Pathogens of the Respiratory System
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1 Pathogens of the Respiratory System Chapter 21, Pages Respiratory System Introduction A. Anatomy (Pages ) i. Upper Respiratory Track a. Nasal Hairs b. Paranasal Sinuses c. Nasal Chonchae d. Ciliated Pseudostratified Columnar Epithelia e. Pharynx f. Epiglottis g. Tonsils Pharyngeal Tonsils (Adionoids) Palatine Tonsils Lingual Tonsils h. Eustachian Tube and Inner ear Normal Flora of Upper Respiratory Tract a. Staphylococcus aureus Page 1
2 2. Streptococcus sp. (Page 534) A. General Information B. Taxonomy (Pages ) i. Blood Agar a. α-hemolytic (Viridans) b. β-hemolytic Hemolysins Antigenic Carbohydrates (A-T) (Page 535) c. γ-hemolytic C. Streptococcus pyogenes Group A β-hemolytic Streptococci i. Antigenic Protein - M protein (Page 535) Other Virulence Factors a. DNAse b. Hyaluronidase c. Streptokinase d. Streptolysins O and S e. Erythrogenic Toxin f. Leukocidin Page 2
3 i Diseases of Group A β-hemolytic Streptococci a. Pharyngitis ( Strep Throat ) Scarlet Fever (p. 683) * Lysogenic Conversion * Erythrogenic Toxin (Page 536) Flesh Eating Streptococcus pyogenes * Necrotizing Fasciitis * Super Antigens iv. Late Nonsuppurative Sequelae (Pages ) a. Rheumatic Fever b. Glomerulonephritis Page 3
4 3. Corynebacterium diphtheriae (Pages ) A. Virulence Factors i. Diphtheria Toxin a. Lysogenic Conversion b. Mechanism B. Treatment c. Pseudomembrane i. Antisera i Tracheotomy Antibiotics C. Prevention by Vaccine i. Children - DTaP b. Diphtheria Toxoid Adult - Td Page 4
5 D. Streptococcus pneumoniae (ages ; ) i. General Information (Pages ) Virulence Factors a. Polysaccharide Capsule (Pages ) 90 Serotypes C3b Compliment Interference (Page 547) b. Hemolysin c. Leukocidin d. Hyaluronidase i Diseases Lobar pneumonia (Page 547) Bacteremia (Page 547) Meningitis (Page 547) Otitis media (Page ) iv. Vaccines (Pages ) PPSV23 (Pneumococcal Polysaccharide Vaccine, 23 Serotypes) PCV13 (Pneumococcal Conjugate Vaccine, 13 Serotypes) Page 5
6 4. Streptococcus pneumoniae (ages ; ) i. General Information (Pages ) Virulence Factors a. Polysaccharide Capsule (Pages ) 90 Serotypes C3b Compliment Interference (Page 547) b. Hemolysin c. Leukocidin d. Hyaluronidase i Diseases a Lobar pneumonia (Page 547) b Bacteremia (Page 547) c Meningitis (Page 547) d Otitis media (Page ) iv. Vaccines (Pages ) a. PPSV23 (Pneumococcal Polysaccharide Vaccine, 23 Serotypes) b. PCV13 (Pneumococcal Conjugate Vaccine, 13 Serotypes) Page 6
7 5. Haemophilus influenzae (Hib) (Pages ) A. Virulence Factors i. Capsule (type b) B. Diseases i. Meningitis Brain Damage Acute Epiglottitis i Middle Ear Infections (Otits Media) iv. Hib Vaccine a. Conjugated Vaccine Page 7
8 6. Klebsielle Pneumoniae (Pages ) A. Transmission (Pages 548) B. Virulence Factor i. Capsule C3b Compliment Interference, probable Colonization Factors (Adhesins) (Page 548) i iv. Cytotoxic Resistance plasmid borne b-lactimase producers Extended spectyrum b-lactimase producers effect also cephalosporins Carbapenem resistant - Carbamenems have b-lactum ring and used as a last resort. Page 8
9 7. Mycoplasma pneumoniae (Pages ) Note: Atypical Pneumonias consist of Mycoplasmas Respiratory viruses Chlamydias (psittacosis) Rickettsiae (Q fever) Legonella Characteristics A. Virulence Factors i. Crowded conditions a. Aerosolized Droplets Autoimmune Response B. Diseases i. Mycoplamal pneumonia (or Primary Atypical Pneumonia or Walking Pneumonia ) C. Drugs Page 9
10 8. Bordetella pertussis (Pages ) A. Virulence Factor i. Colonization Factors i Trachael Cytotoxin Pertussis toxin (A-B Exotoxin) Page 10
11 B. Disease - Whooping Cough (Pertussis) i. Stages a. Catarrhal Stage b. Paroxysmal Stage c. Convalescence Stage Vaccine a. Whole Cell b. Purified Cell Fraction (ap - Acellular Pertussis Vaccine) i Contemporary State a. DTaP Vaccine b. Tdap Booster Page 11
12 9. Mycobacterium tuberculosis (Pages ) A. Historical Perspective B. Transmission C. Latent Tuberculosis Infection (LTBI) (Page 552 ff) D. Tuberculosis Disease (Pages ) i. Primary Infection i Caseation Necrosis Miliary Tuberculosis E. Chemotherapy Tuberculous Meningitis - etc etc etc i. First line - 8 weeks Isoniazid (INH) Pyrazinamide Then - 18 weeks Isoniazid (INH) Rifampin Ethambutol Rifampin Second line Aminosalicylic acid & salts Capromycin Cycloserine Ethionamide Streptomycin Page 12
13 F. Diagnosis i. Tuberculin Skin Test (Mantoux test) i Blood tests x ray G. Vaccine i. Mycobacterium bovis H. AIDS Patients I. Epidemic 10. Legionella pneumophila (Pages ) A. Historical Perspective B. Overview C. Diseases i. Legionnaires Disease Page 13
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chapter 18: practical applications of immunology
chapter 18: practical applications of immunology Revised 4/18/2018 immunological memory immunological memory movement via circulation memory B bone marrow secrete Ab continuously effector memory T tissue