Flaccid paralysis
Caused by : Botulinum toxin produced
by C. botulinum
Mechanism: Botulinum toxin blocks the
release of Acetylcholine (Excitatory NT)
at the synaptic cleft, inhibiting muscle
stimulation, thus resulting to Flaccid
paralysis
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spastic paralysis
Caused by : Tetanospasmin produced
by C. tetani
Mechanism: Tetanospasmin blocks the
release of GABA and Glycine(Inhibitory
NT) at synaptic cleft thus motor
neurons remains at the excited state
resulting to Spastic paralysis
Culture medium

Media Microorganism
Skirrows Agar Campylobacter j ejuni
Helicobacter pylori
TCBS (Thiosulfate Citrate Bile Salt Agar Vibrio spp.

Loefflers serum Corynebacterium diptheria

Lowenstein-Jenssen medium Mycobacterium tuberculosis

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Bacterial motility

Types of Motility Bacteria

Tumbling motility Listeria
Gliding motility Mycoplasma
Stately motility Clostridium
Darting motility Vibrio cholerae, Campylobacter j ejuni
Swarming motility Proteus spp. Clostridium tetani
Corkscrew motility (lashing, flexion
Spirochete
extension motility)
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Bacterial shapes

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Antibiotics

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 Capsulated organisms

S Streptococcus pneumonia
Mnemonics:
K Klebsiella pneumonia “Some Killers
H Haemophilus influenzae Have Pretty Nice
P Pseudomonas aeruginosa Capsules”
N Neisseria meningitidis
C Crytococcus neoformans (fungi)
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 Capsulated organisms

S Streptococcus pneumonia
Mnemonics:
K Klebsiella pneumonia “Some Killers
H Haemophilus influenzae Have Pretty Nice
P Pseudomonas aeruginosa Capsules”
N Neisseria meningitidis
C Crytococcus neoformans (fungi)
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2 extreme forms of M.leprae

Tuberculoid Lepromatous

Strong Cell- mediated immunity Weak

(+) Lepromin skin test (-)

↓↓↓ ↑↑↑
Paucibacillary No. of microorganism Multibacillary

Hypopigmented plaques Clinical manifestation Leonine facies

Well demarcated, dry patch Saddle nose
Hyposthetic skin lesion No eyebrows
Claw-shaped hands
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Antimicrobials and their sources
SOURCE
B polymxa
B subtilis
Penicillum griseofulvum
Streptomyces aurofaciens
Saccharopolyspora erythraea
Streptomyces fradiae
Streptomyces griseus
Streptomyces lincolnensis
Streptomyces nodosus
Streptomyces noursei
Streptomyces orientalis
Streptomyces venezuelae
ANTIBIOTIC/S
- Polymyxin
- Bacitracin
- Griseofulvin
- Chlortetracycline
- Erythromycin
- Neomycin
- Streptomycin
- Lincomycin
- Amphotericin
- Nystatin
- Vancomycin
- Chlormaphenicol
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Summary of diseases:
• Staphylococcus aureus
Scalded skin syndrome
• Staphylococus epidermidis
Bacterial endocarditis
• Staphylococus saprophyticus
UTI in young women
• Streptococcus pyogenes
Necrotizing fasciitis
Scarlet fever/ Rheumatic Fever
• Streptococcus pneumoniae
Common cause of Community
Acquired Pneumonia (CAP)
• H aegyptius
Brazilian purpuric fever
• Chlamydia pneumoniae • Leptospira interrogans
Taiwan Acute Resp. Syndrome (TWAR) Weil’s disease
• Chlamydia psitacci • Legionella pneumophila
respiratory psittacosis Pontiac fever
endemic avian chlamydiosis • Coxiella burnetti
• Campylobacter Q fever
Guillain-barre’s syndrome • Ricketsia akari
• Klebsiella granulomatis Rickettsial fever
Donovanosis
• Clostridium botulinum
Floppy baby syndrome
• B. burgdorferi
Lyme disease
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Mode of Action of Drugs
Drug Plasmid MOA
Penicillin, Cephalosporin Y Hydrolysis of B-lactam ring by B-lactamase
N Change in PBP
Methicillin

Tetracycline Y Efflux pump pushes drug out of the cell

Aminoglycoside Modification of drug by plasmid encoded

Y
enzyme
Sulfonamide Y Sulfanilamide resistant dihydropteroate synthase

TMP-SMX Y TMP-resistant dihyrofolate reductase

Y Enzymatic modification
Erythromycin

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DNA virus

Parvoviridae
Papilloma • Double stranded
except PARVO
Pox • Icosahedral except POX
Polyoma • Naked except POX,
HEPADNA, HERPES
Adeno • Replicate in Nucleus
Herpes except POX

Hepadna
Mnemonic : PaPaPoPo AHH!

