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Disease of Skin and Eyes Ch 21 Necrotizing fasciitis • Streptococcus pyogenes • Causes extensive tissue damage • Treatment is Surgical removal of tissue, Penicillin Invasive Group A Beta Hemolytic Streptococcal Infections • Streptokinases • Hyaluronidase • Exotoxin A, superantigen • Cellulitis • Necrotizing fasciitis Figure 21.8 Impetigo • Staphylococcus aureus or Streptococcus pyogenes • Superficial skin infection; isolated pustules • Penicillin for Streptococcus infections • Methicillin or cephalosporin for Staphylococcus Streptococcal Skin Infections • Erysipelas • Impetigo Figure 21.6, 7 Shingles • Varicella-zoster virus (VZV) • Vesicles similar to chickenpox; typically on one side of waist, face and scalp, or upper chest – Usualy along dermatome’s. One or 2 – Can cause persistant pain in the affected nerves postherpetic neuralgia • Normal immunity is best • Acyclovir esp for immunocompromised Boils • Staphylococcal infection • A somewhat larger pus-containing lesions within the dermis. • May cause abscesses that are accumulations of pus that may penetrate into deeper tissues and develop into cellulitis • Can be treated with penicillins • May need to be lanced and foreign body removed. Acne • Small inflamed papules and pustules • Heal spontaneously within a few days. • When Propionibacterium acnes (anaerobic) produces fatty acids and causes an immune response. • Skin peels reduce the chance of pores bercomming clogged • Tetracyclines can reduce the amount of bacteria Chicken Pox • • • • • • Mild disease in children VZV herpes only in humans. Oka live attenuated vaccine With Aspirin can cause Reye’s syndrome Develop into shingles as an adult 100 deaths a year Herpes • • • • Herpes simplex virus type 1 Large Double stranded DNA virus Develops latent infection in nerves Most commonly as cold sores-vesicles around mouth; can also affect other areas of skin and mucous membranes • Fluid in vessels contains virus and is infectious • Acyclovir may modify (reduce)symptoms. Rubella (German measles) • Rubella virus • Mild disease with a rash resembling measles, but less extensive and disappears in 3 days or less • No treatment. • MMR • Can cause Birth defects and death to undeveloped fetus • May want to screen women of childbearing age for antibodies Measles (Rubeola) • Measles virus • Transmitted by respiratory route • Macular rash and Koplik's spots • Prevented by vaccination(MMR) at 15mo • Encephalitis in 1 in 1000 cases • Subacute sclerosing panencephalitis in 1 in 1,000,000 cases Figure 21.14 Ringworm • Dermatophytes • Infect the bodies outermost surface • Depends on the bodys immune response – Red, weeping, swelling • Topical antifungals – Miconazole – clotrimazole Scabies • • • • Sarcoptes scabiei a mite Transferred from person to person or by fomites Common worldwide Lives on skin, female burrows into the skin to lay eggs. • Resembles other itchy skin disease, need to look for mites or eggs. • Lasts a long time (7 year itch) • Arachnicide gamma benzene Disease of the nervous system Ch 22 Meningitis • • • • • Neisseria meningitidis Transferred by respiratory droplets May live in nose and throat as normal flora Vaccine does not cover all serotypes Rapid onset, high fever, stiff nect, headache worsteing, possible agitated behavior similar to drug overdose • Rifampin and Penicillin G Tetanus • • • • • Clostridium tetani Normal flora of animals some humans. Neurotoxin made in bacteria in a wound. Immunization Stiff muscles Botulism • Clostridium botulinum • Affects the preipheral nervous system. • Stops release of acetylcholene, resulting in flaccid paralysis • Support of systems untill toxin is neutralized. • Antiserum • Honey a risk in infant botulism Poliomyelitis • • • • Enterovirus group: polioviruses Paralysis only in 1% of infected individuals Multiplies in throat and intestines. Viremia results in infection of the motor cells of CNS. Killing these cells. • The Sabin oral vaccine is no longer used in the US because of reversions. • Inactivated now used. Rabies • Family Rhabdoviridae genus Lyssavirus bullet shaped negative-sense RNA • Initially nonspecific compatible with Fluelike illness. (fever, headache and general malaise 10 days to 6 years after infection. • Hydrophobia • Not treatable after symptoms occur death in 100% Rabies 2 • Treatment: post exposure prophylaxis • Antirabies vaccine and immune globulin injections. • Skunk is the primary reservoir in the bay area. Trypanosomiasis African Sleeping sickness • Trypanosoma brucie gambiense • Spread by tsetse fly vector • Early symptoms include reduction of physical and mental activity, will move into coma as organism enters CSF. • Treatment,eflornithine (enzyme blocker) • Vaccine is being developed, hampered by antigen variability mainly avoidance. Crutzfeldt-jakob disease • Spongiform encephalophathies • 200 cases per year in the us, often in families. • Prion-contaminated tissue • Not known. • May be infected blood or tissue Transmissible Spongiform Encephalopathies Figure 22.17a Disease of Cardiovascular and Lymphatic system Ch 23 Rheumatic fever • Group a beta hemolytic streptococci (Streptococcus pyogenes) • Autoimmune condition; repeated streptococcal infections result in antibodies that damage the heart