Ch 12 13 14 micro

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Gastrointestional system

2nd most common site of infection

How does flora prevent infection?

by competing with pathogens

Oral cavity

has most species

Stomach

has few bacteria because of acid

Helicobcter pylori

gram neg- microaerophillic, spiral shaped- motile w/ flagella- 30-50% is colonized with it.

What burrows into mucosa of stomach to find neutral pH?

H. pylori

small intestine

bacteria get washed out by pancreatic juice and bile- gram + lactobacilli- metabolize compunds that humans cannot.

Enterococcus faecalis

duodenum

illieum

enteric rods and bacteroides

20% of bacteria is

feces

Large intestine

is holding tank for bacteria that help in digestion-slow flow rate-high bacteria colonization-bacteroids & bifidobacteria

Bacteria found in large intestine

enteric rods, strep, clostridia and lactobacilli

dental plaque

biofilm

Caries=

cavities

gingivitis

inflammation of gums

overpopulation of normal flora and causes cavities

fusobacteria and actinomyces

gingivitis

bleeding of gums and inflammation

periodontitis

chronic

acute necrotizing ulcerative gingivitis

painful chewing

risk factors for periodontal disease

smoking, genetic predispotion, pregnancy, puberty, stress, medication, diabetes, poor nutrition

Periodontal disease can lead to?

decay, toothloss and systemic infection

gastroenteritis

inflammation of stomach and intestine caused by microorganism or ingestion of toxin- stomach flu

gastroenteritis is caused by

contaminated food or water, contact w infected person, unwashed hands, dirty food utensils, and contaminated work space. ingestion of bacterial toxins

most common cause of foodborne illness

bacteria and toxins

How bacterial infections come about

pathogen enters gi tract, adheres and multiplies

bacterial intoxication

toxins produced by bacteria

Helicobacter peptic ulcer

transmitted via food, water, kissing- weightloss, poor appetite, burping, nausea, vomiting- antibiotics, h2 blockers, proton pump, & stomach lining protector drug

salmonellosis

salmonella- enterobacteriacae family- faculative anerobe, rod, gram-neg, non sporing-typhoid fever, food born illness- diarrhea, fever, cramps- contaminated or uncooked food.5-7 days

thyphoid fever

caused by salmonella enterrica-serotype typhi-rod, gram neg, flagella-contaminated food or water-high fever 103-104, headache, nausea, pain, diarrhea, cough, constipation.

enteric fever

parathyphoid fever- milder

shigellosis

bacillialy dysentry- in humans and monkeys- gram neg, non sporing, rod shaped- produces shiga toxin- destroys tissue- dysentry- febrile sezures

4 species of shigella

boydii, dysenteriae, flexneri, sonnei(most common)

camplyobacteriosis

camplybacter jejuni- C. fetus & C. coli- vibroid or helical- gram neg- motile- microerophilles- raw poultry- raw milk, nonchlorinated water

C. jejuni

leading cause of diarrhea in US

Escherichia spp. gastroenteritis

E. Coli- pathogen or normal synthesizes vitamins

enterotoxic E. coli(ETEC)

diarrhea- produce toxins- fimbrae

enteroinvasive E. coli (EIEC)

dysentry-no toxins- allow adherance to intestinal epithelium and disrupts microvilli

enteropathic E. coli (EPEC)

no toxins- shigells

enteroaggregative E. coli (EAggEC)

ST toxin, UTI- colonizes small intestine

enterohemorrhagic E. coli (EHEC)

produces enterotoxins

yersiniosis

yersinia enterocolitica- gram-neg, fac-anaerobic, rod

listeriosis

Listeria monocytogenes, gram +, non sporing rod, fac. anaerobic intracellular-can spread to CNS- spread to circulatory-11-70 days-20-30 % mortality

botulism

clostridium botulinum- NEURO TOXIN- Foodborne, infant, wound, and inhalation

Botulism symptoms

blurred vision, dry mouth, dizzy, constipation, respiratory paralysis

Staph intoxication

in flora of nose, staph aureus (no spores), heat resistant, high osmotic resistance, high salt concentration

bacillus intoxication

bacillus cereus- gram +, spore forming, aerobic, produce enterotoxins

diarrheal type of bacillus intoxication

start 4-16 hours- last 12-24 hours

Emetic type of bacillus intoxication

start 30 min -6 hrs-vomiting

cholera

vibrio cholerae- watery diarrhea, vomit, leg cramps- gram neg- fac anaerobe- vibroid or rod- chloratoxin and enterotoxin

Rotavirus

children- 55,000 hosp. 3-8 days

Astroviruses and calciviruses

+ sense, ssRNA group iv- winter animals, and malaise 5 days

norovirus

ssRNA nonenveloped-3 days to 2 weeks- contagious

Adenovirus

group 1, dsDNA, resp, conj, GI, UTI-type 40 and 41 group f

hepatitus

A & E- HAV- hygene and is common; HEV- RARE

oral candida

thrush

Candidasis

candida albicans- flora- illness and medications cause change- antibiotic, birth control and steroids, diabetes, HIV and cancer

