1- Symbiotic relationships 6- Colon contains the largest number & variety of MOs

 Neutralism: neither symbiont is affected 7- Colicin

 Commensalism: beneficial to only one symbiont & of NO  Bacteriocin: antibacterial peptides
consequence to other  Produced by bacteria during primary phase of growth
 Some indigenous microflora  More potent than antibiotics
 Blackhead mite (Demodex)  Narrower spectrum than antibiotics
 Dermatobia hominis (human bot fly)  Used for epidemiologic typing
 Mutualism: beneficial to both symbionts
 Many MOs of indigenous normal microflora 8- Synergism (Synergistic/Polymicrobial) infection
 Medicinal Leeches  ANUG: Acute necrotizing ulcerative gingivitis (ANUG)
 Termites and their intestinal protozoa  Vincent gingivitis, Vincent’s stomatitis (Trench
 Lichen (alga and fungus) mouth)
 Parasitism: beneficial to one symbiont (parasite) &  Serious acute progressive infection with superficial
detrimental to other: Trypanosoma gambiense causes ulceration
African sleeping sickness  Caused by mixed oral bacteria:
 Anaerobes (as Fusobacterium)
2- Types of microflora  Spirochetes (as Borrelia vincentii)
Resident Transient  Bacterial vaginosis
10 times the number of body cells Microflora from external  Vaginal mixed bacteria
(10% human cells, 90% flora) environment  Gardnerella vaginalis + Mobiluncus + anaerobes
Differ according anatomical site Washed by bathing 9- Infections
Body fluids (blood, lymph & CSF), & Flushed by body secretions  Healthcare-onset infection: appearing in healthcare setting
internal tissues & organs: sterile Fail to survive in certain PH
 Community-onset infection: appearing outside healthcare
Their destruction → superinfection Killed by toxins of resident flora
 Community-associated Infections: acquired outside
healthcare facilities
3- Superinfections
 Healthcare-Associated (Nosocomial) Infections (HAIs):
 Antibiotic-associated diarrhea
 Acquired inside healthcare facilities
 Pseudomembranous colitis
 Infections that were not present or incubating at
 Yeast vaginitis
time of admission
 Oral thrush
 Community-onset infections appearing within 14
days of discharge
4- Strep mutans is most often implicated in plaque formation
 Iatrogenic Infections: occurring due to medical or surgical
5- Most frequent causes of urethritis: Chlamydia trachomatis,
intervention
Neisseria gonorrhoeae, & mycoplasmas
10- Pathogens involved in nosocomial infections
 Gram-positive Cocci:
 Staphylococcus aureus :
 Methicillin-resistant (MRSA)
 Coagulase positive
 Coagulase-ve staph:
 Methicillin-resistant S. epidermidis (MRSE)
 Skin normal flora
 Enter blood stream via IV line
 Enterococcus: vancomycin-resistant enterococci
 Gram-negative Bacilli:
 Enterobacteriaceae
 Escherichia coli, Klebsiella pneumoniae,
Klebsiella oxytoca, Enterobacter spp.
 Part of the normal flora in the colon
 Intra-abdominal /liver/urinary tract
infections
 Pseudomonas aeruginosa
 Found in the environment (wet)
 RT and blood stream infections
 Resist antibiotics and sterilization
 Acinetobacter spp.
 Multidrug-resistant Gram-negative bacilli (MDR-GNB)
 Bacteria which produce extended spectrum β-
lactamases (ESBLs)
 Bacteria producing carbapenemase-producing
Enterobacteriaceae (CPEs)
 Clostridium difficile:
 A spore-forming, anaerobic, Gram-positive bacillus
 Part of the colonic normal flora.
