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Classification of the infection diseases Sorokhan V.D., MD, PhD Bukovinian State Medical University Department of the infectious diseases and epidemiology
Microbiological Classification of Infectious Diseases Protozoa Helminths Parasitic Prion Disseminated Localized Fungal DNA virus RNA virus Enveloped vs non-enveloped Viral Gram-negative Gram-positive Bacterial
Gram-negative bacteria   ,[object Object],Gram-negative  Pseudomonas aeruginosa  bacteria (pink-red rods)
Gram negative Cocobacilli H. Influenzae, B. Pertussis Brucella spp., F. Tularensis P. Multosida, L. pneumophila Cocci Neisseria spp. Bacilli N. Meningitidis Glucose and maltose + N. Gonnorrhoeae Glucose + Lactose + Lactose - Slow fermenter Citrobacter Serratia Fast fermenter Klebsiella E.Coli Enterobacter Oxidase + V.Cholerae P. aeruginosa Strict anaerode B. fragilis Oxidase - Urease – Y. Pestis S. Dysenteriae Salmonnela spp. Urease + P. Mirabilis H. pylori
Gram-positive bacteria ,[object Object],Gram-positive  Bacillus anthracis  bacteria (purple rods) in  cerebrospinal fluid  sample. The other cells are  white blood cells .
Gram positive cocci Bacilli, Corinebacterium Clostridium, Listeria, Bacillus Staphylococcus catalase + Streptococcus catalase - S. Aureus Coagulase + Coagulase - β -hemolytic α -hemolytic S. Pneumoniae S. Viridans S. Mutans γ -hemolytic E. Faecalis E. Faecium S. Epidermis Novobiocin sensitive S. Saprophyticus Novobiocin resistant Group A S. Piogenes Group B S.agalactiae
Basic laboratory characteristics   highly motile   Gram-negative, but stains poorly   Borrelia   burgdorferi   Borrelia   Aerobic Unencapsulated   Small  coccobacilli Gram-negative Brucella   abortus   Brucella   canis   Brucella   melitensis   Brucella   suis   Brucella   aerobic   Encapsulated   Small  coccobacilli   Gram-negative   Bordetella   pertussis   Bordetella   Curved, spiral, or S-shaped with single, polar flagellum   Shape   microaerophilic   characteristic darting motion   Gram-negative   Campylobacter   jejuni   Campylobacter   Respiration   Motility   Capsulation   Gram   staining   Important species   Genus
Obligate anaerobic  mostly motile  Large, blunt-ended rods  Gram-positive  Clostridium  botulinum   Clostridium  difficile   Clostridium  perfringens   Clostridium  tetani   Clostridium   Mostly facultative anaerobic  nonmotile  unencapsulated  Small, slender,  pleomorphic  rods  Gram-positive (unevenly)  Corynebacterium   diphtheriae   Corynebacterium   Facultative or strictly aerobic  motile  Small, round, ovoid  (not Gram-stained)  Chlamydia   pneumoniae   Chlamydia   trachomatis   Chlamydophila   psittaci   Chlamydia  and  Chlamydophila   Round to ovoid  Shape   Facultative Anaerobic  Gram-positive  Enterococcus   faecalis   Enterococcus   faecium   Enterococcus   Respiration   Motility   Capsulation   Gram   staining   Important species   Genus
strictly aerobic  Small,  pleomorphic  coccobacillus  Gram-negative Francisella   tularensis   Francisella   Ranging from small coccobacillus to long, slender filaments   Gram-negative  Haemophilus   influenzae   Haemophilus   Facultative anaerobic  Short rods  Gram-negative  Escherichia   coli   Escherichia   Curved or spiral rods pultiple polar flagella   Shape   rapid, corkscrew motility  Gram-negative  Helicobacter   pylori   Helicobacter   Respiration   Motility   Capsulation   Gram   staining   Important species   Genus
highly motile  Long, very slender, flexible, spiral- or corkscrew-shaped rods   Gram-negative, but stains poorly   Leptospira   interrogans   Leptospira   Distinct tumbling motility in liquid medium   Slender, short rods  Gram-positive, darkly  Listeria   monocytogenes   Listeria   motile  unencapsulated  Slender rod in nature, cocobacillary in laboratory. monotrichious flagella   Gram-negative, but stains poorly   Legionella   pneumophila   Legionella   Long, slender rods  Shape   aerobic  nonmotile  (none)  Mycobacterium   leprae   Mycobacterium   tuberculosis   Mycobacterium   ulcerans   Mycobacterium   Respiration   Motility   Capsulation   Gram   staining   Important species   Genus
aerobic  Kidney bean-shaped  Gram-negative  Neisseria   gonorrhoeae   Neisseria   meningitidis   Neisseria   Obligate aerobic  motile  encapsulated  rods  Gram-negative  Pseudomonas   aeruginosa   Pseudomonas   Plastic, pleomorphic  (none)  Mycoplasma   pneumoniae   Mycoplasma   Small, rod-like coccobacillary  Shape   Gram-negative, but stains poorly   Rickettsia   rickettsii   Rickettsia   Respiration   Motility   Capsulation   Gram   staining   Important species   Genus
Facultative anaerobic  rods  Gram-negative  Shigella   sonnei   Shigella   Facultative anaerobic  Round cocci  Gram-positive, darkly  Staphylococcus  aureus   Staphylococcus  epidermidis   Staphylococcus  saprophyticus   Staphylococcus   Facultative anaerobic  Gram-negative  Salmonella   typhi   Salmonella   typhimurium   Salmonella   ovoid to spherical  Shape   Facultative anaerobic  nonmotile  Gram-positive  Streptococcus  agalactiae   Streptococcus  pneumoniae   Streptococcus  pyogenes   Streptococcus   Respiration   Motility   Capsulation   Gram   staining   Important species   Genus
Facultative anaerobic  rapidly motile  Short, curved, rod-shaped with single polar flagellum   Gram-negative  Vibrio   cholerae   Vibrio   Facultative Anaerobe  nonmotile  encapsulated  Small rods  Gram-negative, stains bipolarly  Yersinia   pestis   Yersinia   highly motile  Long, slender, flexible, spiral- or corkscrew-shaped rods   Gram-negative, but stains poorly   Treponema   pallidum   Treponema   Shape   Respiration   Motility   Capsulation   Gram   staining   Important species   Genus
Clinical characteristics Large, grayish, nonhemolytic colonies with irregular borders on blood agar  Direct  immunofluorescence   Anthrax   vaccine   autoclaving  of instruments  In early infection:  Penicillin   Doxycycline   Ciprofloxacin   Cutaneous   anthrax   Pulmonary   anthrax   Gastrointestinal   anthrax   Contact with sheep, goats and horses  Inhalation or skin penetration through abrasions of spore-contaminated dust  Bacillus   anthracis   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
Direct  immunofluorescence   PCR  amplification   Pertussis vaccine,  DPT  vaccine   Macrolide   antibiotics   Azithromycin   Erythromycin   Clarithromycin   Whooping   cough   Complications: Secondary  bacterial   pneumonia   Contact with respiratory droplets expelled by infected human hosts.  Bordetella   pertussis   Microscopy using  Giemsa  or  Wright stain   PCR   serology  (low  precision   rate )  Lyme   vaccine   wearing clothing that limits skin exposure to ticks  insect   repellent   Early stages:  cephalosporins   amoxicillin   doxycycline   If arthritic symptoms have appeared:  Longer courses of antibiotics  Lyme   disease   Ixodes  ticks reservoir in deer, mice and other rodents   Borrelia   burgdorferi   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
Culture (difficult and time consuming)  Agglutination   serology   Combination therapy of:  doxycycline   streptomycin  or  gentamicin   Brucellosis   Direct contact with infected animal  Oral, by ingestion of unpasteurized milk or milk products  Brucella   abortus   Brucella   canis   Brucella   melitensis   Brucella   suis   Symptomatically by fluid and electrolyte replacement  Ciprofloxacin  in severe cases  Acute   enteritis   Fecal/oral from animals (mammals and fowl)  Contaminated meat (especially poultry)  Contaminated water  Campylobacter   jejuni   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
