GROUP 6

Dizon, Lloyd
Garcia, Andre
Martija, Sharon
Salalila, Jeric
Yabut, Stephanie
PRIONS
• Protein aggregates that are known to cause
CNS disease
• Essentially misfolded proteins that
aggregate in the CNS and cause progressive
neurodegeneration that leads to death
• KURU – a prototype that is now a extinct
disease of the Fore people of New Guinea
transmitted by cannibalism
PRION PROTEIN (PrP)

• Exists in a normal isoform and in a

pathogenic form that can transmit disease
• Aggregate into prion rods
• Highly resistant to the normal methods of
sterilization
• TRANSMISSION: via surgical instruments or
electrodes that are implanted in nervous
tissues
KNOWN PRION DISEASES
Sporadic, Familial and Iatrogenic
Creutzfeldt-Jakob Disease
• CJD – rapidly progressive neurodegenerative
disorder characterized by myoclonus, behavior
changes, and dementia
• 3 Types:
• sCJD: 1/1,000,000 frequency, most
common, onset at 65 years of age
• fCJD: associated with a variety of mutations
in the PRNP gene coding for prion protein
• iCJD: Rare, transmitted through
transplanting tissues such as cornea and
dura mater
 New Variant Creutzfeldt-Jakob Disease
• vCJD
• Occurs mainly in young adults, 26 years of age
• Predominant in psychiatric signs and symptoms
• One of the infamous emerging infectious diseases of
the last decades
• Associated bovine spongiform encephalopathy
(madcow disease)
• Underscore the interrelatedness of animal and
human infectious agents.
• Prion disease epidemic leads to the use of animal
products in feeds for domestic ungulates like in
cattle herds in many countries like UK
• Patients were homozygous for methionine at codon
129 of the PRNP gene
• Same homozygous residue is also present in most
but not all cases of sCJD.
 Bacteria

• Smallest living cells (0.1-10 microns)

• Two types of bacterial cell wall
Gram (+) – Blue to Violet in color
- Contains teichoic acids and thick
peptidoglycan layer
Gram (-) – Red to Pink in color
- Contains Lipopolysaccharide known as
Endotoxin (Potent mediator of shock)
Bacteria can also classified by:
• CAPSULE
(Encapsulated or Capsulated)
• SHAPES
(Cocci, Bacilli, Spiral, etc..)
• ARRANGEMENT
(Clusters, Chains, etc..)
Pyogenic Gram-Positive Cocci
• Staphylococcus aureus

- One of the most common bacterial

pathogen
- Normal biota of the skin
- Causes suppurative infection of the
skin, joints, bones leading to infective
endocarditis
Pathogenesis
• S. aureus infections begins as localized infection
producing CELLUTIS AND ABSCESS filled with pus
and bacteria equipped with toxins and destructive
enzymes
• Then invades beyond the initial site, spreading by
the BLOOD and LYMPHATICS to almost any location
of the body
• BONES, JOINTS, and HEART VALVES most
common sites of metastatic S. aureus
Clinical Features
• Folliculitis
- Mild inflammation of hair follicle or oil
gland
• Furuncles (Boils)
- Extension of folliculitis
• Carbuncles (cluster of boils)
- Developed from furuncles, larger
folliculitis
• Styes
- boils around sebaceous gland of the
eyelid
• Scalded skin syndrome
- Affects children under 3 years old, who
present with a sun-burn like rash
- Also known as Ritter’s disease
• Osteomyelitis
- Affects usually bones of the legs among
3-10 year old boy who has history of
trauma (Acute osteomyelitis)
- Ages 50 year old adult (Chronic
osteomyelitis)
• Respiratory tract infections
- Mostly affects infants under 2 years old
(especially 2 months old)
- Ulceration of upper airway, scattered
foci pneumonia, pleural effusions,
empyema and pneumothorax
• Bacterial arthritis
- Septic arthritis
- Mostly affects 50-70 years old
• Toxic shock syndrome
- Mostly affects menstruating women,
who has high fever, nausea, vomiting,
diarrhea, and myalagias
- Associated with the use of
hyperabsobent tampons
• Staphylococcal food poisoning
- Source is the affected food handlers
- Begins less than 6 hours after meal
- Nausea and vomiting begin to resolve
after 12 hours
• Steptococcus pyogenes
- Group A Lancefield
- Part of endogenous flora of the
oropharynx and the skin
- Most common cause of bacterial
pharyngitis (Strep Throat)
Pathogenesis
• S. pyogenes attaches to the epithelial cells
• Bacterium produces hemolysins, DNAase,
hyaluronidase and streptokinase which allow
to damage and invade human tissues
• M protein associated with virulence and
prevents complement decomposition, and
protects the bacteria from being
phagocytized
• Invading organism elicits an acute
inflammatory response, producing an
exudate of neutrophils in tonsillar fossae
Infections of S. pyogenes
• Primary
-Erysipelas, Aphthous ulcer, Pharyngitis,
Impetigo, Pneumonia, Puerperal sepsis

