Other infections Flashcards
What is Leprosy known as?
Hansen’s disease
Describe the disease of Leprosy
Bipolar
Describe the infection of Leprosy
Slowly progressive
What is this infection caused by?
Mycobacterium leprae
What is the Mycobacterium leprae known as?
Lepra bacilli
What does this infection affect? (2 points)
Skin
Peripheral nerves
What does this infection mainly result in?
3 points
Deformity
Paralysis
Ulceration
What is the incubation period of the Mycobacterium leprae?
5-10 years
What is the mode of infection of Leprosy?
Droplet
What does this droplet infection occur via?
Nasal mucosa
What is the classification of the Leprosy bipolar disease based on?
Host immune responses
What are the 2 forms of the Leprosy disease classified based on the host immune responses?
Nodular
Maculoanaesthetic
What is the nodular leprosy known as?
Lepromatous
What is the Maculoanaesthetic leprosy known as?
Tuberculoid
What is another form of Leprosy?
Border line
Describe Border line Leprosy
Grade between Tuberculoid and Lepromatous
Describe the form of Nodular Leprosy
Severe
What is the tissue destruction in the Leprosy known as?
Leproma
Describe Leproma
Granuloma
How many cells is this granuloma composed of?
4
What are the 4 cells where this granuloma is composed of?
Macrophages
Lymphocytes
Plasma cells
Giant cells
Describe the cytoplasm of these Macrophages
Foamy
Describe the color of this cytoplasm
Pale
What do these Macrophages do with the Lepra bacilli?
Engulfment
What do these Lepra bacilli rapidly do?
Multiplication
Where do these Lepra bacilli rapidly multiply in the Macrophages?
Cytoplasm
What does the Macrophages do with the Lepra bacilli then?
Lysis
Describe this lysis (2 points)
Partial
Incomplete
What causes this incomplete lysis of the Lepra bacilli?
Defective digestion
What is resulted due to the partial lysis of the Lepra bacilli?
Foamy cytoplasm
What are the Macrophages then known as?
2 points
Foam cells
Lepra cells
Describe the resistance of the patient in Nodular Leprosy
Very low
What causes this low resistance?
A defect
Which cells does this defect occur in causing the low resistance of the patient?
T Lymphocytes
What aren’t the T Lymphocytes stimulated by as a result?
Lepra bacilli
What doesn’t occur to the Macrophages as a result?
Instruction
What aren’t the Macrophages instructed to do?
Killing
What aren’t the Macrophages instructed to kill?
Phagocytosed Lepra bacilli
What also occurs in the Leproma?
Healing
What is healed in the Leproma?
Old lesions
What do the old lesion heal by?
Fibrosis
How many lesions occur in the Nodular Leprosy?
5
What are the 5 lesions that occur in the Nodular Leprosy?
Skin Nasal Neural Trophic Visceral
Describe the 2 forms of the skin lesion
Nodular
Macular
Where is the skin lesion especially nodular in?
2 points
Face
Extremities
Where is the skin lesion also nodular in?
Forehead
Describe the appearance of the nodular skin lesion in the face and in the forehead
Lenione
Describe the 2 forms of the macular skin lesion
Erythematous
Hypopigmented
What occurs in the Nasal lesion? (3 points)
Mucosal ulceration
Nasal obstruction
Septal destruction
What is affected in the neural lesion?
Big peripheral nerves
Which big peripheral nerves are especially affected in Neural lesion?
Ulnar
What occurs in these big peripheral nerves?
Thickening
Destruction
Describe this thickening and destruction
Diffuse
What causes Trophic lesion?
Loss of sensation
What occurs due to the Trophic lesion?
2 points
Traumatic ulcer
Deformities
Where do these traumatic ulcer and deformities occur in?
2 points
Hands
Feet
What are the 4 organs in which the infection occur in, in Visceral lesion?
Liver
Spleen
Testis
Eye
Describe the form of the Maculoanaesthetic Leprosy
Mildest
Describe the resistance of the patients in Maculoanaesthetic Leprosy compared to the resistance of the patients in Nodular Leprosy
Relatively higher
What is occurs in the tissue reaction?
Granuloma
Describe this granuloma
Non-caseating
How many cells is this non-caseating granuloma formed of?
3
What are the 3 cells that form this non-caseating granuloma?
