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* Normal Microbiota of the Respiratory system

Upper respiratory system lower respiratory system

Normal microbiota supress pathogens is nearly sterile .

by

② competing for nutrients .

② producing inhibitory substances .

* Microbial diseases of the upper respiratory system .

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pharyngitis sorethroat.ws-1W .

Laryngitis p.bg/o.W-1.CcommoncoldIJ1b..--.sw&tasH-iw-

Tonsillitis

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Epiglottitis Most life -

threatingdiseaseofthe upper respiratory system

.
Diseases of the Upper Respiratory System

Prevention /
Diagonosis treatment

Group A streptococci (GAS) Local inflammation, fever, tonsillitis, rapid antigen

(Streptococcus pyogenes) enlarged lymph nodes detection tests

Prevented by:
DTaP vaccine
(Gram-positive rod; pleomorphic) forms skin
- Ulcer.
*Diphtheria toxoid

*Streptococcus pneumoniae
Infection of the middle ear
* Nonencapsulated Haemophilus influenzae
– Formation of pus puts pressure on
*Moraxella catarrhalis
the eardrum
*S. pyogenes *respiratory syncytial viruses

Over 200 different viruses Sneezing, nasal secretion, congestion Relief via:
*Can lead to laryngitis and otitis media cough suppressants
Antibiotics are of no use. D68 (EV-D68)
*Not accompanied by fever and antihistamine
Thrive in temperatures lower
*

than body temperature

*
(30–50%)

④ Notes 8
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* Resistant to phagocytosis .

streptokinase lyse clots

Streptococcus pyogens
.

* : .

*
* streptolysins : cytotoxic .

forms a membrane in the throat Lysogenized bacteria lid www.s-W-l-5.t

Corynebacterium diptheriae
.

*
-

tough produce :

grayish Exotoxin
from fibrin and dead tissue .

Blocks passage ofairtothe lungs -

circulates in the blood , damage the heart and kidney .

* otitis Media ; common in childhood due to smaller auditory tube

.

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"‫سبَُلن َا‬ َِّ ‫"َوَما َلن َآ أ ََّال َنت ََوَّكَل َعَلى ٱ‬
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Bacterial Diseases of the Lower Respiratory System

11
Bacterial Pneumonias Caused by Infects

Typical pneumonia S. pneumoniae •

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Atypical pneumonia other microorganisms -

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Lobarpneumonia the lobes of the lungs .

Bronchopneumonia the alveoli adjacent to

the bronchi.

Pleurisy Pleural membranes inflamed

 Bacterial Diseases of the Lower Respiratory System Cont . - .

④ SAI! Tb D= ix.⇐Hog : -4--6 ④

Bacteria Description Diseases

Bordetella pertussis Gram-negative coccobacillus Pertussis (Whooping Cough)

Mycobacterium tuberculosis Acid-fast rod; obligate aerobe Tuberculosis

– 20-hour generation time
– Lipids in the cell wall make it
resistant to drying and antimicrobials.

Mycobacterium bovis Bovine tuberculosis; < 1% of

U.S. cases

Mycobacterium avium- Infects people with late-stage HIV

intracellulare infection
complex

S. pneumoniae Gram-positive; encapsulated

diplococci
– 90 serotypes

Haemophilus Influenzae Gram-negative coccobacillus

Mycoplasma pneumoniae No cell wall Mycoplasmal Pneumonia

Also called primary atypical
pneumonia or walking pneumonia

Legionella pneumophila Aerobic, gram-negative rod Legionellosis

Grows in water and air conditioning,
biofilms, and waterborne amebae

Chlamydophila psittaci I
Gram-negative intracellular bacterium Psittacosis (Ornithosis)

Chlamydophila pneumoniae Chlamydial Pneumonia

Obligately parasitic, intracellular

Coxiella burnetii Q Fever
gammaproteobacteria
 Tuberculosis Leading cause of death for those with HIV
The cause :

The cause :
The main cause: Other causes
Mycobacterium tuberculosis * Mycobacterium bovis
- Bovine tuberculosis; < 1% of U.S. cases
Mortality rate:
* 10 million develop TB annually; 2 million die * Mycobacterium avium-intracellulare complex
*1⁄3 of the world's population has latent TB. - Infects people with late-stage HIV infection

Pathogenesis of Tuberculosis: Diagnosis

Inhaled organisms phagocytized by alveolar macrophages.

Mycolic acids in the cell wall stimulate an inflammatory response. Tuberculin skin test Rapid blood test for

Delayed hypersensitivity IFN-γ and Nucleic acid

Organisms are isolated in walled-off tubercle induration amplification test
(NAAT)
TB bacterium.
Higher specificity
Tubercles heal and become calcified (Ghon's complexes) purified protein and less cross-
reactivity
Tubercle breaks down T cells react with protein

releasing bacteria into

the lungs Positive reaction means

cardiovascular a current or previous

infection.
lymphatic systems Followed by

X-ray or CT exam, acid-fast staining of

Miliary tuberculosis: disseminated infection sputum, and culturing of bacteria

Treatment of Tuberculosis
Minimum of 6 months of drug therapy due to slow growth and dormancy
First-line drugs Second-line drugs Multi-drug-resistant (MDR) strains
resistant to first- line drugs

BCG vaccine Extensively drug-resistant (XDR) strains

Not widely used in the United States resistant to second-line drugs
due to questionable effectiveness
Bacterial Diseases of the Lower Respiratory System Cont . - .

