Disease Cards 29-38.. | Lecture notes Microbiology

29. Syphilis: Primary, Secondary, Tertiary, Congenital syphilis Treponema pallidum

Bacteria, Gram- spirochetes, helical form, flagella, endoflagella,

2. Main Host/Tissues: GU/STD, mucous membranes, P=skin, 2=skin/throat, 3=NS

3. S&S: Primary: 9day-3 month infection, hard chancre (small red hard bump), lymph node

enlarged/firm, communicable Secondary: 3wk-6mth, fever, headache, sore throat,

lymphadenopathy, red/brown rash, communicable Tertiary: 30% untreated gummas (tumors),

neurosyphilis, severe headaches, convulsions, mental, noncommunicable Congenital: women

pregnant-fetus, nasal discharge, skin eruptions/loss, bone deformation, NS abnormalities

4. Virulence Factors: inflammatory response to host, outer membrane proteins, granulomas

block circulation, spirochetes hooked tip, cant survive long outside, anti treponemal antibodies

form

5. Res/Trans: Res: Gay/bisexual men, prostitutes, drug abusers Trans: STD/GU, direct contact,

communicable/non communicable, endogenous, skin lesions, nosocomial Congenital: Vertical

6. Diagnosis: dark-field microscopy, direct immunofluorescent staining, DNA probe, serological

tests (RPR, VDRL, Kolmer), MHA-TP, FTA-ABS, TPI, children(western blot test)

7. Prev/TX: Prev: trace sexual contacts, condoms TX: penicillin G with benzathine or procaine,

tetracycline/erythromycin (only for penicillin allergy),

8. Comps/Seq: Comps: Primary: Secondary: bones, hair follicle, joint, liver, eye, brain Tertiary:

muscle loss, loss of activity & coordination, mental derangement, blindness, cardiovascular

syphilis Congenital: stillbirth, miscarriage, Hutchinson’s Teeth Seq: Primary: Secondary:

Tertiary: destruction of spinal cord, Argyll-Robertson pupil reaction Congenital:

9. Anything Else: high in Africa/Asia, have other concurrent STDs, risk of infection is 12-30%

30. Leptospirosis Leptospira interrogans

Spirochetes, bacterial, obligate aerobe, gram- spirochetes, tight coils w/ 1 hook/bend

2. Main Host/Tissues: GU Tract, kidney, liver, brain, and eyes, CSF

3. S&S: high fever, chills, muscle aches, headache, vomiting, conjunctivitis, Weil’s Syndrome

4. Virulence Factors: spirochetes with tights coils, lysis, agglutination, hemolysin, outer

membrane proteins, adhesion molecules

5. Res/Trans: Res: Zoonosis, tropics, animals (horses, dogs, cattle, pigs, rodents, skunks,

racoon, foxes) Trans: non-communicable, urine from infected animals in neutral or alkaline

soil/water, mucous membrane contact(integumentary), direct/indirect contact

6. Diagnosis: dark field microscopy, Macroscopic slide agglutination test, serological tests,

Leptospira culture, environmental exposure

7. Prev/TX: Prev: strain specific vaccines for humans, dogs, cattle; protective footwear/clothing,

avoid swimming in natural water used by animals TX: penicillin, tetracycline

8. Comp/Seq: Comp: Weil’s Syndrome, anemia, hepatic disease, neurological disturbance,

kidney invasion Seq: long term disability/death from injury to kidneys/liver only in virulent strains

