NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)
TOPIC OUTLINE
I. Communicable Diseases of the Nervous
System
II. Communicable Diseases of the
Circulatory System
III. Communicable Diseases of the
Integumentary System
IV. Communicable Diseases of the
Respiratory System
COMMUNICABLE DISEASES – NERVOUS
SYSTEM
COMMUNICABLE DISEASES OF NERVOUS
SYSTEM
BACTERIAL INFECTION: TETANUS
❖ Caused by Clostridium
tetani (from herbivorous
animals in feces and soil
and environment; rich in
oxygen)
❖ Infectious but not
contagious
❖ Incubation period is 5-10
days
❖ Characterized by chronic
muscular spams
❖ In newborns (tetanus
neonatorum), it is acquired
from the umbilical cord
❖ Clostridium tetani is
anaerobic (do not thrive in
oxygen environment), they
Description form spores to protect
themselves until
environment is void of
oxygen
❖ Mode of Transmission is
through wound setting
where it may enter an open
wound, release its toxins
tetanolysin and
tetanospasmin, but do not
travel into the bloodstream.
❖ Tetanolysin: responsible
Treatment &
for dissolving RBCs which
Management
can produce anemia,
making patient pale
❖ Tetanospasmin: causes
involuntary muscle spasms
(full body)
❖ Wound- inflammatory
process (calor, dolor, rubor,
tumor, and loss of function)
❖ Restlessness and irritable
Manifestations - Masseter muscle:
lockjaw/trismus
- Facial muscle: rissus
sardonicus (sardonic
smile)
1
Transcribed by Kirsten Laine C. Santos
- Muscle of spine:
opisthotonos (arching of
back)
- Respiratory muscles:
dyspnea
- Abdominal muscles:
contraction
- Genito-urinary tract
muscle: urinary
retention (catheterize
patient)
- GI tract muscles:
smooth muscles won’t
have enough peristaltic
movement causing
constipation
- Muscles of extremities:
stiffness, difficulty in
flexing extremities
❖ Presence of trismus:
stiffness that gradually
increases until jaw locks
Wound Culture – ask patient if
Diagnosis he/she has a wound and culture;
find Clostridium tetani in culture
Medical Management
❖ Neutralize the toxin with
Anti-tetanus serum (ATS) or
Tetanus Anti-toxin (TAT)
❖ Kill the microorganism
❖ Prevent and control muscle
spasms with IV Diazepam
(Valium) that’s used for the
acute stage or lockjaw;
doctor’s give sedatives to
relax patients (muscle
relaxants compliment the
action of sedatives)
❖ Methocarbamol (Robaxin,
Rotasinal)
❖ Lioresal (Bacloten)
❖ Epiresone (Myonal)
❖ Nursing Intervention: verify
client allergies; .01+.99 NSS
= dilute medication with
normal saline solution; stand
by epinephrine or
corticosteroids; administer
antibiotics as ordered by
physician; treat wounds
using hydrogen
peroxide/betadine since
clostridium tetani stays in
the wound (anaerobic) then
NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)

place a thin dressing - After 1 month – tetanus

Nursing Management: toxoid 5
❖ Prevent spams
❖ Enteroceptive: lighting, COMMUNICABLE DISEASES OF THE NERVOUS
noise (dim the lights and SYSTEM
minimize the noise by VIRAL, FUNGAL, BACTERIAL INFECTION:
closing the windor/doors MENINGITIS
❖ Interoceptive: stimulation of
❖ Also called Epidemic,
internal organs
Cerebrospinal Meningitis,
❖ Proprioceptive: do not touch
and Cerebrospinal Fever
the patient if not necessary;
❖ The meninges: dura mater,
turn the patient in bed
arachnoid mater, pia mater
(minimize handling the
❖ Viral: cytomegalovirus
patient)
❖ Fungal
❖ Cluster your care
❖ Bacterial: most common
❖ Practice gentle handling of
cause of meningitis
the patient
❖ Tb meningitis
❖ Prevent injury (respiratory
❖ Staphylococcal meningitis
injury – airway obstruction)
❖ Meningococcemia
(apply a padded tongue
(causative agent is
depressor)
Neisseria meningitides)
❖ Aspiration – do not overfeed
❖ Meningococcemia is the
the patient (prevents
Description most fatal (spotted fever)
bloating) – small frequent
because aside from the
feeding
meninges, this can also
❖ Prevent patient from falling
affect vascular system
(padded side rail); never
causing a vascular collapse;
leave patient alone and
highly contagious; all
allow them to complete
exposed individuals are
spasms (never restrain)
given prophylactic treatment
❖ Maintain comfort (let patient
- Rifampicin 450 mg OD
die with dignity)
for 3 days
❖ Immunization
- Ciprobay 450 mg OD for
- Diphtheria, Pertussis,
3 days
Tetanus (given to
❖ Mode of Transmission is
children after 6 weeks, 3
respiratory droplets
doses at 1 month
❖ Portal of entry is the
interval in vastus
nasopharynx
lateralis)
❖ From nasopharynx, it will
- Educate the mother
show Symptoms that are
(instruct that DPT may
like Upper Respiratory Tract
cause fever; swelling
Infection, then it will reach
and tenderness may
the blood stream (bursting
occur)
of capillaries) producing
❖ Not all medications should
petechial formation
be massaged (DPT can be Manifestation
Nursing Intervention: teach
massaged for faster patients how to properly
absorption) dispose body excretions
