16. Infectious Diseases - Pathologies Flashcards
What are systemic symptoms of infectious diseases?
Fever*
Fatigue
Headache
Nausea
*one of the biggest indicators of infection
What are local signs of infectious diseases?
Pain
Swelling
Redness
Warmth
Purulent exudate
What is a possible complication of an infection?
Sepsis (septicaemia)
What is sepsis?
When a pathogen infects the blood
What can sepsis lead to?
Body’s own response causing organ injury
Multi-organ failure
Who is more at risk of developing sepsis?
Immuno-compromised:
* Over 75s
* <1 yrs
* Alcoholics
* Diabetics
* Chemo patients
* Those on steroid treatment
What are the symptoms of sepsis?
Lethargy
Nausea/vomiting
Abdominal pain
Diarrhoea
Coughing
How can infectious diseases be tested?
Culture/staining
Blood tests
Stool tests
Radiography
What can blood tests for infection detect?
Leukocytosis: sign of bacterial infection
Leukopenia: sign of viral infection
High ESR*: marker of infection, influenced by inflammation
*erythrocyte sedimentation rate
What is leukocytosis?
High leukocyte count
What is leukopenia?
Low leukocyte count
Cellulitis: definition
Bacterial infection of the skin creating inflammation of dermal/subcutaneous layers
Erysipelas: definition
Bacterial infection of the skin creating inflammation of dermis/upper subcutaneous layer
More superficial than cellulitis
Well defined edge
Cellulitis/Erysipelas: aetiology
Bacterial - Staphylococcus aureus Infections can enter the skin through minor trauma, eczema (itching), IV drug abuse, ulcers (from diabetes)
Streptococci bacteria in subject’s own nasal passages
Cellulitis/Erysipelas: signs and symptoms
Very red, inflamed skin
Cellulitis: mainly limbs
Erysipelas: face and limbs
Fever, malaise
Cellulitis/Erysipelas: diagnostics
Microbe analysis
Clinical presentation
Cellulitis/Erysipelas: allopathic treatment
Antibiotics
oral/intravenous
Impetigo: definition
Very contagious bacterial skin infection
Common in infants/young adults
Impetigo: aetiology
Staphylococcus aureus
Haemolytic streptococci
Poor hygiene
Impetigo: signs and symptoms
Pustules with round, oozing patches and golden-yellow crusts that grow larger each day
Affects mostly exposed areas - hands/face
Skin folds - particularly armpits
Impetigo: allopathic treatment
Antibiotics
Oral Candidiasis: definition
Superficial fungal yeast infection* of mucous tissues
*mycosis
Oral Candidiasis: aetiology
Often presents after broad spectrum antibiotics
Immune-compromised patients
Skin/mucous barrier and CD4 cells usually enough to protect
Oral Candidiasis: signs and symptoms
White plaques
Dysphagia
Reduced appetite
Oral Candidiasis: complications
Can become systemic in immune-compromised patients - deposits on organs (systemic candidiasis)
Oral Candidiasis: allopathic treatment
Antifungals - topical/oral
eg. Clotrimazol
Can impact liver function/damage local skin
Genital Candidiasis: definition
Very common mycosis* of the genitals
*fungal infection
Genital Candidiasis: aetiology
Not sex-related (opportunistic)
Immune-compromised patients
* Antibiotic treatment
* Diabetes mellitus
* Pregnancy
* Immune system disorders
* Significant stress
Genital Candidiasis: signs and symptoms
Vaginal/genital itch, discomfort, irritation
Thick, clumpy discharge (cottage cheese)
Genital Candidiasis: diagnostics
Physical exam
Fungal culture/analysis
Genital Candidiasis: allopathic treatment
Antifungals - topical/oral
Lyme Disease: aetiology
Bacterium - borrelia, transmitted by tick bites
Lyme Disease: signs and symptoms
Different bacterial strains cause different clinical manifestations (differences between Europe and USA)
Circular pink/red rash at site of tick attachment, over 5cm dia*
Flu-like symptoms - can lead to neurological disease, cardiovascular disease and arthritis if not treated
*can take days/weeks to appear
Lyme Disease: allopathic treatment
Antibiotics
Lyme can be quite resistant
Diphtheria: definition
Highly contagious upper respiratory tract infection affecting primarily the nose and throat
Diphtheria: aetiology
Bacterial - Corynebacterium diphtheriae (gram positive*), transmitted by droplets
* secretes exotoxins that cause necrosis
