1

Viral Infections of Humans

• Viruses can only infect the cells bearing appropriate surface receptors
• Specific to types of cell(s)
• Viruses multiply within host cells and it is during escape from those cells that the host cells are destroyed
Viral Infections of the Skin Patient care Pathogen Reservoir Mode of transmission
1. Chicken pox (Varicella)
• Acute, generalized viral infection with fever and a skin
rash
use airborne and contact : person to person by direct
• Vesicles also form in the mucous membrane
precautions for Varicella-zoster virus contact or droplet or airborne
Shingles (herpes zoster) infected
hospitalized patients until (VZV) – aka human spread of vesicle fluid or
• Reactivation of varicella, often the result of humans
their lesions become dry herpesvirus 3 (HHV-3) secretion of the respiratory
immunosuppression
and crusty system
• Inflammation of sensory ganglia of cutaneous sensory
nerves, producing fluid-filled blisters, pain and
paresthesia (numbness and tingling)

2. German measles (rubella)

• Mild, febrile viral disease
• A fine, pinkish, flat rash begins 1-2 days after the onset
Use droplet precautions
of symptoms Droplet spread or direct contact
for hospitalized patients Infected
• With fewer complications than rubeola but if acquired Rubella virus with nasopharyngeal secretions
until 7 days after the onset humans
during the 1st trimester of pregnancy, it may cause of infected people
of rash
congenital rubella syndrome in the fetus
• Intrauterine death, spontaneous abortion or congenital
malformations of major organ systems

3. Hand, foot and mouth disease (HFMD)

• Common viral illness that usually affects infants and
close personal contact,
children younger than 5 years
Coxsackie A16 and Infected respiratory secretions , contact
• Starts with fever, sore throat, malaise. After 1-2 days,
Enterovirus 71 humans with feces or contaminated
painful sores can develop in the mouth
objects
• Skin rash with red spots may develop over the next few
days on the palms of the hand s and soles of the feet

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4. Measles (hard measles, rubeola) airborne transmission – by

• Acute, highly communicable viral disease with fever, use airborne precautions droplet spread and direct
conjunctivitis, cough. Photosensitivity, koplik spots in the for hospitalized patients Measles virus (rubeola infected contact with nasal or throat
mouth and red blotchy skin rash until 4 days after the onset virus) humans secretions of infected persons
• Complications include bronchitis, pneumonia, otitis of rash or with articles freshly soiled
media, encephalitis with nose and throat secretions

use airborne and contact

5. Smallpox
precautions for
• Systemic viral infection with fever, malaise, headache, person-to-person transmission
hospitalized patients until Variola virus (Variola
prostration, sever backache, a characteristic skin rash infected via the respiratory tract
all scabs have crusted and minor and Variola
and occasional abdominal pain and vomiting human (droplet spread) or skin
separated (3-4 weeks). Use major)
• Potential biologic warfare and bioterrorism agent inoculation
N95 or higher respiratory
• Eradicated worldwide through aggressive vaccination
protection

6. Warts
• Consist of many varieties of skin and mucous At least 70 types of • Direct contact
Infected
membrane lesions, including common warts (verrucae human • Genital warts are sexually
humans
vulgaris), venereal warts, and plantar warts papillomaviruses (HPV) transmitted
• Most are harmless but some can become cancerous

Respiratory Syncytial
Virus (RSV),
7. Viral Infections of the Ears rhinovirus/enterovirus,
• A viral respiratory infection often precedes the influenza viruses,
development of otitis media human
metapneumovirus,
adenovirus
Viral Infections of the Eyes Patient care Pathogen Reservoir Mode of transmission
8. Conjunctivitis, keratitis, keratoconjunctivitis
• Conjuctivitis – infection of the conjuctiva Adenoviruses –
• Keratitis – infection of the cornea Use contact precautions conjunctivitis and Direct contact with eye
• Keratoconjuctivitis – infection of both the cornea and for hospitalized patients keratoconjuctivitis Infected secretions or contact with
conjunctiva for the duration of the Herpes Simplex viruses humans contaminated surfaces,
• Acute viral diseases of one or both eyes, associated with illness – keratitis (and some instruments or solutions
inflammation of the conjunctiva, edema of the eyelids and keratoconjunctivitis)
periorbital tissue, pain, photophobia and blurred vision

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9. Hemorrhagic conjunctivitis
• Has sudden onset, with redness, swelling, and pain in Use contact precautions
one or both eyes for hospitalized patients Adenoviruses and Infected direct or indirect contact with
• Pharyngoconjunctival fever – adenoviral syndrome, for the duration of the Enteroviruses humans discharge from infected eyes
characterized by upper respiratory disease, fever, and illness
minor degrees of corneal epithelial inflammation

10. Uveitis and retinitis

Cytomegalovirus,
• Has many manifestation depending on the site of the
Herpes simplex, Herpes
infection (anterior or posterior structures of the eye)
zoster, West Nile virus,
• May result in loss of vision acuity or even blindness
Ebola and Zika virus

