Download VA Bacterial Diseases

V. A.
Bacterial Diseases
A. Airborne Bacterial Diseases
B. Foodborne & Waterborne Bacterial
Diseases
C. Soilborne Bacterial Diseases
D. Arthropodborne Bacterial Diseases
E. Sexually Transmitted Bacterial Diseases
F. Miscellaneous Bacterial Diseases
V. A.
Airborne Bacterial Diseases
1. Streptococcal Diseases
2. Diphtheria
3. Pertussis
4. Meningococcal Infections
5. Haemophilus influenzae Infections
6. Tuberculosis
7. Pneumococcal Pneumonia
8. Primary Atypical Pneumonia
9. Legionellosis
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V. A. 1. Streptococcal Diseases
• Properties of the Genus Streptococcus
– General Properties
• Gram-positive Cocci in Chains or Pairs
• Catalase Negative
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V. A. 1. Streptococcal Diseases
• Properties of the Genus Streptococcus (cont.)
– Hemolytic Reactions
• Detected by Blood Agar Cultures
• Beta Hemolysis
– Complete Hemolysis
– Clear Zone Around Colonies on Blood Agar
• Alpha Hemolysis
– Incomplete Hemolysis
– Greenish Zone Around Colonies on Blood Agar
• Gamma Reaction
– Absence of a Hemolytic Reaction
– No Change Around Colonies on Blood Agar
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V. A. 1. Streptococcal Diseases
• Properties of the Genus Streptococcus (cont.)
– Lancefield Groups
• Based on Serological Groupings
Also may be distinguished by
Biochemical Testing or Antibiotic Sensitivity
• Group A
– Streptococcus pyogenes
– The most virulent human pathogen of the genus
– Beta hemolytic
– Often identified by rapid serological tests or by
antibiotic resistance
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V. A. 1. Streptococcal Diseases
• Properties of the Genus Streptococcus (cont.)
– Lancefield Groups (cont.)
• Group B
– Streptococcus agalactiae
– Mildly to moderately virulent;
esp. in children & elderly
– Usually beta or alpha hemolytic;
some strains are gamma
– Detected biochemically
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V. A. 1. Streptococcal Diseases
• Properties of the Genus Streptococcus (cont.)
– Lancefield Groups (cont.)
• Group D
– Includes the fecal streptococci (enterococci)
– Normal colon flora
in humans & other animals
– Genus Enterococcus
– Several species; eg. Enterococcus faecalis
– Occasionally pathogenic;
often in urinary tract infections
– Usually gamma reactive
– Detected biochemically
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V. A. 1. Streptococcal Diseases
• Diseases Associated with Streptococcus pyogenes
– Respiratory Symptoms
• Upper Respiratory Tract
• Pharyngitis
– Systemic Symptoms
• Septicemia
• Internal infections
– Scarlet fever
Due to strains that produce an erythrogenic toxin
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V. A. 1. Streptococcal Diseases
• Diseases Associated with Streptococcus pyogenes
(cont.)
– Immune-Related Complications
• Rheumatic fever
• Glomerulonephritis
– Other Conditions/Portals of Entry
• Erysipelas
• Necrotizing fasciitis
• Puerperal sepsis
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V. A. 2. Diphtheria
• Cause: Corynebacterium diphtheriae
– Properties of the Genus Corynebacterium
• Gram-positive rods; non-sporeforming
• Coryneform (diphtheroid) arrangement
• “Snapping division”
• Metachromatic Granules
• Several different species
• Frequently found in soil & in the skin flora
• Only virulent strains of Corynebacterium diphtheriae
are considered pathogenic
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V. A. 2. Diphtheria
• Cause: Corynebacterium diphtheriae
– Properties of Corynebacterium diphtheriae
• Virulent strains contain a extra gene
that encodes for the diphtheria exotoxin
• The exotoxin is a cytotoxin that
inhibits protein synthesis -- kills host cells
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V. A. 2. Diphtheria
• Transmission & Symptoms
– Airborne; contact with infected persons
– Upper Respiratory Infection
– Pseudomembrane Formation
– May Spread into Bloodstream
– Cardiovascular damage
– Vaccination with diphtheria toxoid vaccine
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V. A. 3. Pertussis
• Cause: Bordetella pertussis
– Gram-negative aerobic rod
– Found among the respiratory flora of humans
& other animals
• Transmission and Symptoms
– Airborne contact with infected persons
– Upper respiratory tract infection;
may be severe in children & elderly
– Difficulty breathing; staccato cough
(“whooping cough”)
– Usually does not spread into bloodstream
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V. A. 4. Meningococcal Infections
• Cause: Neiserria meningitidis
– Properties of the Genus Neiserria
• Gram-negative cocci in pairs
• Several species;
some of which are normal colon flora
• Fastidious nutritional requirements
Grow best on chocolate agar
– Notable pathogenic species
• Neiserria meningitidis
• Neiserria gonorrhoeae
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V. A. 4. Meningococcal Infections
• Transmission & Symptoms
– Airborne contact with infected persons
• Often associated with children
& with persons in close or crowded quarters
eg. schools, daycare, etc.