and elderly

9. Anything Else: 100 cases reported annually, older children, young adults, soldiers, half

cases occur in Hawaii

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Syphilis: Primary, Secondary, Tertiary, Congenital syphilis Treponema pallidum Bacteria, Gram- spirochetes, helical form, flagella, endoflagella, 2. Main Host/Tissues: GU/STD, mucous membranes, P=skin, 2=skin/throat, 3=NS 3. S&S: Primary: 9day-3 month infection, hard chancre (small red hard bump), lymph node enlarged/firm, communicable Secondary: 3wk-6mth, fever, headache, sore throat, lymphadenopathy, red/brown rash, communicable Tertiary: 30% untreated gummas (tumors), neurosyphilis, severe headaches, convulsions, mental, noncommunicable Congenital: women pregnant-fetus, nasal discharge, skin eruptions/loss, bone deformation, NS abnormalities 4. Virulence Factors: inflammatory response to host, outer membrane proteins, granulomas block circulation, spirochetes hooked tip, cant survive long outside, anti treponemal antibodies form 5. Res/Trans: Res: Gay/bisexual men, prostitutes, drug abusers Trans: STD/GU, direct contact, communicable/non communicable, endogenous, skin lesions, nosocomial Congenital: Vertical 6. Diagnosis: dark-field microscopy, direct immunofluorescent staining, DNA probe, serological tests (RPR, VDRL, Kolmer), MHA-TP, FTA-ABS, TPI, children(western blot test) 7. Prev/TX: Prev: trace sexual contacts, condoms TX: penicillin G with benzathine or procaine, tetracycline/erythromycin (only for penicillin allergy), 8. Comps/Seq: Comps: Primary: Secondary: bones, hair follicle, joint, liver, eye, brain Tertiary: muscle loss, loss of activity & coordination, mental derangement, blindness, cardiovascular syphilis Congenital: stillbirth, miscarriage, Hutchinson’s Teeth Seq: Primary: Secondary: Tertiary: destruction of spinal cord, Argyll-Robertson pupil reaction Congenital: 9. Anything Else: high in Africa/Asia, have other concurrent STDs, risk of infection is 12-30%
Leptospirosis Leptospira interrogans Spirochetes, bacterial, obligate aerobe, gram- spirochetes, tight coils w/ 1 hook/bend 2. Main Host/Tissues: GU Tract, kidney, liver, brain, and eyes, CSF 3. S&S: high fever, chills, muscle aches, headache, vomiting, conjunctivitis, Weil’s Syndrome 4. Virulence Factors: spirochetes with tights coils, lysis, agglutination, hemolysin, outer membrane proteins, adhesion molecules 5. Res/Trans: Res: Zoonosis, tropics, animals (horses, dogs, cattle, pigs, rodents, skunks, racoon, foxes) Trans: non-communicable, urine from infected animals in neutral or alkaline soil/water, mucous membrane contact(integumentary), direct/indirect contact 6. Diagnosis: dark field microscopy, Macroscopic slide agglutination test, serological tests, Leptospira culture, environmental exposure 7. Prev/TX: Prev: strain specific vaccines for humans, dogs, cattle; protective footwear/clothing, avoid swimming in natural water used by animals TX: penicillin, tetracycline 8. Comp/Seq: Comp: Weil’s Syndrome, anemia, hepatic disease, neurological disturbance, kidney invasion Seq: long term disability/death from injury to kidneys/liver only in virulent strains and elderly 9. Anything Else: 100 cases reported annually, older children, young adults, soldiers, half cases occur in Hawaii

