A serious illness caused by serotype toxin B of S.aureus.

S/S: lesions around nose & mouth--->bright red area that spreads within 48 hrs. Skin peels off in sheets when touched.

Frequent in newborns and children<2.

Treatment: vigorous antibiotic therapy

A life-threatening condition caused by the staphylococcal toxin (TSST-1).

S/S: fever, vomiting, sunburn-like rash followed by shock

1st observed from staph growth around highly absorbent tampons.

Nonmenstrual TSS occurs from infections following nasal surgery from packings, surgical incisions, & womenwho have just given birth.

serious streptococcal infection of the dermis.

S/S: localized reddish patches with raised margins that can progress to local tissue destruction & and septicemia, high fever common. 1st appears on face and ofter preceded by strep throat.

A streptococcal skin infection.

S/S: isolated pustules that crust & rupture. Spread by contact thru a minor abrasion or insect bite.

Occurs in toddlers and elementary age children.

Staph often present.

S/S: attack solid tissue (cellulitis), muscle, muscle covering(necrotizing fasciitis).

15,000 cases anually in US by "flesh-eating" bacteria.

40% fatal.

ENDOTOXIN A: superantigen

Aerobic, G- rod.

Common in soil & water.

Resistant to many antibiotics & disinfectants.

Most prominent species of Pseudomonads.

Model of an opportunistic pathogen.

exotoxins and endotoxins

a self limiting rash for two weeks. often associated with swimming pools, hot tubs, pool-type saunas.

Pathogen: Pseudmonas aeruginosa

Mode of entry: Skin abrasions, hair folicles

S/S: superficial rash

Treatment: usually self-limiting

1. blackheads -treated with topical agent- azelaic acid

2. inflammatory acne-propionibacteriumaon the skin cause increased inflammation and pustules. treated with antibiotics(erythromycin)and Benzoyl peroxide-effective against P.aeruginosa

3. cystic acne: nodules or cysts filled with pus deep within the skin that leaves pitted scars. treatment-ISO-trentinoin(Retin-A, vitamin A derivative)antibiotic-erythromycin

Shingles

complication of chickenpox. Latent virus remains located in dorsal root ganglion near spine until reactivated decades later(>50yrs age)by stress or aging. It moves along peripheral nerves--->cutaneous sensory nerves.

S/S: similar vesicles to chickenpox with less fluid but localized to waist, face, upper chest, & back.

severe pain.

can result in nerve damage, vision impairment, & even paralysis

diseases of the skin caused by viruses.

types: plantar & skin ->benign skin growths

incubation period: several week

transmitted: person to person by contact, even sexually

treatment:cold liquid Nz(cryotherapy), dry with electrical current(electrodesiccation), burn with acids or lasers.

Some skin & cervical cancers are caused by the same virus

viral disease.

2 forms : Variola major - mortality rate 20-30%

Variola minor - mortality rate <1%

Transmitted: via respiratory route ->infect internal organs ->blood -->rash on skin 2-5 days later

3 possible reasons eradication of Small Pox(Variola) was successful?

1. effective vaccine(long lasting immunity)

2. no animal host reservoirs

3. virus fragile - does not survive long outside host

viral skin disease - Herpesvirus(Varicella-zoster)

common childhood disease

Mode of Entry: respiratory tract & localizes on skin

Incubation:2 wks

S/S: Pus-filled vesicles develop, rupture & scab over in 3-4 days. Usually confined to face, throat & lower back, occasionaly can occur on chest and shoulders.

Affects 90% of americans by age.

3rd most common disease in US and is more severe in adults.

Reye's Syndrome

Complication of Chickenpox.

S/S: vomiting & brain dysfunction.

Coma & death in 30% of cases.

survivors show neurological damage.

aspirin increases chances. 

Measles(Rubeola)

Extremely contagious viral disease. Persons with measles are infectious before symptoms appear.

Transmitted: via respiratory droplets(before symptoms appear).

Incubation: 10-12 days--->1st symptoms appear- hacking cough, common cold, high fever.

