Disease of Skin and Eyes Ch 21

1
Disease of Skin and EyesCh 21
2
Necrotizing fasciitis

• Streptococcus pyogenes
• Causes extensive tissue damage
• Treatment is Surgical removal of tissue,
  Penicillin

3
Invasive Group A Beta Hemolytic Streptococcal
Infections

• Streptokinases
• Hyaluronidase
• Exotoxin A, superantigen
• Cellulitis
• Necrotizing fasciitis

Figure 21.8
4
Impetigo

• Staphylococcus aureus or Streptococcus pyogenes
• Superficial skin infection isolated pustules
• Penicillin for Streptococcus infections
• Methicillin or cephalosporin for Staphylococcus

5
Streptococcal Skin Infections

• Erysipelas
• Impetigo

Figure 21.6, 7
6
Shingles

• Varicella-zoster virus (VZV)
• Vesicles similar to chickenpox typically on one
  side of waist, face and scalp, or upper chest
• Usualy along dermatomes. One or 2
• Can cause persistant pain in the affected nerves
  postherpetic neuralgia
• Normal immunity is best
• Acyclovir esp for immunocompromised

7
Boils

• Staphylococcal infection
• A somewhat larger pus-containing lesions within
  the dermis.
• May cause abscesses that are accumulations of pus
  that may penetrate into deeper tissues and
  develop into cellulitis
• Can be treated with penicillins
• May need to be lanced and foreign body removed.

8
Acne

• Small inflamed papules and pustules
• Heal spontaneously within a few days.
• When Propionibacterium acnes (anaerobic) produces
  fatty acids and causes an immune response.
• Skin peels reduce the chance of pores bercomming
  clogged
• Tetracyclines can reduce the amount of bacteria

9
Chicken Pox

• Mild disease in children
• VZV herpes only in humans.
• Oka live attenuated vaccine
• With Aspirin can cause Reyes syndrome
• Develop into shingles as an adult
• 100 deaths a year

10
Herpes

• Herpes simplex virus type 1
• Large Double stranded DNA virus
• Develops latent infection in nerves
• Most commonly as cold sores-vesicles around
  mouth can also affect other areas of skin and
  mucous membranes
• Fluid in vessels contains virus and is infectious
• Acyclovir may modify (reduce)symptoms.

11
Rubella (German measles)

• Rubella virus
• Mild disease with a rash resembling measles, but
  less extensive and disappears in 3 days or less
• No treatment.
• MMR
• Can cause Birth defects and death to undeveloped
  fetus
• May want to screen women of childbearing age for
  antibodies

12
Measles (Rubeola)

• Measles virus
• Transmitted by respiratory route
• Macular rash and Koplik's spots
• Prevented by vaccination(MMR) at 15mo
• Encephalitis in 1 in 1000 cases
• Subacute sclerosing panencephalitis in 1 in
  1,000,000 cases

Figure 21.14
13
Ringworm

• Dermatophytes
• Infect the bodies outermost surface
• Depends on the bodys immune response
• Red, weeping, swelling
• Topical antifungals
• Miconazole
• clotrimazole

14
Scabies

• Sarcoptes scabiei a mite
• Transferred from person to person or by fomites
• Common worldwide
• Lives on skin, female burrows into the skin to
  lay eggs.
• Resembles other itchy skin disease, need to look
  for mites or eggs.
• Lasts a long time (7 year itch)
• Arachnicide gamma benzene

15
Disease of the nervous systemCh 22
16
Meningitis

• Neisseria meningitidis
• Transferred by respiratory droplets
• May live in nose and throat as normal flora
• Vaccine does not cover all serotypes
• Rapid onset, high fever, stiff nect, headache
  worsteing, possible agitated behavior similar to
  drug overdose
• Rifampin and Penicillin G

17
Tetanus

• Clostridium tetani
• Normal flora of animals some humans.
• Neurotoxin made in bacteria in a wound.
• Immunization
• Stiff muscles

18
Botulism

• Clostridium botulinum
• Affects the preipheral nervous system.
• Stops release of acetylcholene, resulting in
  flaccid paralysis
• Support of systems untill toxin is neutralized.
• Antiserum
• Honey a risk in infant botulism

19
Poliomyelitis

• Enterovirus group polioviruses
• Paralysis only in 1 of infected individuals
• Multiplies in throat and intestines.
• Viremia results in infection of the motor cells
  of CNS. Killing these cells.
• The Sabin oral vaccine is no longer used in the
  US because of reversions.
• Inactivated now used.

