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chronic, hard, nontender swelling that drains pus. trauma situations (abscessed tooth/appendicitis/wounds) follows sinus tracts.
1. hard, painless chancre
2. maculopapular rash on palms and soles, flu-like sxs, photophobia, condylomata lata. dissemination --> meningitis, nephritis.
3. GUMMAS, tabes, paresis, cardiovascular lesions.
Congenital: Hutchingson's incisors and mulberry molars
Borrelia burgdorferi (Lyme dz)
1. target-like, painless rash "erythema migrans," flu-like sxs.
2. meningitis, carditis, MSK pn, eye problems, BELL'S PALSY
latent up to 3 decades
3. arthritis in large joints
infectious phase: conjunctivitis/RED EYES + flu sxs
immune phase (high IgM): aseptic meningitis/jaundice (Weil's dz) and renal involvement. Find organisms in urine now.
Chlamydia trachomatis A-C
trachoma (conjunctivitis and blindness); caused by finger/fomite to eye. scarring causes eyelashes to turn inward --> vascularization of cornea
Chlamydia trachomatis D-K
urethritis/epididymitis/salpingitis, neonatal conjunctivitis and pneumonia. non-ciliated epithelial cells on mucous mem. of urethra, cervix, endometrium, rectum
Chlamydia trachomatis L1-L3
lesions on genitalia, becomes systemic, replicate in mononuclear phagocytes, buboes rupture to form abscesses. Reactive polyarthritis.
congestion and coughing, infected alveolar macrophages, spread to lungs, blood, spleen, liver and heart. hung out w/ birds
Rickettsia rickettsii (Rocky mountain spotted fever)
macule-->petechial rash begins on hands and feet, move to trunk. Vasculitis, edema, hemorrhage, DIC.
Coxiella burnetii (Q fever)
inhaled animal poo --> fever, HA, chills, NO RASH!, can complicate w/ pneumonia and granuloma in lungs, liver, bone marrow, and spleen. Chronic inf --> subacute bacterial endocarditis. Biphasic.
Rickettsia prowazekii (Epidemic typhus)
sudden onset of flu-like sxs, maculopapular-->petechial rash begins on trunk and spreads peripherally, spares face, palms and soles. complicate as meningoencephalitis. May recur following latency (Brill-Zinsser dz). spread by louse.
Rickettsia tsutsugamushi (Scrub typhus)
sudden onset of flu-like sxs, maculopapular-->petechial rash begins on trunk and spreads peripherally, spares face, palms and soles. complicate as meningoencephalitis. transmitted by chiggers & mites.
fever, HA, myalgia, leukopenia (low WBC) and increased liver enzymes. infected granulocytes. transmitted by ixodes tick.
Ehrlichia chaffeensis (HME)
fever, HA, myalgia, leukopenia (low WBC) and increased liver enzymes. infected monocytes and macrophages (morulae in cytoplasm). transmitted by lonestar tick.
dysentery (bloody, mucus-containing diarrhea), lower abdominal pain, farting, and liver abscess. aspiration of liver abscess: brown-yellow pus w/ "anchovy paste" consistency. intestinal flask-shaped ulcer. granulomatous lesion "ameboma" may form in cecal or rectosigmoid areas of colon. (not cancer)
blackwater fever (dark urine from kidney damage), occlusion of capillaries, hemorrhage and necrosis, esp. in brain and kidney. infects RBCs of all ages. Chloroquine resistance.
resembles mono, Congenital form (occurs only if mom is infected during pregnancy): chorioretinitis, intracranial calcification, blindness, abortion, stillbirth, encephalitis.
sudden onset of fever, non-productive cough, dyspnea, tachypnea, rales, ronchi, "ground-glass" infiltrates bilaterally, diffuse interstitial pneumonia. cysts in lungs, frothy exudate.
Trypanosoma cruzi (Chagas' disease)
acute phase: facial edema and nodule near bite, coupled w/ lymphadenopathy and hepatosplenomegaly. Unilateral palpebral swelling "Romana's sign"
chronic phase: myocarditis, megacolon, megaesophagus. death by cardiac arrhythmias/failure
low grade chronic course: indurated skin ulcer (chancre) at bite site. intermittent fever and enlarged post cervical lymph nodes, "Winterbottom's sign," encephalitis, tremors, slurred speech, coma
acute, rapidly progressive course: indurated skin ulcer (chancre) at bite site. intermittent fever and enlarged post cervical lymph nodes, "Winterbottom's sign," encephalitis, tremors, slurred speech, coma
Leishmania donovani (Kala-azar/visceral)
intermittent fever and weight loss. reticuloendothelial sys. (liver, spleen, BM) infection w/ amastigotes, hemorrhages, hyperpigmentation of skin
Leishmania tropica/mexicana/braziliensis (cutaneous)
granulomatous response, necrotic ulcer. Disfiguring granulomatous lesions: destroy nasal cartilage but not bone.
Taenia solium (cysticercosis)
in head: HA, vomiting, seizures, "space-occupying lesion," dead organisms release substances causing inflammation, calcify
in eyes: retinitis
liver granuloma, fibrosis --> portal hypertension, splenomegaly, prominent eosinophilia, death from ruptured esophageal varices
most asx, but some diarrhea. RECTAL PROLAPSE in severe infections, whitish worms on prolapsed mucosa. eggs in stool. no significant anemia
Usually asx, can cause malnutrition, pneumonia, and WORM BALL, obstruction of GI tract. oval egg w/ irregular surface in stool.
GI (small intestinal) bleed, anemia, "Ground itch," pruritic papule or vesicle at site of entry into skin
diarrhea, then 2 wks later: periorbital edema and eosinophilia. SUBCONJUNCTIVAL HEMORRHAGES, cardiac and CNS dz, ate home-prepared sausage
lung inf. usually asx, can disseminate --> granulomatous lesions can occur in almost any organ but most often in bones (osteomyelitis) and CNS (meningitis), erythema nodosum. Women in 3rd trimester!
often asx, can cause pneumonia. Small granulomas that heal via calcification, In AIDS pts: ulcerated lesions on tongue. Erythema nodosum. was hanging out near bird/bat droppings
infection via RT --> dissemination to form ulcerated granulomas in skin, bone, etc.
lesions in lungs, can disseminate --> oral mucous membranes and other organs
white patches in mouth, pseudomembrane, esophagitis, vaginitis, diaper rash. Complications: dissemination --> endocarditis, endophthalmitis, chronic mucocutaneous candidiasis, candidemia
lung infection is often asx or may produce pneumonia. In pts w/ reduced CMI, esp. AIDS, disseminates to CNS (Meningitis) and other organs. SubQ nodules often seen in disseminated dz. 1/2 pts w/ meningitis of this kind fail to show immunosuppression.
fungus ball in lungs, granulomas. asthmatic sxs, expectorate brownish plugs containing hyphae. Infections of skin, eyes, ears, etc.
DKA/burn/leukemia pts: bloody sputum and infiltrates w/ cavitation. invade tissue and grow in walls of blood vessels (sinuses, lungs, gut) --> infarction.
inflamed circular border containing papules and vesicles surrounding a clear area of normal skin. warm, humid area of body. contact w/ people or animals.
hypopigmented areas of skin (esp. on tanned skin in summer) itching and scaling, oily skin or working outside, hyperhidrosis.
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