CHAPTER 17 MAJOR VIRAL, BACTERIAL AND FUNGAL DISEASES OF HUMANS Infectious diseases of the skin General information Termsrelating to skin and infectious disease of the skin are as follows: • Epidermis. The superficial epithelial portion of the skin. • Dermis. The layer of skin containing blood and lymphatic vessels, nerves, and nerve endings, glands, and hair follicles. • Dermatitis. Inflammation of the skin • Sebaceous Glands. Glands in the dermis that usually open into hair follicles and secrete an oily substance known as sebum. • Folliculitis. Inflammation of a hair follicle, the sac that contains the hair. • Sty (stye). Inflammation of a sebaceous gland that opens Into a follicle of an eyelash. • Furuncle(boil). A localized pyogenic (pus producing) infection of the skin, usually resulting from folliculitis. • Carbuncle. A deep-seated pyogenic infection of the skin, usually arising from a coalescence of furuncle. Note: EA – etiologic agent MT – mode of transmission SKIN Viral Infections • • • • • Chicken pox and Shingle – EA: Varicella-zoster virus (VZV);MT: airborne droplets and direct contact German Measles (Rubella) – EA: Rubella virus; MT: airborne droplets and direct contact Measles (Rubeola) – EA: Measles virus; MT: airborne droplets and direct contact Small pox – EA: Variola minor and Variola major; MT: airborne droplets, person to person Warts – EA: Human Papilloma Virus (HPV) ; MT: direct contact, person to person Bacteria Infections • Acne – EA: Propionibacterium spp. ; MT: infected humans, probably not transmissible Furuncles. Paratrachoma – EA: certain serotypes of Chlamydia trachomatis. MT: inhalation of droplets. MT: direct skin to skin contact with the purulent lesion Streptococcal Skin Infections ( Scarlet Fever. Moraxella catarrhalis. and ingestion of endospores Gas Gangrene (Myonecrosis) – EA: Clostridium perfringens. Tinea (“Ringworm”) – EA: Dermatophyte fungi. Scalded Skin Syndrome) – EA: Staphylococcus aureus. Impetigo. MT: contact via eye and respiratory discharges Chlamydial Conjunctivitis. Haemophilus influenzae. Proteus vulgaris. Necrotizing Faciitis) – EA: Streptococcus pyogenes. MT: probable not communicable EYES Bacterial Infections • • Bacterial Conjuntivitis (“Pinkeye”) – EA: Haemophilus influenzae and Streptococcus pneumoniae are the common cause. Carbuncles. nonchlorinated swimming pools . direct skin to skin contact Fungal Infections • Dermatophytosis. contaminated fingers to eye. or entrance of bacteria in open skin Staphylococcal Skin Infections (Folliculitis. Impetigo of the Newborn. Erysipelas. Staphylococcus aureus. MT: entrance of Clostridium spores in open wounds Leprosy (Hansen’s Disease) – EA: Mycobacterium lepare. MT: direct or indirect contact with lesions EARS Viral and Bacterial Infections • • Otitis Externa (Swimmer’s Ear) – EA: Pseudomonas aeruginosa. article inserted in the ear canal Otitis Media (Middle Ear Infection) – EA: Streptococcus pneumoniae. MT: inhalation of endospores. MT: contaminated swimming pool water. Abscesses.• • • • • Anthrax (Woolsorter’s Diseases) – EA: Bacillus anthracis. Inclusion Conjunctivitis. MT: inhalation of droplets. entrance of endospores through breaks in skin. MT: contact with genital discharge of infected people. contact with contaminated hands or fomites Viral Infections • Acute. etc. indirect by hands or fomites Bacterial Infections • Diphtheria – EA: Corynebacterium diphtheriae. Black Creek Canal. also spread by flies Gonococcal Conjunctivitis. Strep Throat – EA: Streptococcus pyogenes. New York-1.• • Trachoma. MT: bird-tohuman via contact with infected poultry or surfaces contaminated from infected poultry secretions • Hantavirus Pulmonary Syndrome (HPS) – EA: five different hantaviruses (Sin Nombre. newborn via contact with the infected birth canal during delivery RESPIRATORY SYSTEM Upper Respiratory Tract Viral Infection • Common Colds. fomites. Gonorrheal Ophthalmia Neonatorum – EA: Neisseria gonorrhoeae. Viral Respiratory Disease – EA: Parainfluenza viruses. . MT: droplet inhalation. MT: adult infection via finger-to-eye contact with infectious genital secretions.. respiratory syncytial virus (RSV). Staphylococcus aureus. eating utensils. MT: direct oral contact. Febrile. MT: inhalation of respiratory droplets. Bayou. MT: direct contact