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chlamydial pneumonia
chlamydial pneumoniae
  • T-human respiratory secretions
  • fever,productive cough,mild pharyngitis, bronchitis, sinusitis
  • observation of symptoms, microimmunofluorescense and antibiotic therapy
diptheria
cornyebacterium diptheriae
  • T-airborne via nasopharyngeal secretions
  • observations of pseudomembrane in throat
  • D-bacterial culture
  • antitoxin is given to neutralize and absorb exotoxin in patient tissue, antibiotic therapy, activated DPT vaccine
legionnaire's disease
legionella pneumophila
  • T-airborne via transmission from environmental resevoir to human host
  • fever, cough, headache, neuralgia, bronchopneumonia
  • isolation of bacteria and immunodiagnostics, symptomatic supportative therapy and antibiotic therapy and ID/elimination of environmental source
pontiac fever
legionella pneumophila
  • T-airborne via transmission from environmental resevoir to human host
  • resembles allergic disease, abrupt onset of fever, headache, dizziness, muscle pain
  • spontaneously resolves in 2-5 days
  • isolation of bacteria and immunodiagnostics, symptomatic/supportative/antibiotic therapy; ID/elimination of environmental source
meningitis (bacterial)
streptococcus pneumonia, neisseria meningitis, listeria monocytogenes, mycobacterium tuberculosis, nocardia asteroides, staph aureus, staph epidermis
  • T- respiratory secretions
  • initial respiratory illness or sore throat interrupted by: vomitting, headache, lethargy, confusion, stiffness in the neck and back
  • culture of bacteria from cerebrospinal fluid and rapid tests, antibiotic therapy, immunization against haemophilus influenzae type B
meningitis (aseptic)
fungi, amoebae, treponema pallidum, mycoplasmas, leptspires, viruses, cancers, parasitic cysts, chemicals
  • T- respiratory secretions
  • similar to bacterial meningitis, but shows no microbial agents in gram-stained specimen and in culture
  • must rule out bacterial diagnosis
  • treatment is difficult
tuberculosis (TB)
mycobacterium tuberculosis
  • T-person to person, infected animals and their products
  • has 4-12 week incubation period, fever, fatigue, weight loss, cough (characteristic of pulmonary involvement may result in expectoration of bloody sputum)
  • observation of acid-fast bacteria, chest x-ray, dna based tests, mantoux or tuberculin skin test; antimicrobial therapy (drug-resistant strains have developed)
  • rapid/specific treatment to interrupt spread, retreatment of patients with MDR-TB, immunization, improved sanitation and housing, reduction in homelessness and drug abuse
pertussis
bordatella pertussis
  • T-droplet inhalation
  • 7-14 day incubation, initially cold-like symptoms and inflamed mucous membranes, followed by prolonged coughing seizures with inspiratory whoop
  • permanent long-lasting immunity develops
  • bacterial cultures, fluorescent antibody staining serological tests, antibotic therapy, immunization with DPT vaccine
mycoplasmal pneumonia
mycoplasma pneumoniae
  • T-close contact/airbone droplets
  • usually mild in infants, and more serious in older children and young adults
  • headache, weakness, low fever, characteristic cough, pneumonia that exists for weeks
  • rapid immunological tests, isolation from respiratory secretions (fried egg appearance on agar), other bacteria or viruses cannot be detected and immunodiagnostic tests, antibiotic therapy, no preventative measures
cellulitis
caused by strep bacteria
  • T-respiratory droplets/direct/indirect contact
  • diffuse, spreading infection of sub-q infection, redness, swelling
  • treated by antibiotic therapy, best prevention is prevention of transmission
impetigo
caused by strep bacteria, also staph aureus
  • T-respiratory droplets/direct/indirect contact
  • superficial cutaneous infection commonly seen in children, crusty lesions and vesicles surrounded by red border
  • treated by antibiotic therapy, best prevention is prevention of transmission
ersipelas
caused by strep bacteria
  • T-respiratory droplets/direct/indirect contact
  • doesn't go away--acute infection of the dermal layer of skin, red patches that may occur periodically at the same site for years, similar to type 4 reaction
  • treated by antibiotic therapy, best prevention is prevention of transmission
invasive streptococcal A infections
streptococcus pyogenes
  • T-respiratory droplets/direct/indirect contact
  • necrotizing fasciitis, myositis, toxic-like shock syndrom (TSLS)
  • treated by antibiotic therapy, best prevention is prevention of transmission
post streptococcal diseases
