Cardiovascular Lymh Diseases

ninth edition TORTORA  FUNKE  CASE
MICROBIOLOGY
an introduction
23 Part A
Microbial Diseases of
the Cardiovascular
and Lymphatic Systems
PowerPoint® Lecture Slide Presentation prepared by Christine L. Case
Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings
The Cardiovascular System
and Lymphatics System
 Blood: Transports nutrients to and wastes from cells.
 WBCs: Defend against infection.
 Lymphatics: Transport interstitial fluid to blood.
 Lymph nodes: Contain fixed macrophages.

The Lymphatic System
Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Figure 23.2
Sepsis and Septic Shock
 Sepsis: Bacteria
growing in the blood
 Severe sepsis:
Decrease in blood
pressure
 Septic shock: Low
blood pressure cannot
be controlled
Sepsis
 Gram-negative sepsis
 Endotoxins caused blood pressure decrease.
 Antibiotics can worsen condition by killing bacteria.
 Gram-positive sepsis
 Nosocomial infections
 Staphylococcus aureus
 Streptococcus pyogenes
 Group B streptococcus
 Enterococcus faecium and E. faecalis
Sepsis
 Puerperal sepsis (childbirth fever)

 Streptococcus pyogenes
 Transmitted to mother during childbirth by attending
physicians and midwives.

Bacterial Infections of the Heart
 Endocarditis: Inflammation of the endocardium

 Subacute bacterial endocarditis: Alpha-hemolytic
streptococci from mouth
 Acute bacterial endocarditis: Staphylococcus aureus
from mouth
 Pericarditis: Streptococci

Bacterial Infections of the Heart
Rheumatic Fever
 Inflammation of heart valves

 Autoimmune complication of Streptococcus pyogenes
infections
Tularemia
 Francisella tularensis,
gram-negative rod
 Transmitted from rabbits
and deer by deer flies.
 Bacteria reproduce in
phagocytes.
Brucellosis (Undulant Fever)
 Brucella, gram-negative rods that grow in phagocytes.

 B. abortus (elk, bison, cows)
 B. suis (swine)
 B. melitensis (goats, sheep, camels)
 Undulating fever that spikes to 40°C each evening.
 Transmitted via milk from infected animals or contact
with infected animals.

Anthrax
 Bacillus anthracis, gram-positive, endospore-forming

aerobic rod
 Is found in soil.
 Cattle are routinely vaccinated.
 Treated with ciprofloxacin or doxycycline.
 Cutaneous anthrax
 Endospores enter through minor cut
 20% mortality

Anthrax
 Gastrointestinal anthrax
 Ingestion of
undercooked food
contaminated food
 50% mortality.
 Inhalational anthrax
 Inhalation of
endospores.
 100% mortality.
Biological Weapons
 1346: Plague-ridden bodies used by Tartar army against Kaffa.

 1925: Plaque-carrying flea bombs used in the Sino-Japanese
War.
 1950s: U.S. Army spraying of S. marcescens to test weapons
dispersal.
 1972: International agreement to not possess biological weapons.
 1979: B. anthracis weapons plant explosion in the Soviet Union.
 1984: S. enterica used against the people of The Dalles.
 2001: B. anthracis distributed in the United States

Biological Weapons
Bacteria Viruses
Bacillus anthracis “Eradicated” polio and measles
Brucella spp. Encephalitis viruses
Chlamydophila psittaci Hermorrhagic fever viruses
Clostridium botulinum toxin Influenza A (1918 strain)
Coxiella burnetti Monkeypox
Francisella tularensis Nipah virus
Rickettsia prowazekii Smallpox
Shigella spp. Yellow fever
Vibrio cholerae
Yersinia pestis

Gangrene
 Ischemia: Loss of blood supply to tissue.

 Necrosis: Death of tissue.
 Gangrene: Death of soft tissue.
 Gas gangrene
 Clostridium perfringens, gram-positive, endospore-
forming anaerobic rod, grows in necrotic tissue
 Treatment includes surgical removal of necrotic
tissue and/or hyperbaric chamber.

Animal Bites and Scratches
 Pasteurella multocida
 Clostridium
 Bacteroides
 Fusobacterium
 Bartonella hensellae: Cat-scratch disease

Plague
 Yersinia pestis, gram-negative rod

 Reservoir: Rats, ground squirrels, and prairie dogs
 Vector: Xenopsylla cheopsis
 Bubonic plague: Bacterial growth in blood and lymph
 Septicemia plague: Septic shock
 Pneumonic plague: Bacteria in the lungs

Plague
Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Figures 23.10, 23.11
Relapsing Fever
 Borrelia spp., spirochete

 Reservoir: Rodents
 Vector: Ticks
 Successive relapses are less severe

Lyme Disease
 Borrelia burgdorferi
 Reservoir: Deer
 Vector: Ticks
Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Figures 23.13b–c
Lyme Disease
Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Figure 23.13a
Lyme Disease
 First symptom: Bull's

eye rash
 Second phase:
Irregular heartbeat,
encephalitis
 Third phase: Arthritis
Ehrlichiosis
 Ehrlichia, gram-negative, obligately intracellular

