain test is the first modified VDRL
First reagen test is Wasserman reaction

BORELLIA
Causes relapsing fever
2 types
Louse borne relapsing fever
Tick borne relapsing fever
Louse borne relapsing fever is caused by Borellia recurrentis
Borellia vincenti causes ulcerative gingivostomatitis or oropharyngitis called –
vincent’s angina or cancre oris
Borellia burgdorferi causes lyme disease
Rat bite fever caused by spirillum minus or streptobacillus moniliformis

LEPTOSPIRA
Leptospira icterohaemorrhagica causes Weil’s disease which causes hepatorenal
damage.
Antibodies appear in serum towards the end of first week of disease and increase till
4th week. Caonicola fever is caused by leptospira canicola.

MYCOPLASMA
Smallest free living microorganism. Organism in colony have ‘fried egg’ appearance.
Mycoplasma causes pneumonia and genital infection especially of children and
adolescents.

ACTINOMYCETES
Gram positive. Between bacteria and fungi
It causes ‘lumpy jaw’ in cattle.

Actinomycosis is a chrnic granulomatous infection characterized by development of

indurated swelling mainly in connective tissue with suppuration and discharge of
sulphur granules. Actinomycosis in human being is an endogenous infection.
Actinomycetes Israeli is the causative organism.
3 forms
1. Cervico fascial
2. Thoracic

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3. Abdominal
Pelvic actinomycosis is associated with the use of IUCD (intra uterine
contraceptive device)

Actinomycetes mycetoma( Madura mycosis)

It is a localized chronic granulomatous involvement of subcuteneous and

deeper tissue affecting foot and less commonly hands and presenting as a tumour
with multiple discharging sinuses.

Helicobacter pylori associated with antral gastritis and peptic ulcer disease.
Legionella pneumonia is caused by Legionella pneumophilia. Human infection is
typically caused by inhalation of aerosols produced by airconditioners and shower
heads.

RICKETTSIAE
Gram negative organism
Weil – Felix raction used for diagnosis of rickettsial infection.

Scrub typhus
Rickettsiae tsu tsu gambusti
Epidemic typhus
Rickettsiae prowazekii (vector is louse or pediculus humanis)
Recrudescent typhus is activated latent infection called Brill- Zeinsser disease
Rocky mountain spotted fever - Rickettsia rickettsi
Endemic typhus is caused by rickettsiae typhi ( r. mooseri)
Transmitted by xenopsyla cheopis or rat flea

Trench fever is caused by Rickettsiae Quintana

Transmitted by body louse
Q fever is caused by coxellia burnetti

CHLAMYDIAE
Main pathogenitic varieties are
Chlamydiae psittaci
Chlamydiae pneumoniae

trachomatis causes
1.Trachoma which is a chronic keratoconjunctivitis (lab diagnosis by Hp bodies)
2. Inclusion benorrhoea (neonatal form of inclusion conjunctivitis)
3. Pool conjunctivitis
4. Lymphogranuloma venerum

Chlamydia psittaci
Causes psittacosis – consumption of infected poultry products leads to this
disease

VIROLOGY
Interferon – antiviral substances, it is a family of host coded proteins
produced by cells on induction by viral or non viral substances
Pox virus:- small pox- last detected case of small pox – sarban devi , a bengladeshi
woman on 24th may 1975.

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HERPES VIRUS
Herpes simplex virus type I causes oral and cutaneous lesions spreading by
direct contact

Herpes simplex type II causes genital tract infection transmitted venerally.

Occupational variety of cuteneous lesion is herpetic whitlow seen in doctors, nurses

and dentists.

Eczema herpeticum
Generalized eruption occurs in children suffering from eczema
Crops of vesicles appear around the ulcer;clinically indistinguishable from vaccinia
virus infections . both designated as Kaposi’s varicella form eruptions.

In chicken pox eruptions are centrifugal in distribution. (small pox rashes are
centripetal in distribution)
In chicken pox patients , secondary bacterial infection due to streptococci or
staphylococci occurs. This is called Reyes syndrome. Clinically characterized by acute
hepatic failure, encephalopathy and hypoglycemia.

