Micro Diseases

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Impetigo

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Cause: Staphylococcus aureus 80%; Streptococcus pyogenes 20% enters through direct contact with compromised skin
Symptoms: small flattened red patches usually on face and limbs. patches become vesicles filled with puss and honey colored crust.
Erysipelas: is once the infection spreads to lymph nodes
Virulence factors: M protein, Hyaloric acid capsule,Pyrogenic toxins
Treatment: diagnosed by vesicles, medications-topical mupirocin and oral erythromycin or dicloxacillin
Prevention: Good Hygiene

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Necrotizing fascilitis

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Cause:Streptococcus pyogenes Group A, enters through skin wounds and spreads rapidly
Symptoms:intense pain(more than expected), swelling at site,as muscle is digested the skin becomes distended and discolored, hot to the touch may look like a sunburn rash.
Virulence factors: enzymes and exotoxin A (Streptolysin S kills human cells)
Treatment: diagnosis is difficult but pain is indicator, affected tissue must be removed, IV broad spectrum antimicrobial drugs clindamycin and penicillin combined
Prevention: wash every wound and observation

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Acne

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Cause:Propionbacterium grows on sebum, pus is dead bacteria and leukocytes. Blackhead-dead and dying bacteria blocks pore. Cystic acne worst form creating scars.
Symptoms; pus filled vesicles on the skin, red raised and black or white
Virulence:opportunistic pathogen normal microbiota
Treatment:immune system in severe cases antimicrobial drugs doxycycline, benzoyl peroxide(exfoliation of dead skin cells), Accutane (rare and never for women)

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Pseudomonas Infection

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Cause:Pseudomonas aeruginosa enters through skin breaks or mucous membranes (Burns)(nosocomial infections)
Symptoms:fever, chills, shock, blue-green pigment (pyocyanin)
Virulence: located almost everywhere moist and metabolizes organic carbon and nitrogen decaying organic material. Fimbriae and adhesins biofilms capsule and enzymes and endotoxin. drug resistances.
Treatment:diagnosis blue-green pigment. Medications combination of aminogylcoside and beta-lactam antimicrobials. Last resort: Polymyxin toxic to humans as well

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Rocky Mountain Spotted Fever

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Cause:Rickettsia rickettsii enters by a feeding tick for several hours. rarely by contact of tick feces and tissues or fluids from crushed ticks
Symptoms: non-itchy spotted rash on trunk and limbs, including palms and soles. 50% of the time petechiae in subcutaneous tissues from rash. fever, headache, chills, muscle pain, nausea, vomiting. Severe cases respiratory, central nervous, GI, renal systems fail. It causes low blood pressure by damage to blood vessels reducing the nutrient and oxygen delivery to organs.
Virulence:Endotoxin, slime layer, enduces endocytosis to enter phagosomes then stops digestion by lyses.
Treatment:diagnosis by serological test and symptoms. Medications-doxycycline, tetracycline, or chloramphenicol
Prevention: limiting access for tick to skin

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Herpesvirus

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Cause:Simplexvirus-Human herpesvirus I(above the waist) (HHV-I)& 2(below the waist)(HHV-2) usually involved in neonatal herpes. Enters thru cracks and cuts in mucous membranes
Symptoms:Painful itchy skin lesions on the lips(fever blisters or cold sores) flu like, malaise, fever, muscle pain, Whitlow( blister on fingers). Lessions are recurring due to the latency of this virus. Often enter sensory nerve cells. recurrent lesions can happen as often as q2weeks.
Virulence: capsule, and proteins that inactivate complement
Treatment:Chemotherapeutic agents such as Acyclovir. Topical creams to reduce viral shedding will always have disease just manageable
Prevention: Gloves reduce contact with lesions

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Chickenpox / Shingles
(varicella) / (herpes zoster)

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Cause:Varicella-zoster virus (VZV) enters through the mucous membrane of the respiratory tract ->liver, spleen, and lymph nodes via blood and lymph then after 2 weeks to the skin in a second wave.
Symptoms: rash with pus vesicles, fever, malaise, virus sheds through respiratory droplets and lesion fluids. Typically more severe in adults than childhood
Virulence:Latent
Treatment:diagnosis by the lesions, shingles follows a nerve path. Supportive for symptoms with acetaminophen and antihistamines. (no Asprin), bed rest for shingles. Acyclovir for pain relief.
Prevention: immunizations

