Infectious diseases of resp,gas,nervs & sexually transmitted Diseases, circulatory system, CNS, central nervous system, Urinary tract, GT
INFECTIOUS DISEASES MAJID MOHIUDDIN
INFECTIOUS DISEASES OF THE RESPIRATORY SYSTEM Bronchitis, Bronchopneumonia, Epiglottitis(windpipe), Laryngitis(voicebox), Pharyngitis, Pneumonia, SinusitisVIRAL INFECTIONS CAUSITIVE AGENT TRANSMISSION DIAGNOSISof (URT)COMMON COLD, -Many different -Infected humans Cell cultureACUTE VIRAL viruses -Direct contact or techniques inRHINITIS, ACUTE -Rhinoviruses inhalation of specific cause.CORYZA (infection (>100serotypes) airborne droplets.of lining of the -Coronaviruses, panose, sinuses, rainfluenzathroat and large viruses, RSV, influeairways) secondary nzainfection chances viruses, adenoviru ses & enteroviruses
Bacterial Infection Agent Transmission Diagnosisof URTDiphtheria Corynebacterium -Infected Humans Nasopharyngeal swab & -Airborne droplets throat swab in Leoffler diphteriae, serum medium & cystine pleomorphic, G+ve -Direct contact tellurite or Tinsadale -Contaminated bacilli medium fomites, rawmilk. Toxigenicity in lab animalsStreptococal Streptococcus -Infected Humans -Culture pyogenes; beta- -Direct contact -Rapid strep testsPharyngitis , Strep (antigen)Throat hemolytic, catalase – -Hand, aerosol -Throat culture ve, G+ve of group A -Contaminated dust or -Bacitracin susceptibility articals -Milk and milk products
Viral Infection of Agent Transmission DiagnosisLRTAcutem Febrile, -Parainfluenza -Infected humans Cell cultureViral Respiratory viruses, Respiratory -Direct oral contactDisease syncytial virus -Droplets & articals (RSV), adenovirus, rhinoviruses, coronaviruses, coxsackieviruses & echovirusesHantavirus Hantaviruses (Sin -Rodents Immunodiagnostic Nombre, Bayou, Black -Inhalation of proceduresPulmonarySyndrome(HPS) Creek canal, New aerosolized rodent York-1, Monongahela) feces, urine & salivaInfluenza, Flu Influenza Viruses, -Infeccted humans, From pharyngeal or nasal types A, B & C (RNA pigs and birds. secretions using cell viruses) -Airborne spread culture techniques - Immunodiagnostic Orthomyxovirus family -Direct contact procedure
Bacterial Infection Agent Transmission Diagnosisof LRTLegionellosis, Legionella -Environmental water -Sputum, blood & Urine sources. sample.Legionnaire’s pneumophila, -Culture contain cysteineDisease, Pontiac Poorstained, G-ve, -Airborne & other nutrients transmission fromFever and other -Buffered charcoal yeast water and dust extract agar. Legionella spp. -Immunodiagnoses.Mycoplasmal Mycoplasma -Infected humans Demostration of rise in pneumoniae (G-ve -Dropletes, direct antibody titer betweenPneumonia, acute & convalescentPrimary Atypical bacillus lacking cell contact or articals sera. wall)pneumoniaTuberculosis (TB) Mycobacterium -Infected human & -AFB in sputum tuberculosis G+ve cattle and other specimens mammals -DNA probes, PCR -Airborne dropletsWhooping Cough, Bordetella pertussis -Infected humans - Nasopharyngeal (small, encapulated, -Airbone droplets aspirates / swabsPertussis -Bordet Gengou agar nonmotile, G-ve -Endotoxin and -Regan Lowe agar coccobacilli) exotoxins -Nuclei acid or immunodiagnoses
Fungal Infection of Agent Transmission DiagnosisLRTCoccidiodomycosis Coccidiodes immitis -Soil -direct examination -Inhalation of - Culturing of sputum, (dimorphic fungus, pus, urine, CSF, biopsy arthroconodia, arthrospores materials. -Person to person spherules)Cryptococcosil Cryptococcus -Pigeon nests, pigeon -Microscopic examination neoformans droppings, bird of budding yeasts (encapsulated yeast) drospings, soil. -Culture -Biochemical tests -Inhalation of yeasts -ImmunodiagnosticHistoplasmosis Histoplasma -Soil containing bird, -Microscopic examination capsulatum var. chicken, bat droppings -Culture & identification capsulatum, -Inhalation of conidia of biochemical tests. (dimorphic)Pneumocystis Pneumocystis jiroveci - Infected humans - Pneumocystis in (Pneumocystis carinii) -Direct contact, material from bronchialPneumonia (PCP), brushingsInterstitial Plasma protozoal and fungal transfer of pulmonary Demonstrations, open properties secretionscell Pneumonia lung biopsy, lung aspirates, staining methods, cannot be cultured.
