[MICRO 20] LEC 12 - Microbial Skin Infections

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Propionibacterium acnes
What microbe causes acne?
Chronic Ulcers Causes: Bacterial: Treponema pallidum Haemophilus ducreyi Corynebacterium diphtheriae Bacillus anthracis Nocardia Mycobacterium Fungal: Sporothrix Viral: Herpes Virus
All of the following skin conditions can be caused by Staphylococcus aureus except one, which one is it and identify a microbe that causes it: A. Impetigo B. Intertrigo C. Chronic Ulcers D. Folliculitis
Pasteurella multocida
Microbe that is a common source of infection following animal bites
Staphylococcus aureus
Furuncles are caused by what microbe?
Folliculitis and Intertrigo
Candida albicans can cause which skin syndrome/s?
Clean surgical wounds
Group A streptococci can infect what kind of wounds?
Clostridium Enterobacteriaceae Pseudomonas aeruginosa
Trauma wounds can be infected by which kinds of microbes?
Pseudomonas aeruginosa Staphylococcus aureus Enterobacteriaceae
Burns can be infected by which microbes?
Haemophilus influenzae can cause which skin syndrome/s?
Impetigo and Cellulitis
Group A streptococci can cause which skin syndrome/s?
Localized Cutaneous Infections
Can lead to infections of subcutaneous tissues or even muscles
Inflammation of hair follicles
Hydradenitis Supprativa
Inflammation of glands, Extensive scarring with multiple sinuses in and around the axilla
Large, red, extremely tender abscess or pustule caused by the inflammation of a hair follicle or a sebaceous gland
Larger and deeper lesion created by aggregation and secondary interconnection of furuncles
Little Thief
Furuncles are known as "little ____"
Little coal
Carbuncles are known as "little ____"
Most common presentation of Staphylococcus aureus
Bullous Impetigo
Bubble-like epidermal swellings that could peel away like a localized scalded skin syndrome
The common sight of infection of Miscellaneous systemic infections is the _____
Established in the highly vascular metaphyses of a variety of bones (often femur, tibia, ankle, or wrist)
Abscess formation in the affected area results in an elevated, tender lump, and necrosis of the bony tissue
Secondary osteomyelitis
Develops after traumatic injury, specifically compound fracture or surgery in cancer and diabetes patients
Pneumonia with multiple lung abscesses
Usually in children with cystic fibrosis and measles, Most serious complications of influenza
Staphylococcal bacteremia
Bacteria released from infection site or colonized medical devices
deforming arthritis; infection of joints
Invades cranial vault; severe form
Staphylococcal Scalded Skin Syndrome (SSSS)
also known as ritter's disease
Staphylococcus aureus
A gram positive Staphyloccus that is its most pathogenic variant
Which protein gives Staphylococcus aureus anti-phagocytic properties
FALSE. Staphylococcus aureus is resistant to heat and drying
TRUE OR FALSE: Staphylococcus aureus is NOT resistant to heat and drying
virulence factors that contribute to the pathogenesis
FALSE. Endotoxins are only found in gram-NEGATIVE bacteria
TRUE OR FALSE: Endotoxins are only found in gram-positive bacteria
1. Surface Proteins 2. Invasins 3. Surface factors 4. Biochemical properties
Identify the virulence factors of toxigenic staphylococcal diseases
binding protein (FnBP); responsible for attaching to host cell
Surface factors
inhibit phagocytic engulfment capsule
promote bacterial spread in tissues
leukocidin, kinases, hyaluronidase
Identify three invasins
Surface proteins
promote colonization of host tissues adhesins
Biochemical properties
enhance staphylococcus survival in phagocytes
bind directly to class II major histocompatibility complexes (MHC II) of antigen-presenting cells outside the normal antigen-binding groove
The release of ______ in large amounts causes the symptoms of toxic shock syndrome
Exotoxins can become _____
What is the %carriage rate of staphylococcus aureus in pre-menopausal women
TRUE OR FALSE. Staphylococcus aureus can be a part of normal flora
FALSE. Staphylococcus aureus are catalase and coagulase positive
TRUE OR FALSE. Staphylococcus aureus are catalase and coagulase negative
The drug ________ is taken if you have Methicillin Resistant Staphylococci (MRSA)
1. Dicloxacillin 2. Erythromycin 3. Cephalexin
Antibiotics used in the treatment of toxigenic staphylococcal diseases
Secondary to the alteration of beta-lactam ring and some peptidoglycan transpeptidase often called as the penicillin binding protein
What are the basis of resistance of Staphylococcus aureus against methicillin?