Diphtheria: signs and symptoms
Sore throat and fever
Grey membrane (necrosis) grows across the tonsils, pharynx, nose (impairs breathing)
Enlarged cervical lymph nodes
Diphtheria: complications
Exotoxins cause endothelial necrosis by inhibiting protein synthesis
Can cause myocarditis and paralyse diaphragm
The membrane can block the airways
Diphtheria: allopathic treatment
Medical emergency
Anti-toxins
Antibiotics
Respirator
DPT vaccine
Scarlet Fever: definition
Infectious disease resulting from exotoxins released by Streptococci pyogenes bacteria
Usually occurs in children (90% <10yrs)
Scarlet Fever: pathophysiology
Bacteria secrete haemolytic enzymes and exotoxins (damage capillaries which both cause red rash)
Scarlet Fever: aetiology
Streptococcus pyogenes (haemolytic streptococcus)
Scarlet Fever: transmission
Droplets
Scarlet Fever: incubation time
3-4 days incubation
Scarlet Fever: signs and symptoms
Sore throat, fever, scarlet rash (blanches under pressure)
Haemorrhagic spots on palate
First 2 days - white tongue with red papillae
After this - more raw/red
Scarlet Fever: allopathic treatment
Antibiotics
Cold Sores: definition
Viral infection causing small blisters around mouth/on lips
Cold Sores: pathophysiology
Classical opportunistic virus
When immunity is low, the virus migrates along the nerve (often the trigeminal) to the skin/mucosa around mouth causing tingling/burning sensation
Cold Sores: aetiology
Herpes simplex virus (Type I)
Stress
Drugs - steroids
Trauma, local infections, sunlight exposure
Cold Sores: transmission
Direct contact or indirect (saliva)
Saliva remains contagious for weeks after symptoms
Cold Sores: signs and symptoms
Commonly asymptomatic
Tingling, itching, burning sensation around the mouth
Small, fluid filled sores that appear most commonly on lower lip
Cold Sores: allopathic treatment
Antiviral cream - acyclovir
Chicken Pox: definition
Highly infectious viral disease, caused by *Varicella-zoster**
*part of Herpes viral family
Who is mainly affected by chicken pox?
Mostly affects children (90%)
Chicken Pox: aetiology
Varicella zoster virus (part of herpes family)
Chicken Pox: transmission/incubation time
Droplets into upper respiratory tract mucosa
Direct contact
2-3 weeks incubation
Chicken Pox: signs and symptoms
Prodromal fever and malaise
Vesicular eruptions on the skin appear over 3-5 days mostly on head/trunk.
Very itchy*
Infective 2 days before rash until all lesions at ‘crusting’
*Danger of secondary infection due to skin breakages
Chicken Pox: complications
Infection because of scratching
Encephalitis
Viral pneumonia
Chicken Pox: allopathic treatments
None
Shingles: definition
Infection by the varicella zoster virus following chicken pox infection
Reactivated varicella virus
Shingles: aetiology
Varicella zoster virus - travels down infected nerve causing neuritis (nerve inflammation) in an immune-compromised individual
Commonly affects thoracic nerves or trigeminal nerve*
The pattern of neuritis clealy demarcates the nerve(s) affects
Shingles: signs and symptoms
1-2 days before rash - burning, itching, tingling
Eruptive phase - skin lesions similar to chicken pox (affecting head/face), causing severe dermatomal pain, altered sensation and vesicular rash
Shingles: allopathic treatment
Antiviral cream - acyclovir
Whooping Cough: definition
Bacterial infection with characteristic coughing attacks where there’s a desperate attempt to breathe in
Whooping Cough: aetiology
Bacterial - Bordetella pertussis
Whooping Cough: signs and symptoms
Initial 1-2 weeks flu like symptoms
Then, a cough that doesn’t respond to usual cough medication
Cough gets worse and presents with attacks (for 3-6 weeks)
Whooping Cough: complications
Pneumonia
Rib fracture
Death
Tuberculosis: definition
A systemic infection usually caused by pyogenic bacteria - *Mycobacterium tuberculosis**
Chronic, granulomatous disease
*Very aerobic bateria, loves oxygen - hence presence in lungs
Tuberculosis: pathophysiology
Macrophages in the lungs engulf the bacteria and carry them to the hilar* lymph nodes
Some organisms can spread to distant areas
80% of cases the granulomas formed will be eliminated by the immune system.