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RNA virus
• Single stranded except
(+) SENSE (-) SENSE REO
• Enveloped except
Picorna Paramyxo Picorna, Calici, Reo, T cell
Corona Filo leukemia virus
Toga Arena • Helical except Picorna
Calici Reo Toga Flavi,
Calici Bunya Rhabdo (bullet)
Flavi Orthomyxo • Replicate in cytoplasm
Retro Rhabdo except Reo & Orthomyxo
Hepe Mnemonics:
Astro (+) Sense : PiCoToCaFlaRe HePas
(-) Sense : Par FABOR
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viral replication LYTIC CYCLE
A ttachment
P enetration
U ncoating
G ene expression/multiplication
A ssembly/Maturation
R elease

LYSOGENIC CYCLE
A ttachment
P enetration
U ncoating
I ntegration of viral nucleic acid
into host DNA (prophage)
M itosis
Viral NA separates  cyctic cyle

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Exanthem and Enanthem
definitions
exanthem
• A rash that appears
abruptly and affects
several areas of the skin
simultaneously
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enanthem
• is a rash inside of the
body/mucosal surface
• Ulcerative lesions or rash on
internal epithelial surfaces
like oral cavity, pharynx or
vagina
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Exanthem and Enanthem

Disease & Causative agent Other name Exanthem Enanthem

1st disease Rubeola, Measles, 14 day measles Maculopapular rash (begins on the Kopliks spot (bluish white dots o
Measles virus face and spread cephalocaudally mucosal surface)
and centrifugally)

2nd disease Scarlet fever Facial erythema with circumoral Strawberry or Raspberry tong
S. Pyogenes palor, sandpaper rash

3rd disease Rubella, German measles, 3 days Pink-red macules and papules ; Petichial lesions in soft palate
Rubella virus measles spread of rash is faster ( 24hrs) uvula, Forchherimer’s sign

4th disease Scalded Skin Syndrome

S. aureus
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5th disease Erythema infectiosum Slapped cheeked (Bright red
 Hepatitis viridae aisling

CHARACTERISTIC A B C D E

FAMILY Picorna Hepadna Flavi Hepe

GENOME ssRNA dsDNA ssRNA ssRNA ssRNA

TRANSMISSION Fecal-Oral Parenteral/Sexual Parenteral/Sexual Parenteral/Sexual Fecal-Ora

CHRONIC NO YES YES YES NO

ONCOGENIC NO YES YES ? NO

F U L M I N A N T RARE RARE RARE FREQUENT I

DISEASE PREGNAN

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 •
antibodies
Your body makes antibodies when it detects an infectious agents (an antigen).
Antibodies neutralize and destroy antigens
• Once we’ve recovered from an infection, our immune cells “remember” the
antigen. If we are reinfected, antibodies are rapidly made to remove it. This
is called immunity, it can be lifelong for some diseases, and fades over time
ANTIBODY TEST RESULTS for others

IgM IgG Result IgM antibodies IgG antibodies

Production starts 5- Production starts
- -
No infection
10 days after 10-14 days after
infection infection
+ -
Early-stage
infection
Production peaks Production peaks 4-8
+ +
Active/Recent
infection around 21 days weeks after infection
after infection
- +
Past infection

Remain undetectable Remain detectable

Antibodies don’t appear until someone has had an infection for several 2-4 months after for months or years
days, so this result doesn’t guarantee that they’re not infected
infection after infection
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General eukaryotic structures

Molds
• Multicellular
• Can develop tiny spores that ride in
the air and spread by air currents
• Reproduction : Sporulation
• Hyphae : branched tubules
• Mycelium : intertwined hyphae
• Septa : cross walls that divide
hyphae into cells
Yeasts
• Unicellular
• Simplest form of fungi
• Reproduction : Budding
• can form Pseudohyphae
`

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 aisling
Dermatophytes

Epidermophyton Skin and nails

Microsporum Hair and Skin
Trichophyton Hair, Skin, Nails
Taxonomy

Characteristic Zygomycota Ascomycota Basidiomycota

Other name Conjugation fungi Sac fungi Club fungi

Sexual spores Zygospore Ascospore Basidiospore

Asexual spores Sporangiospore Conidiospore Conidiospore
Members Rhizopus sp. Most yeast and Mushrooms
Mucor sp. molds - Amanita sp.
- Cryptococcus sp.
- Malassezia

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Superficial mycoses

Disease Causative organisms

Pityriasis versicolor Malassezia furfur - Common
Seborrhoeic dermatitis (Pitysporum ovale) - Chronic mild infection of stratum
including Dandruff and corneum
Follicular pityriasis
Tinea nigra/Tinea Hortaea werneckii - Rare
palmaris (Exophiala werneckii) - Chronic asymptomatic infection of
stratum corneum
White piedra Trichosporon beiglii - Common
- Soft nodular infection of the hair
Black piedra Piedraia hortae - Rare
- Hard nodular infection of hair
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Cutaneous mycoses

