Diseases of Endocrine System

Diseases of thyroid gland
-thyroiditis
-goitre
-tumours
-hypothyroidism

Diseases of parathyroid glands
-hyperparathyroidism
-hypoparathyroidism
-tumours

Diseases of the pituitary glands
-pituitary necrosis
-tumours
-pituitary hypofunction
-diabetes insipidus


Diseases of the adrenals
-adrenocortical hyperfunction
-adrenocortical hypofunction
-tumours
-ddiabetes mellitus

Diabetes Mellitus

Diseases of Nervous System

Inflammatory
- Meningitis
- Brain abscess
- Encephalitis

Viral
- Poliomyelitis
- Rabies
- Herpes Zoster

Vascular
a) Intracranial haemorrhage
b) Cerebral aneurysms
c) Cerebral infarction
d) Hydrocephalus

Tumour

ANAEROBIC INFECTIONS

classification

predisposing factors

features

common type

lab diagnosis

treatment

NORMAL FLORA OF THE HUMAN BODY

resident flora

transient flora

role of resident flora

normal flora may produce disease under certain condition

normal flora mouth, throat, pharynx

normal flora intestine

normal flora skin

normal flora of vagina

carrier

salmonella choleraesuis

septicaemia and bacteraemia

Blood diseases

Anaemias

Polycythaemia

Leucocytosis

Leucopenia

Agranulocytosis

Leukaemia

Haemorrhagic blood diseases

Diseases of Endocrine System

Diseases of thyroid gland
- Thyroiditis
- Goitre
- Tumours of the thyroid gland
-Hypothyroidism

Diseases of parathyroid glands
- Hyperparathyroidism
- Hypoparathyroidism
-Parathyroid tumours

Diseases of the pituitary glands
- Pituitary necrosis
- Pituitary tumours
- Pituitary hypofunction
-Diabetes Insipidus

Diseases of the adrenals
-Adrenocotical hyperfunction
- Adrenocortical hypofunction
- Tumors of the adrenal gland

DIABETES MELLITUS

Diseases of Lymphoid and Haemopoietic System

Lymphadenitis

Infectious mononucleosis

Tumour of lymph nodes

Hodgkins lyphoma

Non hodgkins lyphoma

Causes of splenic enlargement

Hypersplenism

Diseases of Digestive system

Lips

-Herpes simplex

- 1ry syphilis

-Tumours

Mouth

- Stomatitis

- Tumours

Tongue

- Glossitis

- Leukoplakia

- Ulcers

- Tumours

Salivary glands

- inflammation

- tumours


Oesophagus

- inflammation

- Barrets oesophagus

- Ulcers of oesophagus

- Diverticulae

- Varicose

-Tumours

Stomach

- Congenital pyloric stenosis

- Gastritis

- Acute ulcer of stomah and duodenum

- Chronic peptic ulcers

-Tumours

- Gastric carcinoma

-Haematemesis

Intestine

- Typhoid fever

- Dysentery

- Chronns disease

- Ulcerative colitis

- Diverticulae

- Hernia

- Acute int obstruction

- Chronic int obstruction

-Malabsorbtion syndrome

- Tumor of small int

- Tumor of large int

-Carcinoma of large int

-Megacolon

-Haemorrhoids (piles)

- Bleeding per rectum

Appendix

- Acute appendicitis

- Chronic appendicitis

- Mucocele of appendix

- Tumor of appendix

Gall bladder

- Acute cholecystitis

- Chronic cholecystitis

-Cholesterolosis

- Gall stones

- Tumor

Pancreas

- Acute haemorrhagic pancreatitis

- Chronic pancreatitis

- Carcinoma of pancreas

Peritoneum

- Septic peritonitis

- Ascites

- Tumours

Jaundice

- Haemolytic jaundice

- Obstructive jaundice

- Hepatocellular jaundice

Liver

- Bleeding per rectum

- Liver necrosis

- Acute viral hepatitis

- Chronic hepatitis

- Liver cirrhosisi

- Liver abscess

- Tumours

Diseases of Bone and Joints

Osteomyelitis
-Acute haematogenous osteomyelitis
-Acute no haematogenous osteomyelitis
-Chronic suppurative osteomyelitis

Tumor of bone



Osteodystrophies
- Fibrous dysplasia
- Paget's disease of Bone ( Osteitis Deformance)
- Osteoporosis
-Osteitis Fibroca cystica
- Rickets
- Osteomalacia


Causes of pathological fracture

Diseases of joints
-Arthritis
-Suppurative arthritis
-Rheumatodi arthritis
-Osteoarthritis
-Neuropathic arthritis
-Pigmented villonodular synovitis

Tumor of joints
- Maligannt synovioma

morganella morganii

UTI

wound infections and diarrhoea

providencia rettgeri

urinary tract

wound

burn infections

Diseases of Urinary Tract

Diseases of glomeruli

Congenital anomalies of kidney
Acute diffuse proliferative glomerulonephritis
RPGN
Minimal change glomerulonephritis
Membranous
Membranoploriferative
Focal lomerulonephritis
Chronic glomerulonephritis
Nephrotis syndrome