– Upper respiratory tract symptoms
– Septicemia
– Meningitis
• Headache and stiff neck
• Listlessness; dizziness; disorientation
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• Seizures; coma; death
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V. A. 5. Haemophilus influenzae
Infections
• Cause: Haemophilus influenzae
– Properties of the genus Haemophilus
• Gram-negative rod
• Facultatively anaerobic
• Fastidious -- requires chocolate agar
for growth
• Several species; common among the
respiratory flora
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V. A. 5. Haemophilus influenzae
Infections
• Cause: Haemophilus influenzae (cont.)
– Notable species
• Haemophilus influenzae: Several strains;
common in the upper respiratory tract.
Type b is associated with some cases of
bacterial meningitis; type III is sometimes
the cause of certain eye infections
• Haemophilus ducreyii: Causative agent of
chanchroid
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V. A. 5. Haemophilus influenzae
Infections
• Transmission & Symptoms
– Infections most frequently associated
with the virulent strain, type b
– Upper respiratory tract symptoms
• Rhinitis and Sinusitis
• Otitis media
• Epiglottitis
– Septicemia and Meningitis
– Prevented by HIB vaccine
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V. A. 6. Tuberculosis
• Cause: Mycobacterium tuberculosis
– Properties of the genus Mycobacterium
• Acid-fast rods
• Grow slowly; some species are difficult to culture
• Several species;
some found in soil and among skin flora
– Major pathogenic species:
• Mycobacterium tuberculosis
• Mycobacterium avium-intracellulare
• Mycobacterium cheloni
• Mycobacterium scrofulaceum
• Mycobacterium leprae
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V. A. 6. Tuberculosis
• Transmission & Symptoms
– Transmission
• Airborne Contact
• Prolonged Exposure
• Occasionally via skin contact
or wounds
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V. A. 6. Tuberculosis
• Transmission & Symptoms (cont.)
– Symptoms
• Lung Infection
• Destruction of alveoli
• Cough; sputum
• Tubercle Formation
• May remain dormant for years
and then become active again
• May spread to other areas of the body:
Miliary TB
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V. A. 6. Tuberculosis
• Transmission & Symptoms (cont.)
– Detection:
• Microscopic examination
• Chest X-Ray
• Culture
• Tuberculin Skin Test
– TB Vaccination
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V. A. 7. Pneumococcal Pneumonia
• Cause: Streptococcus pneumoniae
– Properties of the Genus -- See Earlier Notes
– Formerly Known as Diplococcus pneumoniae
– No Lancefield classification
– Gram-positive diplococci;
virulent strains are encapsulated
– Alpha Hemolytic
– A common cause of secondary bacterial
pneumonia
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V. A. 7. Pneumococcal Pneumonia
• Transmission & Symptoms
– A frequent cause of secondary bacterial
pneumonia
– Airborne transmission
– Lower Respiratory Tract Infection
– Pneumonia
– Fluid Buildup in Lung
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V. A. 8. Primary Atypical Pneumonia
• Cause: Mycoplasma pneumoniae
–
Properties of the Genus Mycoplasma
• Small, irregular cells
• Naturally cell wall deficient
• Several species
• Common among respiratory flora in humans &
other animals
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V. A. 8. Primary Atypical Pneumonia
• Transmission & Symptoms
– Airborne Transmission
– May be opportunistic
– Frequently causes mild cases of primary
pneumonia
– Mycoplasma pneumoniae may also cause severe
secondary pneumonia in immunocompromised
patients
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V. A. 9. Legionellosis
• Cause: Legionella pneumophila
– Properties of the genus Legionella
• Gram-negative rods
• Strictly aerobic
• Found in highly aerated, moist environments
eg. streams
• May parasitize certain aquatic protozoa
• Can contaminate building ventilation systems, air
filters, etc.