Macrophages
Lymphocytes
Giant cells
What does this non-caseating granuloma has a marked tendency for?
Fibrosis
What does this granuloma differ from?
Sarcoidosis
What does this granuloma have which is a difference between it and sarcoidosis?
Lepra cells
Describe the number of these lepra cells
Few
Which stain may these lepra cells be found by?
Ziehl-Neelsen
Where does this granuloma occur along side of which is a difference between it and Sarcoidosis?
Nerves
What is accompanied by these nerves due to the occurrence of this granuloma along side them?
Nerve destruction
Describe the infection of the Maculoanaesthetic Leprosy
Mild
What does this infection mainly occur in? (2 points)
Skin
Peripheral nerve
How many lesions occur in the Maculoanaesthetic Leprosy?
3
What are the 3 lesions that occur in the Maculoanaesthetic Leprosy?
Skin
Neural
Trophic
What occurs in the skin lesion in Maculoanaesthetic Leprosy?
Macules
Where exactly do these macules occur in the skin lesion in Maculoanaesthetic Leprosy?
(3 points)
Face
Trunk
Limbs
Describe the occurrence of these macules
Single
Or
Very few
What is the color of these macules?
Red
Describe the border of these macules
Slightly elevated
Describe the center of these macules
Anesthetic
What does anesthetic mean?
Impaired sensation
Describe the color of these macules center
Pale
What is also impaired?
Sweating
Describe the occurrence of the neural lesion
Early
What does the peripheral nerve show in the neural lesion?
Thickening
Describe this thickening (2 points)
Diffuse
Or
Fusiform
What does this thickening cause?
Muscle atrophy
What causes the trophic lesion
Loss of sensation
What occurs due to the Trophic lesion?
2 points
Traumatic ulcer
Deformities
Where do these traumatic ulcer and deformities occur in?
2 points
Hand
Feet
Describe the disease of the Syphilis
Venereal acquired
Describe the disease of the Syphilis
Venereal acquired
What does the Syphilis cause?
Infective granuloma
What is the etiological agent of the Syphilis?
Treponema pallidum
What is the form of the Treponema pallidum?
Spirochetes
What are the 2 ways of Syphilis transmission?
Sexual
Vertical
What is the transmission of the Syphilis most contagious to?
Sex partners
During which stages of the Syphilis is the transmission most contagious to sex partners? (2 points)
Primary
Secondary
What does the Treponema pallidum enter the body via?
2 points
Skin
Mucous membrane
Through what does the Treponema pallidum enter the body via skin and mucous membrane?
Abrasions
When does the Treponema pallidum enter the body via skin and mucous membrane through abrasions?
During sexual contact
What is the other mode of infection of the Syphilis?
Transplacentally
How is this infection transmitted transplacentally?
From mother to fetus
When is this infection transmitted placentally from mother to fetus?
During pregnancy
What occurs in the pathogenesis of the disease?
Invasion
What does the Treponema pallidum directly invade?
Mucosa
What is this Treponema pallidum possibly aided by?
Surface abrasions
What are these surface abrasions resulted from?
Intercourse
Describe the person which has this intercourse that causes surface abrasions
Infected
What develops at the site of infection?
Primary lesion
What is this primary lesion known as?
Chancre
What is the usual site of infection in which the primary lesion develops in?
External genitalia
What are the other 2 sites of infection in which the primary lesion develops in?
Lips
Anorectal region
What does the Treponema pallidum then pass to within hours?
Regional lymph nodes
What does the Treponema pallidum gain access to within hours?
Systemic circulations
What are the 5 histologic hallmarks of the Syphilis whatever the disease is that the location of the lesions are?
Endarteritis Obliterans Plasma cell Lymphocytes Giant cells Necrosis
Describe the occurrence of the Endarteritis Obliterans
Early
Which cells are mainly the histologic hallmarks of the Syphilis?
Plasma cells
Describe these giant cells
Relatively small
Describe the nuclei of these giant cells
Central
Which Syphilis stage does the necrosis occur in?
Tertiary
What is developed in the primary syphilis?
Primary lesion
Which site does this primary lesion develops at?
Inoculation
What are these 2 sites of inoculation?
Genital
Extra genital
What are the 2 extra genital sites?
Lips
Tongue
When does the primary lesion appear?