Diseases of renal tubules

Acute tubular necrosis
Ischaemic tubular necrosis

Diseases of renal blood vessels

Diseases of renal interstitial tissue

Pyelonephritis
Hydronephrosis
Renal calculi

Tumor of kidney

Diseases of the urinary bladder

Bladder diverticulum
Acute cystitis
Chronic specific cystitis
Tumor of urinary bkadder

Villous papilloma
Bladder carcinoma
Uraemia
Haematuria

Diseases of Female Genital System

- Gonorrhea

- Cervicitis

- Endometritis

- Puerperal sepsis

- Abnormal uterine haemorrhage

- Endometrial hyperplasia

- Adenomyosis

- Endometriosis

- Valvular dystrophy

- Tumor of vulva

- Tumor of vagina

- Tumor of uterus

- Malignant tumor of uterus

- Non-neoplastic ovarian cyst

- Tumor of ovary

- Disease placenta

a) hydatidiform mole
b) choriocarcinoma
c) ectopic pregnancy

Diseases of Breast

-Mastitis

- Mammary cystic hyperplasia

- Benign tumor of breast
(a) fibroadenoma
(b) phyllodes tumor
(c) duct papilloma

- Malignant tumor of breast
(a) mammary carcinoma
infiltrating duct carcinoma
medullary carcinoma
medullary (colloid ) carcinoma
paget's disease
lobular carcinoma

(b) sarcoma of breast

-Causes of breast mass

- Diseases of male breast
a) gynaecomastia
b) carcinoma of male breast

Diseases of Male Genital System

-Congenital anomalies

-Gonorhea

-Specific infections

-Non specific infections

-Nodular hyperplasia of the prostate

-Tumorof the testis

-Haematocele

-Chylocele

-Varicocele

Diseases of Blood Vessels

Arteriosclerosis

Atherosclerosis ( atheroma)

Medial calcification

Arteriolosclerosis

Hypertension
-Essenytial hypertension
a)Benign esssential hypertension
b)Malignant essential hypertension

-2ry hypertension

Collagen diseases of arteries

Thromboangitans obliterans (buerger's disease)

Aneurysm
-True aneurysm
-False aneurysm

Disease of vein
- varicose vein

Tumor of blood vessels

Diseases of Heart

Rheumatic fever

Endocarditis
-Acute infective endocarditis
-Subacute infective endocarditis

Valvular diseases
-Mitral stenosis
-Mitral incompetence
- Aortic incompetence
- Aortic stenosis
- Pulmonary stenosis

Diseases of myocardium
- Myocarditis
- Cardiomyopathy

Ischaemic coronary heart diseases
- Arteriosclerotic heart disease ( Gradual incomplete coronary occlusion)
- Sudden complete coronary artery occlusion

Myocardial infarction

Congenital heart disease
-Atrial septal defect
- Ventricular septal defect
- Pulmonary stenosis
- Patent ductus arteriosus
- Coarctation of aorta
- Fallot.s trilogt
- Fallot's tetralogy

Heart failure
- Acute heart failure
- Chronic heart failure a) right sided
b) left sided

Pericarditis
- Fibrinous pericarditis
- Suppurative pericarditis
- Tuberculous pericarditis
- Adherent Mediastino-pericarditis
-Constrictive pericarditis

Hydropericardium

Haemopericardium

Tumor of heart

Diseases of Respiratory system

Nose

1. Rhinitis
2. Acute catarrhal rhinitis
3. Allergic rhinitis
4. Chronic non specific rhinitis
5. Atrophic rhinitis
6.Scleroma
7. Sinusitis
8.Epistaxis

Pharynx

1. Pharynx
2. Adenoids
3. Tumor of pharynx

Tonsills

1. Acute tonsillitis
2. Chronic tonsillitis
3. Diphtheria

Larynx

1. Laryngitis
2. Laryngeal nodule
3. Tumour of larynx
4. Acute suppurative otitis media

Bronchi

1. Acute tracheobronchitis
2. Chronic bronchitis
3. Bronchial asthma
4. Bronchiectasis

Lung

1. Pulmonary oedema
2. Pneumonia
3. Influenza
4. Lung abscess
5. Lung gangrene
6. Pulmonary emphysema
7. Lung atelectasis
8. Lung collapse
9. Tumor at lung
10. Bronchogenic carcinoma
11. Lung 2ry metastasis
12. Haemoptysis

Pleura

1. Fibrinous pleurisy
2. Emphysema
3. Hydrothorax
4. Haemothorax
5. Pneumothorax
6. Tumor of pleura

b) systemic disease with skin rash

Bacterial

Meningococcaemia---Neisseriae meningitidis

Toxic shock syndrome---S.aureus, S. pyogenes

Scarlet fever-----S. pyogenes

Rocky mountain Spotted fever- --Rickettsia ricketsii

Secondary syphilis---Treponema pallidum

Lyme disease----Borrellia burgdorferi

Staphylococcal scalded skin syndrome----S. aureus

Viral

Chickenpox----Varicella-zoster virus (VZV)