• Secondary
- Meningitis, Subacute bacterial
endocarditis, septicemia
• Non-infectious complications
- Rheumatic fever, Scarlet fever,
Glomerulonephritis
• Streptococcal Pharyngitis (Strep throat)
- Associated with fever, malaise,
headache and elevated leukocyte count
- Spreads by direct contact with oral or
respiratory secretions
- Primarily affects children and
adolescents
- May lead to rheumatic fever or acute
poststreptococcal glomerulonephritis if left
untreated
• Scarlet fever
- Describes as punctate red rash on skin
and mucous membranes
- Rash is associated with production of
bacterial erythrogenic toxin
Erysipelas
- It is an erythematous swelling of the
skin
- A diffuse, edematous, acute
inflammatory reaction in epidermis and
dermis extends to subcutaneous
tissues
• Impetigo (pyoderma)
- Intraepidermal infection of the skin
caused by S. aureus or S. pyogenes
- Most commonly seen in children
- Minor trauma or insect bite is the
inoculation of the bacteria into the skin,
where they form a intraepidermal pustule,
which ruptures nad leaks a purulent exudate
• Streptococcal Cellulitis
- Infection on the loose connective tissue
of the deeper layers of dermis
• Streptococcus pnemoniae
- Aerobic, Gram (+) diplococcus,
termed as pneumococcus
- Causes pyogenic infections,
primarily involving the lungs, middle ear,
sinuses, and meninges
- Commensal organism in
oropharynx
Pathogenesis
• Pneumococcal sinusitis and otitis media are
usually precede by a viral infection such as
common cold, which injured the ciliated
epithelium and fills affected air spaces with
fluid
• Polysaccharide capsule prevents activation of
the complement pathway thereby blocking
C3b
Bacterial Infection of
Childhood
 Corynebacterium diphtheriae

• General characteristics:
• Small
• Pleomorphic
• Gram-positive rod
• appear in short chains (“V”
or “Y” configurations) or in
clumps resembling “Chinese
letters”
Pathogenesis and Pathology
  Spread by droplet infection or
hand-to-mouth contact.
 Site of infection: Tonsils or
Pharynx
 Causes cell necrosis and
pseudomembrane
(inflammation)
Via toxin production;
-may lead to cardiac and
neurologic disturbances
• Diptheriae toxin produces by some bacterial strains
is absorbed systematically and acts on tissues
throughout the body.
Heart – myocardium displays fat droplets in the
myocytes and focal necrosis
Nerves
Kidneys
are most susceptible to damage
Bordatella pertussis
• Small
• Gram-negative
coccobacillus
• causative agent of
“whooping cough”
(pertussis)
• Whooping cough
-Is a prolonged upper respiratory
tract illness (4-5 weeks)
-Characterized by paroxysmal
coughing, followed by a long,
high-pitched isnspiration, the
“whoop”, which gives the dse its
common name.
B. pertussis

• MOT: spreads from person to person (infected

respiratory aerosols)
• Disease of children younger than the age of 5
years
 Pathogenesis
• The bacteria attach to the respiratory
cilia, produce toxins that paralyze the
cilia, and cause inflammation of the
respiratory tract, which interferes with
the clearing of pulmonary secretions.
• Pertussis antigens appear to allow the
organism to evade host defenses. Despite
remarkable lymphocytosis, chemotaxis is
impaired.
 Haemophilus influenzae
• Small
• Gram-negative
• Pleomorphic bacteria
(coccobacilli)
• Capsulated
• Aerobic
• Require enriched media
usually containing blood
Pathogenesis
• Serotype B is the most important
pathogen under this specie
• Allows them to evade phagocytosis and
bacteremic infections are common
• Meningitis in children
• Infections involved the middle ear,
sinuses, facial skin, epiglottis, meninges,
lungs & joints
• MOT: respiratory droplets and secretions
Clinical features
• H.influenzae meningitis
-characterized by predominantly acute, inflammatory
leptomeningeal infiltrates
-Involving the subarachnoid space
• H.influenzae pneumonia
-complicates chronic lung disease
-followed viral infection of the respiratory tract
-alveoli filled with neutrophils
-bronchial epithelium is necrotic and infiltrated by
macrophage
• H. influenzae epiglottitis
-affects chldren (2-7 years old)
-swelling and acute inflammation of the epiglottis, ar
folds and pyriform sinuses
-death occurs from obstruction of URT
Neisseria meningitidis
• Gram-negative (cocci)
• Paired
• Aerobic
• Bean-shaped
N. meningitidis
• Commonly termed meningococcus
• Produces disseminated blood-borne infections
accompanied by shock and profound
disturbances in coagulation
• MOT: Respiratory droplets
• Fatal cases are more common in less
developed countries
Pathogenesis
Airborne droplet of N.meningitidis

Enter into nasopharynx & attach to epithelial

cell of nasopharynx

Invade mucous membrane (Colonize)