occur 1-4 weeks after acute infection
glomerulonephritis (Bright's disease)
type 3 hypersensitivity
  • edema, fever, hypertension, hematuria, may spontaneously heal or become chronic
  • antibiotic therapy to kill residual bacteria, otherwise no specific therapy
rheumatic fever
autoimmune disease involving heart valves, joints, sub-q tissues, cns
  • vary widely, making diagnosis difficult
  • therapy directed at decreasing inflammation and fever, and controlling cardiac failure, treatment with salicylates and corticosteroids
streptococcal pharyngitis (strep throat)
caused by strep bacteria
  • T-spread by droplets of saliva or nasal secretions
  • infection in throat or on tonsils (tonsilitis);signs and symptoms not diagnostic because many viral infections have similar presentation
  • rapid kits, antibiotics important for children to lessen chance of complications such as rheumatic fever, glomerulonephritis, controlling by preventing contact with contaminated materials or discharges from infected individuals
streptococcal pneumonia
streptococcus pneumoniae
  • T-only occurs in patients with predisposed condition
  • redness, edema, lymph node enlargement in the throat; abrupt onset of chills, hard labored breathing, chest pains, rust colored sputum
  • chest x-ray, gram stain, culture, and tests for metabolic products
  • antibiotic therapy, resistant strains have appeared, immunization and treatment of infected persons (vaccine is only given to high-risk populations)
arthropod-borne disease epidemic (louse-borne) typhus (select agent)
rickettsia prowazekii
  • T- person to person by body lice, ricketsia containing insect feces are deposited when louse takes blood meal (US- flying squirrel)
  • vasculitis, headache, fever, muscle aches, rash, high mortality if untreated
  • recovery provides immunity also to endemic
  • rash symptoms, immunofluorescence testing
  • antibiotic therapy, body louse control, pulic hygeine, immunization of high-risk individuals
endemic (murine) typhus
rickettsia typhi
  • T-rats via fleas
  • similar to epidemic typhus, milder with lower mortality rate
  • same diagnostic tests used
  • same antibiotic therapy as epidemic typhus, rat control, avoidance of rats
lyme disease
Borrelia burgdorferi, B. garinii, B. afzelli
  • T-transferred from animal resevoirs by ticks (deer, field mice, wood rats)
  • vary with stage of disease
  • localized stage: develops 1wk to 10 days after infection, expanding ring shaped skin lesion; flu-like symptoms
  • disseminated stage: occurs weeks or months after infection; neurological abnormalities, heart inflammation
  • last stage: occurs years later, demyelination of neurons, behavioral stages and symptoms resembling alzeihmer's disease and multiple sclerosis
  • diagnosis needs to be done early or all of the bacteria will be gone
  • antibiotic therapy most effective in early stages, tick control and avoiding ticks
plague (a select agent)
yersinia pestis
  • T-starts with flea infested animals, followed by spread among people by airborne transmission
  • sub-q hemorrhages, fever, buboes, high mortality rate if untreated
  • diagnosis made in reference labs that use direct microscopic examination, culture and serologic tests and PCR
  • antibiotic therapy, ectoparasite and rodent control, isolation of human patients, prohylaxsis of exposed persons, immunization of high risk people (vets)
q fever
coxiella burnetii
  • T-ticks between animals, contaminated dust to humans, occupational hazard among slaughterhouse workers, farmers, and vets
  • mild respiratory symptoms and acute onset of severe headache, muscle pain, and fever; and endocarditis can develop years later
  • diagnosis in reference labs using immunofluorescence
  • serological tests and antibiotic therapy, vaccination of high risk individuals and pasteurization of cow and sheep milk where disease is endemic
rocky mountain spotted fever
rickettsia rickettsii
  • T-ticks by transovarian passage(transmission of bacteria from generation to generation of ticks through their eggs)
  • vasculitis and sudden onset of headache, high fever, chills, and skin rash; can destroy blood vessels in heart, lungs, or kidneys leading to death
  • observation of signs and symptoms and serological tests
  • antibiotic therapy and symptomatic supportative therapy, tick control, avoidance of ticks
gas gangrene (clostridial myonecrosis)
clostridium perfrigens
  • T-contamination of injured tissue by spores from soil or bowel microbiota
  • severe pain, edema, drainage, and muscle necrosis
  • recovery of appropriate clostridial species and characteristic disease symptoms