2-4 days later -Koplik spots appear on gum line; diagnostic

2 days later - macular rash: hairline-->trunk-->extremeties-->then fades

Vaccine: attenuated virus

MMR-measles, mumps, rubella

Possible eradication:humans only hosts

3 day measles

S/S: mild cold symptoms, light fever, & small macular rash.

Transmitted: respiratory droplets

Incubation:2-3 wks

Complication: Congenital rubella syndrome-viral infection during 1st trimester-35% chance serious fetal damage--> deafness, heart defect, mental retardation,& death. 15% of babies die in 1st year.

Human herpesvirus 1 & 2

Type 1 - cold sores

Transmitted: oral contact & respiratory routes

latent virus in trigeminal nerve ganglion, recurring, could lead to herpetic keratitis.

Type 2 - genital herpes

transmitted: sexual contact, latent virus in sacral nerve ganglion near base of spine.

"Slapped Cheek Disease"

Primarily affects children

transmitted: via respiratory droplets

S/S: mild flu case, fiery red rash on cheeks & ears that slowly fades. Can spread to trunk & extremeties & can reoccur.

More serious for adults: anemia, arthritis, or rarely miscarriage

Roseola

mild childhood disease that is very common

S/S: high fever for few days, followed by a rash over much of body 1-2 days.

Immunity on recovery

Virus present in saliva of 85% of adults.

fungi that infect hair, nails, & outer layer of epidermis.

they digest Keratin.

Commonly known as tineas or ringworm:

ringworm of scalp

common among elementary school children

S/S: bold patches

transmitted: contact with fomites - dogs, cats, hair brushes,shoes

treatment: oral antibiotics-griseofulvin for hair

"jock itch"

ringworm of the groin

Treatment: topical drugs=OTC=miconazole & clotrimazole

"athletes foot"

ringworm of the foot

Treatment: Topical allylamine preparations containing terbinafine or naftifine, or butenavine.

difficult to cure

fungal infection of nails.

treatment:oral itraconazole & terbinafine

subcutaneous myosis caused by soil fungi that penetrate the skin thru a small wound that allows entry into subcutaneous tissue.

Affects mostly gardners or people working with soil

specific agent: Sporothrix schenkii

mode of transmission: small ulcer on hands at site & lesions(nodules)along lymphatic vesicles.

seldom fatal

fungal disease

Affects the mucous membranes of mouth & genitourinary tract, intestines

Specific agent: Candida albicans

causes thrush in infants & vaginitis--> esp. problem with antibacterial drugs when normal flora is suppressed.

Complications: can become systemic in diabetic pts, obesity, immuno-suppressed conditions-->sudden & severe problems-->death

Treatment: miconazole, clortrimazole, nystatin, & fluconazole for systemic

Parasitic infection of the skin

specific agent:mite infestation-->burrows under the skin to lay eggs under skin

S/S: inflammatory skin lesions & intense local itching

Transmitted: intimate contact &sexual contact, often seen in family members, nursing homes, & teenagers affected by children they baby-sit.

parasitic skin disease

specific agent:Pediculosis humanus

2 types: pediculosis humanus capitis & corporis

incubation:several wks

S/S: itching, nits, & adult louse

Complications: body louse spread disease such as epidemic typhus

Treatment: permethrin & pyrethrin insecticides

Cojunctivitis

eye disease

"pink eye"

specific agent: pathogens bacterial->Haemophilus influenzae & pseudomonads, viral->adenoviruses, protazoan

Esp. problem for contact wearers(soft*)

Treatment: No homemade saline solutions, follow manufactorers instructions for cleaning and disinfecting, heat and hydrogen peroxide.

serious pus-laden conjunctivitis.

specific agent:Neisseria gonorrhoeae(cause of gonorrhea)

complications: ulceration of cornea if treatment delayed, high risk of blindness.

transmission: obtained as infant passes thru birth canal & mom has Neisseria gonorrhoeae.

