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Systemic Infections

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Title: Systemic Infections


1
Chapter 27Systemic Infections
2
Organs of the Cardiovascular and Lymphatic Systems
Figure 27.1
3
Infections of the Heart
  • Carditis
  • inflammation of heart tissue
  • endocarditis--epithelial and connective (valves)
  • subacute bacterial endocarditis (?-hemolytic
    strep)
  • acute bacteria endocarditis (S. aureus and S.
    pyogenes)

4
Infections of the Heart
  • Myocarditis
  • cardiac muscles
  • Viral myocarditis
  • coxsackievirus
  • American Trypanosomiasis (Chagas disease)
  • Trypanosoma cruzi
  • animal and insect hosts
  • Pericarditis
  • membrane surrounding heart
  • usually viral
  • Streptococcus spp.
  • Staphylococcus spp.

5
Systemic Bacterial Infections
  • Plague
  • Yersinia pestis
  • bubonic
  • bubos--inflamed lymph nodes
  • septicemic plague
  • bloodborne
  • tissue necrosis
  • skin blackened
  • Black death
  • pneumonic plague
  • lung infection

6
Systemic Bacterial Infections
  • Tularemia
  • Francisella tularensis
  • vector deer fly in SW/wood tick NW and Midwest
  • direct contact ingest/handle, rabbits
  • highly virulent
  • ulceroglandular tularemia
  • small sore at entrance
  • swelling in surrounding lymph node
  • multiply in phagocytes
  • symptoms
  • high fever, chills, headache, possibly pneumonia

7
Systemic Bacterial Infections
  • Brucellosis
  • several Brucella species
  • domestic animals
  • Pasteurization
  • symptoms
  • undulating fever
  • disoriented

8
Systemic Bacterial Infections
  • Lymes Disease
  • Borrelia burgdorferi
  • Spirochete
  • tick born Ixodes species
  • animal reservoir
  • 1975 Lyme, Connecticut
  • cluster of pediatric arthritis
  • three phases
  • bulls eye rash--75 of cases
  • headache, stiff neck, muscle aches, fatigue
  • eventually arthritis

9
Systemic Bacterial Infections
  • Relapsing Fever
  • Borrelia spp.
  • Symptoms
  • sudden onset of fever, slowly subsides
  • week later, symptoms reappear
  • Antigenic variation
  • type-specific antibodies during fever
  • bacteria are cleared
  • alter surface antigens and reappear
  • Epidemic relapsing fever
  • Endemic relapsing fever

10
Systemic Bacterial Infections
  • Anthrax
  • Bacillus anthracis
  • spore former
  • three exotoxins
  • symptoms
  • domestic and wild animals
  • humans
  • cutaneous anthrax
  • respiratory anthrax
  • gastrointestinal anthrax

Figure 27.6
11
Systemic Bacterial Infections
  • Cat Scratch Disease
  • Bartonella bonselae
  • symptoms
  • swollen lymph gland
  • arm or groin
  • healing scratch marks on same limb

12
Systemic Bacterial Infections
  • Typhus
  • epidemic typhus
  • Rickettsia prowazekii
  • vector lice from human to human/crowded
    conditions
  • murine typhus
  • Rickettsia typhi
  • vector flea from mouse/rat, endemic
  • scrub typhus
  • Rickettsi tsutsugamushi
  • Asia and SW pacific
  • WWII and Vietnam War

13
Systemic Bacterial Infections
  • Rocky Mountain Spotted Fever
  • Rickettsia rickettsii
  • wood tick
  • dog tick
  • Lone Star tick
  • symptoms
  • spotty rash
  • abnormal clotting

Incidence of cases within the U.S.
Figure 27.7
14
Systemic Viral Infections
  • Yellow fever
  • RNA flavivirus
  • mosquito Aedes aegypti
  • symptoms
  • most--mild fever, headache, weakness
  • 20--sever fever, chills, headache, jaundice
  • reservoir
  • monkeys
  • prevention
  • vaccine

