Cardiovascular and CNS Infections PDF

 What makes up the cardiovascular system? HEART BLOOD BLOOD VESSELS Lymphatic system Blood The heart pumps blood into _______________ connected via __________________ to ___________ whic...

 What makes up the cardiovascular system? HEART BLOOD BLOOD VESSELS Lymphatic system Blood The heart pumps blood into _______________ connected via __________________ to ___________ which carry blood back to the heart.  Atria Valves The heart wall is Major vessels composed of three layers Flow of blood through the heart  Begins when… à ______________________________________ is picked up Capillaries permeable Nodes à ________________________  SEPTICEMIA Fever, chills, vomiting, shortness of breath, malaise Can progress rapidly to SEPTIC SHOCK PATHOGENS, VIRULENCE and PATHOGENESIS Opportunistic normal microbiota or nosocomial Must have virulence factor(s) Gram-Negative: P. aeruginosa, N. meningitidis, E. coli Gram-Positive: S. aureus, S. pneumoniae, S. pyogenes Red Streaks Petechiae Inflamed lymph vessels visible under skin à _______________________ PATHOGENESIS Direct inoculation ENDOTOXIN (Lipid A) Leukocytes release Blood Clotting Complement cytokines Reactions (C3a)  DIAGNOSIS, TREATMENT and PREVENTION Based on signs and symptoms Culture à ___________________________________________ Prompt diagnosis and treatment is key to prevention Antimicrobial Drugs Intravenous Fluid Replacement  ENDOCARDITIS BICUSPID (MITRAL) Inflammation à roughed spots VALVE Breathing difficulty, tachycardia, murmurs Blood clots, stroke, destruction of valves TRICUSPID VALVE Opportunists: TREATMENT: antibacterial drugs Valve damage, heart failure, emboli  TULAREMIA Lesions, pus-filled lymph nodes, lymphangitis Cause: Francisella tularensis; Gram-negative Virulence: pili, capsule, endotoxin Portal of Entry Number of Cells Biting arthropod As few as 10 Inhalation 50 Ingestion 108 TREATMENT: Non β-lactam drugs Attenuated vaccine  PLAGUE BUBONIC PLAGUE PNEUMONIC PLAGUE ___________________ Lungs Inhalation Fever, chills, muscle pain Rapid Septicemia Fever, cough, difficulty breathing  PLAGUE...Yersinia pestis – ADHESINS, anti-phagocytic proteins Flea bite Blood/lymph DIC UNTREATED: Bubonic – 50 % Pneumonic – 100 % TREATMENT: Antibiotics, vaccines???  LYME DISEASE 1. Expanding Red Rash Headaches, stiff neck, swollen nodes 2. Neurological Symptoms 3. Severe Arthritis Can last for years Borrelia burgdorferi Uses manganese (not iron) Antigenic variants THE VECTOR: hard ticks 3 stages of development  LYME DISEASE Tick bite Spirochetes move through blood and lymph Accumulate in joints with antibodies DIGANOSIS: ELISA, Western Blot TREATMENT: Antibiotics, anti-inflammatory drugs Stopped vaccine use  INFECTIOUS MONONUCLEOSIS Sore throat, fever, enlarged nodes, fatigue PATHOGEN: HHV-4 or ___________________________________ Suppresses APOPTOSIS of infected B lymphocytes Transmission: saliva Pathogenesis: throat cells, salivary glands à blood à lymphocytes Cytotoxic T cell B Lymphocyte  INFECTIOUS MONONUCLEOSIS Age a determining factor in seriousness of disease Immature or efficient Care of mono patients: Relieve symptoms Burkitt’s lymphoma: chemotherapy, surgery to remove tumors  YELLOW FEVER “yellow jack” 1. EARLY STAGE 2. REMISSION 3. SEVERE STAGE: Delirium, coma, degeneration of liver, kidney, heart, massive hemorrhaging, high fever PATHOGEN: flavivirus genus 3-6 days No treatment, vaccine  DENGUE FEVER “breakbone fever” Two phases – 24 hour remission Fever, edema, Fever, rash severe pain Life-long immunity following recovery There isn’t ONE virus that causes dengue...there are FOUR Reinfection: Dengue Fever Dengue Hemorrhagic Fever No treatment...hopeful for a vaccine  AFRICAN VIRAL HEMORRHAGIC FEVERS Fatigue, dizziness, muscle pain Filoviridae Minor petechiae Hemorrhaging Death Ebola (Ebolavirus) – 2 to 21 d Marburg (Marburgvirus) – 5-10 d Hemorrhaging: malfunction