Overview of Infectious Diseases

PABRNMAN CxXVII
• Microbial intoxication - ingestion of a
toxin produced outside the body ( in
vitro ) by the pathogen
• Infectious disease - caused by
colonization of some body site by a
pathogen
 Infectious diseases of the skin (p320 17-
1)
• Epidermis - superficial portion of skin
• Dermis - inner layer of skin
• Dermatitis
• Sebaceous glands - secretes sebum
• Folliculitis- inflammation hair follicle
• Sty or stye - inflammation of sebaceous
gland opens into follicle of eyelash
• Furuncle – boil- localized pyogenic infection of
the skin (fr. folliculitis)
• Carbuncle – deep-seated pyogenic inf. of the
skin (arising fr. coalescence of furuncles)
Types of surface lesions - p 321 fig. 17-2
• Macule - measles- surface lesion that is
neither raised nor depressed
• Papule – chicken pox - surface lesion that
is firm and raised
• Vesicle – blister/small fluid-filled sac
(chicken pox and shingles)
• Pustule – pus-filled surface lesions
Infectious diseases of the ears (p322 fig 17-3)

• Otitis media - inflamation of the middle

ear
• Otitis externa - inflamation of outer ear
canal

• Mode of entry
o Eustachian tube, throat, pharynx
o External ear
o Via blood or lymph
 Infectious diseases of the eyes p323 fig 17-4
• Conjunctiva - thin tough lining that
covers the inner wall of the eyelid and
the sclera
• Conjunctivitis -
• Keratitis - inflamation of the cornea
• Keratoconjunctivitis- inflamation that
involve both the cornea and the
conjunctiva
• Retinitis - inflamation that involves the
retina. often caused by viral
Infectious diseases of the respiratory system - p324-
fig 17-5
• URT – paranasal sinuses, nasopharynx,
oropharynx, epiglottis, and larynx.
• LRT – trachea, bronchial tubes, alveoli
• URTI – colds & sore throats are more
common than LRTI
• URTI – predisposes patients to sinusitis,
otitis media, bronchitis, and pneumonia
• LRTI – the most common cause of death
from infectious disease
 infectious diseases of the respiratory
system

• Bronchitis – respiratory viruses

• Bronchopneumonia – combination of bronchitis and
pneumonia
• Epiglottitis – frequently caused by Haemophilus
influenzae type b (Hib)
• Laryngitis
• Pharyngitis – sore throat or “strep throat”; caused
by Streptococcus pyogenes (most “publicized”;
most common cause are viruses
• Sinusitis – most common cause are S. pneumoniae
and H. influenzae; less common causes are S.
pyogenes, Moraxella catarrhalis, and S. aureus
 Typical vs Atypical Pneumonia

• Typical Pneumonia
o Chest pain, dyspnea (SOB), fever, chills, &
productive cough (purulent)
o Less common symptoms: anorexia, headache,
nausea, diarrhea, & vomiting; x-ray
abnormalities are proportional to the physical
symptoms
o Common causes: S. pneumoniae, H.
influenzae, & S. aureus; viruses – influenza
virus type A & B, parainfluenza viruses, &
respiratory syncytial virus (RSV)
o Other causes: Legionella pneumophila,
Mycoplasma pneumoniae, Chlamydophila
pneumoniae, & other Gram negative bacilli
• Atypical Pneumonia

o More insidious (slower) onset

o Headache, cough with little sputum, & myalgia
o X-ray abnormalities are usually greater than
physical symptoms
o Common causes: M. pneumoniae, C.
pneumoniae, & L. pneumophila; viruses –
influenza viruses, RSV, & adenoviruses
o Other causes: Chlamydophila psittaci
(bacterium), Pneumocystis jiroveci (fungus),
varicella-zoster virus, & parainfluenza virus
o Pathogens can produce either typical or
atypical pneumonia
Infectious diseases of the oral region - p325 fig 17-6