❖ Cold compress within 24 (mucus)
hours (hot compress after Ecchymosis also happens
but needs a doctor’s order) (blotching wrist and lower
❖ No convulsions must extremities)
happen for 7 days Meningococcemia:
❖ Mother – Tetanus toxoid ❖ Meningeal irritation:
(deltoid muscles) – 2 doses - Nuchal rigidity (neck
1 month interval stiffness)
Diagnosis
❖ During organogenesis do ❖ Positive Kernig’s Sign: lie
not administer any drug your patient flat and extend
- Second trimester – the knees; if there’s pain
then it’s positive
tetanus toxoid 4
2
Transcribed by Kirsten Laine C. Santos
NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)
❖ Positive Brudzinski’s
Sign: lie patient in supine
position then flex the neck to
chest; if there’s abnormal
action/movement of the
wrist or pain, it’s positive
❖ Increased Intracranial
Pressure: headache,
increased blood pressure,
nausea (projectile vomiting
so move 2-3 feet away from
patient), abnormal vital
signs (increased
temperature, pulse and
respiratory rate are
decreased), widening of
pulse pressure, could lead
to convulsions, and diplopia
(double vision) due to
choking of the optic disc
❖ As the disease progresses,
there will be an alteration on
the level of consciousness
❖ For infants, expect high-
pitched cries
Meningitis:
❖ Lumbar tap (lumbar
puncture); evaluating the
cerebrospinal fluid (CSF);
CSF is usually clear, so if it
is yellowish and turbid, then
it is a sign of meningitis
❖ Herniation of the brain
❖ Increased White blood cells
in the CSF
❖ Decrease in glucose
components
Nursing Diagnosis:
❖ Alteration in body
temperature
❖ Risk for injury due to
convulsions and diplopia
❖ Risk for fluid and electrolyte
imbalance
❖ Discomfort due to headache
Medical Management:
❖ Doctors will give
antimicrobial medications
(antibiotics)
❖ Doctors will give steroids for
the inflammatory response
- Dexamethasone
Treatment and
- Prednisone (not
Prevention
applicable for patients
with meningococcemia
since it may cause
sodium retention,
causing more increased
ICP)
❖ Mannitol (diuretic) to
3
Transcribed by Kirsten Laine C. Santos
decrease fluid (decreased
ICP)
Nursing Intervention: check
the blood pressure first (too
much urination=decreased
blood pressure or
hypotension)
❖ Dilantin (phenytoin): anti-
convulsions
Nursing Management (Symptomatic)
❖ Monitor vital signs
COMMUNICABLE DISEASES OF THE NERVOUS
SYSTEM
VIRAL INFECTION: ENCEPHALITIS
❖ Also called Brain Fever
❖ Causative agent is ArBo
virus
❖ 3 classifications:
1) Primary Encephalitis
a. Mosquito agents:
Aedes sollicitans
and Culex tarsalis
b. Ticks of horses
c. Examples:
- Saint Louise
Encephalitis
- Japanese B
Encephalitis
Description - Easter Equine
Encephalitis
- Western Equine
Encephalitis
2) Secondary
Encephalitis: there’s a
previous infection
3) Toxic Encephalitis:
due to lead or mercury
❖ Another classification is
Lethargic Encephalitis:
high fever, headache,
double vision, delayed
physical and mental
response, and lethargy
❖ Lumbar puncture: check’s
signs of infection in the CSF
❖ Electroencephalography
Diagnosis (EEG): slow background
rhythms along with
presence of focal
epileptogenic discharges.
Medical Management:
❖ Anti-inflammatory drugs
such as acetaminophen
(Tylenol), ibuprofen (advil),
Treatment &
and naproxen sodium
Prevention
(aleve) to relieve headaches
and fevers
❖ Antiviral drugs: acyclovir
(zovirax), ganciclovir,
NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)
foscarnet
Nursing Management:
❖ Place patient to complete
bed rest
Preventive Measure:
❖ CLEAN
Chemically treated
mosquito net
Larvivarous fishes
Environmental Sanitation
Antimosquito soap
Neem tree
COMMUNICABLE DISEASES OF THE NERVOUS
SYSTEM
VIRAL INFECTION: POLIOMYELITIS
❖ Also called Infantile
Paralysis, Heine-Medin
Disease
❖ Causative agent is polio
virus (Legio debilitans or Ld)
❖ Strains of Ld:
- Ld. Brunhilde:
permanent immunity
Description
- Ld. Lansing
- Ld. Leon
❖ Modes of Transmission
are nasopharyngeal and
fecal-oral secretions
❖ Airborne have thinner
particles (nasopharynx)
than droplets
1) Invasive Stage: paresis
(partial paralysis)
2) Pre-paralytic stage:
headache, sore throat,
malaise; lasts from a few
hours to a few days (1-3
days)
3) Paralytic stage: paresis
develops to paralysis in
some patients; flaccid
paralysis
3 Types of Paralysis in Polio:
1) Bulbar: inability to swallow
(pharyngeal paralysis);
Manifestations
patient requires ventilatory
support and Ryle’s tube for
feeding
2) Spinal: lower limb muscles
are often involved; common
flexion contractures of hip,
knee and equinus deformity
3) Combination (Bulbo-
spinal): both bulbar and
spinal
❖ Other symptoms include
severe muscle pain,
stiffness of hamstrings, and
Hoyne’s sign (patient
4
Transcribed by Kirsten Laine C. Santos
supports himself when
asked to sit up)
Samples of throat secretions, stool,
Diagnosis
or CSF is checked for poliovirus.