Measles---Rubeola virus

German measles---Rubella virus

Febrile illness--Echovirus

AIDS---Human immunodeficiency virus

Smallpox---Variola virus

hsv2

1. herpes genitalis

2. neonatal herpes

3. aseptic meningitis

4. precancerous

HSV 1

1. Acute gingivostomatitis

2. Recurrent herpes labialis

3. Encephalitis

4. Keratoconjunctivitis

5. Herpetic whitlow

6. Disseminated infections e.g: pneumonia in ADS patients

a) localized infection of skin

Bacterial

Folliculitis, furuncles, carbuncles, or abscess------------------S. aureus

Cellulitis, ersipelas, impetigo (pyoderma), necrotizing fasciitis---------S. pyogenes

Malignant pustule-------Bacillus anthracis

Actinomycotic mycetoma------------Actinomycetes

Fungal

Superficial mycoses: Pityriasis versicolor-----------Yeast:Malessezia furfur

Cutaneous candidiasis-----------Yeast: Candida species

Cutaneous mycoses---------Dermatophytes

Eumycotic mycetoma----Madurella and Allescheria species

Viral

Skin warts--------Human papillomaviruses (HPVs)

Herpes simplex-------Herpes simplex viruses 1 or 2

Zoster (shingles)-------Varicella-zoster virus (VZV)

Roseola infantum------Human herpes viruses 6 (HHV 6 )

Erythema infectiosum----Human parvovirus B 19

Molluscum contagiosum----Molluscum contagiosum virus ( MCV)

Smallpox ---------Variola virus

herpesviruses-VZV47

1.varicella-chickenpox

2.zoster-shingles

herpesviruses-Epstein Bar viruses (EBV)48

1.Glandular fever

2.Nasopharyngeal carcinoma

3.Burkitts lymphoma

4.Oral hairy leukoplakia

5.Hodgkins disease

Human Herpes Virus

6exanthum subitum high fever skin rash

7 salivary gland infection

8 kaposi sarcoma

herpesviruses-Cytomegaloviruses49-

congenital infection mononucleosis syndrome

astroviruses35

sporadic gastroenteritis in infants, children

caliciviridae-norwalk viruses34

epidemic viral nonbacterial gastroenteritis in school children and adults

reoviridae-rotaviruses34

infantile gastroenteritis

fusobacteria

1.trench mouth

acute necrotizing ulcerative gingivitis ( ANUG)

2.vincents angina

infection of pharynx with formation of pseudomembrane

leptospira interrogans

Weil's disease( infectious jaundice)

- ranging from a mild self limiting febrile illness to a fulmnating fatal illness associated with hepatorenal failure

- ip is 7 -14 days

- a biphasic illness with quiescent period in between

1. Initial septicaemic phase---------jaundice

2. Second phase ---------meningitis

borrelia burgdorferi

Lyme disease

inflammatory disorder----mule2 erythema migrans with headache, stiff neck, myalgias, arthralgia or swelling of the lymph nodes

----lame2 ade meningoencephalitis, myocarditis, or chronic arthritis

borrellia recurrentis, borrellia duttoni ,borrelia hernsii-

Relapsing Fever

- febrile

-septicaemic

-sudden onset

-IP: 2-15 days

-fever persists for 3 to 7 days followed by an a febrile interval ofseveral days to several weeks

- 3 to 7 relapse may occur

borreliarecurrentis

relapsing fever

treponema pallidum

syphilis

-1ry syphilis
a) manifested as single hard, painless ulcer called chancre

b) ip 10-60 days

c) chancre represent the 1ry site of initial multiplication

d) usually appears on the penis, labia, cervix, anorectal region, or around the mouth

e) regional lymph nodea also becomes enlarged

d) the chancre heals within 4-6 weeks even without treatment

-2ry syphilis ( four cardinal features)

a) generalized skin rash

b) mucous patches in mouth and throat

c) chondyloma lata ( moist papules) form around the genitals or anus

d) generalized lymphadenopathy

* the symptoms usually last 3-6 months and disappear spontaneously

-the latent (hidden) stage

a) no symptoms neither lesion

b) serology is positive

c) range from a few months to a life time

-tertiary syphilis

a) 40 % of untreated case

b) characterized by gumma formation

c) lead to cardiovascular syphilis

d) serology is positive

-congenital syphilis

a) can lead to a stillbirth

b)

helicobacter pylori

1.chronic gastritis

2.duodenal ulcer

3.gastric ulcer

4.mucosal atrophy

5.gastric carcinoma

6.gastric lymphoma

coronaviruses33

1.upper resp.tract illness

2.common cold

3.SARS(explain)

rubella(german measles)32

1.maculopapular rash

2.cervical lymphadenopathy

During pregnancy

1.abortion

2.intrauterine foctal death

3.congenital malformation-(mental retardation, deafness, heart anomalies, microcephaly, cataract, blindness

THIS IS CALL CONGENITAL RUBELLA SYNDROME

orthomyxo and paramyxo-respiratory syncytial virus (RSV)31

1.lower resp tract disease in infants and youngchildren

2.common cold like

3.febrile bronchiolitis

4.bronchitis

5.pneumonia

orthomyxo and paramyxo-parainfluenza viruses29

1.lower resp. tract disease

2.mild fever

3.rhinitis

4.bronchitis

5.spasmodic laryagotracheitis(croap)