If not, the bacteria can become active immediately, later, or may remain dormant
Can affect lungs but also CNS, lymph, circulation, genitourinary, bones, joints, skin
Lymph nodes in the lungs
Tuberculosis: transmission
Droplets
Inspiration of dust
Dry excretions
Contaminated milk
Tuberculosis: signs and symptoms
Pulmonary TB: fever, chronic cough, purulent/bloody sputum, drenching night sweats, severe malaise, weight loss, anorexia
Tuberculosis: diagnostics
Blood tests - high ESR, leukocytosis
X-rays, other imaging, showing up granulomas
Tuberculosis: allopathic treatment
Antibiotics for 6 months
Measles: definition
Acute and very infectious viral disease mainly in children
Measles: aetiology
Measles virus
Measles: transmission/incubation
Droplets
11 days incubation
Measles: signs and symptoms
Early phase:
3-5 days - non-specific cold-like symptoms
Koplik spots - small grey spots on oral mucosa opposite molar teeth
Eruptive phase -
measles-like rash that initially begins on face/forehead
Rash fades within 1 week (contagious 4 days before and after rash)
Measles: complications
Middle ear infection
Pneumonia (alveolic infection)
Encephalitis
Low rate of complications
Measles: allopathic treatment
No specific treatment
Part of MMR virus
Mumps: definition
Acute, viral infection causing swelling of the parotid/salivary glands
Mumps: aetiology
Mumps virus
Mumps: signs and symptoms
Feeling unwell
Fever
Head and joint pains
Swollen parotid glands
First one then both sides
Mumps: complications
After puberty, about 30% of males get testicular inflammation
Because mumps virus targets exocrine glands
Rubella: definition
Rare, harmless viral infection
German measles, RNA virus
Rubella: signs and symptoms`
Sore throat, fever, headache
Petechiae on hard palate
Pink rash with small macules that starts on face and behind ears
Rubella: complications
Abnormal foetal development
Miscarriage
Viral Hepatitis: definition
Acute viral infection of the liver
Viral Hepatitis: aetiology
Hepatitis virus
(types A, B, C, D, E)
Viral Hepatitis: transmission
A/E - faecal-oral
B/C/D - blood, other bodily fluids
Viral Hepatitis: signs and symptoms
- Pre-icteric stage - malaise, diarrhoea
- Icteric stage - jaundice, pale stools, dark urine (hepatic stasis), pruritic skin, enlarged liver, impaired blood clotting
Viral Hepatitis: diagnostics
Blood test - liver function
Viral Hepatitis: complications
Chronic liver disease - cirrhosis, liver cancer
Viral Hepatitis: allopathic treatment
Limited - antiviral therapy
Hep B vaccine in vulnerable groups
HIV (Human immunodeficiency virus): definition
An STI which attacks the immune system
Retrovirus - a double-strand* RNA virus
Retrovirus means it converts from RNA to DNA
AIDS (Acquired immune deficiency syndrome): definition
Later stages of HIV when the immune system is severely impaired and life-threatening
HIV (Human immunodeficiency virus): pathophysiology
Binds to CD4 receptor on T-Helper cells and macrophages
Viral envelope and cell membrane fuse and viral RNA enters the cell
Converted into viral DNA by ‘reverse transcriptase’ enzyme
Using integrase, it integrates into the host cell DNA
Viral DNA forces the host cell to produce viral RNA and proteins
Assembles in cytoplasm and buds off
As viral load goes up, T-cell count goes down
Can mutate, destroys CD4 cells leading to immune compromise
HIV (Human immunodeficiency virus): transmission
Primarily through blood and semen (unprotected anal sex)
Low risk with saliva and vaginal secretions