Disease Causative organisms   Incidence

Dermatophytosis Dermatophytes - Common

Ringworm of the scalp, (Epidermophyton, Trichophyton, - Tinea infections
glabrous skin and nails. Microsporum)

Candidiasis of skin, Candida, Debaryomyces, - Common

mucous membranes Kluyveromyces, Meyerozyma, - Normal flora ( can become
and nails. Pichia, etc. opportunistic)
Dermatomycosis Non-dermatophyte moulds - Rare
Neoscytalidium, Scopulariopsis

Subcutaneous mycoses
Disease Causative organisms
Sporotrichosis Sporothrix spp.
(rose gardeners disease)
Chromoblastomycosis Fonsecaea pedrosoi
Phialophora verrucosa
Cladophialophora
Phaeohyphomycosis Cladophialophora, Exophiala,
Bipolaris, Exserohilum etc
Eumycetoma Pseudallescheria boydii
Madurella sp.
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Incidence
- Rare
- Chronic granulomatous infection
- Necrotic, ulcerative nodules
- Rare
- Chronic, progressive, verrucous/ wart-
like lesions. Hyperplasia
- Found in rotting woods : cauli flower like
warts
- Rare
- Can be systemic
- Rare
- Progressive painful swelling
- True mycetoma

Primary systemic mycoses
Disease
Blastomycosis
(North American
blastomycosis)
Coccidioidomycosis
(San Joaquin Valley Fever)
Histoplasmosis
(Spelunkers disease/ great
mimic)
Paracoccidioidomycosis (South
American Blastomycosis)
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*more common in endemic areas.
Causative organisms
Blastomyces dermatitidis - Rare*
- Granulomatous and suppurative lesions
in the lungs
Coccidioides immitis - Rare*
- Pneumonia
- Erythema nodosum and erythema
multiforme
Histoplasma capsulatum - Rare*
- From birds and bat
- Resembles TB
Paracoccidioides brasiliensis - Rare*
- Pulmonary granuloma
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Secondary/ Opportunistic systemic mycoses

Disease Causative organisms Incidence

Candidiasis Candida albicans - Common in antibiotic overuse

- Oral thrush, vulvovaginitis, systemic candidiasis

Cryptococcosis Cryptococcus neoformans - Common in HIV/AIDS

- Flu-like symptoms, meningitis, encephalitis

Aspergillosis Aspergillus fumigatus complex - Common in leukemia, steroid takers, stem cell transplants
- Causes allergy, source of aflatoxin
- Farmers lung

Zygomycosis Rhizopus oryzae, Mucor spp. - Common in acidosis, leukemia, burns and steroid takers
(Mucormycosis) - Rhinocerebral mucomycosis

Pneumocystis pneumonia Pneumocystis jiroveci ( P. carinii ) - Common in HIV/AIDS

Penicilliosis Penicillium marneti

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Parasitology
PROTOZOAS

amoeba flagellates ciliates sporozoa

- Pseudopods - 2 or more flagella - with cilia
- Sarcodina - Ciliophora - Non motile/ complex
- Mastigphora
- Cytoplasmic life cycle
Giardia lambia Balantidium - Apicomplexa
proj ection
Trichomonas Plasmodium
Entamoeba vaginalis Cryptosporidium
Acanthamoeba Leishmania Cyclospora
Naegleria Trypanosoma Toxoplasma
Babesia
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Parasitology
CYTOPLASM Reproduction:
1. Ectoplasm • Asexual - most of the protozoa reproduce by
a.) Locomotor apparatus Ø BINARY FISSION - parasite divides transversely.
• Pseudopodia or “false feet” – Amoeba Ø MULTIPLE SCHIZOGONY - nucleus divides into multiple daughter cells
• Flagella – Flagellates Ø ENDODYOGENY - single internal body results into two daughter cells
• Cilia - Ciliates • Sexual
• Undulating membrane – Trichomonas spp. Ø SYNGAMY - Sexual cells will unite to form a zygote containing many
b.) Structure for Procurement of food daughter cells inside.
Mouth  CYTOSOME Ø CONJUGATION - two cells attached to one another; exchange nuclear
c.) Structure for excretion of metabolic waste materials they separate.
Anus  CYTOPYGE
2. Endoplasm - vital function/processes Protozoa has only 2 stages:
• Ribosomes 1. Trophozoite – vegetative/ motile stage
• Mitochondria 2. Cyst – infective stage, non-motile stage, non-feeding stage
• Nucleus Trophozoite Cyst
• Macronucleus – vegetative function (response to food) (Encystatioon)
• Micronucleus – reproductive function Cysts Trophozoite
• Lysosomes (Excystation)
• Vacuole – regulates the osmotic pressure
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Classification of parasites based on type of host