of blood clotting system TREATMENT: replace lost fluids, electrolytes, blood  MALARIA Cyclical fever and chills, diarrhea, headache Anemia, weakness, fatigue, jaundice PATHOGEN: Plasmodium: P. ovale – mild; P. vivax – chronic P. malariae – serious; P. falciparum – fatal VIRULENCE FACTORS: Adhesins, toxins, enzyme Change body chemistry Anopheles Malaria resistance: hemoglobin mutations TREATMENT: Standard anti-malarials or combinations for drug resistance 1. EXOERYTHROCYTIC PHASE: Mosquito injects _____________________ Schizogony in liver 2. ERYTHROCYTIC CYCLE: RBCs infected and phagocytized _________________________ develop 3. SPOROGONIC PHASE: Mosquito feeds Fertilization produces _____________ Ruptures releasing __________________________  TOXOPLASMOSIS “toxo” > 80 % cases: asymptomatic Fever, headache, malaise, inflammation of lungs, liver, heart Confusion, spastic paralysis, blindness, encephalitis, death DANGERS: transplacental transfer INFECTION (Toxoplasma gondii): Ingestion of undercooked meat Contaminated soil Affects assigned-female more than assigned- male fetuses T. gondii  TOXOPLASMOSIS à oocysts shed in cat feces Ingested Sporozoites released Invade heart, tongue, diaphragm Proliferation forming pseudocysts – Dormant until consumed TREATMENT: Sulfonamides, clindamycin  CHAGAS’ DISEASE “American trypanosomiasis” Swelling Fatigue, fever, swollen lymph nodes Irregular heartbeat, fatal congestive heart failure INFECTION: Bite of a Trypanosoma cruzi infected “kissing bug” Infects macrophages and cardiac muscle  SCHISTOSOMIASIS 1. Larvae enter – Dermatitis ________________________________ 2. Females lay eggs in vessel walls 3. Granulomas 4. Trapped eggs die – calcify – leading to: Splenomegaly Heart failure Bladder cancer TREATMENT: Life Cycle: Praziquantel Schistosoma – blood fluke Vaccine?  STRUCTURES OF THE CENTRAL NERVOUS SYSTEM Composed of: brain and spinal cord cerebrum cerebellum Right H. brainstem  STRUCTURES OF THE CENTRAL NERVOUS SYSTEM BLOOD SUPPLY: vessels lie on top of pia mater Tightly joined cells: __________________________________________  STRUCTURES OF THE PERIPHERAL NERVOUS SYSTEM Nerves that originate from the brain à CRANIAL NERVES Nerves that originate from the spinal cord à SPINAL NERVES Three types of nerves: Sensory, Motor, Mixed Spinal Cord Skeletal Muscle  CELLS OF THE NERVOUS SYSTEM Two basic types of cells: _______________________________________________  PORTALS OF INFECTION OF THE CNS The environment considered to be à _____________________ Pathogens may access CNS through: 1. Breaks 2. Medical procedures 3. Axonal transport 4. Blood, lymph, CSF 5. Inflammation  BACTERIAL MENINGITIS Characterized by: Increased WBC High fever Inflammation SWELLING CAUSES... Slow flow Cranial and spinal pressure ENCEPHALITIS: when the brain becomes infected Deafness, blindness, behaviour changes, coma, death  BACTERIAL MENINGITIS Spinal tap – Gram stain Petechiae NORMAL INFECTION GRAM STAIN  BACTERIAL MENINGITIS – Pathogens and Virulence Opportunistic microbiota 1. NEISSERIA MENINGITIDIS: _____________________________________________ Capsule, endotoxin ½ cases non-blanching rash 2. STREPTOCOCCUS PNEUMONIAE: Pneumococcal meningitis Opportunistic à spread via blood Capsule, pneumolysin Binds tissues via ______________________________________ 3. HAEMOPHILUS INFLUENZAE: Obligate parasite Six strains - capsule antigens 4. STREPTOCOCCUS AGALACTIAE: ____________________________________________________ Reproductive microbiota Capsule 5. LISTERIA MONOCYTOGENES: Contaminated food and drink Pregnant women, fetuses, newborns, elderly, immunosuppressed Invades epithelial cells __________________________________ Sheltered from immunity LISTERIOSIS manifests as bacteremia and meningitis BACTERIAL MENINGITIS – Pathogenesis and Treatment Spread Surgery/trauma Capsules Bacterium Pathogenesis Treat/Prevent N. meningitidis Inhalation H. influenzae Inhalation S. pneumoniae Inhalation S. agalactiae Birth canal L. monocytogenes Food and drink  HANSEN’S DISEASE (LEPROSY) – SIGNS and SYMPTOMS 1. Strong T cell response - ________________________________________ Lost sensation 2. Weak T cell response - ___________________________________ Destroyed tissues 1. 