Systemic infections

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Bacterial, Tick-Borne Diseases examples

✓ Lyme Disease

✓ Babesiosis

✓ Rocky Mountain Spotted Fever

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viral diseases

Infectious mononucleosis
✓ Arboviruses – mosquito
vector
✓ Filoviruses- direct contact
with infected fluids

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protozoan infections

malaria

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lymph

Plasma that has diffused out of capillaries into
and around tissues

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lymph is normally

sterile

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WBC in lymph do what

fight foregn pathogens

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lymph delivers contaminating microbes to lymph nodes to be

phagocytosed

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Blood is normally

axenic (sterile)*

(but recent studies say no and blood microbiome dwells inside blood cells)

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venipuncture

different ubes with different anticoagulants for specific tests

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anticoagulant of choice

sodium polyanethol sulfonate (SPS- yellow top)

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what is done when a microbial infection in blood is suspected

blood culture

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Septicemia:

presence of microbial infection on the blood that

causes disease

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Bacteremia:

septicemia caused by bacteria

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Viremia:

presence of viruses in blood

• Remember that aseptic meningitis refers to viral

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Fungemia:

presence of fungi in blood

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• Parasitemia:

presence of parasites in blood

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toxemia

presence of toxins in the blood

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Septic shock:

extremely low blood pressure (hypotension) as a result of inflammation and dilation of blood vessels.High mortality rate

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Bacteremia can spread to

joints and bones causing osteomyelitis and to CNS causing meningitis

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Lymphangitis:

septicemia spreads to the lymphatic vessels, appearing as a red streak

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bacteremia clinical presentation

High fever (over 38°C 99°F)

• Chills, nausea, vomiting, diarrhea,

shortness of breath, and malaise

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Bacteremia – Causative Agents

all bacteria can cause bacteremia as long as they can access the bloodstream and survive to multiply

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Most septicemia causing bacteria are

opportunistic pathogens

ex Escherichia coli, Pseudomonas aeruginosa, Bacteroides,

Staphylococcus, and Streptococcus

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bactericemia caustive agents virulence factors

• Capsule: useful to prevent phagocytosis from WBC circulating in

bloodstream

• Siderophores: certain bacteria require iron for metabolism; therefore

they use molecules that chelate (“trap”) iron from carrier proteins in plasma

• Hemolysins: substances that destroy RBCs

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bactericemia pathogenesis

Septicemia usually presents as a result of

  • direct inoculation of bacteria into blood ex

  • • Medical procedures

  • • Catheters, surgery, central venous

  • line, dialysis

  • • IV-drug users

  • • Abrasions

  • • Result of a secondary infection

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who is at higher risk for bactericemia

people with AIDS, cancer, diabetes, malnutrition,

elderly, newborns are all more susceptible

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which gram class usually causes severe septicemia

G-

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in bacteremia, outer meembrane of dying bacteria releases

Lipid A. causes stronger immune response

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exotoxins

produced by gram-positive bacteria only

• Cytotoxins: cell lysing

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endotoxins

produced by gram negatvie bacteria

• Lipid A portion of LPS from outer cell membrane

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toxic shock syndrome caused by

Staphylococcus aureus and Streptococcus pyogenes

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toxic shcok syndrome caused by bacteria secreting

exotoxin: toxic shock syndrome toxin (TSST), a type of superantigen

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toxic shock syndrome symtoms

exaggerated immune response

resulting in high fever, vomiting, rash,

and extremely low blood pressure

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Staphylococcal Toxic Shock Syndrome

  • can grow in vagina or wounds

  • associated with superabsorbent tampons

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Bacteremia and Toxemia prevention

taking care of wounds, promptly treat initial

infections, sterilization of surgical equipment

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Bacterial Endocarditis

Bacteria infect the endocardium

triggering inflammation,

endocarditis and the formation of

vegetations (masses of platelets

and clotting factors in the

endocardium that bury the bacteria)

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Bacterial endocarditis symtpoms

similar to bacteremia signs as well as tachycardia and heart murmurs. complications can lead to strokes are cardiac failure

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most common cause of bacterial endocarditis

Viridans alpha streptococci

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other things that can bacterial endocarditis

Pseudomonas aeruginosa,

Neisseria meningitidis, Escherichia coli, Salmonella spp.,

Staphylococcus spp., Streptococcus spp.