 Important cause of antibiotic-associated diarrhea
(AAD) and pseudomembranous colitis (PMC)
11- Precaution Protocols
 Standard precautions
 All patients in all healthcare settings
 To minimize transmission of infection
 Transmission-based precautions:
 Airborne precautions
 Particles ≤ 5 µm and travel > 1m
 Negative pressure ventilation
 Respirator instead of mask: the size of
pores is small so prevent small particles
 TB, measles, chickenpox
 Droplet precaution
 Particles ≥ 5 µm and travel < 1m
 Influenza, Meningitis (meningococcal
[N.meningitidis] and pneumococcal
[Streptococcus pneumonia])
 Contact precaution
 Microbes are expected to be transmitted
through contact, whether direct or indirect
 Protective isolation
 Neutropenic isolation or reverse isolation
 Positive pressure ventilation
 Primarily used in immunocompromised patients to
decrease the risk of their exposure to pathogens
12- The most severe: Airborne and then Contact and then Droplet
13- Hand washing is the most important technique in infection
prevention and control
14- Ayliffe technique is recommended for hand hygiene
15- The 1st personal protective equipment (PPE) to wear is gown
16- The last personal protective equipment (PPE) to wear is glove
17- The father of the epidemiology is John snow
18- Infectious disease: a disease that is caused by a pathogen
19- Communicable disease: infectious disease that is transmissible
from one human to another (gonorrhea STD)
20- Contagious disease: communicable disease that is easily
transmitted from one person to another
a- Influenza and common cold
b- Measles and mumps
c- Tuberculosis and HIV/AIDS
d- COVID-19
21- Zoonotic disease: humans acquire from animals
 Malta fever (brucellosis)
 Hydatid cyst (Echinococcus granulosus)
22- Sporadic disease: disease that occurs only occasionally within
the population of a particular geographic area (rabies)
23- Endemic disease: always present within population of a
geographic area (typhoid fever by salmonella in Africa)
24- Epidemic disease (outbreak): greater than usual number of
cases of a disease in a particular region, usually within a
Category
relatively short period of time
A B.anthracis
25- Pandemic disease: a disease that is occurring in epidemic
proportions in many countries simultaneously sometimes
worldwide. (1918 Spanish flu)
 HIV (Sub-Saharan Africa)
 TB (Sub-Saharan Africa)
 Malaria (Sub-Saharan Africa)
 COVID-19
26- Terms
 Incidence: number of new cases of disease in a defined
population during a specific time period
 Morbidity rate: number of new cases of disease that
occurred during a specified time period per a specifically
defined population (usually per 1,000, 10,000, or 100,000)
 Period prevalence: number of all cases of the disease
existing in a given population during a specific time period
 Point prevalence: number of all cases of the disease
existing in a given population at a particular moment
 Mortality rate (death rate): number of people who died of
a particular disease during a specified time period per a
specified population (per 1,000, 10,000, or 100,000)
27- Chain of infection
 There must first be a pathogen
 There must be a source of the pathogen
 There must be a portal of exit to escape from the reservoir
 There must be a mode of transmission
 There must be a portal of entry
 There must be a susceptible host
28- Critical Biological Agent Categories
Microbe Disease
Anthrax
C.botulinum Botulism
Y.pestis Plague
Variola major Smallpox
F.tularensis Tularemia
Filovirus Hemorrhagic fever
29- Water: tested for fecal contamination by checking coliforms
a- E. coli
b- Lactose-fermenting Enterobacter & Klebsiella
30- Water is potable if contains 1 coliform or less per 100 mL
31- FIRST LINE OF DEFENSE : 38- Ags : Antibody-generating LARGE FOREIGN organic substances
a- Skin and Mucous Membranes a- Proteins >10,000 daltons MW (foreign proteins are Best)
b- Dryness of most areas of skin b- Polysaccharides >60,000 daltons MW
c- Acidity (pH 5.0) & temperature (less than 37°C) of the skin c- Large molecules of DNA or RNA
d- Oily sebum : fatty acids: toxic to some pathogens d- Any combination of biochemical molecules
e- Perspiration contains enzyme, lysozyme
f- Sloughing off of dead skin 39- Epitopes (Antigenic determinants) = individual molecules or
g- Lactoferrin is a protein that binds iron antigenic sites on microbial surface (e.g. bacterial cell wall, cell
h- Lactoperoxidase: enzyme produces superoxide radicals membrane, capsule, flagella, pili) capable of stimulating
i- Cilia : sweep the trapped dust and microbes production of Abs.
