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Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
Lecture 4. classification of inf. dis.
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Lecture 4. classification of inf. dis.

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  • 1. Classification of the infection diseases Sorokhan V.D., MD, PhD Bukovinian State Medical University Department of the infectious diseases and epidemiology
  • 2. Microbiological Classification of Infectious Diseases Protozoa Helminths Parasitic Prion Disseminated Localized Fungal DNA virus RNA virus Enveloped vs non-enveloped Viral Gram-negative Gram-positive Bacterial
  • 3. Gram-negative bacteria
    • Gram-negative bacteria are those that are stained red or pink by Gram staining
    Gram-negative Pseudomonas aeruginosa bacteria (pink-red rods)
  • 4. Gram negative Cocobacilli H. Influenzae, B. Pertussis Brucella spp., F. Tularensis P. Multosida, L. pneumophila Cocci Neisseria spp. Bacilli N. Meningitidis Glucose and maltose + N. Gonnorrhoeae Glucose + Lactose + Lactose - Slow fermenter Citrobacter Serratia Fast fermenter Klebsiella E.Coli Enterobacter Oxidase + V.Cholerae P. aeruginosa Strict anaerode B. fragilis Oxidase - Urease – Y. Pestis S. Dysenteriae Salmonnela spp. Urease + P. Mirabilis H. pylori
  • 5. Gram-positive bacteria
    • Gram-positive bacteria are those that are stained dark blue or violet by Gram staining . This is in contrast to Gram-negative bacteria , which cannot retain the crystal violet stain, instead taking up the counterstain ( safranin or fuchsine ) and appearing red or pink.
    Gram-positive Bacillus anthracis bacteria (purple rods) in cerebrospinal fluid sample. The other cells are white blood cells .
  • 6. Gram positive cocci Bacilli, Corinebacterium Clostridium, Listeria, Bacillus Staphylococcus catalase + Streptococcus catalase - S. Aureus Coagulase + Coagulase - β -hemolytic α -hemolytic S. Pneumoniae S. Viridans S. Mutans γ -hemolytic E. Faecalis E. Faecium S. Epidermis Novobiocin sensitive S. Saprophyticus Novobiocin resistant Group A S. Piogenes Group B S.agalactiae
  • 7. Basic laboratory characteristics highly motile Gram-negative, but stains poorly Borrelia burgdorferi Borrelia Aerobic Unencapsulated Small coccobacilli Gram-negative Brucella abortus Brucella canis Brucella melitensis Brucella suis Brucella aerobic Encapsulated Small coccobacilli Gram-negative Bordetella pertussis Bordetella Curved, spiral, or S-shaped with single, polar flagellum Shape microaerophilic characteristic darting motion Gram-negative Campylobacter jejuni Campylobacter Respiration Motility Capsulation Gram staining Important species Genus
  • 8. Obligate anaerobic mostly motile Large, blunt-ended rods Gram-positive Clostridium botulinum Clostridium difficile Clostridium perfringens Clostridium tetani Clostridium Mostly facultative anaerobic nonmotile unencapsulated Small, slender, pleomorphic rods Gram-positive (unevenly) Corynebacterium diphtheriae Corynebacterium Facultative or strictly aerobic motile Small, round, ovoid (not Gram-stained) Chlamydia pneumoniae Chlamydia trachomatis Chlamydophila psittaci Chlamydia and Chlamydophila Round to ovoid Shape Facultative Anaerobic Gram-positive Enterococcus faecalis Enterococcus faecium Enterococcus Respiration Motility Capsulation Gram staining Important species Genus
  • 9. strictly aerobic Small, pleomorphic coccobacillus Gram-negative Francisella tularensis Francisella Ranging from small coccobacillus to long, slender filaments Gram-negative Haemophilus influenzae Haemophilus Facultative anaerobic Short rods Gram-negative Escherichia coli Escherichia Curved or spiral rods pultiple polar flagella Shape rapid, corkscrew motility Gram-negative Helicobacter pylori Helicobacter Respiration Motility Capsulation Gram staining Important species Genus
  • 10. highly motile Long, very slender, flexible, spiral- or corkscrew-shaped rods Gram-negative, but stains poorly Leptospira interrogans Leptospira Distinct tumbling motility in liquid medium Slender, short rods Gram-positive, darkly Listeria monocytogenes Listeria motile unencapsulated Slender rod in nature, cocobacillary in laboratory. monotrichious flagella Gram-negative, but stains poorly Legionella pneumophila Legionella Long, slender rods Shape aerobic nonmotile (none) Mycobacterium leprae Mycobacterium tuberculosis Mycobacterium ulcerans Mycobacterium Respiration Motility Capsulation Gram staining Important species Genus
