Micro Ch 23 And 24


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Micro Ch 23 And 24

  1. 1. Chapter 23 Microbial Diseases of the Cardiovascular and Lymphatic Systems
  2. 2. The Cardiovascular System Figure 23.1
  3. 3. The Lymphatic System Figure 23.2
  4. 4. The Cardiovascular System and Lymphatics System <ul><li>Blood —Transports nutrients to and wastes from cells </li></ul><ul><li>White blood Cells —Defend against infection </li></ul><ul><li>Lymphatics —Transport interstitial fluid to blood </li></ul><ul><ul><li>Interstitial fluid (lymph) is blood plasma that has filtered out of the capillaries into spaces between tissue cells (interstitial spaces) </li></ul></ul><ul><li>Lymph nodes —Contain macrophages that clear pathogens from the lymph </li></ul>
  5. 5. <ul><li>Sepsis </li></ul><ul><ul><li>Bacteria growing in the blood </li></ul></ul><ul><ul><li>Fever, chills, increased heart rate and breathing </li></ul></ul><ul><li>Severe sepsis </li></ul><ul><ul><li>Results in drop in blood pressure , affects organs </li></ul></ul><ul><li>Septic shock </li></ul><ul><ul><li>Low blood pressure cannot be controlled by addition of fluid </li></ul></ul>Sepsis and Septic Shock
  6. 6. <ul><li>Gram-Negative Sepsis </li></ul><ul><ul><li>Endotoxins caused blood pressure decrease </li></ul></ul><ul><ul><li>Antibiotics can worsen condition by killing bacteria </li></ul></ul><ul><li>Gram-Positive Sepsis </li></ul><ul><ul><li>Nosocomial infections </li></ul></ul><ul><li>Puerperal Sepsis (Childbirth fever) </li></ul><ul><ul><li>Streptococcus pyogenes </li></ul></ul><ul><ul><li>Transmitted to mother during childbirth by attending physicians & midwives </li></ul></ul><ul><ul><li>Rx penicillin </li></ul></ul>Sepsis
  7. 7. Brucellosis <ul><li>Brucella abortus </li></ul><ul><li>Gram - rod </li></ul><ul><li>Cattle, swine </li></ul><ul><li>Direct contact, milk products. </li></ul><ul><li>Infects uterus- mesoerythritol requirement. ( a carbohydrate produced in the fetus ) </li></ul><ul><li>Chills, fever, malaise, heavy sweating. </li></ul><ul><li>Undulating - fever rises in evening 104˚C. </li></ul><ul><li>Animals secrete bacteria in milk. </li></ul><ul><li>Pasteurization process tailored for this pathogen. </li></ul><ul><li>Organism survives phagocytosis, grows intracellularly. </li></ul><ul><li>R x ~ tetracycline + streptomycin -long treatment. </li></ul>
  8. 8. Gas Gangrene <ul><li>Clostridium perfringens </li></ul><ul><li>Produces toxins that travel down muscle bundles. </li></ul><ul><li>Many proteolytic enzymes, hyaluronidase, collagenase, lipases. </li></ul><ul><li>P. aeruginosa can co-infect. </li></ul><ul><li>Treatment - remove necrotic tissue, amputation, surgical maggots. </li></ul><ul><li>Hyperbaric O 2 - internal tissues </li></ul><ul><li>R x ~ penicillin. </li></ul>
  9. 9. Gas Gangrene <ul><li>Clostridium perfringens </li></ul><ul><li>Gram + rod, anaerobe (not strict), sporeformer. </li></ul><ul><li>Ischemia -lack of blood supply. </li></ul><ul><li>Necrosis -tissue death. </li></ul><ul><li>Gangrene -death of soft tissue. </li></ul><ul><li>Diabetes, injury, cancer. </li></ul>