usually by hands. Acute Viral Rhinitis. MT: direct contact with infectious ocular or nasal secretions or contaminated articles. Legionella pneumophila. Chlamydia Keratoconjunctivitis – EA: certain serotypes of Chlamydia trachomatis.. direct contact. inhalation of droplets. inhalation of aerosol droplets Lower Respiratory Tract Multiple Causes • Pneumonia – EA: Streptococcus pneumoniae (most common cause of pneumonia in the world). Klebsiella pneumoniae. indirect by handkerchiefs. raw milk • Streptococcal Pharyngitis. Acute Coryza – EA: major cause are Rhinoviruses. direct oral contact. etc. MT: airborne droplets. contaminated fomites. Haemophilus influenzae. some viruses fecal to oral route • Avian Influenza (Bird flu) – EA: Avian Influenza viruses. and rotaviruses. MT: airborne from water and perhaps dust. Pertussis – EA: Bortedella pertusis. MT: fecal-oral • Type B Hepatitis. MT: droplets produced by coughing Fungal Diseases • Coccidioidomycosis – EA: Coccidioides immitis. MT: inhalation of conidia from soil • Pneumocystis Pneumonia (PCP). MT: sexual or household contact with an infected . HBV Infection. MT: droplet inhalation. MT: fecaloral route. Flu – EA: Influenza viruses. astroviruses. Interstitial Plasma-Cell Pneumonia – EA: Pneumocystis jiroveci. occasionally other Mycobacterium spp. foodborne • Type A Hepatitis. MT: via airborne spread. HAV Infection. perhaps airborne GASTROINTESTINAL TRACT Viral Infections • Viral Gastroenteritis. Pontiac Fever – EA: Legionella pneumophila. TB – EA: primarily Mycobacterium tuberculosis. MT: inhalation of yeasts • Histoplasmosis – EA: Histoplasma capsulatum.• • Monongahela). Viral Diarrhea – EA: enteric adenoviruses. MT: airborne droplets. caliciviruses. nose or eye after touching a contaminated surface or object Bacterial Infections • Legionellosis. direct contact with infected person or articles contaminated with nasal secretions or sputum • Tuberculosis. Serum Hepatitis – EA: Hepatitis B virus (HBV). Primary Atypical Pneumonia – EA: Mycoplasma pneumoniae. and saliva Influenza. touching the mouth. and C.. perhaps transfer of pulmonary secretions from infected to susceptible person. Epidemic Hepatitis – EA: Hepatitis A virus (HAV). MT: inhalation of arthrospores • Cryptococcosis – EA: Cryptococcus neoformans. probably not person-to-person • Mycoplasmal Pneumonia. prolonged direct contact with infected persons • Whooping Cough. MT: inhalation or aerosolized rodent feces. urine. types A. MT: respiratory droplets.direct contact Severe Acute Respiratory Syndrome (SARS) – EA: SARSassociated coronaviruses (SARS-CoV). Viral Enteritis. Infectious Hepatitis. MT: direct contact. B. Legionnaire’s Disease. MT: primarily parenterally transmitted (e. fecally contaminated beef. Non-A Non-B Hepatitis – EA: Hepatitis C virus (HCV). less sever Salmonella paratyphi. coli. MT: exposure to infected blood and body fluids. primarily via fecally contaminated drinking water. Bacillary Dysentery – EA: Shigella dysenteriae. ingestion of fecally contaminated food or water Protozoal Infections • Amebiasis – EA: Entamoeba histolytica.g. ingestion of fecally contaminated food and water • Enterohemorrhagic Escherichia coli (EHEC) Diarrhea –EA: Escherichia coli O157:H7. less common Campylobacter coli. contaminated water supplies • Typhoid Fever. contaminated needles. fecal-oral transmission. MT: fecal-oral route. MT: ingestion of contaminated food. and other Shigella spp. fecally contaminated hands and fingernails. MT: fecal-oral route. tattooing. coinfection with HBV is necessary Type E Hepatitis – EA: Hepatitis E virus (HEV). injected drug use. Traveler’s Diarrhea –EA: many different serotypes of Enterotoxigenic E. HCV Infection. needle stick injuries (nosocomial) Type C Hepatitis. MT: direct or indirect fecal-oral transmission. MT: ingestion of contaminated food. unpasteurized milk. MT: fecal-oral route. MT: fecal-oral transmission. sexual transmission. Delta Hepatitis – EA: Hepatitis D virus (HDV).. contact with feces or vomitus.MT: parenteral Bacterial Infections • Bacterial Gastritis and Ulcers – EA: Helicobacter pylori. contact with infected animals • Cholera – EA: Vibrio cholerae serogroup 1.