Microbiology and Parasitology - Lab

Module #11 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

LESSON TITLE: ENCEPHALITIS, FILARIASIS AND FUNGAL Materials:

INFECTION
Pen, paper, index card, book, and class List
LEARNING OUTCOMES:
At the end of the lesson, the nursing student can: Reference:
1. Describe what encephalitis, filariasis and fungal infection;
2. Explain the mode of transmission of encephalitis, filariasis and Navales D., (2010). Handbook of Common
fungal infection; Communicable and Infectious Diseases 3rd
3. Identify the etiologic agent of encephalitis, filariasis and Edition, Philippines: C&E Publishing Inc.
fungal infection;
4. Enumerate the different fungal infections;
5. Enumerate the signs and symptoms of encephalitis,
filariasis and fungal infection; and,
6. Outline the different nursing management of encephalitis,
filariasis and fungal infection.

A. LESSON PREVIEW/REVIEW (5 minutes)

Instruction: What is the pathognomonic sign of Diphtheria? Explain your answer.

Swollen glands (enlarged lymph nodes) in the neck are one symptom of diphtheria. Diphtheria is a dangerous bacterial infection that typically affects the nose and throat mucous membranes. A
dangerous infection known as diphtheria is brought on by Corynebacterium diphtheriae bacteria, which produce a toxin (poison). It is the toxin that has the potential to make people really ill.
Diphtheria germs are typically transmitted from person to person through respiratory droplets such as those produced by coughing or sneezing.

B.MAIN LESSON (50 minutes)

Content and Skill-Building

Encephalitis

Encephalitis or brain fever is an inflammatory disease involving part or all of the nervous system, resulting in abnormal functioning of
the brain and the spinal cord.

Causative Agent:
⎯ Bacteria, viruses’ fungi, rickettsia, toxins, chemical substances or trauma
⎯ Arboviruses which inhabit in Culex group mosquito

Incubation period:
⎯ 5 to 15 days, may range from 4 to 21 days.

Mode of transmission:
⎯ Bite of an infected mosquito.

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 Microbiology and Parasitology - Lab
Module #11 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

Classification
1. Primary Encephalitis is an infection caused by direct invasion of the CNS by the virus resulting in an inflammatory
reaction. These arthropod-borne viruses are:
a. Eastern Equine Encephalitis (EEE) is serious epidemic disease of the horses and affects children under 5- years-
old.
b. Western Equine Encephalitis (WEE) is milder and usually affects adults.
c. St. Louis Encephalitis the organism gains entrance through the olfactory tract. This is caused by a mosquito bite.
d. Japanese Encephalitis is a potentially severe viral disease spread by mosquito bite Culex Triteaniorhynchus that live in
rice fields and pig farms. This affect children 5-10-years-old more in males. The peak season is March to April and
September to October. There has NO known treatments.
2. Secondary Encephalitis
a. Post Infection Encephalitis is a complication to some viral diseases like measles, chickenpox, and mumps.
b. Post vaccinal is common in anti-rabies vaccine

Clinical Manifestations:
Japanese Encephalitis
⎯ flu- like symptom
⎯ stiff neck, confusion and neurologic manifestations occur within 72 hours.
⎯ decreased IQ
⎯ serious brain damage
General Manifestations
⎯ 1-4 days of infection there is fever, headache, dizziness, vomiting, and apathy (lack of feeling or emotions).
⎯ Chills, sore throat, conjunctivitis, arthralgia (joint pains), abdominal pain.
⎯ Encephalitic signs are nuchal (region of the nape) rigidity, ataxia (loss of full control of bodily movements), tremors, mental
confusion, speech difficulties, stupor (nearly unconscious) or hyper-excitability, convulsions, coma, and death.
⎯ Ocular palsy, ptosis (drooping or falling of the upper eyelid), flaccid paralysis.
⎯ Disturbances in swallowing, mastication, phonation, respiration, and movements of the muscles of the eyes or face.
⎯ Muscles of the different parts of the body contract uncontrollably and twitch.

