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199 Cards in this Set
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Treatment for Streptococcus pyogenes
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Confirm via test and throat culture.
Treatment with penicillin or erythromycin about 90 effective prevents post streptococcal sequelae |
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What is post streptococcal sequelae
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Complication that develops after strep infections
Thought to result from immune response |
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Post streptococcal sequelae examples
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Acute rheumatic fever
Acute poststreptococcal glomerulonephritis |
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Acute rheumatic fever
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3 weeks after recovery of strep infection
Fever arthritis chest pains rash nodules under the skin uncontrollable body movements or chorea. Carditis leads to chronic rheumatic heart disease some MHC class 2 alleles involved in susceptibility |
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Post streptococcal glomerulonephritis
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Can follow strep throat but is more often a skin infection
Fever high BP blood and protein in the urine. Damage to kidneys from inflammatory reaction to a cockle antigen antibodies bind activate the complement system very few s pyo genes cause this |
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Diphtheria
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Rare because of immunisation
Epidemic in 1990 to 1995 Russian Federation 125,000 cases 4000 deaths |
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diptheria
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Mild sore throat slight fever fatigue malaise swelling of the neck a pseudomembrane formation on the tonsils and throat
Heart and kidney failure |
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pseudomembrane
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Made of dead epithelial cells, clotted blood, fibrin, and leukocytes that accumulate
May come loose and suffocate the patient |
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Diphtheria causative agent
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Corynebacterium diphtheriae
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Corynebacterium diphtheriae
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pleomorphic non motile non spore forming G positive irregular stain.
releases dyptheria toxin powerful exotoxin |
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diphtheria
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A & B are exotoxins cells lacking receptor are unaffected
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A B exotoxin dyptheria
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Bechain attaches to receptors entire molecule taken up by endocytosis
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diphtheria epidemiology
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Humans are primary
spread by air. Acquired via inhalation or from fo mites Cutaneous diphtheria with chronic ulcers may be the source |
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Diptheria treatment and prevention
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Injection of antiserum
Delaying can be faithful Antibodies can clear the causative agent but is uneffective on the toxins absorbed. Immunization extremely effective |
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Diphtheria mortality
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Even with treatment approximately 10% mortality rate
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Conjunctivitis otitis media sinusitis haemophilua influenzae
Streptococcus pneumoniae |
Tend to all occur together
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One third of otitis media and sinusitis are caused by
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Viruses
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Conjunctivitis
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Airborne respiratory droplets or contaminated hands
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Antivirus
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resist destruction by lysozyme
Attachment sometimes aided by degradation of mucin Releases proteases, collagenases, coagulase, sometimes toxins Distribute tissue and allow entry |
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Otitis media, sinusitis
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Usually preceded by an infection of the nasal chamber and necessary next that spreads through the eustachian tube
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otitis media sinusitis pathogenesis
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Infection damages ciliated cells resulting in inflammation swelling and prevents the removal of secretions
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otitis media sinusitis pathogenesis result of inflammattion
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collection of fluid and pus behind eardrum
Eardrum burst |
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Pink eye earache sinus infection
Epidemiology |
Carrier rates reach 80 percent in absence of disease
virulence crowding presence of respiratory viruses are all causes |
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Pink eye earache and sinus infection
Treatment and prevention |
Antibiotics for bacterial infection preventive measures include hand washing and avoiding touching the eyes
ear tubes |
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Contraindicated treatment for pink eye earache and sinus infection
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Decongestant and antihistamine are generally ineffective and can actually reduce immune response
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how many viral infections of the upper respiratory system occur per year
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2 infections to five infections per year in the US
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Viral infections of the upper respiratory system how many are common cold
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More than one half
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The common cold
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Malaise sore throat runny nose cough hoarseness
Nasal secretions first watery then thinkin and become cloudy No fever unless there's a secondary bacterial infection May include persistent cough Symptoms gone within a week |
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Causative agent for the common cold
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Approximately 100 or more of the human rhinovirus can cause 30 to 50 %
The picornavirus - non enveloped single stranded RNA Many other viruses and bacteria cause cold symptoms |
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Pathogenesis of the rhinovirus
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Attached to host receptors on respiratory epithelial cells
Replication cycle produces large number of visions Ciliary motion of infected cells stop and cells may die Damage leads to the release of cytokine and inflammation Increased nasal secretions tissue tissue swelling and sneezing Later blood vessels dilate and allow leukocytes and plasma out Infection can spread to ears sciences and LR T Eventually it is stopped by the innate and adaptive response |
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Common cold epidemiology
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Humans are the only source
Airborne droplets touching eyes nose Transmission likely during the first two or three days of infection Easily transmitted Emotional stress can double the risk |
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Common cold treatment
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New treatments
Where s is not affected by medication Analgesics and antipyretic can reduce symptoms but may prolong symptoms and duration under |
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Common cold prevention
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Hand washing
