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Cardiovascular and Lymphatic System Diseases
Causative agents, Methods of Transmission, Symptoms, Treatment, & Prevention.
17
Microbiology
Undergraduate 2
06/05/2011

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Term
Endocarditis
Definition
Bacterial infection
Inflammation of the endocardium (inner lining of the heart)
Patients with prosthetic valves are at risk
Acute – large blood stream challenge
Subacute – damage to heart valves
Symptoms – fever, anemia, abnormal heartbeat, abdominal/side pain, petechiae, enlarged spleen (subacute)
Term
Acute Bacterial Endocarditis
Definition
Usually normal heart
Sudden, rapid progression
Staph. aureus causes ½ of these cases
Treat with cephalosporins, penicillinase-resistant penicillin
Die within weeks of onset of symptoms
Term
Subacute Bacterial Endocarditis
Definition
Usually abnormal heart
Places for bacteria to adhere to
Fever and fatigue for months
Several cultures usually to isolate organism
Usually weak pathogen from GI or respiratory tract
Enter blood through daily activity (i.e. dentist)
Fatal without treatment
Term
Septicemia
Definition
Bacterial infection
Fungal infection
Organisms actively multiply in the blood (septic)
Symptoms – appear very ill, fever, increased breathing rate, respiratory alkalosis, low BP (endotoxic shock, death)
Term
Plague
Definition
Permanently established among rodents in US west of Rocky Mtns.
Transmission rare
Yersinia pestis
Transmission – bites from fleas
Pathogenis-survive in fleas and disease in mice.
Term
Pneumonic Plague
Definition
Respiratory
Lungs infected, coughing, aerosolize bacteria
Symptoms 2-3 days
Mortality near 100%
Potential biological weapon
Term
Bubonic Plague
Definition
2-6 days after bite
Enters lymph
Fever, chills, headache, nausea, weakness, bubo
More that 15% mortality with treatment
Term
Septicemic Plague
Definition
can result from pneumonic and bubonic plague
In most untreated cases
“Black death”
Bacteria enter blood, spread to most organs, blood vessels destroyed, black spots on skin from bleeding
Usually fatal
Term
Tularemia
Definition
Bacterial infection – Francisella tularensis
Zoonotic – aka rabbit fever
Bioterroism (will talk about later)
Rodents, rabbits, and hares often serve as reservoirs,[but waterborne infection accounts for 5 to 10% of all tularemia in the US.

bacteria can penetrate into the body through damaged skin and mucous membranes, or through inhalation.
Humans most often infected by tick bite or through handling an infected animal.
Ingesting infected water, soil, or food
Inhalation
hunters are at a higher risk because of the potential of inhaling the bacteria during the skinning process.
inhaling particles from an infected rabbit ground up in a lawnmower
not spread directly from person to person.

Ulcer at point of entry on skin
Headache, fever, chills, malaise, weakness, swollen lymph glands, conjunctival inflammation, sore throat, intestinal disruption, pulmonary symptoms
Prevention: wear rubber gloves when handling or skinning reservoir animals, avoid ingesting uncooked wild game and untreated water sources, wear long-sleeved clothes, and use an insect repellant to prevent tick bites.
Treatment – antibiotics
Prevention – live attenuated vaccine for at-risk, not available to general public
Term
Infectious Mononucleosis
Definition
Epstein-Barr virus.
Cytomegalovirus – immunocompromised
Sore throat, high fever, cervical lymphadenopthy, grey-white exudate in throat, skin rash, enlarged spleen and liver
95% adults in US have had EBV
Plays role in development of nasalpharyngeal cancer and Burkitt’s lymphoma (not normally found in US)
Supportive Treatment.
No prevention.
Term
Lyme Disease
Definition
Borrelia burgdorferi-Bacterial.
Tick Transmission.