INFECTIOUS DISEASES OF THE GASTROINTESTINAL TRACT• Colitis : Inflammation of the colon (large intestine)• Diarrhea: An abnormally frequent dischage of semisolid or fluid fecal matter.• Dysentery: frequent watery stools, accompanied by abdominal pain, fever & dehydration.• Enteritis: inflammation of the intestines (small intestine)• Gastritis: Inflammation of the mucosal lining of the stomach.• Gastroenteritis: Inflammation of the mucosal linings of the stomach and intestines.• Hepatitis: Inflammation of the liver (viral infection)
Viral Infection Agent Transmission DiagnosisViral Gastroenteritis, -enteric adenoviruses, -Infected Humans, water Electron microscopic exam of astroviruses, caliciviruses and shellfish. stool specimenViral enteritis, Viral -Immunodiagnostic proceduresDiarrhea (including (Norwalk-like -Transmission – fecal oral viruses) and rotaviruses route, airborne and fomites.Type A Hepatitis HAV Hepatitis A virus; HAV; -Fecal-oralinfection, epi nonenvelop, linear ssRNA, -Person to person Heptovirus, Piconaviridae -Infected food /waterType B Hepatitis HBV, Hepatitis B virus, HBV; -Sexual/householdserum Hepatitis enveloped, circular dsDNA, -Mother to infant before or Orthohepadnavirus, during birth, Hepadnaviridae -Injected drug,needlesticks etcType C Hepatitis HCV , Hepatitis C virus; HCV; -Blood transfusionNonA NonB enveloped, linear ssRNA, -Rarely sexually Hepacivirus, FlaviviridaeType D Hepatitis Hepatitis D virus; HDV; -infected blood and bodyDelta Hepatitis delta virus; enveloped fluids, circular ssRNA viral -Needles, satellite, Delavirus -SexuallyType E Hepatitis Hepatitis E Virus; HEV; a -Fecal oral transmission spherical, nonenveloped -fecal contaminated ssRNA,; Calcivirus,viridae drinking water, person to personType G Hepatitis Hepatitis G virus; HGV; -Parenterally Hepacivirus;Flaviviridae Linear ssRNA;
Bacterial Infection Agent Transmission Diagnosisof GI TRACTBacterial Gastritis & Helicobacter pylori; -Infected humans -Culturing -Ingestion -Staining, biopsy, UreaUlcers Curved, breath test, NH4 excretion microaerophillic, -Oral-oral/fecal-oral test, Immunodiagnosis tranmision capnophilic, G-veCamphylobacter Camphylobacter -Animal, poultry - Stool specimen, camp jejuni/coli, curved, S- -Raw poultry blood agar, campy gasEnteritis mixture and 420 c haped or spiral shaped -Improper hygine incubation. G-ve bacilli -Food, raw milk, waterCholera Vibrio cholerae sero 01; -Infected Humans, aquatics -Rectal swabs or stool on curved, G-ve, enterotoxin -Fecal oral route Thiosulfate citrate bile sucrose choleragen agar; -Fecal contamination of -Biochemical tests water and foodSalmonellosis -Salmonella typhimurium -Animals -Stool specimen on MacConkey Salmonella enteritidis -Fecal contamination agar (Colorless colonies) & -Biochemical tests Serotype – G-ve bacilli -Person to personTyphoid Fever, Salmonella typhi, G-ve -Infected humans -Blood, urine, feces or bone bacilli – endo & exotoxins -Fecal contamination marrow. & Biochemical testEnteric FeverShigellosis, Bacillary Shigella dysenteriae, S.flexneri. -Infected Humans -Presence of leukocytes in stool S.boydii & S.soneii, nonmotile G- -Fecal oral transmission specimens. GN enrichment brothDysentery and solid media xylose lysine ve Coccai -Fecal contamination deoxycholate XLD and Hektoen Enteric agar.