  10. 10. Bacterial Infections of the Heart <ul><li>Endocarditis </li></ul><ul><ul><li>Inflammation of the endocardium ( inner heart muscle lining) </li></ul></ul><ul><ul><li>Rapid destruction of the heart valves leads to death </li></ul></ul><ul><ul><li>Can be caused by Stapylococcus aureus and Streptococci </li></ul></ul><ul><ul><li>Rx penicillin </li></ul></ul>
  11. 11. Rheumatic Fever <ul><li>Repeated infections with S. pyogenes -strep throat. </li></ul><ul><li>Ages 4 - 18. </li></ul><ul><li>Joint pain. </li></ul><ul><li>Streptococal antigens (M protein) cross react with heart antigens. </li></ul><ul><li>Antibody response to kill organisms damages heart. </li></ul><ul><ul><li>Initial signs, arthritis and fever followed by nodes </li></ul></ul>
  12. 12. Anthrax <ul><li>Bacillus anthraci s, gram-positive, endospore-forming aerobic rod, found in soil </li></ul><ul><li>Cutaneous anthrax </li></ul><ul><ul><li>Endospores enter through minor cut, 20% mortality </li></ul></ul><ul><ul><li>Skin infection begins as a raised itchy bump that resembles an insect bite. Has a necrotic area in the center. </li></ul></ul><ul><li>Gastrointestinal anthrax </li></ul><ul><ul><li>Ingestion of undercooked food contaminated food, 50% mortality </li></ul></ul><ul><li>Inhalational anthrax </li></ul><ul><ul><li>Inhalation of endospores, </li></ul></ul><ul><ul><li>100% mortality </li></ul></ul>
  13. 13. Inhalation Anthrax cont. <ul><li>Initial symptoms may resemble a common cold – sore throat, mild fever, muscle aches and malaise. After several days, the symptoms may progress to severe breathing problems and shock. </li></ul><ul><li>Pulmonary form most serious, enters lungs then to bloodstream, leads to septicemia; usually fatal. Pathogenic factors include: </li></ul><ul><li>Anti-phagocytic capsule (poly- D -glutamic acid) </li></ul><ul><li>A potent exotoxin. </li></ul><ul><ul><li>EF- edema factor </li></ul></ul><ul><ul><li>PA- protective antigen - binding factor </li></ul></ul><ul><ul><li>LF- lethal factor </li></ul></ul><ul><li>R x ~ penicillin, docycycline; ciprofloxacin. </li></ul>
  14. 14. What Disease ? <ul><li>Ring around the rosy 1 </li></ul><ul><li>A pocketful of posies 2 </li></ul><ul><li>&quot;Ashes, Ashes&quot; 3 </li></ul><ul><li>We all fall down! </li></ul>1 rosy red rash in the shape of a ring on the skin- flea bite. 2 Pockets and pouches were filled with sweet smelling herbs ( or posies) which were carried due to the belief that the disease was transmitted by bad smells. 3 The term &quot;Ashes Ashes&quot; refers to the cremation of the dead bodies!
  15. 15. Vector Borne Diseases - Plague <ul><li>Ysernia pestis </li></ul><ul><li>Gram - rod. </li></ul><ul><li>Zoonoses, disease of rodents (squirrels, prairie dogs) spread by rat flea. </li></ul><ul><li>14 -15th Centuries killed 1/4 th to 1/3 rd of entire European population. </li></ul><ul><li>The Black Death </li></ul>
  16. 16. Vector Borne Diseases - Plague <ul><li>Ysernia pestis </li></ul><ul><li>Gram - rod. </li></ul><ul><li>Pathogenic factors: </li></ul><ul><ul><li>9.5 kb plasmid that codes for a plasminogen activator that is necessary for systemic spread. </li></ul></ul><ul><ul><li>Another plasmid that codes for an anti-phagocytic capsule. </li></ul></ul>Organism enters blood via bite and can grow in phagocytes. R x ~ streptomycin, tetracycline .