Prevention
Infected alveoli of the lung fill conjugated
with fluids and RBCs; interferes pneumococcal
with oxygen uptake vaccine
in urine .

Risk group: The Hib vaccine

Children under 5 and reduced the incidence
adults over 65 (X and V factors) in children by 99%

*“Fried-egg” appearance
Common in children
and young adults on media.
*PCR.

high fever and cough Transmitted by inhaling

– Similar to symptoms of Pontiac
Legionnaires’ disease fever
Fever, headache, chills,
disorientation
aerosols; not transmitted
person to person
Transmitted to humans by growth of bacteria in eggs,
intracellular
elementary bodies from bird cell culture or
droppings transmitted through air. PCR.

Transmitted person to
person.
Possible association
with artherosclerosis

High fever, muscle aches,

Acute Q fever
headache, coughing. -Transmitted to farm animals
from tick bites
– Transmitted to humans from
Q Fever the inhalation of aerosols
from animals and
unpasteurized milk.

Endocarditis (may occur years

Chronic Q fever
after infection)

Produces a capsule
Allows attachment to ciliated
Pertussis cells in the trachea
Bordetella DTaP vaccine
(Whooping Tracheal cytotoxin of cell wall
Cough) pertussis damages ciliated cells.
shuts down the ciliary escalator
Pertussis toxin enters the bloodstream.

Stage 1: catarrhal stage, like the common cold

Ciliated Cells of the Respiratory System Infected with Bordetella Pertussis

Stage 2: paroxysmal stage, violent coughing, gasping

for air ④ IDEAS
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Stage 3: convalescence stage, may last for months

④ 1-51 E#£É④
 Viral Diseases of the Lower Respiratory System

SARS-associated
as a complication of Few labs are equipped
coronavirus (SARS)
Viral influenza, measles, or to test clinical samples Middle East respiratory
chickenpox. properly for viruses syndrome coronavirus
pneumonia (MERS-CoV)

Causes cell fusion Almost all children are Most common viral
Respiratory Respiratory (syncytium) in cell infected by age 2
serological test for respiratory disease in
Syncytial Virus viruses and
Syncytial Virus (RSV)
culture
– 14,000 deaths
infants and life-
Coughing and antibodies. threatening
(RSV) disease wheezing for more than annually, mostly in pneumonia in older
a week. older adults . adults .

Influenzavirus *Avian, *swine, and

*Chills, *fever, *3,000 to 50,000 deaths in Difficult to diagnose
Influenza Contains eight RNA *headache, and the United States annually from clinical *mammalian strains
symptoms Swine serve as
(Flu) segments and an outer *muscle aches
“mixing vessels” for
*No intestinal *1% mortality; usually the
lipid bilayer. new strains
symptoms very young and very old.

NAJI ! '¥µñEgIµ Influenza HEA 8%-4 *

Neuraminidase (NA) spikes

Help the virus separate from the infected cell

Hemagglutinin (HA) spikes

Recognize and attach to host cells

osi.SI#Hbo--1..-m-I*Ws&1*O

Antigenic shift .
Antigenic drift

Changes great enough to evade most immunity, Minor antigenic changes in HA and NA
reassortment of the eight RNA segments

Lead to pandemics. Allow the virus to elude some host immunity

•
Antigenic shifts ! Jaws ↳JI @

☒ Prevention A multivalent or polyvalent vaccine is designed to

immunize against two or more strains of the same
Multivalent vaccine for the most important strains microorganism, or against two or more
microorganisms *

④ Composition of the vaccine determined annually by the identification of circulating viruses

*Labor-intensive to produce
*Does not provide long-term immunity
 Fungal Diseases of the Lower Respiratory System

|
Fungi Description Diseases

Histoplasma capsulatum *Dimorphic fungus Histoplasmosis

*

unijmultio.SI
*Yeast-form grows intracellularly in
macrophages.

Coccidioides immitis *Dimorphic fungus. Coccidioidomycosis

*Form a spherule filled with " "
" " " (Valley fever or San
endospores in tissues Joaquin fever)

Blastomyces dermatitidis *Dimorphic fungus Blastomycosis (North American

*Grows in soil Blastomycosis)

aspergillosis
.

Aspergillus fumigatus *Airborne conidia;

*grows in compost piles

Rhizopus and Mucor *Mold spores. *Predisposing factors:

– Immunocompromised state.
– Cancer.
– Diabetes.

☒ GIGI ! ftp.s.j.UII-iysblfungiJII-i
Fungal Diseases of the Lower Respiratory System

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"‫سبَُلن َا‬ َِّ ‫"َوَما َلن َآ أ ََّال َنت ََوَّكَل َعَلى ٱ‬
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Malak&Manar121