1. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings PowerPoint ® Lecture Slide Presentation prepared by Christine L. Case Microbiology B.E Pruitt & Jane J. Stein AN INTRODUCTION EIGHTH EDITION TORTORA FUNKE CASE Ch. 13 Microbial diseases of Skin & soft tissue Medical Microbiology

2. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Skin Salt inhibits microbes Lysozyme hydrolyzes peptidoglycan Fatty acids inhibit some pathogens Figure 21.1

3. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Line body cavities Epithelial cells attached to an extracellular matrix Cells secrete mucus Some have cilia Mucous Membranes

4. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Gram-positive, salt- tolerant bacteria Staphylococci Micrococci Diphtheroids Normal Microbiota of the Skin Figure 14.1a

5. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Exanthem Skin rash arising from another focus of infection Enanthem Mucous membrane rash arising from another focus of infection Microbial Diseases of the Skin

6. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings S. epidermidis Gram-positive cocci, coagulase-negative Staphylococcus aureus Gram-positive cocci, coagulase-positive Leukocidin Exfoliative toxin Staphylococcal Skin Infections

7. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Staphylococcal Skin Infections Figure 21.3

8. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Staphylococcal Skin Infections Folliculitis Infections of hair follicles Sty Folliculitis of an eyelash Furuncle Abscess; pus surrounded by inflamed tissue Carbuncle Inflammation of tissue under the skin

9. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Staphylococcal Skin Infections Impetigo of the newborn Toxemia Scalded skin syndrome Toxic shock syndrome Figure 21.4

10. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Streptococcus pyogenes Group A beta- hemolytic streptococci M proteins Streptococcal Skin Infections Figure 21.5

11. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Erysipelas Impetigo Streptococcal Skin Infections Figure 21.6, 7

12. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Streptokinases Hyaluronidase Exotoxin A, superantigen Cellulitis Necrotizing fasciitis Invasive Group A Streptococcal Infections Figure 21.8

13. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Pseudomonas aeruginosa Gram-negative, aerobic rod Pyocyanin produces a blue-green pus Pseudomonas dermatitis Otitis externa Post-burn infections Infections by Pseudomonads

14. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Comedonal acne Occurs when sebum channels are blocked with shed cells Inflammatory acne Propionibacterium acnes Gram-positive, anaerobic rod Treatment: Preventing sebum formation (isotretinoin) Antibiotics Benzoyl peroxide to loosen clogged follicles Visible (blue) light (kills P. acnes) Nodular cystic acne Treatment: isotretinoin Acne

15. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Papillomaviruses Treatment: Removal Imiquimod (stimulate interferon production) Interferon Warts

16. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Smallpox (Variola) Smallpox virus (Orthopox virus) Variola major has 20% mortality Variola minor has <1% mortality Monkeypox Prevention by smallpox vaccination Poxviruses Figure 21.9

17. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Varicella-zoster virus (Human herpes virus 3) Transmitted by the respiratory route Causes pus-filled vesicles Virus may remain latent in dorsal root ganglia Herpesviruses Figure 21.10a

18. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Reactivation of latent HHV-3 releases viruses that move along peripheral nerves to skin. Shingles Figure 21.10b

19. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Human herpes virus 1 and HHV-2 Cold sores or fever blisters (vesicles on lips) Herpes gladiatorum (vesicles on skin) Herpes whitlow (vesicles on fingers) Herpes encephalitis (HHV-2 has up to a 70% fatality rate) HHV-1 can remain latent in trigeminal nerve ganglia HHV-2 can remain latent in sacral nerve ganglia Acyclovir may lessen symptoms Herpes simplex 1 and Herpes simplex 2

20. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Measles virus Transmitted by respiratory route Macular rash and Koplik's spots Prevented by vaccination Encephalitis in 1 in 1000 cases Subacute sclerosing panencephalitis in 1 in 1,000,000 cases Measles (Rubeola) Figure 21.14

21. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Rubella virus Macular rash and fever Congenital rubella syndrome causes severe fetal damage Prevented by vaccination Rubella (German Measles) Figure 21.15

22. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Dermatomycoses: tineas or ringworm Metabolize keratin Trichophytoninfects hair, skin, nails Epidermophytoninfects skin and nails Microsporuminfects hair and skin Treatment Oral griseofulvin Topical miconazole Cutaneous Mycoses

23. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Cutaneous Mycoses Figure 21.16

24. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Sporotrichosis Sporothrix schenckii enters puncture wound Treated with KI Subcutaneous Mycoses

25. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Candida albicans (yeast) Candidiasis may result from suppression of competing bacteria by antibiotics Occurs in skin; mucous membranes of genitourinary tract and mouth Thrush is an infection of mucous membranes of mouth Topical treatment with miconazole or nystatin Candidiasis

26. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Candidiasis Figure 21.17

27. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Sarcoptes scabiei burrows in the skin to lay eggs Treatment with topical insecticides Scabies Figure 21.18

28. Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Pediculus humanus capitis (head louse) P. h. corporis (body louse) Feed on blood Lay eggs (nits) on hair Treatment with topical insecticides Pediculosis Figure 21.19