6.pneumonia

7.mumps

orthomyxo and paramyxo-influenza viruses27

cellular destruction

desquamation of superficial mucosa

viraemia is rare

1.chills

2.malaise

3.fever

4.muscle pain(myalgia)

5.resp. syndrome-rhinitis,pharyngitis

6.pneumonia

picornavirus-rhinovirus26

1.acute rhinitis

2.otitis media by 2ry infection

3.sinusitis by 2ry infection

4.bronchitis by 2ry infection

5.bronchopneumonia by 2ry infection

picornavirus-poliovirus23

poliomyelitis

a) inapparant infection

b) abortive infection

c) aeptic meningitis ( non paralytic poliomyelitis)

d) paralytic poliomyelitis

enter0coccus enterococcus faecalis enterococcus faecium

character

antimicrobial suscepblity

streptococcus pneumoniae (pneumococci)

morphology

culture

virulence factors

antimicrobial suscepbility

prevention

viridans streptococci

treatment and prevention

streptococcus agalacticae

prevention

streptococcus pyogenes

virulence factors and pathogenesis

streptococcus pyogenes infections

post streptococcal sequelae

treatment and prevention

staphylococcus saprophyticus

sakit taya

staphylococcus epidermidis

sikit sangat

staphylococcus aureus

virulence factor and pathogenesis

prevention and control

treatment and antibiotic suscepbilities

adenoviruses50

resp disease

eye infections

GIT disease

CNS infection

genitourinary tract infections

hepatitis pneumonia and disseminated disease

human parvovirus-parvovirus b19-

erythema infectiosum transient aplastic crisis foetal hydrops foetal loss chronic anaemia leukopenia thrombocytopenia

Human papillomavirus

malignant tumor non melanoma skin cancer plantar warts in the sole of the feet common warts in hands and arms apidermodysplasia may change to carcinoma condyloma acuminata

human parvoviruse-papovavirus-polyomavirus53-

progressive multifocal leukoencephalopathy (pml)...haemorrhage UTI

pox virus-molluscum contagiosum virus 54

wart like benign tumor

retrovirus-HIV16

acute HIV infection(acute retroviral syndrome)

-the blood contain many viral particles that spread throughout the body

- ip is 2-4 weeks

- suffer an acute flu-like or infectiousmononucleosis-like illness

- the most common symptoms are fever, maculopapular rash, oral ulcers, lymphadenopathy, arthralgia, pharyngitis, malaise,weight loss, aseptic meningitis and myalgia

-


AIDS(explain)

hepatitis E15

1.disceminated intravascular coagulation especially in pregnant females

hepatitis D14

1.acute hepatitis

2.acute exacerbation

hepatitis B10

1.hepatic dysfunction

2.serum sickness(vash,urticaria,polyarthragia)

3.vasculitis

4.glomerulonephritis

5.malaria

6.anorexia

7.jaundice

8.nausea

9.vomiting

10.abd. pain

11.skin rashes

12.joint paints

13.arthritis

14.enlarged liver + tenden

15.hepatic ferilure

16.cronic active hepatitis

17.cirrhosis

18.liver failure

19.death

20.hepatocellular ceranoma

hepatitis A9

1.hepatitis

2.generalized gostrointestinal symptom

3.fever,

4.nausea,

5.vomiting,

6.anorexia.

HEPATITIS

1.Microbial causes

viral:

a) 1ry target via oral: hepatitis A E
b) 1ry target via parenteral : hepatitis B C D G
c) 2ry taget via parenteral : yellow fever virus, Epstein Barr virus and cytomegalovirus

bacteria:

a)coxiella burnetii
b)Leptospira interrogans

fungal:

a) ergot poisoning
b) aflatoxin: aspergillus flavus mycotoxin

2.other causes

1. Autoimmunehapatitis

2. SLE

3.Drugs

4. Toxins

Food borne illnesses and food poisoning

a)staph aureus

AF: Carbohydrate rich food e.g : cake, pasta and koskosi
Protein rich food: milk and its products

IP: very short 1-6hrs

SS: sever vomiting and diarrhoea but no fever

DR: 24-48hrs

LT: stools

b)salmonella enteritidis and S.typhimurium

AF : raw and undercooked eggs
contaminated poultry

IP: 8-48 hrs

SS: Sever diarrhoea, fever and abd cramps

DR: 4days or more

LT


c)clostridium perfringens

AF: cooked meat stored at the inappropriate temperature

IP: 8-24 hrs

SS: Diarrhoea and abd cramps

DR: 24 hrs

LT:


d)clostridium botulinum

AF: Canned food, sausage, and salted fish

IP: 12-72hrs

SS: Diplopia, blurred vision, and bulbar weakness;paralysis

DR: Variable ( days to months)
LT



e)bacillus cereus

e1)emetic form

AF: improperly refrigerated cooked or fried rice

IP: 1-6hrs

SS: vomiting and abd cramps

DR: 24hrs

LT:


e2) diarrhoeal form

AF: meat

IP: 6-24 hrs

SS: diarrhoea and abd cramps

DR: 24-48hrs

LT:


f)listeria monocytogenes

AF: fresh soft cheese
ready eat to meat

IP: 9-48hrs

SS: diarrhoea and abd cramps

DR: 24-48hrs

LT:

g)vibrio parahaemolyticus

AF: undercooked or raw seafood, such as fish , shellfish

IP: 2-48hrs

SS: watery diarrhoea, abd cramps, vomiting

DR: 2-5 days

LT

MICROBIAL DISEASES OF THE GASTROINTESTINAL TRACT

1.BACTERIAL

-Chronic gastritis and peptic ulcer caused by helicobacter pylori

-Noninvasive bacterial gastroenteritis

causes:clostridium perfringens
enterotoxigenic escherichia coli
bacillus cereus
clostridium difficile
vibrio cholerae