Viral Infection of the Upper Respiratory Tract

11. Common Cold (Acute Viral Rhinits and Acute
• Pathogens:
Coryza)
Rhinoviruses – most
• Viral infection of the lining of the nose, sinuses, throat, • Mode of transmission: via
common cause - Others:
and large airways • Patient care:Use droplet • Reservoir: respiratory secretions by way of
coronaviruses,
• Symptoms include coryza (profuse discharge from precautions for Infected hands and fomites or direct
parainfluenza viruses,
nostrils), sneezing, runny eyes, sore throat, chills and hospitalized patients humans contact with or inhalation of
RSV, influenza viruses,
malaise airborne droplets
adenoviruses,
• Maybe accompanied by laryngitis, tracheitis or
enteroviruses
bronchitis

Viral Infections of the Lower Respiratory Tract Patient care Pathogen Reservoir Mode of transmission
12. Acute, febrile, viral respiratory disease
• Patient care: Use standard • Mode of transmission: via direct oral
• Characterized by fever and one or more of the following systemic • Pathogens: Parainfluenza
precautions for adult patients; contact or by droplets; indirectly via
reactions: chills, headache, general aching, malaise, anorexia, and viruses, RSV, human • Reservoir:
add contact precautions for handkerchiefs, eating utensils or other
sometimes GI disturbances in infants metapneumovirus, Infected humans
infants and young children for the fomites; or for some viruses, via fecal-
• May include rhinitis, pharyngitis, tonsillitis, laryngitis, bronchitis, coxsackieviruses, echoviruses
duration of the illness oral route
pneumonia, conjunctivitis, otitis media and/or sinusitis
13. Hantavirus pulmonary syndrome (HPS) Hantaviruses - Sin Nombre, Rodents (deer
Use of standard precautions for Via inhalation of aerosolized rodent
• Acute viral disease characterized by fever, myalgias (muscular pain), Bayou, Black Creek Canal, mice, pack rats,
hospitalized patients feces, urine and saliva
GI complaints, cough, difficulty breathing, hypotension New York-1, Monongahela chipmunks)
14. Influenza (Flu) • Patient care: Use droplet Infected humans
• Acute, viral respiratory infection with fever, chills, headache, aches precautions for hospitalized • Pathogens: Influenza viruses (primary • Mode of transmission: Via airborne
and pains throughout the body, sore throat, cough and nasal drainage patients, usually for 5 days from –Type A, B and C reservoir), pigs spread and direct contact
• Sometimes causing bronchitis, pneumonia, and death in severe cases the onset of symptoms and birds
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• Mode of transmission:
15. Avian influenza (bird flu)
• Bird-to-bird transmission – via
• Primarily a disease of the birds, but can infect humans
• Reservoir: contact with infected poultry or
• Causes a respiratory infection with manifestations ranging from • Patient care: Use droplet • Pathogen: Avian influenza
Infected wild and surfaces that have been contaminated
influenzalike symptoms to eye infections, pneumonia, acute and severe precautions for hospitalized virus type A – H5N1 is the
domesticated with excretions from infected birds
respiratory distress and other severe and life-threatening patients most virulent strain
birds • Person-to-person transmission –
complications
relatively rare but increased instances
can occur due to mutation
• Patient care: Use standar,
• Reservoir:
16. Middle East respiratory syndrome (MERS) contact and airborne precautions • Mode of transmission: Respiratory
Camels
• Viral respiratory illness with high fever, chills, headache, a general for hospitalized patient for the • Pathogen: MERS-associated droplets or by touching the mouth, nose
(suspected
feeling of discomfort, body aches and sometimes diarrhea Middle East duration of illness. Use N95 or coronavirus (MERS-CoV) or eye after touching contaminated
reservoir);
respiratory syndrome (MERS) higher respiratory protection and surface or object
Infected persons
eye protection

Viral Infections of the Oral Region Patient care Pathogen Reservoir Mode of transmission

1. Cold sores (Fever Blisters and Herpes

Labialis) • Pathogens: HSV type 1
• Superficial clear vesicles on an erythematous (most cases), HSV type
(reddened) base, which may appear on the face or lips • 2 (most common cause
Reactivation may be caused by trauma, fever, physiologic of genital herpes)
changes or disease

Viral Infections of the Gastrointestinal Tract

2. Viral Gastroenteritis (Viral Enteritis and Viral • Pathogens:
• Patient care: Use
Diarrhea) Enteric adenoviruses,
standard precautions for • Reservoir: • Mode of transmission: Via
• May be an endemic or epidemic illness in infants, astroviruses,
hospitalized patients. Add Infected fecal-oral route
children and adults caliciviruses (including
contact precautions for humans, - airborne and contact with
• Symptoms include nausea, vomiting, diarrhea, noroviruses),
diapered or incontinent contaminated contaminated fomites
abdominal pain, myalgia, headache, malaise, and low- rotaviruses – most
patients and for patients water, - foodborne, waterborne and
grade fever common viruses
with norovirus and shellfish shellfish transmission
• Gastroenteritis can be fatal to infant and young children infecting children in
rotavirus infections
(caused by rotavirus) their 1st year of life
Viral Hepatitis

