FINALS

STAPHYLOCOCCAL INFECTION LAB EXERCISE 1: Bacterial Infection PNEUMOCOCCAL STREPTOCOCCAL INFECTION INFECTION Lobar Pneumonia Bronchopneumonia STREPTOCOCCAL INFECTION Rheumatic Heart Disease

COCCAL Meningococcal Infection (Brain)

LAB EXERCISE 2: Bacterial Infection BACILLI BACILLI Leprosy (Mycobacterium Tuberculosis (Lungs) leprae)

BACILLI Salmonella Infection

SHIGELLA INFECTION Bacillary Dysentery (Large Intestine)

LAB EXERCISE 3: Bacterial Infection SPIROCHETES Syphilis

SPIROCHETES Yaws (Frambesioma)

VIRAL HEPATITIS

LAB EXRCISE 4: Viral Infection MEASLES MOLLUSCUM Koplicks Spot CONTAGIOSUM Umbiliction

HEMORRHAGIC/DENGUE FEVER (Aedes aegypti)

1. Hyaline spherical mass 2. Cellular swelling 3. Cellular shrinkage 4. Loose reticulated cytoplasm AMEBIASIS Amoebic Liver Abscess LAB EXRCISE 5: Parasitic Infection MALARIA SCHISTOSOMIASIS

LAB EXRCISE 6: FUNGAL INFECTIONS ACTINOMYCOSIS CRYPTOCOCCOSIS

INFECTIOUS DISEASES Diseases caused by pathogenic microorganisms INFECTION Invasion of the tissues by pathogenic microorganisms or animal parasites It is the local of general reaction that follows PORTAL OF ENTRY anatomic point at which a parasite or microorganism gain access to the body. PRIMARY FOCUS first or original infection during the course of the disease SECONDARY FOCUS infection occurring in the host already suffering from infection Factors That Determine the Disease Producing Potential of An Organism: 1. The invading agent must have an appropriate portal of entry 2. The invasion must be of sufficient size for the agents to survive in their new environment 3. They must be capable of obtaining in their new environment that appropriate conditions for survival 4. They must be capable of being transmitted to new hosts and these have a continuing supply of nourishment BACTERIAL INFECTION

Responsible for the bacterial spread

Most Common Infections Produced by S.A. 1. Superficial Infection

Eg FOLLICULITIS simple infection of hair follicle manifested by minute evrythematous nodules which involvement of surrounding skin and deeper structures. CARBUNCLE, FURUNCLE Staphylococceal pneumonia Staphylococceal food poisoning Staphylococceal bacteremia Osteomyelitis

2.

Abscess (eg. Liver / Lungs)

A.

PNEUMOCOCCEAL INFECTION

Acute disease characterized by severe anoxemia due to severe inflammation of the air spaces and bronchioles

** PNEUMOCOCCI are gram (+), lancet-shaped, non-motile and non-spore forming diplococcic evoking suppuratice exudation Microscopic Appearance (Lobar Pneumonia)

A.

necrotic tissue undergoes liquefaction. Staphylococci, streptococci, pneumococci, meningococci, and gonococci are designated cocci because they evoke suppurtative exudation and cause abscess.

STAPHYLOCOCCI INFECTION

More commonly superficial suppurative infection in man which are relatively harmless, however they also produce serious infection of the lungs, pleural spaces, endocardium, myocardium, long bones, kidney and surgical wounds. 1. 2. 3. Staphylococci .. ..

A.

The alveolar capillaries are congested and there is an abundance of inflammatory exudates consists of fibrin which are distributed from one alveolus to another through SCORES OF CONHEIM, there is an increase in the number of extravasated RBCs than PMNL, there is also the presence of hemosiderin laden macrophages Characterized by diffused congestion

3 Variants

STREPTOCOCCAL INFECTION Most common bacterial pathogen in man They can invade any tissue and depending on the site of invasion they can produce different clinical syndrome On the basis of specific CHO strains, 18 seriologic strains of streptococcus (accdg to Lancefield classification) They are designated to A through O Eg. Respiratory infection are caused by Group A and rarely by Group C and G Group D or enterococci found in the intestine and urinary tract

Pathologic Strains of Staphylococci aureus 1. Coagulase

Protects the SA from bacteriostatic substance in normal serum Protects SA from phagocytosis by the PMNI Promotes abscess formation

2. 1. 1. 1.