Avoiding touching face Avoid crowded places and affected individuals in the first few days of symptom No vaccine due to the large number of viruses |
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Common cold incubation period
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1 to 2 days
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adenovirus
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variety of febrile infections
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Adenovirus signs and symptoms
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runny nose
fever sore throat whitish gray pus on their pharnyx and tonsils Enlarged lymph nodes of the neck Mild cough Conjunctivitis and diarrhea may occur Chest pain recovery is 1 to 3 weeks |
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What viruses can the adenovirus be confused with
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Strep throat pneumonia whooping cough pleurisy
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Adenoviral causative agent
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More than 50 antigenic types of adenovirus
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Adeno viral resistance
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Remains infectious environment for a long. Of time
Resistant to destruction by detergents Alchohol |
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Effective against Edina viral infections
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Heat
Chlorine disinfectants |
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Adena viral pathogenesis
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Virus attaches to receptors of epithelial cells near the basement membrane
Junoon transported to nucleus |
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What virus avoid host defenses by delaying apop tosis blocking interferon function interfering with antigen presentation by MHC class 1 molecules?
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Adenovirus
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How does adenovirus cause cell lysis
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Falling replication: death proteins
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Who is affected by adenoviral infections
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Human
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How is adenovirus spread
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By respiratory droplets pancreatic condition
From the respiratory tract and can be eliminated in the feces for months Improperly chlorinated swimming pools also pose a risk |
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Idina viral treatment
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Ministrations recover with time
Secondary bacterial infections may occur |
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Adenovirus vaccination
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vaccines for two strains are under evaluation
Was used in the military |
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Bacterial infections of the lower respiratory
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Less common but much more serious
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Pneumonia
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Inflammatory disease of the lungs fluid fills alveoli
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What are some common bacterial infections of the lower respiratory system
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Whooping cough
tuberculosis Legionnaires disease |
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Pneumococcal pneumonia signs and symptoms
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Cough fever chest pain speed in production and other material coughed up from the lungs
Without treatment profuse sweating |
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Pneumococcal pneumonia detailed signs and symptoms
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One to two days of runny nose and congestion that ends with the rise in temperature in chill
Sputum becomes pink or rust from blood Chest pain causes shallow and rapid breathing patient complexion becomes dusky from poor oxygenation |
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Pneumococcal pneumonia causative agent
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Streptococcus pneumoniae
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Streptococcus pneumoniae description
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Gram positive cockle
Thick polysaccharide capsule necessary for virulence 90 different serotypes |
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Pneumococcal pneumonia pathogenesis
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Capsule pneumococcal surface protein PS PA interferes with c3b of complement system blocking figure cytosis
causes accumulation in the alveoli Can lead to sepsis endocarditis or meningitis |
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None encapsulated pneumococcus
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Does not cause invasive disease
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Risk factors for pneumococcal pneumonia
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Alcohol narcotic use viral respiratory infection heart lung disease diabetes cancer and being over the age of 50
Because of the defense reduced Mucociliary escalator |
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Up to 30% of healthy people carry what in there throught
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pneumococcal pneumonia
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What mechanism keeps pneumococcal pneumonia out of the lung
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Mucociliary escalator
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Pneumococcal pneumonia
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penicillin
Erythromycin if caught early Resistant strains increasingly |
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Pneumococcal pneumonia prevention
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Vaccine available for 23 pneumococcal strains that caused over 90% of the disease
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Pneumococcal pneumonia prevention in children
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Conjugate vaccine against 13 strains available
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Klebsiella pneumoniae
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Interio bacteria that causes pneumonia it is a common hospital acquired pathogen
The leader of deaths from healthcare-associated infections |
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Klebsiella pneumonia signs and symptoms
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Cough
Fever Chest pain Chills bloody gelatinous sputum indistinguishable from pneumococcal pneumonia |
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Klebsiella pneumoniae description
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Gram-negative large capsule
Produces large mucoid colonies when cultured on agar |
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Klebsiella pneumoniae spread
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contracted via inhalation contact or medical equipment such as ventilators
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Klebsiella pneumoniae pathogenesis
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air Klebsiella colonize the throat and reached via inhaled air and mucus
Adhesions at colonization Capsule is the various factor interferes with c3b As long as S is currently damage Blood and causes abscesses resulting in endotoxin shock |
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Where is Klebsiella found
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The skin through GI tract as normal microbiota. Nature
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In compromised immune system very old or young contract this disease
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Klebsiella pneumonia
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Klebsiella pneumoniae
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Beta lactamase an extended spectrum lactamase which resists many cephalosporins
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Klebsiella pneumoniae treatment