Medical Management:
❖ Oral polio vaccine (excreted
via the stool)
Nursing Management:
Treatment & ❖ Apply warm compress
Prevention ❖ Codeine
❖ Don’t give morphine
because it cases
depression of respiratory
system
COMMUNICABLE DISEASES OF THE NERVOUS
SYSTEM
VIRAL INFECTION: RABIES
❖ Also called Hydrophobia,
Lyssa, La Rage
❖ There are 2 kinds of Rabies:
- Urban/Canine Rabies
- Sylvatic Rabies:
disease of wild animals
and bats
❖ Modes of Transmission
include direct contact
(through broken skin/mucus
membrane in eyes, nose, or
Description
mouth) with saliva or
brain/nervous system tissue
from an infected animal
❖ People usually get rabies
from the bite of a rabid
animal
❖ Incubation period is usually
30-90 days but
manifestations begin
anywhere from 10-240 days
after exposure
In animals:
❖ Dumb stage: animals
appear depressed,
Manifestations
lethargic, and
uncoordinated
❖ Furious stage:
NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)
hyperactivity, excitable
behavior, hydrophobia,
aerophobia, muscle spasms
of throat, excessive
salivation (drooling),
complete paralysis
In Humans:
❖ Invasive stage: low fever,
malaise, anorexia, nausea,
sore throat, sensitivity to
light
❖ Excitement stage:
aerophobia (fear of air),
hydrophobia (fear of water),
and maniacal behavior
❖ Paralytic stage:
hydrophobia disappears
and swallowing becomes
less difficult; progressive
flaccid paralysis develops,
urinary incontinence,
peripheral vascular collapse
starts and death follows
❖ In animals: Direct
Fluorescent Antibody
(DFA) Test: Detection of
rabies virus (negri bodies)
from any part of the affected
brain (tissue specimen)
preferably from the brain
stem and cerebellum
(animal should be
euthanized)
❖ Rabies travels at 3mm per
hour
Diagnosis Nursing Intervention: clean
wound for 15-20 minutes
with soap and water and
apply a strong antiseptic
❖ Rabies dies at 65 degrees
centigrade for 35 seconds
then destroyed
❖ In humans: RT-PCR may
be used for the detection of
rabis virus RNA
❖ Factors of Observation:
site of bite, extent of bite,
and reasons for bite
Nursing Management:
❖ Place in dim and quiet
environment (away from
other patients as well as this
may trigger both or all
patients due to sensitivity)
Treatment &
❖ Before maniacal behavior
Prevention
sets in, restrain
❖ Wear all protective barrier-
gloves, mask, cap and
gown
Medical Management:
❖ Post-exposure rabies shots
5
Transcribed by Kirsten Laine C. Santos
but once symptoms
manifest, no effective
treatment is available
COMMUNICABLE DISEASES OF THE NERVOUS
SYSTEM
VIRAL INFECTION: DENGUE HEMORRHAGIC
FEVER
❖ Also called H-fever
❖ Causative agent is ArBo
virus
❖ Types of Viruses:
- Type 1 –
Onyongnyong virus
- Type 2 –
chickungunya virus
- Type 3 – West Nile
Virus
- Type 4 – flavivirus
Description (epidemic in the PH)
❖ 3 mosquitos:
- Aedes aegypti:
morning, breeds on
clear, stagnant water,
black and white; can
transmit dengue
- Aedes albopictus: can
transmit dengue as well
- Culex fatigans: can
transmit dengue virus
after infection
Classifications:
❖ Type 1: dengue fever (no
bleeding)
❖ Type 2: bleeding of
gums/gastrointestinal tract
❖ Type 3: bleeding plus
circulatory failure (cold skin
– to assess circulatory
failure, you may conduct a
Manifestations
capillary refill)
❖ Type 4: hard to find
circulating so it causes
strong symptoms and
complications; bleeding of
nose and gums and is
easily spread since most
population doesn’t have
immunity against it
Tourniquet Test: Rumpel Leads
Test – assesses fragility and
capillaries and identifies
thrombocytopenia (low platelet
Diagnosis count)
Blood Exam:
- Platelet count
- Hematocrit
Determination
Treatment & Nursing Management:
Prevention ❖ Prioritize bleeding
NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)
Medical Management:
❖ Symptomatic treatment
since it is viral
❖ Vitamin K preparation
- Syncavit
- Aquemephyton
- Menaquion
❖ Vitamin C Preparation
COMMUNICABLE DISEASES – CIRCULATORY
SYSTEM
COMMUNICABLE DISEASES OF CIRCULATORY
SYSTEM
PROTOZOAL INFECTION: MALARIA
❖ Also called AGUE
❖ Caused by plasmodium
❖ 4 species of plasmodium:
- Plasmodium Vivax
- Plasmodium Falciparum
- Plasmodium Ovale
- Plasmodium Malariae
• Some plasmodium enters the
red blood cells and
reproduce (merozoites) and
some enter the liver
(hypnozoites) and remain
dormant, waiting for the liver
to produce red blood cells.