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17. Hepatitis E
• Family Hepeviridae, genus Hepevirus
• Small, naked ssRNA virus • Mode of transmission: fecal-oral
route, particularly contaminated drinking water
• Incubation period: 2 to 9 weeks
• Causes acute, self-limiting disease with clinical symptoms
similar to HAV
• Signs and symptoms: fever, malaise, nausea, vomiting,
jaundice, dark urine
Other Hepatitis
• Hepatitis G virus
• Family Flaviviridae
• From patients with NANB hepatitis
• Clinical significance is still under investigation
• Diagnosis: Experimental RT-PCR
• SEN virus • Transmission appears to be linked to blood transfusion • May be associated with some cases of post-transfusion
• Has circular DNA genome • Torque Teno virus (TTV) hepatitis
• Bloodborne • Family Circoviridae, genus Anello virus
• ssDNA virus (related to animal circoviruses)

Viral Infections of the Genitourinary System Patient care Pathogen Reservoir Mode of transmission

18. Anogenital herpes viral infections

• Patient care: Use • Mode of transmission:
(genital herpes)
standard precautions • Via direct sexual contact
• HSV infections are characterized by a localized
for hospitalized • Pathogen: HSV-2 or oral-genital, oral-anal, or
primary lesion, latency and a tendency of
patients. Add Contact (most common • Reservoir: anal-genital contact during
localized recurrence
precautions for severe cause), HSV-1 Infected humans the presence of lesions
• Women – principal sites of primary anogenital
disseminated or (occasionally) • Mother-to-fetus or
herpes virus infection are the cervix and vulva
primary mother-to-neonate
• Men – lesions appear on the penis and in the
mucocutaneous herpes transmission
anus and rectum of those engaging in anal sex

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19. Genital warts (genital

• Pathogen:
papillomatosis, condyloma
30-40 types of • Mode of transmission: Via
acuminatum)
Human direct contact, usually
• Tiny, soft, moist, pink or red swellings, which
Papillomavirus sexual; through breaks in
grow rapidly and may develop stalks • Reservoir:
(HPV) skin or mucous
• Rough appearance give them the appearance Infected humans
• HPV genotypes 16 membranes; or from
of small cauliflowers
and 18 – strongly mother to neonate during
• Grow in the penis in men; vulva, vaginal wall,
associated with birth
cervix and skin surrounding in the vaginal area
cervical cancer
in women

Viral Infections of the Circulatory System Patient care Pathogen Reservoir Mode of transmission
20. HIV infection and AIDS
• Mode of transmission:
• Signs and symptoms usually occur within
• Direct sexual contact
several weeks to several months after infection
(homosexual or
• Acute infection is often undiagnosed or
heterosexual)
misdiagnosed because anti-HIV antibodies are
• Sharing of contaminated
usually not present in a high enough
needles and syringes by
concentration to be detected during this early
intravenous drug users
phase of infection
• Transfusion of
• Sign and symptoms: Pathogen: HIV –
• Reservoir: contaminated blood and
• Initial: acute, self-limited mononucleosis-like type 1 (HIV-1) and
Infected humans blood products
illness lasting 1 or 2 weeks. type 2 (HIV-2)
• Transplacental transfer
• Fever, rash, headache, lymphadenopathy,
from mother to child
pharyngitis, myalgia, arthralgia, aseptic
• Breastfeeding by HIV-
meningitis, retro-orbital pain, weight loss,
infected mothers
depression, GI distress, night sweats, and oral or
• Transplantation of HIV-
genital ulcers
infected tissue or organs’
• AIDS – severe, life-threatening syndrome that
• Needlestick, scalpel, and
represents the late clinical stage of infection
broken glass injuries
with HIV

21. Infectious mononucleosis

• Mono or kissing disease • Patient care: Use • Mode of transmission:
• Acute viral disease that may be asymptomatic standard precautions • Pathogen: Epstein- • Reservoir: Person-to-person by direct
or may be characterized by fever, sore throat, for hospitalized Barr virus (EBV) Infected humans contact with saliva; via
lymphadenopathy (especially posterior cervical patients blood transfusion
lymph nodes), splenomegaly and fatigue

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22. Mumps (infections parotitis)

• Patient care: Use
• Characterized by fever and swelling and • Mode of transmission: Via
droplet precautions for
tenderness of the salivary glands • Pathogen: Mumps • Reservoir: droplet spread or direct
hospitalized patients
• Complications: orchitis, oophoritis, meningitis, virus Infected humans contact with the saliva of
until 9 days after onset
encephalitis, deafness, pancreatitis, arthritis, an infected person
of swelling
mastitis, nephritis, encephalitis, pericarditis