Aspergillosis

mold- Aspergillus flavus- corn and peanuts- produces aflatoxin- causes hepatitus, immunosupression, and helptocellular carcinoma- abcess in GI tract- systemic

Ergotism

fungus- claviceps purpures- produces alkaloids- hallucinations, GI upset, gangrene, st anthonys fire (pain in limbs)

St. Anthonys fire

pain in limbs from ergotism

Giardiosis

Giardialamblia or G. intestinalis- greasy stools, flatuence, cramps, nausea- 1-2 weeks after infection, last 2-6 weeks

Balantidium coli

largest protozoan parasite of humans, pigs and monkeys- fecal/oral transmission- watery stools, anorexia, nausea and pain- tetracycline to treat and metronidazole and todoqunol

Entameoba histolytica (Amebiosis)

100k annual mortality- water containing cysts or fecal oral route- no animal reservoir- acute amoebic colitis

Cryptosporidiosis

cryptosporidium- fecal-oral route- uncooked meat- water- resistant to chlorine (swimming pools)- most common water born in US.

Taeniasis

tapeworm infection

Taenia sagmata

bat

Taenia solium

pig

Pinworm

'seatworm'- enterobius vermicularus-nematode rectum-most common worm infection in US.

What meds are used to treat pin worms

mebendazole or pyrantal pamoate

Ascariasis

Ascaris lumbricoides- asymptomatic- most common worldwide worm infection- fruits and veggies- surgery for heavy infestation- treat: albendazole & pyratel panote, and mebanzote

Hookworm infection

necaturiasis- dogs, cats, and humans- adult attaches to villi of intestine and sucks blood- heavy infection- anemia

2 hookworm infections in humans

Ancylostoma duodenate and Necator americanus

CNS

Brain and spinal cord

PNS

12 pairs of cranial nerves, 31 pairs of spinal nerves, ganglia, sensory receptors

brain and spinal cord are covered w?

meninges

Meninges consist of?

3 membranes- outer, middle, and inner

duramatter

outer

arachnoid

middle

piamater

inner

Subarachtoid space

between arachnoid and pia- contains CSF

Cerebrospinal fluid

circulates brain ventricles, central canal of spinal cord and subarachoid, low level of compliment proteins, bacteria in CSF can multiply w/ little immune response

meningitis

inflammation of the meninges- caused my microorganisms or injury- bacteria, virus, fungi and protozoans

aseptic meningitis

is viral infection

during CNS infection (meningitis)...

increase in lymphocytes, monocytes, and proteins.CSF remains clear

During bacterial infection of meningitis...

rapid increase in granulocytes and proteins- CSF becomes trubid

blood-brain barrier

barrier between nervous tissue and blood- help CNS resist infection

Chloramphenicol

lipid soluable antibiotic- can enter brain

CNS invasion

inflammation of brain alters blood-brain barrier and allows drugs in- lymphatic and bloodstream

encephalitis

inflammation of the brain

meningioencephalltis

brain and meninges

bacterial meningitis

1-2 days incub.- initial symp- nausea, vomit, stiff neck, fever headache-secondary: confusion, sleepiness, light sensitive, coma- less common, more severe.

Treatment of bacterial meningitis

penacillin G, ampicillin, amoxicillin, chloramphenicol, lefotaxime, vanc and ceftriaxone

Most common cause of bacterial meningitis

Strep. pneumoniae and Neisseria meningitis

Haemophilus influenza

used to be most common cause of bact. meningitis

E. coli and Kleibsiella normally causes meningitis due to?

head injury, brain or spinal injury, sepsis, or nonsocomial infection

Meningococcal meningitis

Neisseria meningitis- gram neg aerobic diplococcus- 5 serotypes: A,B,C,Y,W

Neisseria meningitis disease info:

spread resp or person 2 person- incub. 1-3 days- sore throat, headache, drowsiness, fever, stiffneck, photosensitivity- hemorrhagic skin rash= septicemia- can cause amputation

Haemophilus influenzae meningitis

H. influenza, gram neg, coccobacillus, normal flora of throat-can enter blood stream cause pneumonia, otis media, epiglotidis, meningitis-Resp droplet- IV antibiotics & steroids- 6 serotypes by their capsular polysaccharide.