• Hypnozoites are responsible
Description for relapsing malaria caused
by P. vivax and P. ovale.
• Once new RBCs are
released, hypnozoites
penetrate them and remain
for 4-5 years.
• Entered RBCs by the
merozoites start to rupture
and release the
microorganisms.
• The malaria parasite
becomes schizonts (asexual
stage) and lyse as they
invade RBCs and mature
• When mature, they produce
new generations of the
merozoites.
Rupture causes severe anemia
(from rapid RBC rupture), cerebral
hypoxia (restlessness, delirium,
Manifestation convulsion, confusion, or coma) and
s black water fever (passage of dark-
red or black urine) with chills due to
infection
Cold Stage – chilling sensation
manifested by shaking of the body
lasts for 3-15 minutes
Nursing Intervention: give blankets
and provide lamps that radiate heat;
provide warmers
6
Transcribed by Kirsten Laine C. Santos
Hot Stage – patient experiences
fever and headache with abdominal
Stages of pain and vomiting; lasts for 4-6 hours
Manifestation Nursing Intervention: lower the body
s of Malaria temperature by giving sponge bath,
and Nursing cold compress, lose clothing, and
Interventions provide antipyretics ordered by the
physician
Diaphoretic Stage – excessive
sweating and patient is weak
Nursing Intervention: ensure client
comfort with comfortable bedding and
keep them dry from the sweats;
increase fluid intake
Malaria Smear – extract blood from
Diagnosis the hot stage of patient
Malaria Quantitative Buffy Coat –
rapid results but expensive
❖ Antimalarial Agents – blood
schizonticides; drugs that act
on the sexual blood stages of
parasites responsible for
manifestation of malaria
• (Main medication)
Chloroquine
phosphate 250mg
(150mg base/tablet)
• Sulfadoxine
(Sulfalene) 50mg-
pyrimethamine
25mg/tablet
• Quinine sulfate
300mg/tablet
• Quinine
hydrochloride
300mg/ml, 2
ampules
Treatment & • Tetracycline
Prevention hydrochloride
250mg/capsule
• Quinidine sulfate
200mg/durules
• Quinidine gluconate
80mg (50mg base)
mL, 1mL vial
❖ Before going to malaria
endemic areas or is
pregnant, bring chloroquine
for chemoprophylaxis
❖ Quinine is the only drug
administered parenterally
❖ Preventive measures include
clean clothing, avoiding
vector biting hours (9PM-
3AM), zoo prophylaxis
(animals that are not hosts
are bitten instead)
NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)
COMMUNICABLE DISEASES – INTEGUMENTARY
SYSTEM
COMMUNICABLE DISEASES OF INTEGUMENTARY
SYSTEM
BACTERIAL INFECTION: LEPROSY
❖ Also called Hansen’s
Disease/Hansenosis
❖ Caused by the
Mycobacterium
leprae/Hansen’s bacillus
❖ Enanthem: rashes found in
the mucus membranes
❖ Exanthem: rashes found in
the skin
❖ There are 4 characteristics
of these rashes:
- Macule: flat rashes
- Papule: slightly
elevated
- Vesicles: elevated
and fluid-filled
- Pustule: elevated
and pus-filled
❖ All characteristics of rashes
are visible in chickenpox
❖ Children 3 years old and
below are prone to leprosy
❖ Modes of Transmission
are prolonged skin-to-skin
contact and via droplets
❖ 3 cardinal signs of
leprosy:
❖ Peripheral nerve
enlargement
❖ Loss of sensation on the
Description affected part
❖ (+) skin smear test for
mycobacterium leprae E
❖ 4 types of leprosy:
- Indeterminate
- Tuberculoid: non-
infectious/benign
type; few
mycobacterium
leprae found in
lesion
- Lepromatous:
malignant/infectious
type; many
mycobacterium
leprae is found
- Borderline: possess
characteristics of
tuberculoid and
leptromatic type
❖ Indeterminate and
tuberculoid leprosy are
treated with the
paucibacillary approach
7
Transcribed by Kirsten Laine C. Santos
(few lesions are found and
treatment lasts 6-9 months)
❖ Lepromatous and borderline
leprosy are treated with
multibacillary approach
(contains many lesions and
treatment takes 24-30
months)
❖ It’s the same regardless of
leprosy type
❖ During early stage, the color
changes and doesn’t
disappear (either reddish or
whitish)
❖ Presence of skin ulcers (not
treatable with medicine)
❖ Redness of the eyes
❖ muscle weakness and
paralysis
❖ nasal obstruction
❖ nose bleeding
❖ skin is thickened and painful
(thickening and pressure on
nerves)
❖ Areas affected lose
sensation, having hair loss
and anhidrosis (no
sweating)
❖ Late manifestations include:
• Lagophthalmos:
inability to close
eyelids
• Madarosis: hair fall
Manifestation of eyebrows
• Small bones are
being
absorbed/eaten
such as the nose,
fingers, cartilages
❖ Leprosy patients undergo
natural amputation and
manifest lion face due to
nasal bones obstruction and
madarosis
❖ They have contractures and
chronic ulcers as well
❖ Male patients also have
gynecomastia
❖ Skin smear test
❖ Skin lesion biopsy
❖ Lepromin test (uses antigen
Diagnosis and observe for reaction):
identifies whether type is
tuberculoid or lepromatous
NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)