None for routine use  None  Doxycycline   Erythromycin   Community-acquired respiratory infection  Respiratory droplets  Chlamydia   pneumoniae   Cellular cytoplasmic inclusions by  immunofluorescence   DNA  hybridization   ELISA  for lipopolysaccharides  No vaccine  Erythromycin or silver nitrate in newborn's eyes  Safe   sex   Azithromycin   Erythromycin   Tetracyclines   Doxycycline   Nongonococcal   urethritis  (NGU)  Lymphogranuloma   venereum  (LGV)  Trachoma   Inclusion conjunctivitis of the newborn  (ICN)  Sexual ( NGU ,  LGV )  Direct or contaminated surfaces and flies (trachoma)  Passage through birth canal ( ICN )   Chlamydia   trachomatis   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
Rise in antibody titre Complement fixation  indirect immunofluorescence  Tetracycline   Doxycycline   Erythromycin  (less efficient)  Psittacosis   Inhalation of dust with secretions or feces from birds (e.g. parrots)   Chlamydophila   psittaci   Mouse inoculation detects toxin from food, intestinal contents or serum  Culture in standard aerobic culture  Proper food preservation techniques  Antitoxin  (horse  antiserum )  Botulism   Spores from soil and aquatic sediments contaminating vegetables, meat and fish   Clostridium   botulinum   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
ELISA  for  Toxin ELISA  for toxin A or B  Endoscopy  for pseudomembrane  None  Discontinuing predisposing antibiotic  Fluid and electrolyte replacement  Vancomycin  or  metronidazole  if severe  Pseudomembranous   colitis   Spores both indoors and outdoors  Human flora , overgrowing when other flora is depleted  Clostridium   difficile   Microscopically  Blood agar culture, forming double-zone  β - hemolysis   Sugar fermentation  Organic acid production  Appropriate food handling  Food poisoning: Self-limiting; Supportive care is sufficient  Gas   gangrene   Acute  food   poisoning   Anaerobic   cellulitis   Spores in soil  Human flora  in vagina and GI tract  Clostridium   perfringens   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
(difficult)  DPT  vaccine   Tetanus immune globulin  Horse antitoxin, alternatively  Sedatives  Muscle relaxants  Mechanical   ventilation   Tetanus   Spores in soil infecting puncture wounds, severe burns or surgery  Clostridium   tetani   no rapid)  Culture on  Tinsdale  agar , followed by immunologic  precipitin  reaction  DPT  vaccine   Horse serum antitoxin  Erythromycin   Penicillin   Diphtheria   Respiratory droplets  Part of human flora  Corynebacterium   diphtheriae   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
Culture in 6.5%  NaCl   Can hydrolyze  esculin  in presence of bile  No vaccine  Hand washing and other  nosocomial  prevention   Penicillin and an  aminoglycoside   Vancomycin   Quinupristin  and  dalfopristin   Nosocomial infections  Part of human flora,  opportunistic  or entering through GI tract or urinary system wounds  Enterococcus   faecalis  and  Enterococcus   faecium   Culture on  MacConkey  agar  and study carbohydrate fermentation patterns: Lactose fermentation (most E. coli strains) . Gas production in glucose fermentation  Mannitol fermentation  (no vaccine or preventive drug)  Food and water preparation  Hand washing and disinfection  UTI:  Co-trimoxazole   Fluoroquinolone , e.g.  ciprofloxacin   Meningitis: Cephalosporin  and  gentamicin  combination  Diarrhea: Antibiotics above shorten duration  Electrolyte and fluid replacement  Urinary   tract   infections  (UTI)  Diarrhea  Meningitis in infants  Part of  gut flora , spreading extraintestinally or proliferating in the GI tract  Escherichia   coli  (generally)  laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
rarely cultured)  Serology  Avoiding insect vectors  Precautions when handling wild animals or animal products  Streptomycin   Gentamicin   Tularemia   vector -borne by anthropods  Infected wild or domestic animals, birds or house pets  Francisella   tularensis   Culture on  chocolate agar  with  hemin  (factor X) and  NAD+  (factor V)  Quellung   reaction   Immunofluorescence  staining of capsule  Detection of capsular antigen in  CSF  or other body fluids  Hib   vaccine  to infants  Rifampin  prophylactically  Meningitis:  (resistance-tests are required first) Third generation cephalosporin , e.g.  cefotaxime  or  ceftriaxone   Ampicillin  and  sulbactam  combination  Bacterial meningitis  Upper   respiratory   tract   infections   Pneumonia ,  bronchitis   Droplet contact  Human flora of e.g. upper respiratory tract  Haemophilus   influenzae   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
Microscopically Corkscrew movement  Urease -positivity by radioactively labeled urea  Serology by  ELISA   (No vaccine or preventive drug)   Tetracycline ,  metronidazole  and  bismuth salt  combination  Peptic   ulcer   Risk factor for  gastric carcinoma  and gastric  B-cell lymphoma   Colonizing stomach  Unclear person-to-person transmission  Helicobacter   pylori   Culture from respiratory secretions on buffered charcoal  yeast extract  enriched with L- cysteine , iron and  α - ketoglutarate   Serology, including direct immunofluorescence and radioimmunoassay for antigen in urine  Hybridization to ribosomal RNA using  DNA probe   (no vaccine or preventive drug)  Heating water  Macrolides , e.g.  erythromycin  or  azithromycin   Fluoroquinolones   Legionnaire's   Disease   Pontiac   fever   Droplet contact, from e.g.  cooling   towers ,  humidifiers , air conditioners and water distribution systems  Legionella   pneumophila   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
Dark-field microscopy  on fresh blood smear (but doesn't stain well)  Serologic agglutionation tests  (no vaccine)  Doxycycline   Prevention of exposure Rodent control  Penicillin  G   Tetracycline , e.g.  doxycycline   Leptospirosis   Food and water contaminated by e.g. urine from wild or domestic animals.  Leptospira survives for weeks in stagnant water  Leptospira   interrogans   Isolation from e.g. blood and  CSF   Beta- hemolysis  and catalase production on blood agar  Microscopy for morphology and motility  (no vaccine)  Proper food preparation and handling  Ampicillin   Co-trimoxazole   Listeriosis   Dairy products, ground meats, poultry  Vertical  to newborn or fetus  Listeria   monocytogenes   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
Tuberculoid form:  Hard to isolate (diagnosis on clinical findings and histology of biopsies)  Lepromatous form: Acid-fast staining from e.g. skin scrapings  BCG vaccine  shows some effects   Tuberculoid form:  Dapsone  and  rifampin   Lepromatous form: Clofazimine  Leprosy  (Hansen's disease)  Prolonged human-human contact, e.g. through exudates from skin lesions to abrasion of other person  Mycobacterium   leprae   Ziehl-Neelsen  stain showing  acid-fast  bacteria  Hybridization probes  for DNA, succeeded by  PCR   Culture on  Lowenstein-Jensen  agar  BCG  vaccine   Isoniazid   Standard "short" course: First 2 months, combination:  Isoniazid   Rifampicin   Pyrazinamide   Ethambutol   Further 4 months, combination:  Isoniazid   Rifampicin   Tuberculosis   Droplet contact  Mycobacterium   tuberculosis   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