-Invasive bacterial gastroenteritis
causes:salmonella
shigellaspecies
campylobacter and acrobacter
enterohemorrhagic
listeria monocytogenes
vibrio parahaemolyticus
yersinia anterocolitica
aeromonas

d) Ingestion of preformed bacterial toxins presenting with gastronitestinal tract symptoms with vomiting as primary symptom; diarrhoea may alse be present

e) Ingestion of preformed nacterial toxins presenting with neurological manifestations

f) Intestinal infection presenting with systemic illnesses

2.VIRAL GASTROENTERITIS
-viral gastroenteritis
rotavirus
norwalk virus
astroviruses
adenovirus

-viral infection of salivary glands and pancreas by:
Mumps virus
Human Herpes Virus 7


3.FUNGAL DISEASES
-ergot posioning
-mushroom poisoning
-aflatoxin poisoning ( aspergillus flavus mycotoxin)
-candidiasis

URINARY TRACT INFECTIONS

-Escherichia coli
-Enterococcus faecalis
-Staphylococcus saprophyticus
-Proteus mirabilis, klebsiella pneumoniae, and other enterobacteriacae
-Pseudomonas aeruginosa
-Staphylococcus aureus
-Coagulase negaive staphylococcus other than S. saprophyticus
-Mycobacterium tuberculosis
-Adenoviruses
- candida Albicans

Urethritis

-Gonococcal urethritis-Neisseria Gonorrhoea

-Nongenoccal urethritis
a) chlamydia trachomatis
b) ureaplasma urealyticum
c) mycoplasma hominis
d) trichomonas vaginalis

-pyogenic bacteria
a) e coli
b) staph
c) strep


-intrameatal warts by human papilloma virus

-intrameatal ulcers by herpes simplex virus

-intrameatal chancre

-adenovirus

PYREXIA OF UNDETERMINED ORIGIN(PUO)

Major causes of PUO
1. Infections
2. Neoplasms
3. Autoimmune diseases as systemic lupus and rheumatic fever
4. Drug induced fever
5. Granulomatous disease

Infective causes of PUO

A- Non specific causes:


B-Specific causes

bacteria

-tuberculosis
-leptospirosis
-typhoid
-relapsing fever
-brucellosis
-Q fever
-Typhus
-Nocardiosis

virus

-hepatitis A or B
-yellow fever
-cytomegalovirus
-HIV infection AIDS
-Lassa fever
- Infectious mononucleosis

fungi

-Cryptococcis
-Histoplasmosis
-Candidiasis
-Aspergillosis
-Penumocystis

INFECTIVE ENDOCARDITIS

-viridans streptococci
-coagulase negative staphylococci
-streptococcus pyogenes
-staphylococcus aureus
-enterococcus species
-haemophilus species
-coxiella burnetii

CONJUNCTIVITIS

Bacteria

-S pneumoniae
-Haemophilus aegyptius
-Moraxella lacunata
-Chlamydia trachomatis
-Staph aureus causes sticky eyes in neonates
-N. gonorhhoaea causes ophthalmia neonatorum
-Pseudomonas aeruginosa: following trauma to the eye or presence of foreign bodies or operations

Virus

-Adenoviruses
-Herpes simplex
-Enterovirus groups: Coxsackieviruses A, Enterovirus type 70

Fungus

-Candida and Aspergillus species are rare causes of corneal ulcers with serious complications.

Atypical pneumonia

-Mycoplasma pneumoniae
-Chlamydophila pneumoniae
-Chlamydophila psittaci
-Legionella pneumophila
-Coxiella burnetii (Q fever)

-Pneumocystis jeroveci

-Parainfluenza viruses
-Resp syncytial viruses
-Adenovirus

Viral pneumonia

-influenza A virus
-Resp syncytial virus

BACTERIAL PNEOMONIA

-streptococcus pneomoniae
-enterobacteriaceae
-mycoplasma pneumoniae
-legionella pneumophila
-chlamydophila pneumoniae
-chlamydophila psittaci
-S.aureus
-P.aeruginosa
-coxiella burnetti
-M.catarrhalis
-S.agalactiae
-mycobacterium tuberculosis

chlamydophila psittaci

psittacosis: atypical pneumonia

chlamydophila pneumoniae

1.atypical pneumonia

2.artherosclerosis

3.Heart disease

4. Adult asthma

5. Alzheimer's disease

chlamydia trachomatis

a) non sexually transmitted 1) ocular---trachoma
---inclusion conjunctivitis
2) neo natal pneumonia

b) genital tract infection1) non gonococcal urethritis
2) lymphogranuloma venereum