• • • • person. presumed to be either oral-oral or oral-fecal transmission • Campylobacter Enteritis – EA: Campylobacter jejuni. flies • Salmonellosis – EA: Salmonella typhimurium and Salmonella enteriditis. raw milk and water. MT: fecal-oral route. ingestion of fecally contaminated water and foods. mother to infant before or during birth. MT: probably via ingestion. ingestion of inadequately cook food. feces to food by flies • Shigellosis. MT: ingestion of focally contaminated food and water with oocysts . Enteric Fever – EA: Salmonella typhi. also person to person Type G Hepatitis – EA: Hepatitis G virus (HGV). and fecally contaminated water • Enterotoxigeic Escherichia coli (ETEC) Diarrhea. ingestion of food or water contaminated by feces or urine of patients or carriers. via blood transfusion) Type D Hepatitis. also by needstick Bacterial Infections • Lyme Disease – EA: Borrelia burgdorferi. MT: via flea bite (rodent to to flea. Rabbit Fever – EA: Francisella tularensis. secretions. Septicemic Plague – EA: Yersinia pestis. or semen. MT: direct contact. “Black Death”. MT: fecat-oral. through breaks in the skin or mucous membranes. type 2 (HSV 2). oral-genital. Pneumonic Plague. Genital Papillomatosis. ingestion of contaminated food and water Giardiasis – EA: Giardia lamblia. sharing of contaminated needles and syringes • Mumps. Bubonic Plague. entry of organism into wounds. Acquired Immune Deficiency Syndrome (AIDS) – EA: Human Immunodeficiency Virus (HIV). Infectious Parotitis – EA: Mumps virus. HPV genotypes 16 and 18 have been associated with cervical cancer. ingestion of contaminated meat or drinking water GENITOURINARY TRACT Viral STDs • Anogenital Herpes Viral Infections. MT: droplet spread. MT: direct sexual contact. or anal-genital contact during presence of lesion. internal organs. MT: direct sexual contact. flea to human) • Tularemia. Condyloma Acuminatum – EA: Human Papilloma viruses (HPV). MT: direct contact with infected blood. MT: via tick bite. mother to fetus during pregnancy. MT: via tick bite • Plague. direct contact with saliva of infected person • Viral Hemorrhagic Diseases – EA: Ebola virus and Marbug virus. mother to neonate during birth • Genital Warts. usually sexual. MT: fecal-oral.• • Cryptosporidiosis – EA: Cryptosporidium parvum. Genital Herpes – EA: herpes simplex virus. from mother to neonate during birth Bacterial STDs . oral-anal. ingestion of cysts in fecaly contaminated water or food CIRCULATORY SYSTEM Viral Infections • Human Immunodeficiency Virus (HIV) Infection. MT: direct contact with lesions. semen. transplacentally from mother to fetus Protozoal Infection • Trichomoniasis – EA: Trichomonas vaginalis. and vaginal discharges of infected people. MT: ingestion of contaminated food • Tetanus. saliva. usually during sexual contact. St. genital Chlamydiasis – EA: certain serotypes of Chlamydia trachomatis. WEE virus. MT: ingestion of food with toxin (food poisoning). EEE virus. Lockjaw – EA: Clostridium tetani. falciparum). Polio. Arthropodeborne Viral Encephalitis – EA: West Nile virus. African Sleeping Sickness – EA: Trypanosoma brucei. Louis encephalitis virus. body secretions.• • • Genital Chlamydia Infections. California encephalitis virus. MT: bite of infected tsetse fly • American Trypanosomiasis – EA: Trypanosoma cruzi. MT: by tick bite • Malaria – EA: four different species of Plasmodium (vivax. MT: injection of sporozoites by infected female Anopheles mosquito . ovale. mother to neonate during birth Syphilis – EA: Treponema pallidum. MT: bite of reduviid bigs • Babesiosis – EA: Babesia microti. MT: fecal-oral route • Rabies – EA: Rabies virus. entrance of spores in wounds (wound infection) • Listeriosis – EA: Listeria monocytogenes. MT: direct sexual contact. LaCrosse encephalitis virus. burns or needlestick injury Protozoal Infections • African Trypanosomiasis. usually sexual contact. MT: bite of rabid animal • Viral encephalitis. mother to neonate during birth Gonorrhea – EA: Neisseria gonorrhoeae. malariae. MT: direct mucous to mucous membrane contact. also through blood transfusion. MT: arthropod vector (mosquito) Bacterial Infections • Botulism – EA: Clostridium botulinum. MT: sexual intercourse CENTRAL NERVOUS SYSTEM Viral Infections • Poliomyelitis. Infantile Paralysis – EA: Polioviruses. mucous membranes. MT: entrance of spores in puncture wound.
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