Herpes zoster (syn; shingles, zona)

Occurs in patients affected with chicken pox years later.
Ramsay hunt syndrome:- rare form of zoster affecting facial nerve with eruption on
areas of tympanic membrane and external auditory canal with facial palsy.

Epstein – Barr virus

Causes IMN (infectious mono nucleosis)
Associated with
- Burkitt’s lymphoma
- Immunodeficiencies
- Naso pharyngeal carcinoma
IMN (glandular fever) – acute self limited illness seen in non immune adults following
primary infection with EB virus. Incubation period is 4- 8 weeks . standard diagnostic
test is Paul - Bunnel test
Adenovirus causes respiratory infection , usually picorno virus includes
- enterovirus - coxachie virus and polio virus
poliomyelitis is mainly 3 types
1. Minor illness :- called abortive polio with head ache, sore throat, and
malaise
2. Non paralytic illness:- it does not progress beyond asceptic meningitis
3. 5-10% causes paralytic polio

Vaccine:- 2 types
a. Salk’s killed polio vaccine
b. Live polio vaccine is oral polio vaccine
Orthomyxovirus causes influenza.
Paramyxovirus Eg. Mumps virus

Measles (Rubiola) – genus morbiliform virus

Multinucleated giant cells called Warthin – Finkelclay cells are found in lymphoid
tissue of patients.
Koplik’s spots developon buccal mucosa two or three days before the appearance of
rash.

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FLAVI VIRUS
Causes
1. Japanese encephalitis (vector- culex tritaneorynchus)
2. Yello fever – Vector – Aedes aegypti
3. Dengue fever - Vector - Aedes aegypti
Tick borne encephalitis eg. KFD (Kyansur forest disease)

RHABDO VIRUS
Eg. Rabies virus causes hydrophobia
Diagnosis is confirmed by negri bodies (inclusion bodies) in brain in post mortem
examination mostly in hippocampus and cerebellum

PAPOVA virus include papilloma virus group and polyoma virus group.

The common human disease produced by papova virus is papilloma or wart. (verruca
vulgaris)
A special type of wart is condylom accuminatum or genital wart found on external
genitalia. This may be transmitted venerally and may occasionally turn malignant.

Parvo virus cause erythema infectiosum –‘the fifth disease’ a contagious disease of
children characterized by erythematous rash first appearing on cheeks. – slapped
cheek appearance.

RUBELLA OR GERMAN MEASLES

Caused by genus rubivirus of family toga viridae
- Koplik’s spot absent
- Rash is discrete and coalesce and disappear on 3rd day
- Non tender enlargement of post cervical glands is characteristic
- If Rubella occurs in early pregnancy, the foetus may die
- Congenital malformations are common during first trimester.
- Infected babies constitute an important source of infection for about 6
months (virus may persist for years in tissues such as cataractous lenses)
- Diagnosis of Rubella in early pregnancy is an indication for therapeutic
abortion.
- Cruzfelt – Jacob disease is sub acute encephalopathy with progressive
incoordination and dementia caused by group b prion virus.

Haemorrhagic fever with renal syndrome(HFRS)- also known as epidemic

haemorrhagic nephrosonephritis is caused by Huntaan virus of family Bunya viridae.

HIV – human immunodeficiency virus – retro virus now called Human T cell
lymphotrophic virus
- RNA virus attacks CD4 cells.
A. Envelops antigens – 1. spicks antigen, 2. transmembrane
B. Shell antigen
C. Core antigen
D. Polymerase antigen
Incubation period varies from 2-6 weeks to 15 years.
Features characaterising AIDS
1. Lymphopenia
2. Selective T cell deficiency – reduction in numbers of T4 (CD4) cells,
inversion of T4: T8 ratio

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 3. Decreased delayed hypersensitivityon skin testing
4. Hypergammaglobulinaemia – predominantly IgG and Ig A; also IgM in
children.
5. Polyclonal activation of B cells an dincreased spontaneous spontaneous
secretion Ig.
Common malignancies associated with HIV infection is Kaposi’s sarcoma and
lymphoma- hodgkin’s and Non hodgkin’s types.