Treatment: then 1% silver nitrate--> now erythromycin

eye disease

specific agent:Chlamydial trachomatis-obligate intrcellular parasite.

transmitted: passed to infants thru the birth canal from mom infected with Chlamydia. spreads in unchlorinated swimming pools "swimming pool conjunctivitis".

treatment: usually resolves in wks or months & rarely scars cornea. Can be treated with tetracycline as an ophthalmic ointment.

infectious eye disease.

specific agent:C. trachomatis

#1 cause of infectious blindness in world

Occasionally in SW US among Native Americans

Transmitted: hand contact, fomites(towels), & flies.

Complications: inturning of the eyelashes causing abrasions to the cornea, eventually causes scarring of the cornea and blindness.

Treatment: sanitary procedures, health education, and oral antibiotic - azithromycin.

infectious eye disease

Specific agent: Herpes simplex Type 1 virus

S/S: virus latent in CNS causing recurring infections, infection of the cornea, resulting in deep ulcers that may be the most common cause of infectious blindness in the US.

Treatment:drug trifluridine -often an effective treatment

infectious eye disease

specific agent: Amoeba in fresh water, tap water, hot tubs, soil.

contributing factors: wearing of contact lenses overnite & while swimming, also faulty disinfection(need heat to kill cysts)

S/S: mild inflammation-early stages, severe pain & corneal damage-later stages

Treatment: early-propamidine isothionate eye drops & topical neomycin.

late stages- severe damage requires corneal transplant or even removal of the eye.

pustules- sm. pus-filled elevation of skin.

papule - sm. solid elevation of the skin.

Inflammation of the vagina;caused by one of several organisms mainly the fungus  - Candida albicans, the protozoan - Trichomonas vaginalis, and the bacterium - Gardnerella vaginalis

acronymn for a panel of test that screen for antibodies for diseases that cause birth defects.

Toxoplasmosis

Other(syphilis,

hep B,

enterovirus,

Epstein-Barr virus, Varicella-zoster virus)

Rubella

cytomegalovirus

herpes simplex virus

diseases that occur primarily in wild and domestic animals can be transmitted to humans.

ex. rabies, lyme disease

a condition resulting from the ingestion of a microbially produced toxin.

ex. botulism

short for arthropod-borne virus

ex.mosquito-->encephalitis

 initial disease that affects pts. caused by a true pathogen

ex. strept throat

subsequent disease aquired due to the weakness from primary disease.

ex. heart disease caused from having strep

haemophilus meningitis(Hib)

Haemophilus influenzae

aerobic, G- bacterium.occurs mostly in children under 4, esp. at about 6mths.

mortality rate = 6%

diagnosis: initiate treatment

spinal tap

modify treatment

meningococcal meningitis

Neisseria meningitis

specific agent: Neisseria meningitis

aerobic, G- bacterium with a polysaccharide capsule that is important to its virulence.

present in nose and throat of carriers.

s/s: fever, headache, stiff neck,-->N/V-->convulsions and coma.

mortality rate: high, yet pathogen specific, survivors have neurological damage. Death is quick due to shock from G- endotoxins.

distinguishing features: rash that does not fade when pressed. usually begins with throat infection-->bacteremia-->eventually meningitis

children under 2 and residential college students

pneumococcal meningitis

Streptococcus pneumoniae

common cause of bacterial pneumonia.

effects mostly elderly and young

bacteria in lungs(pneumonia)-->blood-->meninges

U.S>500,000 cases pneumonia---->3000 meningitis cases

1/2 of cases among children 1 month - 4 years

hospitalized older adults also very susceptible.

specific agent: Listeria monocytogenes

G+ rod, causes stillbirth and neurological disease in animals---> excreted in feces--->widely distributed in soil and water.

tranmitted: food' esp dairy products(soft cheese), deli cold cuts or soil. Grows at refrigeration temps.

S/S:healthy human adults-mild symptomless disease but shed organism indefinitely in feces.

Esp. pathogenic to immunosuppressed, cancer pts, and pregnant women.

60% infant mortality rate, surviving newborns-->septicemia & meningitis

Cryptococcosis

fungal meningitis

Most dangerous fungal disease in humans, affects lungs & meninges. Accounts for >25% of fungal deaths.

yeast that grows in soil of urban environments and esp. grows on pigeon droppings

Transmission: Airborne--> respiratory passages-->air sacs

a gelatinus capsule surrounds cells and allows for resistance to phagocytosis

S/S: sometimes rare

if blood infected-->meninges and brain-->piercing headaches, neck stiffness, paralysis.

