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Presentation of diseases
Exam 4
43
Microbiology
05/16/2010

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Term
Difficult to detect, pale, slightly raised, small papule. Closed comedones - white heads follicular impaction of lipid, keratin, melanin causes the brown or black appearance. Open comedones = black heads - non inflammatory
Definition
Acne vulgaris
Term
closed or open comedones become inflamed and evolve into pustules, inflammatory papules, or nodules
Definition
acne vulgaris - propionibacterium acnes (infected)
Term
small, painless papule which progresses to black colored vesicle that eventually ruptures producing a painless, blackish, edematous ringed lesion (eschar) - malignant pustule. Farmer/cattleman from western USA at risk.
Definition
Cutaneous Anthrax
Term
superficial, intraepidermal lesions which ruptures and forms thin varnish-like light brown crust or a toxic epidermal necrosis of the superficial layers of the skin. Oblique pressure to lesions will cause sloughing off in sheets of skin - bullae.
Definition
Bullous impetigo
Term
Following skin abrasions or tinea, intensely inflamed rapidly advancing deep skin infection. advancing edge of the infection may be elevated but it is NEVER sharply indurated or sharply demarcated - systemic signs present (fever, chills, malaise, leukocytosis), often suppurative - after AB treatment symptoms resolve in 1-2 days.
Definition
Cellulitis
Term
Superficial infection of the independent follicle and apocrine region of epidermis - small erythematous papule topped by superficial pustule. occurs on any hair bearing site.
Definition
folliculitis.
Term
A firm, tender, painful, discrete red nodule about 1 cm in diameter with purulent discharge caused by infection of an individual hair follicle and underlying tissue. skin around lesion is hot but no systemic signs. Peaks in children 3-15yrs old. Neck face axillae buttocks thighs.
Definition
Boils - furuncles.
Term
An erythematous, edematous, painful lesion (deeper and larger than furuncle) with a central necrotic crater caused by infection of several hair follicles - extends into subq fat. Lesions coalesce and drain to the surface along hair follicle - fever and malaise present.
Definition
Carbuncle
Term
form of non-bullous impetigo extending into the dermis (punched out ulcers with greenish-yellow crust and violaceous margin) suppurative - frequently occurs on legs. Scarring can occur.
Definition
Ecthyma.
Term
in superficial epidermis - small vesicles form which develop into pustules with little erythema then rupture with purulent discharge drying on top of the lesion results in thickened amber colored adhesive crust - not associated with a hair follicle.
Definition
Classic impetigo
Term
signs and symptoms of either streptococcal pharyngitis or epidemic impetigo - at same time patient has fever, scartiniform rash and charateristic "first white then strawberry" tongue on a person. Rash is blanching, erythematous, sand paper like covering most of the body. first appears on trunk then spreads.
Definition
scarlet fever - exotoxin.
Term
fever, purulent conjunctivitis, erythematous, dry, fissuring, peeling, bleeding lips. widespread, diffuse erythroderma, progressing to extensive in size and widley distributed in 1-2 days. Followed by total body desquamation - exotoxin mediated.
Definition
Ritters Disease/scalded skin syndrome.
Term
high fever of 102F, headache, chills, back pain, prostration of 3 days. Next day the fever defervesces and a maculopapular rash appears on face and hands and forearms and then spreads to trunk and legs. 2 days later all the lesions become vesicular and then progress to pustules and eventually scab.
Definition
smallpox
Term
mild flulike symptoms, mildly pruritic, sparse rash more or less randomly distributed on his trunk, all of which began about 2 days ago. closer inspection reveals the rash now consists of macules, papules, vesicles and crusted lesions. history otherwise unremarkable - child has received all vaccinations.
Definition
Breakthru chicken pox or vaccine-shingles.
Term
Prodromal symptoms generally absent, low grade fever, malaise, myalgia, ab pain, anorexia, headache 24-48 hours before lesions. Rash more severe on head and trunk than extremeties. intensely pruritic and evolves within hours. all stages visible at once (maculopapular, papule, vesicles, pustules, and crust).
Definition
Chicken Pox
Term
Fever, malaise, headache, and itchy, painful asymmetrical rash. follows a single dermatone. Number of lesions had wide range.
Definition
Shingles.
Term
in late winter/early spring child manifests with prodrome of mild illness - fever, anorexia, malaise for several days which then evolves to erythematous slapped cheek lacy rash appearing on face. Rash is intense on the face but decreases when going down the body.
Definition
Human parvovirus - erythema infectiosum.
Term
late winter/early spring, any person with anemia presents with symptoms of dyspnea fatigue and confusion which has evolved over several days. History reveals patient has been ill before with mild flulike symptoms which persisted for about 3 days. Rash and or arthropathy may be present. Lab results unremarkable except for anemia.
Definition
Human parvovirus - erythema infectiosum
Term
late winter/early spring, otherwise healthy adult presents with arthralgias of the hands and wrists - patient had low grade fever, headache, malaise, myalgia, respiratory syndrom and some nausea vomiting and ab pain about a week ago. history with contact with children.
Definition
Human parvovirus - erythema infectiosum.
Term
sustained fever of 103-104F for 2-5 days, fever diminishes and then a fine, erythematous blanching macular rash appears on the afebrile child. Peaks in children.