(difficult to culture)  Serologic tests, e.g.  complement fixation test   DNA probes  on sputum specimens  Doxycycline  and  erythromycin   Mycoplasma   pneumonia   Human flora  Droplet contact  Mycoplasma   pneumoniae   Microscopy showing gram-negative diplococci, often with  PMNs   Culture on  chocolate agar , giving positive  oxidase  test  and fermentation of glucose and maltose in 5% CO2 in air  NmVac4-A/C/Y/W-135  vaccine  Rifampin   Penicillin  G   Cefotaxime   Ceftriaxone   Meningococcal   disease  including meningitis  Waterhouse-Friderichsen   syndrome   Respiratory droplets  Neisseria   meningitidis   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
Colourless colonies on  MacConkey  agar .  Production of  pyocyanine  and  fluorescein   Positive  oxidase  test . No lactose fermentation.  (no vaccine)  Topical  silver sulfadiazine  for burn wounds  Aminoglycoside  and anti-pseudomonal  β - lactam   Pseudomonas   infection   Localized to eye, ear, skin, urinary, respiratory or gastrointestinal tract or CNS, or systemic with bacteremia, secondary pneumonia bone and joint infections, endocarditis, skin, soft tissue or CNS infections.   Infects damaged tissues or people with reduced immunity   Pseudomonas   aeruginosa   Serology  Immunofluorescence  against Rickettsia antigens  no preventive drug or approved vaccine)  Vector control, such as clothing  Prompt removal of attached ticks  Doxycycline   Chloramphenicol   Rocky   mountain   spotted   fever   Bite of infected  wood  or  dog tick   Rickettsia   rickettsii   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
Isolation from blood, feces, bone marrow, urine or rose spots on skin  Colorless, non-lactose fermenting colonies on  MacConkey  agar   Serology for antibodies against  O antigen   Ty21a  and  ViCPS  vaccines  Hygiene and food preparation  Ceftriaxone   Fluoroquinolones , e.g.  ciprofloxacin   Typhoid fever  type  salmonellosis  (dysentery, colitis)   Human-human  Fecal-oral through food or water  Salmonella   typhi   Colourless colonies on  MacConkey  agar   (No vaccine or preventive drug)  Proper sewage disposal  Food preparation  Good personal hygiene  Fluid and electrolyte replacement for severe diarrhea  Antibiotics (in immunocompromised to prevent systemic spread)  Salmonellosis  with  gastroenteritis  and  enterocolitis   Fecal-oral  Food contaminated by fowl (e.g. eggs), pets and other animals  Salmonella   typhimurium   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
Culture on  Hektoen  agar  or other media for intestinal pathogens  Protection of water and food supplies  Vaccines are in trial stage  Ciprofloxacin  or  azithromycin   Bacillary   dysentery / Shigellosis   Fecal-oral  Flies  Contaminated food or water  Shigella   sonnei   Microscopy showing strongly positive  Gram stained  cells in grape-like clusters  Positive  Catalase  test  and  coagulase  test   Culture on enriched media producing deep yellow, hemolytic colonies  (no vaccine or preventive drug)  Barrier precautions, washing hands and  fomite  disinfection in hospitals  Incision and drainage of localized lesions  Nafcillin  and  oxacillin   Vancomycin  for  Methicillin -resistant (MRSA)   Coagulase-positive  staphylococcal   infections :  Localized skin infections  Diffuse skin infection ( Impetigo )  Deep, localized infections  Acute   infective   endocarditis   Septicemia   Necrotizing   pneumonia   Toxinoses   Toxic   shock   syndrome   Staphylococcal   food   poisoning   Human flora on  mucosae  in e.g. anterior  nares  and vagina, entering through wound  Staphylococcus   aureus   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
Microscopy showing strongly positive  Gram stained  cells in grape-like clusters  Positive  Catalase  test  but negative  coagulase  test   Novobiocin -sensitivity (S. epidermidis)  Novobiocin -resistance (S. saprophyticus)  Culture on enriched media producing white, nonhemolytic colonies  None  Vancomycin   Infections of implanted  prostheses , e.g. heart valves and catheters  Human flora in skin and anterior nares   Staphylococcus   epidermidis   Microscopy showing  gram-positive , encapsulated lancet-shaped diplococci  α - hemolysis  on blood agar, bile-soluble, optochin-sensitive  Positive  Quellung   reaction   23-serotype vaccine for adults ( PPV )  Heptavalent conjugated vaccine for children ( PCV )  Penicillin  G   Vancomycin  for resistant strains  Acute  bacterial pneumonia  &  meningitis  in adults  Otitis  media  and  sinusitis  in children  Respiratory droplets  Often human flora in nasopharynx (spreading in immunocompromised)  Streptococcus   pneumoniae   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
Culture on  sheep blood agar  forming small,  opalescent  surrounded by large zone of  β - hemolysis   Serology for  ASO   Very  bacitracin -sensitive  No vaccine  Rapid antibiotic treatment helps prevent rheumatic fever  Penicillin  G   Macrolide , e.g.  clarithromycin  or  azithromycin  in penicillin allergy  Drainage and  debridement  for Necrotizing fasciitis   Streptococcal   pharyngitis   Scarlet   fever   Rheumatic   fever   Impetigo  and  erysipelas   Puerperal   fever   Necrotizing   fasciitis   Respiratory droplets  Direct physical contact with  impetigo  lesions  Streptococcus   pyogenes   Culture on  blood  or  MacConkey  agar , enhanced by  TCBS   Positive  oxidase   test   Preventing fecal contamination of water supplies and food  Adequate food preparation  Fluid and electrolyte replacement  e.g.  doxycycline  to shorten duration  Cholera   Contaminated water and food, especially raw seafood  Vibrio   cholerae   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
Gram-negative smear  If pneumonic, culture from aspirate on  MacConkey  or  blood agar   Formalin-killed  plague   vaccine   Minimize exposure to rodents and fleas  Streptomycin  primarily  Gentamicin   Tetracyclin   Supportive therapy for  shock   Plague :  Bubonic   plague   Pneumonic   plague   Fleas  from animals  Ingestion of animal tissues  Respiratory droplets  Yersinia   pestis   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Species  Species of human pathogenic bacteria
nucleus  icosahedral  non-enveloped  adenovirus   dsDNA   Adenoviridae   icosahedral   non-enveloped   coxsackievirus ,  hepatitis A virus ,  poliovirus ,  rhinovirus   + ssRNA   Picornaviridae   nucleus   enveloped   Herpes simplex, type 1 ,  Herpes simplex, type 2 ,  Varicella -zoster virus ,  Epstein- barr  virus ,  Human cytomegalovirus ,  Human  herpesvirus , type 8   dsDNA   Herpesviridae   nucleus   icosahedral   enveloped   Hepatitis  B  virus   dsDNA  and  ssDNA   Hepadnaviridae   icosahedral enveloped   Hepatitis C virus ,  yellow fever virus ,  dengue virus ,  West Nile virus   + ssRNA   Flaviviridae enveloped   Human   immunodeficiency   virus  (HIV)   + ssRNA Retroviridae   Replication site  Virion shape  envelopment   Important species  Baltimore   group   Family  Comparison table of clinically important virus families and species
nucleus  spherical  enveloped  Influenza   virus   - ssRNA   Orthomyxoviridae   spherical  enveloped  Measles virus ,  Mumps virus ,  Parainfluenza  virus ,  Respiratory  syncytial  virus ,  Human  metapneumovirus   - ssRNA   Paramyxoviridae   nucleus icosahedral  non-enveloped  Human   papillomavirus   dsDNA   Papillomaviridae   helical, bullet shaped  enveloped  Rabies   virus   - ssRNA   Rhabdoviridae   icosahedral enveloped  Rubella   virus   + ssRNA   Togaviridae   icosahedral  enveloped  Human   bocavirus ,  Parvovirus  B19   ssDNA   Parvoviridae   Replication site  Virion shape  envelopment   Important species  Baltimore   group   Family   Comparison table of clinically important virus families and species