TREATMENT:Fatal if untreated. Amphotericin B effective antifungal drug.

toxic side effects:kidney damage & anemia

problems esp if immune system severely suppressed.

Cause of death for AIDS pts.

specific agent: Clostridium tetani

anaerobic, endospore-forming, G+ rod.

esp. common in soil contaminated with animal fecal wastes.

transmission:

2nd most powerful exotoxin known=neurotoxin

caused uncontrolled contractions, and spasms of muscles

Lockjaw - violent death

S/S: rapid onset-several hours

Treatment:immunization(tetanus toxoid in DPT vaccine)

specific agent:Clostridium botulinum

the most powerful exotoxin known to man

flaccid paralysis leads to death.

specific agent:Mycobacterium leprae(no lab media, grows in living tissues)

Transmitted: by multiple skin contacts and droplets from upper respiratory tract.

incubation: 3-6yrs

S/S: affects extremities-skin and peripheral/nervous system. disfigurement of skin and bones-claw hand

poliomyelitis

S/S: most are asymptomatic, or exhibit only mild symptoms, such as headache, sore throat, fever, and nausea. Damage to the body becomes apparent as pts age

 Affects spinal cord and brain

Transmitted: via contaminated food & water

Characteristics: multiplies in tonsils and gastrointestinal tract-->X

in blood-->meninges-->paralysis of extremities and trunk-->? medulla

Treatment: Trivalent vaccine

Salk-vaccine->shot

Sabin-vaccine->sugar cube vaccine-no longer administer

Viral disease

most fatil if symptoms are allowed to develop

infects most warm blooded animals

Transmitted via skin wound contaminated with blood, urine, saliva, or other fluid

Incubation: 6 days - 1 year depending on the proximity to the CNS

S/S: habnormal sensation at bite, fever, increased mucles tension, alert and aggressive paralysis

Treatment: multiple injections of inactivated vaccine,+rabies immune globulin- immediate antibodies at site of wound.

Negri bodies

travels thru the spinal cord

Encephalitis caused by mosquito-borne virus.

exposure increases in the summer months

S/S: chills, headache, and fever, as it progresses, mental confusion, and coma. all can causes subclinical - severe symptoms including death. survivors may suffer permenant neurological problems.

African sleeping sickness or South American sleeping sickness

a protozoan disease that affects the nervous system

Trypanosoma-id shape characteristic undulating membrane.

African vector: tsetse fly

South American:Triatomid bugs "kissing bugs"

ASS symptoms: high fever,paralysis, coma, death

drugs to treat.

SASS symptoms: fever, tissue damage-->heart:cardiac nerves, Sudden heart failure, Coma and death.

no drugs to treat.

Naegleria meningoencephalitis

Primary amebic meningoencephalitis(PAM)

Naegleria fowleri

protozoan amoeba that causes neurological disease

initially infects nasal mucosa and later penetrates to the brain.

transmitted: by inhaling organism in fresh water lakes

S/S: peircing headache, neck rigidity, seizures, encephalitis/meningitis symptoms

Fatality rate=100%

diagnosis usually made in autopsy

few survivirs treat with antifungal drug-amphotericin B

first initiate treatment with a broadspan antibiotic

next spinal tap-using spinal fluid for gram stain and seriologic test(20 mins)

last modify treatment according to type of meningitis.

viral- treat symptoms and withdraw antibiotics

fungal-gram stain, has nucleus, yeast-like, antifungal drug for treatment

bacterial: treat with antibiotics specific to type meningitis

protozoan:100% mortality rate. treatment if can antifungal drug. "brain-sucking ameoba"

Salk vaccine-uses viruses that have been inactivated by treatment with formalinand requires a series of injections

Sabin vaccine-contains 3 living attenuated strains of the virus(trivalent) and is administered orally-sugar cubes-no longer use