• Most infections are caused by members of

the indigenous oral microflora.
• Sometimes one member acting
independently and other times several
members acting together.
• Streptococcus (S. salivarius, S. mitis, S.
sanguis, S. mutans) and Actinomyces
spp., often interact to protect the oral
surfaces, in other circumstances, they are
involved in oral disease.
• Dental caries – most common cause is S.
mutans
• Gingivitis
• Periodontitis – inflammation of the
periodontium (tissues that surround and
support the teeth, including the gingiva
and supporting bone)
• Periodontal diseases – gingivitis,
periodontitis, & trench mouth
• Oral infections result from a
combination of:
o Unique microbial population
o Reduced host defenses
o Improper diet
o Poor dental hygiene
• Oral infections are the consequence of
at least four microbial activities:
o Formation of dextran (polysaccharide)
o Acid production by lactic acid-producing
bacteria
o Deposition of calculus by Actinomyces
o Secretion of inflammatory substances
(endotoxin) by Bacteriodes species
• Periodontal diseases can be prevented
by:
o Maintaining good health
o Proper oral hygiene
o Adequate diet without sugars
o Regular fluoride treatments
• Severe gingivitis and periodontitis
require professional care by specially
trained dentist called a periodontist.
Infectious diseases of the GIT - p326 fig 17-7

• Colitis
• Diarrhea
• Dysentery – frequent watery stools,
abdominal pain, fever, & dehydration; the
stool may contain blood or mucus
• Enteritis
• Gastritis
• Gastroenteritis
• Hepatitis
 Infectious diseases of the GUT

• Upper UTI – nephritis or pyelonephritis

and ureteritis
• Lower UTI – cystitis, urethritis, prostatitis
• UTIs – may be caused by any of a variety
of microorganisms, introduced by:
o Poor personal hygiene
o Sexual intercourse
o Insertion of catheters
o Other means
• Cystitis – most common type of UTI
o Most common cause is E. coli
o Other common causes: Klebsiella, Proteus,
Enterobacter, Pseudomonas, Enterococcus,
Staphylococcus saprophyticus,
Staphylococcus epidermidis, & Candida
albicans
• Nephritis
• Pyelonephritis – inflammation of the renal
parenchyma
o Most common cause is E. coli
o Preceded by cystitis
o Bacteria may gain access via bloodstream
• Ureteritis
• Urethritis – usually transmitted sexually
o Most common cause is Chlamydia
trachomatis
o Other causes: N. gonorrhoeae, ureaplasmas,
& mycoplasmas
o Urethritis not cause by N. gonorrhoeae is
often referred to as nonspecific urethritis
(NSU) or nongonococcal urethritis (NGU)
• Prostatitis – most often not an infectious
disease; may be caused by bacterium,
virus, fungus, or protozoa
 Infections of the genital tract
• Destruction of some members of the
vaginal microflora can lead to an
overgrowth (superinfection) of other
members.
• Lactobacillus, Staphylococcus,
Streptococcus, Enterococcus, Neisseria,
Clostridium, Actinomyces, Prevotella,
diphtheroids, enteric bacilli & Candida
• Bartholinitis
• Cervicitis
• Endometritis
• Epididymitis
• Pelvic inflammatory disease (PID)
o Inflammation of the fallopian tubes
o Also known as salpingitis
• Vulvovaginitis
• Vaginitis
o 3 most common causes: C. albicans (a
yeast), Trichomonas vaginalis (a protozoan),
and a mixture of bacteria referred to as
bacterial vaginosis (BV)
 STDs of the Genital Tract
• STD formerly called venereal disease (VD)
• STDs affect not only the genital tract, but
can also involve the skin, mucous
membrane, blood, lymphatic and digestive
systems, and many other anatomic sites.
• AIDS, chlamydial and herpes infections,
gonorrhea, and syphilis
• Hepatitis B, amebiasis, and gardiasis can
be transmitted by sexual activities
 Infectious diseases of the circulatory system

• Blood normally is sterile.

