Medical Technology Department, Faculty of Science, Islamic University-Gaza MB M ICRO B IOLOGY Dr. Abdelraouf A. Elmanama Ph. D Microbiology 2008 Chapter 23 Microbial Diseases of the Cardiovascular and Lymphatic Systems

2008 The Cardiovascular System and Lymphatics System Blood—Transports nutrients to and wastes from cells WBCs—Defend against infection Lymphatics—Transport interstitial fluid to blood Lymph nodes—Contain fixed macrophages

2008 The Cardiovascular System Figure 23.1

2008 The Lymphatic System Figure 23.2

2008 Sepsis Bacteria growing in the blood Severe sepsis Decrease in blood pressure Septic shock Low blood pressure cannot be controlled Sepsis and Septic Shock Figure 23.3

2008 Gram-negative Sepsis Endotoxins caused blood pressure decrease Antibiotics can worsen condition by killing bacteria Gram-Positive Sepsis Nosocomial infections Staphylococcus aureus Streptococcus pyogenes Group B streptococcus Enterococcus faecium and E. faecalis Sepsis

2008 Puerperal Sepsis (Childbirth fever) Streptococcus pyogenes Transmitted to mother during childbirth by attending physicians & midwives Sepsis

2008 Endocarditis Inflammation of the endocardium Subacute bacterial endocarditis Alpha-hemolytic streptococci from mouth Acute bacterial endocarditis Staphylococcus aureus from mouth Pericarditis Streptococci Bacterial Infections of the Heart

2008 Bacterial Infections of the Heart Fgirue 23.4

2008 Inflammation of heart values Autoimmune complication of Streptococcus pyogenes infections Rheumatic Fever Figure 23.5

2008 Francisella tularensis, gram-negative rod Transmitted from rabbits and deer by deer flies Bacteria reproduce in phagocytes Tularemia

2008 Tularemia Figure 23.6

2008 Brucella, gram-negative rods that grow in phagocytes B. abortus (elk, bison, cows) B. suis (swine) B. melitensis (goats, sheep, camels) Undulating fever that spikes to 40°C each evening Transmitted via milk from infected animals or contact with infected animals Brucellosis (Undulant Fever)

2008 Bacillus anthracis, gram-positive, endospore-forming aerobic rod Found in soil Cattle are routinely vaccinated Treated with ciprofloxacin or doxycycline Cutaneous anthrax Endospores enter through minor cut 20% mortality Anthrax

2008 Gastrointestinal anthrax Ingestion of undercooked food contaminated food 50% mortality Inhalational anthrax Inhalation of endospores 100% mortality Anthrax Figure 23.7

Plague-ridden bodies used by Tartar army against Kaffa 1925Plaque-carrying flea bombs used in the Sino-Japanese War 1950sU.S. Army spraying of S. marcescens to test weapons dispersal 1972International agreement to not possess biological weapons 1979B. anthracis weapons plant explosion in the Soviet Union 1984S. enterica used against the people of The Dalles 2001B. anthracis distributed in the U.S. Biological Weapons

2008 Biological Weapons BacteriaViruses Bacillus anthracis“Eradicated” polio and measles Brucella spp.Encephalitis viruses Chlamydia psittaciHermorrhagic fever viruses Clostridium botulinum toxinInfluenza A (1918 strain) Coxiella burnettiMonkeypox Francisella tularensisNipah virus Rickettsia prowazekiiSmall pox Shigella spp.Yellow fever Vibrio cholerae Yersinia pestis

2008 Ischemia Loss of blood supply to tissue Necrosis Death of tissue Gangrene Death of soft tissue Gas gangrene Clostridium perfringens, gram-positive, endospore- forming anaerobic rod, grows in necrotic tissue Treatment includes surgical removal of necrotic tissue and/or hyperbaric chamber Gangrene

2008 Pasteurella multocida Clostridium Bacteroides Fusobacterium Bartonella hensellae Cat-scratch disease Animal bites and scratches

2008 Yersinia pestis, gram-negative rod Reservoir Rats, ground squirrels, prairie dogs Vector Xenopsylla cheopsis Bubonic plague Bacterial growth in blood and lymph Septicemia plague Septic shock Pneumonic plague Bacteria in the lungs Plague