• Pathogens:
• Dengue virus
• Mode of transmission:
(mosquito-borne)
23. Viral hemorrhagic diseases • Patient care: Exercise • Direct contact with
• Yellow fever virus • Reservoir:
• Extremely serious, acute viral illnesses standard, droplet and infected blood, secretions,
(mosquito-borne) Infected humans;
• Initial symptoms include sudden onset of contact precautions for internal organs or semen,
• Crimean-Congo African green
fever, malaise, myalgia, and headache followed hospitalized patients or by needlestick
hemorrhagic fever monkey (Marburg
by pharyngitis, vomiting, diarrhea, rash, and for the duration of the • Highest risk when the
virus (tick-borne) virus)
internal hemorrhaging illness patient is vomiting, having
• Lassa virus
diarrhea, or hemorrhaging
• Ebola virus
• Marburg virus
Viral Infections of the Central Nervous
System
• Mode of transmission:
• exposure to mouse urine,
24. Lymphocytic choriomeningitis
droppings, saliva or nesting
• Rodent-borne viral disease that presents as • Reservoir:
• Patient care: Use material
aseptic meningitis, encephalitis or Infected rodents,
standard precautions • Pathogen: LCM • It can enter through
meningoencephalitis primarily the
for hospitalized virus broken skin; through nose,
• Possible complications of CNS involvement common house
patients the eyes, or mouth, or via
include deafness and temporary or permanent mice
the bite of an infected
neurologic damage
rodent
• Organ transplantation
25. Poliomyelitis (polio, infantile
paralysis) • Patient care: Use
• Most patients, it can cause minor illness with contact precautions for • Mode of transmission:
• Pathogen: • Reservoir:
fever, malaise, headache, nausea and vomiting hospitalized patients person-to-person primarily
Polioviruses Infected humans
• 1% of the patient – progresses to sever muscle for the duration of via the fecal-oral route
pain, stiffness of the neck and back, with or illness
without flaccid paralysis

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• Reservoir: Wild
26. Rabies
and domestic
• Fatal, acute viral encephalomyelitis of
• Patient care: Use mammals
mammals, with mental depression, restlessness,
standard precautions • Pathogen: Rabies including dogs, • Mode of transmission: Via
headache, fever, malaise, paralysis, salivation,
for hospitalized virus foxes, coyotes, the bite of a rabid animal
spasms of throat muscles induced by slight
patients wolves, jackals,
breeze or drinking water, convulsions, and
skunks, raccoons,
death caused by respiratory failure.
mangooses, bats

1. Viral meningitis 2. Viral encephalitis (arthropod-borne viral encephalitis)

• Aseptic meningitis and nonbacterial or abacterial meningitis • Patient may be asymptomatic or have mild fever and headache
• Sudden onset of febrile illness with the signs and symptoms of meningeal involvement Viral • Severe infection is also possible, with headache, high fever, stupor, disorientation, coma,
meningitis tremors, occasional convulsions, spastic paralysis and death
Patient care: Use of standard precautions for hospitalized patients. Add contact precautions for • Patient care: Standard precautions for hospitalized patients. Transmission based precautions
infants and young children may be necessary, depending on the etiologic agent
Pathogens:
• Enteroviruses - coxsackie and enteric cythopathic human orphan (ECHO) virus
• Arboviruses
• Measles virus
• Mumps virus
• HSV
• VZV
• LCMV
• Adenoviruses

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Bacterial Infections of Humans  Factors that prevent destruction within phagocytes

 Factors that suppress the host immune system
How do bacteria cause disease?
 Endotoxins
 Adherence and colonization factors  Exotoxins
 Factors that prevent activation of complement  Production of necrotic and other types of destructive enzymes
 Factors that enable escape from phagocytosis by WBCs
Bacterial Infections of the skin Patient care Pathogen Reservoir Mode of transmission

1. Acne
Pathogens:
• Common condition in which pores become Reservoir: Mode of Transmission:
• Propionibacterium acnes other
clogged with dried sebum, flaked skin, and Infected humans Not transmissible
• Propionibacterium spp.
bacteria

Reservoir: Anthrax-
2. Anthrax Patient care:
infected animals;
• Aka woolster disease – can affect skin, Standard
spores may be
lungs or gastrointestinal tract, depending on precaution and Mode of transmission:
Pathogen: Bacillus anthracis present in soil,
the portal of entry contact precaution Via entry of endospores
animal hair, wool,
• Cutaneous anthrax – depressed black for cutaneous
animal skins and
lesions called eschars anthrax
hides and products
3. Gas Gangrene (Clostridia
Myonecrosis)
Patient care: Mode of
• Caused by necrotizing exoenzymes and
Standard transmission:When soil
toxins – destroy muscle and soft tissue,
precaution for Pathogen: Clostridium perfringens Reservoir: Soil containing clostridial
allowing deeper penetration by the
hospitalized spores enters an open
organisms
patients wound
• Gas gangrene produces massive tissue
destruction, shock and renal failure

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4. Leprosy
 Mode of transmission:
• Hansen disease
- Present in nasal
• 2 forms:
discharges and is shed
- Lepromatous – numerous nodules in skin Patient care:
Reservoir: Infected from cutaneous lesions
and possible involvement of the nasal Standard Pathogen: Mycobacterium leprae
humans - Organism may gain
mucosa and eyes precautions
entrance through
- Tuberculoid – relatively few skin lesions,
respiratory system or
peripheral nerve involvement tends to be
broken skin
sever with loss of sensation
5. Staphylococcal Skin Infections
1. Skin and wound infections
• Folliculitis
Mode of transmission:
• Furuncles (boils) Patient care:
Via direct contact with a
• Carbuncles Standard and Reservoir: Infected
Pathogen: Staphylococcus aureus person having a
• Bullous impetigo – highly contagious Contact humans
purulent lesion or is an
infection Precautions
asymptomatic carrier
2. Scalded Skin Syndrome
• Ritter’s disease
• Exfoliative dermatitis