(in white blood cells)
 Reservoir: Deer,
rodents
 Vector: Ticks
Typhus
 Epidemic typhus
 Rickettsia prowazekii
 Vector: Pediculus humanus corporis
 Transmitted when louse feces rubbed into bite
wound

Typhus
 Epidemic murine typhus:

 Rickettsia typhi
 Vector: Xenopsylla cheopsis

Spotted Fevers (Rocky Mountain
Spotted Fever)
 Rickettsia rickettsii
 Measles-like rash except
that the rash appears on
palms and soles too.
Spotted Fevers (Rocky Mountain
Spotted Fever)
Tick Life Cycle
Human Herpes Virus 4 Infections
 Epstein-Barr virus (HHV–4)

 Infectious Mononucleosis
 Childhood infections are asymptomatic.
 Transmitted via saliva
 Characterized by proliferation of monocytes
 Burkitt’s lymphoma
 Nasopharyngeal carcinoma
 Cancer in immunosuppressed individuals, and
malaria and AIDS patients
Infectious Mononucleosis
Cytomegalovirus Infections
 Cytomegalovirus (Human herpesvirus 5)

 Infected cells swell (cyto-, mega-)
 Latent in white blood cells
 May be asymptomatic or mild
 Transmitted across the placenta; may cause mental
retardation
 Transmitted sexually, by blood, or by transplanted
tissue

Viral Hemorrhagic Fevers
Pathogen Portal of Reservoir Method of

entry transmission
Yellow Arbovirus Skin Monkeys Aedes
fever aegypti
Dengue Arbovirus Skin Humans Aedes
aegypti;
A. Albopictus
Marburg, Filovirus, Mucous Probably Contact with
Ebola, arenavirus membranes fruit bats; blood
Lassa other
mammals
Hantavirus Bunyavirus Respiratory Field mice Inhalation
pulmonary tract
syndrome
Ebola Virus
American Trypanosomiasis (Chagas’ Disease)
 Trypanosoma cruzi
 Reservoir: Rodents,
opossums, armadillos
 Vector: Reduviid bug
Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Figures 23.22, 12.33d
Toxoplasmosis
 Toxoplasma
gondii
Malaria
 Plasmodium vivax, P. ovale, P. malariae, P. falciparum

 Anopheles mosquito
Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Figure 12.31b
Malaria
Malaria
Malaria
Leishmaniasis
Disease Visceral Cutaneous Mucocutaneous Babesiosis
leishmaniasis leishmaniasis leishmaniasis
Fatal if Papule that Disfiguring Replicates in
untreated ulcerates and RBCs
scars
Causative Leishmania L. Tropica L. Braziliensis Babesia
agent donovani microti
Vector Sandflies Sandflies Sandflies Ixodes ticks
Reservoir Small Small mammals Small Rodents

mammals mammals
Treatment Amphotericin Amphotericin B Amphotericin B Atovaquone +
B or or miltefosine or miltefosine azithromycin
miltefosine
Geographic Asia, Africa, Asia, Africa, Rain forests of United States
distribution Southeast Mediterranean, Yucatan, South
Asia Central America, America
South America
Babesiosis
Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Figures 23.26, 12.32
Schistosomiasis
Schistosomiasis
 Tissue damage (granulomas) in response to eggs

lodging in tissues
S. haemotobium Granulomas in urinary Africa, Middle East

bladder wall
S. japonicum Granulomas in intestinal East Asia
wall
S. mansoni Granulomas in intestinal African, Middle East,
wall South American,
Caribbean
Swimmer’s itch Cutaneous allergic U.S. parasite of
reaction to cercariae wildfowl

Schistosomiasis
Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Figure 23.27a
Schistosomiasis
Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Figure 23.27b

Cardiovascular Lymh Diseases

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ninth edition TORTORA  FUNKE  CASE

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

 Puerperal sepsis (childbirth fever)

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

 Endocarditis: Inflammation of the endocardium

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

 Inflammation of heart valves

 Brucella, gram-negative rods that grow in phagocytes.

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

 Bacillus anthracis, gram-positive, endospore-forming

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

 1346: Plague-ridden bodies used by Tartar army against Kaffa.

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

 Ischemia: Loss of blood supply to tissue.

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

 Yersinia pestis, gram-negative rod

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

 Borrelia spp., spirochete

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

 First symptom: Bull's

 Ehrlichia, gram-negative, obligately intracellular

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

 Epidemic murine typhus:

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

 Epstein-Barr virus (HHV–4)

 Cytomegalovirus (Human herpesvirus 5)

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

Pathogen Portal of Reservoir Method of

 Plasmodium vivax, P. ovale, P. malariae, P. falciparum

Reservoir Small Small mammals Small Rodents

 Tissue damage (granulomas) in response to eggs

S. haemotobium Granulomas in urinary Africa, Middle East

Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings

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