2-6 weeks after infection
What are the 3 progressions of this primary lesion?
Macule to Papule to ulcer
Describe this primary lesion (2 points)
Painless
Highly infectious
Describe the edge of this primary lesion
2 points
Sharp
Indurated
Describe the base of this primary lesion
Clean
What also occurs in the primary syphilis?
Regional lymphadenopathy
Describe the regional lymphadenopathy
2 points
Painless
Bilateral
Describe the regional lymphadenopathy when touched
Classically rubbery
When does the secondary Syphilis occur?
2 months after the primary chancre
What is the most common lesion in the Secondary Syphilis?
Mucocutaneous
What are the 3 clinical manifestations?
Skin lesion
Hair
Lymph node
What occurs in the skin lesion? (3 points)
Rash
Mucous patches
Condylomata lata
Describe this rash
Generalized
What is present in this rash? (3 points)
Macule
Papule
Pastule
What is the percentage of the occurrence of the macule, papule and pustule?
75%-100%
Describe these mucous patches
Highly infectious
What are these mucous patches?
Ulcers
Describe these ulcers
Snail track
Where are these mucous patches found on?
2 points
Pharynx
Genitalia
What is the Condylomata lata?
Papular lesions
What do these papular lesions look like?
Wart
Where do these papular lesions occur in?
Moist areas
Which 4 moist areas do these papular lesions occur in?
Axillae
Perineum
Vulva
Scrotum
What are these moist areas stuffed with?
Treponema pallidum
Describe the occurrence of these Treponema pallidum
Abundant
What occurs in the hair?
Spots
Loss of eyebrows
Describe these spots (2 points)
Patchy
Bald
What occurs in the lymph nodes?
Generalized Lymphadenopathy
Which lymph nodes does this Generalized Lymphadenopathy especially occur in?
Epitrochlear
Cervical
What are the 5 general manifestations of Secondary Syphilis?
Malaise Fever Headache Joint pain Syphilis lesions
What happens to these Syphilis lesions while the person remains infected?
Resolve without treatment
When does the Tertiary Syphilis occur?
After 2-12 years
Describe the stage of this disease
Destructive
What are the 3 main types of the Tertiary Syphilis?
Syphilitic gummas
Cardiovascular
Neurosyphilis
What is the most common complication of late syphilis?
Gummas
What is the color of this gummas?
Gray white
Describe the gummas when touched
Rubbery
What occurs in this gummas? (2 points)
Granulomas
Necrosis
Describe this necrosis (2 points)
Central
Coagulative
What is infiltered in this gummas?
Plasma cell
What are the 5 most common sites where this gummas occur in?
Skin Subcutaneous tissue Bone Joints Testis
What do these gummas do in the skin?
Break down
What do these gummas form when broken down?
Ulcers
Describe these ulcers
Punched-out
What happens to the liver as a result of this gummas?
Scarring
What does this scarring cause?
Distinctive hepatic lesion
What is this distinctive hepatic lesion known as?
Hepar lobatum
What does the Cardiovascular Syphilis result in?
Weakening
What is weakened due to the Cardiovascular Syphilis?
Aortic wall
What will the weakening of this aortic wall due to the Cardiovascular Syphilis progress into?
Late syphilis vascular manifestations
What are the 2 late syphilis vascular manifestations of the aorta?
Aneurysm
Dilatation
Which aorta do Aneurysm and the Dilatation occur in?
Ascending
Where does the Aneurysm also occur in?
Aortic arch
What is the aortic arch known as?
Thoracic aorta
What is resulted from the dilatation of the ascending aorta?
Stretching
What is stretched?
Aortic valve ring
What is produced due to the stretching of the aortic valve ring?
Aortic insufficiency
What does the Neurosyphilis cause? (4 points)
Syphilitic meningitis
Meningovascular syphilis
General insane paresis
Tabes dorsalis
What does the Meningovascular syphilis cause? (3 points)
Syphilitic arteritis
Thrombosis
Infraction
Where does the Syphilitic arteritis occur in?
Cerebral arteries
Which type of infraction occurs in the Meningovascular syphilis?
Liquefactive
What occurs in the general paresis of insane?
Loss of cortical function
Describe this loss
Gradually progressive
What does the Tabes dorsalis result in?