  • 11. aerobic Kidney bean-shaped Gram-negative Neisseria gonorrhoeae Neisseria meningitidis Neisseria Obligate aerobic motile encapsulated rods Gram-negative Pseudomonas aeruginosa Pseudomonas Plastic, pleomorphic (none) Mycoplasma pneumoniae Mycoplasma Small, rod-like coccobacillary Shape Gram-negative, but stains poorly Rickettsia rickettsii Rickettsia Respiration Motility Capsulation Gram staining Important species Genus
  • 12. Facultative anaerobic rods Gram-negative Shigella sonnei Shigella Facultative anaerobic Round cocci Gram-positive, darkly Staphylococcus aureus Staphylococcus epidermidis Staphylococcus saprophyticus Staphylococcus Facultative anaerobic Gram-negative Salmonella typhi Salmonella typhimurium Salmonella ovoid to spherical Shape Facultative anaerobic nonmotile Gram-positive Streptococcus agalactiae Streptococcus pneumoniae Streptococcus pyogenes Streptococcus Respiration Motility Capsulation Gram staining Important species Genus
  • 13. Facultative anaerobic rapidly motile Short, curved, rod-shaped with single polar flagellum Gram-negative Vibrio cholerae Vibrio Facultative Anaerobe nonmotile encapsulated Small rods Gram-negative, stains bipolarly Yersinia pestis Yersinia highly motile Long, slender, flexible, spiral- or corkscrew-shaped rods Gram-negative, but stains poorly Treponema pallidum Treponema Shape Respiration Motility Capsulation Gram staining Important species Genus
  • 14. Clinical characteristics Large, grayish, nonhemolytic colonies with irregular borders on blood agar Direct immunofluorescence Anthrax vaccine autoclaving of instruments In early infection: Penicillin Doxycycline Ciprofloxacin Cutaneous anthrax Pulmonary anthrax Gastrointestinal anthrax Contact with sheep, goats and horses Inhalation or skin penetration through abrasions of spore-contaminated dust Bacillus anthracis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 15. Direct immunofluorescence PCR amplification Pertussis vaccine, DPT vaccine Macrolide antibiotics Azithromycin Erythromycin Clarithromycin Whooping cough Complications: Secondary bacterial pneumonia Contact with respiratory droplets expelled by infected human hosts. Bordetella pertussis Microscopy using Giemsa or Wright stain PCR serology (low precision rate ) Lyme vaccine wearing clothing that limits skin exposure to ticks insect repellent Early stages: cephalosporins amoxicillin doxycycline If arthritic symptoms have appeared: Longer courses of antibiotics Lyme disease Ixodes ticks reservoir in deer, mice and other rodents Borrelia burgdorferi laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 16. Culture (difficult and time consuming) Agglutination serology Combination therapy of: doxycycline streptomycin or gentamicin Brucellosis Direct contact with infected animal Oral, by ingestion of unpasteurized milk or milk products Brucella abortus Brucella canis Brucella melitensis Brucella suis Symptomatically by fluid and electrolyte replacement Ciprofloxacin in severe cases Acute enteritis Fecal/oral from animals (mammals and fowl) Contaminated meat (especially poultry) Contaminated water Campylobacter jejuni laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 17. None for routine use None Doxycycline Erythromycin Community-acquired respiratory infection Respiratory droplets Chlamydia pneumoniae Cellular cytoplasmic inclusions by immunofluorescence DNA hybridization ELISA for lipopolysaccharides No vaccine Erythromycin or silver nitrate in newborn's eyes Safe sex Azithromycin Erythromycin Tetracyclines Doxycycline Nongonococcal urethritis (NGU) Lymphogranuloma venereum (LGV) Trachoma Inclusion conjunctivitis of the newborn (ICN) Sexual ( NGU , LGV ) Direct or contaminated surfaces and flies (trachoma) Passage through birth canal ( ICN ) Chlamydia trachomatis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 18. Rise in antibody titre Complement fixation indirect immunofluorescence Tetracycline Doxycycline Erythromycin (less efficient) Psittacosis Inhalation of dust with secretions or