Lyme Disease Borrelia burgdorferi Bacterial, gram-, anaerobe, helical 2. Main Host/Tissues: Skin, multiple systems, circulatory/lymphatic, joints, nerves, heart 3. S&S: 50-70% of cases rash (erythema migrans bulls-eye), fever, headache, stiff neck, dizziness, red papules, spotty rash, poly-arthritis 2nd: cardiac/neurological symptom (facial palsy) 4. Virulence Factors: motile through viscous fluids/materials, spirochetes change repeatedly, ixodes scapularis, larva/nymph feed on mouse (infectious agent), nymph bite human 5. Res/Trans: Res: zoonoses, black-legged deer ticks, high mouse & deer population, hikers, backpackers, woodlands, forests Trans: non-communicable, exogenous, biological vector 6. Diagnosis: ring shaped lesions, isolation of spirochetes, ELISA rising antibody titer, spirochetal DNA, 7. Prev/TX: Prev: insect repellent containing DEET, protective clothing, vaccine for dogs, vaccine for humans discontinued TX: tetracycline, amoxicillin, antibiotics (ceftriacycline, azithromycin) 8. Comp/Seq: Comp:chronic neurological complications, Seq: crippling polyarthritis 9. Anything Else: Occurs in NY, NJ, RH, MD, PA, CT, reproductive phase of tick completed on deer, larvae/nymph feed on white-footed mouse
Chlamydial infections: NGU, Conjunctivitis Chlamydia trachomatis Bacterial, gram-, pleomorphic rods (bacilli), anaerobe 2. Main Host/Tissues: STD, attack GU, lungs, genitalia, 2nd: eyes 3. S&S: systematic women(white drainage, PID, endometritis) NGU- among males similar to gonorrhea, inflammation of urethra, lymphogranuloma venereum (headache, fever, muscle ache, buboes deforming genitalia/anus) Conjunctivitis- mild conjunctival exudate, inflammation of conjunctiva, infiltration of lymphocytes/macrophage, pebbled appearance of upper eye, pannus, INCLUSION-conjunctival irritation, adherent exudate, redness, swelling 4. Virulence Factors: phagolysosome fusion, elementary body shielded by envelope, reticulate body forms new Eb, catabolizing glucose, synthesize ATP, ribosomes, 5. Res/Trans: Res: human bodies Conjunctivitis (hot dry climate, flies, fomites, fingers) NGU (body) Trans: direct contact, vertical trans, communicable, GU/STD, mechanical vector, fomites 6. Diagnosis: genetal swabs, cultures from chicken embryos, immunofluorescence, PCR-based probe, Conjunctivitis (Giemsa, iodine stains) 7. Prev/TX: Prev: condom TX: urogenital infec (doxycycline, azithromycin) Conjunctivitis (tetracycline, sulfa drugs, INCLUSION-erythromycin & tetracycline), drug therapy 8. Comp/Seq: Comp: Seq: reproductive damage, Conjunctivitis (Blindness) 9. Anything Else: in about 10% of pop., 70% (women) asymptomatically on cervix, 10% males no S&S, increase 8-10% a year in teens, Conjunctivitis: most severe in children and infants

Histoplasmosis:Ohio Valley Fever Histoplasma capsulatum Fungal, dimorphic, yeast, white/brown hairlike mycelium 35C, creamy/white 37C 2. Main Host/Tissues: respiratory tract 3. S&S: usually asymptomatic, aches, pain, coughing, fever, weight loss, night sweats, benign 4.Virulence Factors: grow dimorphic, saprobic mycelium, pathogenic yeast, microconidia, spores, cytoplasm of phagocytes 5. Res/Trans: Res: moist soil, bird/bat poop, zoonoses Trans: indirect transmission, non-communicable, oral-fecal route, exogenous 6. Diagnosis: spherical fish-eye yeats in macrophages, free yeast in sputum and cerebrospinal fluid, isolate dimorphism, complement fixation, immunodiffusion serological tests 7. Prev/TX: Prev: avoid caves, respiratory protectionTX: chemotherapy, amphotericin B, itraconazole, surgery removing affected masses in lungs, etc 8. Comps/Seq: Comp: Children-anemia, death, liver/spleen enlargement, Adults- Seq: Children-circulatory collapse Adults-lesions in brain, heart, bone marrow, adrenal gland, liver, spleen, lymph nodes, skin 9. Anything Else: Not in Australia, more serious in AIDS patients, OH,IL, MO, KY, TN, MI, GA, AR 80-90% of pop show prior infection before 20, with emphysema cause chronic pulmonary histoplasmosis
Coccidioidomycosis: Valley Fever Coccidioides immitis Fungal, dimorphic, endospores, arthrospores @ 37-40C spherules, 25C moist/white/brown colonies/branching septate hyphae/thick-walled arthroconidia 2. Main Host/Tissues: Respiratory Tract 3. S&S: 60% inapparent, 40% cold like symptoms (fever, chest pain, cough, headache, malaise), lifelong immunity result 4. Virulence Factors: grow dimporhically, saprobic mycelium, pathogenic spherule, grows endospores that lack resistance traits, spores 5. Res/Trans: Res: natural reservoirs in wind, animals, hot climate, high carbon, high salt, drought, heavy rain, windstorms San Joaquin Valley, AZ, Mexico, Central/South America Trans: vehicle transmission, spores inhaled 6. Diagnosis: spherules in sputum, spinal fluid, biopsies, isolation of typical mycelia, spores on Sabouraud's agar, induction of spherules, immunodiffusion, latex agglutination tests, skin test 7. Prev/TX: Prev: oiling dirt roads, plant vegetation, respiratory protection TX: no treatment, amphotericin B, itraconazole 8. Comps/Seq: 5/1000 cases chronic progressive pulmonary disease (fungomas), cavity formation in lungs, dissemination of endospores in 7% 9. Anything Else: more severe in ethnic groups, impaired immunity, pregnant women, AIDS, 100,000 cases per year