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who is at highest rsik for bacterial endocarditis

Patients with tooth lesions or wounds, IV-drug users, artificial

heart valve recipients

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Borrelia burgorferi – Lyme disease phases

  1. bulls eye rash

  2. neurological symptoms

  3. severe arthritis

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lyme disease signs and stages

1. Erythema migrans
2. Early disseminated stage
• Multiple erythemas
• Arthritis
• Musculoskeletal pain
• Meningitis
• Lymphocytoma
• Carditis
3. Late disseminated stage
• Acodermatitis
• Arthritis
• Neurological symptoms
4. Post-treatment Lyme disease
syndrome

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Babesia spp caused by

B. microti (a parasite! not a bacterium). spread throgh ticks

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Babesiosis signs

General malaise, fever,

headaches, chills, sweating,

fatigue, and weakness

(nonsynchronous)

• Hemolytic anemia

• Renal failure

• Hepatosplenomegaly

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Rocky Mountain Spotted Fever (RMSF) caused by

Rickettsia rickettsii (spread by ticks)

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Rocky Mountain Spotted Fever (RMSF)

Headache, vomiting, and muscle pain

• Rash consisting of small, flat, pink/red, non-

itchy spots that spread from the wrists,

arms, and ankles inward to the torso

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rocky mountain spotted fever pathophysiology

infects endothelial cells

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rocky mountain spotted fever complications

If untreated, may cause blood vessel damage impacting circulation to the arms and legs
• May require limb amputation
• Vessel damage in 5% of cases causes fatal organ or brain
bleeding
• Untreated cases can be fatal within 8 days


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viral diseases of cardiovascular system

• Infectious mononucleosis (EBV)
• Arboviruses
• Yellow fever
• Dengue
• Filoviruses
• Ebola
• Marburg

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Infectious Mononucleosis causitive agent

epstein barr virus

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Infectious Mononucleosis transmission

person-to-person or sharing of fomites (glasses) or via inhalation of respiratory droplets containing the virus
• “Kissing disease”

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infectious mononucleosis pathogenesis

infects epithelial cells of throat and salivary glands, enters the blood where it infects B lymphocytes. becomes latent. infects and replicates in oropharyngeal epithelium, tonsils and salvary glands.

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infectious mononucleosis signs

Lymphadenitis (especially lymph nodes of the neck)

• Extreme fatigue, nausea, loss of

appetite, headache, and sore throat

• May lead to chronic tiredness

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many hosts of mononuelcosis are

asymptomatic

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Arboviruses 2 types

yellow fever and degnue fever

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yellow fever symotoms

Acute: headache, fever, and muscle pain 3-5 days
• Severe disease (15%): high fever, severe nausea, violent-black
vomit. Liver damage, internal bleeding, delirium, coma, and death

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arborvirus pathogenesis

Viruses infect and replicate in the liver and spleen, leading to
viremia
• Cytokine release incites systemic inflammatory response
• Causes leaky capillaries, decreased blood pressure, may lead to
shock and organ failure

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yellow fever transmission

Jungle: Transmits primarily between monkeys via mosquitoes in jungle areas
• Intermediate: In areas with both villages and jungle, mosquitoes infect both humans and monkeys
• Urban: Human-to-human transmission via mosquitoes


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dengue fever is common or uncommon

Most common arboviral disease in humans. can be asymptomaitc

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dengue fever 1st stage

febrile phase - Fever, vomiting, rash, and
body aches

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dengue fever 2nd stage

critical stage
• Extreme abdominal pain, persistent vomiting, and dehydration
• Hemorrhagic features may develop
• Bleeding from the nose or mouth, petechiae, and leaky capillaries
• May lead to decrease in blood volume, shock, organ failure, and death
• For both – Monkeys/humans are initially infected and then pass the virus via mosquito vector

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arborviruses transmission

Monkeys/humans are initially infected and then pass the virus via
mosquito vector

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filoviruses examples

Marburg and Ebola viruses

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filoviruses transmission

Transmission is person-to-person,
Ebola – ingestion of bush meat,
Marburg – inhalation of bat droppings

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how does filovirus replicate

Virus replicate in monocytes,
macrophages, and dendritic cells

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filoviruses can cause

  • severe hemmoragic fever

  • Extensive tissue necrosis of liver, spleen, lymph nodes, and lungs

  • Hemorrhage causes edema and hypovolemic shock

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malaria caused by

protozoan

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species of plasmodium that cause malaria

P. falciparum (*most deadly)
• P. vivax (*most prevalent)
• P. malariae
• P. ovale
• <P.knowlesi – emerging parasite>

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definitive host of malaria is

where sexual reproduction takes place

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malaria signs

Causes cycles of fevers, headaches, delirium, body aches (due to rupture of RBCs & release of toxins)

• Death from loss of RBCs, complications from blood clots

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plasmodium depends on what to complete its life cycle

Anopheles mosquito and humans

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