feces from birds (e.g. parrots) Chlamydophila psittaci Mouse inoculation detects toxin from food, intestinal contents or serum Culture in standard aerobic culture Proper food preservation techniques Antitoxin (horse antiserum ) Botulism Spores from soil and aquatic sediments contaminating vegetables, meat and fish Clostridium botulinum laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 19. ELISA for Toxin ELISA for toxin A or B Endoscopy for pseudomembrane None Discontinuing predisposing antibiotic Fluid and electrolyte replacement Vancomycin or metronidazole if severe Pseudomembranous colitis Spores both indoors and outdoors Human flora , overgrowing when other flora is depleted Clostridium difficile Microscopically Blood agar culture, forming double-zone β - hemolysis Sugar fermentation Organic acid production Appropriate food handling Food poisoning: Self-limiting; Supportive care is sufficient Gas gangrene Acute food poisoning Anaerobic cellulitis Spores in soil Human flora in vagina and GI tract Clostridium perfringens laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 20. (difficult) DPT vaccine Tetanus immune globulin Horse antitoxin, alternatively Sedatives Muscle relaxants Mechanical ventilation Tetanus Spores in soil infecting puncture wounds, severe burns or surgery Clostridium tetani no rapid) Culture on Tinsdale agar , followed by immunologic precipitin reaction DPT vaccine Horse serum antitoxin Erythromycin Penicillin Diphtheria Respiratory droplets Part of human flora Corynebacterium diphtheriae laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 21. Culture in 6.5% NaCl Can hydrolyze esculin in presence of bile No vaccine Hand washing and other nosocomial prevention Penicillin and an aminoglycoside Vancomycin Quinupristin and dalfopristin Nosocomial infections Part of human flora, opportunistic or entering through GI tract or urinary system wounds Enterococcus faecalis and Enterococcus faecium Culture on MacConkey agar and study carbohydrate fermentation patterns: Lactose fermentation (most E. coli strains) . Gas production in glucose fermentation Mannitol fermentation (no vaccine or preventive drug) Food and water preparation Hand washing and disinfection UTI: Co-trimoxazole Fluoroquinolone , e.g. ciprofloxacin Meningitis: Cephalosporin and gentamicin combination Diarrhea: Antibiotics above shorten duration Electrolyte and fluid replacement Urinary tract infections (UTI) Diarrhea Meningitis in infants Part of gut flora , spreading extraintestinally or proliferating in the GI tract Escherichia coli (generally) laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 22. rarely cultured) Serology Avoiding insect vectors Precautions when handling wild animals or animal products Streptomycin Gentamicin Tularemia vector -borne by anthropods Infected wild or domestic animals, birds or house pets Francisella tularensis Culture on chocolate agar with hemin (factor X) and NAD+ (factor V) Quellung reaction Immunofluorescence staining of capsule Detection of capsular antigen in CSF or other body fluids Hib vaccine to infants Rifampin prophylactically Meningitis: (resistance-tests are required first) Third generation cephalosporin , e.g. cefotaxime or ceftriaxone Ampicillin and sulbactam combination Bacterial meningitis Upper respiratory tract infections Pneumonia , bronchitis Droplet contact Human flora of e.g. upper respiratory tract Haemophilus influenzae laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 23. Microscopically Corkscrew movement Urease -positivity by radioactively labeled urea Serology by ELISA (No vaccine or preventive drug) Tetracycline , metronidazole and bismuth salt combination Peptic ulcer Risk factor for gastric carcinoma and gastric B-cell lymphoma Colonizing stomach Unclear person-to-person transmission Helicobacter pylori Culture from respiratory secretions on buffered charcoal yeast extract enriched with L- cysteine , iron and α - ketoglutarate Serology, including direct immunofluorescence and radioimmunoassay for antigen in urine Hybridization to ribosomal RNA using DNA probe (no vaccine or preventive drug) Heating water Macrolides , e.g. erythromycin or azithromycin Fluoroquinolones Legionnaire's Disease Pontiac fever Droplet contact, from e.g. cooling