Folliculitis impetigo Bullous

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6. Streptococcal Skin Infections

Pyodermal infections
• Impetigo – localized skin disease
• Erysipelas – characterized by acute spreading skin
lesion
Patient care: Mode of transmission:
• Cellulitis – deep tissue infection
Standard, Pathogen: Reservoir: Person-to-person via large
• Scarlet fever – diffuse red rash that appears in the
Contact and/or Streptococcus Infected respiratory droplets or
upper chest and spreads to the trunk and extremities
Droplet pyogenes humans direct contact with patients
Necrotizing Fasciitis
Precautions or carrier
• Invasive infection characterized by a rapidly
progressing inflammation and necrosis of the skin,
subcutaneous fat and fascia
• “flesh-eating disease” – flesh-eating bacterial
syndrome

Bacterial Infections of the Ears

Reservoir and Mode of

Pathogens:
7. Otitis Externa (External Otitis, Ear Canal Infection, transmission:
• Escherichia coli • Pseudomonas
Swimmer’s Ear) • Contaminated
aeruginosa – causative agent of
• Infection of the outer ear canal with itching, pain, a malodorous swimming pool water
“swimmer’s ear)
discharge, tenderness, redness, swelling and impaired hearing •Indigenous microbiota
• Proteus vulgaris
• Most common in summer swimming season or articles inserted into
• Staphylococcus aureus
the ear canal

8. Otitis Media (Middle Ear Infection)

• Often develops as a complication of the common cold Pathogens: Reservoirs and Mode of
• Manifestations include persistent and severe earache, temporary • Streptococcus pneumoniae Transmission:
hearing loss, pressure in the middle ear, and bulging of the •Haemophilusinfluenzae • Probably not
eardrum (tympanic membrane) • Moraxella catarrhalis communicable
• Most common in young children (3 mos to 3 y/o)

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Bacterial Infections of the Eyes Patient care Pathogen Reservoir Mode of transmission
Mode of transmission:
• Human-to-human via contact
9. Bacterial Conjunctivitis (“Pinkeye”) Pathogens: with eye and respiratory
• Involves irritation and reddening of conjunctiva, Patient care: Haemophilusinfluenzae Reservoir: discharges, contaminated
edema of eyelids, mucopurulent discharge and Standard subp. aegyticus Infected fingers, facial tissues, clothing,
sensitivity to light precaution Streptococcus humans eye makeup, eye medication,
• Highly contagious pneumoniae ophthalmic instruments,
contact lens-wetting and
cleaning agents
Mode of transmission:
10. Chlamydial Conjunctivitis (Inclusion • Via contact with genital
Conjuctivitis, Paratrachoma) discharges of infected people,
• Neonates – may result in mild scarring of Pathogens: Chlamydia Reservoir: contaminated fingers to eye
Patient care:
conjuctivae and cornea; conconcurrent with trachomatis (certain Infected • Newborns – via an infected
Standard
chlamydial nasopharyngitis or pneumonia serotypes/serovars) humans birth canal
• Adults – may be concurrent with nongonococcal • Nonchlorinated swimming
urethritis or cervicitis pools (“swimming pool
conjunctivitis)
Reservoir:
11. Trachoma (Chlamydia Keratoconjunc
Infected Mode of transmission: Via
tivitis) Patient care: Pathogens: Chlamydia
humans nasal direct contact with infectious
• Highly contagious, acute, or chronic conjunctival Standard trachomatis (certain
secretions or ocular or nasal secretions or
inflammation, resulting in scarring of cornea and precautions serotypes/serovars)
contaminated contaminated articles
conjunctiva, deformation of eyelids and blindness
articles

12. Gonococcal Conjunctivitis (Gonorrheal Reservoir: Mode of transmission:

Opthalmia Neonatorum) Infected • via contact with the infected
Patient care:
• Associated with an acute redness and swelling of Pathogen: Neisseria humans – birth canal during delivery
Standard
conjunctiva and purulent discharge gonorrhoeae infected • Adults – finger-to-eye contact
precautions
• Untreated – lead to corneal ulcers, perforation and maternal birth with infectious genital
blindness canals secretions

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Bacterial Infections of the Upper Respiratory Tract Patient care Pathogen Reservoir Mode of transmission
13. Diphtheria
• Potentially serious upper respiratory tract disease
• Acute, contagious bacterial disease primarily Patient care: Droplet
Pathogen: Reservoir: Mode of transmission:
involves the tonsils, pharynx, larynx and nose precautions; Contact
Corynebacteriu Infected Via airborne droplets, direct contact and
• Characteristic lesion: tough, asymmetrical, adherent precautions for
m diphtheriae humans contaminated fomites
gray-white membrane in the throat, with surrounding cutaneous diphtheria
inflammation

Mode of transmission:
• Human to human by direct contact,
usually hands
14. Streptococcal Pharyngitis (Strep Throat) Patient care: Droplet
• Aerosol droplets
• Acute bacterial infection of the throat with soreness, precautions for Pathogen: Reservoir:
• Secretions from patients and nasal
chills, fever, headache, a beefy red throat, white hospitalized infants and Streptococcus Infected
carriers
patches of pus on pharyngeal epithelium, enlarged young children; Standard pyogenes humans
• Contaminated dust, lint, or
tonsils and enlarged and tender cervical lymph nodes precautions for others
handkerchiefs
•Contaminated milk and milk products –
assoc with foodborne outbreaks