H. influenza in children

Capsulated strain b= Hib

Pheumococcal meningitis

most common- streptococcus pneumoniae- gram +, encapsulated faculative anaerobic diplcoccus- 90 serotypes- vaccine for high risk- immune response against capsular serotype

pneumonicocci can also cause?

otitis media- complication include mustoidis and meningitis

Listeria meningitis

listeria monocytogenes- gram + coccobacillus-foodborne illness-fatal-4 days- from blood stream to CNS

Listeria meningitis symptoms

fever, personality changes, uncoordinated movement, seizures, conciousness, tremors

listeria in pregnancy

microphages hiding from immune system can cross placenta-early onset:infected during pregnancy- late onset: infect during childbirth- treated w/ antibiotics

Tetanus

acute and fatal, prolonged contracted skeletal muscles caused by tetanoplasmic

C. tetani

produces neuro toxin(exotoxin)- gram + rod anaerobic spore- toxins are what spreads it.

local tetanus

persistant contractions at site of injury- uncommon, mild, subsides

cephalic tetanus

rare, C.tetani in middle ear, head injury- cranial nerves

Generalized tetanus

most common, lock jaw, stiff neck, diff. swallowing, calf and pectoral spasms

Neonatal tetanus

newborns, umbilical stump- rare in developed countries

Botulism

C.botulism, gram +, anaerobic, spore forming rod. produces neurotoxin- 7 serotypes A-G-A,B,E,F= human

Toxin A

most virulent- death if food is even tasted-60-70% mortality- CA, WA, CO, OR, NM

Toxin B

Europe and E. US - 25% mortality

Toxin E

Clostridium in marine sediments- seafood- Pacific NW, Alaska and great lakes.

Toxin F

C. baratii- infant botulism- also treats torticollis

Transmission of botulism

Toxin enters body, toxin binds to nerve endings @ neuromuscluar junction- stops release ACH, inhibits- fOODBORNE, infant, wound, inhalation

Symptoms of botulism

muscle weakness, dry mouth, diff swallowing, blurred vision, slurred speech, vomit and diarrhea, drooping eyelids

Leprosy

hansens disease-Mycobacteria leprae- gram +, acid fast, pleomorphic, intracellular- aerobic bacillus- waxy coating- skin, PNS, mucous membranes: nose, throat, eyes

Paucibacillary

tuberculoid- hypopigmented, PNS damage

Multibacilliary

lepromatous-more virulent- symmetric visions, nodules, plaques, thickened dermis

Conjunctivitis

pinkeye- inflammation of transparent membrane that lines eyelid and eyeball- redness, itchy, roughness, discharge, teary

Bacteria that causes conjunctivitis

strep. pneumoniae, H.influenza, s. aureus, H.spp

Post polio syndrome

symptoms 30-40 years after polio

Viral meningitis

aseptic meningitis- mosquitos- no treatment, runs course-bulging of fontanel in infants

Poliomyelitis

poliovirus- non enveloped ssRNA-

Abortive poliomyelitis

asymtomatic- 95%

Paralytic Poliomyelitis

1%- enters CNS- muscle paralysis-> death

Rabies

zoonotic- ssRNA, bullet shaped-causes encephalitis- saliva- fatigue, muscle aches, anxiety, irritability, insomnia, headache, nausea, vomiting and abd pain.

PEP- rabies treatment

Post exposure propilaxis- 5 doses over 28 days

Arboviral encephalitis

biological vector-encephalitis- west nile virus

EEE

easter equine enceph.-human, horse, bird

WEE

can be fatal- high fever, headache, drowsy, irritable, nausea, vomit, confusion and coma-

SLE

St Louis Enceph- Flavivirus- aseptic meningitis or encephalitis

LAC

Lacrosse enceph.- rare- children- midwest

WNV

west nile- Africa, Asia- rash, headache, fever, diarrhea

West Nile poliomyelitis

inflamation of spinal cord

Fungal Infections

opportunistic

Cryptococcoisis neoformans

encapsulated yeast- inhalation or wound

Cryptococcal meningitis

immunocompromised- head ache, vomit, photophobia, blurry vision, stiff neck, seizure, confusion, coma

Cerebral toxoplasmosis

toxoplasmagondii-obligate intracellular- undercooked meat- speech, seizures, confusion, lethargy

Trypanosomiasis

Hemoflagellates

African trypanosomiasis

sleeping sickness

Prion disease

TSE- transmibble spongiform encephal.- neurodegenerative disease, long incubation, always fatal, no cure-dementia, personality change, memory and brain funct.

Human disease

CJD- Degenerative brain disorder, sporadic, hereditary and acquired.

Variant-Creutzfeld Jacob (VCJD)

affects younger age- 29 yrs- foodborne by cattle (mad cow)

Gerstmann-Straussler-Scheinler (GSSS)

defective gene coding for PRNP protein- multicentric amyloid plaques in frontal lobe

Fatal familial insomnia

deteriorate motor functions- inherited or sporatic

Kuru

endemic foretribe in New Guinea-cannibalism

Animal prion disease

Bovine spongiform ecephalopathy: madcow- chronic wasting disease, scrapie, feline SE, ungulate SE

Circulatory

cardiovascular: heart, blood and blood vessels and lymphatic: lymph, lymphatic tissue, vessels and organs- returns excess tissue fluid to cardiovascular system (direct acess)

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