j- Peristalsis and urination
k- Microbial Antagonism 40- Haptens = SMALL molecules w act as Ags ONLY if coupled with
large carrier molecule (protein), formed Abs will combine with
32- SECOND LINE OF DEFENSE free hapten. e.g. penicillin & other low MW chemical
a- Transferrin molecules occasional allergy (or hypersensitivity)
b- Fever
c- Interferons 41- Primary response: slow / weak / IgM
d- The Complement System 42- Secondary response: faster / stronger / IgG
e- Acute-Phase Proteins: C-reactive protein, serum amyloid A
protein, protease inhibitors , coagulation proteins 43- issue Macrophages
f- Cytokines a- Wandering macrophages: leave PB & migrate
g- Inflammation b- Fixed macrophages
h- Phagocytosis  Histiocytes: spleen
 Liver (Kupffer cells)
33- Interferons: small, antiviral proteins produced by virus  Lungs (alveolar or dust cells)
infected cells, “interfere” with viral replication, not virus  Brain (microglia)
specific, activate certain lymphocytes (NK cells) to kill virus-
infected cells. 44- T-dependent Ag: depend on T helper and require APC
(majority of Ags) (complex proteins)
34- Active natural immunity: infection by live pathogen
35- Active artificial immunity: vaccines 45- Antibody structure : 2 identical light chains + 2 identical heavy
36- Passive natural immunity: IgA (milk) & transplacental IgG chains + 2 Fab regions (Ag-binding) + 1 Fc region (cell-binding)
37- Passive artificial immunity: human gamma globulin(ISG) , 46- NK cells: Kill target cells including foreign cells, virus-infected
Hyperimmune serum globulin host cells & malignant tumor cells.
47- Type 1 HS: IgE + Mast cell or basophil, most common Ex : Hay  ONLY
fever , Asthma ,hives , allergy to drugs and insect bites , a- To have two forms: IgA
anaphylactic shock , latex allergy b- To be a dimer: IgA = 4 binding sites = valency 4
48- Type 2 HS: IgG + IgM + complement, ex : incompatible blood c- To cross placenta : IgG
transfusions, Rh incompatibility, drug-induced hemolysis & d- In secondary response : IgG
myasthenia gravis e- In primary response : IgM
49- Type 3 HS: IgG + IgM + complement + neutrophils, ex : f- Pentamer : IgM = 10 binding sites = valency 10
farmer’s lung , serum sickness, arthus reaction , SLE , RA , g- To fix complement : IgG & IgM
Rheumatic fever h- Protect newborn (maternal): IgA & IgG
50- Type 4 HS: Abs do NOT play a major role, ex : PPD , Fungal skin
tests, Allergic contact dermatitis , Rejection of transplant 55- Components of high-quality specimen
1- Selection of appropriate representative sample
51- DiGeorge syndrome: congenital absence of thymus & 2- Collection:
parathyroid glands  Standard precautions
52- Wiskott-Aldrich syndrome: decrease B cells, T cells, monocytes  Before antimicrobial therapy
& platelets, bleeding, recurrent infections & eczema  Detailed instructions to patients
53- Chediak-Higashi Syndrome  Sufficient quantity (QNS is rejected)
 Autosomal recessive 3- Transport
 Abnormal lysosomes: do not fuse with phagosomes  ASAP: as soon as possible
 ↓ bactericidal activity & recurrent infection  Containers:
 Albinism & CNS abnormalities  Leak-proof, sterile or clean (stool)
 Properly labeled, (un/mislabeled) →
54- Regarding Abs rejected/ NOT processed
 Most :  Request forms should be completed
a- In secretions: IgA
b- On B cell surface: IgD 56- Pathology department
c- In allergic reaction: IgE
Anatomical pathology Clinical pathology
d- On surface of basophils and mast cells: IgE
 Morgue  Clinical chemistry
e- Abundant in serum: IgG
 Histopathology  Hematology
f- Light MW: IgG  Cytology  Immunology
g- Half-life: IgG  Cytogenetics  Blood bank
h- Large: IgM  Electron microscopy  Clinical microbiology
i- Efficient complement-fixing : IgM
57- 4 Major day-to-day responsibilities of CML:
a- Processing of clinical specimens
b- Isolation of potential pathogens
c- Identification of isolated pathogens
d- AST: antibiotic sensitivity test
58- Mycobacteriology section: large hospitals & medical centers
(NOT in small hospitals)
59- Virology section: in large hospitals & medical centers (NOT in
small hospitals)
60- Immunology section:
 ONLY in smaller hospitals as part of the CML
 In larger hospitals & medical centers = independent
