Exam Prep? Infectious Diseases. A Balancing Act. Ehrlichia

Transcription

1 Exam Prep? Infectious Diseases A Balancing Act Ehrlichia 1

2 SARS SARS Infiltrate Bioterrorism Category A Category A Cholera Cot Hantavirus 2

3 Viral Diseases By far the most common Direct killing Autoimmune Tumor transformation Chlamydia Bacterial Intracellular Almost bacteria Common Many forms of disease Direct cell death Autoimmune Aerobic & anaerobic Gram +/- Direct killing Toxins Autoimmune Altered body substances Fungi Protoza Some are biphasic Yeast or hyphal Challenge to immune system Systemic vs. Cutaneous infections Direct killing Autoimmune (cell mediated) Numerous One of the most common causes of death world-wide. Habitat modification Complex life cycle 3

4 Helminthes Complex life cycle Intestinal Tissue Seizures in Mexico A Balancing Act Host Factors 4

5 Tears Immune System Charles Lutwidge Dodgson Human Microbe, Co-Evolution Lewis Carroll January January Mathematician Alice Liddell Alice's Adventures in Wonderland, 1865 Through the Looking-Glass and what Alice found there, 1872 The Hunting of the Snark, 1876 Coevolution also means coextinction. Differences in replication rate. Keep evolving just to stay in the game. Red Queen hypothesis Red Queen dynamics Through the Looking Glass Population specific Human Bug 5

6 A Balancing Act No spitting in the street. Actually fined in most towns. Organisms resistant to drying M. tuberculosis Vectors 6

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8 Essay Scenario Cytopathic Effect 8

9 Rhinovirus Influenza A Bacterial Pneumonia H1N1 Pandemic of 1918 US Population 1918 Spanish flu of 1918 World-wide pandemic At least 26 million died One Twin-Towers Every day For 24 continuous years US deaths 700,000 9

10 US Population 1918 Measles (rubeola) Measles Giant Cells Mumps Polio 10

11 Polio Rotovirus Hemorrhagic Fevers Herpes 11

12 CMV Varicella-Zoster Varicella-Zoster Varicella-Zoster Varicella-Zoster 12

13 Hepatitis B Chronic Hepatitis B EBV HPV Cervical and vulvar cancers Very disturbed epi maturation Staphylococcal Infections 13

14 Pneumonia with abscess Streptococcal erysipelas Pneumonia Rheumatic Fever 14

15 Acute Glomerulonephritis C. diphtheriae C. diphtheriae Diphtheria GC 15

16 Neisseria meningtidis Haemophilus Influenza B. pertussis Hurricane Isabel Approaches a Tanker Listen to the cough. Salmonella Shigella 16

17 Cholera Helicobacter 17

18 Tuberculosis Mycobacterium tuberculosis (most cases) Type IV hypersensitivity Granuloma Primary infection Pulmonary Perhaps goes lymphatics Hopefully it stops here. Secondary TB Internal reactivation Perhaps years later Not all patients Tuberculosis Tuberculosis Ghon Lesion Ghon Complex Tuberculosis 18

19 Skin Test PPD Injected intradermally Read in 2 days Measure swelling Not redness Positivity maybe life long 19

20 Miliary Spread of TB Leprosy Disease in History If your hand causes you to stumble, cut it off. It is better for you to enter life maimed than to have two hands and go to Gehenna to the unquenchable fire. Syphilis And if your foot causes you to stumble, cut it off; for it is better for you to enter life lame than to have two feet and be thrown into Gehenna. And if your eye causes you to stumble, tear it out; for it is better for you to come into the Reign of God with one eye than to have two eyes and be thrown into Gehenna where their worm never dies, and the fire is never quenched. Mark 9 Syphilis 20

21 Lyme Disease Lyme Disease Clostridial infections 21

22 Gas Gangrene Chlamydia Reiter Syndrome Arthritis Non-GC urethritis or cervicitis Chlamydia Shigella, Salmonella Conjunctivitis Men in their 20 s HLA-B27 (80% +) Autoimmune with infectious trigger Low back stiffness and pain. Reiter Syndrome HLA B27 Yong men Chlamydia Symptoms may regress, but 50% have recurring problems 22

23 Rickettsial Disease More Rocky Mountain Spotted Fever Typhus Allergic reactions to fungi Histoplasmosis 23

24 Pseudomonas Candidiasis Candida Esophagitis Cryptococcosis Aspergillus 24

25 Mucomyocsis Pneumocystis Pneumonia (PCP) Malaria Malaria Malaria 25

26 Cerebral Malaria Leishmaniasis Leishmaniasis Giardia Amebiasis Alpha Hall 26

27 Trichinella Worms T. solium T. solium Cysticercosis 27

28 Schistosomiasis Onchocercerciasis 28

29 Cavitary, Be careful What You Say TB Pericarditis Slide 78 Reading the PPD 29

30 Miliary Spread of TB 30

31 Opisthotonus Strabismus Always look for papilledema first! CSF pressure Color and clarity Sp. Gravity Protein Glucose (2/3 of blood) Cells PMNs Lymphs Others Gram stain Culture CSF Analysis Lymphangitis 31

32 Strep Tissue planes Lymphangitis Rapid spread Aggressive types 32