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Surgery to drain abscesses
Antibiotics are effective Sensitivity test to determine which strain can be antibiotic resistant |
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Klebsiella pneumoniae fatality rate
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50%
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Layman's term for mycoplasma pneumonia
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walking pneumonia
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What is the leading pneumonia of college students and military recruits
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Mycoplasma pneumoniae
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Severity of Mycoplasma pneumoniae
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Mild, generally
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Signs and symptoms of Mycoplasma pneumoniae
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Gradual onset
Initially fever headache muscle pain fatigue Several days later dry cough Mucoid studem produced later on and otitis media in approximately 15 % cases |
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Mycoplasma pneumonia causative agent
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Mycoplasma pneumoniae
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Characteristics of Mycoplasma pneumoniae
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small
Easily deformed bacterium Lacks cell wall slow aerobic growth Sumter colonies on a car look like a fried egg |
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Mycoplasmal pneumonia pathogenesis
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Few and held cells can start an infection
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Where does pathogenesis occur with Mycoplasma pneumoniae
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Receptors on respiratory epithelium
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Causative action Mycoplasma pneumoniae
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Interferes with ciliary action causes cells to slough off
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What happened during Mycoplasma pneumonia inflammatory response
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Accumulation of lymphocytes and macrophages thicken the wall of bronchial tubes and alveoli
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How is Mycoplasma pneumoniae
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Aerosolized droplets shed from about 1 week before symptoms begin to many weeks afterwards
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What kind of immunity is provided for mycoplasma pneumonia
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Immunity is not permanent attacks can occur within 5 years.
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Accounts for approximately one fifth of all bacterial pneumonia
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Mycoplasma pneumoniae
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Treatment of Mycoplasma pneumoniae
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Tetracycline
Erythromycin Both short and illness and are only bacteriostatic |
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Mycoplasma pneumoniae prevention
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Preventive measure is only avoiding overcrowding in schools and military Facilities
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What is pertussis
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What's the nation preventable disease causes up to half a million deaths annually globally
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Signs and symptoms of pertussis three stages
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Number one catarrhal stage
Number 2 paroxysmal stage Number 3 convalescent stage |
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Pertussis catarrhal stage
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Inflammation of mucous membranes
1 to 2 weeks of signs resembling upper respiratory infection |
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Paroxysmal stage of pertussis
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Repeated sudden attacks
Frequent purse violent uncontrollable coughing Drive it severe rupturing of small blood vessels in eye neck veins stand out |
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whooping cough convalescent stage
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Not contagious
Coughing decreases |
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Pertussis causative agent
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Bordetella pertussis
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Description of Bordetella pertussis
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Funny encapsulated aerobic Ren - broad which is sensitive to sunlight and drawing and quickly dies outside the host
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Pertussis pathogenesis
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Colonize nasopharynx trachea bronchi and bronchioles in dense masses
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Pertussis causative action
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Soldier and held and attached to seleted cells of the respiratory epithelium aided by filamentous hemagglutinin Pili a and pertussis toxin a A B endotoxin
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Severe cough in pertussis is caused by
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Increased mucus production and decreased ciliary action
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W what happens to bronchioles during pertussis
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Some are completely obstructed which leads to small areas of collapsed on
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Pertussis partial mucus plugging
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allows air to enter but not escape causing spasms
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Bordetella pertussis cause of death
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Pneumonia
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How is pertussis spread
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Air droplets moves contagious during earlier stages
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In 2010 how many children were killed in California due to pertussis
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10 infants
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Pertussis treatment
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Antibiotics are effective during catarrhal stage
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Pertussis prevention
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Vaccine
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TB history
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1985 begun to rise due to expanding AIDS
Plan developed by the CDC in 1989 Approximately one-third of the globe population is infected |
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Annual fatalities due to tuberculosis
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2 million
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Causative agent of Tb
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Mycobacterium tuberculosis
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Mycobacterium tuberculosis
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Acid-fast rod shaped aerobic 16 hour generation time cell wall contains mycolic acid
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Tissue affected by Mycobacterium tuberculosis
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Mainly the lungs
Also bones kidneys joint C n s |
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Signs and symptoms of Mycobacterium tuberculosis
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Asymptomatic
Later in life active tuberculosis disease may develop Immune response controls but cannot eliminate |
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tuberculosis pathogenesis
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Alveolar macrophages quickly in gulf but are unable to destroy