61- Urine
- Sterile in urinary bladder
- Specimens & collection:
a- CCMS urine in sterile container (for adults)
 Clean-catch (washing area around external opening
of urethra with soap & water to remove skin flora)
 Mid-stream (discarding initial portion of urine
stream to flush MOs in distal urethra)
b- Catheterized urine: bedridden and sedated patients
c- Urine bag to collect urine in children
d- Supra-pubic needle aspiration (SPA)
 Invasive method (needle is inserted into bladder)
 Gold standard method for culture
 ANY growth of pathogenic bacteria is significant
62- Urine processing
 Within 30min of collection or refrigerate at 4°C
 Inoculation using calibrated loops
 0.01 mL [dilution factor = 100]
 0.001 mL [dilution factor = 1000]
 Colony count: multiply colony # by dilution factors (100 or
1000) → # of viable bacteria (colony-forming units/mL)
  100,1000 (1X105) CFU/mL is indicative of UTI
63- Blood
- Usually sterile
- Sample Should NOT be refrigerated
- Obtained from a vein located at the ante-cubital fossa
- Indications (at least 3 blood cultures over 24hr for better Dx):
1- Bacteremia (bacteria in peripheral blood) in
 Bacterial meningitis, typhoid fever & salmonella
 Pneumococcal pneumonia, UTIs, endocarditis,
brucellosis
 Tularemia, plague, anthrax, syphilis, & wound
infections by GAS, staphylococci
2- GNB Septicemia (bacteria &/or their toxins in PBS)
3- IV line with fever
64- Cerebrospinal fluid (CSF)
- For: Meningitis, Encephalitis, Meningoencephalitis
- Microbial pathogens of meningitis:
a- Major: H.influenza, Meningococcus & Pneumococcus
b- Neonates: GBS, E. coli, Enterobacteriaceae & Listeria
c- VP shunt: S.epidermidis
d- Fungus: C.neoformans (the commonest fungus)
- Collection:
a- By the physician
b- By lumbar puncture (spinal tap)
c- Under strict surgical asepsis
d- Collected in sterile tubes
- Transport: ASAP, NO delay, NO refrigeration
- Lab Processing: immediate (STAT/ Emergency)
- Other Lab results:
a- Hematology (WBC & RBC): neutrophils = bacterial,
lymphocytes = viral
b- Chemistry (Glucose & Total Protein): ↓ glucose + ↑
protein = bacterial
65- Lung needle biopsy for Pneumocystis jiroveci (carinii) [fungus
NOT protozoan] pneumonia (as in AIDS patients)
66- Dog bite (Pasteurella multocida) = cellulitis
67- Throat swab: Group A streptococcus (S.pyogenes)
68- Infective dose: 1 Coxiella, 10 Shigella & 100-1000 Salmonella
69- Four Periods (Phases) in course of ID
1- Incubation (IP): from entry of MO to onset of symptoms
2- Prodromal Period: something is coming (out of sorts)
3- Illness Period: actual typical symptoms (communicable
diseases are most easily transmitted during this period)
4- Convalescent Period: Recovery
70- Virulence Factors
a- Attachment:
 Adhesin (protein F) on GAS + protein (fibronectin)
receptor on host
 Adhesin (gp120) on HIV envelope + CD4 receptor
on CD4 lymphocyte
b- Intracellular survival
 Chlamydia: GNB, can’t synthesize ATP
 Ricketssia: GNB, leaky membranes & live
within endothelium
 Ehrlichia: GNB, intra-leukocytic
 Sporozoan protozoa (intra-erythrocytic)
 Plasmodium spp → human malaria
 Babesia spp → human babesiosis
c- Capsule: antiphagocytic, usually composed of
polysaccharide except in Bacillus anthracis (polypeptide)
d- Microbial mechanisms to escape host IR
 Camouflage: coating of adult schistosomes with
host proteins
 Molecular Mimicry
 GAS with hyaluronic acid capsule identical to
hyaluronic acid of human CT
 Mycoplasma pneumoniae → Abs against their
Ags bind with other similar host Ags →
damage to heart, lung, brain & RBCs
 Antigenic Variation: Flu viruses, HIV, Gonococcus,
Borrelia recurrentis (relapsing fever), &
trypanosomes (sleeping sickness)
 Destruction of Abs: H. flu, Gonococcus, &
Pneumococcus → IgA protease
e- Exoenzymes
 Coagulase: S.aureus
 Kinase: streptokinase & staphylokinase
 Hyaluronidase (Spreading factor): Staph, Strep &
Clostridium
 Collagenase: C. perfringens
 Lecithinase: C. perfringens
 Necrotizing enzymes
 Flesh-eating strains of GAS → proteases →
necrotizing fasciitis
 Clostridium → proteases & lipases →
myonecrosis/ gas gangrene
f- Endotoxins
 Lipid-A of LPS of GNB cell walls
 Mycoplasma possessing NO endotoxin
 Cause septic shock

g- Exotoxins