towers , humidifiers , air conditioners and water distribution systems Legionella pneumophila laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 24. Dark-field microscopy on fresh blood smear (but doesn't stain well) Serologic agglutionation tests (no vaccine) Doxycycline Prevention of exposure Rodent control Penicillin G Tetracycline , e.g. doxycycline Leptospirosis Food and water contaminated by e.g. urine from wild or domestic animals. Leptospira survives for weeks in stagnant water Leptospira interrogans Isolation from e.g. blood and CSF Beta- hemolysis and catalase production on blood agar Microscopy for morphology and motility (no vaccine) Proper food preparation and handling Ampicillin Co-trimoxazole Listeriosis Dairy products, ground meats, poultry Vertical to newborn or fetus Listeria monocytogenes laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 25. Tuberculoid form: Hard to isolate (diagnosis on clinical findings and histology of biopsies) Lepromatous form: Acid-fast staining from e.g. skin scrapings BCG vaccine shows some effects Tuberculoid form: Dapsone and rifampin Lepromatous form: Clofazimine Leprosy (Hansen's disease) Prolonged human-human contact, e.g. through exudates from skin lesions to abrasion of other person Mycobacterium leprae Ziehl-Neelsen stain showing acid-fast bacteria Hybridization probes for DNA, succeeded by PCR Culture on Lowenstein-Jensen agar BCG vaccine Isoniazid Standard "short" course: First 2 months, combination: Isoniazid Rifampicin Pyrazinamide Ethambutol Further 4 months, combination: Isoniazid Rifampicin Tuberculosis Droplet contact Mycobacterium tuberculosis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 26. (difficult to culture) Serologic tests, e.g. complement fixation test DNA probes on sputum specimens Doxycycline and erythromycin Mycoplasma pneumonia Human flora Droplet contact Mycoplasma pneumoniae Microscopy showing gram-negative diplococci, often with PMNs Culture on chocolate agar , giving positive oxidase test and fermentation of glucose and maltose in 5% CO2 in air NmVac4-A/C/Y/W-135 vaccine Rifampin Penicillin G Cefotaxime Ceftriaxone Meningococcal disease including meningitis Waterhouse-Friderichsen syndrome Respiratory droplets Neisseria meningitidis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 27. Colourless colonies on MacConkey agar . Production of pyocyanine and fluorescein Positive oxidase test . No lactose fermentation. (no vaccine) Topical silver sulfadiazine for burn wounds Aminoglycoside and anti-pseudomonal β - lactam Pseudomonas infection Localized to eye, ear, skin, urinary, respiratory or gastrointestinal tract or CNS, or systemic with bacteremia, secondary pneumonia bone and joint infections, endocarditis, skin, soft tissue or CNS infections. Infects damaged tissues or people with reduced immunity Pseudomonas aeruginosa Serology Immunofluorescence against Rickettsia antigens no preventive drug or approved vaccine) Vector control, such as clothing Prompt removal of attached ticks Doxycycline Chloramphenicol Rocky mountain spotted fever Bite of infected wood or dog tick Rickettsia rickettsii laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 28. Isolation from blood, feces, bone marrow, urine or rose spots on skin Colorless, non-lactose fermenting colonies on MacConkey agar Serology for antibodies against O antigen Ty21a and ViCPS vaccines Hygiene and food preparation Ceftriaxone Fluoroquinolones , e.g. ciprofloxacin Typhoid fever type salmonellosis (dysentery, colitis) Human-human Fecal-oral through food or water Salmonella typhi Colourless colonies on MacConkey agar (No vaccine or preventive drug) Proper sewage disposal Food preparation Good personal hygiene Fluid and electrolyte replacement for severe diarrhea Antibiotics (in immunocompromised to prevent systemic spread) Salmonellosis with gastroenteritis and enterocolitis Fecal-oral Food contaminated by fowl (e.g. eggs), pets and other animals Salmonella typhimurium laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 29. Culture on Hektoen agar or other media for intestinal pathogens Protection of water and food supplies Vaccines are in trial stage Ciprofloxacin or azithromycin Bacillary dysentery / Shigellosis Fecal-oral Flies Contaminated