Bacteria exit and multiply within the macrophage cytoplasm Pro-inflammatory response recruits more macrophages Fuse to form giant multinucleated cells Lymphocytes wass infected area and form a granuloma |
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Granulomas in Tb
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Rupture release bacteria into a long
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At BD
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Active tuberculosis disease
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A TB D signs and symptoms
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Slight fever
Weight loss Night sweats Persistent cough blood streaked sputum |
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----- may develop a TBD upon primary infection as well as ----- -----
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Children
immune compromised |
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LTBI
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Latent tuberculosis infection
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Approximately how many Americans have L TBI
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15 million
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How many cases LTB I will progress into a TBD
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Approximately five to ten
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Highest demographic affected by TB
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Non whites in elderly poor
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TST
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tuberculin skin test
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TB treatment
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Multiple drugs over a long periods Of time
Rifampin isoniazid pyrazinamide ethambutol for 2 months Isoniazid and rifampin 4 7 months |
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Are there multidrug resistant tuberculosis strains
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Yes
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MDR TB resist
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RiF and in H
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XDR TB
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Threatens global control
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TB vaccine known as BCG
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Effective against childhood TB but ineffective against LTBI
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Legionnaires signs and symptoms
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Headache
muscle ache high fever confusion and shaking chills Shortness of breath Dry cough produces sputum with blood |
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Legionnaires causative agent
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Legionella pneumophila
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Legionella pneumophila description
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Gram-negative rod
Fastidious Stains poorly Facultative intracellular parasite under freshwater aMebas |
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Where is legion Ellen Numa filia normally found
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Natural waters and water systems
Protected from chlorine via amoebas |
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Isn't not spread by direct person-to-person transmission
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Legionella newer philia
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Legionella pneumophila Lea treatment
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High doses of erythromycin and/or or rifampin and some cephalosporin
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Legionnaires disease prevention
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Equipment design and disinfection
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How many humans are affected by the flu annually
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20%
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Three major virus types of influenza
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a most serious c least serious
Type A Type B Type C |
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RNA viruses versus DNA
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RNA infects more individuals
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Flu signs and symptoms
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Approximately 2 days incubation.
Headache fever sore throat muscle pain in 6 to 12 hours Dry cough acute symptoms last about one week |
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Causative agents influenza
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Influenza A
orthomyxovirus |
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Hemagglutinin and neuraminidase antigen are glycoprotein spikes embedded in envelope of
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Influenza A
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Hemaglutenin antigen or ha
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attaches to receptors
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Neuraminidase antigen or na
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Is critical in release destroying surface receptors that bind to budding virion
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flu is named after how many hemagglutinin and neuraminidase antigens are on the surface
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H 1
H2 H3 and N 1 n 2 |
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The spread of influenza via
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Inhalation of droplets or transfer to our eyes or nose from contaminated fomites
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How does influenza virus live
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Attaches to receptors of respiratory epithelial cells and enters via endocytosis
Host cell protein NNA synthesis stops rapid synthesis of viral RNA and proteins embedding of HA and NA 6HRS virion buds and spreads infected cells die and destroy Mucociliary escalator |
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How long does complete recovery of the respiratory epithelium take with influenza
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2 months or more
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What bacterial infection causes the most deaths
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Influenza
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Uncommon mixture of 8 RNA segments causes
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Pandemic influenza
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Spanish Flu killed how many
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Forty million to hundred million
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What year did the Spanish flu kill
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1918 to 1919
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Treatment of the flu
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Antivirals
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Prevention of the flu
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Vaccines multivalent vaccines against three most important strains in circulation
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Efficacy of flu vaccine
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80 to 90 percent effective but new one required each year because of antigenic
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RSV
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Respiratory syncytial virus
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Stats on RSV
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90,000 hospitalizations and 4,500 deaths per year
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RSV signs and symptom
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Runny nose cough wheezing difficulty breathing fever similar to a cold croup
Sometimes fatal for the elderly |
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Croup
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High pitched cough and noisy inhalation from airway obstruction
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Incubation period of 1 - 4 days