Diagnostic exams:
⎯ CSF analysis
⎯ Serologic test done on the 7th day of illness
⎯ ELISA
⎯ Polymerase chain reaction

Treatment:
Symptomatic and supportive
⎯ Control convulsions
⎯ Proper disposal of nose and throat secretions
⎯ TSB for fever
⎯ Increase fluid intake, unless comatose
⎯ Oral care.
⎯ Mouth gag, protective devices, bedrails should be made available
⎯ Monitor I&O
⎯ Observe for neurologic signs
⎯ Observe for convulsions
Nursing Management:
⎯ Provide comfort
⎯ Prevent complication
⎯ Monitor I&O

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 Microbiology and Parasitology - Lab
Module #11 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

Prevention and Control:

⎯ Identify mosquito vectors
⎯ Elimination of breeding places, destruction of larvae, screening of homes, and use of repellents.
⎯ Public education

Filariasis

Filariasis also known as elephantiasis is a parasitic disease caused by the microscopic, threadlike African eye worm. This causes
extreme disability, gross disfigurement, and untold sufferings.

Causative agents:
a. Wuchereria Bancrofti a threadworm that affects the lymph nodes and lymph vessels of the legs, arms, vulva, and breasts.
b. Brugia Malayi causes swelling of extremities is confined to areas below the knees and below the elbows
c. Brugaria Timori rarely affects the genitals.
d. Loa Loa commonly known as the eyeworm.
Mode of transmission:
⎯ Person to person by mosquito bites.

Pathology:
⎯ The adult worm can reach the lymph vessels with the bites of an infected mosquito.
⎯ The adult worms’ mate and release millions of microscopic worms known as microfilaria.
⎯ At first, filariasis is asymptomatic.
⎯ The disease causes collection of fluids and causes swelling in the arms, breasts, legs, and for men, genital area.
⎯ The entire legs, arms, and genital area may swell to several times their normal sizes.
⎯ A person with filariasis tends to have more bacterial infections in the skin, skin hardens and thickens – this is called
elephantiasis.
⎯ If conjunctival filariasis is untreated, it can cause blindness known as onchocerciasis.

Symptoms:
⎯ On-and-off chills, headache, fever between 3 months and 1 year after the insect bite
⎯ Swelling, redness, and pain in the arms, legs, or scrotum.

Diagnostic procedure:
⎯ Circulating filarial antigen (CFA) is performed on a finger-prick blood droplet. Results are available in a few minutes.
⎯ Nocturnal Blood Examination the larvae are found in the blood at night. Larvae are usually found about 10 pm to 2 am.

Treatment:
⎯ Ivermectin for onchocerciasis
⎯ Albendazole for lymphatic filariasis
⎯ Diethylcarbamazine (DEC) or Hetrazan
⎯ Surgery is used to drain the fluid around the damaged lymphatic vessels minimizing massive enlargement of the scrotum.

Nursing Management:
⎯ Destruction of breeding places of mosquito.
⎯ Psychological and emotional support.
⎯ Personal hygiene

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 Microbiology and Parasitology - Lab
Module #11 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

⎯ Prevention and Control:

⎯ Sleep under a mosquito net
⎯ Use of mosquito repellant in the hours between dusk and dawn.

Fungal Infections

Tinea Flava (Tinea alba/ Tinea versicolor) a common, benign, superficial, cutaneous fungal infection, characterized by
hypopigmentation or hyperpigmentation on the skin, usually on the back or chest.
Causative Agent: Tinea flava (a lipophilic fungus, Malassezia furfur)

Incidence:
⎯ Usually affects people at puberty age; both male and female
⎯ Tropical areas can have a prevalence of high as 40%

Pathology:
⎯ Malassezia furfur is a member of the normal human flora and is found in 18% of infants, and 90 to 100% of adults. It is an
opportunistic pathogen.

Clinical manifestation:
⎯ Disturbing abnormal skin pigmentation (white to reddish brown “fawn”)
⎯ Usually affects the trunk, back, abdomen, proximal extremities, and face with mild pruritus

Treatment:
⎯ Miconazole
⎯ Ciclopirox colamine
⎯ Propylene glycol lotion
⎯ Topical terbinafine
⎯ Benzoyl peroxide

Nursing Management:
⎯ Use clean towel and washcloth daily
⎯ Do not share towel and washcloth of persons with fungal infections.
⎯ Dry the skin thoroughly especially skin folds that retain moisture.
⎯ Wear clean cotton clothing.

Tinea barbae (Barber’s Itch) is the colonization of the bearded areas of the face and neck. (Adults male only)

Causative Agents: Trichophyton mentagrophytes (originating from cattle) and Trichophyton verrucosum (originating from horses)

Mode of transmission:
⎯ Contact with cattle, dogs, horses, and other animals.
⎯ Person-to-person transmission:
⎯ Direct contact (skin-to-skin contact)
⎯ Indirect contact (vehicle)

Clinical Manifestations:
Mild superficial form
⎯ Erythema or abnormal redness, perifollicular papules and pustules.
⎯ Brittle and lusterless hair.