❖ Wassermann test (also
used for syphilis)
Medical Management
❖ Republic Act of 4073;
leprosy can be treated at
home; liberalizing treatment
❖ Multiple drug therapy (no
longer communicable after
2 weeks)
❖ Rifampicin 600mg in adults
and 300mg in child
❖ Ofloxacin 400mg in adults
and 200mg in children
❖ Minocycline 100mg in adults
and 50mg in children
Nursing Management
❖ Provide psychological care
because leprosy patients
struggle on self-esteem and
Treatment & social stigma
Prevention ❖ Provide skin care
❖ Supervise handling objects
with high temperature since
leprosy patients have lost
sensations
❖ Provide physical exercises
❖ Provide information on drug
therapy (side effects such
as orange urine, sweat, and
sputum with rifampicin,
schedule)
❖ Monthly medication is given
again on 28th of the month
❖ Inform patients that they
may have leprae reactions:
• Mild: nodules,
edema, sudden
increase in number
of lesions, and
tenderness
• Severe: iritis (eye
inflammation,
sudden acute
paralysis
❖ Stop multiple drug therapy
(like rifampicin) if patient
experiences joint pain,
urinary disturbances, and
body malase
❖ Stop lamprene also if skin is
flaky
❖ In stopping multiple drug
therapy, only one
medication is stopped and
the rest are still continued
COMMUNICABLE DISEASES OF INTEGUMENTARY
SYSTEM
VIRAL INFECTION: ERUPTIVE FEVER (MEASLES)
❖ Also called Rubeola, Little
8
Transcribed by Kirsten Laine C. Santos
Red Disease, 7 Day
Measles, 9 Day Measles,
Hard Measles, Morbilli
❖ Acute and highly
communicable
❖ Characterized by fever,
rashes, and symptoms with
the upper respiratory tract
❖ Eruption is proceeded by 2
Description days of coryza and
mirbilliform rash appears on
3rd and 4th day, ending in
branny desquamation
❖ Rashes provide permanent
immunity
❖ Causative agent is
paramyxovirus or rubeola
virus (filterable virus)
❖ Mode of Transmission:
measles is airborne, so
secretions must be avoided
❖ Incubation period is 10 days
to 14 days with rashes
disappearing
1) Pre-eruptive Stage:
presence of high-grade
fever (3-4 days), 3 Cs of
measles (cough, cold,
coryza) and conjunctivitis
with photophobia; stimson
signs (characteristic
conjunctivitis); puffiness of
eyelids and showing linear
congestion of lower
conjunctiva; presence of
Stages of exanthem (koplik spots) in
Manifestations buccal cavity which is the
pathognomonic sign of
measles
2) Eruptive Stage:
appearance of rashes on 3rd
day (maculopapular) on
hairline to the extremities
(cephalocaudal distribution)
3) Post-eruptive stage:
rashes start to disappear
cephalocaudally (branning
desquamation) and peels off
Diagnosis Clinical Physical Exam: for rashes
Nursing Management
❖ For symptomatic: increase
Treatment & body resistance (lesser
Prevention chance of complications) by
providing adequate rest and
nutrition; increase fluid
NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)
intake (restore fluid) and
implement hygienic
practices; skin care (bathing
should be careful and in
lukewarm temperature;
close curtain or windows;
only expose bathed parts)
❖ Measles is not fatal itself but
its complications, namely
secondary encephalitis and
bronchopneumonia
Preventive Measures
❖ Measles Vaccination at 9
months (0.5cc
subcutaneously)
❖ Measles Mumps Rubella
vaccine (MMR) at 15
months and female
adolescents (0.5 cc
subcutaneously) but not with
pregnant women and
patients allergic to eggs
❖ Inform patients about health
education such as proper
disposal of nasal secretions
COMMUNICABLE DISEASES OF INTEGUMENTARY
SYSTEM
VIRAL INFECTION: GERMAN MEASLES
❖ Also called 3 day Measles, 3rd
Dsiease, Rubella, Rotelm
❖ Lasts for 3 days
❖ Causative agent is pseudo
Description
paramyxovirus (rubella or
TOGA virus)
❖ Mode of transmission is via
droplets only
1) Pre-eruptive stage: (+) or (-)
fever that lasts for 1-2 days,
mild cough and colds, and
presence of forchheimer’s
spots (enanthem before
eruption of rashes)
Stages of
Manifestatio
ns
2) Eruptive Stage: enlargement
of sub-occipital, post-
auricular, and cervical lymph
nodes (used in differential
diagnosis for measles, only in
german measles);
appearance of maculopapular
rashes (pinkish, smaller and
final) with cephalocaudal
9
Transcribed by Kirsten Laine C. Santos
distribution
3) Post-eruptive Stage: rashes
start to disappear on 3rd day
(differential diagnosis for
german measles as well) and
lymph nodes enlargement
also subside
Detection of gram-positive bacilli in
Diagnosis pairs and growth in culture under
anaerobic condition
Nursing Management (Preventive
Measures)
❖ It may be fatal for the first
trimester of pregnancy
because it may produce
congenital anomalies:
- Congenital cataract:
lead to blindness
- Microcephaly: small
Treatment & brain (not compatible
Prevention with survival)
- Congenital heart
defects (tetralogy of
