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Powerpoints Chap. 12

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  • 1. 1 Chapter 12 Sexually Transmitted, Contact, and Miscellaneous Bacterial Diseases
  • 2. Sexually Transmitted Diseases • Syphilis • Gonorrhea • Chlamydia • Ureaplasmal Urethritis • Chancroid 2
  • 3. ?? Why Aren’t Sexually Transmitted Diseases Caught by “Casual” or “Familial” Contact?? 3
  • 4. 4 Syphilis • Syphilis Is a Chronic, Infectious Disease • Syphilis is one of the top five most reported microbial diseases in the U.S. • It is caused by Treponema pallidum, a spirochete for which humans are the only host
  • 5. 5 • Primary syphilis is characterized by a lesion (chancre) where the bacteria entered the body • Secondary syphilis involves: • fever • skin rash • swollen lymph nodes • A chronic latent stage of 3-30 years follows in which relapses of secondary syphilis occur
  • 6. 6 • Tertiary syphilis involves formation of gummas that can cause: • Aneurysms • degeneration of spinal cord tissue – “tabes dorsalis” • brain damage leading to personality and judgment changes and insanity
  • 7. Congenital syphilis can occur in the fetus of a pregnant woman, leading to: • stillbirth • birth defects like Hutchinson’s triad 7
  • 8. Gonorrhea • caused by Neisseria gonorrhoeae • Gonorrhea can affect the: • Reproductive organs • Pharynx • Rectum • Eyes 8
  • 9. 9 • Many affected females are asymptomatic • Males experience: • tingling of the penis • pain when urinating • penile discharge • swollen lymph nodes • painful testicles • It can cause infertility in males
  • 10. • In females it can spread to the fallopian tubes, causing: • salpingitis • pelvic inflammatory disease (PID) • possible sterility • ectopic pregnancy 10
  • 11. Salpingitis Can Cause Sterility 11
  • 12. Neonatal Gonococcal Ophthalmia • Infants can contract gonococcal ophthalmia while passing through the birth canal 12
  • 13. 13 Chlamydial Urethritis • Can Be Asymptomatic • Chlamydial urethritis (chlamydia) is caused by Chlamydia trachomatis • Chlamydia is the most commonly reported notifiable disease in the U.S. • Chlamydia is one of several diseases known as a non- gonococcal urethritis (NGU) • 85-90% of infected individuals are asymptomatic
  • 14. 14 • C. trachomatis cannot make its own ATP and must rely on the host cell for energy • It has two phases: the infectious elementary body and the noninfectious reticulate body Figure 12.6, page 340
  • 15. 15 • Spreading to the fallopian tubes can cause salpinigitis • Left untreated it can cause PID • Males complain of painful urination and watery discharge • It can cause infertility in males Figure 12.7, page 340
  • 16. 16 • Chlamydia can also occur in the pharynx or anus • Newborns can contract chlamydial ophthalmia during delivery • Infection can be detected by a fluorescent antibody test or DNA analysis, chlamydiazyme test
  • 17. 17 Chancroid • Causes Painful Genital Ulcers • Chancroid (soft chancre) is caused by Haemophilus ducreyi • It is common in areas with low public health standards and tropical climates • A papule forms at the entry site that fills with pus and breaks down • This leaves a painful, bleeding ulcer • Lesions often form on the penis in men, labia or clitoris in females
  • 18. Chancroid chancres Bubo 18
  • 19. 19 Ureaplasmal Urethritis • Produces Mild Symptoms • It is an NGU caused by Ureaplasma urealyticum (T-mycoplasma) • Symptoms are similar to those of gonorrhea or chlamydia, but are often mild • Infertility can occur in men, salpingitis in women • U. urealyticum can colonize the placenta during pregnancy, causing: • miscarriage or • premature birth
  • 20. Contact Bacterial Diseases • Hansen’s Disease • Staphylococcal Skin Infections • Toxic Shock • Septicemia • Streptococcal Skin Infections • SSSS • STSS • Necrotizing Fasciitis • Trachoma • Bacterial Conjunctivitis • Yaws 20
  • 21. 21 Hansen’s Disease (Leprosy) • Leprosy (Hansen’s Disease) Is a Chronic, Systemic Infection • It is caused by Mycobacterium leprae, an obligate intracellular parasite • About 95% of the world’s population is immune to leprosy • It is spread through contact, Upper respiratory tract secretions • It has a long incubation period of 3-6 years
  • 22. 22 • Leprosy causes: • disfigurement of skin and bones • twisting of limbs and curling of fingers • loss of facial features Figure 12.9, page 346
  • 23. Mycobacterium leprae • Gram neutral, acid- fast bacillus • Thick waxy capsule • Generation time = 30 hours • In certain individuals, M. leprae can evade the immune system 23
  • 24. 24 • Two forms: • Tuberculoid (neural) • Lepromatous • Tuberculoid leprosy painless non-progressive disease involving the skin and surface nerves • Patients lose feeling in their hands, skin • Can lead to accidental damage to body
  • 25. In lepromatous leprosy, tumor-like lepromas form on the skin and respiratory tract • The immune system does not react leading to a more serious form of the disease 25