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V. A. 9. Legionellosis
• Transmission & Symptoms
– Airborne
– Contact with infected persons or environments
– Mild to Moderate Pneumonia
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V. B.
Foodborne & Waterborne
Bacterial Diseases
1. Foodborne Intoxications vs Infections
2. Botulism
3. Staphylococcal Food Poisoning
4. Clostridial Food Poisoning
5. Typhoid Fever
6. Salmonellosis
7. Shigellosis
8. Cholera
9. Diseases associated with Escherichia coli
10. Camphylobacteriosis and Helicobacteriosis
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V. B. 1. Foodborne Intoxications vs
Infections
• Foodborne intoxications: Caused by the
exotoxin secreted by bacteria in contaminated
food
• Foodborne infections: Caused by the ingestion
of live bacteria that colonize the digestive
tract
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V. B. 2. Botulism
• Cause: Clostridium botulinum
– Properties of the genus Clostridium
• Gram-positive rod
• Strictly anaerobic
• Spore-former
• Widely distributed, especially in soil
– Important species:
• Clostridium botulinum
• Clostridium perfringins
• Clostridium tetani
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V. B. 2. Botulism
• Transmission & Symptoms
– Transmitted via contaminated food
– Botulinum toxin:
• A neurotoxic exotoxin
• Heat sensitive
• Inhibits synaptic transmission at motor neuron end
plates
• Causes flaccid paralysis
• Very deadly: Death due to respiratory & cardiac
failure
• Treatment: Administration of antitoxin
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V. B. 2. Botulism
• Transmission & Symptoms (cont.)
– Other mechanisms of transmission:
• Wound botulism
• Animal botulism
• Infant botulism
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V. B. 3. Staphylococcal Food Poisoning
• Cause: Staphylococcus aureus
– Properties of the genus Staphylococcus
• Gram positive coccus in clusters
• Catalase positive
– Two major species
• Staph. aureus is more virulent
& is coagulase positive
• Staph epidermidis is more common
& is coagulase negative
• Both are common skin & upper RT flora
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V. B. 3. Staphylococcal Food Poisoning
• Transmission & Symptoms
– Certain strains of Staph. aureus:
Produce staphylococcal enterotoxin
– Toxin is secreted in contaminated food
– Causes abdominal pain, nausea, diarrhea,
for a few hours
– Staph. aureus enterotoxin is unusually
heat-resistant
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V. B. 4. Clostridial Food Poisoning
• Cause: Clostridium perfringins
– Certain strains secrete an enterotoxic exotoxin
• Transmission & Symptoms
– Similar to staphylococcal food poisoning, except
that the clostridial enterotoxin is not as heat-stable
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V. B. 5. Typhoid Fever
• Cause: Salmonella typhi
–
Properties of the genus Salmonella
• A member of the family Enterobacteriaceae
• Colon flora; sometimes carried asymptomatically
• Gram negative rods
• Facultatively anaerobic
–
Salmonella typhi
• Most virulent member of the genus
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V. B. 5. Typhoid Fever
• Transmission & Symptoms
– Transmission via oral route
• often associated with contact with infected persons,
either symptomatic or carriers
• sewage
• flies
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V. B. 5. Typhoid Fever
• Transmission & Symptoms
– Invades intestinal epithelium tissue
• ulceration
• bloody stools but little diarrhea
• Blood invasion
• fever; delirium
• blood vessel hemorrhaging
• rose-colored spots on the abdomen
• bowel perforation
• gall-bladder infection
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V. B. 6. Salmonellosis
• Cause: Salmonella serotypes
