Transmission Infectious Endocarditis Bacteria or virus in the blood infects interior heart muscle, causing damage and resulting

clot

Pathogenesis Bacteria stick to the clot, may increase it Emboli clot breaks off, flows to a smaller blood vessels and blocks blood flow petechial hemorrhages, stroke, coronary embolism Abs bind the emboli and recruit complement, increasing cell damage

Incidence Common causes: oralstreptococci enter via bleeding gums Skin or fecal bacteria enter via wounds

Symptoms

Other

Diseases

Vaccine?

Bacteremia Same as endocarditis bugs and Group B Strep (GBS) Beta hemolytic streptococcus S.agalactiae normal vaginal flora, but not present in all women. Testing in last 3 weeks before giving birth Epstein Barr Virus (EBV; herpes 4)

Most common cause of neonatal death in US

Puerperal fever, sepsis in mother, post birth. Major cause of death due to childbirth if no access to clean water, Abx. Neonatal bacteremia, meningitis, pneumonia depending on where infant infected

Droplet-hard to get: requires high ID50

Kills pharyngeal cells, causing inflammation. Causes some B cells to divide, encouraging viral replication. Makes B cells look like Monocytes (atypical lymphocytes_ Tissue tropism: lytic in pharyngeal epithelia, latent in B cells

-Asymptomatic in most healthy people, just feel tired -fetuses if mothers primary infection is in pregnancy, fetus may be born jaundiced -hearing loss and learning disabilities may develop later. Immunocompromised pneumonia if respiratory, flu like symptoms and pneumonia if via transfusion/transplant -Rash sometimes bullseye shape with fever, pain for months. Lack of neutrophil response, chronic inflammation. -Arthritis later inflammation to joints, very painful

Lyme Disease Borellia borgdorferi: fastidious spiral bacterium with reservoir in mice, problem especially in E. US

Deer tick

Difficult to study! Hypothesis: unusual cell wall LPS triggers confused chronic immune reaction wherever pathogen is (first skin, later joints/brain)

Chagas Disease Trypanosoma cruzi Protozoan flagellate

Transmission Vector, vertical kissing bug so called because it is attracted to CO2 exhaled while victim sleeps. Bites near mouth, but actual transmission is from its poop, which may enter through eye or wound. Lives in thatched roofs Food esp. unpasteurized milk. Goats/sheep, swine, cattle Multiple usually would infected while butchering small mammals. Ex: rabbits, squirrels for meat. Improbable but ID 50 is low! Vector: flea bite

Pathogenesis May stay at bite site inflammation. If disseminates, forms a pseudocyst inside cardiac or autonomic nervous system cells

Incidence Distribution: LatinAmericaUS issue with immigrants, blood banks

Brucellosis Brucella spp.

Tularemia (Rabbit fever) Francisella tularensis fastidious bacterium

Symptoms Acute: flu-like symptoms. If poop was in eye, get droopy eye for a few weeks, like the kid. Some develop chronic infection and may immediately or years later suffer organ failure, especially of heart or GI, due to pseudocyts Flu-like symptoms. May develop into chronic nocturnal fever -Causes spontaneous abortion in humans too Ulcerated would Granulomas in skin Buboes -if disseminated, high fever, organ failure, high mortality

Other

Diseases

Vaccine?

Bioterrorism: has been explored as possible bioterror agent

Bioterror: can also be inhaled, so proposed bioterror agent (but so tough to grow this is really unlikely)

Plague Black plague name for buboes Yersinia pestis Gram negative bacteria

Lives in macrophages, spreads to lymph nodes and rapidly multiplies. -Massive immune recruitment there, and dying bacteria release LPS into lymph, then blood septic/toxic shock

Bubonic Plague: buboes are purple, swollen lymph nodes. High fever, death in days

Rickettsial infections Obligate intracellular bacteria. Very small and simple, kind of like viruses, and also intracellular. Rickettsial infections Rocky Mountain Spotted Fever R. rickettsia Rickettsial infections Typhus flu-like symptoms

Arthropods. All are transmitted by insect/arachnid bites

Vector: tick

Infects and kills endothelial cells, causing blood vessel collapse.

Epidemic Typhus R. prowazeckii Vector: lice Endemic Typhus R. typhi Vector: rat flea

-rash due to blood leaking into tissues, possible clot development and subsequent embolism. -rash (same rash as RMSF), very high fever, high mortality if untreated

Arboviruses Insect born viruses

Transmission Aedes mosquitoesstriped mosquito invasive to Americas

Pathogenesis

Incidence Distribution Dengue Fever: tropics (can only be spread by Aedes) US Emergence? Mosquito recently seen in SW US Distribution of Yellow fever: Equatorial Africa and Latin America

Symptoms

Other West Nile born by other species of Aedes mosquito genus, found father north, including here. Serious human infections rare.

Diseases Dengue Fever: Quebrante huesos breakbone fever. Terrible muscle and joint pain, high fever. Dengue Hemorrhagic fever: may develop, depending on strains. Hemmorhage internal and external Yellow fever virus: diseases similar to dengue fever but pain is less and liver problems more. Jaundice, swollen abdomen, Hemorrhagic fever may develop.

Vaccine? Vaccine for Yellow Fever: most effect vaccine ever developed. You get a yellow card (photo) to prove you have it.

Ebola and Marburg viruses

Blood reservoir unknown; bats suspected. Possibly begins with bat bite and spreads to victims caretakers

Break down cell: cell boundaries between epi/endothelial cells

Lymphatic filiariasis Sometimes called elephantiasis Wuchereria bancrofi, Brugia malayi roundworms Malaria: review from unit 1 HIV: review from unit 5

Mosquito

Baby worms in blood; adult worms live in lymph vessels. Have bacteria inside them that, when released on worm death, cause inflammation, scarring.

Outbreaks: small, every few year in Central/East Africa. Only large outbreaks (numbering in hundreds) associated with iatrogenic transmission: non sterile practices in hospital care Distribution: tropics

Fever Sever hemorrhaging Inside and out

Early: parasitemia (baby worms in blood), fever, fatigue. People born in endemic areas may not have symptoms. Later, if untreated: painful swollen limbs. scrotum from repeated scarring.