1- CNS → Neurotoxins (most potent exotoxins)
 C. tetani → tetansospasmin → Tetanus
 C. botulinum → botulinal toxin → Botulism
2- GIT → Enterotoxins → (often diarrhea & vomiting)
 S.aureus & C.perfringens
 Bacillus cereus: (rice: Chinese restaurant)
 V.cholerae (Lysogenic conversion)
 C.difficile: enterotoxin (toxin A), cytotoxin
(toxin B) → AAD & PMC
 Salmonella spp, Shigella spp, certain E.coli
3- S.aureus → exfoliative (epidermolytic) toxin
 Separation of epidermal layers of skin
 Staph scalded skin syndrome (SSSS)
4- S.aureus
 Toxic shock syndrome toxin-1 (TSST-1)
 Staph toxic shock syndrome (STSS) in tampon-
using ♀
5- Staph & strep → Leukocidins→ destroy WBCs
6- GAS (Lysogenic conversion) → Erythrogenic toxin (SAg)
→ Scarlet fever
71- Pathogen transmitted by food and water
a- C.jejuni
b- C.parvum
c- E.coli
d- Giardia
e- Listeria
f- Salmonella
g- Shigella
72- Gram-Positive Cocci
 Staphylococci
 S.aureus is the main pathogenic staph
 Produces the coagulase enzyme
 Skin infections, pneumonia
 Food poisoning, osteomyelitis
 Coagulase-negative staphylococci (CONS)
 S.epidermidis (skin flora): contaminate blood
 S.saprophyticus: urinary tract infection
 Streptococcus pyogenes
 β-hemolytic (complete hemolysis)
 Skin and soft tissue infections and tonsillitis
 Sequelae (rheumatic fever, glomerulonephritis)
 S. pneumonia: pneumonia and meningitis
 Viridans streptococci: oral flora + endocarditis
73- Gram-Positive Bacilli
 Corynebacterium diphtheriae
 The causative agent of diphtheria
 Possibly fatal, toxin-mediated disease of the URT
 Listeria monocytogenes
 Severe infections in pregnant women, neonates,
and the immunocompromised
 Septicemia & neonatal meningitis
 Bacillus spp. (spore-forming bacteria)
 B. anthracis: agent of anthrax (bioterrorism)
 B. cereus: food poisoning + eye infection after trauma
74- Gram-Negative Cocci
 Members of the genus Neisseria: diplococcal arrangement
 N. meningitides: causing meningitis & septicemia
 N. gonorrhoeae causes gonorrhea (STD) which attacks the
urethra and can spread throughout the genital tract
 75- Enterobacterales  Bordetella pertussis (pertussis/ whooping cough)
 Gastroenteritis: E. coli, Shigella & nontyphoidal Salmonella  Brucella spp (brucellosis /Maltese fever)
 UTI: E. coli, Proteus, Klebsiella & Enterobacter  Legionella pneumophila (legionnaires disease & Pontiac
 Nosocomial pneumonia: E. coli, Proteus & Klebsiella fever)
 Septicemia and neonatal meningitis  Pasteurella multocida: cellulitis following bites or scratches
 Typhoid fever: Salmonella enterica & typhi from dogs or cats
 Plague: Yersinia pestis  Francisella tularensis: causes tularemia, a disease usually
coming after exposure to rabbits
76- Oxidase-Positive
80- Mycobacteria:
Vibrio Campylobacter Helicobacter
 Have a cell wall rich in lipids
Can ferment glucose Can’t ferment glucose Can’t ferment
 Can’t take the aqueous stains of the Gram technique
Curved polar Curved polar flagellate glucose
flagellate The most common Curved polar  Alternatively, they are acid-fast (Ziehl-Neelsen)
GIT disease: severe cause of bacterial flagellate  Causes tuberculosis: primarily attacking the lungs
watery diarrhea gastroenteritis Gastritis, PUD,
coming in epidemics Gastric cancer 81- M. avium-intracellulare complex:
77- Non-Fermenters  A collective term given for some mycobacteria
 Pseudomonas aeruginosa:  Especially known for their ability to cause disseminated
 Pneumonia (especially in cystic fibrosis patients) disease in immunocompromised individuals (HIV)
 Wound infections
 Burkholderia: pneumonia in cystic fibrosis patients 82- M. leprae (Causes leprosy):
 Acinetobacter: urinary tract infections and pneumonia  A chronic disfiguring disease
 Primarily affecting the skin and peripheral nerves
78- Obligate anaerobes
 Cl. perfringens (the causative agent of gas gangrene) 83- Cell wall-deficient:
 Cl. tetani (the causative agent of tetanus)  Mycoplasma pneumoniae: which primarily attacks the
 Cl. botulinum (the causative agent of botulism) respiratory tract
 Cl. difficile (pseudomembranous colitis)  Ureaplasma urealyticum: which primarily attacks the
kidneys and urethra
79- Parvobacteria (SMALL, Gram-negative fastidious bacilli)