– Serotypes of the genus Salmonella other than
S. typhi
– Hundreds of serotypes; species names exist but
are often not reported
– Examples
• Salmonella enteriditis
• Salmonella gallinarum
• Salmonella typhimurum
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V. B. 6. Salmonellosis
• Transmission & Symptoms
– Contaminated food
• Meat
• Poultry products
• Dairy products
– Gastroenteritis
• Cramps
• Nausea
• Vomiting
• Diarrhea
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V. B. 7. Shigellosis
• Cause: Shigella species
– Genus Shigella
• A member of the family Enterobacteriaceae
• Colon flora; sometimes carried asymptomatically
• Gram negative rods
• Facultatively anaerobic
– Species
• Shigella sonnei
• Shigella dysenteriae
• Shigella flexneri
• Shigella boydii
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V. B. 7. Shigellosis
• Transmission & Symptoms
– Transmission:
• Similar to salmonellosis
– Gastroenteritis
• Often with watery diarrhea
• Sometimes with bloody stools: Dysentery
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V. B. 8. Cholera
• Cause: Vibrio cholerae
– Genus Vibrio
• Gram-negative curved bacteria
• comma-shaped
• facultatively anaerobic
• Normal flora in many animals
– Notable Pathogenic Species
• Vibrio cholerae
• Vibrio parahaemolyticus
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V. B. 8. Cholera
• Transmission & Symptoms
– Transmission:
• Contaminated food
– shellfish
• vermin
• livestock
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V. B. 8. Cholera
• Transmission & Symptoms (cont.)
– Gastroenteritis with extensive severe diarrhea
• Cholera enterotoxin
• Toxin blocks water reabsorption by inhibiting the
anion active transport mechanism in large
intestinal epithelium
• “Rice water” stools
• Dehydration & death
– Recent epidemic due to spread of new drugresistant strain
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V. B. 9. Diseases associated with
Escherichia coli
• Cause: Escherichia coli
– Family Enterobacteriaceae
– Gram-negative rods
– Facultatively anaerobic
– Widely distributed among humans & animals
– Normal colon flora
– Used as indicator of water & food
contamination
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V. B. 9. Diseases associated with
Escherichia coli
• Transmission & Symptoms
– Oral route
• Extremely common normal flora
• Different strains in different geographical
regions
• Colonize gut in infancy
– Infantile diarrhea
– Traveler's diarrhea
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V. B. 9. Diseases associated with
Escherichia coli
• Transmission & Symptoms (cont.)
– E. coli strain O157:H7
• A rare, particular virulent & deadly strain
• Hemorrhagic E. coli disease
• Kidney damage in children
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V. B. 10.
Camphylobacteriosis and
Helicobacteriosis
• Camphylobacter jejuni
– Gram-negative spirillum
– Microaerophilic
– Normal flora of colon
– Common cause of mild to moderate
gastroenteritis
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V. B. 10.
Camphylobacteriosis and
Helicobacteriosis
• Helicobacter pylori
– Gram-negative spirillum
– Microaerophilic
– Can colonize the stomach lining
underneath the protective mucous layer
– Stomach irritation and ulcers
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V. C.
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Soilborne Bacterial Diseases
1.
Anthrax
2.
Tetanus
3.
Gas Gangrene
4.
Leptospirosis
5.
Listeriosis
V. C. 1.
Anthrax
• Cause: Bacillus anthracis
– Genus Bacillus
– Gram-positive rods
– Facultatively anaerobic
– Spore-forming
– Widely distributed in soil
– Many species; Bacillus anthracis is the most
important human pathogen of the group
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V. C. 1.