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Scabies

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Cause:Sarcoptes scabiei enters by burrowing arachnid mite,damages nerve endings, antigens trigger inflammation direct contact and fomites, child under 15 usually
Symptoms:intense itching, localized rash w/ pimple like vesicles. Commonly found in webbing and skin folds. Secondary infections w/ staphylococcus and streptococcus
virulence:usually under 10 bugs
Treatment: Topical lotions to kill mites below neck for q8h
Prevention: wash fomites in hot water and hot dryer, good hygiene, isolate infected person

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Strep pharyngitis (strep throat)

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Cause: Streptococcus Group A (S. pyogenes) enters by respiratory droplets and breaks in the mucous membranes
symptoms:back of pharynx red and swollen lymph nodes and purulent(pus vesicles) on the tonsils. Fever, malaise, headache. Severe cases inflammation of the larynx and bronchi(laryngitis&bronchitis), coughing and hoarseness
Virulence: enzymes & toxins, capsule many strains
Treatment:diagnosis thru serological testing 50% actually viral not bacterial. Medication Penicillin or Erythromycin or cephalosporin if sensitive to penicillin
Prevention: isolation of sick child staying home from and good hygiene.

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Tuberculosis

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Cause:Mycobacterium tuberculosis enters via airborne transmission via droplets to the respiratory tract. 3 types-Primary,Secondary and Disseminated(travels to other organs via blood and lymph
Symptoms:minor cough and fever, to breathing difficulty, fatigue, malaise, weight loss, chest pain, wheezing and coughing blood. Tubercles form in lungs
Virulence: intracellular growth, 0 gram stain, not killed when phagocytized, cord factor of daughter cells, waxy walls, live up to 8 months on dried aerosol droplets
Treatment:diagnosis-skin check and X-ray. Medications:penicillin, erythromycin combination of isoniazid rifampin and ethambutol or streptomycin for 2months followed by 4 months of rifampin alone.
Prevention:antibacterial drugs prophylactically, vaccine is available but will always have (+) skin test.

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Pertussis ( Whooping Cough)

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Cause:Bordetella pertussis enters via airborne respiratory droplets and binds to tracheal cilia,
3 stages; Catarrhal,paroxymal, convalescent
Symptoms: common cold, runny nose(rhinorrhea),slight cough and mild fever. singnature coughing, vomiting, diarrhea, and choking after 2wks in the paroxymal stage. Oxygen exchange limited so cyanosis develops, death results
Virulence: 2 adhesions and 4 toxins, endotoxin gram(-).
Treatment:diagnosis by symptoms. Supportive care immune system wins, recovery by regeneration of tracheal epithelium.
Prevention: Vaccine DTaP (acellular) or DTP (attenuated)

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Coccidiomycosis (Valley Fever)

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Cause:Coddidioides immitis (dimorphic soil fungus) enters via airborne soil particles w/ asexual arthroconidia spores germinate in the alveoli into spherule form. common in south western US
Symptoms: fever, cough, chest pain, difficulty breathing, night sweats, weight loss and pneomonia
virulence:fungus assumes a pathongenic yeast form at human body temp.
Treatment: diagnosis is by identifying spherules in clinical specimens, confirmed by antigens under skin like TB and looking for inflammatory response. Medicatons:Amphotericin B (toxic to humans) also itraconazole or fluconazole
Prevention: protective mask sometimes impractical

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Histoplasmosis

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Cause:Histoplasma capsulatum( dimorphic ascomycete a fungus) needs moist soil and high nitrogen levels like from bat or bird droppings(chickens).
Symptoms: 95% asymptomatic, severe coughing with blood tinged sputum or skin lesions. AIDS pt rapidly develops hempatomegaly and splenomegaly.
Virulence: macrophages spread fungus from lungs via blood and lymph.
Treatment:Diagnosis is by identifying budding yeast in macrophages or in skin scrapings, sputum, cerebrospinal fluid and various tissues. Medications-itraconazole, ketoconazole, or amphotericin B

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Fungus treatments end in

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usually "zole"

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Endocarditis

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Cause:50% by Viridans streptococci (greenish pigment when cultured on blood) enters via surgical wounds, dental procedures, lacerations of gums and small lesions in the lungs, Normal microbiota opportunistic, Subacute and acute forms
Symptoms:fever, extreme fatigue, malaise, difficulty breathing, may have tachycardia or mummurs. Commplications-blood clots, stroke, and heart valve damage, heart failure. Usually left aterioventricular mitral valve, then aortic semilunar valve. hemorrhages under nail beds or in retina of eye
Treatment:Diagnosis via symptoms and vegetations on echocardiogram. Medications IV over long periods 6 wks. Infection site cleaned and drained of pus, surgical removal of vegetations and abscesses & heart valve repair.
Prevention: preventive antimicrobial drugs prior to dental work and surgeries.