Definition
Exanthem subitum/roseola infantum. HH6
Term
prodrome - nonproductive, brassy cough. coryza, conjunctivitis, Koplicks spots on mucosa, vagina, conjunctiva. High fever, lymphadenopathy, pharyngitis then 3-4 days later prodrome continues with blanching, symmetrical rash, on face first then descends lower. Rash clears within 24-72 hours by desquamation.
Definition
Measles, Rubeola.
Term
conjunctivitis, coryza, pronounced enlargement of lymphs, pharyngitis, malaise, low grade fever, discrete pink/red macule rash that appears on face and descends. lasts 3-5 days. Peaks in children.
Definition
German Measles
Term
NOn itching, non inflammatory, fawn colored depigmentation patches on chest and sometimes pastules, pustules on trunk and or upper arms - resembles acne.
Definition
Pityriasis versicolor.
Term
ectothrix on face, head, genital areas - no symptoms. Resembles lice or nits.
Definition
White piedra
Term
resembles enothrix of microsporum.
Definition
black piedra
Term
In florida and other coastal states, female <18 yrs has discrete 1-8cm brown to black mottled macule. Usually on palm or fingers. No inflammation, induration, or scaling.
Definition
Tinea nigrans.
Term
Spectrum from scales - vesicles - ulcers. Patient has history of itching, inflamed, vesicular crusted lesions.
Definition
Tina pedis, cruris, and barbae. "The big three" (ringworm)
Term
leukonchia mycotica (superficial white nail fungus) - nails lose luster and become opaque, brittle, and have crumbling consistency.
Definition
Tinea unguium - dermatophytic onychomycosis.
Term
ectothrix - spores produced outside of hair shaft. Fluoresces, infected hair becomes dull and breaks off 3-4mm above scalp.
Definition
Microsporum - Tinea capitis
Term
Endothrix spores produced in hair shaft - break at scalp "black dot"
Definition
trichophyton - tinea capitis
Term
1 or more painless, raised, cutaneous, or subq nodular lesions on the arms that track along draining lymphatics and which later break down and form ulcers. Direct microscopic examination of biopsy show material cigar shaped yeast cells and hyphae. Occurs in people who work with plants.
Definition
sporotrichosis.
Term
fever, malaise and fatigue, anorexia, nausea, vomiting, diarrhea, dark urine, clay stool, yellow skin+cornea. Increased serum levels of ALT and AST.
Definition
Hepatitis.
Term
fever, headache, pharyngitis, lymphadenopathy, hepatosplenomegaly, myalgias, nausea, vomiting, and diarrhea. Rash present. mucotaneous ulcerations in mouth, esophagus, or genitals. Thrush and neurological symptoms
Definition
Acute HIV syndrome
Term
prodromal symptoms of fever, headache, general malaise, lethargy for 3-5 days, then manifest with enlarged lymph nodes,, erythematous edematous supuurative pharyngitis with high fever lasting for up to 3 weeks. May have rash or liver involvement. Can last 2 months or longer.
Definition
Infectious mono
Term
insidious onset of fever, which increases stepwise over a week to 104F with headache, anorexia, lethargy, malaise, prostration, aches and pains, cough, intestinal signs. Second week temperature may be sustained plus mental dullness, apathy, splenomegaly, leukopenia. Rose spots may appear. Fever subsides in 3rd week.
Definition
typhoid fever
Term
flu like illness, lasting 3-4 days then fever, headache, blanching macular rash on wrist and ankles. then spreads to trunk as well as hands and feet (including soles), rash if untreated can progress to petechial then purpuric lesions. High mortality if left untreated.
Definition
Rocky mountain spotted fever
Term
systemic signs and symptoms followed by abrupt onset of fever, headache, blanching maculo rash, which spreads centrifugally sparing face, palms, and soles. rash lasts 4-7d and can evolve to petechial if untreated. mortality without treatment is high.
Definition
louse-borne epidemic typhus. recrudescence causes milder infection - brill-Zinserr disease
Term
Petechial, non blanching rash on trunk, thighs, feet, ankles and forearms - present if septicemia occurs.
Definition
Meningococcemia.
Term
Recurring cycles of 4 days symptomatic then 4 days asymptomatic. Rash, malaise, night sweats, bone pain, increase in severity with each recurrence.
Definition
Trench fever
Term
patient manifests with fever and regional lymph node enlargement. Had exposure to cat.
Definition
Cat scratch fever
Term
prolonged course of flulike symptoms, large circular rash with central cleared area which resolves slowly. Lesion is self limiting.
Definition
lyme disease
Term
patient presents with episode of pain and swelling in left knee of 1 week duration. this is the third episode in 2 months. each previous episode also lasted about 1 week and involved both knees. was on hiking trip in NY 3 months earlier when fever/bulleye rash appeared.
Definition
Lyme disease stage 2
Term
prodrome of flu like symptoms followed by paroxsyms (chills, high fever, rigor) lasting about 12 hours. Fever rapidly diminishes and patient is soaked by drenching sweats. Patient is aymptomatic until prodrome and paroxysms appear every 4 days. Recently returned from Africa.
Definition
Malaria.