3 clinical stages, all 3 not experienced by every patient
3-32 days – bull’s-eye rash (hallmark of disease), disappears spontaneously
Several weeks after 1st – bacteria spreads to lymph nodes, blood, organs including brain, joints, heart, liver, spleen, kidneys
Headache, stiff neck, muscle aches, fatigue, meningitis, myocardial damage
6 months after bite – chronic arthritis, especially in knees.
Bull's eye lesions.
Prolonged antibiotic treatment.
Avoid ticks for prevention.
Term
Hemorrhagic Fever
Definition
Viral infection
Yellow fever
Dengue fever
Ebola and Marburg
Lassa fever
Capillary fragility
Disrupts blood clotting system
Supportive care for Yellow, Dengue, & Ebola Fevers.
Vaccines for Yellow and Dengue Fevers.
Term
Nonhemorrhagic Fever
Definition
Brucellosis
Q fever
Cat-scratch disease
Trench fever
Ehrlichioses
Rocky Mountain Spotted fever
Antibiotics.
Animal control, pasteurization, vaccines, clean wound sites, avoid vectors.
Term
Malaria
Definition
Plasmodium spp.
Protozoan infection
Falciparum malaria- most common virulent type
Cerebral malaria-obstruction of small blood vessels in the brain
Life cycle in humans and mosquitoes
Asexual reproduction in human RBCs
parasite into blood with bite, goes to liver where matures
Infected liver cell bursts and parasite into blood where invade RBCs
Multiply in RBCs and burst them
protozoan taken up from blood by mosquito for next part of life cycle
Relapses can occur
Every 72 hrs, shaking chills, high fever, drenching sweat (RBC lysis) – anemia, clots from debris, enlarged spleen, urine turns black from hemoglobin (blackwater fever)
If get blackwater fever, usually fatal
Cerebral malaria – also usually fatal
Symptoms decline between attacks
**Diagnosis – blood smear
Control mosquitoes, though insecticides bad for environment and expensive
Quinine (tonic water), **Chloroquine to treat, though resistant strains
Vaccines in development, though none currently available
Term
Anthrax
Definition
Bacillus anthracis- forms spores*
Anthrax
Bacillus anthracis – forms spores*
Cattle, goats, sheep, pigs, buffalo, deer
Transmission – cutaneous, respiratory, oral
Pathogensis
Triple endotoxin – edema factor, protective antigen, lethal factor
Capsule
Hemolysins and other damaging enzymes
Cutaneous anthrax – break in skin
Blackened crater, usually heals spontaneously
Respiratory anthrax aka wool-sorter’s disease
Rare, bioterrorism
Inhale spores
Mild respiratory symptoms followed by septicemia (high fever, labored breathing, shock) and death soon after
Almost none survive
Gastrointestinal anthrax – extremely rare, infected meat
Systemic – untreated or respiratory
Fatal septicemia, toxins
Headache, fever, malaise, intestinal bleeding, bleeding from mucous membranes and orifices
Early treatment key to improving survival rate with combo of antibiotics
Burn carcasses - spores
Prevention – vaccination of safe strain (spores and toxoid) – 6 shots in 1.5 yrs, yearly boosters
Term
Human Immunodeficiency Virus (HIV)
Definition
Human immunodeficiency virus (HIV)
Viral infection - HIV
Acquired immunodeficiency syndrome (AIDS)
Infects helper T cells (CD4 receptor)
Transmission
Body fluids through sexual contact
Blood transfusion
Sharing needles
Pregnancy (vertical transmission)
Breast milk
NOT from casual contact

Dendritic cells infected first, fuse with CD4 lymphocytes, infection carried to lymph nodes where multiplies
Virus enters bloodstream within a few days and spreads systemically
Acute phase
Massive viral replication and death of CD4 lymphocytes
Fever, headache, rash, fatigue
Hard to diagnose at this stage and serology negative

Chronic phase
Immune system starts to control virus
CD8 lymphocytes kill infected cells
Symptoms disappear
6 months, viral load declines for about the next 8 years
CD4 cells continue to decline until hit 200
***at 200 per mm3, AIDS (500 to 1500 per mm3 normal)
Below 100, immune system loses control, viral load soars, patient dies 1-2 years later


Symptoms of infection
Fatigue, diarrhea, weight loss, neurological changes, opportunistic infection
Wasting, diarrhea, poor nutrient absorption, protracted fever, fatigue, sore throat, night sweats, rash, lymphadenopathy
Lesions in brain, meninges, spinal column, peripheral nerves
Memory loss, withdrawal, spasticity, sensory loss, dementia
AIDS is a cluster of symptoms associated with the initial infection of HIV.

HAART – antiretroviral therapy, extremely costly, though that may go down with the end of the patent on AZT
Not economically feasible for poorer countries
3 drugs that act on reverse transcriptase, HIV protease essential for viral replication
Resistance when only use 1 drug
8 weeks of treatment viral load declines tenfold, undetectable at 6 months
Many pills as well as treatments for opportunistic infections
Side effects: rash, nausea, diarrhea, headaches, anemia, neuropathy, hepatitis, diabetes
HUGE COST


Secondary infection usually cause of death
Worse in children
AIDS dementia – virus crosses blood-brain barrier, deteriorates mental function (seen in babies)
Kaposi’s sarcoma – blood vessel cancer
Cancer of lymphatic system, rectum, tongue

Can take 3-6 months for positive diagnosis through blood testing
A newer type of test checks for HIV antigen, a protein produced by the virus immediately after infection.
confirm a diagnosis within days of infection
Prevention: avoid means of transmission, vaccination very dangerous, even if killed, high mutation rate
Term
Leukemia
Definition
Acquired, not inherited
Acute or chronic
Virus infection – HTLV-1, HTLV-2 (oncogene?)
Symptoms – easy bruising or bleeding, paleness, fatigue, recurring minor infections
Pathology – Anemia, Platelet deficiency, immune dysfunction
Complications - tumors
Treatment – antineoplastic drugs, radiation therapy, transplants, alpha interferon
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