A,B,C : trachoma(blindness endemic in egypt)

D--->K : inclusion conjunctivitis
neonatal pneumonia
NGV urethritis

L-1,L-2,L-3 : LGV ( suppurative lymphadenopathy)

legionella pneumophila

1.Legionnaire's disease: atypical bacteria pneumonia

2.Pontiac fever: mild..flulike form that does not result in pneumonia

brucella

undulant fever

- systemic symptoms include fever, which is usually prolonged and intermittent ( undulant)
- chills
-weakness
- malaise
- body aches
-sweating
-headache
- may also involve liver, heart (endocarditis) and central nervous system ( meningitis)

* in its subacute form it may resemble tuberculosis

bordetella

whooping cough

-acute resp disease transmitted by droplet

-incubation period is 7-10days

-classical pertussis has 3 stages CATARRHAL, PAROXYSMAL, CONVALESCENT

-most prominent symptoms : sever paroxysmal cough

-complication: cyanosis, 2ry infections as pneumonia and otitis media

-encephalopathy is the most serious complication

Acute otitis mediae

-s.pneumonia
-H.influenzae
-moraxella catarrhalis
-S.pyogenes
-S.aureus
-some viruses such as respiratory syncytial virus.

Pharyngitis,tonsillitis and sore throat

~bacterial infections
-streeptococcus pyogenes
-vincent's angina
-mycoplasma pneumoniae
-corynebacterium diphtheriae

~fungal infections
-Candidiasis

~viral infections
-Adenoviruses ( the most common viral cause)
-Rhinoviruses
-Coronaviruses
-Parainfluenza viruses
-Influenza viruses
-Enteroviruses groups: Coxsackieviruses A (herpangina)
-Herpesviruses (rare): Varicella zoster virus (VZV), Epstein Barr virus (EBV), cytomegalovirus (CMV) and herpes simplex virus (HSV-1)

Fungal meningitis

1 Cryptococcus neoformans
2 Coccidiodes imitis

Viral meningitis

1.enteroviruses:poliovirus(rare due to immunization),coxsackieviruses A,coxsackieviruses B and anterovirus type 71

2.herpes simplex virus type 2(HSV-2)

3.adenoviruses

Bacterial meningitis

a)common causes

1.neisseria meningitis
2.haemophilus influenzae type b(HIB)
3.Streptococcus pneumoniae(pneumococcal meningitis)

b)mycobacterium tuberculosis(pneumococcal meningitis)

c)less common causes

1.listeria monocytogenes
2.staphylococcus species
3.streptococcus species
4.gram-negative enteric bacilli
5.pseudomonas aeruginosa
6.spirochetes:leptospira interrorgans(weil's diseases),treponema pallidum(syphilitic meningitis in secondary syphilis and neurosyphilis in tertiary syphilis) and borrelia burgdorferi(lyme disease)

d)neonatal meningitis

1.streptococcus agalactiae
2.escherichia coli
3.listeria monocytogenes
4.gram-negative enteric bacilli including k.pneumoniae and citrobacter spp.

mycoplasma hominis, mycoplasma genitalium, ureaplasma urealyticum.

non gonococal urethritis

neonatal sepsis

acute pyelonephritis

septic arthritis

mycoplasma pneumoniae

1.atypical pneumoniae

2.bronchopneumonia

3.acute pharyngitis

4.anemia

5.aeptic arthritis

coxiella burnetii

Q fever

1. acute Q fever: (a) atypical pneumonia
(b) hepatitis
(c) meningoencephalitis
(d) myocarditis, pericarditis

2.chronic Q fever: (a) endocarditis
(b) prolonged fever
(c) osteomyelitis
(d) hepatitis

orientia tsutsugamushi

scrub thyphus

ricketsia conorii

Boutanneous fever

rickettsia akari

Rickettsialpox(USA)

rickettsia ricketsii

rickettsia ricketsii

rickettsia typhi

Murine typhus

rickettsia prowazekii

epidemic typhus

nocardia brasiliensis

actinomycetoma

nocardia astroides

1.pulmonary nocardiosis-bronchopneumonia

2.brain abscess

3.cutaneous nocardiosis-pustules, fever, and tender regional lymphadenitis

actinomyces israelii

1.cervicofacial infection-fece, neckand mandible are affected

2.chronic endometritis-intrauterine contraceptive devices

acinetobacter

nosocomial
-pneumonia
-UTI
-meningitis
-skin infection
-wound infection

community acquired
-pneumonia
-UTI

pseudomonas

community acquired
-folliculitis
-external ear infection
-eye infection
-osteomyelitis
-endocariditis

nosocomial
-resp tract infections
-UTI
-wound infection and septicaemia
-meningitis
-chronic lung infection in cystic fibrosis