Bacterial Infection Agent Transmission Diagnosisof GI TRACTEnterohemorrhagic E.Coli O157.H7 -Cattle & humans -Stool specimens on Sorbitol Macconkey (SMAC)E.Coli (EHEC) G-ve bacilli- cytotoxins -Fecal oral route, agar – assay for O157Diarrhea – Shiga – like toxins -Fecal contamination, antigen using antiserum milk, water and beefEnterotoxigenic Serotypes of -Infected humans -stool specimens, enterotoxigenic E.coli – -Fecal oral route Followed by dmonstrationE.Coli (ETEC) of enterotoxin production,Diarrhea, Traveler’s heat labile toxin or both -Fecal contamination DNA probe techniquesDiarrheaBotulism Clostridium botulinum, -Dust , soil, foods -Toxin in the patient;s sporeforming G+ve contamination serum or gastric aspirate or anaerobic bacillus – toxin in incriminated food producer- botulinumClostridium perfringens Clostridium perfringens, -Spores in soil, GI tract of -Demonstration of organisms in G+ve sporeforming, humans and animals. food or patient’s stool orFood Intoxication detection of toxin. enterotoxin producing, -Ingestion of contaminated anaerobic bacillus food by feces or dirtStaphylococcal Food Enterotoxin producing -Infected humans, -Isolation of enterotoxin strains of Staphylococcus cows, dogs and fowl, producing staph. FromIntoxication, stool or vomitus.Staphylococcal Food aureus growing in foods. -Ingestion of contaminated foods,Poisoning milk
Protozoal Infection Agent Transmission Diagnosisof GI TRACTAmebiasis, Amebic Entamoeba histolytica Humans -Microscopic examination – subphylum Sarcodina – Fecal contamination of From fecal specimensDysentery, AmebicAbscesses, reproducing trophozoite food and water stage (Ingestion)AmebomasBalantidiasis Balantidium coli, ciliated -Pigs and anything Identifying trophozoites or protozoan contaminated by pig cysts in fecal specimens or feces, Ingestion blood and mucus.(largest protozoa that infect humans)Cryptosporidiosis Cryptosporidium parvum, -Infected humans, cattle & -Microscopic identification of coccidian animals. Fecal oral small, acid fast Oocysts in stained smears of fecal transmission, person to specimens and person and food immunodiagnosisCyclosporiasis Cyclospora cayetanensis, a -Fecal contaminated water -Microscopic observation of coccidian acid fast oocystGiardiasis Giardia -Infected humans & -Microscopic observation lamblia/intestinalis, animals of trophozoites and/or flagelated protozoan -Contaminated water cysts in stained smears of fecal specimens.
INFECTIOUS DISEASES OF THE CENTERAL NERVOUS SYSTEM (CNS• Encephalitis: Inflammation of the brain• Encephalomyelitis: Inflammation of the brain and spinal cord• Meningitis: Inflammation of the membranes(meninges) that surround the brain and spinal cord.• Meningoencephalitis: Inflammation of the brain and meninges• Myelitis: Inflammation of the spinal cord.