15
Systemic Viral Infections
  • Dengue fever
  • RNA flavivirus
  • mosquito Aedes aegypti
  • symptoms
  • high fever and headaches
  • rash and pain in the limbs
  • breakbone fever
  • apparent recovery--return of fever
  • supportive care
  • dengue hemorrhagic fever
  • children--bleeding and shock

16
Systemic Viral Infections
  • Infectious mononucleosis
  • Epstein-Barr virus (herpesvirus)
  • age 15-25, 90 adults seropositive
  • Pathogenesis
  • replication in URT
  • infection of B lymphocytes
  • virus-induced proliferation of B cells
  • T cell suppression response to turn off B cells
  • immune battling itself
  • Symptoms
  • sore throat, low-grade fever, enlarged lymph
    nodes
  • general fatigue/ 2-3 weeks/even month
  • Cancers associated with EBV
  • Nasopharyngeal carcinoma, Burkitts lymphoma

17
Systemic Viral Infections
  • Acquired immunodeficiency syndrome
  • Human immunodeficiency virus (HIV)
  • Virus binds receptor on CD4 TH cells

Figure 27.11
18
Systemic Viral Infections
  • HIV/AIDS
  • Transmission
  • sexual transmission
  • exposure to contaminated blood
  • mother to fetus
  • Treatment
  • HAART (highly active antiretroviral therapy)
  • long term survival
  • costly

19
Systemic Viral Infections
  • HIV infection
  • Acute phase
  • first weeks
  • viral replication
  • killing TH cells
  • Chronic phase
  • peripheral blood viral load decreases
  • TH continues decreasing
  • normal 800 /mm3
  • AIDS 200/ mm3

Figure 27.10
20
Systemic Viral Infection
  • Ebola hemorrhagic fever
  • filovirus--threadlike morphology
  • Pathogenesis
  • spread in blood and fluids
  • throughout blood, replication in many organs
  • focal necrosis liver, lymphatic, kidneys,
    gonads
  • central lesions
  • bleeding mucosa, abdomen, peridcardium vagina
  • shock, fever, delirium acute respiratory disorder
  • Potential vaccine (DNA and vector)

21
Systemic Protozoal Infection
  • Malaria
  • 100 million cases/year (1 million die)
  • tropical and subtropical
  • Plasmodium species (4 species)
  • different disease pathogenesis
  • Vector Anopheles mosquito

22
Systemic Protozoal Infection
  • Plasmodium Life cycle
  • mosquito infects sporozoites into blood
  • sporozoites reproduce asexually in liver
  • Merozoites enter red blood cells--asexual
    reproduce
  • some return to liver
  • some develop into male and female gametocytes
  • mosquito feeds and takes in gametocytes
  • sexual reproduction in mosquito

Figure 27.13
23
Systemic Protozoal Infection
  • Malaria
  • Symptoms
  • 2 weeks after infection
  • chills, fever, headaches, muscle ache
  • cycles with destruction of red cells--release of
    merozoites
  • Prevention
  • early attempts--control mosquito
  • drug therapy not as effective
  • vaccine research and testing
  • multiple stages of protozoa
  • slow and weak immunity

24
Systemic Protozoal Infection
  • Toxoplasmosis
  • Toxoplasma gondii
  • zoonosis
  • eating meat with cysts
  • heating kills cysts
  • Babisiosis
  • Babesia spp
  • zoonosis
  • tick vector

25
Systemic Helminthic Infections
  • Schistosomiasis
  • Schistosoma japonicum
  • blood flukes (flatworm)
  • complex life cycle
  • infection
  • lasts for decades
  • human proteins on surface
  • many worms in blood
  • granulomas

Figure 27.16
26
Systemic Helminthic Infections
  • Filariasis
  • nematodes
  • Wuchereria bancrofti and Brugia malayi
  • transmitted by mosquitoes
  • adult worm grows in lymph node
  • elephantiasis
  • swelling of limb or scrotum
  • worms block lymphatic circulation
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