  • surgical debridement, administration of antitoxin, antibiotic therapy, prompt treatment of all wound infections, amputation of limbs
inclusion conjunctivitis
clostridium thrachomatis serotypes D-K
  • T-spread primarily through sexual contact (in newborns acquired during passage through infected birth canal)
  • copious discharge from eye inflammation, swollen conjunctiva, newborn can cause respiratory system infections, including pneumonia, resolves spontaneously
  • immunofluorescence, Giemsa stain, nucleic acid probes and culture
  • antibiotic therapy, diagnosis and treatment of all individuals
leprosy (hansen's disease)
mycobacterium leprae
  • T-humans are the only significant reservoir,prolonged exposure to infected individuals, nasal secretions
  • incubation usually 3-5 years; initial symptoms is slightly pigmented skin eruptions; development of disease to be related to strength of cell-mediated immune response to bacterium
  • tuberculoid (mild)- nonprogressive form, associated with delayed-type hypersensitivity; damaged nerves and regions of skin that have lost sensation and are surrounded by a border of nodules
  • lepromatous (progressive): individuals do not develop hypersensitivityl skin tissue killed, leading to prgressive loss of facial features, fingers, toes, and other structures, disfiguring nodules all over body
  • diagnosis- direct fluorescent antibody staining of biopsy specimens, serodiagnostic tests, dna amplification, elisa
  • antibiotic and immunotherapy with vaccine, ID and treatment of patients and prophylactic therapy for uninfected household members
peptic ulcer disease and gastritis
helicobacter pylori
  • T-probably from person to person
  • diagnosis: culture of gastric biopsy specimens, examination of stain biopsies, serological testing, urea breath test, test for ammonia in urine, detection of urease activity in biopsies
  • combination of drugs to decrease stomach acid and drugs to kill the bacteria
bacterial vaginosis
gardnerella vaginalis
  • T-requires some sort of change in the vaginal area
  • diagnosis: signs and symptoms, microscopic observation of cells in discharge; sloughed-off vaginal epithelial cells covered with bacteria
  • antibiotic therapy, including drugs to kill anaerobes necessary for termination of the diease
gonorrhea
neisseria gonorrhea
  • T-disease of mucous membranes of the genitourinary tract, eye, rectum, throat; can also be transmitted from other to child during bith causing conjunctivitis
  • males: rectal discharge of yellow, creamy pus, and painful burning urination
  • females: vaginal discharge beginning 7-21 days after infection, PID results from infection of fallopian tubes and surrounding tissue, disseminated gonococcal infections
  • diagnosis: culture of bacterium followed by gram-stain, oxidase test, determination of cell and colony morphology; dna probe test
  • antibiotic therapy, penicillin resistance common
  • public education, diagnosis and treatment of asymptomatic individuals, condom use and quick diagnosis and treatment of of infected individuals
nongonococcal urethritis (NGU)
variety of non-N. gonorrhea inflamatory agents
  • T-
  • males: asymptomatic or urethral discharge, itching and inflammation of genital tract
  • females: somtimes symptomatic, may cause PID, if pregnant, can lead to miscarriage, still-birth, inclusion conjunctivitis, infant pneumonia
  • diagnosis: demonstration of leukocyte exudate, exclusion of urethral gonorrhea by gram stain and culture, rapid diagnostic tests
  • antibiotic therapy
syphilis
treponema pallidum, subspecies Pallidum
  • T-veneral syphilis is sexually transmitted; congenital syphilis is aquired in utero
  • 3 stages: primary : chancre (small painless reddened ulcer) at infection site and contains spirochetes; secondary: highly variable skin rash followed by latent period; tertiary stage: formation of gummas (degenerative lesions) in skin, bone, and nervous systems
  • diagnosis: clinical history, microscopic examination, serology
  • antibiotic therapy most effective in early stages before it becomes systemic, public education, prompt treatment of new cases, follow up on sources and contacts, sexual hygeine and use of condoms
tetanus
clostridium tetani
  • T-portal of entry is a skin wound
  • early in the disease- tension or cramping or twisting of skeletal muscles and tightness of jaw muscle
  • advanced disease- trismus (lockjaw), characteristic facial expressions, board-like rigidity of trunk, tonic convulsions and backward bowing of the back
