MICROBIOLOGY &

PARASITOLOGY
Group Members:
Labador, Marielle A.
Gungon, Jehan
Guevarra, Destine
 CONTENTS
01 02
PERTUSSIS TUBERCULOSIS

03 04
PULMONARY OTHER SYSTEMIC
ANTHRAX CONDITIONS
PERTUSSIS
(Whooping
Cough)
 BORDETELLA PERTUSSIS
• is a small, encapsulated, gram negative rod.
• It is a pathogen that only naturally infects humans.
• Its virulence can be attributed to the various toxins it
produces that are responsible for tissue destruction and
manifestations of pertussis.
• Pertussis is a highly contagious disease.
• It occurs primarily in infants and young children.
 MODE OF TRANSMISSION

• The organism is transmitted by airborne droplets

during the severe coughing episodes.
 CLINICAL FINDINGS
Pertussis consists of three stages, namely:
1. Catarrhal stage – this is the most contagious stage
and lasts 1–2 weeks. It manifests as a mild upper
respiratory tract infection with non specific signs and
symptoms. The greatest number of microorganisms is
produced during this stage.
 CLINICAL FINDINGS
2. Paroxysmal stage – this stage is characterized by a series
of 5–20 forceful, hacking coughs accompanied by
production of copious amounts of mucus that ends in a high
pitched indrawn breath that makes the “whoop” noise, hence
the term whooping cough. During paroxysms, the patient
may turn cynotic, the tongue protrudes, the eyes bulge, and
neck veins engorge. This may last for 2–10 weeks.
 CLINICAL FINDINGS
3. Convalescent stage – this stage is characterized by a
reduction in the symptoms of the patient leading to
recovery. The patient is no longer contagious.
 COMPLICATIONS
• Pertussis, like measles, can unmask underlying
tuberculosis.
• Convulsions may occur due to cerebral anoxia during
coughing spells.
• Blindness can also develop resulting from hemorrhages
into the conjunctiva during paroxysms.
• Pneumonia, deafness, and hernias may also develop.
 LABORATORY DIAGNOSIS
• Diagnosis is done through the culture of specimens from
nasopharyngeal swabs taken during the paroxysmal stage
is diagnostic. The culture medium used before was Bordet
Gengou medium demonstratingthe “fried egg” appearance
of the colonies but this has been replaced by Regan Lowe
charcoal medium.
 TREATMENT AND PREVENTION

• The drugs of choice are the macrolides. It is given not only

to the patient but also to exposed individuals.
Administration of the drug during the paroxysmal stage
will not alter the course of the disease. Supportive care
such as oxygen therapy and suctioning of mucus during the
paroxysmal stage is important. An acellular vaccine helps
prevent infection.
TUBERCULOSIS
Mycobacterium
Tuberculosis
 MYCOBACTERIUM TUBERCULOSIS
• M. tuberculosis is the main cause of tuberculosis globally.
• M. bovis causes tuberculosis in cattle and other animals as well as
humans.
• In AIDS patients, atypical tuberculosis occurs which is caused by
M. avium intracellulare complex. M. africanum is the major
cause in Africa.
• M. tuberculosis is an acid fast, obligately aerobic bacillus that is
stained poorly by the dyes used in Gram stain. Its cell wall
contains complex lipids, one of which is mycolic acid, which
contributes to the acid fastness of the organism.
 MODE OF TRANSIMISSION
• The major mode of transmission is by person to person
spread through respiratory aerosols generated through
coughing by infected individuals. A rare mode of
transmission is through killing. M. bovis is transmitted
through ingestion of contaminated cow’s milk leading to
development of gastrointestinal tuberculosis. The
organism may survive in fomites such as utensils and
glassware.
 CLINICAL FINDINGS
1. Primary infection (Primary Complex) –
represents initial infection in childhood. It may affect
any part of the lung but most commonly involves the
middle and lower lobes of the lungs. The lesion is
called Ghon complex. Most patients are
asymptomatic.
 CLINICAL FINDINGS
2. Secondary or Reactivation Pulmonary Tuberculosis
– usually caused by tubercle bacilli that have survived in
the primary lesion. It almost always begins at the apex of
the lung, where the oxygen tension is highest. The classical
symptoms include easy fatigability, afternoon rises in
temperature, weight loss, night sweats, loss of appetite,
chronic non productive cough with or without hemoptysis.
 CLINICAL FINDINGS
3. Disseminated Tuberculosis – also called extrapulmonary
tuberculosis. It is characterized by multiple disseminated lesions.
The most common initial organ involved in extrapulmonary
tuberculosis is the lymph nodes. In some instances, the involved
lymph nodes may aggregate and ulcerate forming what is called as
scrofula.
Tuberculous meningitis and tuberculous osteomyelitis (Pott’s
disease) are important disseminated forms. Other disseminated
forms: gastrointestinal, oropharyngeal, renal, genitourinary TB, and
pericardial TB.
CLINICAL FINDINGS
 LABORATORY DIAGNOSIS
1. Acid fast staining of sputum: requires collecting early
morning sputum with adequate amount of inoculum and
must be collected on the day of consultation with the
physician followed by another collection 1 hour after. If the
patient cannot wait for the second collection, the patient is
made to come back the following day.
2. Culture using Lowenstein Jensen medium not usually done
because the organism is a slow grower.
3. Chest x ray
 LABORATORY DIAGNOSIS
4. Skin test
• Tuberculin Skin Test using purified protein derivative (PPD) as
antigen
• Method: Mantoux (intradermal test)
• The skin test is evaluated by measuring the diameter of the
induration (thickening) surrounding the skin test and not by simply
observing for the presence of erythema.
• A positive skin test result indicates previous infection by the
organism or exposure to an active case but not necessarily active
disease.
 LABORATORY DIAGNOSIS
Skin test is considered positive in the following:
a. induration of 15 mm or more in a person with no known risk
factors
b. induration of 10 mm or more in a person with high risk factors
(e.g., homeless person, IV drug users, or nursing home residents)
c. induration of 5 mm or more in a person with deficient cell
mediated immunity (e.g., AIDS patients
 TREATMENT AND PREVENTION

• Multidrug anti Koch’s or anti TB therapy is used to

prevent emergence of drug resistance.
• WHO recommended a Direct Observed Treatment
Short Course (DOTS) program aimed at preventing
development of drug resistance and to reduce morbidity
and mortality from TB.
 TREATMENT AND PREVENTION
• Preventive measures include:
(1) improvement of housing conditions and nutritional status of the
population.
(2) prompt identification and adequate treatment of patients.
(3) careful follow up of contacts of patients with active TB (e.g.,
tuberculin tests, x rays, sputum examination)
(4) use of masks and other respiratory isolation procedures to prevent
spread to medical personnel; public health education.
(5) eradication of tuberculosis in cattle and pasteurization of milk (6)
immunization with BCG vaccine.
PULMONARY
ANTHRAX
• also called Woolsorter’s disease.
• It begins with non specific symptoms that resemble
influenza which rapidly progresses to edema,
enlargement of mediastinal lymph nodes, bloody pleural
effusion, septic shock, and death. Chest x ray would show
widening of the mediastinum due to enlarged lymph
nodes. Hemorrhagic meningitis and hemorrhagic
mediastinitis are severe life threatening complications.
The drug of choice is ciprofloxacin with doxycycline as
an alternative drug
 MODE OF TRANSMISSION
• transmitted by inhalation of spores of Bacillus
anthracis into the lungs.
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