Loss
What is lost as a result of Tabes dorsalis?
Peripheral reflexes
Position sense
Ataxia
Describe the loss of the peripheral reflexes and ataxia
Progressive
What may be seen in advanced cases in Tabes dorsalis?
Chronic destructive changes
Where do these chronic destructive changes occur in?
Large joints
Which large joints do these chronic destructive changes occur in?
Of affected limbs
What are these large joints of affected limbs which have chronic destructive changes known as?
Charcot’s joints
How is the Treponema pallidum transmitted in Congenital Syphilis?
From a pregnant woman to her fetus
What occurs due to Congenital Syphilis?
4 points
Spontaneous abortion
Still birth
Neonatal death
Survive
Describe the affection of the baby in neonatal death
Severe
When does this baby die in neonatal death?
Soon after birth
What happens when the baby survives?
Develops late manifestations
Which stage of Congenital Syphilis does the transmission occur in?
Any
Which Congenital Syphilis stages is the risk much higher in? (2 points)
Primary
Secondary
When does the fetal infection of Congenital Syphilis occur?
Any trimester of pregnancy
What are the 3 sites in which the fetal infections of Congenital Syphilis occur in?
Bone
Teeth
Eye
What occurs in the bone? (2 points)
Saddle nose
Saber shins
What occurs in the teeth? (2 points)
Hutchinson’s teeth
Mulberry molars
What occurs in the eye? (2 points)
Corneal inflammation
Interstitial keratitis
What are the other 2 fetal infections of Congenital Syphilis?
Neurosyphilis
Hutchinson’s triad
What occurs in the Neurosyphilis of Congenital Syphilis?
Eighth nerve deafness
Describe Bilharziasis
Inflammation
What type of Inflammation is the Bilharziasis?
Chronic specific
Describe this chronic specific inflammation
Infective granuloma
Which country is the Bilharziasis present in?
Egypt
Describe the occurrence of the Bilharziasis in Egypt
Endemic
What are the 2 causative species of Bilharziasis?
S. Haematobium
S. Mansoni
What does the S. Haematobium affect?
Urogenital system
What does the S. Mansoni affect?
Digestive system
What is the pathogenesis of the Bilharziasis?
Lesions
How many lesions caused by the Bilharziasis?
3
What are the 3 lesions caused by?
Cercaria
Adult worms
Ova
What are the 3 lesions caused by the cercaria?
Acute dermatitis
Papular
Vesicular eruption
Where are the papular
and the vesicular eruption present in?
Skin
Which site are the papular
and the vesicular eruption present at?
Penetration
Describe the nature of the adult worm that can be present which causes lesions (2 points)
Living
Dead
What do the living worms produce? (2 points)
Bilharzial pigments
Ova
What happens to these bilharzial pigments?
Phagocytosis
What are the bilharzial pigments phagocytosed by?
RES
What do the dead worms cause?
Inflammation
Necrosis
What type of inflammation is caused by the dead worms?
Severe allergic
Where does the severe allergic inflammation occur?
Wall of blood vessels
What is this severe allergic inflammation known as?
Thrombophlebitis
Were do the ova pass in? (2 points)
Urine
Stool
What happens when the ova pass in the urine and stool?
Bleeding
Where does this bleeding occur in?
Rectum
Describe another form of bleeding that can occur
Terminal hematuria
What occurs due the bleeding?
Anemia
Where can the ova be trapped in?
Submucosa
What is caused due to the trapping of the ova in the submucosa?
Bilharzial granuloma
Describe this bilharzial granuloma
Periovular
What is involved in the bilharzial granuloma?
Miracidium
What does this miracidium secrete? (2 points)
Antigens
Proteolytic enzymes
What occurs when the miracidium secrete antigens and the proteolytic enzymes?
Sensitization
Which cells make this sensitization?
T-lymphocytes
What feature of these T-lymphocytes make this sensitization?
Lymphokines
What is created after the sensitization of these T-lymphocytes lymphokines?
Granulomatous reaction
Which cells are present in the granulomatous reaction?
Multinucleated giant cells
Describe the 3 passages of the granuloma
Cellular
Fibrocellular
Fibrous
What is involve in the cellular granuloma?
Ova
What are the ova surrounded by in the cellular granuloma?
Cells
What is involved in the fibrocellular granuloma?