2.  HANSEN’S DISEASE – Pathogen, Virulence, Transmission Mycobacterium leprae 30°C Cell wall waxy lipids Slow growth, protection, resistance Bacteria reproduce in: Nerve endings, mucous membranes, skin Immune system attacks Person-to-person contact Inhalation or breaks in skin Multidrug BCG vaccine  BOTULISM (intoxication) – Signs, Symptoms, Virulence ___ _ : _____________________: ___________________: Weak and dizzy Under 6 mo. Endospores Blurred vision Bacterium ingested Bacterial growth Paralysis Incubation >4 d Detecting Toxin Activity in Food  BOTULISM (intoxication) – Pathogenesis and Treatment Motor nerve __________________________________ Treatment: Botulism immunoglobulin, antimicrobial drugs  TETANUS (intoxication) – Signs, Symptoms Initial signs Spasms and contractions Death  TETANUS (intoxication) – Pathogen and Pathogenesis Clostridium tetani Skin Toxin released ______________________________________ TREATMENT: Passive immunotherapy, antimicrobials, active immunization  VIRAL MENINGITIS Fever, headache, stiff neck, drowsiness, confusion, nausea Pathogens: Coxsackie A and B, echovirus Contagious, Ingested Treatment: Rest Drink plenty of fluids Medicine to reduce fever/headache  POLIOMYELITIS Infects pharyngeal and intestinal cells 1. Asymptomatic infections 2. Minor polio 3. Non-paralytic polio 4. Paralytic polio Degree of paralysis POSTPOLIO SYNDROME Poliovirus stable outside body Viremia à infect/destroy CNS TREATMENT: No treatment, eradication possible  RABIES Initial pain, fever, malaise Infects CNS à death Primary reservoir Rabies virus Glycoprotein spikes to skeletal muscles CNS degenerate Virus travels to periphery  ARBOVIRAL ENCEPHALITIS – Signs, Symptoms, Pathogen Arthropod-borne viruses Mild, cold-like symptoms…occasionally cross BBB Six arboviruses West Nile Encephalitis (WNE) Mosquito pass to offspring Transmitted via blood transfusion & transplant  CRYPTOCOCCAL MENINGITIS _________________________________ Common signs Lungs to brain Late stages à loss of vision, coma Pathogen: Cryptococcus neoformans Lives in soil, bird feces, sap of eucalyptus trees Capsules and melanin production TREATMENT: Amphotericin B Flucytosine  AFRICAN SLEEPING SICKNESS ____________________________________________________ Progresses (months-years): 1. Lesion and necrotic tissue 2. Fever, swelling of lymph nodes, headaches 3. Invasion of CNS Pathogen: Trypanosoma brucei Randomly changes antigens when replicates Enter brain or circulate in blood TREATMENT: Eflornithine (crosses BBB, blocks proliferation)  PRIMARY AMEBIC MENINGOENCEPHALOPATHY The Cause... Naegleria fowleri Common in ponds, puddles, moist soil, pools, contact solution Pathogenesis: Cuts/scrapes in skin or eye, inhalation Migrate to brain Produce cysts Treatment: N. fowleri Antibiotics  Structure and Function Cardiov 3 components of the cardiovascular system & CNS ascular Link between cardiovascular and lymphatic system Infectio ns Components of the CNS and PNS Ways microorganisms invade cardiovascular and nervous systems Cardiovascular System Septicemia – common causes, effects of endotoxins, treatment Bacterial D. – endocarditis, tularemia, plague, lyme Viral D. – infectious mononucleosis, hemorrhagic fevers (3) Protozoan D. – malaria, toxoplasmosis, Chagas’ disease Helminthic D. – schistosomiasis Nervous System Bacterial D. – meningitis (5), Hansen’s Disease, botulism, tetanus Viral D. – meningitis, poliomyelitis, rabies, West Nile Virus Fungal D. – meningitis Protozoan D. – sleeping sickness, amebic meningoencephalopathy For each D. à pathogen, pathogenesis, transmission, treatment