L.doderlein

reponsible for vagInal acidic pH

L.acidophilus,

treat intestinal disturbance

L.odontolyticus,

dental caries

p.acne

acne vulgaris

Yersinia enterocolitica, Yersinia pseudotuberculosis

enteric disease

- mild diarrhoea
- acute appendicitis
- typhoid like septicaemia

non capsulated

1.pneumonia

2.bacteraemia

3.otitis media

4.sinusitis

capsulated haemophilus type B hiB

1.bacterial meningitis

2.epiglotitis

3.pericarditis

4.pneumonia

5.septic arthritis

6.osteomyelitis

7.facial cellulitis

8.bacteraemia

haemophilus aegyptius

1.acute mucopurulent conjunctivitis

2.brazilian purpuric fever

haemophilus ducreyi

chancroid

proteus mirabilis, proteus vulgaris

1.UTI

2.wound infection

3.abscess

4.resp infection

5.otitis media

6.pneumonia

7.septicaemia

8.meningitis

Yersinia pestis

plague

-Bubonic plague: Enlarged tender lymph nodes, fever, chills and prostration

-Septicaemic plague: Fever, chills, prostration, abd pain, shock and blleding into skin and organs

-Pneumonic plague: Fever, chills, coughand difficulty in breathing, shock and death if not treated early

Shigella: shigella dysenteriae, shigella flexneri, shigella boydis, shigella sonnei.

bacillary dysentery

- stools contain blood and mucous

-heavy inflammtion of the colonic mucosa

-pseudomembrane formation

salmonella typhi salmonella paratyphi A salmonella paratyphi B salmonella paratyphi C

typhoid fever

- generalized infection of reticuloendithelial system and intestinal lymphoid tissue accompanied by sustain fever and bacteraemia

- the typhoid tend to be severe while the paratyhphoid tend to be milder

- globally,the typhoid is more common than paratyphoid

- huma are the only erservoir either the patient or carrier
-transmitted through faecally contaminated food and water or person-to person contact

- the organism adhere to the mucosa of smalli netstine, then invades to the submucosl layer

- then invasion of macrophages

- then transported to lypmhatics and mesenteric lymph glands

- it disseminates to the blood stream

- phase of bacteraemia ( first week)

- at the same time uptake of the organism to liver and spleen take place where replication inside macrophages occur

- then transported to gall bladder to be excreted with bile into intestine

- ip is 10-14 days

- onset with fever malaise and headache is slow and insidious and vague

- complication is relapse, perforation of the bowel, haemoorhage from th ebowel

salmonella enteritidis salmonella typhimurium

food poisoning

- linked to food of animal andpoultry origins

- water or food contaminated with rat excreta can also transmit the infection

- all ages are affected

- the incidence is highest in infants

- accompanied by severe diarrhoea, fever and abd cramps

- ip is 8-48n hours

- disease last for 1 week or longer

- the organism replicate and invade the epithelial cells of small and large intestine ( not n macrophages ) leading to intestinal lesions and diarrhoea

-

acinetobacter

nosocomial
-pneumonia
-UTI
-meningitis
-skin infection
-wound infection may progress to septicaemia

community
-pneumonia
-UTI

pseudomonas

community acquired infection

-folliculitis
-external ear infections
-eye infections
-osteomyelitis
-endocarditis

nosocomial

-resp tract infection
-UTI
-wound infection and septicaemia
-meningitis
-chronic lung infection in cystic fibrosis

Citrobacter, Enterobacter and Serratia

similar with K pneumoniae

Klebsiella rhinoscleromatis

rhinoscleroma : a destructive granuloma of the noase and pharynx

Klebsiella ozaenae

atrophic rhinitis (ozena): a fetid, progressive atrophy of nasal mucosa

Klebsiella pneumoniae, Klebsiella oxytoca

1. UTI

2. Pneumonia

3. Wound and bloodstream infection with focal lesion (eg liver or lung abscesses)

4. Neonatal sepsis: septicaemia and meningitis in newborns and premature infants

Escherichia coli

1.UTI
a) community-acquired UTI
b) hospital acquired UTI

2.neonatal meningitis

3.pneumonia, sepsis, septicaemia, endotoxic shock

4.diarrhoea

a) Enterotoxigenic E coli- severe diarrhoea in infants and children and traveler's diarrhoea in adults

b) Enterohaemorrhagic E.coli- bloody diarrhoea, haemorrhagic colitis ( a disease similar to shigell dysentery), haemolytic uraemic syndrome (HUS)

c) Enteropathogenic E .coli- infantile diarrhoea

d) Enteroinvasive E.coli- disease identical to that caused by Shigella spp. but do not produce shiga toxin

e) Enteroaggregative E. coli- persistent diarrhoea in children

mycobacterium chelonae

disseminated nodular skin disease

mycobacterium abscesses

chronic lung diseases

post traumatic wound infections

abscesses

disseminated cutaneous diseases

nosocomial bacteraemia asssociated with contaminated hemodialysis equipment

mycobacterium ulcerans

buruli ulcers

mycobacetrium kansasii

chronic lung diseases

M. Intracellulare

pulmonary diseases, lymphadenitis in children

disseminated infection in AIDS

aeromonas hydrophila

bacteraemia and septicaemia

wound infection ( cellulitis, myonecrosis, ecythema gangrenosum)

gastroenteritis ( a watery diarrhoea and a dysenteric illness)

vibrio vulnificus

wound infection

fetal septicaemia

vibrio parahaemolyticus

watery diarrhoea

dysenteric syndrome

vibrio cholerae

cholera

- sever diarhoeal disease

- begin with an abrupt onset of massive watery diarrhoea

- several litres of fluid may besecreted within hours, leading to hypovolemic shock.

