1. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings PowerPoint ® Lecture Slide Presentation prepared by Christine L. Case M I C R O B I O L O G Y a n i n t r o d u c t i o n ninth edition TORTORA  FUNKE  CASE Part A 23 Microbial Diseases of the Cardiovascular and Lymphatic Systems

2. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings The Cardiovascular System and Lymphatics System  Blood: Transports nutrients to and wastes from cells.  WBCs: Defend against infection.  Lymphatics: because lymph capillaries are very permeable, they readily pick up microbes or their products. Transport interstitial fluid to blood.  Lymph nodes: Contain fixed macrophages.

3. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings The Cardiovascular System Figure 23.1

4. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings The Lymphatic System Figure 23.2

5. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Bacterial Diseases of Cardio/Lymphatic  Once bacteria gain access to the bloodstream, they become widely disseminated.  Blood is normally sterile.  Hospital conditions contaminate blood due to catheters, IV tubes.  Blood is low in “availible for use” iron (necessary for bacterial growth)

6. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Sepsis and Septic Shock  Sepsis: Bacteria growing in the blood (fever, chills)  Severe sepsis: Drop in BP & dysfunction of organ  Septic shock: low BP uncontrolled with fluid  Lymphangitis- inflamed lymph, red streaks Figure 23.3

7. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Sepsis  Gram-negative sepsis or endotoxic shock  Endotoxins caused blood pressure decrease.  Antibiotics can worsen condition by killing bacteria, releasing the toxins  Gram-positive sepsis  Nosocomial infections  Staphylococcus aureus,Streptococcus pyogenes  Group B streptococcus  Enterococcus faecium and E. faecalis

8. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Sepsis  Puerperal sepsis (childbirth fever)  Streptococcus pyogenes  Infection of the uterus as result of birth or abortion, progresses to abdominal cavity  Once was transmitted to mother during childbirth by attending physicians and midwives via hands and instruments, now use disinfectants

9. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Bacterial Infections of the Heart  Endocarditis: Inflammation of the endocardium  Subacute bacterial endocarditis: streptococci from mouth, develops slowly, fever, weakness, heart murmur  Acute bacterial endocarditis: Staphylococcus aureus from mouth, rapid destruction of heart valves  Pericarditis: Streptococci, inflammation of the sac around the heart

10. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Bacterial Infections of the Heart Figure 23.4

11. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Rheumatic Fever  First expressed as arthritis and fever, leading to inflammation of heart valves  Autoimmune complication of Streptococcus pyogenes infections  Sydenham’s chorea (Middle ages St. Vitus’ dance, involuntary movements Figure 23.5

12. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Tularemia (rabbit fever or deer fly fever)  Francisella tularensis  Transmitted from rabbits and deer by deer flies.  Enter skin via abrasion or respiratory infection by dust contaminated by urine or feces  symptoms include fever, swollen lymph nodes, ulcerative lesions, conjunctivitis, and pneumonia Figure 23.6

13. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Brucellosis (Undulant Fever)  Brucella, grow in phagocytes, then travel to the blood  B. abortus (elk, bison, cows)  B. suis (swine)  B. melitensis (goats, sheep, camels)  Begins with chills, fever can progress to undulating fever that spikes to 140°F each evening.  Transmitted via unpasteurized milk from infected animals or contact with infected animals.

14. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Brucellosis (Undulant Fever  A Zoonosis  seen in the patient as a fluctuating fever, with headache, muscle pain and weakness  associated with pathogen in the blood  an occupational illness of people that work with animals

15. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Anthrax  Bacillus anthracis, endospore-forming rod  Is found in soil for as long as 60 years, strikes grazing animals and cattle are routinely vaccinated.  Exotoxins& capsule enable it to be dangerous  Edema toxin causes edema  Lethal toxin targets and kills macrophages  Capsule does not stimulate immune response

16. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Anthrax  Cutaneous anthrax  Endospores enter through minor cut  Ulcerated area covered by black eschar (scab), derived from Greek word for coal

17. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Anthrax  Gastrointestinal anthrax  Ingestion of undercooked food contaminated food  Symptoms nausea, abdominal pain, bloody diarrhea, lesions in GT tract, 50% mortality.  Inhalational anthrax-most dangerous  Inhalation of endospores then enters blood  Symptoms mild fever, cough, chest pain  Enters the bloodstream, 100% mortality. Figure 23.7

18. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Biological Weapons  1346: Plague-ridden bodies used by Tartar army against Kaffa.  1925: Plaque-carrying flea bombs used in the Sino-Japanese War.  1950s: U.S. Army spraying of S. marcescens to test weapons dispersal.  1972: International agreement to not possess biological weapons.  1979: B. anthracis weapons plant explosion in the Soviet Union.  1984: S. enterica used against the people of The Dalles, Oregon.  2001: B. anthracis distributed in the United States

19. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings BacteriaViruses Bacillus anthracis“Eradicated” polio and measles Brucella spp.Encephalitis viruses Chlamydophila psittaciHermorrhagic fever viruses Clostridium botulinum toxinInfluenza A (1918 strain) Coxiella burnettiMonkeypox Francisella tularensisNipah virus Rickettsia prowazekiiSmallpox Shigella spp.Yellow fever Vibrio cholerae Yersinia pestis Biological Weapons

20. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Gangrene  Ischemia: Loss of blood supply to tissue.  Necrosis: Death of tissue.  Gangrene: Death of soft tissue, resulting from blood loss.  Substances released from dying or dead cells provide nutrients for many bacteria  Once ischemia & necrosis develop then gas gangrene develops in the muscle.

21. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Gangrene  Gas gangrene  Clostridium perfringens, grows in necrotic tissue producing gases: CO 2 and H 2 and toxins that move along muscle bundles, then into the bloodstream  Treatment includes surgical removal of necrotic tissue and/or hyperbaric chamber (oxygen saturates infected tissue, preventing the growth of anaerobes.

22. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings System disesases:Animal Bites and Scratches  Dog bites 80%, cat bites 10%  Pasteurella multocida (many killing) causes swelling, pian, forms of pneumonia and sepsis  Clostridium,Bacteroides, Fusobacterium  Bartonella hensellae: Cat-scratch disease  People who are closely exposed at risk  Inside cats’ RBCs, could be in salvia & on fur

23. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings System disesases:Animal Bites and Scratches  Rat bite fever- headache, muscle ache, fever  Infection can spread to the bloodstream leading to swollen lymph nodes and a rash

24. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Plague  Dramatically affected human history  Yersinia pestis  Reservoir: Rats, ground squirrels, and prairie dogs  Vector: Xenopsylla cheopsis (rat flea)  Flea bites sends bacteria into the blood  Bubonic plague: Bacterial growth in blood and lymph causing swollen nodes “buboes”  Septicemia plague: Septic shock, black death  Pneumonic plague: Bacteria in the lungs, 100% fatal

25. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Plague Figures 23.10, 23.11 Cases in the Southwest due to prairie dogs and squirrels.

26. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Relapsing Fever  Borrelia  Incidences increase during summer months  Reservoir: Rodents  Vector: Ticks that feed on rodents  Symptoms: fever, jaundice, & rose colored skin spots  Successive relapses are less severe

27. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Lyme Disease  First reported as rheumatoid arthritis near Lyme, CT  Seasonal occurrence (summer months)  Lack of contagiousness  Unusual skin rash  Borrelia burgdorferi  Reservoir: Deer, mice  Vector: Ticks Figures 23.13b–c

28. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Lyme Disease Figure 23.13a

29. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Lyme Disease  First symptom: Bull's eye rash, flu-like  Second phase (absence of treatment): Irregular heartbeat, encephalitis  Third phase: Arthritis Figure 23.14

30. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Ehrlichiosis  Ehrlichia (in white blood cells)  Reservoir: Deer, rodents  Vector: Ticks  Symptoms: flu-like,  Most dangerous to the  Immune compromised Figure 23.15

31. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Typhus  Inflammation of vascular system causes blockage and rupture of small blood vessels  Epidemic typhus  Rickettsia prowazekii  Reservoir: Rodents  Vector: Pediculus humanus corporis (human body louse) pathogen grows in the GT tract of louse  Transmitted when louse feces rubbed into bite wound  Symptoms: High fever 2 weeks, stupor, rash

32. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Typhus  Epidemic murine typhus:  Murine- Latin for mouse  Rickettsia typhi  Reservoir: Rodents, rats/ squirrels  Vector: Xenopsylla cheopsis (rat flea)

33. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Spotted Fevers (Rocky Mountain Spotted Fever)  Rickettsia rickettsii  Week after bite: the measles-like rash except that the rash appears on palms and soles too.  Fever, headache Figure 23.18

34. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Viral diseases of Cardio/Lymphatic system  Most in tropical areas  Mono- especially infectious

35. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings  Epstein-Barr virus (HHV–4)  Infectious Mononucleosis (mono)  Children are asymptomatic, young adults: fever, sore throat, swollen lymph nodes, weakness  Transmitted via saliva (kissing, drinking after)  Burkitt’s lymphoma  fast growing tumor on jaw  Cancer in immunosuppressed individuals, and malaria and AIDS patients Human Herpes Virus 4 Infections

36. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Other diseases and EBV  Not proven relationship  Multiple sclerosis  Hodgkin’s disease  Nasopharyngeal cancer

37. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Cytomegalovirus Infections  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 milk, or by transplanted tissue

38. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings symptomsPortal of entry Method of transmission Yellow feverFever, chills, nausea, vomit Skin Aedes aegypti DengueFever, muscle, joint pain, rash Skin Aedes aegypti; A. Albopictus Marburg, Ebola, Lassa Headache, muscle pain, fever, vomit blood Mucous membranes Contact with blood Hantavirus pulmonary syndrome Infection of lungs Respiratory tract Inhalation Viral Hemorrhagic Fevers

39. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Ebola Virus Figure 23.21

40. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Protozoan Diseases of Cardio/Lymphatic  Have complex life cycle  Presence may affect human hosts seriouly

41. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings American Trypanosomiasis (Chagas’ Disease)  Disease of the cardiovascular, discovered by Chagas in 1910  Trypanosoma cruzi  “kissing bug” bites  Dangerous to children Figures 23.22, 12.33d

42. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Toxoplasmosis  Toxoplasma gondii  Dangerous for pregnancy  Repro in cats’ GI tract, shed in feces  Cysts in victims Figure 23.23

43. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Malaria  Plasmodium vivax, P. ovale, P. malariae, P. falciparum  Symptoms: fever, chills, vomitting, headache with alternating asymptomatic periods, occuring 48-72 hours cycles  Anopheles mosquito  Kills African child every 30 seconds Figure 12.31b

44. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings DiseaseVisceral leishmaniasis Cutaneous leishmaniasis Mucocutaneous leishmaniasis Babesiosis Fatal if untreated Papule that ulcerates and scars Disfiguring of nose, mouth, throat Replicates in RBCs Causative agent Leishmania donovani L. TropicaL. BraziliensisBabesia microti VectorSandflies Ixodes ticks symptomsChills, sweating of malaria ulcerulcersChills, sweating of malaria Geographic distribution Asia, Africa, Southeast Asia Asia, Africa, Mediterranean, Central America, South America Rain forests of Yucatan, South America United States Leishmaniasis

45. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Babesiosis Figures 23.26, 12.32

46. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Helminthic diseases of cardio/lymphatic  Many use the cardiovascular system for part of their life cycle.  Some stay there, shedding eggs into the bloodstream

47. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Schistosomiasis Figure 23.28 Eggs lodged in the tissue, body responds by making a scar.

48. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings S. haemotobiumGranulomas in urinary bladder wall Africa, Middle East S. japonicumGranulomas in intestinal wall East Asia S. mansoniGranulomas in intestinal wall African, Middle East, South American, Caribbean Swimmer’s itchCutaneous allergic reaction to cercariae U.S. parasite of wildfowl Schistosomiasis  Transmitted by fecal/urine waste contaminating the water supply or snails (intermediate host, not in US)

49. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Schistosomiasis Figure 23.27a Female lives in a groove on the ventral surface of the male “split body”, which is continuously fertilized and laying eggs.

50. Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Schistosomiasis Figure 23.27b