Infectious Disease

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Steps of different steps n the pathogenesis of an infectious disease...

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encounter, entry, spread/multiplication,damage and outcome

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Encountering the microbe

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enviroment is a key issue
e.g. - panama canal -malaria
poor sewerage and sanitation- cholera, typhoid, Salmonella
rodent infestation- bubonic plague

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entry: protective barrrier

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skin
pulmonary defense mechanism
GI barriers

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Spread and multiplication

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time frame determines the incubation period oftern referrred to as teh prodromal period when the infection is characterized by nonspecific symptoms (fever, chill, malaise)

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damage

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tissue damage
bacgteria secrete toxins that result in a # of adverse effects.

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two major types of toxins

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endotoxins
exotoxins

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endotoxins lipopolysaccharide (LPS)

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gram negative bacteria
actual component of teh microbe and it may be released or shed during its destruction
It is a powerful activator of immune responses- SUPERantigen
causes cytokine release, fever and shock when released in large amounts

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exotoxin

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spore forming microbe C
botulinum secretes an exotoxin
tetanospasmin
botulinum

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tetanospasmin- exotoxins

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blocks the release of inhibitory transmitter like glycine and GABA from spinal neurons - results in spastic paralysis

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Botulinum toxin

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prevents the release of ACH and result in paralysis
used cosmetically BOYX

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enterotoxin

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s aureus releases and results in food poisoning
-diphtheria toxin
-cholera toxin
-anthrax toxins
we are often immunized with toxoids to precent their effects

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toxin genes are often located in the _______________ !

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plamids

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Clostridium perfringens

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causes gangrene
release phospholipase C and this destroys cell membrances
the massive and uncontrolled release of cytokines from immune effector cells and/or the activation of complement proteins can also results in serious clinical problems

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Outcome

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either the microbe or the host wins- there is usually peaceful coexsitence
in many cases survival from an acute bacterial or viral encounter often induces long term immunity- the basis of vaccinations

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baterical virulence mechanism

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adherence
invasion
by products of growth
toxins (degradative enzymes, AB toxins)
endotoxins
superantigen
induction of excess inflammation
evasion of phagocytic and immune clearance
resistance to antibiotics

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Host defense mechanisms

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normal flora
skin, GI secretions
cells- neutrophils, eosinophils, basophils, macrophages, t-cells, b-cells, plasma cells
cytokines incling monokines, chemokines, and lymphokines
antibodies
complement protiens

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bacteria shapes and sizes

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bacillus
coccus
spiral

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bacillus

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rod shaped
single
sporeformer
stertoballis (chain)

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coccus

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sphere
single
dipiococcus
tetrad
staphlococccous
stetpcoccocu (chain)

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spiral

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spitillum
spirochete
vibrio (comma shaped)

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gram stain

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crystal violet
purple color tf= P-purple positive

other stains can be used--- TB(mycobacterium) is colored with acid-fast stains

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Group A steptococci (s pyogenes)

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gram stained chaing of purple sheres
cause Scarlett and rheumatic fever, necrotizing facitis, and toxic shock

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clinical features of an infectious disease

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inflmmation
fever
leucocytosis

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inflammation

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tumor
ruor
dolor
calor

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fever

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a result of pyrogens including IL- 1 and 6 (remember that drugs And neoplasms can also cause fever)

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leucocytosis

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an increase in WBCs, both mature and band forms

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Gram + cocci

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Streptococcus pneumonia
step. pyogenes (group A strp)
Strep agalactiae ( Group B step)
staphlococcus aureus
staph epidermidis

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Strep pneumonia

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causes pneumonia, otitis media and meningitis

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Strep pyogenes- group A

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pharyngitis, rheumatic fever

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Strp agalactiae- group B

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neonatal sepsis, meningitis

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stephlococcus aureus

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food poisoning

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staph epidermidis

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catheter and prosthetic infections

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Gram negative cocci

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neisseria meningitidis (meningococcus), meningitis, septicemia
N. gonorrhea (gonococcus): urethritis/cervicitis, PID

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Gram positive bacilli

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rod shaped
corynebacterium diptheria
baillus antracis- anthrax
c. botulinum, tetany, perfiringens: botulism, tetany, gas gangrene
C diff: antibiotic- associated GI diseases including diarrhea to colitis

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NB Bacillus and clostridial organims

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spore formers
can persist in the environment for long periods of time

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Gram negatice rods

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e coli
shigella
salmonella
yersinia pestix
vibrio cholera
h. pylori
pseudomonas aeruginosa
bordetella pertussis

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e coli

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diarrhea, hemorrhagic colitis

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shigella

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bloody diarrhea

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salmonella

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typhoid fever

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yersinia pestia

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bubonic plague

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vibrio cholera

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cholera

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h pylori

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ulcers

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pseudomonas aeruginosa

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pneumonia, nosocomial acquired or CF

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Bordetella pertussis

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whooping cough

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acid fast bacteria

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mycobacterium TB
M leprae- lerpsy
M avium- infects liver and bone marrow- problem with AIDS

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Spirochetes

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treponema pallidum- syphyllis
borrelia burgdoorferi- lyme disease

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Chlamydia and rickettsia

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these bactera are small and gain access to the cell interior
- chlamydia trachomatis - conjunctivitis, STD
- Rickettsia: rocky mountain spotted fever
intera cellular organism- very small and get into the cell
similar to virsus