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RSV
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RSV causative agent
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single-stranded RNA para myxo virus
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RSV pathogenesis
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Infect the respiratory tract epithelium
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Occurrences during RSV
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cells die and slough off
Bronchiolitis Bronchioles partially plugged mucus clot and plasma and flushed cells |
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When is RSV common
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Late fall to late spring
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Weak or strong immunity gained rsv
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Weak and short-lived
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RSV treatment
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No effective antivirals
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RSV prevention
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Isolation
Passive immunity via monthly injections of antibody pa living Mab no vaccine |
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Antivirus pulmonary syndrome
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Small outbreak in 1993 influenza like symptoms
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1950 s Korean War
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hantavirus that plagued American troops
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Antivirus pulmonary syndrome
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Fever muscle ache in the lower back nausea vomiting diarrhea
Unproductive cough severe shortness of breath shock anda |
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Antivirus pulmonary syndrome causative agent
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Hanta virus of Bunya virus family
Which infects rodents species |
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How is hantavirus pulmonary syndrome spread
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Enters by inhalation of dust
Zoonotic emerging disease |
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hantavirus pulmonary syndrome dust
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Container with the urine feces or saliva of infecting rodents
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How does the hantavirus work
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Inflammatory response causes capillaries to leave plasma in to longs suffocating the patient and lowering BP
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Shock and deaths occur in more than 40% of cases
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Hanta virus
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Horizontal transmission is very rare in
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Hanta virus
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Where is hanta virus found
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From Canada to Argentina
Regions with high rat and mouse populations |
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Hantavirus treatment
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No proven treatment
Disease is highly fatal |
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Hantavirus prevention
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Moust proofing building keeping food in containers pest removal prevention of exposure to rodents and contaminated dust
Maximum ventilation do use of mops rather than broom |
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Fungal infections of the long
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coccidioidomycosis and histoplasmosis
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Coccidioidomycosis
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Valley fever
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Valley Fever location
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US Southwest
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How many develop symptoms of valley fever
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Approximately 40 percent
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V valley fever signs and symptoms
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Flu like signs fever cough chest pain loss of appetite and weight are common
Spontaneous recovery within a month |
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Valley fever causative agent
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Coccidioides immitis
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Describe Coccidioides immitis
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dimor phic fungus
Grows and soil like mold produces highly infectious structures such as arthroconIdia |
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Pathogenesis of arthro con India
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thickWalled spheruled containing fungal endospores
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Endospores
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They develop into more spherules each cycle provokes damaging inflammatory response
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Valley fever epidemiology
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Semi arid areas of the Western Hemisphere
Infections occur during hot dry and dusty season Dust from earthquakes can result in epidemics |
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Valley fever treatment
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antifungal treatment given term
Disseminated disease can reactivate months or years later |
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valley fever prevention
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Dust avoidance
Watering and planting vegetation |
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Histoplasmosis
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Spelunker s disease
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Occasionally this disease mimics tuberculosis
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Histoplasmosis
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When a serious reaction of histoplasmosis occurs what is suggested
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But there is a serious form of underlying immuno deficiency
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Histoplasmosis signs and symptoms
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Fever cough chest pain shortness of breath mouth sores
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Histoplasmosis causative agent
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histo plasma capsulatum
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Propagation of histoplasma capsulatum
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Questions so little contaminated by bird or bat droppings
Grows within host macrophages as a tiny oval yeast mold forms produced macroconidia |
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Histoplasmosis pathogenesis
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inhaled conidia taken up by macrophages
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Histoplasmosis develop into
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yeast been granulomas resembling those of TB then calcified lesions
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Where is histoplasmosis found
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Send in the u.s
Tropical Temperate Caves |
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Histoplasmosiss treatment and prevention same as coccidioidio mycosis
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aVoid soil and antifungal treatment
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Antigenic shift
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Popping out of one of the gene strands with the gene strands from a different influenza virus
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Antigenic drift
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Into Jen's gradually change their amino acid composition
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