• Endocarditis
• Myocarditis
• Pericarditis
• Bacteremia
• Transient bacteremia
o Often results from dental extractions, wounds,
bites, & damage to intestinal, respiratory, or
reproductive tract mucosa
• Septicemia – chills, fever, and prostration
• Test routinely performed on donor
blood in the US:
o Treponema pallidum antigen (syphilis)
o HIV-1, HIV-2, HIV p24 antigen
o HTLV-1 antibody (human T-cell lymphotrophic
virus type 1)
o Hepatitis B surface antigen
o Hepatitis B core antibody
o Hepatitis C antibody
• Lymphadenitis – inflamed & swolen
lymph nodes
• Lymphadenopathy – diseased lymph
nodes
• Lymphangitis – inflamed lymphatic
vessels
 Infectious diseases of the CNS
• Nervous system is sterile.
• Microbes gain access to the CNS
through:
o Trauma (fracture & medical procedure)
o Via blood & lymph to the CSF
o Peripheral nerves
• Encephalitis
• Encephalomyelitis
• Meningitis
• Meningoencephalitis
• Myelitis
 Meningitis
• Can be caused by:
o Ingestion of poisons, injection or ingestion of
drugs, a reaction to a vaccine, or a pathogen
o If caused by pathogen: virus, bacterium,
fungus, or protozoa
• Viral meningitis – “aseptic meningitis”
o Virus may infect or cause immune reaction
o Chicken pox, measles, rubella viruses
o Enteroviruses, coxsackieviruses, echoviruses,
mumps virus, arboviruses (arthropod-borne
viruses), poliovirus, adenoviruses, measles
virus, herpes simplex, & varicella virus
o Viral meningitis is less serious than bacterial
meningitis
• Bacterial meningitis
o Most common cause is H. influenzae
(children), N. meningitidis (adolescents), S.
pneumoniae (elderly)
o Less common causes: S. aureus, P.
aeruginosa, Salmonella, and Klebsiella.
o Major causes of neonates: Streptococcus
agalactiae (Group B, beta-hemolytic
streptococci), E. coli, and other members of
the family Enterobacteriaceae, & Listeria
monocytogenes
• S/Sx
o Fever, headache, stiff neck, sore throat, and
vomiting
o Neurologic symptoms: dizziness, convulsions,
minor paralysis, & coma; death in few hours
• Parasites that can cause CNS diseases
include free-living amebas & Toxoplasma
& Trypanosoma spp.
• Fungal meningitis – Cryptococcus
neoformans
• CNS diseases cause by toxins – bacterial
neurotoxin & botulinal toxin &
tetanospasmin
 Opportunistic Infections
• Aspergillosis & other mould infections
– can become systemic
• Candidiasis – mouth, throat, vagina; can
become systemic
• Cytomegalovirus (CMV) infections –
eye disease that can lead to blindness
• Herpes simplex virus infections – cold
sores, genital herpes
• Malaria
• Mycobacterium avium complex –
recurring fevers, problems with digestion,
& serious weight loss
• Pneumocystis pneumonia – fungal
infection that can cause a fatal pneumonia
common to AIDS patients
• Toxoplasmosis – protozoal infection of
the eyes and brain
• Tuberculosis
 Emerging and Reemerging Infectious
Diseases
• “New” (previously unknown) infections
continue to emerge
• Infectious diseases thought to be
eradicated continue to reemerge.
• Emerging diseases: avian flu, ebola
hemorrhagic fever, HIV & AIDS, SARS,
• Reemerging disease: cholera, dengue
fever, diphtheria, malaria, TB, yellow fever,
MRSA
 Causes of Emerging Diseases
• Changes in human demographics &
behavior
• Ecological changes such as dams,
deforestations, & climate change
• Increased international travel
• Increased exposure to exotic animals
• Misuse of antibiotics & other measures
• Breakdown of public health measures
 Causes of Reemerging Diseases

• Pathogen mutations and genetic

recombinations
• Acquired drug resistance
• Decreased compliance with vaccination
policies and other breakdown in public
health measures
• Population shifts
• War & civil conflicts
• Famine, floods, droughts, & bioterrorism
• KEEP ALL YOUR CPs INSIDE
YOUR CLOSED BAG
• ONLY YOUR PEN AND PAPER
ON TOP

09/10/22