Bacterial Infections of the Lower Respiratory

Tract
Pathogens:
• Streptococcus pneumoniae – cause of
community-acquired pneumonia
• Haemophilus influenzae
• Staphylococcus aureus
15. Pneumonia • Klebsiella pneumoniae
Patient care: Standard precautions;
• Acute nonspecific infection of the small air sacs • Legionella
Droplet and/or Contact Precautions
(alveoli) and tissues of the lung, with fever, • Mycoplasma pneumoniae- atypical
are required in additional for certain
productive cough, acute chest pain, chills, and pneumonia
pathogens
shortness of breath • Chlamydophila pneumonia
• Chlamydophila psittaci – psittacosis
• Klebsiella, Enterobacter, Serratia,
Acinetobacter ssp., Pseudomonas
aeruginosa and S. aureus (common cause)
- Healthcare-associate pneumonia

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16. Legionellosis (Legionnaires Disease,
Pontiac Fever)
• Acute bacterial pneumonia with anorexia,
malaise, myalgia, headache, high fever, chills and
dry cough followed by a productive cough,
shortness of breath, diarrhea and pleural and
abdominal pain
17. Mycoplasma Pneumonia (Primary
Atypical Pneumonia)
• Gradual onset with headache, malaise, dry
cough, sore throat, and less often, chest
discomfort
18. Tuberculosis (TB)
• Acute or chronic with malaise, fever, night
sweats, weight loss, and productive cough
19. Whooping cough (Pertussis)
• Highly contagious, acute infection common in
children
• First stage (prodromal or catarrhal stage) –
mild coldlike symptoms
• Second stage (paroxysmal stage) – severe,
uncontrollable coughing fits often ends in a
prolonged, high-pitched, deeply indrawn breath
(“whoop”)
• Third stage (recovery or convalescent stage)
– begins within 4 weeks of onset
Bacterial Infection of the Oral Region
Patient care: Standard precautions
Patient care: Droplet precautions
Patient care: Airborne precautions;
Standard precautions for
extrapulmonaryTB; Airborne and
Contact precautions for patients with
draining lesions
Patient care: Droplet precautions for
hospitalized patients until 5 days
after initiation of effective therapy
Pathogen: Legionella pneumophila
Pathogen: Mycoplasma pneumoniae
Pathogen: Mycobacterium tuberculosis
complex
Pathogen: Bordetella pertussis
Reservoir: Environmental water
sources; hot water and air-
conditioning systems, cooling
towers and evaporative
condensers; whirlpool spas, hot
tubs, shower heads, humidifiers,
tap water and water distillation
systems, fountains
Reservoir: Infected humans
Reservoir: Infected humans
Reservoir: Infected humans
Mode of transmission: Aerosols
of Legionella spp.
Mode of transmission: Via
droplet inhalation or direct
contact with an infected person,
or articles contaminated with
nasal secretions or sputum
from an ill, coughing patient
Mode of transmission:
•Via airborne droplets;
prolonged direct contact with
infected individual
• Bovine TB – exposure to
infected cattle or ingestion of
unpasteurized, contaminated
milk and other dairy products
Mode of transmission: Via
droplets produced by coughing
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20. Acute Necrotizing Ulcerative Gingivitis Pathogens:Anaerobic bacteria

• AKA Vincent angina and trench mouth • Fusobacterium nucleatum – most
• Result of a combination of poor oral hygiene, common cause
physical or emotional stress, and poor diet Patient care: Standard • Treponema vincetii – spirochete; Prevention and Control: Good
• It involves painful, bleeding gums and tonsils, precautions most common cause oral hygiene
erosion of gum tissue, and swollen lymph nodes • Bacteriodesspp.
beneath the jam •Prevotella intermedius
• Extremely bad breath •Prevotella melaninogenica

Bacterial Infections of the Gastrointestinal Tract Patient care Pathogen Reservoir Mode of transmission

21. Bacterial Gastritis and Gastric Ulcers

• Chronic gastritis and duodenal ulcers
• Gastritis – upper abdominal pain with nausea or Mode of transmission: Via ingestion;
Patient care: Standard Pathogen: Helicobacter Reservoir: Infected
heartburn presumed to be either oral-oral or fecal-
precautions pylori humans
• Duodenal ulcers – gnawing, burning, aching, oral transmission
mild-tomoderate pain just below the breastbone, an
empty feeling and hunger

Mode of transmission:
22. Campylobacter enteritis
• Via ingestion of contaminated food, raw
• Acute bacterial enteric disease, ranging from Patient care: Standard
Pathogen: milk or water
asymptomatic to severe, with diarrhea, nausea, precautions; contact Reservoir: Animals
Campylobacter jejuni • Contact with infected pets or farm
vomiting, fever, malaise and abdominal pain precautions
animals
• Self-limiting (2-5 days)
• Contaminated cutting boards