Viral Infection of CNS Agent Transmission DiagnosisPoliomyelitis, Polio, Polioviruses: RNA Infected humans -Isolation of polio virus from stool sample, CSF orInfantile Paralysis viruses – Picornaviridae Person to person via oropharyngeal secretions fecal oral route or using cell culture, throat secretions immunodiagnosis alsoRabies Rabies virus; a bullet shaped, -wild & domestic -virus isolation using cell culture enveloped RNA virus – mammals, techniques or immunodiagnostic procedure; Rhabdoviridae - Transmission via bite of observation of Negribodies in rabid animal , airborne animal brain tissue. transmissionViral Encephalitis, -ImmunodiagnosticArthropod Borne viralEncephalitis procedures and Cell1. Eastern Equine EEE virus; a RNA virus (Toga) -Birds horse cultureEncephalitis (EEE) Vectors: Aedes, Coquilletidia Culex, and Culiseta mosquitoes2. California CE virus a RNA virus – -Rodents, RabbitsEncephalitis Bunyaviridae . Aedes and Culex mosquitoes vectors3. LaCrosse LE virus, a RNA virus - - Chipmunks, squirels -Aedes Mosquitoes (vector)Encephalitis Bunyavidae4. St.Louis Encephalitis St.L E Virus, a RNA virus - Flav -Birds -Culex mosquitoes (vector) -Culex mosquitoes (vector)5. West Nile Flaviviridae , RNA -Birds, horse -Aedes and Culex mosquitoes6. Western Equine RNA - Togaviridae -Birda, horse (vector)
Bacterial Infection Agent Transmission Diagnosisof CNSBotulism Clostridium Dust, soil, Food -Botulinum toxins in serum botulinum, G+ve anaerobic bacillusListeriosis Listeria monocytogenes -Soil, water, mud, Isolation & identification of G+ve coccobacillus silage, infected pathogen from CSF, blood, mammals amniotic fluid, placenta and other specimesTetanus, Lockjaw Clostridium tetani, a -Soil contaminated with Clinical and epidemiologic motile, G+ve, anaerobic, human, horse or other grounds. Isolation from spore-forming bacillus- animal feces. wounds or demostrate antibody producing are neurotoxin called rarely successful. tetanospasminHelminth Infection of CNS AgentCysticercosis Cysts (large stage) of the Taenia solium in brainHydatidosis Enhinococcus granulosis or E. multilocularis in brain and other location in the body – hydatid cysts
Protozoal Infection Agent Transmission Diagnosisof CNSAfrican Trypanosoma brucei -Infected humans; wild -Observation in blood, cause Af Tryposomiasis & animals, cattle. lymph or CSFTrypanosomiasis, -ImmunodiagnosticAfrican sleeping spp. gambiense - -Transmission by bite of procedure cause(sleeping sickness) infected flysicknessAmerican Trypanosoma cruzi; as -Infected humans, Observation in blood or hemoflagellate – non animals amastigotes in tissue orTrypanosomiasis, lymph node biopsyChagas’ Disease motile intracellular -Transmission by blood specimen. parasite transfusion and organ Immunodiagnoses transplantationBabesiosis Babesia microti, -Rodents for B.microti; Observation and intraerythrocytic cattle for B.divergens identification within sporozoan parasites -By tick bite; or blood redblood cells in Giemsa Stained blood smears. transfusion ImmunodiagnosesMalaria 4 different spp. of -Infected human & Observation and Plasmodium P.vivax, mosquitoes identification of falciparum, malariae & -By injection of intraerythrocytic plasmodium parasites in ovale sporozoites by female Giemsa stained blood Anopheles mosquito smearsPrimary Amebic Naegleria fowleri, free living -Water and soil Microscopic examination ofMeningoencephalitis ameba -Nasal passage from wet mount of fresh CSF(PAM) contaminated water
INFECTIOUS DISEASES OF THE GENITOURINARY (GU) SYSTEM• Urinary Tract Infection (UTIs) – Upper UTIs: Infection of kidneys (Nephritis or Pyelonephritis) and ureters (ureteritis) – Lower UTIs: Infection of the urinary bladder (cystitis), Urethra (urethritis) and in males, the prostate (prostatitis). – Cystitis: Inflammation of the urinary bladder.(Klebsiella, Proteus, Enterobacter, Pseudomonas & enterococcus, Staphylococcus saprophyticus, Staphylococcus epidermidis, & Candida albicans) – Nephritis: Inflammation of the kidneys(E.coli) • Pyelonephritis: Inflammation of the renal parenchyma. – Ureteritis: Inflammation of one or both ureters. – Urethritis: Inflammation of the urethra.(Chlamydia trachomatis, Neisseria gonorrhoeae, ureaplamsma & mycoplasmas) – Prostatitis: Inflammation of the prostate gland.(Bacteria,virus, fungus or a protozoan)