- the watery diarrhoea is pseckled with flakes of mucus and epithelial cells " rice water stools"and contains enormous numbers of vibrios.

-vomiting usually occurs

-

campylobacter jejuni ,campylobacter fetus, campylobacter upsaleinsis

1.campylobacter enteritis: diarrhoea maybe ild or severe may be watery or bloody

2.extraintestinal infection: reactive arthritis, bacteraemia, meningitis, pneumonia, abortion and acute cholecystitis

3.guillan barre syndrome: acute paralytic disease of peripheral nervous system.

helicobacter pylori

chronic gastritis

duodenal and gastric ulcer

mucosal atrophy

gastric carcinoma

gastric lymphoma

Mycobactreium Leprae

leprosy
.the exact mode of ytranmission os not known
.infection requires prolonged and closed contact with ptients
. chronic infectious disease that primarily affect cooler surface area of the body such as skin ear lobes
.usually some of irreversible nerve damage
.


a) Tuberculoid leprosy

- cell-mediated immune response predominates and form granulomas so destruct most of mycobacteria

- so only few remain in the tissue

- lesions are few and mainly in the hypopigmented maculo-anesthetic skin lesions

- spontaneous regression of tuberculid leprosy occur in 90 % of cases

b)Lepromatous leprosy

- cell-mediated immune response is depressed

- humoral response is dominating but not protective as the organism is intracellular

mycobacterium tuberculosis mycobacterium bovis mycobacterium africanum mycobacterium microti

tuberculosis

- mode of infection

- local lesion

- transient bacteraemic ( bacillaemic ) phase

- CMI response, activation of macrophages and granuloma formation

-the host patasite infection

fusobacterium

1.dental or brain abscesses

2.fusospirochaetal disease in the oral cavity

bacteroides fragilis

1.intra abdominal and soft tissue infection below the diaphragm

2.bacteraemia

3.infection of head and neck

clostridium difficile

pseudomembranous colitis

clostridium botulinum

botulism

(a) food-borne botulism

- spores wide spread in soil,contaminate vegetables and meat.

-when these fooa are canned without adequate sterilization, spores survive and germinate in the aerobic environment

- toxin is produced within the canned food and ingested preformed

- the highest-riskfoods are vegetables such as green beans and mushrooms, smoked and salted fish, commercially canned salmon

- toxin is activated by proteases in the gastric fluid and by gastric acidity

- toxin is absorbed in the intestineand is transported systemically via the bloodstream to reach the peripheral neuromuscular synapses

-toxin bind to the neurone

- it prevents the release of Ach across the synaptic cleft

- thus it produce paralysis of the motor system

- botulinum toxin is quick acting

- ip short 12hours

- once fixed it actions is very difficult to reverse with antitoxin treatment

- 1ry symptoms is weakness of flaccid paralysis.

- the cranial nerve are affected first ( blurred vision, inabiity to swallow, difficulty in speech)

- followed by a descending, symmetric paralysis of motornerves

- nausea and vomiting are not usuall prominent

- no fever is apparent

- death is caused by resp failure

(b) infant botulism

-result from germination of spores in the gastrointest tract

- occurs in infants between 2 weeks and 6 months of age

- the disease is characterized by constipation and weak sucking ability and generalized weakness

- almost all cases of the disease recover.

clostridium tetani

tetanus

- highly fatal

- mortality rates 40 % in adults and 40 % in neonates

- result from lacerations or smaall puncture wounds contaminated with its spores.

- ingestion of tetanus toxin does not produce the disease




Clinical forms
----unimmunized patients
----motherlack immunity
----inadequate immunize
----fully immunize

clostridium perfringens

1.gas gangrene

- poor prognosis

-fatal outcome

-infected muscle is discoloured ( purple mottling) and oedematous and a foul smelling exudate and gas bubble which cause crepitation

2.food poisoning

- result from ingestion of large number of organism in contaminated food usually meat or meat products

- incubtion period is 8-24 hours

- symptoms include diarrhoea , cramps, and abd pain

- lasts for 24 hours

- no specific treatment

- only fluid therapy to correct the electrolyte imbalance

3.faecal pollution of water

bacillus cereus

food poisoning

(a) short incubation or emetic form

ip

character

similar

associated with?

(b) long incubation or diarrhoeal form

ip

character

similar

associated with?

bacillus anthracis

anthrax

1.cutaneous anthrax:

-handling infected material

-spores from the soil or an infected or dead animal enter through a cut abrasion

- the spores germinate and vegetative cells multiply locally forming a small papule which change rapidly to a vesicle than a pustule and finally to a necrotic ulcer whch blakens to form charactersitic eschar

- the lesion is painless and surrounded by marked oedema

- untreated case may develop fatal fulminating septicaemia

2.intestinal anthrax

- from eating infected meat

3. pulmonary anthrax

- from inhaling spore-laden dust

-