The clinical characteristics of viruses may differ substantially among species within the same family: Cell culture, antibody detection  None  None  Coxsackie   infections   fecal-oral, droplet contact  Picornaviridae   Coxsackievirus   virus   neutralization   hemagglutination assay  ELISA  None None  acute   febrile   pharyngitis   pharyngoconjunctival fever  epidemic keratoconjunctivitis  infantile gastroenteritis  droplet contact (mainly)  fecal-oral  venereal  direct contact (ocular infections)  adenoviridae   adenovirus  laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Family  Type
antibody detection  Vaccine  immunoglobulin (post-exposure prophylaxis)  avoid food-contamination  Immunoglobulin  ( post-exposure   prophylaxis )  acute   hepatitis   fecal-oral  Picornaviridae   Hepatitis  A  virus   viral antigen detection  antibody detection  nucleic acid detection  vaccine  immunoglobulin (perinatal and post-exposure prophylaxis)  immunoglobulin  Adefovir   Entecavir   Pegylated   interferon  alfa-2   Lamivudine   acute   hepatitis   chronic hepatitis  hepatic cirrhosis  hepatocellular carcinoma  All  body   fluids  (blood, semen, saliva, mother's milk etc.)  Hepadnaviridae   Hepatitis  B  virus   Antibody detection  immunoflourescence  ELISA  Nucleic acid detection  None  None  infectious   mononucleosis   Burkitt lymphoma  Saliva  Herpesviridae   Epstein-Barr   virus laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Family  Type
The clinical characteristics of viruses may differ substantially among species within the same family: immunofluorescence   immunoperoxidase  nucleic acid detection  None  acyclovir   famciclovir  foscarnet  penciclovir  primary  HSV-1  infection   ( gingivostomatitis  in children,  tonsillitis  &  pharyngitis  in adults,  keratoconjunctivitis )  latent HSV-1 infection ( herpes   labialis ,  cold   sores )  direct contact with saliva and lesions  Herpesviridae   Herpes   simplex   virus ,  type  1   antibody detection  nucleic acid detection  None  Pegylated   interferon  alfa-2   Ribavirin  acute hepatitis   chronic hepatitis  hepatic cirrhosis  hepatocellular carcinoma   blood  (sexual)  Flaviviridae Hepatitis  C  virus   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Family  Type
The clinical characteristics of viruses may differ substantially among species within the same family: antibody and nucleic acid detection  None ganciclovir   cidofovir  foscarnet  infectious   mononucleosis   Cytomegalic inclusion disease  tears  urine  semen  saliva  vaginal secretions  mother's milk  crosses  placenta   blood  Herpesviridae   cytomegalovirus   cell culture  immunofluorescence  immunoperoxidase  nucleic acid detection  contact-avoidance with lesions  safe sex  acyclovir   famciclovir  foscarnet  penciclovir  cidofovir  primary  HSV-2  infection   latent HSV-2 infection  aseptic meningitis  sexually  birth  Herpesviridae   Herpes   simplex   virus ,  type  2   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Family  Type
The clinical characteristics of viruses may differ substantially among species within the same family: nucleic acid,  p24  antibody detection  zidovudine  (perinatally)  blood product screening  safe sex  HAART   AIDS   sexual  blood  mother's milk  Retroviridae   HIV   Nucleic acid and antibody detection None many in evaluation-stage  Kaposi   sarcoma   multicentric  Castleman   disease   primary effusion lymphoma  Herpesviridae   Human   herpesvirus ,  type  8   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Family  Type
The clinical characteristics of viruses may differ substantially among species within the same family: antibody detection  MMR  vaccine   None  measles   postinfectious encephalomyelitis  droplet contact  Paramyxoviridae   measles   virus Hemagglutination   assay   antigen detection  Influenza   vaccine   amantadine  rimantadine  amantadine   rimantadine  zanamivir  oseltamivir  influenza  ( Reye   syndrome )  droplet contact  Orthomyxoviridae   Influenza   virus   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Family  Type
The clinical characteristics of viruses may differ substantially among species within the same family: Visual inspection  Antigen detection  Nucleic acid detection  HPV  vaccine   wart tissue avoidance  safe sex  liquid   nitrogen   laser vaporization  cytotoxic chemicals  interferon  cidofovir  direct contact hyperplastic   epithelial   lesions  ( common ,  flat ,  plantar  and  anogenital   warts ,  laryngeal   papillomas ,  epidermodysplasia   verruciformis ) 55+ (hands/ feet) 30+ (anogenital/ some are oral/ throat/ respiratory)  Malignancies for some species ( cervical   carcinoma ,  squamous   cell   carcinomas )  direct contact  Papillomaviridae   Human   papillomavirus antibody detection  MMR  vaccine None  Mumps   droplet contact  Paramyxoviridae   Mumps   virus   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Family  Type
The clinical characteristics of viruses may differ substantially among species within the same family: antibody detection  MMR  vaccine   None  measles   postinfectious encephalomyelitis  droplet contact  Paramyxoviridae   measles   virus Hemagglutination   assay   antigen detection  Influenza   vaccine   amantadine  rimantadine  amantadine   rimantadine  zanamivir  oseltamivir  influenza  ( Reye   syndrome )  droplet contact  Orthomyxoviridae   Influenza   virus   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Family  Type
The clinical characteristics of viruses may differ substantially among species within the same family: Antibody detection  None  None  croup   pneumonia  bronchiolitis  common cold  droplet contact  Paramyxoviridae   Parainfluenza   virus   Antibody detection  None  None  croup   pneumonia   bronchiolitis   common   cold   droplet contact  Paramyxoviridae   Parainfluenza   virus   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Family  Type
The clinical characteristics of viruses may differ substantially among species within the same family: Histology (postmortem)  Pre- and postexposure prophylaxis  Post-exposure prophylaxis  Rabies   Animal bite  droplet contact  Rhabdoviridae   Rabies   virus   Antibody detection  Polio   vaccine   None Poliomyelitis   fecal-oral  Picornaviridae   Poliovirus   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Family  Type
The clinical characteristics of viruses may differ substantially among species within the same family: Antibody detection  MMR  vaccine   None  German   measles   congenital rubella  droplet contact  Togaviridae   Rubella   virus   antibody and antigen detection  hand-washing avoidance  palivizumab  in high risk individuals  ( ribavirin )  bronchiolitis  pneumonia  influenza-like syndrome  severe bronchiolitis with pneumonia  droplet contact, hand-to-mouth  Paramyxoviridae   Respiratory   syncytial   virus   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Family  Type
The clinical characteristics of viruses may differ substantially among species within the same family: Cell culture  antigen and nucleic acid detection  Varicella   vaccine   varicella-zoster immuneglobulin  Varicella:  acyclovir  famciclovir  valacyclovir  Zoster: acyclovir  famciclovir  Varicella   herpes zoster  droplet contact  Herpesvirida  Varicella-zoster   virus   laboratory   diagnosis   Prevention  Treatment  Diseases  Transmission   Family  Type
Mycosis ,[object Object]
Disseminated fungal infections ,[object Object],Candida albicans  at 200X magnification.