Cellular granuloma
What is involved in the cellular granuloma?
2 points
Fibroblasts
Capillaries
What can some ova be carried by?
Blood
What are these ova carried by the blood as?
Emboli
What are the 2 organs which these ova reach when they are carried by the blood as emboli?
Lung
Liver
What is caused when the Bilharziasis occurs in the urinary bladder?
Bilharziasis cystitis
What occur in the early lesion during the Bilharziasis cystitis?
Hyperemia
Petechial hemorrhage
What is more common in the Bilharziasis cystitis?
Sandy patches
Describe the shape of these sandy patches
2 points
Irregular
Granular
What is the color of these sandy patches?
Yellow
What are the areas of these sandy patches covered with?
Atrophic mucosa
Where are the bilharzial ova deposited which cause these sandy patches?
Submucosa
Where could happen to these sandy patches?
Pressure atrophy
What is caused due to the pressure atrophy of the sandy patches?
Mucosal ischemia
What are less common in the Bilharzias cystitis?
Polyps
What occurs in the polyps?
Protrusion
What is protruded in the polyps? (2 points)
Mucosa
Submucosa
What is accompanied with this protrusion?
Bilharzial reaction
What is seen microscopically in the Bilharzial cystitis?
Connective tissue core
What does this connective tissue core contain? (2 points)
Ova
Granuloma
What is this connective tissue core covered with?
Hyperplastic mucosa
What is deposited in massive amounts causing these sandy patches?
Bilharzial ova
What is ulcerated in the Bilharzias cystitis?
Polyp
What causes ulceration in the polyp?
Extrusion
What is extruded causing this ulceration?
Ova
Which cases does the dense fibrosis occur in?
Long standing
What do these long standing cases involve?
Mucosa
What do these long standing cases sometimes involve?
Submucosa
Describe the epithelial changes of the Bilharziasis cystitis
Urothelial changes
What are the 6 urothelial changes?
Hyperplasia Squamous metaplasia Dysplasia Brunn's nests Leukoplakia Cystitis
Which 2 epithelium does the dysplasia occur in?
Urothelial
Squamous
What occurs in the Brunn’s nests?
Solid buds
Where are these solid buds present in?
Urothelial epithelium
Describe the leukoplakia
Mucosal patches
What is the color of these mucosal patches?
White
Describe the thickness of these mucousal patches
Thick
What are the 2 types of cystitis involved in the urothelial changes?
Cystica
Glandularis
What are involved in the Cystitis cystica and the Cystitis glandularis?
Cysts
What are these cysts lined by in Cystitis cystica?
Transitional epithelium
What are these cysts lined by in Cystitis glandularis?
Columnar cells
What do these columnar cells secrete?
Mucin
What are the 5 complications of Bilharziasis cystitis?
Bladder neck obstruction Renal calculi Bladder carcinoma Terminal hematuria Fistulous communication
What does the bladder neck obstruction cause? (7 points)
Diverticulum Hydroureter Hydronephrosis Pyoureter Pyonephrosis Chronic renal failure Urine retention
What are involved in the renal calculi?
Calcium phosphate stones
What does the Terminal hematuria cause?
Anemia
What does the fistula communicate with? (2 points)
Rectum
Vagina
What are the 3 organs which the complications of the Bilharziasis cystitis occur in?
Ureter
Urethra
Genitalia
Which part of the ureter will be affected?
Lower 1/3
What occurs in the ureter as a complication?
Ureteric stricture
What does the ureteric stricture cause?
Black pressure
What occurs in the urethra as a complication (3 points)?
Sandy patches
Polyps
Ulcers
What occurs in the male genitalia as a complication?
Sterility
What causes this sterility?
Fibrosis
Where does this fibrosis occur around?
Vas deferens
What occurs in the female genitalia as a complication?
Bilharzial granuloma
What does the intestinal Bilharziasis cause?
Bilharzial colitis
What is involved in the Bilharzial colitis?
4 points
Hyperemia
Edema
Petechial hemorrhage
Sandy patches
What are the most common intestinal lesions that occur in the Bilharzial colitis?
Polyps
What are the 2 most common sites where the polyps occur in?