food or water Shigella sonnei Microscopy showing strongly positive Gram stained cells in grape-like clusters Positive Catalase test and coagulase test Culture on enriched media producing deep yellow, hemolytic colonies (no vaccine or preventive drug) Barrier precautions, washing hands and fomite disinfection in hospitals Incision and drainage of localized lesions Nafcillin and oxacillin Vancomycin for Methicillin -resistant (MRSA) Coagulase-positive staphylococcal infections : Localized skin infections Diffuse skin infection ( Impetigo ) Deep, localized infections Acute infective endocarditis Septicemia Necrotizing pneumonia Toxinoses Toxic shock syndrome Staphylococcal food poisoning Human flora on mucosae in e.g. anterior nares and vagina, entering through wound Staphylococcus aureus laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 30. Microscopy showing strongly positive Gram stained cells in grape-like clusters Positive Catalase test but negative coagulase test Novobiocin -sensitivity (S. epidermidis) Novobiocin -resistance (S. saprophyticus) Culture on enriched media producing white, nonhemolytic colonies None Vancomycin Infections of implanted prostheses , e.g. heart valves and catheters Human flora in skin and anterior nares Staphylococcus epidermidis Microscopy showing gram-positive , encapsulated lancet-shaped diplococci α - hemolysis on blood agar, bile-soluble, optochin-sensitive Positive Quellung reaction 23-serotype vaccine for adults ( PPV ) Heptavalent conjugated vaccine for children ( PCV ) Penicillin G Vancomycin for resistant strains Acute bacterial pneumonia & meningitis in adults Otitis media and sinusitis in children Respiratory droplets Often human flora in nasopharynx (spreading in immunocompromised) Streptococcus pneumoniae laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 31. Culture on sheep blood agar forming small, opalescent surrounded by large zone of β - hemolysis Serology for ASO Very bacitracin -sensitive No vaccine Rapid antibiotic treatment helps prevent rheumatic fever Penicillin G Macrolide , e.g. clarithromycin or azithromycin in penicillin allergy Drainage and debridement for Necrotizing fasciitis Streptococcal pharyngitis Scarlet fever Rheumatic fever Impetigo and erysipelas Puerperal fever Necrotizing fasciitis Respiratory droplets Direct physical contact with impetigo lesions Streptococcus pyogenes Culture on blood or MacConkey agar , enhanced by TCBS Positive oxidase test Preventing fecal contamination of water supplies and food Adequate food preparation Fluid and electrolyte replacement e.g. doxycycline to shorten duration Cholera Contaminated water and food, especially raw seafood Vibrio cholerae laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 32. Gram-negative smear If pneumonic, culture from aspirate on MacConkey or blood agar Formalin-killed plague vaccine Minimize exposure to rodents and fleas Streptomycin primarily Gentamicin Tetracyclin Supportive therapy for shock Plague : Bubonic plague Pneumonic plague Fleas from animals Ingestion of animal tissues Respiratory droplets Yersinia pestis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 33. nucleus icosahedral non-enveloped adenovirus dsDNA Adenoviridae icosahedral non-enveloped coxsackievirus , hepatitis A virus , poliovirus , rhinovirus + ssRNA Picornaviridae nucleus enveloped Herpes simplex, type 1 , Herpes simplex, type 2 , Varicella -zoster virus , Epstein- barr virus , Human cytomegalovirus , Human herpesvirus , type 8 dsDNA Herpesviridae nucleus icosahedral enveloped Hepatitis B virus dsDNA and ssDNA Hepadnaviridae icosahedral enveloped Hepatitis C virus , yellow fever virus , dengue virus , West Nile virus + ssRNA Flaviviridae enveloped Human immunodeficiency virus (HIV) + ssRNA Retroviridae Replication site Virion shape envelopment Important species Baltimore group Family Comparison table of clinically important virus families and species
  • 34. nucleus spherical enveloped Influenza virus - ssRNA Orthomyxoviridae spherical enveloped Measles virus , Mumps virus , Parainfluenza virus , Respiratory syncytial virus , Human metapneumovirus - ssRNA Paramyxoviridae nucleus icosahedral non-enveloped Human papillomavirus dsDNA Papillomaviridae helical, bullet shaped enveloped Rabies virus - ssRNA Rhabdoviridae icosahedral enveloped Rubella virus + ssRNA Togaviridae icosahedral enveloped Human bocavirus , Parvovirus B19 ssDNA Parvoviridae Replication site Virion shape envelopment Important species Baltimore group Family Comparison table of clinically important virus families and species