20
Rabies

• Family Rhabdoviridae genus Lyssavirus bullet
  shaped negative-sense RNA
• Initially nonspecific compatible with Fluelike
  illness. (fever, headache and general malaise 10
  days to 6 years after infection.
• Hydrophobia
• Not treatable after symptoms occur death in 100

21
Rabies 2

• Treatment post exposure prophylaxis
• Antirabies vaccine and immune globulin
  injections.
• Skunk is the primary reservoir in the bay area.

22
Trypanosomiasis African Sleeping sickness

• Trypanosoma brucie gambiense
• Spread by tsetse fly vector
• Early symptoms include reduction of physical and
  mental activity, will move into coma as organism
  enters CSF.
• Treatment,eflornithine (enzyme blocker)
• Vaccine is being developed, hampered by antigen
  variability
• mainly avoidance.

23
Crutzfeldt-jakob disease

• Spongiform encephalophathies
• 200 cases per year in the us, often in families.
• Prion-contaminated tissue
• Not known.
• May be infected blood or tissue

24
Transmissible Spongiform Encephalopathies
Figure 22.17a
25
Disease of Cardiovascular and Lymphatic systemCh
23
26
Rheumatic fever

• Group a beta hemolytic streptococci
  (Streptococcus pyogenes)
• Autoimmune condition repeated streptococcal
  infections result in antibodies that damage the
  heart valve tissue.
• Reason that strep throat is vigorously treated.
• Still sensitive to Penicillin.

27
Yellow Fever

• Fiver chills and headache followed by nausea and
  vomiting. Followed by jaundice.
• Mortality rate 20
• Viral hemorrhagic fever carried by mosquito
• Monkey are a reservoir but human-human is mostly
  how it happens.
• Live attenuated viral vaccine

28
Anthrax

• Symptoms vary according to portal of entry
• Cutaneous
• Gastrointestinal
• Inhallational (pulmonary) most deadly
• Mild fever, coughing and some chest pain.
• Mild symptoms not usually responded to
• Progresses to septic shock in 2-3 days
• Antibiotics if administered on time.

29
Gangrene
30
Lyme Disease
31
Tularemia
32
Relapsing Fever
33
Infectious mononucleosis
34
Malaria

• Plasmodium
• A mosquito-borne disease common to hot climates,
  characterized by fever and chills at intervals
  may be fatal in small children.
• Working on vaccine.

35
Elephantitis

• Student talk

36
Schistosomiasis

• Schistosoma spp
• Eggs produced by schistosomes lodge in tissue and
  induce damaging inflammation.

37
Ebola
38
Disease of the Respiratory SystemCh 24
39
Strep throat

• Streptococcus pyogenes
• Inflame Mucous membranes of the throat

40
Pneumonia
41
Pneumonic Plague
42
Diphtheria
43
Pertussis
44
Tuberculosis
45
Legionellosis

• Legionella pneumophila
• Potentially fatal pneumonia that tends to affect
  older males who drink or smoke heavily. Pathogen
  grows in water such as air-conditioning towers
  and shower heads.

46
Influenza

• Influenzavirus many types
• Characterized by chills, fever, headache, and
  muscular aches. Virus changes antigenic
  character rapidly, so there is limited immunity
  following recovery.
• 10-20k Americans die a year.
• Transferred from humans to animals
• Usually from the orient.

47
Histoplasmosis

• Histoplasma capsulatum
• Fungal pathogen grows in soil, esp if
  contaminated with bird droppings. Widespread in
  Ohio and Mississippi river valleys occasionally
  fatal.