  17. 17. Vector Borne Diseases - Plague <ul><li>Symptoms: </li></ul><ul><li>8 days post infection </li></ul><ul><li>Fever, chills, headache, then vomiting and nausea. </li></ul><ul><li>6-8 days later bubos form in lymph glands, </li></ul><ul><li>sensitive and painful. </li></ul>Ysernia pestis Septicemia causes septic shock. Death occurs in a week. 50-75% Mortality if untreated. Some cases can go pneumonic form of the disease -death can occur in 15 -24 hours. Only pneumonic form can be spread person to person. Pneumonic form produces a blood tainted sputum.
  18. 18. Relapsing Fever <ul><li>Borrelia recurrensis or hermsii </li></ul><ul><li>Spirochete - no Gram reaction. </li></ul><ul><li>Spread by soft ticks. </li></ul><ul><li>Fever, jaundice, rose-colored skin spots. </li></ul><ul><li>Fever breaks after 3-4 days and patient appears to recover. </li></ul>
  19. 19. Relapsing Fever <ul><li>Borrelia recurrensis or hermsii </li></ul><ul><li>Fever reappears due to surface antigens changing. </li></ul><ul><li>R x ~ penicillin. </li></ul>
  20. 20. Lyme’s Disease <ul><li>Borrelia burgdorferi </li></ul><ul><li>Spirochete - no Gram reaction. </li></ul><ul><li>Spread by hard ticks. </li></ul><ul><li>Organisms infects tick salivary glands. </li></ul><ul><li>10,000 cases annually -most prevalent ABD. </li></ul><ul><li>Rodents reservoir. Deer in life cycle of tick. </li></ul>
  21. 21. Lyme’s Disease <ul><li>Borrelia burgdorferi </li></ul><ul><li>Bull’s -eye rash -erythema migrans around bite. </li></ul><ul><li>Flu-like symptoms follow. </li></ul><ul><li>Later stages similar to syphilis - heart and neurological involvement. </li></ul><ul><li>Joint degeneration. </li></ul><ul><li>R x ~ penicillin. </li></ul>
  22. 22. Lyme’s Disease
  23. 23. Chapter 24 Microbial Diseases of the Respiratory System
  24. 24. Breathing <ul><li>It starts at the nose. About 20 times a minute. </li></ul><ul><li>When you do, you inhale air and pass it through your nasal passages where the air is filtered, heated, moistened and enters the back of the throat. </li></ul><ul><li>Interestingly enough, it's the esophagus or food pipe which is located at the back of the throat and the windpipe for air which is located at the front. </li></ul><ul><li>When we eat, a flap -- the epiglottis -- flaps down to cover the windpipe so that food doesn't go down the windpipe. </li></ul>
  25. 25. what happens to the carbon dioxide? <ul><li>It goes through the lungs, back up your windpipe and out with every exhale. </li></ul><ul><li>It's a remarkable feat, this chemical exchange and breathing in and out. </li></ul><ul><li>You don't have to tell your lungs to keep working. Your brain does it automatically for you. </li></ul>
  26. 26. Factoids <ul><li>Your lungs contain almost 1500 miles of airways and over 300 million alveoli. </li></ul><ul><li>Every minute you breathe in 13 pints of air. Plants are our partners in breathing. </li></ul><ul><li>We breathe in air, use the oxygen in it, and release carbon dioxide. Plants take in carbon dioxide and release oxygen. </li></ul><ul><li>People tend to get more colds in the winter because we're indoors more often and in close proximity to other people. </li></ul><ul><li>When people sneeze, cough and even breathe -- germs go flying </li></ul>