  • 35. The clinical characteristics of viruses may differ substantially among species within the same family: Cell culture, antibody detection None None Coxsackie infections fecal-oral, droplet contact Picornaviridae Coxsackievirus virus neutralization hemagglutination assay ELISA None None acute febrile pharyngitis pharyngoconjunctival fever epidemic keratoconjunctivitis infantile gastroenteritis droplet contact (mainly) fecal-oral venereal direct contact (ocular infections) adenoviridae adenovirus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 36. antibody detection Vaccine immunoglobulin (post-exposure prophylaxis) avoid food-contamination Immunoglobulin ( post-exposure prophylaxis ) acute hepatitis fecal-oral Picornaviridae Hepatitis A virus viral antigen detection antibody detection nucleic acid detection vaccine immunoglobulin (perinatal and post-exposure prophylaxis) immunoglobulin Adefovir Entecavir Pegylated interferon alfa-2 Lamivudine acute hepatitis chronic hepatitis hepatic cirrhosis hepatocellular carcinoma All body fluids (blood, semen, saliva, mother's milk etc.) Hepadnaviridae Hepatitis B virus Antibody detection immunoflourescence ELISA Nucleic acid detection None None infectious mononucleosis Burkitt lymphoma Saliva Herpesviridae Epstein-Barr virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 37. The clinical characteristics of viruses may differ substantially among species within the same family: immunofluorescence immunoperoxidase nucleic acid detection None acyclovir famciclovir foscarnet penciclovir primary HSV-1 infection ( gingivostomatitis in children, tonsillitis & pharyngitis in adults, keratoconjunctivitis ) latent HSV-1 infection ( herpes labialis , cold sores ) direct contact with saliva and lesions Herpesviridae Herpes simplex virus , type 1 antibody detection nucleic acid detection None Pegylated interferon alfa-2 Ribavirin acute hepatitis chronic hepatitis hepatic cirrhosis hepatocellular carcinoma blood (sexual) Flaviviridae Hepatitis C virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 38. The clinical characteristics of viruses may differ substantially among species within the same family: antibody and nucleic acid detection None ganciclovir cidofovir foscarnet infectious mononucleosis Cytomegalic inclusion disease tears urine semen saliva vaginal secretions mother's milk crosses placenta blood Herpesviridae cytomegalovirus cell culture immunofluorescence immunoperoxidase nucleic acid detection contact-avoidance with lesions safe sex acyclovir famciclovir foscarnet penciclovir cidofovir primary HSV-2 infection latent HSV-2 infection aseptic meningitis sexually birth Herpesviridae Herpes simplex virus , type 2 laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 39. The clinical characteristics of viruses may differ substantially among species within the same family: nucleic acid, p24 antibody detection zidovudine (perinatally) blood product screening safe sex HAART AIDS sexual blood mother's milk Retroviridae HIV Nucleic acid and antibody detection None many in evaluation-stage Kaposi sarcoma multicentric Castleman disease primary effusion lymphoma Herpesviridae Human herpesvirus , type 8 laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 40. The clinical characteristics of viruses may differ substantially among species within the same family: antibody detection MMR vaccine None measles postinfectious encephalomyelitis droplet contact Paramyxoviridae measles virus Hemagglutination assay antigen detection Influenza vaccine amantadine rimantadine amantadine rimantadine zanamivir oseltamivir influenza ( Reye syndrome ) droplet contact Orthomyxoviridae Influenza virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 41. The clinical characteristics of viruses may differ substantially among species within the same family: Visual inspection Antigen detection Nucleic acid detection HPV vaccine wart tissue avoidance safe sex