48
Colds

• Rhinoviruses, Coronaviruses
• Young average 4 per year.
• Isolate populations develop group immunity.
• Sneezing excessive nasal secretion.
• Usually not accompanied by fever
• Last about a week. OCDs do not reduce this

49
Diseases of the Digestive systemCh 25
50
Food poisoning

• Staphylococcus aureus Exotoxins
• Toxin causes rapid onset of nausea, vomiting and
  diarrhea

51
Salmonellosis
52
Periodontal disease
53
Shigellosis

• Shigella may be pathogenic E. coli
• Bacteria are shed in human feces ingested, they
  invade and multiply in intestinal epithelial
  cells. Infection spreads to neighboring cells
  causing tissue damage and dysentery.
• Only in primates
• Low death rate
• Not a good vaccine.
• Antibiotics and rehydration

54
Colitis
55
Cholera

• student

56
Hepatitis C
57
Peptic ulcer disease

• Helicobacter pylori
• Pathogen is adapted to survive in stomach
  presence leads to peptic ulcers
• Mixture of antibiotics.
• Urea breath test. (urease from bacteria)

58
Mumps

• Mumps virus
• Painful swelling of parotid glands
• Transmitted by saliva to respiratory tact
• MMR (measles, mumps, rubella vaccine)
• Is a live attenuated viral disease.
• Sterility or other organ systems is rare.

59
Viral gastroenteritis

• Rotavirus or Norwalk agent
• Is a self-limiting infection.
• Usually not fatal.
• Rehydration is best therapy.
• May cause death in 3rd would countries.

60
Cryptosporidiosis

• Cryptosporidium parvum
• Shed in animal feces, protozoan enters water
  supply causes self-limiting diarrhea but may be
  life-threatening if immunosupressed.
• Diarrhea for 10 -14 days
• Cysts must be removed by filtration
• Oral hydration is the only treatment

61
tapeworm

• Taenia saginata or T. solium
• Helminth lives off undigested intestinal contents
  with few symptoms.
• Usually transmitted by ingesting larvae in meats.
  (larvae stage is most damaging)
• 3 of human population
• Niclosamide is drug of choice

62
Diseases of the urinary and reproductive
systemsCh 26
63
Cystitis

• E. coli Staphylococcus saprophyticus
• Difficulty or pain in urination.
• Trimethoprim-sulfamethoxazol other antibiotics
  have been show to be successful.

64
Gonorrhea

• Neisseria gonorrhoeae
• Males painful urination and discharge of pus.
  Females few symptoms but possible complication
  such as PID.
• Fairly good infection rate bout 50
• Ophthalmia neonatorum

65
PID

• N. gonorrhoeae, Chlamydia trachomatis
• Chronic abdominal pain possible infertility if
  uterine tubes are scarred.
• Combination of doxycycline and cephalosporins

66
Genital herpes

• Herpes simplex virus type2
• Painful vesicles in genital area
• Have recurrences, may taper over time.
• Neonatal herpes possible, most damaging if
  initial infection occurs during pregnancy.
• Acyclovir may reduce symptoms and prevent
  recurrences.

67
Genital warts

• Papillomavirus
• Warts in genital area
• Predisposition to cancer.
• Usually self resolves
• By use various therapies to remove dermal layer.

68
trichomoniasis

• Trichomonas vaginalis
• Vaginal itching, greenish yellow discharge
• Is Protozoan
• When pH of the vagina increases
• Diagnosed by protozoa in discharge
• Oral metronidazol to both partners

69
Candidiasis

• Fungal Candida albicans
• NGU
• Vulvovaginal has lesions, itching and irritation.
• Predisposing factors pregnancy, diabetes, tumors
  and antibacterial chemotherapy.
• Diagnosis observation of fungus and isolation
  from lesions

70
Aids

• student

71
Food poisining

• http//vm.cfsan.fda.gov/mow/chap3.html