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Infectious Diseases of the Cardiovascular and Lymphatic Systems

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Lyme Disease Borrelia burgdorferi. Rocky Mountain Spotted Fever - Rickettsia rickettsii ... Lyme Disease is caused by Borrelia burgdorferi ... Lyme Disease Vectors ... – PowerPoint PPT presentation

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Title: Infectious Diseases of the Cardiovascular and Lymphatic Systems


1
Infectious Diseases of the Cardiovascular and
Lymphatic Systems
2
The Cardiovascular System
  • Heart
  • Blood vessels
  • Lymphatics
  • Lymph nodes, spleen, MALT
  • RBC
  • WBC
  • Monocyte?Macrophage
  • T, B, NK lymphocytes

3
The Blood
  • Carries O2, CO2, nutrients
  • Cells plasma
  • Infectious agents in the blood
  • Bacteremia / viremia bacteria / viruses in
    blood
  • Septicemia growth of
  • bacteria in blood
  • Septic shock
  • ? endotoxin (LPS) release
  • ? macrophage cytokines
  • ? low blood pressure (leaky capillaries),
  • ? high fever

4
Cardiovascular System Defenses
  • Defensins - antimicrobial proteins in lysosomes
    of phagocytic cells
  • Neutrophils, antibodies, complement
  • Filtering function of Lymph Nodes
  • No normal flora
  • Transient flora ?
  • Infectious agents in blood are systemic

5
Selected Bacterial Infections of the Blood
  • Plague Yersinia pestis
  • Lyme Disease Borrelia burgdorferi
  • Rocky Mountain Spotted Fever
  • - Rickettsia rickettsii

6
Yersinia pestis
  • Cause of Plague
  • Gram negative rod
  • Grows in digestive tract of flea vector
  • Reservoir is rodents, prairie dogs
  • Endemic above 4,000 ft elevation in Arizona

7
The infection cycle of Yersinia pestis.
8
Animal Reservoirs United States
9
Plague in Arizona
10
Prairie Dog Plague, Flagstaff 2001
  • 99 colonies observed
  • 49 colonies experienced 99 mortality
    May-September 2001
  • Y. pestis confirmed as cause of die offs at 19
    colonies

11
Bubonic Plague
  • Transmitted by flea bite
  • Y. pestis enters blood and grows in macrophages
    in lymph nodes
  • Swollen lymph nodes are buboes

12
Plague
  • Septicemic plague
  • proliferation in blood
  • endotoxin shock
  • Pneumonic plague
  • lung infection
  • 100 mortality
  • spread by droplets
  • Curable with antibiotic
  • if diagnosed quickly

13
Lyme Disease
  • Primary Lesion
  • bulls-eye rash on skin
  • Secondary lesion
  • flu-like symptoms, neurological symptoms
  • Tertiary lesion
  • inflammation of large joints

14
Lyme Arthritis
  • Immune system Type III hypersensitivity to
  • ? persisting antigen
  • ? antigen-antibody
  • complexes
  • ? inflammation, tissue
  • damage by neutrophils
  • Treated with antibiotics

15
Lyme Disease is caused by Borrelia burgdorferi
  • Spirochetes are very narrow spiral-shaped
    bacteria
  • Gram negative
  • Motile

After Willy Burgdorfer
16
Lyme Disease Vectors
  • Tick vector bites infected reservoir (deer,
    mouse) and becomes infected transmits disease to
    humans through bites

17
Cycle of infection with B. burgdorferi
Disease emerged when humans moved into
tick/reservoir environment
18
Rocky Mountain Spotted Fever
  • Fever, chills, headache, muscle pain
  • Red ? black rash
  • Transmitted to
  • humans by tick bites
  • Now found mostly in
  • Eastern Atlantic states

19
Rickettsia rickettsii
  • Gram negative bacillus or coccobacillus
  • Obligate intracellular parasite

20
Rickettsia and Obligate Intracellular Parasitism
  • Bind to cell surface and are taken into
    endothelial cells by phagocytosis
  • Escape from phagosome into cytoplasm
  • Have ETC
  • Obtain nutrients, NAD and CoA from host
  • Cause capillaries to degrade

21
Vectors Wood Tick and Dog Tick
22
RMSF Epidemiology 1942-2002
23
Rocky Mountain Spotted Fever
  • Treatable with antibiotics
  • Diagnosed using fluorescent antibodies on tissue
    samples, PCR
  • 20 of untreated cases and 5-10 of treated cases
    are fatal

24
Some Virus Infections of the Cardiovascular System
  • Persistent Herpesviruses
  • Human herpes viruses 4,5,6,7,8 !
  • Viral hemorrhagic Fevers
  • Yellow Fever, Dengue Fever, Ebola, Lassa Fever
  • HIV

25
Virus Infections of the Cardiovascular System
  • Persistent Herpesviruses in lymphocytes
  • Human Herpes 4 Mononucleosis
  • (Epstein Barr virus) Mono Infectious Mono
  • Human Herpes 5 Cytomegalovirus
  • ( Cytomegalovirus) Inclusion Disease
  • Human Herpes 6 Roseola
  • Human Herpes 7 ?
  • Human Herpes 8 Kaposis Sarcoma (in AIDS
    patients)

26
Infectious mononucleosisInfects B lymphocytes -
viral latency in B lymphocytesA cause of Chronic
fatigue syndrome?Cytomegalovirus Inclusion
DiseaseNewborns, rarely. A cause of mental
retardation?Viral latency is in lymphocytes, and
kidney cells.Severe infection in
immunocompromised patient HIV Cancer and
transplant patients
27
Viral Hemorrhagic fevers
  • Viral infection Reservoir Location
  • Yellow fever Aedes agypti Cent Africa
    S. America
  • Dengue fever Aedes agypti World-wide T
    ropical
  • Ebola Fruit Bat Cent Africa
  • Lassa fever Rodent West Africa

28
Viral Hemorrhagic fevers
  • Capillary fragility and leakage
  • Disruption of the blood clotting system
  • Bleeding, Hemorrhage
  • Liver damage, Hepatitis
  • High Fatality rate

29
Human immunodeficiency virus (HIV)
  • Blood-Borne Viral infection
  • Infects helper T lymphocytes (CD4 receptor)
  • Acquired immunodeficiency syndrome
  • Long (Latent)
  • incubation period

30
HIV has specific glycoprotein receptors that bind
to CD4 receptors of T cells.
CD4 CRCX5
31
Four main stages of an HIV infection
32
Stages of an HIV infection
Antibody resistant variants and Neutralizing
antibody
33
Sources and routes of infection by HIV
Blood injection IV drug use
  • STD
  • MSM
  • Prostitution
  • Heterosexual

34
Some important secondary infections in AIDS
35
AIDS and Herpesviruses..an example Kaposis
Sarcoma .caused by Human Herpes 8
HHV-8 causes a mixed cell tumor of Lymphocytes,
fibroblasts, and blood vessels On the skin,
esophagus and many other sites
36
Nucleoside analogs and protease inhibitors are
effective therapies used to treat HIV infections.
37
HIV Transmission U.S. compared To the World
38
HIV/AIDS prevalence in the world
39
HIV/AIDS prevalence in the world
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