plasmid mediated
Penicillinase production is ______ mediated
penicillin resistant
Most strains of S. aureus are now _____ resistant
No. Infection is localized in the hair, nail, or upper layer of the skin
Do superficial mycoses invade living tissues?
used to describe skin conditions which wherein the scales appear similar to oats or wheat
Pityriasis versicolor
chronic, mild infection of stratum corneum
faint or tan to pink spots
How does pityriasis versicolor appear in white skin?
Light or dark areas
How does pityriasis versicolor appear in dark skin?
Malassezia furfur
The most common causative agent of Pityriasis versicolor
Is Malassezia furfur part of the normal skin flora?
sebaceous glands
Malassezia furfur are especially found in skin areas rich in what?
1. M. globosa 2. M. sympodialis 3. M. obtusa 4. M. slooffiae
Other than Malassezia furfur, what are the other etiologic agents of Pityriasis versicolor?
Induced enlargement of melanosomes, which are found in the basal layer of the epidermis
Due to melanosome abnormalities related to dicarboxylic acids produced by M. furfur which diminishes melanin synthesis by tyrosinase activity
itchy skin due to various inflammatory responses
Oral Medications: Ketoconazole, Itraconazole, Fluconazole
Used for extensive tinea versicolor infections
Topical treatment: Selenium sulfide, Imidazoles, Ciclopriox Olamine, Bifonazole, Terbinafine
Treatment when there are only selected areas involved in tinea versicolor
Human papillomavirus
Double-stranded naked DNA virus that belongs to the Papovaviridae family
DNA, Capsid protein
The detection of HPV _____ or _____ is indicated for HPV Infection
5. HPV 1, HPV 2, HPV 3 HPV 4, HPV 5
How many main subtypes are there for HPV?
HPV Type 16/18
Which types of HPV is associated with cervical malignancy, oropharyngeal cancer, nasopharyngeal cancer, and anal cancer
Condyloma acuminata
warts found in the perianal region
Cervical dysplasia and neoplasia
most severe manifestation of HPV infection and can lead to cervical cancer in the future
1. Spontaneous regression (may take many months) 2. Electrocautery 3. Cryotherapy 4. Chemical treatment: e.g. podophyllin
Which treatment options are available for HPV infection?
Viral exanthem
Eruptive skin rashes including measles, acquired through the respiratory route, selected viral airborne infections
Respiratory invaders
Most common cause of respiratory infection (even before bacterial or fungal infections)
S. pyogenes S. pneumoniae M. pneumoniae Chlamydia
Give an example of microbial professional respiratory invaders capable of adhesions to normal mucosa
resist destruction in alveolar macrophages
Legionella is considered a professional respiratory invader due to its ability to ______
interfering with cells
Bardatella pertussis, M. pneumoniae, and A. pneumoniae are all professional respiratory invaders capable of _______
damaging local tissues
C. diphtheria and S. pneumoniae are professional respiratory invaders capable of _____
1. Adhesion to normal mucosa 2. Ability to interfere with cells 3. Ability to resist destruction in alveolar macrophages 4. Ability to damage local tissues
What are the requirements of being categorized as a professional respiratory invader?
1. Initial induction and damage by respiratory virus 2. Local defenses impaired 3. Local foreign body or tumor 4. Depressed immune responses 5. Depressed resistance
What are the requirements of being categorized as a secondary respiratory invader?
Pneumocystis carinil, CMV, M. tuberculosis
Which microbes are considered as secondary respiratory invaders capable of depressing immune response?