HIV- Elisa for detection

Western blot for confirmation

Ergotoxicosis (ergotism) is due to claviceps purpura growing on fruiting heads of rye.

HEPATITIS
Hepatitis A – incubation period - 2- 6 weeks
Hepatitis B - I P 4 – 8 weeks
Hepatitis C - IP 2 – 22 weeks
Hepatitis D Ip 4 – 8 weeks
Hepatitis E IP 2 – 9 weeks
Hepatitis B – DNA virus ; all others are RNA virus
Spreads by faeco oral route - hepatitis A and E
Spreads by percutaneous route - Hepatitis B,C and D
Hepatitis B also spread by vertical and sexual route

- Oncogenicity present in Hepatitis B especially after neonatal infection.

- Carrier state present in Hepatitis B only
- Hepatitis B virus may present in blood and other body fluids and
excretions such as saliva, breast milk,semen, vaginal secretions, urine , bile
etc.
- Feces not known to be infectious
- HBs Ag is the first viral marker to appear in blood after infection; it
remains in circulation throughout icteric course of disease. In a typical case it
disappear within roughly 2 months but may last for 6 months.
- HBsAg is not demonstrable in circulation but antibody, antiHBe appear in
serum a week or two after appearance of HbSAg
- So anti-HbeAg is the antibody marker to be seen in blood.
- HBeAg (HB envelop antigen) appears in blood concurrently with HBsAg.
HbeAg is an indicator of intrahepatic viral replication and its presence in blood
indicates high infectivity.
- For diagnosis of HBV infection, simultaneous presence of IgM, HBC
indicates recent infection and presence of IgG ;anti H-Be indicates remote
infection.

Type E hepatitis : enterically transmitted.

Non A – non B hepatitis caused by Hep. C virus

Inclusion body inviruses

a. Intracytoplasmic
Guarnieri body - Varicella, Vaccinia
Negri body – Rabies
Henderson – Paterson body - Molluscum contagium
b. Intranuclear
a. Lipschutz bodies - herpes fibrilis, herpes zoster, varicella

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 b. Councilmann’s bodies - yellow fever, virus B encephalitis
c. Nicolau’s bodies – herpes fibrilis, herpes zoster , polio, Rift valley
fever

Association of virus with human cancer

Virus family Virus genus Human cancer

Herpes virus E-b Virus Nasopharyngeal carcinoma

African Burkitt’s lymphoma
B- cell lymphoma

Herpes 2 virus Cervical carcinoma

Papova viridae Papilloma virus Urogenital tumour

Squamous cell carcinoma

Hepadne virus Hep B virus Primary Hepatocellular carcinoma

Retrovirus HTL virus Adult T Cell Leukaemia

Viral infections associated with associated with maculopapular rash

1. Adenovirus infection
2. Arbovirus infection
3. Measles
4. Cytomegalovirus infections
5. Enterovirus
6. Hep-B virus
7. IMN (kissing disease)
8. Rubella

- Haemolytic uraemic syndrome caused by virotoxin producing e-coli

- Brazilian purpuric fever caused by Haemphilus aegypticus
- Cryptospridum causes diarrhea
- Cat scratch disease is caused by cat scratch bacillus

FUNGAL INFECTIONS
Superficial mycosis(cutaneous ) or dematophytis
1. Microsporum - attacks skin and hair ; not nail
2. Tricophyton attacks skin , hair and nails. Most important human
parasites are T. rubrum and T. tonsuran
3. Epidermophyton - e.floccosum attacks skin and nails but not hair.
Dermatophytes:
- Tinea capitis – ring worm of scalp
- Tinea circinata – ringworm of glabrous skin
- Tinea barbae - ringworm of beard

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 - Tinea pedis – Athletes foot
- Tinea cruris – Dhobi itch or Jock itch
- Tinea unguum - ring worm of nails

Systemic mycosis
Candid albicans – yeast like fungi
Histoplasma capsulatum - Darling’s disease
Cryptococcus neoformans – yeast
Aspergillus - fungus ball
Cocciodes immitis – desert rheumatism

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