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MENINGITIS
inflammation of the meninges
MENINGITIS
requires a sample of cerebrospinal fluid obtained by a spinal tap, or lumbar puncture, then Gram-staining
HAEMOPHILUS INFLUENZAE
the bacterium is normally in the throat ● Hib-caused meningitis is mostly in children under age 4; can be prevented by vaccine
NEISSERIA MENINGITIDIS
normally present in the nose and throat of carriers ● transmission by droplet aerosol or direct contact ● Symptoms caused by an endotoxin that is produced very rapidly and is capable of causing death within just a few hours ● The most distinguishing feature is a rash that does not fade when pressed. ● 6 serotypes cause the disease, but serotype B has no vaccine
STREPTOCOCCUS PNEUMONIAE -
inhabitant of the nasopharyngeal region ● Has vaccines, but the many serotypes make it difficult to develop vaccines against all of them
LISTERIOSIS
caused by Listeria monocytogenes ● Widely distributed in soil and water ● The bacterium reproduces in phagocytes ● Acquired by ingestion of contaminated food ● May be asymptomatic in healthy adults, but can cause meningitis in newborns, immunosuppressed, pregnant women, and cancer patients. ● Can cross placenta and cause spontaneous abortion and stillbirth
TETANUS
Caused by Clostridium tetani, a spore-forming, obligate anaerobe found in soil
BOTULISM
a form of food poisoning (food-borne botulism)
Adult intestinal toxemia
very rare kind of botulism; spores get into an adult's intestines, grow, and produce the toxin
Iatrogenic
too much botulinum toxin is injected for cosmetic reasons
Type A toxin
most virulent; can cause death when food is only tasted but not swallowed
Type B
-responsible for most European outbreaks
Type E
can be destroyed by boiling, but can be produced at refrigerator temp Botulinum toxin is also known for its medical use, such as Botox
LEPROSY(HANSEN'S DISEASE)
Caused by Mycobacterium leprae, an acid-fast rod ○ Grows best in cooler body regions, e.g. peripheral nerves and skin cells ● Transmission requires prolonged contact with an infected person ○ Mostly via nasal secretions of lepromatous leprosy patients ● Diagnosis: skin biopsy, skin smears ● Treatment: Dapsone, rifampin, and clofazimine, usually in combination
Tuberculoid
skin regions with loss of sensation and surrounded by border of nodules; occurs in effective immune responses
Lepromatous
progressive form; skin cells infected, disfiguring lesions all over body; occurs if cell mediated immune response is least effective ○ Lion-faced appearance and deformation of hand; necrosis can occur
POLIOMYELITIS
● Caused by poliovirus ● The great majority of cases are asymptomatic or exhibit only mild symptoms, such as headache, sore throat, fever, and nausea. ○ Paralysis affects fewer than 1% of those infected with the virus ● Transmission by ingestion of water contaminated with feces that have the virus ● Diagnosis: isolation of virus from feces, throat secretions ● Prevented by vaccine ● From throat to small intestine, the virus travels to the lymph nodes, then to bloodstream, causing viremia ● If viremia is persistent, the virus enters the CNS and has affinity for motor nerve cells in the upper spinal cord. ● Death results from respiratory failure
RABIES
● A disease that almost always results in fatal encephalitis ● Caused by the rabies virus ● Proliferates in the PNS and moves, fatally, to the CNS ● Rabies is unique in that the incubation period is usually long enough to allow immunity to develop from postexposure vaccination.
ARBOVIRAL ENCEPHALITIS
● Arboviruses are arthropod-borne viruses that belong to several families. ○ Prevention by mosquito control ○ Horses and humans affected ● Diagnosis based on serological tests. ● Symptoms from subclinical to coma and death
CRYPTOCOCCOSIS/ Cryptococcus neoformans meningitis
● Soil fungus associated with pigeon and chicken (aerosolization of dried up contaminated droppings) ○ Transmitted through respiratory route; spreads through blood to the CNS ● Diagnosis: Serology to detect cryptococcal antigens in serum or CSF ● Treatable through amphotericin B and flutocytosine
AFRICAN TRYPANOSOMIASIS/
sleeping sickness ● Caused by Trypanosoma brucei gambiense and T. brucei rhodesiense ○ These parasites are capable of antigenic variation to escape the immune system ● Transmitted by tsetse fly ● Occurs throughout western and central Africa ● Symptoms: none at first, after a few months, chronic fever, headaches, progress to mental deterioration, coma and death ○ T. brucei gambiense also causes daytime sleepiness and night sleep disturbance
Variant Creutzfeldt-Jakob disease (vCJD)
The prion disease obtained from eating beef with mad cow disease(bovine spongiform encephalopathy or BSE) ○ Psychiatric symptoms and delayed neurological signs observed in patients ○ Median age of death: 28 yrs
Kuru
Observed in the Fore people in Papua New Guinea, who used to practice ritual cannibalism ■ Disease is disappearing as the practice is dying out
Classic Creutzfeldt-Jakob disease (CJD)
Most people develop the disease spontaneously (sporadic CJD); inherit the mutation (familial CJD); or, rarely, be acquired from medical procedures, such as a cornea or skin transplant, and brain surgery (iatrogenic CJD) ○ Median age of death: 68 yrs ○ Dementia and early neurologic signs distinguish it from another form, variant CJD