  27. 27. <ul><li>Upper respiratory normal microbiota may include pathogens </li></ul>Upper Respiratory System Figure 24.1
  28. 28. Microbial Diseases of the Upper Respiratory System <ul><li>Laryngitis </li></ul><ul><ul><li>Infection of the larynx, affects speaking ability </li></ul></ul><ul><li>Tonsillitis </li></ul><ul><ul><li>Inflammed tonsils </li></ul></ul><ul><li>Sinusitis </li></ul><ul><ul><li>Mucous membranes become inflammed </li></ul></ul><ul><li>Epiglottitis </li></ul><ul><ul><li>Inflammation of the epiglottis, most dangerous </li></ul></ul>
  29. 29. Steptococcal Pharyngitis <ul><li>Streptococcus pyogenes </li></ul><ul><li>Gram + cocci, chains </li></ul><ul><li> -hemolytic, M protein makes resistant to phagocytosis. </li></ul><ul><li>Streptokinase, streptolysin. </li></ul><ul><li>Culture from throat swab. </li></ul><ul><li>Local infection, sore throat, fever. </li></ul><ul><li>Can progress to otidis media. </li></ul><ul><li>R x ~ penicillin. </li></ul>
  30. 30. Scarlet Fever <ul><li>Streptococcus pyogenes </li></ul><ul><li>Invades upper respiratory tract. </li></ul><ul><li>Erythrogenic toxin produces small “goose bumps” on skin - spreads over entire body except face, palms, and soles to make red rash. </li></ul><ul><li>High fever, chills, nausea, vomiting, abdominal pain, and malaise. </li></ul>
  31. 31. Scarlet Fever <ul><li>Streptococcus pyogenes </li></ul><ul><li>While the rash is still red, the patient may develop Pastia's lines, bright red coloration of the creases under the arm and in the groin. </li></ul><ul><li>R x ~ penicillin. </li></ul>
  32. 32. Diphtheria <ul><li>Corynebacterium diphtheriae </li></ul><ul><li>Gram + pleomorphic rods </li></ul><ul><ul><li>Club shaped, chinese characters. </li></ul></ul><ul><li>Colonizes throat. </li></ul><ul><li>Produces potent toxin that inhibits protein synthesis. </li></ul>
  33. 33. Diphtheria <ul><li>Corynebacterium diphtheriae </li></ul><ul><li>Produces pseudomembrane on back of throat. </li></ul><ul><ul><li>Can block breathing. </li></ul></ul><ul><ul><li>Diphtheria means “leather” for the texture of the pseudomembrane. </li></ul></ul><ul><li>Produces potent toxin that inhibits protein synthesis. </li></ul><ul><li>Give anti-toxin </li></ul><ul><ul><li>First developed by Von Behring* in 1890. </li></ul></ul><ul><li>R x ~ penicillin, erythromycin. </li></ul><ul><li>Vaccine DTaP -2, 4, 6 months. </li></ul>
  34. 34. Otidis media <ul><li>Earache. </li></ul><ul><li>S. pneumoniae 35% </li></ul><ul><li>H. influenzae 20-30% </li></ul><ul><li>M. catarrhalis 10-15% </li></ul><ul><li>S. pyogenes 8-10% </li></ul><ul><li>S. aureus 1-2% </li></ul><ul><li>85% under age of 3 </li></ul><ul><ul><li>Eustacian tube “S-shaped”. </li></ul></ul><ul><li>R x ~ amoxicillin, sulfa drugs. </li></ul>
  35. 35. Lower Respiratory System <ul><li>Is nearly sterile, does not typically have normal microbiota </li></ul>
  36. 36. <ul><li>Bacteria, viruses, & fungi cause: </li></ul><ul><ul><li>Bronchitis </li></ul></ul><ul><ul><li>Bronchiolitis </li></ul></ul><ul><ul><li>Pneumonia </li></ul></ul>Microbial Diseases of the Lower Respiratory System
