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