Rectum
Sigmoid colon
Describe the ulcers that occur in the Bilharzial colitis
Shallow
Describe the shape of these ulcers
Irregular
Describe the edges of these ulcers
Sharp
Describe the floor of these ulcers
Granular
Which cases does the fibrosis occur in?
Long standing
What does this fibrosis prevent the passage of?
Ova
What does this fibrosis prevent the passage of the ova with?
Stool
Describe the Intestinal Bilharziasis caused
Closed
What are the 5 complications of the Bilharzial colitis?
Recurrent intestinal hemorrhage Intestinal stenosis Large polyps Marked fibrosis Secondary infection
What causes this intestinal stenosis?
Fibrosis
What do these large polyps cause?
Intestinal obstruction
Where does the ova pass to in the marked fibrosis?
Liver
What does the secondary infection lead to?
Dysentery
What occurs in the Bilharziasis of the liver?
Portal tract lesion
What is involved in this portal tract lesion?
Periportal fibrosis
What happens to the liver cells in the portal tract lesion?
Fatty changes
What are the 2 types of the Bilharzial hepatic fibrosis?
Periportal
Mixed
What are the 4 types of periportal fibrosis?
Fine
Diffuse
Coarse
Pipe stem
What is not involved in the Bilharzial liver?
Regenerating nodule
What happens to the ova in the Bilharzial liver?
Impaction
Penetration
Where are the ova impacted?
Portal vein branches
What does the impaction of these ova in the portal vein branches recult in?
Proliferation
What will be proliferated?
Endothelial lining
Where are these ova deposited in?
Portal tract
What do these deposited ova penetrate?
Venous wall
What is then caused when the ova penetrate the venous wall?
Granuloma
What does this granuloma cause?
Fibrosis
Where are the dead worms impacted in?
Large portal tract
What do the impacted worms cause in these large portal tract?
Thrombophlebitis
What does this thrombophlebitis cause?
Severe allergic necrosis
What does this severe allergic necrosis cause?
Dense cellular filtrate
Where are these dense cellular filtrate found around?
Veins
What also occurs in the prognosis of the Bilharzial liver?
Angiomatoids
Describe the angiomatoids
Dilated capillaries
Where are these dilated capillaries found between? (2 points)
Hepatic artery branches
Portal veins
What does the Bilharzial periportal fibrosis cause? (3 points)
Portal hypertension
Portal vein thrombosis
Ammonia encephalopathy
What does the portal hypertension causes?
7 points
Splenomegaly Ascites Venous congestion Varicosities Esophageal Piles Caput medusa
What is accompanied by the Splenomegaly?
Splenic vein thrombosis
Where does the venous congestion occur in?
Viscera
Where does the varicosities occur in?
Porto-systemic anastomosis
Describe the portal vein thrombosis
Vascular stasis
What does the normal ammonia come form?
Colon
What is this ammonia converted to?
Urea
Which organ converts the ammonia to urea?
Liver
In ammonia encephalopathy, which organ does the ammonia?
Brain
What are opened so that the ammonia reaches the brain in ammonia encephalopathy?
Shunts
Describe the spleen in Bilharzial splenomegaly
Enlarged
Describe the spleen in the early and late stages of Bilharzial splenomegaly
Firm
Describe the capsule of the spleen in the early and late stages of Bilharzial splenomegaly
Tense
Describe the surface of the spleen in the early and late stages of Bilharzial splenomegaly
Smooth
What 2 features are increased in the spleen in the early and late stages of Bilharzial splenomegaly?
Size
Weight
What occurs in the early stage of Bilharzial splenomegaly? (2 points)
Congested sinusoids
Reticuloendothelial hyperplasia
What occurs in the late stage of Bilharzial splenomegaly? (2 points)
Portal hypertension Chronic venous congestion Subcapsular haemorrhage Adhesions Thrombosis Atrophic lymphoid follicles Dilated congested sinusoids Thick capsules
What is prognosis of the Bilharzial splenomegaly in the early stage?
Reticuloendothelial hyperplasia
What are the 2 prognosis of the Bilharzial splenomegaly in the late stage?
Portal hypertension
Chronic venous congestion
What are the 2 complications of the Bilharzial splenomegaly?
Hypersplenism
Compression
What what the hypersplenism cause?
Pancytopenia
What does this Pancytopenia result in?
3 points
Anemia
Leucopenia
Thrombocytopenia
What is compressed as a complication?