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Mode of transmission:
Reservoir: Infected • Via fecal-oral route, contact with feces
23. Cholera
Patient care: Standard humans and or vomitus of infected people
• Acute bacterial diarrheal disease with profuse Pathogen: Vibrio
precautions; Contact aquatic reservoirs • Ingestion of fecally contaminated water
watery stools, occasional vomiting and rapid cholerae serogroup 01
precautions (copepods and or food (raw and uncooked shellfish and
dehydration
other zooplankton) other seafood)
• Mechanical transmission by flies

Pathogen: Salmonella
24. Salmonellosis
enterica
• Gastroenteritis with sudden onset of headache, Mode of transmission:
• S. enterica subp.
abdominal pain, diarrhea, nausea and sometimes Patient care: Standard Reservoir: Wild and • Via ingestion of contaminated food
enterica serovar
vomiting precautions; Contact domestic animals; • Fecal-oral transmission from person to
typhimurium
• Dehydration precautions Infected humans person, food handlers, contaminated
• S. enterica subp.
• Septicemia or localized infection in any tissue of water supplies
enterica serovar
the body
enteritidis

Mode of transmission:
• Fecal-oral route
• Food or water contaminated by feces or
25. Typhoid Fever (Enteric Fever)
urine of patients or carriers
• Systemic bacteria disease with fever, severe Patient care: Standard Pathogen: Salmonella
Reservoir: Infected • Oysters harvested from fecally
headache, malaise, anorexia, rash on truck (25% of precautions; Contact typhi Salmonella
humans contaminated waters
patients), nonproductive cough and constipation precautions paratyphi – less severe
• Fecally contaminated fruits and raw
vegetables
• Feces to food by mechanical
transmission by flies
Mode of transmission
• Direct or indirect fecal-oral
26. Shigellosis (Bacillary Dysentery) Pathogens: transmission from patients or carriers
• Acute bacterial infection of the lining of the small Patient care: Standard • Shigella dysenteriae • Fecally contaminated hands and
Reservoir: Infected
and large intestine, producing diarrhea with blood, precautions; Contact • Shigella flexneri fingernails
humans
mucus, and pus. precautions • Shigella boydii • Fecally contaminated food, milk,
• Nausea, vomiting, cramps and fever • Shigella sonnei drinking water
• Latrines to food by mechanical
transmission by flies
27. Clostridium difficile – Associated Patient care: Contact Pathogen:

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Diseases precautions for the • Clostridium difficile

• Major cause of antibiotic-associated diarrhea duration of illness • Hospitalized patients
(AAD) and pseudomembranous colitis (PMS) frequently become
colonized with C.
difficile as a result of its
presence in the hospital
environment
28. Enterohemorr hagic E.coli (EHEC) Mode of transmission:
Diarrhea Pathogen: • Fecal-oral route
• Consists of hemorrhagic, watery diarrhea with Patient care: Standard • E.coli O157:H7 –most Reservoir: cattle • Inadequately cooked, fecally
abdominal cramping precautions; Contact common and infected contaminated beef
• Patient may develop hemolytic uremic syndrome precautions • O26:H11, O111:H8 and humans • Unpasteurized milk
(HUS), with anemia, low platelet count, and kidney O104:H21 • Person-to-person contact
failure •Fecally contaminated water
29. Enterotoxigenic E.coli (ETEC) Diarrhea Mode of transmission:
Patient care: Standard Pathogen: Different
(Traveler’s diarrhea) Reservoir: Infected • Via fecal-oral route
precautions; Contact serotypes of
• Watery diarrhea with or without mucus or blood, humans • Ingestion of fecally contaminated food
precautions enterotoxigenic E.coli
vomiting and abdominal cramping or water

Bacterial Infections of the Genitourinary System

30. Urinary Tract Infections (UTI)
Pathogens:
• Upper UTI – infections of the kidney (nephritis or pyelonephritis)
• Most common cause: Escherichia coli and other Enterobacteriaceae (Proteus spp, Klebsiella spp.)
• Lower UTI – infection of urinary bladder (cystitis), urethra (urethritis), prostate (prostatitis)
• Others: Staphylococcus spp., Enterococcus spp., Pseudomonas aeruginosa
• Dysuria, lumbar pain, fever and chills

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Bacterial Sexually Transmitted

Patient care Pathogen Reservoir Mode of transmission
Diseases
31. Genital Chlamydial Infections,
Genital Chlamydiasis
• One of the most common sexually
transmitted pathogen
Patient care: Pathogen: Mode of transmission: Via direct
• Serovars D through K are the major Reservoir: Infected
Standard Chlamydia sexual contact or mother to
causes of nongonococcal urethritis (NGU) humans
precautions trachomatis neonate during birth
and epididymitis in men, and cervicitis,
urethritis, endometritis, and salpingitis in
women