liquid nitrogen laser vaporization cytotoxic chemicals interferon cidofovir direct contact hyperplastic epithelial lesions ( common , flat , plantar and anogenital warts , laryngeal papillomas , epidermodysplasia verruciformis ) 55+ (hands/ feet) 30+ (anogenital/ some are oral/ throat/ respiratory) Malignancies for some species ( cervical carcinoma , squamous cell carcinomas ) direct contact Papillomaviridae Human papillomavirus antibody detection MMR vaccine None Mumps droplet contact Paramyxoviridae Mumps virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 42. The clinical characteristics of viruses may differ substantially among species within the same family: antibody detection MMR vaccine None measles postinfectious encephalomyelitis droplet contact Paramyxoviridae measles virus Hemagglutination assay antigen detection Influenza vaccine amantadine rimantadine amantadine rimantadine zanamivir oseltamivir influenza ( Reye syndrome ) droplet contact Orthomyxoviridae Influenza virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 43. The clinical characteristics of viruses may differ substantially among species within the same family: Antibody detection None None croup pneumonia bronchiolitis common cold droplet contact Paramyxoviridae Parainfluenza virus Antibody detection None None croup pneumonia bronchiolitis common cold droplet contact Paramyxoviridae Parainfluenza virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 44. The clinical characteristics of viruses may differ substantially among species within the same family: Histology (postmortem) Pre- and postexposure prophylaxis Post-exposure prophylaxis Rabies Animal bite droplet contact Rhabdoviridae Rabies virus Antibody detection Polio vaccine None Poliomyelitis fecal-oral Picornaviridae Poliovirus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 45. The clinical characteristics of viruses may differ substantially among species within the same family: Antibody detection MMR vaccine None German measles congenital rubella droplet contact Togaviridae Rubella virus antibody and antigen detection hand-washing avoidance palivizumab in high risk individuals ( ribavirin ) bronchiolitis pneumonia influenza-like syndrome severe bronchiolitis with pneumonia droplet contact, hand-to-mouth Paramyxoviridae Respiratory syncytial virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 46. The clinical characteristics of viruses may differ substantially among species within the same family: Cell culture antigen and nucleic acid detection Varicella vaccine varicella-zoster immuneglobulin Varicella: acyclovir famciclovir valacyclovir Zoster: acyclovir famciclovir Varicella herpes zoster droplet contact Herpesvirida Varicella-zoster virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 47. Mycosis
    • Mycosis is a condition in which fungi pass the resistance barriers of the human or animal body and establish infections . Mycoses can result when the climate is hot and humid , and when people live in crowded conditions. Some fungi reproduce through tiny spores in the air. People inhale those spores or they land on the skin . Therefore, fungal infections often start in the lungs or on the skin.
  • 48. Disseminated fungal infections
    • Candida species are important human pathogens that are best known for causing opportunist infections in immunocompromised hosts (e.g. transplant patients, AIDS sufferers, cancer patients).
    Candida albicans at 200X magnification.
  • 49. Disseminated fungal infections
    • Aerosolized Aspergillus spores are found nearly everywhere so we are routinely and almost constantly exposed to them.
    Aspergillosis. H&E stain .
  • 50. Disseminated fungal infections
    • Cryptococcus neoformans can cause a severe form of meningitis and meningo-encephalitis in patients with HIV infection and AIDS .
    Cryptococcus. FNA specimen . Field stain .
  • 51. Disseminated fungal infections
    • Histoplasma capsulatum can cause histoplasmosis in humans, dogs and cats.
    Histoplasmosis. PASD stain .
  • 52. Disseminated fungal infections
    • Pneumocystis jirovecii (or Pneumocystis carinii) can cause a form of pneumonia in people with weakened immune systems , such as premature children, the elderly, and AIDS patients.