  • death usually results from spasms of diaphragm and intercostal respiratory muscles (locking of breathing muscles causes suffocation)
  • diagnosis: clinical history or wound infection and muscle stiffness
  • antibiotic therapy and treatment with antitoxin: active immunization with toxin DPT vaccine
trachoma
clostridium trachomatis serotypes A-C
  • T-hand to hand contact, contact with infected soaps and towels and flies
  • first infection: abrupt onset of inflamed conjunctiva, leading to inflammatory cell exudate and necrotic eyelash follicles
  • usually heals spontaneously
  • reinfection: pannus formation (vascularization of cornea), leading to scarring conjunctiva; if scarring of cornea occurs, blindness results
  • diagnosis: same as for inclusive conjunctivitis
  • same as for inclusion conjunctivitis; health education, personal hygiene, and access to clean water for washing
botulism
clostridium botulinum
  • T-insufficiently heated home-canned food (endospores are not killed)
  • infant botulism: endospores digested, germinate, reproduce and produce exotoxin; constipation, listlessness, general weakness, poor appetite, death may result from respiratory failure
  • diagnosis: restricted to reference laboratories, demonstration of toxin in patient's serum , stools or vomitus or c. botulinum in stool cultures
cholera
vibrio cholerae
  • T-ingesting food or water contaminated with fecal matter from patients or carriers (shellfish are natural reservoirs)
  • presence of toxin results in massive loss of water, electrolytes ("rice-water stools")
  • diagnosis: culture from feces with subsequent identification by agglutination reactions
  • oral rehydration, antibiotic therapy
salmonellosis
>2000 salmonella serovars
  • T-human to human by contaminated foods such as beef products, poultry, egg products, and water (food-borne infection)
  • abdominal pain, cramps, diarrhea, nausea, vomitting and fever
  • diagnosis: isolation of organism from food or patient's stools
  • fliud and electrolyte replacement; good food handling practices, proper refrigeration, adequate cooking
typhoid fever
salmonella enterica
  • T-ingestion of food or water contaminated with feces, infected humans, person to person contact
  • fever, headache, abdominal pain, anorexia, malaise; in carriers (Typhoid Mary) bacteria grow in gallbladder and reach intestine through the bile duct
  • diagnosis: demonstration of typhoid bacilli in blood, urine, or stools; serology (Widal test)
  • antibiotic therapy; vaccine for high risk individuals; purification of drinking water, prevention of food handling by carriers, and isolation of patients
shigellosis
shigella (four species)
  • T-humans are the only host
  • blood, mucous, pus in the stool
  • diagnosis: biochemical characteristics, serology
  • antibiotic therapy; prevetion by use of good personl hygiene and a clean water supply
traveler's diarrhea and e. coli infections
escherichia coli and other viruses/bacteria/protozoa normally absent from a traveler's flora
  • T-transmitted via food and water normally absent from a traveler's diet, as well as fecal contamination of water
  • enterotoxigenic e.coliĀ  (ETEC): produces one or both enterotoxins responsible for diarrhea; distinguished by heat stability
  • enteroinvasive e. coli (EIEC): multiplies within intestinal epithelial cells; may produce a cytotoxin and an enterotoxin
  • enteropathogenic e.coli (EPEC): caused effacing lesions; caused by destruction of brush border microvilli on interstinal epithelial cells
  • enterohemorrahagic (EHEC): produces effacing lesions, leading to hemorrhadic colitis; releases shiga-like toxins
  • diagnosis: past travel history and symptoms, isolation and identification of causative agents using DNA probes, tests for virulence factors and PCR
  • symptomatic/supportive therapy and antibiotic therapy; avoiding contaminated food and water
anthrax
bacillus anthracis (select agent)
  • T-direct contact with infected animals or their products (potential bioterrorism agent)
  • cutaneous anthrax: infection through a cut in the skin; 1-15 day incubation, skin papule that ulcerates (eschar), headache, fever, and nausea
  • pulmonary anthrax (woolsorter's disease): inhalation of endospores; resembles influenza, if bacteria reach the bloodstream its usually fatal
  • gastrointestinal anthax: ingestion of endospores
  • diagnosis: presumptive ID in sentinal labs of laboratory response network (LRN); confirmation diagnosis by pcr and serology
  • antibiotic therapy and symptomatic/supportive therapy; immunization of animals and persons at high risk
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