32. Gonorrhea
Mode of transmission:
• May present asymptomatic mucosal
• Via direct mucous membrane-
infection, opthalmia neonatorum,
Patient care: Pathogen: to-mucous membrane contact,
urethritis, proctitis, pharyngitis, Reservoir: Infected
Standard Neisseria usually sexual contact
epididymitis, cervicitis, Bartholin gland humans
precautions gonorrhoeae • Adult to child (may indicate
infection, PID, endometritis, salpingitis,
sexual abuse)
peritonitis and disseminated gonococcal
• Mother to neonate during birth
infection
33. Syphilis
• Treponemal disease with 4 stages:
Mode of transmission:
• Primary syphilis– a painless lesion
• Direct contact with lesions, body
known as chancre
secretions, mucous membranes,
• Secondary syphilis – skin rash (palms
Patient care: Pathogen: blood, semen, saliva and vaginal
and soles) about 4 -6 weeks later; with Reservoir: Infected
Standard Treponema discharges of infected person,
fever and mucous membrane lesions humans
precautions pallidum usually during sexual contact
• Long latent period – as long as 5 -20
• Blood transfusion
years
• Transplacentally from mother to
• Tertiary syphilis – damage to CNS,
fetus
cardiovascular system, visceral organs,
bones, sense organs and other sites

Bacterial Infections of the Cardiovascular System

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34. Spotted fever rickettsiosis (Rocky Mountain spotted

fever)
Mode of transmission:
• A tick-borne rickettsial disease characterized by sudden onset Reservoir: Infected ticks on dogs,
Pathogen: Rickettsia rickettsii • Bite of infected tick
of moderate-to-high fever, extreme exhaustion, muscle pain, rodents and other animals
• Person-to-person – rare; blood transfusion
sever headache, chills, conjunctival infection, and muculopapular
rash on extremities which spread to the palms, soles and body

 Mode of transmission:
35. Endemic typhus • Rat to flea to human
Reservoir: Rats, mice, possible other
• AKA murine typhus Pathogen: Rickettsia typhi • Infected fleas defecate with feeding, and the rickettsiae in
mammals and infected rat fleas
• Flea-borne typhus the feces are rubbed into the bite wound or other
superficial abrasions
Mode of transmission
36. Epidemic Typhus Fever •Human to louse to human
Reservoir: Infected humans and
• Louse-borne typhus Pathogen: Rickettsia prowazekii • Infected fleas defecate with feeding, and the rickettsiae in
body lice (Pediculus humanus)
• Rash appears on the 5th or 6th day the feces are rubbed into the bite wound or other
superficial abrasions

37. Ehrlichiosis
• Reminiscent of spotted fever rickettsiosis, with the rasg
2 types: Pathogen: Ehrlichia chaffeensis Reservoir: Unknown Mode of transmission: Transmitted by ticks
• Human monocytic ehrlichiosis (HME)
• Human granulocytic anaplasmosis (HGA)

38. Brucellosis Mode of transmission:

• Disease of reticuloendothelial system Pathogen: Brucella melitensis, • Consumption of contaminated food (unpasteurized goat
Reservoir: animals
• Have prolonged incubation period and onset is insidious and Brucella abortus, Brucella suis milk cheese)
nonspecific • Direct contact with infected animas (goats, cattle, sheep)

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39. Lyme disease

•Lyme borreliosis
Tickborne disease characterized by 3 stages:
• Early, distinctive, target-like, red skin lesion Reservoir: Ticks, rodents (deer
Pathogen: Borrelia burgdorferi Mode of transmission: Tick bite
• Early systemic manifestations that may include fatigue, chills, mice). Mammals (deer)
fever, headache, stiff neck, muscle pain, joint aches with or
without lymphadenopathy
• Neurologic abnormalities

Mode of transmission:
• Tick bite
40. Tularemia
Reservoir: Wild animals (rabbits, • Ingestion of contaminated meat or drinking water
• AKA rabbit fever
Pathogen: Francisella tularensis muskrats, beavers), domestic • Entry of organism into the wound while skinning an
• Acute zoonosis with a variety of clinical manifestations,
animals and hard ticks infected animal
depending on the portal of entry of the pathogen into the body
• Inhalation of dust
• Animal bites

41. Plague Mode of transmission:

• Acute, often severe zoonosis • Flea bite (from rodent to flea to
• Initial signs and symptoms – fever, Patient care: human)
chills, malaise, myalgia, nausea, Standard • Handling tissue of infected
Pathogen: Yersinia Reservoir: Wild
prostration, sore throat, headache precautions; rodents, rabbits, and other
pestis rodents and their fleas
Types: Droplet animals
• Bubonic plague precautions • Droplet transmission from
• Pneumonic plague person to person (pneumonic
• Septic plague plague

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Bacterial Infections of the Central
Nervous System
42. Listeriosis
Mode of transmission:
• Can manifest as Reservoir: Soil, water,
• Ingestion of raw or
meningoencephalitis and/or Patient care: mud, silage, infected
Pathogen: Listeria contaminated milk, soft cheeses
septicemia in newborns and elderly Standard mammals, humans and
monocytogenes or vegetables
and/or immunocompromised adults Precautions soft cheeses 
• Mother to fetus or through
• It can cause fever and spontaneous
passage in infected birth canal
abortion in pregnant women

43. Tetanus (Lockjaw)

• Acute neuromuscular disease
Reservoir: Mode of transmission:
induced by a bacterial exotoxin Patient care:
Pathogen: Soil contaminated with Introduction of spores into a
called tetanospasmin – painful Standard
Clostridium tetani human, horse or other puncture wound, burn or NSI with
muscular contractions, primarily of precautions
animal feces contamination
the masseter and neck muscles,
spasms and rigid paralysis

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