Enters to the blood stream CNS

Through pili, they attach to the meninges

Meningitis
ENTEROPATHOGENIC BACTERIAL
INFECTIONS
 Escherichia coli
• Important potential • It can be aggressive
when it gains access to
pathogen in humans
sterile body sites such as
• common isolate from urinary tract, meninges
colon flora
• IMMUNOCOMPROMISE
D HOSTS produces
pneumonia and sepsis
• NEWBORNS produces
sepsis and meningitis
E. coli Diarrhea
ENTEROHEMORRHAGIC E. coli (EHEC
serotype 0157:H7)
• associated with Hemolytic Uremic Syndrome
(HUS) and Thrombotic Thrombocytopenic
Purpura(TTP)
• starts with a watery diarrhea then progresses
to bloody diarrhea.
• SOURCE OF INFECTION: ingestion of
contaminated meat, milk, vegetables or other
food products contaminated with bovine feces
• E. coli adheres to the colonic mucosa and
elaborates an enterotoxin virtually identical to
Shiga toxin which destroys epithelial cells
ENTEROINVASIVE E. coli (EIEC)

• produce dysentery with bowel penetration,

invasion and destruction of intestinal
mucosa(specifically distal ileum and colon)
• dysentery-like/Shigella-like infection
• patients exhibit abdominal pain, fever, tenesmus
and bloody diarrhea
E. coli UTI

• most common in sexually active women and

persons of both sexes who have structural or
functional abnormalities of the urinary tract
PATHOGENESIS
• gains access to the sterile proximal urinary tract
by ascending from the distal urethra.
• UROPATHOGENIC E. coli- have specialized
adherence factors on the pili which enables them
to bind the uroepithelium
• produces acute inflammatory infiltrate at site of
infection in the bladder mucosa->kidney=
pyelonephritis
SALMONELLA
• most serious pathogenic enterobacteria:
• enteric fever (typhoid fever)
• gastroenteritis (food poisoning)
• acquired by ingestion of contaminated food
• transmitted by human carriers
SALMONELLA ENTEROCOLITIS
• acute, self limited, gastrointestinal illness
• symptoms include nausea, vomiting, diarrhea and
fever
• commonly called salmonella food poisoning
• once infected, it can spread from person to person
by fecal-oral route that is common among small
children in daycare settings or within families.
TYPHOID FEVER
• acute systemic illness caused by S. typhi
• acquired from infected patients or chronic carriers
and is spread by ingestion of contaminated food
and water
• It becomes hypertrophic when S. typhi attaches to
and invades the ileum in areas overlaying Peyer
patches
SHIGELLOSIS • Produces Shiga toxin
that causes severe
• characterized by a watery diarrhea
necrotizing infection of the
distal small bowel and colon
• S. Dysenteriae- most
virulent
• self-limited disease
• INFECTIVE DOSE: 10-100
viable bacilli
• Proliferates rapidly in the
small bowel and attaches to
enterocytes
CHOLERA
• Severe diarrheal disease
caused by Vibrio
cholerae
• Acquired by ingesting V.
• Proliferates in the lumen cholerae from fecally
of the small intestine contaminated food or water
and causes profuse
watery diarrhea and
rapid dehydration
PATHOGENESIS

V. Cholerae
Activation of ion
accumulates in Increase cAMP
channels
stomach

NaCl influx into

G-protein stuck in intestinal lumen to
Produces toxin
“on” position drag water into
lumen

Toxin will bind to G-

Inactivation of Lead to watery
protein coupled
GTPase diarrhea
receptor
 Campylobacter jejuni
• Spread from person
• “Traveler’s diarrhea” to person by fecal-oral
• most common cause of contact
Bacterial diarrhea worldwide
• Campylobacter infections
attributed to direct contact
with animals and indirectly
through consumption of
contaminated water and
dairy products and
improperly cooked poultry
Clostridium
• Gram (+), spore forming, anaerobic bacilli
• Found in soil
• Mostly from exogenous sources
• C. perfringens, C. tetani, C. botilinum, C.
difficile
Clostridium perfringens
• Gas gangrene
• Spread through contaminated wounds
• Clinical features: muscles become necrotic,
contains gas
• Spreads rapidly to adjacent tissue
• Necrosis is caused by myotoxins which destroy
membranes of muscle cells, leukocytes and
erythrocytes
Clostridium perfringens
• Food poisoning
• Spread by ingestion of spores formed when
food (sauces, meats) are allowed to stand
unrefrigerated
• Clinical features: generally benign, diarrheal
disease usually lasting less than 24 hrs
• the exotoxins cause loss of intracellular ions
and fluid into the gut
Clostridium tetani
• Tetanus
• Spread by skin penetration by contaminated
matter
• Clinical features: muscle spasm, odd facial
expressions
• The toxin present acts on CNS to produce
prolonged muscle spasms
• Lockjaw, risus sardonicus, difficulty in
breathing
Clostridium botulinum
• Botulism
• Spread by ingestion of spores usually found in
canned vegetables, cured meats (ham), preserved
food, honey or corn syrup
• Clinical features: descending weakness or
paralysis, floppy baby syndrome
• Botulinum toxin is a neurotoxin that acts on the
peripheral nervous system and causes
neuroparalytic illness
Clostridium difficile
• Pseudomembranous colitis
• can be spread from person-to-person by touch
or by direct contact with contaminated objects
• clinical features: diarrhea, inflammation of
bowel, bowel necrosis
• the enterotoxin disrupts the normal bowel
flora and causes diarrhea