fallot and patent
ductus)
- Deafness and
muteness
❖ Gamma globulin is given
within 72 hours with exposed
pregnant women
COMMUNICABLE DISEASES OF INTEGUMENTARY
SYSTEM
VIRAL INFECTION: CHICKENPOX
❖ Also called Varicella
❖ Causative agent is varicella
zoster virus (VZV) found in
the nasopharyngeal
secretions and lesions
❖ Cause of infection is entry of
virus to the nasopharynx
(not skin to skin)
❖ Scabs itself are not infective
❖ It is an acute infectious
disease of sudden onset
characterized by fever and
eruptions of maculopapular
Description
lesions within a few hours
followed by vesicular lesions
for 3-4 days, leaving
granular scabs
❖ Mode of Transmission:
communicable until the last
crust has dried not more
than 1 day or 6 days after
first appearance of lesions;
lesions are more on the
covered parts of the body
❖ Incubation period is within 2-
3 weeks or 13-17 days
NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)

❖ Not common in infancy but ❖ Pain persists up to 2 months

is common in 15-year-olds due to involvement of nerve
1) Pre-eruptive Stage: (+) or endings even when rashes
(-) fever with headache, are healed
body malaise, and muscle ❖ Causes no scar formations
pain Treatment and Nursing Management:
2) Eruptive Stage: Prevention ❖ Give zovirax (acyclovir) or
appearance of macules, potassium permanganate
papules, and vesicles (KMnO4) compressed over
(vesiculopustular rashes) patient’s rash because it has
Nursing Intervention: do not an astringent, oxidizing and
Stages of directly apply bar soap and bactericidal effect
Manifestations make a lather; use cold ❖ Improve patient’s body
water resistance
3) Post-eruptive Stage: ❖ Immunization same with
rashes start to crust and chicken pox: Varicella
peel off Vaccine (0.5 cc
Nursing Intervention: inform subcutaneously) with 2
patient not to peel off to doses on teens 13 above in
prevent scars; instruct 1 month interval. Inform
patient to take a bath daily patient about normal mild
and let it peel off on its own rash formation after
Physical Exam for clinical vaccination
Diagnosis
observation ❖ Health education: cover
Medical Management (Symptomatic mouse and nose with
Treatment): coughing
❖ Give antiviral drugs: zovirax
Treatment &
(acyclovir) COMMUNICABLE DISEASES – RESPIRATORY
❖ Skin care to prevent skin SYSTEM
Prevention
complications and
secondary encephalitis, and COMMUNICABLE DISEASES OF RESPIRATORY
secondary attack of herpes SYSTEM
zoster BACTERIAL INFECTION: DIPTHERIA
❖ It is contagious and affects
COMMUNICABLE DISEASES OF INTEGUMENTARY all ages but is common
SYSTEM among children
VIRAL INFECTION: HERPES ZOSTER ❖ No permanent immunity
❖ Also called Shingles, Zora, ❖ Newborns from mothers
Acute Posterior Ganglionitis with diphtheria are immune
❖ No permanent immunity up to 6 months after birth
❖ Dormant/inactive type of ❖ There are 3 types of
chicken pox (2nd attack) diphtheria:
❖ Affects the ganglion of the - Wound diphtheria:
posterior nerve root wounds
❖ Usually affects adults - Cutaneous
Description ❖ Period of communicability is diphtheria: non-
until the last vesicle has Description respiratory; affects
crusted the mucous
❖ Causative agent is dormant membrane;
varicella zoster virus (those appears localized
that didn’t leave the body and punched-out
from the first chicken pox ulcers; affects
attack and become certain mucous
activated again) membranes:
❖ Same with chicken pox but • Conjunctiv
rashes are not itchy and al:
painful, follows a unilateral conjunctiva
Manifestations
distribution because it • Vaginal: in
follows the nerve pathway female
❖ It appears in clusters • Prepuce:

10
Transcribed by Kirsten Laine C. Santos
NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)
in
uncircumci
sed males
- Respiratory
diphtheria:
causative agent is
Corynbacterium
diphtheria (Klebb-
loeffler bacillus)
❖ Mode of Transmission is
via droplet; pathognomonic
sign is presence of
pseudomembrane (grayish-
white)
❖ Different types of
respiratory diphtheria:
- Nasal type:
irritating nasal
discharge
characterized by
serosanguineous
(with blood and
serum part of
blood) secretions
with foul odor,
producing upper lip
and nasal
excoriation; one-
Treatment and
sided discharge
Prevention
- Pharyngeal/faucia
l type: affects
pharynx and
tonsils; sore throat,
difficulty in
swallowing,
pseudomembrane
on soft palate and
tonsils; bull neck
(red, painful, warm,
and tender)
appearance due to
inflammation and
enlargement of
cervical lymph
nodes
- Laryngeal type:
most fatal; nursing
management
includes
tracheostomy;
hoarseness of
voice, dyspnea, COMMUNICABLE DISEASES OF RESPIRATORY
subcostal chest
indrawing retraction
(due to overuse of
accessory muscles
in breathing);
coughing (barking Description
cough; dry and
metallic)
Diagnosis Schick’s Test: determine
11