Anthrax
• Transmission & Symptoms
– Transmission
• Contact with contaminated soil
• Livestock
• Through skin; wounds; abrasions
• Also through oral route or airborne
– Skin anthrax
– Intestinal anthrax
– Pulmonary anthrax; “Woolsorter’s disease”
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V. C. 2. Tetanus
• Cause: Clostridium tetani
– Genus properties: See “Botulism”
• Transmission & Symptoms
– Wounds; esp. deep or puncture wounds
– Tetanospasmin: A neurotoxic exotoxin
• Acts as a cholinesterase inhibitor
• “Short-circuits” nerve synapses; esp. in the central
nervous system
• Causes rigid paralysis
– Treatment: Antitoxins plus muscle relaxants
– Prevention: Vaccination with tetanus toxoid
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V. C. 3. Gas Gangrene
• Often caused by Clostridium perfringins
– Genus properties: See “Botulism”
• Transmission & Symptoms
– Wounds; esp. deep wounds
– Gangrene:
• Tissue death due to reduced oxygen to tissue
• Gas or moist gangrene: Gangrene accompanied by
bacterial infection
• Swelling; tissue death; blackish discoloration
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V. C. 4. Leptospirosis
• Cause: Leptospira interrogans
– A spirochete
– Found in soil contaminated with animal waste
• Transmission & Symptoms
– Contact with contaminated soil or animals
• Often enters through the feet
– Spreads to several organs, including liver, kidney,
meninges
– Jaundice may be present
– May have bloody vomit
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V. C. 5. Listeriosis
• Cause: Listeria monocytogenes
– Genus Listeria
– Small Gram-positive rods
– Non-sporeforming
– Found in soil; esp in soil contaminated with
animal waste
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V. C. 5. Listeriosis
• Transmission & Symptoms
– Contact with contaminated soil
– Also possibly transmitted via contaminated food
– Listeric meningitis
– Blood infection with high white count
– Uterine infections; miscarriage or congenital
damage
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V. D.
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Arthropodborne Bacterial
Diseases
1.
Plague
2.
Lyme Disease
3.
Rocky Mt. Spotted Fever
4.
Epidemic Typhus
5.
Endemic Typhus
V. D. 1.
Plague
• Cause: Yersinia pestis
– Gram-negative, facultatively anaerobic rods
– in Family Enterobactereaceae; however, not
normally found in colon
– Characterized by bipolar staining
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V. D. 1.
Plague
• Transmission & Symptoms
– Vector: Fleas, esp. rodent fleas
– Bubonic plague: Infection of lymph node tissue;
swelling; hemorrhaging; buboes
– Septicemic plague
– Pneumonic plague
– Cases of airborne transmission among humans
have been noted
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V. D. 2.
Lyme Disease
• Cause: Borrelia burgdorferi
– A spirochete
– Transmitted by deer ticks
– First noted in Northeastern US
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V. D. 2.
Lyme Disease
• Transmission & Symptoms
– Vector: Ticks of the genus Ixodes (deer ticks);
may be transmitted by both immature & mature
ticks
– Incubation period of several weeks
– Initial symptoms
• Flu-like symptoms
• Rash: Erythema chronicum migrans (ECM)
– Several weeks/months later
• Joint pain/swelling
• Arthritis-like symptoms
• Cardiovascular & nervous system damage
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V. D. 3.
Rocky Mt. Spotted Fever
• Cause: Rickettsia rickettsii
– A rickettsia: Small, gram-negative bacterium
Obligately intracellular parasite
– Detected by serological testing,
eg. the Weil-Felix test (Reaction of serum to
Proteus OX19)
• Transmission & Symptoms
– Vector: Ticks
– Macropapipular rash begins on palms & soles
then spreads to other parts of the body
– High fever & other flu-like symptoms
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V. D. 4.
Epidemic Typhus
• Cause: Rickettsia prowasekii
– Genus properties:
See “Rocky Mt. Spotted Fever”
• Transmission & Symptoms
– Vector: Human Louse
– Epidemics; often in areas with reduced sanitation
– High fever; high fatality rate
– Rash begins on trunk of body & spreads to
extremities
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V. D. 5.
Endemic Typhus
• Cause: Rickettsia typhi
– Genus properties:
See “Rocky Mt. Spotted Fever”
• Transmission & Symptoms
– Vector: Fleas; esp. rodent fleas
– Endemic in many areas
– Often with mild or no symptoms
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V. E.
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Sexually Transmitted
Bacterial Diseases
1.
Syphilis
2.
Gonorrhea
3.