Disseminated fungal infections ,[object Object],Aspergillosis.  H&E stain .
Disseminated fungal infections ,[object Object],Cryptococcus.  FNA specimen .  Field stain .
Disseminated fungal infections ,[object Object],Histoplasmosis.  PASD stain .
Disseminated fungal infections ,[object Object],P. jirovecii  cysts in tissue
Protozoan infection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Leishmania  donovani , (a species of protozoa) in a  bone marrow  cell
Amebiasis ,[object Object],Entamoeba histolytica   cyst
Gardiasis ,[object Object],Giardia  cell, SEM
Toxoplasmosis   ,[object Object],T. gondii   tachyzoites
Helminths ,[object Object]
Categorization Ascariasis ,  dracunculiasis ,  elephantiasis ,  enterobiasis  (pinworm) ,  filariasis ,  hookworm ,  onchocerciasis ,  trichinosis ,  trichuriasis  (whipworm)   Schistosomiasis ,  swimmer's   itch   Tapeworm   infection   Example diseases in humans  Lips, teeth, filariform extremities, and dentary plates   Oral sucker and ventral sucker or  acetabulum   Sucker  or bothridia, and  rostellum  with  hooks   Attachment organs  Cylindrical  Unsegmented plane  Segmented plane  Shape  Nematodes (roundworms)   Trematodes (flukes)   Cestodes (tapeworms)
Cestoda (Cestoidea) ,[object Object],Scolex  (head) of  Taenia solium , a tapeworm.
Tremotodes ,[object Object],Skin vesicles on the forearm, created by the penetration of  Schistosoma . Source: CDC
Nematodes  ,[object Object],Two  pinworms
Prion ,[object Object]
Creutzfeldt–Jakob disease  ,[object Object],Microscopic "holes" are characteristic in prion-affected tissue sections, causing the tissue to develop a "spongy" architecture.
Thank you for your attention!

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Lecture 4. classification of inf. dis.

  • 1. Classification of the infection diseases Sorokhan V.D., MD, PhD Bukovinian State Medical University Department of the infectious diseases and epidemiology
  • 2. Microbiological Classification of Infectious Diseases Protozoa Helminths Parasitic Prion Disseminated Localized Fungal DNA virus RNA virus Enveloped vs non-enveloped Viral Gram-negative Gram-positive Bacterial
  • 3.
  • 4. Gram negative Cocobacilli H. Influenzae, B. Pertussis Brucella spp., F. Tularensis P. Multosida, L. pneumophila Cocci Neisseria spp. Bacilli N. Meningitidis Glucose and maltose + N. Gonnorrhoeae Glucose + Lactose + Lactose - Slow fermenter Citrobacter Serratia Fast fermenter Klebsiella E.Coli Enterobacter Oxidase + V.Cholerae P. aeruginosa Strict anaerode B. fragilis Oxidase - Urease – Y. Pestis S. Dysenteriae Salmonnela spp. Urease + P. Mirabilis H. pylori
  • 5.
  • 6. Gram positive cocci Bacilli, Corinebacterium Clostridium, Listeria, Bacillus Staphylococcus catalase + Streptococcus catalase - S. Aureus Coagulase + Coagulase - β -hemolytic α -hemolytic S. Pneumoniae S. Viridans S. Mutans γ -hemolytic E. Faecalis E. Faecium S. Epidermis Novobiocin sensitive S. Saprophyticus Novobiocin resistant Group A S. Piogenes Group B S.agalactiae
  • 7. Basic laboratory characteristics highly motile Gram-negative, but stains poorly Borrelia burgdorferi Borrelia Aerobic Unencapsulated Small coccobacilli Gram-negative Brucella abortus Brucella canis Brucella melitensis Brucella suis Brucella aerobic Encapsulated Small coccobacilli Gram-negative Bordetella pertussis Bordetella Curved, spiral, or S-shaped with single, polar flagellum Shape microaerophilic characteristic darting motion Gram-negative Campylobacter jejuni Campylobacter Respiration Motility Capsulation Gram staining Important species Genus
  • 8. Obligate anaerobic mostly motile Large, blunt-ended rods Gram-positive Clostridium botulinum Clostridium difficile Clostridium perfringens Clostridium tetani Clostridium Mostly facultative anaerobic nonmotile unencapsulated Small, slender, pleomorphic rods Gram-positive (unevenly) Corynebacterium diphtheriae Corynebacterium Facultative or strictly aerobic motile Small, round, ovoid (not Gram-stained) Chlamydia pneumoniae Chlamydia trachomatis Chlamydophila psittaci Chlamydia and Chlamydophila Round to ovoid Shape Facultative Anaerobic Gram-positive Enterococcus faecalis Enterococcus faecium Enterococcus Respiration Motility Capsulation Gram staining Important species Genus
  • 9. strictly aerobic Small, pleomorphic coccobacillus Gram-negative Francisella tularensis Francisella Ranging from small coccobacillus to long, slender filaments Gram-negative Haemophilus influenzae Haemophilus Facultative anaerobic Short rods Gram-negative Escherichia coli Escherichia Curved or spiral rods pultiple polar flagella Shape rapid, corkscrew motility Gram-negative Helicobacter pylori Helicobacter Respiration Motility Capsulation Gram staining Important species Genus
  • 10. highly motile Long, very slender, flexible, spiral- or corkscrew-shaped rods Gram-negative, but stains poorly Leptospira interrogans Leptospira Distinct tumbling motility in liquid medium Slender, short rods Gram-positive, darkly Listeria monocytogenes Listeria motile unencapsulated Slender rod in nature, cocobacillary in laboratory. monotrichious flagella Gram-negative, but stains poorly Legionella pneumophila Legionella Long, slender rods Shape aerobic nonmotile (none) Mycobacterium leprae Mycobacterium tuberculosis Mycobacterium ulcerans Mycobacterium Respiration Motility Capsulation Gram staining Important species Genus
  • 11. aerobic Kidney bean-shaped Gram-negative Neisseria gonorrhoeae Neisseria meningitidis Neisseria Obligate aerobic motile encapsulated rods Gram-negative Pseudomonas aeruginosa Pseudomonas Plastic, pleomorphic (none) Mycoplasma pneumoniae Mycoplasma Small, rod-like coccobacillary Shape Gram-negative, but stains poorly Rickettsia rickettsii Rickettsia Respiration Motility Capsulation Gram staining Important species Genus
  • 12. Facultative anaerobic rods Gram-negative Shigella sonnei Shigella Facultative anaerobic Round cocci Gram-positive, darkly Staphylococcus aureus Staphylococcus epidermidis Staphylococcus saprophyticus Staphylococcus Facultative anaerobic Gram-negative Salmonella typhi Salmonella typhimurium Salmonella ovoid to spherical Shape Facultative anaerobic nonmotile Gram-positive Streptococcus agalactiae Streptococcus pneumoniae Streptococcus pyogenes Streptococcus Respiration Motility Capsulation Gram staining Important species Genus
  • 13. Facultative anaerobic rapidly motile Short, curved, rod-shaped with single polar flagellum Gram-negative Vibrio cholerae Vibrio Facultative Anaerobe nonmotile encapsulated Small rods Gram-negative, stains bipolarly Yersinia pestis Yersinia highly motile Long, slender, flexible, spiral- or corkscrew-shaped rods Gram-negative, but stains poorly Treponema pallidum Treponema Shape Respiration Motility Capsulation Gram staining Important species Genus