2008 Plague Figure 23.10, 11

2008 Borrelia spp., spirochete Reservoir Rodents Vector Ticks Successive relapses are less severe Relapsing Fever

2008 Borrelia burgdorferi Reservoir Deer Vector Ticks Lyme Disease

2008 Lyme Disease Figure 23.13a

2008 Lyme Disease Figure 23.13b, c

2008 First symptom bull's eye rash Second phase Irregular heartbeat, encephalitis Third phase Arthritis Lyme Disease Figure 23.14

2008 Ehrlichia, gram-negative, obligately intracellular (in white blood cells) Reservoir Deer, rodents Vector Ticks Ehrlichiosis Figure 23.15

2008 Epidemic typhus Rickettsia prowazekii Reservoir Rodents Vector Pediculus humanus corporis Transmitted when louse feces rubbed into bite wound Typhus

2008 Epidemic murine typhus Rickettsia typhi Reservoir Rodents Vector Xenopsylla cheopsis Typhus

2008 Rickettsia rickettsii Measles-like rash except that the rash appears on palms and soles too Spotted Fevers (Rocky Mountain spotted fever) Figure 23.18

2008 Spotted Fevers (Rocky Mountain spotted fever) Figure 23.16

2008 Tick Life Cycle Figure 23.17

2008 Nasopharyngeal carcinoma Epstein-Barr virus (Human herpesvirus 4) Cancer in immunosuppressed individuals, and malaria and AIDS patients Burkitt’s Lymphoma

2008 Epstein-Barr virus (Human herpesvirus 4) Childhood infections are asymptomatic Transmitted via saliva Characterized by proliferation of monocytes Infectious Mononucleosis

2008 Infectious Mononucleosis Figure 23.20

2008 Cytomegalovirus (Human herpesvirus 5) Infected cells swell (cyto-, mega-) Latent in white blood cells May be asymptomatic or mild Transmitted across the placenta, may cause mental retardation Transmitted sexually, by blood, or by transplanted tissue Cytomegalic Inclusion Disease

2008 Viral Hemorrhagic Fevers Classic Yellow feverFlavivirusAedes aegyptiMonkeys Dengue & DHFFlavivirus A. aegypti A. albopictus No known reservoir Emerging MarbugFilovirus Monkeys (?) EbolaFilovirus Monkeys (?) Lassa feverArenavirus Rodents Argentine hemorrhagic fever Arenavirus Rodents Bolivian hemorrhagic fever Arenavirus Rodents Hantavirus pulmonary syndrome Hantavirus Rodents

2008 Ebola Virus Figure 23.21

2008 Trypanosoma cruzi Reservoir Rodents, opossums, armadillos Vector Reduviid bug American Trypanosomiasis (Chagas’Disease) Figure 23.22, 12.33d

2008 Toxoplasma gondii Toxoplasmosis Figure 23.23

2008 Plasmodium vivax, P. ovale, P malariae, P. falciparum Anopheles mosquito Malaria 12.31b

2008 Malaria Figure 23.25

2008 Malaria Figure 23.24

2008 Malaria Figure 12.19

2008 Leishmaniasis DiseaseVisceral leishmaniasis Cutaneous leishmaniasis Mucocutaneous leishmaniasis Babesiosis Fatal if untreated Papule that ulcerates and scars DisfiguringReplicates in RBCs Causative agent Leishmania donovani L. TropicaL. BraziliensisBabesia microti VectorSandflies Ixodes ticks ReservoirSmall mammals Rodents TreatmentAmphotericin B or miltefosine Atovaquone + azithromycin Geographic distribution Asia, Africa, Southeast Asia Asia, Africa, Mediterranean, Central America, South America Rain forests of Yucatan, South America U.S.

2008 Babesiosis Figure 12.32

2008 Schistosomiasis Figure 23.28

2008 Tissue damage (granulomas) in response to eggs lodging in tissues Schistosomiasis S. haemotobiumGranulomas in urinary bladder wall Africa, Middle East S. japonicumGranulomas in intestinal wallEast Asia S. mansoniGranulomas in intestinal wallAfrican, Middle East, South American, Caribbean Swimmer’s itchCutaneous allergic reaction to cercariae U.S. parasite of wildfowl

2008 Schitstosomasis Figure 23.27a (a) Male and female schitosomes.

2008 Schitstosomasis Figure 23.27b