Introduction to clinic of infectious diseases

Infectio – Latin word “to infect, contaminate” Infectious process - interrelation of pathogenic microorganism and macroorganism in environment conditions

D. Fracastori ( )

D. Samoylovych ( )

E. Jenner ( )

R. Koch ( )

L. Pasture ( )

I. I. Mechnikov ( )

Peculiarities of infectious diseases  Contagenicity – dangerous for surrounding people  Specificity – every disease has the specific infectious agent  Periodicity –  incubation period;  initial (prodromal) period;  period of acute illness;  period of convalescence or reconvalescence.  Post-infection immunity  Cyclicity – ability to epidemic spreading after some period of time

Interrelations Species inherited immunity Symbiosis:  Synoikia – mutual being, when one species uses another as a living place without harming it  Mutualism – symbiosis, that is profitable for both organisms  Commensalism – one organism gets a benefit from other without harming it Parasitism – microorganism (parasite) feeds with the saps or tissues of the host harming it. Most infectious diseases belong to this kind of symbiosis

 Endogenous diseases (autoinfections) – caused by human own microflora (pathogenic or half-parasites) of the skin, respiratory or alimentary tracts, conjuctive, genitals  Exogenous diseases – caused after penetration of the microorganisms from the environment

Basic negative factors affecting immune system:  Human demographics and behavior  Technology and industry  Economic development and land use  International travel and commerce  Microbial adaptation and change  Violation of public health measures

Intensity of epidemiologic process:  Sporadic  Epidemic  Pandemic

Classification of infectious diseases symptoms according to their diagnostic importance: (by J. Bilibin) I. Main symptoms (pathognostic) : symptoms which are characteristic for one disease only. II. Supporting or optional symptoms: symptoms, which are may be present in some infectious diseases, they give possibility to differentiate diseases.

Diagnostic methods:  Clinical: investigation investigation epidemiological anamnesis epidemiological anamnesis  Laboratory: virological virological bacteriological bacteriological parasitological parasitological serologicalserological allergic allergic biological biological immunoenzyme etc, immunoenzyme etc,

Points of epidemiological anamnesis:  Life style and living conditions of the patient  Patient’s occupation  Previous diseases and preventive vaccinations

Basic symptoms of infectious diseases: 1. Fever 2. Rash 3. Diarrhea 4. Respiratory syndrome 5. Jaundice 6. Meningeal signs 7. Lymphoadenopathy etc

Fever conditions:  Fast (acute) temperature rise – patient clearly fix the hour of the disease onset  Gradual rise  Subfebrile (37,0 – C)  Moderate (38,0 – 39,9 0 C)  High (40,0 – 40,9 0 C)  Hyperpyrexia (41 0 C and higher) Classification of fevers:

Types of fever curves:  Constant fever (febris continua)  Remittent fever (febris remittens)  Intermittent fever (febris intermittens)  Recurrent fever (febris recurrens)  Undulant fever (febris undulans)  Hectic fever (febris hectica)  Distorted fever (febris inversa)  Acute undulating fever (febris undulans acuta)  Relapsing fever (febris recidiva)

Elements of exanthema:  Roseola  Macula  Papula  Erythema  Tuberculum  Nodus  Urtica (hives)  Vesicula  Pustula  Herpes  Bulla (blister)  Hemorrhage (petechiae, purpura, ecchimosis)  Erosio  Ulcus  Dyschromia cutis  Squama  Crusta  Cicatrix

Roseola  Red or purple-red  Diameter 2-5 mm  Spherical form

Macula  Similar to roseola  Diameter 5-20 mm  Color same as roseola’s

Papule  Red or purple-red  Diameter 1-20 mm  Proliferation of epidermis with vasodilatation

Erythema  Result of large maculae joining  Inflammatory fields  Diameter from 2 cm and higher

Tuberculum  Formations without cavities  Granulematous inflammatory infiltrate

Node  Limited dense formation  Diameter 1-5 cm  Spherical or oval form

Vesicula  Small cavity formation containing serous or serouse-hemorrhagic fluid  Half-round element  Diameter from 1 to 5 mm  After damaged erosion develops

Bulla (Blister)  Cavity formation  Dimension up to 10 cm 10 cm

Hemorrhages  Extravasation into the skin  Different kinds and dimensions

Ulcer  A deep defect of the skin (epidermis, derma, underline tissues)

Enanthema – rashes on the mucous membranes

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