Exotoxin An alpha toxin Cause dermal necrosis in animals Enterotoxin Produces nausea, vomiting, diarrhea Leukocidin Destroys leukocytes Hyaluronidase

** On the basis of its ability to hemolyze blood they are grouped into the following: 1. Alpha hemolytic streptococci 2. Beta hemolytic streptococci 3. Gamma hemolytic streptococci Examples: 1. BRONCHOPNEUMONIA

One of the most common disease caused by betahemolytic streptoccus 1. RHEUMATIC FEVER Disease of altered immunologic reaction to group A betahemolytic streptococci infection arising usually from a pharyngitis This infection causes lesion in the nervous system, subcutaneous tissue, joints and frequently in the heart The only lesion capable of causing permanent clinical sequelae are those in heart such as cardiac vascular lesions particularly the mitral valve in 97% of the cases and the aortic valve the second most common only involved this will result in stenous and physical examination Cardiac lesions

Type II (Schmitz bacillus) Most pathogenic shigella Produce bacillary dysentery Well localized to the colon

1. 2. 3.

Shigella flexberi Shigella boydii Shigella sonnei the last 3 variants limit their destruction to the mucosa of the large gut

SPIROCHETES 1. SYPHILIS

A.

MENINGOCOCCAL INFECTION Meningococci are oval or bean-shaped gram (-) cocci which usually occur in pairs. They produce endotoxin which is most important in the pathogenesis of meningococcal disease.

Chronic infectious venereal disease caused by the Treponema pallidum transmitted by sexual contact. Transplacenta transmission occurs readily and active disease during pregnancy results in congenital syphilis to the fetus 3 Important Spirochetes (spiral in form and difficult to stain) 1. Treponema 2. Borelia 3. Leptospirosis Non Venereal Treponematoses

A.

GONOCOCCAL INFECTION Pyogenic gram (-) diplococcic, are well known as the cause of the common gonorrheal urethritis (difficulty in urinating), popularly named CLAP Less commonly, the infection begins with gonococcal pharyngitis/protitis, depending on sexual practices

Pinta caused by Treponema carateum 2 Types of Syphilis 1. Acquired syphilis through sexual intercourse Congenital syphilis in utero, associated with congenital abnormalities Triad of Symptoms Otitis media 3. Conjunctivitis Stages of Syphilis

1. 2. 3.

Beiel caused by Treponema pallidum Yaws caused by Treponema pertenue

I. E. LEPROSY bacilli

2. 1. 2. 1.

Low grade indolent infection caused by Mycobacterium leprae The disease is characterized by a long incubation period Mycobacterium leprae

Hutshinsons incisors / mulberry molars

Resembles Mycobacterium tuberculosis in morphology and staining but can easily be decolorized by acids

1. 2.

These affects rge cooler parts of the body such as the skin, anterior part of the eye, certain peripheral nerves and the testes 2 VARIANTS Tuberculoid Leprosy shows good delayed hypersensitivity. There are few bacilli and it excites severe tissue reaction of the epithelioid granulomatous type Lepromatous Leprosy deficiency of T-lymphocytes absent to poor delayed hypersensitivity; lesions are found the have great umers of bacilli which occupies the histiocytes.

2.

A.

TUBERCULOSIS caseous necrosis

Primary syphilis lesion is called chancre. It occurs at the site of entry (genitalia). The chancre is characterized by an ulcerated firm plaque which is round and indurated with rolled raised edges. Occurs 3-4 weeks after exposure. Secondary syphilis lesion occurs 6-8 weeks after the primary lesion. Their location is not related to the site of the primary lesion. If it occurs on the skin, they are manifested as a fine macular/popular lesion sometimes accompanied by alopecia ** Macule lesion not raised above the skin **Papule circumscribed solid elevated lesion of the skin 3 Types of the Lesion

Widespread infectious disease caused by Mycobacterium tuberculosis Referred to as an acid fast infection because of the staining property of the tubercle bacilli GHON COMPLEX also known as primary tuberculosis or childhood tuberculosis SCROFULA tuberculosis involvement of the cervical node POTTS SYNDROME tuberculosis involving the spine Mx: the tubercle (char. proliferative cellular microscopic granuloma) is vharacterized by caseous necrosis with sharply stained epitheliod cells; each tubercle contains one to two Langhans cell

a.Mucous Patch small smooth erythrematous

b.Condyloma latum grayish moist flat topped

arcas/superficial grayish white lesions found on mucous membrane, vulva, penis and oral cavity

extra large papules found on vulva, anus, scrotum, thighs, axilla, and other intertriginous areas c. Split papule occurs as a double papule on sites such as skin folds and angles of the mouth

1.

Tertiary syphilis lesion is called a gumma and is aymptomatic and may occur anywhere. Involvement of the nervous and CV system may cause serious damage.

A.

SALMONELLA INFECTION

Neurosyphilis involvement of the nervous system Tabes dorsalis syphilitic involvement of the posterior root of the ganglia If it involves the cardiovascular system, it affects the aorta and aortic valves. 2. YAWS

gram (-) non-spore formingmotile organism characterized by systemic reticuloendothelial hyperplasia resulting hypertrophy of lymph nodes lymphoid follicles as well as enlargement of the spleen and liver there is active phagocytosis of the organisms and red cells by these reticuloendothelial cells VARIANTS OF SALMONELLA

a. b.

