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MICROBIOLOGY
Chapter 23
Microbial Diseases of the Cardiovascular and
Lymphatic Systems
Dr. Abdelraouf A. Elmanama
Ph. D Microbiology
Medical Technology Department, Faculty of Science, Islamic University-Gaza
2008
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
2008
The Cardiovascular System
2008
Figure 23.1
The Lymphatic System
2008
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
2008
Figure 23.3
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
2008
Sepsis
• Puerperal Sepsis (Childbirth fever)
• Streptococcus pyogenes
• Transmitted to mother during childbirth by attending
physicians & midwives
2008
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
2008
Bacterial Infections of the Heart
2008
Fgirue 23.4
Rheumatic Fever
• Inflammation of heart values
• Autoimmune complication of Streptococcus pyogenes
infections
2008
Figure 23.5
Tularemia
• Francisella tularensis, gram-negative rod
• Transmitted from rabbits and deer by deer flies
• Bacteria reproduce in phagocytes
2008
Tularemia
2008
Figure 23.6
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
2008
Anthrax
• Bacillus anthracis, gram-positive, endospore-forming
aerobic rod
• Found in soil
• Cattle are routinely vaccinated
• Treated with ciprofloxacin or doxycycline
• Cutaneous anthrax
• Endospores enter through minor cut
• 20% mortality
2008
Anthrax
• Gastrointestinal
anthrax
• Ingestion of
undercooked food
contaminated food
• 50% mortality
• Inhalational anthrax
• Inhalation of
endospores
• 100% mortality
2008
Figure 23.7
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 U.S.
2008
Biological Weapons
Bacteria
Viruses
Bacillus anthracis
“Eradicated” polio and measles
Brucella spp.
Encephalitis viruses
Chlamydia psittaci
Hermorrhagic fever viruses
Clostridium botulinum toxin
Influenza A (1918 strain)
Coxiella burnetti
Monkeypox
Francisella tularensis
Nipah virus
Rickettsia prowazekii
Small pox
Shigella spp.
Yellow fever
Vibrio cholerae
Yersinia pestis
2008
Gangrene
• Ischemia
• Loss of blood supply to tissue
• Necrosis
• Death of tissue
• Gangrene
• Death of soft tissue
• Gas gangrene
• Clostridium perfringens, gram-positive, endosporeforming anaerobic rod, grows in necrotic tissue
• Treatment includes surgical removal of necrotic
tissue and/or hyperbaric chamber
2008
Animal bites and scratches
• Pasteurella multocida
• Clostridium
• Bacteroides
• Fusobacterium
• Bartonella hensellae
• Cat-scratch disease
2008
Plague
• Yersinia pestis, gram-negative rod
• Reservoir
• Rats, ground squirrels, prairie dogs
• Vector
• Xenopsylla cheopsis
• Bubonic plague
• Bacterial growth in blood and lymph
• Septicemia plague
• Septic shock
• Pneumonic plague
• Bacteria in the lungs
2008
Plague
2008
Figure 23.10, 11
Relapsing Fever
• Borrelia spp., spirochete
• Reservoir
• Rodents
• Vector
• Ticks
• Successive relapses are less severe
2008
Lyme Disease
• Borrelia burgdorferi
• Reservoir
• Deer
• Vector
• Ticks
2008
Lyme Disease
2008
Figure 23.13a
Lyme Disease
2008
Figure 23.13b, c
Lyme Disease
• First symptom
• bull's eye rash
• Second phase
• Irregular
heartbeat,
encephalitis
• Third phase
• Arthritis
2008
Figure 23.14
Ehrlichiosis