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Lyme Disease

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Cause: Borrelia burgdorferi-spirochete via deer tick bites saliva thru the skin.
Symptoms:Bull's- eye rash, malaise, headache, dizziness, stiff neck, severe fatigue, chills, muscle pain, and lymphadenopathy.
Virulence:Use of manganese in place of iron to avoid defenses. Can change outer membrane proteins via genetic rearrangement, endotoxin.
Treatment:Diagnosis via Borrelia in the blood and bull's eye rash, confirmed with ELISA for antibodies. Medications-Doxycycline, cefuroxime, ceftriaxome, or penicillin
Prevention:reduce contact with ticks-long clothing, tick repellent, and observation for ticks on skin

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Infectious mononucleosis (Kissing disease or mono)

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Cause: Human herpesvirus 4(HHV-4) AKA Epstein Barr virus (EBV) enters via saliva to epithelial throat cells and salivary glands
Symptoms: Severe sore throat, fever, followed by enlarged lymph nodes in neck, splenomegaly, fatigue, nausea, loss of appetite and headache, Inability to concentrate and fatigue for months
Virulence:Latent, lifelong infection, suppresses apoptosis in B lymphocytes can cause cancer. Cancer of the jaw limited to young african males exposed to malaria before. Worse in later life.
Treatment:Diagnosis via fluorescent antibody testing or ELSIA. Supportive care, limit contact sports if enlarged spleen

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Staphylococcal Toxic Shock Syndrome (TSS)

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Cause:Staphylococcus aureus via normal growth with exotoxins absorbed into blood stream. Opportunistic
Symptoms:Acute fever, chills, vomiting, diarrhea, extremely low blood pressure, mental confusion, and severe red rash.
Virulence: exotoxins, cause overabundance of cytokines released by T-cells.
Treatment:Diagnosis via symptoms (menstruating women) culture of blood samples. Medications-vancomycin, Anti-TSST immunoglobulin to fight toxin. Removal of foreign material(tampoon, sponge, diaphragm, also nasal packing)
Prevention: Avoid use of tampoons, vaginal sponges, birthcontrol diaphragms, and changing tampoons frequently or less absorbent.

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Urinary Tract Infections (UTI)

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Cause: Enteric bacteria(intestinal microbiota most common) Escherichia coli 70%. conditions: urethritis(urethra), cystitis(bladder), pyelonephritis(kidney) and Prostatisis(prostate)
Symptoms: slight fever, dysuria, urgent, frequent, cloudy , bloody, foul smelling urine. Mental confusion. Pyelonephritis is a more serious condition can cause severe abdominal, flank, and back pain w/ higher fever, reddened skin, vomiting, and fatigue.
Virulence: flagella, fimbriae, biofilm
Treatment: Diagnosis Urinalysis reveals leukocytes, erythrocytes and bacterium. Medications-cephalosporins, sulfonamides, and semisynthetic penicillins
Preventions: Wipe front to back, void after sex, refraining from douching, and diaphragms. Cath removal ASAP

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Chlamydia

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Cause:Chlamydia trachomatis via direct contact thru birth canal and sexual intercoarse. skin breaks and mocous membranes including the eye. Most common STD
Symptoms:85% of women asymptomatic, 75% of males so signs., painful urination, pus discharge from penis, Can cause epididymitis(tube) and orchitis(inflamed testis) Babies develop Trachoma in the eye when infected at birth(bumpy eye lid turned in eyelashes scratching cornea) ;leading cause of blindness. Lymphogranuloma venereum-transient genital lesions followed by bubo(inflamed lymph node in groin.
Virulence:Two cellular morphologies Elementary bodies(EB)infective form and Reticulate bodies (RB) reproductive form
Treatment:diagnosis via specimen, Medications-tetracycline, azithromycin, or erythromycin in adults, erythromycin ointment in eyes of infants.
Prevention: Abstinence, monogamy and prompt treatment of babies.