  • 14. Clinical characteristics Large, grayish, nonhemolytic colonies with irregular borders on blood agar Direct immunofluorescence Anthrax vaccine autoclaving of instruments In early infection: Penicillin Doxycycline Ciprofloxacin Cutaneous anthrax Pulmonary anthrax Gastrointestinal anthrax Contact with sheep, goats and horses Inhalation or skin penetration through abrasions of spore-contaminated dust Bacillus anthracis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 15. Direct immunofluorescence PCR amplification Pertussis vaccine, DPT vaccine Macrolide antibiotics Azithromycin Erythromycin Clarithromycin Whooping cough Complications: Secondary bacterial pneumonia Contact with respiratory droplets expelled by infected human hosts. Bordetella pertussis Microscopy using Giemsa or Wright stain PCR serology (low precision rate ) Lyme vaccine wearing clothing that limits skin exposure to ticks insect repellent Early stages: cephalosporins amoxicillin doxycycline If arthritic symptoms have appeared: Longer courses of antibiotics Lyme disease Ixodes ticks reservoir in deer, mice and other rodents Borrelia burgdorferi laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 16. Culture (difficult and time consuming) Agglutination serology Combination therapy of: doxycycline streptomycin or gentamicin Brucellosis Direct contact with infected animal Oral, by ingestion of unpasteurized milk or milk products Brucella abortus Brucella canis Brucella melitensis Brucella suis Symptomatically by fluid and electrolyte replacement Ciprofloxacin in severe cases Acute enteritis Fecal/oral from animals (mammals and fowl) Contaminated meat (especially poultry) Contaminated water Campylobacter jejuni laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 17. None for routine use None Doxycycline Erythromycin Community-acquired respiratory infection Respiratory droplets Chlamydia pneumoniae Cellular cytoplasmic inclusions by immunofluorescence DNA hybridization ELISA for lipopolysaccharides No vaccine Erythromycin or silver nitrate in newborn's eyes Safe sex Azithromycin Erythromycin Tetracyclines Doxycycline Nongonococcal urethritis (NGU) Lymphogranuloma venereum (LGV) Trachoma Inclusion conjunctivitis of the newborn (ICN) Sexual ( NGU , LGV ) Direct or contaminated surfaces and flies (trachoma) Passage through birth canal ( ICN ) Chlamydia trachomatis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 18. Rise in antibody titre Complement fixation indirect immunofluorescence Tetracycline Doxycycline Erythromycin (less efficient) Psittacosis Inhalation of dust with secretions or feces from birds (e.g. parrots) Chlamydophila psittaci Mouse inoculation detects toxin from food, intestinal contents or serum Culture in standard aerobic culture Proper food preservation techniques Antitoxin (horse antiserum ) Botulism Spores from soil and aquatic sediments contaminating vegetables, meat and fish Clostridium botulinum laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 19. ELISA for Toxin ELISA for toxin A or B Endoscopy for pseudomembrane None Discontinuing predisposing antibiotic Fluid and electrolyte replacement Vancomycin or metronidazole if severe Pseudomembranous colitis Spores both indoors and outdoors Human flora , overgrowing when other flora is depleted Clostridium difficile Microscopically Blood agar culture, forming double-zone β - hemolysis Sugar fermentation Organic acid production Appropriate food handling Food poisoning: Self-limiting; Supportive care is sufficient Gas gangrene Acute food poisoning Anaerobic cellulitis Spores in soil Human flora in vagina and GI tract Clostridium perfringens laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 20. (difficult) DPT vaccine Tetanus immune globulin Horse antitoxin, alternatively Sedatives Muscle relaxants Mechanical ventilation Tetanus Spores in soil infecting puncture wounds, severe burns or surgery Clostridium tetani no rapid) Culture on Tinsdale agar , followed by immunologic precipitin reaction DPT vaccine Horse serum antitoxin Erythromycin Penicillin Diphtheria Respiratory droplets Part of human flora Corynebacterium diphtheriae laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 21. Culture in 6.5% NaCl Can hydrolyze esculin in presence of bile No vaccine Hand washing and other nosocomial prevention Penicillin and an aminoglycoside Vancomycin Quinupristin and dalfopristin Nosocomial infections Part of human flora, opportunistic or entering through GI tract or urinary system wounds Enterococcus faecalis and Enterococcus faecium Culture on MacConkey agar and study carbohydrate fermentation patterns: Lactose fermentation (most E. coli strains) . Gas production in glucose fermentation Mannitol fermentation (no vaccine or preventive drug) Food and water preparation Hand washing and disinfection UTI: Co-trimoxazole Fluoroquinolone , e.g. ciprofloxacin Meningitis: Cephalosporin and gentamicin combination Diarrhea: Antibiotics above shorten duration Electrolyte and fluid replacement Urinary tract infections (UTI) Diarrhea Meningitis in infants Part of gut flora , spreading extraintestinally or proliferating in the GI tract Escherichia coli (generally) laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 22. rarely cultured) Serology Avoiding insect vectors Precautions when handling wild animals or animal products Streptomycin Gentamicin Tularemia vector -borne by anthropods Infected wild or domestic animals, birds or house pets Francisella tularensis Culture on chocolate agar with hemin (factor X) and NAD+ (factor V) Quellung reaction Immunofluorescence staining of capsule Detection of capsular antigen in CSF or other body fluids Hib vaccine to infants Rifampin prophylactically Meningitis: (resistance-tests are required first) Third generation cephalosporin , e.g. cefotaxime or ceftriaxone Ampicillin and sulbactam combination Bacterial meningitis Upper respiratory tract infections Pneumonia , bronchitis Droplet contact Human flora of e.g. upper respiratory tract Haemophilus influenzae laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 23. Microscopically Corkscrew movement Urease -positivity by radioactively labeled urea Serology by ELISA (No vaccine or preventive drug) Tetracycline , metronidazole and bismuth salt combination Peptic ulcer Risk factor for gastric carcinoma and gastric B-cell lymphoma Colonizing stomach Unclear person-to-person transmission Helicobacter pylori Culture from respiratory secretions on buffered charcoal yeast extract enriched with L- cysteine , iron and α - ketoglutarate Serology, including direct immunofluorescence and radioimmunoassay for antigen in urine Hybridization to ribosomal RNA using DNA probe (no vaccine or preventive drug) Heating water Macrolides , e.g. erythromycin or azithromycin Fluoroquinolones Legionnaire's Disease Pontiac fever Droplet contact, from e.g. cooling towers , humidifiers , air conditioners and water distribution systems Legionella pneumophila laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 24. Dark-field microscopy on fresh blood smear (but doesn't stain well) Serologic agglutionation tests (no vaccine) Doxycycline Prevention of exposure Rodent control Penicillin G Tetracycline , e.g. doxycycline Leptospirosis Food and water contaminated by e.g. urine from wild or domestic animals. Leptospira survives for weeks in stagnant water Leptospira interrogans Isolation from e.g. blood and CSF Beta- hemolysis and catalase production on blood agar Microscopy for morphology and motility (no vaccine) Proper food preparation and handling Ampicillin Co-trimoxazole Listeriosis Dairy products, ground meats, poultry Vertical to newborn or fetus Listeria monocytogenes laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 25. Tuberculoid form: Hard to isolate (diagnosis on clinical findings and histology of biopsies) Lepromatous form: Acid-fast staining from e.g. skin scrapings BCG vaccine shows some effects Tuberculoid form: Dapsone and rifampin Lepromatous form: Clofazimine Leprosy (Hansen's disease) Prolonged human-human contact, e.g. through exudates from skin lesions to abrasion of other person Mycobacterium leprae