Transcribed by Kirsten Laine C. Santos
susceptibility to diphtheria
Moloney Test: tests
hypersensitivity to diphtheria
Nose and Throat Swab: determine
communicability; patient is
communicable until 3 consecutive
negative result
Nursing Management
(Symptomatic)
❖ Priority management
focused on toxin (which
brings the signs and
symptoms) using Anti-
diphtheria Serum (do skin-
testing first)
❖ Kill microorganism with
antibiotic (penicillin)
❖ Prevent respiratory
obstruction by doing
emergency tracheostomy
❖ Place patient in complete
bed rest for 2 days to
prevent myocarditis
(number one complication
of diphtheria) characterized
by pallor, hypotension,
epigastric pain
❖ Maintain patent airway by
proper positioning and
deep breathing and
coughing exercises
❖ Increase fluid intake to do
chest physiotherapy and
back clapping
❖ Turn patient side to side
every 2 hours
❖ With doctor’s order, do
postural drainage,
suctioning, and inhalation
therapy
❖ Provide adequate and soft
diet
Prevention:
❖ Immunization and booster
shots following a year after
primary dose and another
on 4th or 5th year of age of
the child
❖ Proper disposal of
nasopharyngeal secretions
SYSTEM
BACTERIAL INFECTION: PERTUSSIS
❖ Also called whooping
cough
❖ Causative agent is
Bordetella pertussis
(Pertussis bacillus)
❖ Second attack is rare, but
NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)
it doesn’t provide second
immunity
❖ Common in children below
6 years old
❖ It is both aerobic and
anaerobic
❖ Mode of Transmission
includes respiratory and
salivary contact
❖ Incubation period is from
7-10 days but doesn’t
exceed 21 days
❖ Rendered communicable
in early catharral stage up
to 3rd week after onset of
paroxisimal stage
❖ Catarrhal stage: highly
communicable; presence
of colds, nocturnal
coughing, fever, tiredness,
and restlessness
❖ Paroxisimal stage:
plasmodic stage;
whooping cough after 2
weeks and cough may last
up to 3 months; congested
Stages of
face, purple tongue,
Manifestations
protrusion of eyeballs,
involuntary urination and
defecation, distended
face, possible abdominal
hernia, hemorrhage of
vestibular area of ear
❖ Convalescent: no longer
communicable; signs and
symptoms subside, and
recovery begins
❖ Nasal swabbing
❖ Bordet-Gengou Test:
uses specimen of
Diagnosis
nasopharyngeal secretion
❖ Agar Plating of
nasopharyngeal specimen
Treatment and Medical Management:
Prevention ❖ Give patient pertussis
immunoglobulin
❖ Give antibiotics
(erythromycin as drug of
choice)
❖ Fluid and electrolyte
replacement
Nursing Management:
❖ Complete bed rest
❖ Conserve patient’s energy
❖ Prevent aspiration by
properly positioning
patient when feeding them
❖ During plasmodic attacks
of coughing, keep patient
at nothing per orem.
❖ Apply abdominal binder to
12
Transcribed by Kirsten Laine C. Santos
prevent hernia
❖ Assess signs for
dehydration by monitoring
fluid intake and output
❖ Regulate IV fluids
Preventive Measurements:
❖ During paroxisimal cough,
pick up infant while giving
abdominal support
COMMUNICABLE DISEASES OF RESPIRATORY
SYSTEM
BACTERIAL INFECTION: PULMONARY
TUBERCULOSIS (PTb)
❖ Also called Koch’s Infection
❖ Causative agent is
Mycobacterium tuberculosis
(acid-fast for humans),
Mycobacterium africanum
(acid-fast for humans),
Mycobacterium bovine (from
milk of cattles), and
Mycobacterium avis (from
birds)
❖ Doesn’t provide permanent
immunity
❖ Common in malnourished
individuals living in crowded
areas
❖ There are several strains of
PTb
❖ Mode of Transmission is
through direct invasion of
mucous membranes which
Description is rare; and airborne; Bovine
tuberculosis is transmitted
via ingestion of
unpasteurized milk/dairy
products
❖ Exopulmonary
tuberculosis except for
laryngeal tuberculosis are
generally not communicable
❖ Children with primary Tb are
not infectious from 6-12
months
❖ Children 3 years old below
have highest risk for
infection and lowest at
childhood and highest again
in adolescence
❖ Primary complex is a type
of Tb in children in
underdeveloped and
developing countries
Afternoon low-grade fever, anorexia,
weight loss, body malaise, back and
Manifestation
chest pain, productive cough,
s
hemoptysis (means severe and
could lead to anemia and
NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)

amenorrhea), dyspnea ❖ Also called DOTS or Directly

❖ Tuberculin testing: only a Observed Treatment Short-
screening test for Tb; 4 course Chemotherapy
things to consider: ❖ Rifampicin (side effect:
- It uses purified yellow-orange secretions)
protein derivative Nursing Intervention:
administered remove soft contact lenses
intradermally; to avoid staining
interpreted after 48- ❖ Isoniazid (INH) (side effect
72 hours; if result is is peripheral neuropathy)
Tb +, there should Nursing Intervention: give
be more than 10mm Vit B6 supplement
induration; If Tb (pyridoxine)