  37. 37. Pertussis (Whooping cough) <ul><li>Bordetella pertusis </li></ul><ul><li>Gram - obligate aerobe, capsulated, coccobacillus. </li></ul><ul><li>Destroys cillary cells. </li></ul><ul><li>Cytotoxin. </li></ul><ul><li>Whoop comes from sound of patient gasping for air between coughs. </li></ul><ul><li>Vaccination -DPT has reduced number from 250,000 to 7000. </li></ul><ul><li>Immunity lasts ~12 yrs. </li></ul><ul><li>R x ~ erythromycin. </li></ul><ul><li>Mainly a childhood disease </li></ul><ul><li>Violent coughing, can result in broken ribs in children </li></ul>
  38. 38. Tuberculosis (consumption) <ul><li>Mycobacterium tuberculosis </li></ul><ul><li>Acid -fast rod, in filaments (myco -fungus). </li></ul><ul><li>Air-borne, sputum. </li></ul><ul><li>Enters lung, reaches alveoli. </li></ul><ul><li>Macrophages wall off into a tubercle in healthy people. </li></ul><ul><li>When immune system weakens or fails they can reinfect lungs. </li></ul>
  39. 39. Tuberculosis
  40. 40. Tuberculosis
  41. 41. Tuberculosis <ul><li>Symptoms include coughing, rusty (blood) sputum, weight loss. </li></ul><ul><li>Diagnosis </li></ul><ul><ul><li>X-ray, tuberculin test </li></ul></ul><ul><ul><li>Tuberculin indicates exposure , not necessarily active disease. </li></ul></ul><ul><ul><li>Culture, PCR faster. </li></ul></ul><ul><li>MAIS - AIDS patients. </li></ul><ul><li>R x ~ isoniazid, rifampicin, streptomycin. </li></ul>
  42. 42. Bacterial pneumonias <ul><li>Streptococcus pneumoniae </li></ul><ul><li>Gram + diplococcus, capsulated. </li></ul><ul><li>Infects bronchi and alveoli. </li></ul><ul><li>High fever, difficulty breathing, chest pains. </li></ul><ul><li>Lungs fill with fluid. </li></ul><ul><li>Sometimes progresses to septicemia and meningitis. </li></ul><ul><li>R x ~ penicillin. </li></ul>
  43. 43. Bacterial pneumonias <ul><li>Hemophilus influenzae </li></ul><ul><ul><li>R x ~ cephalosporins. </li></ul></ul><ul><li>Mycoplasma pneumoniae </li></ul><ul><ul><li>Atypical “walking” pneumoniae </li></ul></ul><ul><ul><li>No cell wall </li></ul></ul><ul><ul><li>Low grade fever, headache, cough </li></ul></ul><ul><ul><li>Colonies “fried egg”appearance. </li></ul></ul><ul><ul><li>R x ~ tetracycline. </li></ul></ul><ul><li>Chlamydia pneumoniae </li></ul><ul><ul><li>OIP, needs ATP. </li></ul></ul><ul><ul><li>Associated w atherosclerosis </li></ul></ul><ul><ul><li>R x ~ tetracycline. </li></ul></ul>
  44. 44. Legionaires Disease <ul><li>Legionella pneumophila </li></ul><ul><li>Gram - rod, aerobic, non-sporeformer. </li></ul><ul><li>Occurs in nature, water. Resistant to chlorine. </li></ul><ul><li>Enters lung via aerosol. </li></ul><ul><li>High fever, other symptoms of pneumonia. </li></ul><ul><li>R x ~ erythromycin. </li></ul>
  45. 45. Legionaires Disease <ul><li>NORMAL </li></ul><ul><li>Legionella </li></ul>
  46. 46. Tuberculosis <ul><li>Mycobacterium tuberculosis : Acid-fast rod. </li></ul><ul><li>Transmitted from human to human </li></ul><ul><li>Treatment by prolonged use of multiple antibiotics </li></ul><ul><li>Major problem in treating due to lack of patient compliance </li></ul><ul><li>Vaccines: BCG </li></ul>
  47. 47. Pneumonia <ul><li>Pneumococal Pneumoniae </li></ul><ul><ul><li>Streptococcus pneumoniae : Gram-positive with capsule </li></ul></ul><ul><ul><li>Diagnosis by culturing bacteria </li></ul></ul><ul><ul><li>Penicillin is drug of choice </li></ul></ul><ul><li>Haemophilus influenzae Pneumoniae </li></ul><ul><ul><li>Alcoholism, poor nutrition, cancer, or diabetes are predisposing factors </li></ul></ul>