    P. jirovecii cysts in tissue
  • 53. Protozoan infection
    • Examples of human diseases caused by protozoa:
      • Malaria
      • Amoebiasis
      • Giardiasis
      • Toxoplasmosis
      • Cryptosporidiosis
      • Trichomoniasis
      • Leishmaniasis
      • Sleeping Sickness
      • Dysentery
    Leishmania donovani , (a species of protozoa) in a bone marrow cell
  • 54. Amebiasis
    • Entamoeba histolytica is an anaerobic parasitic protozoan , part of the genus Entamoeba . Predominantly infecting humans and other primates, E. histolytica is estimated to infect about 50 million people worldwide.
    Entamoeba histolytica cyst
  • 55. Gardiasis
    • Giardia lamblia (synonymous with Lamblia intestinalis and Giardia duodenalis ) is a flagellated protozoan parasite that colonises and reproduces in the small intestine, causing giardiasis .
    Giardia cell, SEM
  • 56. Toxoplasmosis
    • Toxoplasmosis is a parasitic disease caused by the protozoan Toxoplasma gondii . The parasite infects most genera of warm-blooded animals, including humans, but the primary host is the cat family . Animals are infected by eating infected meat, by ingestion of feces of a cat that has itself recently been infected, or by transmission from mother to fetus.
    T. gondii tachyzoites
  • 57. Helminths
    • Parasitic worms or helminths are a division of eukaryotic parasites that live inside their host. They are worm-like organisms that live and feed off living hosts , receiving nourishment and protection while disrupting their hosts' nutrient absorption, causing weakness and disease . Those that live inside the digestive tract are called intestinal parasites . They can live inside humans as well as other animals. Approximately 3 billion people globally are infected with helminths.
  • 58. Categorization Ascariasis , dracunculiasis , elephantiasis , enterobiasis (pinworm) , filariasis , hookworm , onchocerciasis , trichinosis , trichuriasis (whipworm) Schistosomiasis , swimmer's itch Tapeworm infection Example diseases in humans Lips, teeth, filariform extremities, and dentary plates Oral sucker and ventral sucker or acetabulum Sucker or bothridia, and rostellum with hooks Attachment organs Cylindrical Unsegmented plane Segmented plane Shape Nematodes (roundworms) Trematodes (flukes) Cestodes (tapeworms)
  • 59. Cestoda (Cestoidea)
    • Cestoda (Cestoidea) live in the digestive tract of vertebrates as adults, and often in the bodies of various animals as juveniles. Several species parasitise humans after being consumed in underprepared meat such as pork ( T. solium ), beef ( T. saginata ), fish ( Diphyllobothrium spp.), poor hygiene ( Hymenolepis spp. or Echinococcus spp.).
    Scolex (head) of Taenia solium , a tapeworm.
  • 60. Tremotodes
    • Schistosomiasis is a parasitic disease caused by several species of tremotodes ("flukes"), a parasitic worm of the genus Schistosoma . The urinary form of schistosomiasis is associated with increased risks for bladder cancer in adults. Schistosomiasis is the second most socioeconomically devastating parasitic disease after malaria .
    Skin vesicles on the forearm, created by the penetration of Schistosoma . Source: CDC
  • 61. Nematodes
    • A pinworm infection or enterobiasis is a human parasitic disease and one of the most common childhood parasitic worm infections in the developed world. It is caused by infestation with the parasitic roundworm Enterobius vermicularis , commonly called the human pinworm .
    Two pinworms
  • 62. Prion
    • A pr oteinaceous i nfectious particle, or prion , is an infectious agent composed primarily of protein , unlike viruses which consist of two or three parts: a helical molecule, protein coat and sometimes a viral wrapper. Prions are the cause of a number of diseases in a variety of mammals , including bovine spongiform encephalopathy (BSE, also known as "mad cow disease") in cattle and Creutzfeldt–Jakob disease (CJD) in humans. In general usage, prion refers to the theoretical unit of infection . All known prion diseases affect the structure of the brain or other neural tissue and all are currently untreatable and universally fatal.
  • 63. Creutzfeldt–Jakob disease
    • Creutzfeldt–Jakob disease or CJD is a degenerative neurological disorder ( brain disease ) that is incurable and invariably fatal. It is the most common among the types of transmissible spongiform encephalopathy found in humans.
    Microscopic "holes" are characteristic in prion-affected tissue sections, causing the tissue to develop a "spongy" architecture.
  • 64. Thank you for your attention!

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