 H. influenzae 84- Aerobic actinomycetes such as Nocardia spp.
 Encapsulated (epiglottitis and meningitis)  May stain acid-fast
 Non-encapsulated (otitis media and pneumonia)  Can opportunistically attack the lungs
 H. ducreyi causes STD called chancroid
 89- Papovaviruses include human papillomavirus (HPV)
 Comes in many types and causes such diseases
85- Anaerobic actinomycetes such as Actinomyces spp.
 Cutaneous warts, anogenital warts, and cervical cancer
 Not acid-fast
 May cause a chronic infection in the jaw and neck
90- Picornaviruses (ss-RNA viruses)
 Polioviruses: poliomyelitis
86- Spirochetes
 Echoviruses: exanthems and aseptic meningitis
 Treponema pallidum: syphilis (STD)
 Coxsackie A: exanthems
 Borrelia burgdorferi: Lyme disease (transmitted by ticks)
 Coxsackie B: aseptic meningitis, myocarditis & pericarditis
 Rhinoviruses: upper respiratory tract infections
 Hepatitis A virus (HAV)
87- Rickettsia spp.:
 Mainly attacks the endothelium causing vasculitis
91- Viruses of Childhood Exanthems
 Species are arthropod-borne
 Measles (paramyxovirus/ss-RNA)
 Divided into the
 Primarily infects the lungs
 Spotted fever group (R. rickettsii)
 Pneumonia + Encephalitis (immunocompromised)
 Typhus group (R. prowazekii)
 German measles (Rubella):
 Caused by a togavirus/Matonavirus (ss-RNA)
88- Herpesviruses (ds-DNA virus)
 Congenital infections when affecting pregnant
 Characterized by latency
 Erythema infectiosum:
 Herpes simplex virus (HSV)
 Caused by parvovirus B19 (ss-DNA)
 May cause herpes labialis or genital herpes
 Affects the RBC precursors in the bone marrow
 Pneumonia, CNS infections (immunocompromised)
92- Respiratory Viruses
 Varicella-zoster virus (VZV)
 Influenza viruses (Orthomyxoviruses)
 Causes varicella (chickenpox) as a primary infection
 Mostly cause a seasonal clinical disease
 May recur as zoster (shingles)
 May cause pandemics with high mortality
 Have segmented genomes = genetic reassortment
 Epstein-Barr virus (EBV)
 Parainfluenza viruses (Paramyxoviruses): Majority of cases
 Causes infectious mononucleosis
of croup (laryngotracheobronchitis)
 Burkitt’s lymphoma
 Respiratory syncytial virus (RSV): Pneumovirus
 Nasopharyngeal carcinoma
 The prime cause of acute bronchiolitis in children
 Hodgkin’s disease
 Coronaviruses:
 Cytomegalovirus (CMV): congenital infections
 Middle east respiratory syndrome (MERS)
  In 2019: (SARS-CoV-2), coronavirus disease 2019 97- Superficial mycoses
(COVID-19), has had immense impact on global
Otomycosis Black White piedra Tinea Tinea nigra
health and economy
piedra (pitryasis)
versicolor
93- Viruses of Gastroenteritis Mold Piedra Trichosporon Malassezia Hortae
 Responsible for most cases of watery diarrhea worldwide hortae beigelii furfur werneckii
(mainly Rotavirus) Outer ear Scalp hair Moustache, Skin of Palms of
 Rotaviruses (ds-RNA, mostly affect children < 2 years) canal beard, pubic chest and hands
 Caliciviruses: such as & axillary back
 Norovirus: epidemics in healthcare settings hair
 Astroviruses
94- Hepatitis viruses
98- Cutaneous mycoses
Virus Family name Genome Transmission route  Tinea capitis (head, eyebrows, eyelashes)
HAV Picornaviruses ss-RNA Fecal-oral (enteral)  Tinea corporis (trunk, major limbs, face)
HBV Hepadnaviruses ds-DNA Parenteral  Tinea cruris (groin, perineal & perianal areas)
