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Powerpoints Chap. 12

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  • 1. Chapter 12 Sexually Transmitted, Contact, and Miscellaneous Bacterial Diseases
  • 2. Sexually Transmitted Diseases
    • Syphilis
    • Gonorrhea
    • Chlamydia
    • Ureaplasmal Urethritis
    • Chancroid
  • 3.
    • ?? Why Aren’t Sexually Transmitted Diseases Caught by “Casual” or “Familial” Contact??
  • 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.
      • 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.
      • 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
  • 8. Gonorrhea
      • caused by Neisseria gonorrhoeae
      • Gonorrhea can affect the:
        • Reproductive organs
        • Pharynx
        • Rectum
        • Eyes
  • 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
  • 11. Salpingitis Can Cause Sterility
  • 12. Neonatal Gonococcal Ophthalmia
      • Infants can contract
      • gonococcal
      • ophthalmia while
      • passing through
      • the birth canal
  • 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.
      • 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.
      • 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.
      • 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.
    • 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
  • 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
  • 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.
      • 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
  • 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
  • 26. Lepromatous Leprosy
  • 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.
      • 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.
      • 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.
      • 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
  • 32. SSSS
  • 33. STSS
  • 34. Septicemia
  • 35. Necrotizing Fasciitis
  • 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.
  • 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.
  • 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
  • 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.
  • 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.
    • 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
    Figure 12.15b, page 355
  • 47. Dental Caries Can Result in Tooth Loss, Infection, Even Death
  • 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
  • 50. Nosocomial Infections
    • Hospital Acquired Infections
      • Escherichia coli
      • Serratia marcescens
      • Enterobacter cloacae
      • Klebsiella pneumoniae
      • Staphylococcus aureus
      • Pseudomonas aeruginosa
  • 51. Nosocomial Infections Relative frequency by body site
  • 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.
      • 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.
      • 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