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Peptic ulcer

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Cause:Helicobacter pylori via fecal-oral route
Symptoms: Abdominal pain, shock, cardiovascular system failure, nausea, vomiting w/blood (coffee grounds) weight loss, chest and back pain, tar like stools.Perforations when through lining of stomach.
Virulence: motile, ureases to increase pH. toxins to decrease mucus layer. survive phagocytoses by enzymes. Gram(-)
Treatment: Diagnosis GI series X-rays w/barium. positive urease test. Medications-antimicrobial drugs to reduce acid production, killing all bacterium may cause esophageal cancer. Surgery to repair perforations.
Prevention: avoidance of fecal-oral transmission

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Hepatitis B

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Cause:Orthohepadnavirus hepatitis B (HBV) via blood and needles sexually transmitted
Symptoms:Yellowing of the skin and eyes(juandice), abdominal pain, dark urine, N&V, fever, fatigue, loss of appetite and weight, light colored stools. Liver damage (cirrhosis), failure, and cancer.
Virulence: envelop, chronic carrier, spherical and filamentous particles to occupy antibodies
Treatment: diagnosis via serological test for antigens or antibodies, Dane particles, along with jaundice and enlarged liver. Medications-immunoglobulins directly after exposure adefovir dipivoxil or lamivudine
Prevention: Vaccine over 6 months

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Hepatitis C

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Cause:Hepacivirus hepatitis C (HCV) via sexual contact and needles
Symptoms:Yellowing of the skin and eyes(juandice), abdominal pain, dark urine, N&V, fever, fatigue, loss of appetite and weight, light colored stools. Liver damage (cirrhosis), failure, and cancer.
Virulence: enveloped, Nonproof reading RNA so mutiple strains, chronic carrier
Treatment:diagnosis via serological test for antigens or antibodies, Medications-alpha interferon and ribavirin.
Prevention:Abstinence, avoid needle sharing and tattoos or piercing, No Vaccine!

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Botulism

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Cause: Clostridium botulinum via inhalation of endospores in dust or ingestion in food, toxins actually cause disease. 3 types Foodborne, Infant, and Wound
Symptoms:Foodborne-blurred vision w/fixed dilated pupils, dry mouth, constipation, N&V, abdominal pain, progressive paralysis of voluntary muscles bilaterally remain mentally alert. Infant-crying, constipation, and "failure to thrive". Wound-dead tissue endospores same as foodborne but incubation period is longer.
Virulence: endospores, toxins, anaerobic gram(+) in soil and water worldwide. Interfers with acetylcholine to block neurotransmitters
Treatment:Diagnosis culture of organism from contaminated food, feces, or wound. Medications-BIG-IV(immunoglobulin via IV) Antimicrobials in infant and wound cases. Repeat cleansing of intestinal tract.
Prevention:Proper canning and cooking for food,no honey for infants, cleansing of wounds

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Tetanus (Lockjaw)

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Cause:Clostridium tetani via endospores through skin breaks
Symptoms:Tightening of the jaw and neck muscles, difficulty swallowing, followed by fever and muscle spasms, sweating, drooling, grouchiness, and constant back spasms, heartbeat irregularities, BP fluctuations.
Virulence:motile, gram(+), endospore, neurotoxin(tetanospasmin) carried to central nervous system. Inhibits muscle relaxation causing bones to break,
Treatment:cleansing of wound, adminstration of immunoglobulin (HTIG) and penicillin
Prevention: Vaccine DTap, DTP, and Td

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Rabies

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Cause:Rhabdoviridae-Lyssavirus via animal bite(Zoonosis) bats common vector
Symptoms:pain itching at infection site,fever, headache, malaise, anorexia, Once in the CNS hydrophobia,seizures,disorientation, hallucinations, and paralysis, death from respiratory paralysis
Virulence:helical capsule, bullet shaped envelope
Treatment:diagnosis via symptoms and antibody test in blood. Postmortem test done on brain in suspected animal. Supportive care. Clean wound with antirabies serum, and immunoglobulin (HRIG) followed by 4 vaccine shots (HDCV)
Prevention: Vaccination of animals. Human rabies vaccine-Human diploid cell vaccine(HDCV) from deactivated rabies viruses after exposure day 0,3,7 &14

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Poliomyelitis (polio)

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Cause:Enterovirus 3 strains defined by antigens, via contaminated water.
Symptoms:4 conditions 1)Asymptomatic 2)Minor polio-fever,headache, malaise, sore throat 3)Nonparalytic polio-after invasion of meninges and CNS, back and muscle pain 4)Paralyitc polio-invasion of the spinal cord and cerebrum causing paralysis by limiting nerve conduction. (bulbar poliomyelitis the brain stem is infected affecting respiration and limb muscles.
Virulence:remains stable for long periods in water and food
Treatment: diagnosis is culture of virus in throat secretions or feces. Supportive care.
Prevention: Vaccines 2
Salk-(IPV);injected, needs booster,inexpensive, inactivated
Sabin-(OPV);attenuated, oral, can revert to cause disease, lifelong immunity