NOT transmitted by casual contact
Risk of transmission during pregnancy/breastfeeding
Recent increase in heterosexual transmission
6-7% intravenous drug use
HIV (Human immunodeficiency virus): progression
- Initial stages - 1-6 weeks after infection
50% asymptomatic
Flu/glandular fever-like sore throat, fever, malaise, muscle/joint pain, swollen lymph nodes
Negative antibody (IgG tests) but viral RNA high - Late stage - huge reduction in CD4 count and rise in viral load
AIDS diagnosis : CD4 count < 14%
Severely impaired immune function
Opportunistic infections
HIV (Human immunodeficiency virus): diagnostics
Blood tests - antibodies
HIV (Human immunodeficiency virus): opportunistic infections CD4 <500
Herpes infections
Candidiasis
Kaposi’s sarcoma
HIV (Human immunodeficiency virus): opportunistic infections CD4 <200
Toxoplasmosis, pneumonia
HIV (Human immunodeficiency virus): opportunistic infections CD4 <50
Severe mycobacterium infection
HIV dementia
HIV (Human immunodeficiency virus): prognosis
Increased with highly active anti-retroviral therapy (HAART)
Anti-retrovirals increases life expectancy but causes a variety of adverse effects due to high toxicity from the drugs
Dysentery: definition
Infection of the intestines that causes diarrhoea containing blood or mucus
Dysentery: aetiology
Bacterial - shigella
Amoebic (protozoa)
Via faecal-oral contamination
Dysentery: signs and symptoms
Diarrhoea - watery stools with mucus and blood
Cramping, possible nausea/vomiting
Dysentery: diagnostics
Stool microscopy
Dysentery: complications
Dehydration - dangerous in small children, infants, pregnancy and elderly
Dysentery: allopathic treatment
Antibiotics - anti-parasitic or anti-bacterial
Rehydration - fluid and mineral replacement
Malaria: definition
Tropical infectious disease spread by anopheles mosquitos that are infected by *plasmodium** species.
5 million affected each year
*protozoan
Malaria: pathophysiology
Infected female anopheles mosquito bites human
Plasmodium parasites (sporozoites) taken up by liver, proliferate and mature.
Can lie dormant for up to a year
Spread to erythrocytes and proliferate further.
Symptoms begin i.e. fever
Infected cells burst and spread infection
Protozoan gametes are formed and are taken up by another mosquitos during blood meal
Malaria: 3 stages of life cycle
- Mosquito
- Human liver
- Erythrocytes
Malaria: aetiology
Plasmodium species
(5 types) - protozoa
Spread by vector/host mosquito
Malaria: signs and symptoms
Headache, fever, malaise, arthralgia*
nausea, vomiting, diarrhoea, anaemia**
Splenomegaly, hepatomegaly, jaundice**
*joint pain **(caused by excessive haemolysis)
Malaria: complications
Death (misdiagnosis as flu)
Relapses
Malaria: allopathic treatment
Quinine/chloroquine (tetracycline)
Anti-inflammatories, anti-pyretics, analgesics
Preventative drugs*
*significant side effects
Chlamydia: definition
Very common sexually transmitted infection
Common <25s
Chlamydia: aetiology
Bacterial - Chlamydia trachomatis
Chlamydia: incubation
Several weeks incubation
Chlamydia: signs and symptoms (males)
50% asymptomatic
Milky white/yellow discharge from penis
Epididymitis
Urethritis
Dysuria
Chlamydia: signs and symptoms (females)
80% asymptomatic
Yellow vaginal discharge
Dysuria
Chlamydia: diagnostics
Urine
Cervical
Urethral swab tests
Chlamydia: complications
Pelvic inflammatory disease*
Risk of infertility
Infection of uterus and fallopian tubes
Chlamydia: allopathic treatment
Antibiotics (e.g. erythromycin and tetracycline).