General paresis syphilic involvement of central tissue

1. 2. 3. 4.

Salmonella typhosa most virulent in the group Salmonella paratyphi A and B Salmonella schuttmulleri Samonella hirschfeldii

a tropical/semi-tropical disease caused by Treponema pertenue the mucous lesions form large warty granulomas Fram besiomas begins with a large, raised skin ulcer The mother yaw but late in the course, bones may also be involved by gummatous lesions

A.

SHIGELLA INFECTION Gram (-) Non sporulating and non-motile enteric bacilli which causes changes in mucous membrane of the large intestine VARIANTS OF SHIGELLA

II. VIRAL INFECTION Viruses are very small parasites or pathogens of plants, animals, and bacteria.

1.

Shigella dysenteriae Type I ( Shiga bacillus)

Inclusion bodies are vacuoles, reserve or waste products/materials located in the cytoplasm

A.

Viruses contain only one type of modifying the metabolic and reproductive activity of host cells. Viral infections are characterized by the formation of acidophilic, intracytoplasmic, or intraocular bodies.

2. A. AMOEBIASIS

Metazoa

VIRAL HEPATITIS

Caused by Entamoeba histolytica. The disease is transmitted by fetal contamination of food and wateras well as articles of daily life. It primarily affects the large intestine, secondary liver, in some cases the lungs and brain.

Infectious disease affecting the liver which is may be induced by chemical agents, drugs associated with collagen disease (Lupus erythematosis) Among the viral hepatitis diseases caused by infectious mononucleiosis and cytomegalic inclusion bodies.

A.

MALARIA

A specific infectious disease produced by one of the protozoan parasites. They are transmitted to man by the bite of infectious anophiline mosquito 4 types of Plasmodia

3 Types of Hepatitis

1. 1.

Hepatitis A infectious hepatitis Incubation period varies from 15-50 days transmitted focally contaminated food and water Hepatitis B serum hepatitis Incubation period varies from 30-180 days

It is thought to be transmitted by the parenteral route but is now known to be present in blood, saliva, and semen. Transmission of Hepatitis B may be parenteral transcutaneous or transmucosal route, although the non-parenteral modes of treatment usually require heavy doses (an open laceration or abrasion)

A.

Plasmodium falciparum responsible for malignant tertian malaria. Highly fatal because of its tendency to involve the brain MX: congestion and presence of edema

Plasmodia vivax causes benign tertian Plasmodium ovale malaria or vivax malaria Plasmodium malaria cause benign quartan malaria

SCHISTOSOMIASIS / BILHARZIASIS

Multiple form (multiform) tropical parasitic infection produced by blood flukes or schistosomes. 3 species:

1.
A.

Non-A and Non-B Hepatitis - cases of hepatitis mostly transfusion associated in which there are no virologic or serologic markers to point to any of the well-defined viral etiologies.

MEASLES

Schistosoma mausini intestinal or visceral involvement Schistosoma haematobium bladder Schistosoma japonicum

A.

Extremely contagious exanthematous disease characterized by coryza, conjunctivitis, and the characteristic focal lesion in the mouth Koplicks spots lesion found on buccal mucosa of oral cavity The causative agent is a RNA-myxovirus. The incubation period is 10 days. It would take 13-15 days before the rash appears.

FUNGAL INFECTIONS Fungi causes disease process due to the progressive development of sensitization to the parasitic protein with resultant allergic reaction in the local areas of implantation Fungi cause chronic diseases and are resistant to antibiotics A. ACTINOMYCOSIS

MOLLUSCUM CONTAGIOSUM

Characterized by multiple or isolated waxy papules with a depressed center (umbilication) occurring in the skin of inner thighs, lower abdomen or external genitalia in children Incubation period is about 3-8 weeks Microscopic appearance: marked acanthuses and hyperkeratosis containing numerous intracytoplasmic inclusion bodies which are basophilic, presence of a characteristic pox virus type of particles. A.

Is a chronic suppurative infection localized chiefly to neck, lung, or abdomen. It is caused by Actinomycosis bovis and Actinomycosis israelii. Anaerobic fungi which occur in the form of minte grayish or slightly yellowish granules called sulfur granules which are found in pus. The lesion contains multiple abscesses that drain to the surfaces by sinuses

Cryptococcosis

III. PARASITIC INFECTIONS Parasites are organisms which live and multiply within human body can be classified into: 1. Protozoa

Caused by Cryptococcosis neoformans round to oval yeast has a distinctive very prominent capsule polysaccharide-rich capsule, gelatinous in consistency Site of predilection meninges, skin, subcutaneous tissue, joints, and lungs