HCV Flaviviruses ss-RNA Parenteral  Tinea pedis (athlete’s foot [soles & between toes])
HDV Delta virus (satellite) ss-RNA Parenteral  Tinea unguium (nails)
HEV Hepevrirus ss-RNA Fecal-oral (enteral)  Tinea barbae (beard & moustache)
95- Rabies virus
 Zoonotic Viruses 99- Subcutaneous mycoses
 A rhabdovirus  Sporotrichosis: rose-thorn disease (upper limb)
 Transmitted by bite of a rabid animal (dogs, cats, bats)  Chromomycosis: sclerotic bodies in tissues (lower limb)
 Causes a fatal neurological disease as a result  Mycetomas
 Caused by various molds
96- Dimorphic fungi:  Chronic granulomatous infections
 Mold at room temperature 25C  Actinomycotic mycetoma is caused by bacteria
 Yeast at body temperature 37C

Sporotrichosis Sporothrix schenkii 100- Fungal infections of lower respiratory tract (LRT)
Histoplasmosis Histoplasma capsulatum  Coccidioidomycosis (Valley Fever)
Blastomycosis Bastomyces dermatitidis  Histoplasmosis: bird droppings (bat droppings)
Coccidioidomycosis Coccidioides immitis  Pneumocystis Carinii Pneumonia (PCP): AIDS
Paracoccidioidomycosis Paracoccidioides brasiliensis  Zygomycosis (Mucormycosis): diabetic
Penicilliosis Penicillium marneffei
101- C. albicans (yeast): most common fungus isolated from 108- Protozoal infections of Circulatory System
clinical specimens  African Trypanosomiasis (African Sleeping Sickness)
 Pathogens: Trypanosoma brucei
102- 3 most common causes of vaginitis (1/3 each)  Mode of Transmission: tsetse flies
 C. albicans (yeast) (85-90% of yeast vaginitis)
 Trichomonas vaginalis (protozoan [flagellate])  American Trypanosomiasis (Chagas’ Disease)
 Mixture of bacteria (Mobiluncus & Gardnerella)  Megaesophagus & megacolon
 Parasite: Trypanosoma cruzi
103- Fungal infections of CNS = Cryptococcosis  Transmission: bugs (reduviid bugs, triatome
 Pathogen: C. neoformans (cryptococcosis) bugs, kissing bugs & cone-nosed bugs)
 Encapsulated yeast
 Diagnosed by negative staining [india ink]  Babesiosis
 Parasites: Intraerythrocytic sporozoa, Babesia
104- Leishmaniasis (protozoa)  Transmission: tick bite & blood transfusion
 Transmission: zoonosis via bite of infected sand fly
 Commonly affects the nose and mouth  Malaria
 Parasites: Plasmodium vivax (most common)
105- Acanthamoeba  Anopheles mosquito is the vector of malaria
 Facultative parasite: free-living or parasitic)
 Serious acanthamoeba keratitis 109- Primary Amebic Meningoencephalitis (PAM): caused
by the parasite: Naegleria fowleri (free living ameba)
106- Toxoplasmosis
 Cerebral toxoplasmosis is common in AIDS 110- Helminths
 During early pregnancy = fetal death or serious defects
Cestodes Trematodes Nematodes
 Parasite: Toxoplasma gondii, intracellular sporozoan
Tenia saginata (beef) Fasciolopsis buski E.vermicularis
 Transmission: eating raw or undercooked meat
Tenia solium (pork) Fasciola hepatica Trichuris trichuria
D. latum (fish) Clonorchis sinensis Ascaris lumbricoides
107- Protozoal infections of GIT Hymenolepis nana Paragonimus Ancylostoma
 Amebiasis (Amebic dysentery) H. diminuta westermani Necator americanus
 Balantidiasis: reservoirs: Pigs Tenia solium (pork) Schistosomiasis Strongyloides
 Cryptosporidiosis Echinococcus Trichinella spiralis
 Cyclosporiasis (hydatid cyst) Loa loa
 Giardiasis: Tear shape trophozoite with two oval nuclei Onchocerca volvulus
(river blindness)