  • 26. Lepromatous Leprosy 26
  • 27. 27 Staphylococcal Contact Diseases • Have Several Manifestations • Localized skin infections involve puss-filled pockets in the skin • Folliculitis is an infection at the base of a hair follicle
  • 28. 28 • An abscess is a circumscribed puss-filled lesion • A furuncle (boil) is a warm, painful abscess associated with a hair follicle • Carbuncles are a group of connected, deeper abscesses transmitted by skin contact • If an abscess breaks internally, infection can be spread
  • 29. 29 • Impetigo is a skin infection common in children involving oozing blisters in the epidermis • Antibiotic resistance in S. aureus is well known • MRSA • VRSA
  • 30. 30 • Some S. aureus diseases result from contact with toxin • Scalded skin syndrome (SSS) involves red, wrinkled, tender, and peeling skin – This usually occurs in children or immunocompromised people • Toxic shock syndrome (TSS) is characterized by sudden fever and circulatory collapse – Use of tampons have been associated with TSS, but it is not the only cause
  • 31. Streptococcal Infections • SSSS • STSS • Impetigo • Necrotizing fasciitis 31
  • 32. SSSS 32
  • 33. STSS 33
  • 34. Septicemia 34
  • 35. Necrotizing Fasciitis 35
  • 36. 36 • Trachoma is Transmitted by Personal Contact • Trachoma is the world’s leading cause of preventable blindness • It is caused by a serotype of Chlamydia trachomatis Figure 12.12, page 349
  • 37. 37
  • 38. 38 • It is transmitted by: • contact with contaminated objects • face-to-face contact • flies • Nodules form in the conjunctiva • The upper eyelid can turn in, causing abrasion of the cornea • Tear flow can be inhibited, allowing for secondary infections
  • 39. 39
  • 40. 40 • Bacterial Conjunctivitis (Pinkeye) Is Very Common • It is often caused by Haemophilus aegyptius • The conjunctive membrane is inflamed - blood vessels dilate • This causes the white of the eye to appear pink • The eye is swollen and itchy and excretes copious discharge • It is extremely contagious, spread by: • contaminated objects • face-to-face contact • airborne droplets
  • 41. Bacterial Conjunctivitis 41
  • 42. 42 • Yaws Starts as Skin Sores • Yaws (frambesia) is caused by Treponema pertenue • It is similar in appearance and chemistry to Treponema palladium • Transmission occurs through nonsexual contact
  • 43. 43
  • 44. 44 • First, a red, raised lesion occurs at the site of entry • Later, numerous soft granular nodules appear on the face, arms, and legs • Left untreated, destruction of limb and face flesh and bone occurs • Bejel and pinta are similar to Yaws • They are referred to as treponematoses
  • 45. 45 Oral Diseases • Cause Pain and Disability for Affected Individuals • At least 600 species of bacteria inhabit the human mouth • Plaque is a biofilm, containing salivary proteins, food debris and bacterial cells and products • Dental caries (tooth decay) results from: • dietary carbohydrates • Synergistic bacteria • Streptococcus mutans – levans and glucans form plaque • Lactobacillus digests these carbohydrates – forms acids • Acids hydrolyze enamel and bone of the teeth
  • 46. Preventing Dental Caries Work with 3 circles in the pie graph: • Teeth • Fluoride replaces OH- group in hydroxyapatite crystals • Coat teeth with polyresin • Bacteria • Reduce dietary sugars • Brush, Floss, Mouthwash 46 Figure 12.15b, page 355
  • 47. Dental Caries Can Result in Tooth Loss, Infection, Even Death 47
  • 48. 48 • Periodontal disease results from the inflammation of periodontal tissue • Poor oral hygiene leads to increased subgingival plaque, which can be populated by bacteria • It is characterized by: – ulcers and bleeding along the gingival margin – degradation of periodontal ligaments and bone – loosened or lost teeth Figure 12.16, page 356
  • 49. Periodontal Disease • ANUG = Acute Necrotizing Ulcerative Gingivitis • AKA “Trenchmouth” • Leptotrichia buchalis • Treponema vincenti 49
  • 50. Nosocomial Infections • Hospital Acquired Infections • Escherichia coli • Serratia marcescens • Enterobacter cloacae • Klebsiella pneumoniae • Staphylococcus aureus • Pseudomonas aeruginosa 50
  • 51. Nosocomial Infections Relative frequency by body site 51
  • 52. 52 • Nosocomial Infections Can Be Acquired in a Healthcare Setting • Up to 10% of all hospital patients in the U.S. develop a nosocomial disease • Many patients have some interference with normal immune defenses, making them susceptible • Most nosocomial diseases are caused by opportunistic organisms the patients bring in themselves
  • 53. 53 • UTIs and post-operative infection with bacteria are common nosocomial infections • Drug-resistant bacteria are a major source of concern Figure 12.19, page 361
  • 54. 54 • A chain of transmission between patients is established by: • Health care workers • Contaminated equipment or instruments • A nurse epidemiologist is often present to identify and report problems • Handwashing between patient examinations is critical in preventing nosocomial infection