• Ehrlichia, gram-negative, obligately intracellular
(in white blood cells)
• Reservoir
• Deer,
rodents
• Vector
• Ticks
2008
Figure 23.15
Typhus
• Epidemic typhus
• Rickettsia prowazekii
• Reservoir
• Rodents
• Vector
• Pediculus humanus corporis
• Transmitted when louse feces rubbed into bite
wound
2008
Typhus
• Epidemic murine typhus
• Rickettsia typhi
• Reservoir
• Rodents
• Vector
• Xenopsylla cheopsis
2008
Spotted Fevers (Rocky Mountain spotted fever)
• Rickettsia rickettsii
• Measles-like rash
except that the rash
appears on palms and
soles too
2008
Figure 23.18
Spotted Fevers (Rocky Mountain spotted fever)
2008
Figure 23.16
Tick Life Cycle
2008
Figure 23.17
Burkitt’s Lymphoma
• Nasopharyngeal carcinoma
• Epstein-Barr virus (Human herpesvirus 4)
• Cancer in immunosuppressed individuals, and malaria
and AIDS patients
2008
Infectious Mononucleosis
• Epstein-Barr virus (Human herpesvirus 4)
• Childhood infections are asymptomatic
• Transmitted via saliva
• Characterized by proliferation of monocytes
2008
Infectious Mononucleosis
2008
Figure 23.20
Cytomegalic Inclusion Disease
• 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
2008
Viral Hemorrhagic Fevers
Classic
Yellow fever
Flavivirus
Aedes aegypti
Monkeys
Dengue & DHF
Flavivirus
•
A. aegypti
•
A. albopictus
No known
reservoir
Emerging
Marbug
Filovirus
•
Monkeys (?)
Ebola
Filovirus
•
Monkeys (?)
Lassa fever
Arenavirus
•
Rodents
Argentine hemorrhagic
fever
Arenavirus
•
Rodents
Bolivian hemorrhagic
fever
Arenavirus
•
Rodents
Hantavirus pulmonary
syndrome
Hantavirus
•
Rodents
2008
Ebola Virus
2008
Figure 23.21
American Trypanosomiasis (Chagas’Disease)
• Trypanosoma cruzi
• Reservoir
• Rodents,
opossums,
armadillos
• Vector
• Reduviid bug
2008
Figure 23.22, 12.33d
Toxoplasmosis
• Toxoplasma
gondii
2008
Figure 23.23
Malaria
• Plasmodium vivax, P. ovale, P malariae, P. falciparum
• Anopheles mosquito
2008
12.31b
Malaria
2008
Figure 23.25
Malaria
2008
Figure 23.24
Malaria
2008
Figure 12.19
Leishmaniasis
Disease
Visceral
leishmaniasis
Cutaneous
leishmaniasis
Mucocutaneous
leishmaniasis
Babesiosis
Fatal if
untreated
Papule that
ulcerates and
scars
Disfiguring
Replicates in
RBCs
Causative
agent
Leishmania
donovani
L. Tropica
L. Braziliensis
Babesia microti
Vector
Sandflies
Sandflies
Sandflies
Ixodes ticks
Reservoir
Small mammals
Small mammals
Small mammals
Rodents
Treatment
Amphotericin B
or miltefosine
Amphotericin B or
miltefosine
Amphotericin B or
miltefosine
Atovaquone +
azithromycin
Geographic
distribution
Asia, Africa,
Southeast Asia
Asia, Africa,
Mediterranean,
Central America,
South America
Rain forests of
Yucatan, South
America
U.S.
2008
Babesiosis
2008
Figure 12.32
Schistosomiasis
2008
Figure 23.28
Schistosomiasis
• Tissue damage (granulomas) in response to eggs
lodging in tissues
• S. haemotobium
• S. japonicum
• S. mansoni
• Swimmer’s itch
2008
Granulomas in urinary
Africa, Middle East
bladder wall
Granulomas in intestinal wall East Asia
Granulomas in intestinal wall African, Middle East,
South American,
Caribbean
Cutaneous allergic reaction
U.S. parasite of wildfowl
to cercariae
Schitstosomasis
(a) Male and female schitosomes.
2008
Figure 23.27a
Schitstosomasis
2008
Figure 23.27b