• Infections of the Genital Tract: • Adult vaginal microflora: spp. of Lactobacillus, Staphylococcus, Streptococcus, Enterococcus, Neisseria, Clostridium, Actinomyces, Prevotella, diphtheroids, enteric bacilli & Candida. – Bartholinitis: Inflammation of the Bartholin’s ducts in females. – Cervicitis: Inflammation of the cervix.(that part of the uterus that opens into vagina) – Endometritis: Inflammation of the endometrium (the inner layer of the uterine wall) – Epididymitis: Inflammation of the epididymis (an elongated struture connected to the testis) – Pelvic inflammatory disease (PID): Inflammation of the fallopian tube; also known as Salpingitis. – Vaginitis: Inflammation of vagina. – Vulvovaginitis: Inflammation of the vulva (the external genitalia of females) and the vagina.Protozoal Infection Agent Transmission Diagnosisof GUTrichomoniasis Trichomonas vaginalis -Humans -Wet mount examination -Direct contact with from freshly collected – flagellate vaginal discharge. vaginal & urethral -Culture are also available dischages- sexual
• Sexually Transmitted Diseases of the Genital Tract: (STDs)• Formally called Venereal Disease (VD)• They are diseases not only of the genital & Urinary tract, but also of the skin, mucous membranes, blood, lymphatic and digestive system and other areas.• Epidemic STDs include Acquired immunodeficiency syndrome (AIDS), Chalamydial and herpes infections, gonorrhea and syphillis.• Further The AIDS virus (HIV) primarily causes damage to helper T Cells and thus inhibits antibody production, it is also consider the diseases of the circulatory system. VIRAL STDs Agent Transmission Diagnosis Anogenital Herpes Viral Herpes simplex virus, -Infected humans -Cytologic change in tissue -Direct sexual contact,oral scrapings or biopsy Infections, Genital type 2 HSV2; occasionally -- Immunodiagnostic procedure Herpes. HSV1 genital, oral anla,or anal genital contact -Mother to neonate Genital Warts, Genital Human papillomaviruses -Infected humans - Clinical grounds Papillomatosis, (HPV) of the papovavirus – -Direct contact (sexual) Condyloma DNA virus- genotype 16 & 18 -Breaks in skin or mucous associated with cervical membranes Acuminatum cancer. -Mother to neonate Human HIV -1 , HIV-2 , RNA viruses – -Infected humans -Immunodiagnostic procedure Retroviridae -Direct sexual contact, for detection of antigen and Immunodeficiency antibodies Virus (HIV) & AIDS Homo & Heterosexual, -PCR etc. -Sharing of contaminated needles & blood&etc -Mother to neonate etc.
BACTERIAL STDs Agent Transmission DiagnosisGenital Chlamydial Certain Serotype of -Infected humans. -Identification by cell Transmission via direct culture, staining andInfections, Genital Chlamydia ImmunodiagnosticChlamydiasis trachomatis,tiny, sexual contact or procedures. mother to neonate. intracellular, G-ve.Gonorrhea Neisseria gonorrhoeae -Infected humans -Staining (gonococcus or GC) -Via direct mucous -Culture on chocolate agar G-ve diplococci some membrane to mucous or modified chocolate agar (such as Thayer-Martin called penicillinase membrane contact, medium, Martin-Lewis producing -Usually sexual contact medium, NewYork City agar N.gonorrhoeae or PPNG -Adult to child or Transgrow) -Mother to neonate -ImmunodiagnosisSyphilis Treponema pallidum, -Infected humans -Primary diagnosed by Grama variable, tightly -Direct contact with darkfield microscopy of coiled spirochete that is lesions, body material scraped from the margin of chancres. too thin to be seen with secretions, mucous -Immunodiagnostic brightfield microscope membranes, blood, procedures such as RPR, semen, saliva and VDRL and FTA-Abs tests for vaginal discharge of detecting antibodies in infected perople serum or spinal fluid -Sexual contact specimens . -Mother to fetus -Antigen detection in lesions or lymph nodes -Blood tranfusion material.