Ziehl-Neelsen stain showing acid-fast bacteria Hybridization probes for DNA, succeeded by PCR Culture on Lowenstein-Jensen agar BCG vaccine Isoniazid Standard "short" course: First 2 months, combination: Isoniazid Rifampicin Pyrazinamide Ethambutol Further 4 months, combination: Isoniazid Rifampicin Tuberculosis Droplet contact Mycobacterium tuberculosis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 26. (difficult to culture) Serologic tests, e.g. complement fixation test DNA probes on sputum specimens Doxycycline and erythromycin Mycoplasma pneumonia Human flora Droplet contact Mycoplasma pneumoniae Microscopy showing gram-negative diplococci, often with PMNs Culture on chocolate agar , giving positive oxidase test and fermentation of glucose and maltose in 5% CO2 in air NmVac4-A/C/Y/W-135 vaccine Rifampin Penicillin G Cefotaxime Ceftriaxone Meningococcal disease including meningitis Waterhouse-Friderichsen syndrome Respiratory droplets Neisseria meningitidis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 27. Colourless colonies on MacConkey agar . Production of pyocyanine and fluorescein Positive oxidase test . No lactose fermentation. (no vaccine) Topical silver sulfadiazine for burn wounds Aminoglycoside and anti-pseudomonal β - lactam Pseudomonas infection Localized to eye, ear, skin, urinary, respiratory or gastrointestinal tract or CNS, or systemic with bacteremia, secondary pneumonia bone and joint infections, endocarditis, skin, soft tissue or CNS infections. Infects damaged tissues or people with reduced immunity Pseudomonas aeruginosa Serology Immunofluorescence against Rickettsia antigens no preventive drug or approved vaccine) Vector control, such as clothing Prompt removal of attached ticks Doxycycline Chloramphenicol Rocky mountain spotted fever Bite of infected wood or dog tick Rickettsia rickettsii laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 28. Isolation from blood, feces, bone marrow, urine or rose spots on skin Colorless, non-lactose fermenting colonies on MacConkey agar Serology for antibodies against O antigen Ty21a and ViCPS vaccines Hygiene and food preparation Ceftriaxone Fluoroquinolones , e.g. ciprofloxacin Typhoid fever type salmonellosis (dysentery, colitis) Human-human Fecal-oral through food or water Salmonella typhi Colourless colonies on MacConkey agar (No vaccine or preventive drug) Proper sewage disposal Food preparation Good personal hygiene Fluid and electrolyte replacement for severe diarrhea Antibiotics (in immunocompromised to prevent systemic spread) Salmonellosis with gastroenteritis and enterocolitis Fecal-oral Food contaminated by fowl (e.g. eggs), pets and other animals Salmonella typhimurium laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 29. Culture on Hektoen agar or other media for intestinal pathogens Protection of water and food supplies Vaccines are in trial stage Ciprofloxacin or azithromycin Bacillary dysentery / Shigellosis Fecal-oral Flies Contaminated food or water Shigella sonnei Microscopy showing strongly positive Gram stained cells in grape-like clusters Positive Catalase test and coagulase test Culture on enriched media producing deep yellow, hemolytic colonies (no vaccine or preventive drug) Barrier precautions, washing hands and fomite disinfection in hospitals Incision and drainage of localized lesions Nafcillin and oxacillin Vancomycin for Methicillin -resistant (MRSA) Coagulase-positive staphylococcal infections : Localized skin infections Diffuse skin infection ( Impetigo ) Deep, localized infections Acute infective endocarditis Septicemia Necrotizing pneumonia Toxinoses Toxic shock syndrome Staphylococcal food poisoning Human flora on mucosae in e.g. anterior nares and vagina, entering through wound Staphylococcus aureus laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 30. Microscopy showing strongly positive Gram stained cells in grape-like clusters Positive Catalase test but negative coagulase test Novobiocin -sensitivity (S. epidermidis) Novobiocin -resistance (S. saprophyticus) Culture on enriched media producing white, nonhemolytic colonies None Vancomycin Infections of implanted prostheses , e.g. heart valves and catheters Human flora in skin and anterior nares Staphylococcus epidermidis Microscopy showing gram-positive , encapsulated lancet-shaped diplococci α - hemolysis on blood agar, bile-soluble, optochin-sensitive Positive Quellung reaction 23-serotype vaccine for adults ( PPV ) Heptavalent conjugated vaccine for children ( PCV ) Penicillin G Vancomycin for resistant strains Acute bacterial pneumonia & meningitis in adults Otitis media and sinusitis in children Respiratory droplets Often human flora in nasopharynx (spreading in immunocompromised) Streptococcus pneumoniae laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 31. Culture on sheep blood agar forming small, opalescent surrounded by large zone of β - hemolysis Serology for ASO Very bacitracin -sensitive No vaccine Rapid antibiotic treatment helps prevent rheumatic fever Penicillin G Macrolide , e.g. clarithromycin or azithromycin in penicillin allergy Drainage and debridement for Necrotizing fasciitis Streptococcal pharyngitis Scarlet fever Rheumatic fever Impetigo and erysipelas Puerperal fever Necrotizing fasciitis Respiratory droplets Direct physical contact with impetigo lesions Streptococcus pyogenes Culture on blood or MacConkey agar , enhanced by TCBS Positive oxidase test Preventing fecal contamination of water supplies and food Adequate food preparation Fluid and electrolyte replacement e.g. doxycycline to shorten duration Cholera Contaminated water and food, especially raw seafood Vibrio cholerae laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 32. Gram-negative smear If pneumonic, culture from aspirate on MacConkey or blood agar Formalin-killed plague vaccine Minimize exposure to rodents and fleas Streptomycin primarily Gentamicin Tetracyclin Supportive therapy for shock Plague : Bubonic plague Pneumonic plague Fleas from animals Ingestion of animal tissues Respiratory droplets Yersinia pestis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
  • 33. nucleus icosahedral non-enveloped adenovirus dsDNA Adenoviridae icosahedral non-enveloped coxsackievirus , hepatitis A virus , poliovirus , rhinovirus + ssRNA Picornaviridae nucleus enveloped Herpes simplex, type 1 , Herpes simplex, type 2 , Varicella -zoster virus , Epstein- barr virus , Human cytomegalovirus , Human herpesvirus , type 8 dsDNA Herpesviridae nucleus icosahedral enveloped Hepatitis B virus dsDNA and ssDNA Hepadnaviridae icosahedral enveloped Hepatitis C virus , yellow fever virus , dengue virus , West Nile virus + ssRNA Flaviviridae enveloped Human immunodeficiency virus (HIV) + ssRNA Retroviridae Replication site Virion shape envelopment Important species Baltimore group Family Comparison table of clinically important virus families and species
  • 34. nucleus spherical enveloped Influenza virus - ssRNA Orthomyxoviridae spherical enveloped Measles virus , Mumps virus , Parainfluenza virus , Respiratory syncytial virus , Human metapneumovirus - ssRNA Paramyxoviridae nucleus icosahedral non-enveloped Human papillomavirus dsDNA Papillomaviridae helical, bullet shaped enveloped Rabies virus - ssRNA Rhabdoviridae icosahedral enveloped Rubella virus + ssRNA Togaviridae icosahedral enveloped Human bocavirus , Parvovirus B19 ssDNA Parvoviridae Replication site Virion shape envelopment Important species Baltimore group Family Comparison table of clinically important virus families and species