HIV+, there’s 5mm ❖ Ethambutol (side effects:
induration. optic effect-color blindness)
❖ Tuberculin testing has 3 Nursing Intervention:
techniques: discontinue drug if side
- Mantoux test: skin effect shows
testing but uses ❖ Streptomycin (side effects:
PPD and results are nephrotoxicity)
interpreted 48-72 Nursing Intervention:
hours after; most monitor intake and output
common because and Bu creatinine, and urine
it’s easier, less consistency and amount
painful, and most ❖ Streptomycin (side effects:
accurate Ototoxicity)
- Multi-puncture test: Nursing Interventions:
punctures 6-8 times assess for tinnitus (ear
in circular manner ringing) and vertigo
Diagnosis - Vollmer & Pirquet Other Nursing Management:
test: skin ❖ Diet must be adequate and
scratch/patch test; nutritious
scratch and tape are ❖ Provide adequate rest and
reagents for 72-96 activity must be done
hours or gradually
approximately 3-4 ❖ Chest physiotherapy (but
days so wait this is contraindicated
another 48 hours because this may aggravate
before hemoptysis
interpretation, Prevention:
therefore, result is ❖ Provide BCG vaccine (0.5cc
after 5-7 days intradermal) to child at birth
❖ Sputum exam: and ask mother to avoid
confirmatory; before oral massaging the area and
care in the morning, obtain provide child paracetamol if
phlegm (halak) specimen fever appears
and patient takes ❖ Indolent abscess may
medication for 2 weeks appear at injection site and
(yields a negative sputum leave a scar
test); ask patient to rest, and Nursing Intervention: if
breath through the nose and abscess lasts 3 months, do
exhale through the mouth. incision and drainage, and
Open the mouth widely and prophylaxis of isoniazid for
cough from within the lungs. 6-9 months depending on
Put tongue at the back of child is
the lower teeth immunocompromised
❖ Chest x-ray: not a definitive ❖ Incubation period of PTb is
test 48 weeks
Anti-Tb agents:
Treatment &
❖ Usually combined to prevent COMMUNICABLE DISEASES OF RESPIRATORY
Prevention
tolerance from drugs SYSTEM
13
Transcribed by Kirsten Laine C. Santos
NRS 1205 Microbiology & Parasitology Lecture
Prof. Ernesto F. Mania Jr. (Lecture Based)
VIRAL, PROTOZOAL, AND BACTERIAL
INFECTION: PNEUMONIA
❖ Doesn’t provide permanent
immunity
❖ It’s an acute infectious
disease of the lungs and
results to consolidation of
lobes of either or both lungs
❖ Inflammation of
parenchymal of lungs
❖ Incubation is 2-3 days due
to secondary infection
(could affect elders)
❖ Mode of Transmission is
droplet that could either be
viral, protozoal, and
bacterial.
❖ Viral: cyto megalo virus
(CMV) infection
❖ Protozoal: pneumocystis
carinii pneumonia (PCP)
infection
❖ Bacterial: Diplococcus
pneumonia (majority
causative agent) and
Pneumococcus of
Friedlander (occasional
causative agent)
Description ❖ It is characterized by rusty
sputum and highly colored
urine with reduced chlorides
and increased urates which
are pathognomonic sign of
pneumonia
❖ Cardinal signs include fever,
shaking chills, productive
cough, sputum production
(rusty colored depending on
causative agent:
- Creamy yellow-
staphylococcus
- Currant jelly-
klebsiella
- Greenish-
pseudomonas
- Clear- no
infection/viral)
And chest/pneumatic pain
❖ Complications include
emphysema, pleural
effusion, endocarditis,
pneumococcal meningitis,
otitis media in children,
hypostatic edema,
hyperemia, jaundice
Manifestations 4 danger signals of pneumonia:
1) Younger patients don’t want
to breast feed
2) Convulsion
3) Abnormally sleepy (difficult
to wake up)
14
Transcribed by Kirsten Laine C. Santos
4) Vomit what they intake
Additionally, are stridor (harsh
breathing) and chest indrawing. If
these signals are present, rush to
the doctor.
Sputum Exam
Diagnosis
Chest x-ray
Nursing Management on Severe
Pneumonia:
❖ Bring them immediately to
the hospital
Medical Management:
❖ Viral: symptomatic
treatment
❖ Protozoal: give pentamidine
❖ Bacterial: antibiotics
Treatment &
General Nursing Management:
Prevention
❖ Ensure patent airway
❖ Adequately rest turn the
patient
❖ Sodium chloride or IV
Prevention:
❖ Immunization for adults
❖ Proper handling of body
secretions (cover mouth
when coughing/sneezing)
VIRAL INFECTIONS OF RESPIRATORY SYSTEM
COLDS
❖ Also called coryza
❖ Caused by adenovirus and
rhinovirus
❖ Mode of Transmission is
by droplet
Description ❖ Incubation period is 1-3
days
❖ Complications in children
include otitis media and
bronchopneumonia and
sinusitis in adults
INFLUENZA
❖ Also called La Grippe of Flu
❖ Highly contagious disease
characterized by sudden
onset of pain and aches
with prostrations which lasts
for 1-6 days
❖ Causative agent is influenza
Description
virus A, B, C
❖ Incubation period is short,
usually 24-72 hours
❖ Clothing soiled with
discharges should be boiled
for 30 minutes before
laundry