INFECTIOUS DISEASES OF THE CIRCULATORY SYSTEM• Endocarditis: Inflammation of the endocardium (that lines the cavities of the heart)• Mycocarditis: Inflammation of the mycocardium- the muscular walls of the heart.• Pericarditis: Inflammation of the pericardium-the membranous sac around the heart.• Lymphadenitis: Inflamed and swollen lymph nodes.• Lymphadenopathy: Diseased lymph nodes.• Lymphangitis: Inflamed lymphatic vessels.
VIRAL Infection of Agent Transmission DiagnosisCirculatory SystemHuman HIV -1 , HIV-2 , RNA viruses – -Infected humans -Immunodiagnostic procedure Retroviridae -Direct sexual contact, for detection of antigen andImmunodeficiency antibodiesVirus (HIV) & AIDS Homo & Heterosexual, -PCR etc. -Sharing of contaminated needles & blood&etc -Mother to neonate etc.Infectious Epstein-Barr virus (EBV); also -Infected Humans -Immunodiagnostic proceduresMononucleosis (Kissing known as human herpes -Person to person by directDisease) (Mono) virus 4 – DNA – contact with saliva, kissing Herpesviridae, infects and -Blood transfusion. transform B cells.Mumps, Infectious Mumps virus; a RNA virus – -Infected humans -Immunodiagnostic procedure Paramyxoviridae -Droplet spread and direct -Cell cultureParotitis contact with the salivaViral Hemorrhagic Ebola virus & Marburg virus, -Infected humans -Immunodiagnostic procedures filamentous virus- Filoviridae -Infected African green -PCR andDiseases -Cell culture monkeys in Marburg infection. -Person to person -Direct contact with infected blood, secretions, internal organs or semen
Rickettsial & Agent Transmission DiagnosisEhrlichial Diseasesof CardiovascularRocky Mountain Rickettsia rickettsii; G-ve, -Infected ticks on dogs, -Immunodiagnostic procedure.Spotted Fever, obligate intracellular rodents and other animalsTickborne Typhus Fever pathogen invades -Via bite endothelial cellsEndemic Typhus Fever, Rickettsia typhi, G-ve, an -Rats, mice, other animals Immunodiagnostic procedure.Murine Typhus Fever, obligate intracellular -Transmission is Rat to FleaFleaborne Typhus pathogen to human.Epidemic Typhus Fever, Rickettsia prowazekii, G-ve -Infected humans and -Immunodiagnostic proceduresLouseborne Typhus Obligate intracellular body lice. pathogen -Transmission is human to louse to humanEhrlichiosis Ehrlichia Spp; G-ve -Reservoir unknown -Immunodiagnostic procedure cocoobacilli; closely related -Transmission via tick bite. and nucleic acid assays. to rickettsias; obligate intraleukocytic pathogens
Other Bacterial Agent Transmission Diagnosisinfections ofCardiovascularsystemInfective Endocarditis Staphylococcus aureus Contaminated needles, -Culture syringes -Staining Streptococcus pneumoniae, Neisseria gonorrhoeae, Streptococcus pyogenes Enterococcus faecalis (Fungus Candida and Aspergillus) alsoLyme Disease, Lyme Borrelia burgdoferi; G-ve, -Ticks, rodents and Immunodiagnostic procedures loosely coiled spirochete mammals and PCRBorreliosis - Barbour-Stoenner-Kelly(BSK) -Via bite medium at 330 c.Plague, “Black Death” Yersinia pestis, nonmotile, -Wild rodents and -Gram stained or Wright Giemsa bipolar staining, Gram –ve domestic cats stained sputum, CSFBubonic Plague, -CulturePneumonic Plague, coccobacillus; referred as -Via flea bite (Rodent to -Biochemical tests plague bacillus flea to human) -Immunodiagnostic testsSepticemic PlagueTularemia, Rabbit Francisella tularensis; a small, -Wild animals, rabbit, -Culture pleomorphic, G-ve coccobacillus muskrats, beavers; -Biochemical TestsFever -Immunodiagnostic procedures domestic animals, hard ticks. -Via bite, - Contaminated meat and water