  • 35. The clinical characteristics of viruses may differ substantially among species within the same family: Cell culture, antibody detection None None Coxsackie infections fecal-oral, droplet contact Picornaviridae Coxsackievirus virus neutralization hemagglutination assay ELISA None None acute febrile pharyngitis pharyngoconjunctival fever epidemic keratoconjunctivitis infantile gastroenteritis droplet contact (mainly) fecal-oral venereal direct contact (ocular infections) adenoviridae adenovirus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 36. antibody detection Vaccine immunoglobulin (post-exposure prophylaxis) avoid food-contamination Immunoglobulin ( post-exposure prophylaxis ) acute hepatitis fecal-oral Picornaviridae Hepatitis A virus viral antigen detection antibody detection nucleic acid detection vaccine immunoglobulin (perinatal and post-exposure prophylaxis) immunoglobulin Adefovir Entecavir Pegylated interferon alfa-2 Lamivudine acute hepatitis chronic hepatitis hepatic cirrhosis hepatocellular carcinoma All body fluids (blood, semen, saliva, mother's milk etc.) Hepadnaviridae Hepatitis B virus Antibody detection immunoflourescence ELISA Nucleic acid detection None None infectious mononucleosis Burkitt lymphoma Saliva Herpesviridae Epstein-Barr virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 37. The clinical characteristics of viruses may differ substantially among species within the same family: immunofluorescence immunoperoxidase nucleic acid detection None acyclovir famciclovir foscarnet penciclovir primary HSV-1 infection ( gingivostomatitis in children, tonsillitis & pharyngitis in adults, keratoconjunctivitis ) latent HSV-1 infection ( herpes labialis , cold sores ) direct contact with saliva and lesions Herpesviridae Herpes simplex virus , type 1 antibody detection nucleic acid detection None Pegylated interferon alfa-2 Ribavirin acute hepatitis chronic hepatitis hepatic cirrhosis hepatocellular carcinoma blood (sexual) Flaviviridae Hepatitis C virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 38. The clinical characteristics of viruses may differ substantially among species within the same family: antibody and nucleic acid detection None ganciclovir cidofovir foscarnet infectious mononucleosis Cytomegalic inclusion disease tears urine semen saliva vaginal secretions mother's milk crosses placenta blood Herpesviridae cytomegalovirus cell culture immunofluorescence immunoperoxidase nucleic acid detection contact-avoidance with lesions safe sex acyclovir famciclovir foscarnet penciclovir cidofovir primary HSV-2 infection latent HSV-2 infection aseptic meningitis sexually birth Herpesviridae Herpes simplex virus , type 2 laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 39. The clinical characteristics of viruses may differ substantially among species within the same family: nucleic acid, p24 antibody detection zidovudine (perinatally) blood product screening safe sex HAART AIDS sexual blood mother's milk Retroviridae HIV Nucleic acid and antibody detection None many in evaluation-stage Kaposi sarcoma multicentric Castleman disease primary effusion lymphoma Herpesviridae Human herpesvirus , type 8 laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 40. The clinical characteristics of viruses may differ substantially among species within the same family: antibody detection MMR vaccine None measles postinfectious encephalomyelitis droplet contact Paramyxoviridae measles virus Hemagglutination assay antigen detection Influenza vaccine amantadine rimantadine amantadine rimantadine zanamivir oseltamivir influenza ( Reye syndrome ) droplet contact Orthomyxoviridae Influenza virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 41. The clinical characteristics of viruses may differ substantially among species within the same family: Visual inspection Antigen detection Nucleic acid detection HPV vaccine wart tissue avoidance safe sex liquid nitrogen laser vaporization cytotoxic chemicals interferon cidofovir direct contact hyperplastic epithelial lesions ( common , flat , plantar and anogenital warts , laryngeal papillomas , epidermodysplasia verruciformis ) 55+ (hands/ feet) 30+ (anogenital/ some are oral/ throat/ respiratory) Malignancies for some species ( cervical carcinoma , squamous cell carcinomas ) direct contact Papillomaviridae Human papillomavirus antibody detection MMR vaccine None Mumps droplet contact Paramyxoviridae Mumps virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 42. The clinical characteristics of viruses may differ substantially among species within the same family: antibody detection MMR vaccine None measles postinfectious encephalomyelitis droplet contact Paramyxoviridae measles virus Hemagglutination assay antigen detection Influenza vaccine amantadine rimantadine amantadine rimantadine zanamivir oseltamivir influenza ( Reye syndrome ) droplet contact Orthomyxoviridae Influenza virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 43. The clinical characteristics of viruses may differ substantially among species within the same family: Antibody detection None None croup pneumonia bronchiolitis common cold droplet contact Paramyxoviridae Parainfluenza virus Antibody detection None None croup pneumonia bronchiolitis common cold droplet contact Paramyxoviridae Parainfluenza virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 44. The clinical characteristics of viruses may differ substantially among species within the same family: Histology (postmortem) Pre- and postexposure prophylaxis Post-exposure prophylaxis Rabies Animal bite droplet contact Rhabdoviridae Rabies virus Antibody detection Polio vaccine None Poliomyelitis fecal-oral Picornaviridae Poliovirus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 45. The clinical characteristics of viruses may differ substantially among species within the same family: Antibody detection MMR vaccine None German measles congenital rubella droplet contact Togaviridae Rubella virus antibody and antigen detection hand-washing avoidance palivizumab in high risk individuals ( ribavirin ) bronchiolitis pneumonia influenza-like syndrome severe bronchiolitis with pneumonia droplet contact, hand-to-mouth Paramyxoviridae Respiratory syncytial virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
  • 46. The clinical characteristics of viruses may differ substantially among species within the same family: Cell culture antigen and nucleic acid detection Varicella vaccine varicella-zoster immuneglobulin Varicella: acyclovir famciclovir valacyclovir Zoster: acyclovir famciclovir Varicella herpes zoster droplet contact Herpesvirida Varicella-zoster virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
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  • 58. Categorization Ascariasis , dracunculiasis , elephantiasis , enterobiasis (pinworm) , filariasis , hookworm , onchocerciasis , trichinosis , trichuriasis (whipworm) Schistosomiasis , swimmer's itch Tapeworm infection Example diseases in humans Lips, teeth, filariform extremities, and dentary plates Oral sucker and ventral sucker or acetabulum Sucker or bothridia, and rostellum with hooks Attachment organs Cylindrical Unsegmented plane Segmented plane Shape Nematodes (roundworms) Trematodes (flukes) Cestodes (tapeworms)
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  • 64. Thank you for your attention!