Gonorrhoea: definition
Common bacterial STI
Gonorrhoea: aetiology
Bacterial - Neisseria gonorrhoea
Infects epithelium of GU tract, rectum, pharynx, conjunctiva
Gonorrhoea: transmission
Direct - oral, anal, genital sex
Mother to baby during birth
Gonorrhoea: signs and symptoms (male)
90% symptomatic
Yellow penile discharge
Dysuria
Gonorrhoea: signs and symptoms (female)
50% asymptomatic
Yellow vaginal discharge
Dysuria
Irregular vaginal bleeding
Lower abdominal pain
Pain during sex (dyspareunia)
Gonorrhoea: diagnostics
Swab culture of urethra, throat, cervix/rectum
Presumptive on-the-spot diagnosis often made based on case history
Gonorrhoea: complications
Permanent complication (particularly women) if untreated
PID
Infertility
Gonorrhoea: allopathic treatment
Antibiotics
Abstain from sexual activity until all clear
Genital Herpes: aetiology
Herpes simplex virus (Type II)
Genital Herpes: transmission
Direct contact - sexually transmitted
Genital-genital
Oro-genital
Genital Herpes: signs and symptoms
Always symptomatic
After initial infection the viruses move to sensory nerves where they remain latent
Painful vesicles, rupturing to leave shallow ulcers
Genital Herpes: allopathic treatment
Antiviral cream - acyclovir
Syphilis: definition
Chronic, contagious systemic disease
Syphilis: aetiology
Bacterial - Treponema pallidum
Syphilis: transmission
Enters body via damaged skin or mucous membranes*
Sexual contact
Pregnancy
*very contagious
Syphilis: signs and symptoms
- Hard, painless ulcer* on infection point. Heals and becomes asymptomatic
- Flat, erythematous rash (v. contagious), potentially covering whole body. Not itchy. Lasts several weeks
- Latent stage - no symptoms but untreated person may remain infectious for up to 2 years
- Years later if left untreated can lead to
* chronic gummas (granulomas),
* neurological syphilis,
* cardiovascular syphilis
*Chancer
Syphilis: allopathic treatment
Penicillin*
Avoid sex until all clear
Without antibiotics can be fatal
Genital Warts: aetiology
Human papillomavirus (HPV)
Genital Warts: incubation
Up to 6 months incubation
Genital Warts: signs and symptoms
Soft, fleshy projections
Cauliflower-like masses
Small pointed masses
Flat lesions on vagina, cervix, penis
Genital Warts: allopathic treatment
Surgery
Laser
Cryotherapy
Oral Candidiasis: natural treatment
Anti-candida protocol: Remove carbohydrates that feed yeast, apple cider vinegar, coconut oil, manuka honey, turmeric, garlic, oregano, probiotics and prebiotics, grapefruit seed extract.
Support immune system; e.g. vitamin C, beta glucans.
Herbs (immune and antifungal) internally; homeopathy;
acupuncture.
Scarlet Fever: complications
vocal, not on slide
Lung and kidney conditions
Rheumatic fever (if untreated)
Chicken Pox: natural treatments
Herbs (immune and antiviral); acupuncture; nutrition to support immunity and antimicrobial activity; homeopathy.
Itch relief (to prevent further infection):
Oats in a bath, bicarbonate of soda, apple cider vinegar, raw honey, lavender (in licorice creams when no open wound).
Poliomyelitis: definition
Acute viral infectious disease
Poliomyelitis: aetiology
Poliovirus (PV)
Poliomyelitis: transmission
Faecal-oral transmission
Poliomyelitis: pathophysiology
Targets anterior horn cells of CNS (motor)
Has no cure
Poliomyelitis: signs and symptoms
90% of polio infections are asymptomatic.
Initially: Fever, fatigue, headache, vomiting, neck stiffness.
In 1% of cases, the virus enters the CNS and causes paralysis.
5 - 10% die from respiratory failure.
HIV (Human immunodeficiency virus): signs and symptoms
Fatigue.
Anaemia.
Anorexia, diarrhoea, cachexia
(weight loss, muscle wasting).
Neurological disease with no
other cause.
Peripheral neuropathy.
Neutropenia and
thrombocytopenia.
Dementia (HIV dementia).
Cognitive / motor dysfunction.
Dysentery: natural treatment
Herbs (antimicrobial & immune), oregano oil, probiotics, colon hydrotherapy (removes amoebic cysts).