Surrounding structure
What is involved in the Bilharziasis of the lung?
Emboli
What does this emboli contain?
S.Mansoni
What is rarely contained in this emboli?
S.Haematobium
Where is this emboli present in?
Collateral circulation
What is the percentage of the patients that get lung Bilharziasis?
20%
Describe the infection of Actinomycosis
Rare
Describe the disease of Actinomycosis
Bacterial
What causes Actinomycosis?
Actinomyces species
What are the 2 species of Actinomyces that cause this infection?
Actinomyces israelii
Actinomyces gerencseriae
What is the percentage of infection caused by these species?
70%
What are the 3 most common sites where the Actinomycosis occur in?
Mouth
Lungs
Gastrointestinal tract
Describe the Actinomycosis in the mouth
Cervicofacial
Describe the Actinomycosis in the lungs
Pulmonary
Describe the Actinomycosis in the Gastrointestinal tract
Intestinal
Where does the Actinomycosis rarely occur in?
Skin
What is formed in Actinomycosis?
Painful abscesses
What happens to these abscesses when the disease progresses?
Grow larger
Where do these abscesses often occur over when they grow larger as the disease progresses?
Mouths
What are the 2 surrounding sites where these abscesses penetrate ,in severe cases?
Bone
Muscle
What do these abscesses reach when they abscesses penetrate the surrounding bone and muscle?
Skin
What do these abscess break open and leak in the skin in large amounts?
Pus
What does this pus contain?
Characteristic granules
Describe these characteristic granules
Sulfur granules
What are these characteristic granules filled with?
Progeny bacteria
What is the feature of these granules where they are named based on?
Appearance
What are these granules actually not composed of?
Sulfur
What is seen in the microscopic picture of Actinomycosis? (2 points)
Colonies
lesions
What do these colonies consist of? (2 points)
Clubs
Filaments
Describe the arrangement of these clubs
Peripheral
Describe the position of these filaments
Central
What are these peripherally arranged clubs stained by?
Eosin
What is the color of these peripherally arranged clubs when stained by Eosin?
Red
What are these central filaments stained by?
Gram positive
What is the color of these central filaments when stained by Gram positive?
Blue
Which 4 cells are the colonies surrounded by?
PNLS
Macrophages
Lymphocytes
Plasma cells
Describe the number of these cells
Large
What is the lesion surrounded by?
Fibrosis
What is the Mycetoma known as?
Madura foot
Describe the disease of Mycetoma (2 points)
Chronic granulomatous
Fungal
What is the Mycetoma caused by?
Mycetoma fungus
What is the mycetoma fungus known as?
Nocardia
What does this mycetoma fungus enter?
Skin
Describe the person where this mycetoma fungus enter his skin
Barefoot
What does the mycetoma fungus enter through ,in the skin of a barefoot person?
Abrasion
What does the Mycetoma mainly affect?
Limbs
What are the 2 countries where the Mycetoma infection occur in?
Africa
India
Describe the infection in these 2 countries
Endemic
Where can the Mycetoma infection also occur in?
Egypt
Describe the initial lesion in the Mycetoma
Small subcutaneous swelling
What is this small subcutaneous swelling followed by?
Minor trauma
What then occurs later?
Sinuses
What do these sinuses discharge?
Exudates
What are the 2 exudates that the sinuses discharge?
Purulent
Seropurulent
What do these exudates contain?
Grains
Describe these grains
Fungal colonies
What may occur in the late stages of Mycetoma in the limbs?
Destruction
Deformity
Loss of function
What are destructed in the late stages of Mycetoma in the limbs?
Deeper tissues
What is the microscopic picture of the Mycetoma the same as?
Actinomycosis
What is seen in the microscopic picture of the Mycetoma? (2 points)
Colonies
Lesions
What does the microscopic picture of the Mycetoma contain?
Fungus colony
What is the center of the fungus colony?
hyphae
What is the color of this hyphae when stained?
Blue
What are these fungus colonies surrounded by?
Clubs
Describe the location of these clubs
Peripheral
What is the color of these peripheral clubs when stained?
Red
Which 4 cells surround these colonies?
PNLS
Macrophages
Lymphocytes
Plasma cells
Describe the number of these cells
Large
What are the lesions surrounded with?
Fibrosis