HOST DEFINITION REQUIRE IN LIFE CYCLE CAN TRANSMIT TO PRIMARY HOST

Primary/ Definitive - Final host/ Parasite reaches

maturity Yes N/A
- Harbors adult parasite
(sexually mature)

Secondary/ - Larval stage/Asexual stage

- Parasite replicates but does Yes Yes
Intermediate not go through its sexual
cycle

Paratenic - Serves as a transport host

for parasitic larva No Yes
- Final host must eat this host
for adult parasite to
develop

Incidental/Accidental - Accidentally harbors

parasite No No
- Appear in unusual hosts
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Cysts/ Oocysts
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Intestinal protozoa

Giardia Lambia - Transmission: ingestion of cyst

- Disease: Giardiasis ( foul smelling greasy stools)
“old man with eyeglasses”
- Tx : Metronidazole

Entamoeba histolytica - Transmission : ingestion of cyst

- Disease : amebiasis
- Most dangerous; pathogenic
- Produce histolytic enzyme -> Hyaluronidase (causes lysis of tissue)
- Transmission: ingestion of cyst
- Tx : Metronidazole

Cryptosporidium sp. - T: transmission of oocyts

- INFECTIVE STAGE: Oocyst ( contains 4 sporozoites and can infect
- C. parvum man and cattle. It is sporulated inside the body
- Disease: cryptosporidiosis (AIDS- defining)
- Tx : Nitrozoxanide

Cyclospora sp. - T: transmission of oocyts

- Disease: Cyclosporiasis
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Sexually - Transmitted
Trichomonas vaginalis
• Transmission : passage of trophozoite through sex
• Habitat: Urogenital tract (vagina, urethra, prostate epididymis).
• Do not have a cyst stage
• Disease : Trichomoniasis
Ø Clinical Features (Trichomoniasis)
- Trichomonas vaginalis infection in women is frequently symptomatic
- Vaginitis with a purulent discharge is the prominent symptom, and can be
accompanied by vulvar and cervical lesions, abdominal pain and dysuria
- The incubation period is 5 to 28 days.
- In men, the infection is frequently asymptomatic; occasionally, urethritis,
epididymitis, and prostatitis can occur
• Treatment : Metronidazole
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Blood and Tissue flagellates ( vector borne)

Trypanosoma spp.
Disease Vector Sign and Symptoms Treatment
East African Tse-tse fly • Infection occurs in 3 stages. Suramin
T. brucei A trypanosomal chancre can develop on the site of Melarsoprol- for
Sleeping Sickness/ (Glossina spp)
rhodesiense Acute Rhodesian
inoculation. This is followed by a : late stage with CNS
1. hemolymphatic stage – with symptoms that include involvement
Sleeping Sickness fever. lymphadenopathy, and pruritus.
2. meningoencephalitic stage/Neurologic stage - invasion
of the central nervous system can cause headaches,
somnolence, abnormal behavior, and lead to loss of
consciousness and coma.
• Course of infection: 1 year

Chronic Gambian Tse-tse fly A trypanosomal chancre can develop on the site of Pentamidine
T. Brucei inoculation. This is followed by a : Eflornithine
Sleeping Sickness/ (Glossina spp)
gambiense 1. hemolymphatic stage – with symptoms that include
West African fever. lymphadenopathy, and pruritus.
Trypanosomiasis 2. meningoencephalitic stage/Neurologic stage - invasion
of the central nervous system can cause headaches,
somnolence, abnormal behavior, and lead to loss of
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Blood and Tissue flagellates ( vector borne)

Leishmania
Disease Vector Sign and Symptoms • Treatment
L. tropica, - Cutaneous Sandfly (Phlebotomus • Rolled edge ulceration Sodium
leishmaniasis sp.) Primary lesion -> reddish papule, stibogluconate,
L. major (Oriental sore, itchy, gradually enlarges, at center Meglumine,
Baghdad boil, Delhi Boil, -> rupture -> ulcer formation Potassium
Aleppo button) (large raised with indurated edges Antimony
Tartrate
Pentamidine

L. Brazielensis - Mucocutaneous Sandfly (Phlebotomus • Weeping lesion (face, mouth, Amphotericin

/nasopharyngeal sp.) nasal
L. Mexicana leishmaniansis cartilage of the facial bone)
L. Peruviana (espundia/ Bubas/ • Erosion of nasal septum and
Chiclero Ulcer) palate (Tapir nose)
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Helminths

Helminths
Platyhelminth (flat) Nematodes (round)
Cestodes (tape worms) Trematodes ( flukes)
• Taenia solium • Schistosome
• Diphyllobotrium • Paragonimus
latum westermani
• Echinococcus • Fasciolopsis
granulosus • Fasciola