Chlamydia
4.
Chanchroid
V. E. 1.
Syphilis
• Cause: Treponema pallidum
–
A spirochete
–
Cannot be cultured on lab medium
–
Detected microscopically or serologically
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V. E. 1.
Syphilis
• Transmission & Symptoms
–
Transmission: Sexual contact or
congenitally
–
Primary Syphilis
• Few days after contact
• Hard Chancre
–
Secondary Syphilis
• Several weeks after chancre disappears
• Fever; flu-like symptoms
• Rash
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V. E. 1.
Syphilis
• Transmission & Symptoms (cont.)
–
Tertiary Syphilis
• Months or years later
• Gummae: Lesions on skin & mucous
membranes
• Damage to internal organs
• Cardiovascular & central nervous system
damage
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V. E. 2.
Gonorrhea
• Cause: Neiserria gonorrhoeae
– Genus Properties: See “Neiserria meningitidis”
• Transmission & Symptoms
– Transmission: Sexual contact or congenital
– Urinary Tract Symptoms
• Urethritis: Burning sensation; discharge
• Cystitis; kidney infection
– Male Reproductive Tract Symptoms
• Prostatitis
• Inflammation of epididymis & testes; sometimes
sterility
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V. E. 2.
Gonorrhea
• Transmission & Symptoms (cont.)
– Female Reproductive Tract Symptoms
• Uterine Infections
• Fallopian Tube inflammation; blockage; occasional
sterility
• Pelvic Inflammatory Disease
– Other Infections
• Gonococcal Eye Infections
• Respiratory Tract Infections
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V. E. 3.
Chlamydia
• Cause: Chlamydia trachomatis
– Genus Properties
• A small, Gram-negative bacterium
• Obligately intracellular parasite; similar to Rickettsia
– Occasionally carried subclinically as part of the
normal vaginal flora
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V. E. 3.
Chlamydia
• Transmission & Symptoms
– Very similar to gonorrhea: Often mistaken for
gonorrhea
– Important to distinguish because the treatment is
different from gonorrhea
– Identified by serological testing
– Transmission: Sexual contact or congenital
– Urinary and Reproductive Tract Symptoms
– Respiratory Tract and Eye Infections
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V. E. 4.
Chanchroid
• Cause: Haemophilus ducreyii
– Genus Properties: See Haemophilus influenzae
– Haemophilus ducreyii is occasionally found among
the vaginal flora or under the prepuce in males
• Transmission & Symptoms
– Transmission: Sexual contact
– Symptoms
• Painful soft chancre; sometimes mistaken for syphilis
• Urethritis; occasional pelvic inflammation
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V. F.
Miscellaneous Bacterial
Diseases
1.
Leprosy
2.
Staphylococcal Infections
3.
Pseudomonas aeruginosa Infections
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V. F. 1.
Leprosy
• Cause: Mycobacterium leprae
– Genus Properties: See “Tuberculosis”
– Cannot be cultured; detected by skin biopsy
• Transmission & Symptoms
– Skin contact; not particularly contagious
– Whitish skin lesions
– Loss of sensation due to nerve damage
– Disfiguration
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V. F. 2.
Staphylococcal Infections
• Cause: Staphylococcus aureus
– Genus Properties: See “Staph. Food Poisoning”
• Transmission & Symptoms
– Skin contact; opportunistic
– Skin Infections
•
•
•
•
Acne; boils; pimples
Abscesses; carbuncles
Impetigo
Scalded Skin Syndrome
– Toxic Shock Syndrome
• Septicemia & High fever
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V. F. 3.
Pseudomonas aeruginosa
Infections
• Cause: Pseudomonas aeruginosa
– Genus Pseudomonas
• Gram-negative rods
• Nonfermentative metabolism
• Most species are strictly aerobic
• Widely distributed in aquatic & moist soil
environments
• Can contaminate moist aerated surfaces:
water faucets; respiration equipment
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V. F. 3.
Pseudomonas aeruginosa
Infections
• Transmission & Symptoms
– Frequently an opportunistic or a nosocomial
infection
– Respiratory tract infections
– Urinary tract infections
– Infections in burn patients
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