valve tissue. • Reason that strep throat is vigorously treated. • Still sensitive to Penicillin. Yellow Fever • Fiver chills and headache followed by nausea and vomiting. Followed by jaundice. • Mortality rate 20% • Viral hemorrhagic fever carried by mosquito • Monkey are a reservoir but human-human is mostly how it happens. • Live attenuated viral vaccine Anthrax • Symptoms vary according to portal of entry – Cutaneous – Gastrointestinal – Inhallational (pulmonary) most deadly • Mild fever, coughing and some chest pain. – Mild symptoms not usually responded to – Progresses to septic shock in 2-3 days • Antibiotics if administered on time. Gangrene Lyme Disease Tularemia Relapsing Fever Infectious mononucleosis Malaria • Plasmodium • A mosquito-borne disease common to hot climates, characterized by fever and chills at intervals may be fatal in small children. • Working on vaccine. Elephantitis • Student talk Schistosomiasis • Schistosoma spp • Eggs produced by schistosomes lodge in tissue and induce damaging inflammation. Ebola Disease of the Respiratory System Ch 24 Strep throat • Streptococcus pyogenes • Inflame Mucous membranes of the throat Pneumonia Pneumonic Plague Diphtheria Pertussis Tuberculosis Legionellosis • Legionella pneumophila • Potentially fatal pneumonia that tends to affect older males who drink or smoke heavily. Pathogen grows in water such as air-conditioning towers and shower heads. Influenza • Influenzavirus many types • Characterized by chills, fever, headache, and muscular aches. Virus changes antigenic character rapidly, so there is limited immunity following recovery. • 10-20k Americans die a year. • Transferred from humans to animals • Usually from the orient. Histoplasmosis • Histoplasma capsulatum • Fungal pathogen grows in soil, esp if contaminated with bird droppings. Widespread in Ohio and Mississippi river valleys; occasionally fatal. Colds • Rhinoviruses, Coronaviruses • Young average 4 per year. • Isolate populations develop group immunity. • Sneezing excessive nasal secretion. • Usually not accompanied by fever • Last about a week. OCD’s do not reduce this Diseases of the Digestive system Ch 25 Food poisoning • Staphylococcus aureus Exotoxins • Toxin causes rapid onset of nausea, vomiting and diarrhea Salmonellosis Periodontal disease Shigellosis • Shigella may be pathogenic E. coli • Bacteria are shed in human feces; ingested, they invade and multiply in intestinal epithelial cells. Infection spreads to neighboring cells causing tissue damage and dysentery. • Only in primates • Low death rate • Not a good vaccine. • Antibiotics and rehydration Colitis Cholera • student Hepatitis C Peptic ulcer disease • Helicobacter pylori • Pathogen is adapted to survive in stomach; presence leads to peptic ulcers • Mixture of antibiotics. • Urea breath test. (urease from bacteria) Mumps • • • • • • Mumps virus Painful swelling of parotid glands Transmitted by saliva to respiratory tact MMR (measles, mumps, rubella vaccine) Is a live attenuated viral disease. Sterility or other organ systems is rare. Viral gastroenteritis • • • • • Rotavirus or Norwalk agent Is a self-limiting infection. Usually not fatal. Rehydration is best therapy. May cause death in 3rd would countries. Cryptosporidiosis • Cryptosporidium parvum • Shed in animal feces, protozoan enters water supply: causes self-limiting diarrhea but may be life-threatening if immunosupressed. • Diarrhea for 10 -14 days • Cysts must be removed by filtration • Oral hydration is the only treatment tapeworm • Taenia saginata or T. solium • Helminth lives off undigested intestinal contents with few symptoms. • Usually transmitted by ingesting larvae in meats. (larvae stage is most damaging) • 3% of human population • Niclosamide is drug of choice Diseases of the urinary and reproductive systems Ch 26 Cystitis • E. coli Staphylococcus saprophyticus • Difficulty or pain in urination. • Trimethoprim-sulfamethoxazol other antibiotics have been show to be successful. Gonorrhea • Neisseria gonorrhoeae • Males painful urination and discharge of pus. Females few symptoms but possible complication such as PID. • Fairly good infection rate bout 50% • Ophthalmia neonatorum PID • N. gonorrhoeae, Chlamydia trachomatis • Chronic abdominal pain; possible infertility if uterine tubes are scarred. • Combination of doxycycline and cephalosporins Genital herpes • • • • Herpes simplex virus type2 Painful vesicles in genital area Have recurrences, may taper over time. Neonatal herpes possible, most damaging if initial infection occurs during pregnancy. • Acyclovir may reduce symptoms and prevent recurrences. Genital warts • • • • • Papillomavirus Warts in genital area Predisposition to cancer. Usually self resolves By use various therapies to remove dermal layer. trichomoniasis • • • • • • Trichomonas vaginalis Vaginal itching, greenish yellow discharge Is Protozoan When pH of the vagina increases Diagnosed by protozoa in discharge Oral metronidazol to both partners Candidiasis • Fungal Candida albicans • NGU • Vulvovaginal has lesions, itching and irritation. • Predisposing factors: pregnancy, diabetes, tumors and antibacterial chemotherapy. • Diagnosis: observation of fungus and isolation from lesions Aids • student Food poisining • http://vm.cfsan.fda.gov/~mow/chap3.html