Candidiasis/Thrush Candida albicans Fungal, yeast, gram+, opportunist, pseudohyphae, true hyphae, budding cells, off white 2. Main Host/Tissues: GU, STD, THRUSH: skin; respiratory, mouth, pharynx, vagina, skin, alimentary canal, lungs, internal organs 3. S&S: VC: yeast infec, for oral antibiotics, diabetic/pregnant, neonates, yellow-white discharge, inflammation, painful ulceration, itching; nausea, vomiting, bleeding ulcerations Onychomycosis: skin/nail constantly in water Intertriginous: beneath breast, armpit, groin Cutaneous : burns, scald like rash of babies Thrush : newborn/elderly, white adherent patchy infection in oral cavity/throat 4. Virulence Factors: Budding cells form elongate pseudohyphae/true hyphae, prototypical opportunist, little virulence with impaired immune, biofilm on artificial joint/catheter/valve 5. Res/Trans: Res: nurseries, childbirth, sexual contact, surgery, 20% in pharynx, genitalia, large intestine, skin Trans: discharge from infected membranes, chronic contact w/ moisture & warmth, GU, Nosocomial 6. Diagnosis: fungal media at 30C, trypan blue, germ tube test, sensitive DNA amplification 7. Prev/TX: Prev: universal precaution TX: topical antifungal agents (azole/polyenes), terbinafine for onychomycosis, amphotericin B, fluconazole, topical azole treatment 8. Comps/Seq: Comps: death, candidal endocarditis Seq: 9. Anything Else: increased in extreme youth, pregnancy, drug therapy, immunodeficiency, trauma, esophageal candidiasis affects 70% AIDS, usually endogenous
Pneumocystis Pneumonia Pneumocystis (carinii) jiroveci Fungal, protozoa, obligate parasite, rRNA, unicellular, weak cell wall 2. Main Host/Tissues: Respiratory Tract 3. S&S: cough, fever, shallow respiration, cyanosis 4. Virulence Factors: adhere to lung pneumocytes, inflammatory condition, epithelial cells lough off, lacks ergosterol, rRNA, 5. Res/Trans: Res: harmless resident in upper respiratory lungs Trans: communicable, vehicle transmission, droplet 6. Diagnosis: symptoms, lung secretion/tissues, DNA amplification probe 7. Prev/TX: TX: pentamidine & in aerosol form for low T-count patients, cotrimoxazole (sulfamethoxazole/trimethoprim) over 10 days, improved therapy for AIDS patients 8. Comps/Seq: block breathing 9. Anything Else: opportunistic infection in AIDS, only in elderly, premature infants who are malnourished or severely debilitated

Disease Cards 29-38.., Lecture notes of Microbiology

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