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 Microbiology and Parasitology - Lab
Module #11 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

Inflammatory
⎯ Deep, pustular, kerion crusting around the hair.
⎯ Unilateral involvement of the neck, chin, maxillary area, sparing the upper lip.
⎯ Seropurulent materials ending up in an abscess-like appearance.
⎯ Loose and brittle hair
⎯ Alopecia
Circinate
⎯ Vesiculo-pustular border with central scaling.

Treatment:
Systemic antifungal agents:
⎯ Griseofulvin
⎯ Ketoconazole
⎯ Fluconazole
⎯ Itraconazole
⎯ Terbinafine

Trichophytosis (Ringworm) id caused by vegetable fungi

Two types:
a. Dry type is characterized by the presence of rounded macular areas of reddish or yellowish-brown color. Are slightly
elevated above the surrounding skin, the center tends to be paler than the periphery of the lesion.
b. Moist type is less frequently seen; usually arise from the dry lesion and rapidly becomes pustular in the presence of a secondary
infection.

Athlete’s foot (Tinea pedis) is an infection usually appears between the toes characterized by red, dry, cracked, and itchy skin
between the toes and can also affect toenails.

Clinical manifestations:
⎯ Red, scaly bumps filled with pus on the plantar area and sides of the feet.
⎯ Prevention:
⎯ Wash feet every day.
⎯ Dry feet completely.
⎯ Wear sandals or shower shoes when walking around in locker rooms, public pools, and public showers.
⎯ Wear clean socks.
⎯ Use medicated powder on your feet to help reduce perspiration.

Jock itch (Tinea Cruris) is the infection of the groin and upper thighs. Both men and women can be infected with the disease.

Prevention:
⎯ Avoid contact with infected animals.
⎯ Avoid sharing undergarments with infected individuals.
⎯ Personal hygiene
⎯ Keep the groin area clean and dry.
⎯ Wear clean, cotton underwear and loose-fitting pants.

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 Microbiology and Parasitology - Lab
Module #11 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

CHECK FOR UNDERSTANDING (30 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct answer and
another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed. You are given 30 minutes
for this activity:

Multiple Choice

1. The mosquito responsible for Japanese encephalitis;

a. Culex Triteaniorhynchus
b. Malassezia furfur
c. Loa loa
d. Aedespolynensis
ANSWER: A
RATIO: Japanese Encephalitis is a potentially severe viral disease spread by mosquito bite Culex Triteaniorhynchus that live in rice
fields and pig farms. This affect children 5-10-years-old more in males. The peak season is March to April and September to October.
There has NO known treatments.

2. General manifestation of encephalitis include drooping or falling of the upper eyelid, known as;
a. stupor
b. ptosis
c. apathy
d. arthralgia
ANSWER: B
RATIO: Ocular palsy, ptosis (drooping or falling of the upper eyelid), flaccid paralysis

3. The adult worm’s mate and release millions of microscopic worms known as:
a. microfilaria
b. macrofilaria
c. elephantiasis
d. onchocerciasis
ANSWER: B
RATIO: The adult worms’ mate and release millions of microscopic worms known as microfilaria.

4. A fungal infection which usually appears between the toes characterized by red, dry, cracked, and itchy skin between the toes
and can also affect toenails.
a. Tinea cruris
b. Tinea versicolor
c. Trichophytosis
d. Tinea pedis
ANSWER: D
RATIO: Athlete’s foot (Tinea pedis) is an infection usually appears between the toes characterized by red, dry,
cracked, and itchy skin between the toes and can also affect toenails.

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 Microbiology and Parasitology - Lab
Module #11 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

5. Fungal infection of the groin and upper thighs.

a. Tinea cruris
b. Tinea versicolor
c. Trichophytosis
d. Tinea pedis
ANSWER: A
RATIO: Jock itch (Tinea Cruris) is the infection of the groin and upper thighs. Both men and women can be infected
with the disease.

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves. Write the
correct answer and correct/additional ratio in the space provided.

1. ANSWER:
RATIO:

2. ANSWER:
RATIO:

3. ANSWER:
RATIO:

4. ANSWER:
RATIO:

5. ANSWER:
RATIO:

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 Microbiology and Parasitology - Lab
Module #11 Student Activity Sheet

Name: Jemimah Grace Dantes Class number:

Section:A4 Schedule: 8:00-4:00PM Date:

C. LESSON WRAP-UP (5 minutes)

AL Activity: Muddiest Point:

In today’s session, what was least clear to you?
so far, everything was clear

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