S. aureus, S. pneumoniae
Which microbes are considered as secondary respiratory invaders capable of Initial induction and damage?
S. aureus, Pseudomonads
Which microbes are considered as secondary respiratory invaders capable of impairing local defenses?
Rubeola virus
The causative agent of measles
Envelope (Attachment proteins): 1. H protein (hemagglutinin protein) 2. F protein - also a hemolysin 3. M protein (matrix protein)
Help with attachment of virus to receptor cells
nasopharynx and regional lymph nodes
Where does Rubeola virus replicates in the human body?
2-3 days
Primary viremia occurs how many days after exposure?
5-7 days after exposure with spread to other tissues
Secondary viremia occurs how many days after exposure?
1. Attachment and penetration 2. Disassembly and replication 3. Maturation 4. Budding
What are the steps to Rubeola pathogenesis?
syncythium formation
Measles virus replication in tissue and certain organs is characterized by the formation of giant multinucleate cells called?
10-14 days
What is the incubation period of measles virus
4 days before to 4 days after rash onset
What is the communicability period of measles virus
Cough, Coryza, Conjunctivitis
Measles prodrome is identified by the 3 C's, which are?
Koplik’s spots on buccal mucosa
whitish plaques seen in the second molar of oral cavity
Measles recovery phase (10-14 days)
Desquamation of skin like a soft glove sock appearance wherein your skin will start to desquamate and slough off
subacute sclerosing panencephalitis
Degenerative condition where patients will be normal up until several years during the preschool age when they start to be clumsy they start to fall, they start to deteriorate in school, and later on they can become paralyzed and succumb to coma and (This may occur 5-7 years after measles bout)
1. Pneumonia - most common cause of death 2. Diarrhea 3. Otitis media 4. Encephalitis 5. SSPE - subacute sclerosing panencephalitis
Serious complications of measles
acute, past
IgM indicates _____ infection, IgG indicates _____ infections
Live, attenuated vaccines 1. Monovalent measles 2. Bivalent MR (Measles ,rubella) 3. Trivalent MMR 4. Quadrivalent MMRB
What type of vaccines are used against measles?
9, 12, 15
In the philippines, measles vaccine is given at ___ months with the booster those at ____ and _____ months
1. Failure to vaccinate susceptible populations 2. Suboptimal vaccination coverage 3. Delayed or suboptimal supplementary immunization activities 4. Controversy over vaccine safety, religious or philosophical objections to vaccination
What are the reasons for measles resurgence?
Mumps virus
Causative agent of mumps
Respiratory droplets
Mumps are transmitted via?
3 days before to 4 days after active infection
What is the communicability period of mumps?
Only once
How many times can you get mumps?
14-18 days, 12-25 days (based on CDC)
What is the incubation period of mumps?
Aseptic meningitis
Type of meningitis wherein routine bacterial cultures of CSF come back negative
1. Meningitis 2. Tinnitus and deafness 3. Orchitis/oophoritis 4. Pancreatitis
What are the serious complications of mumps?
Live, attenuated vaccines: 1. MMR 3. MMRV
What type of vaccines are used for mumps?
Mild, highly contagious disease, chiefly of children, characterized clinically by a generalized vesicular eruption of the skin and mucous membranes
Sporadic, incapacitating disease of adults or immunocompromised individuals that is characterized by a rash limited in distribution to the skin innervated by a single sensory ganglion
Varicella-Zoster virus
Causative agent of Varicella-Zoster morphologically identical to herpes simplex virus
FALSE. Varicella-Zoster virus has no animal reservoirs
TRUE OR FALSE. Varicella-Zoster virus has animal reservoirs.
1. Mucosa of the upper respiratory tract or conjunctiva 2. Initial replication in regional lymph nodes 3. Primary viremia spreads virus and leads to replication in liver and spleen 4. Secondary viremia involving infected mononuclear cells transport virus to the skin 5. Swelling of epithelial cells, ballooning degeneration, and the accumulation of tissue fluids result in vesicle formation
What is the pathogenesis of Varicella?
1. Reactivation of latent varicella-zoster virus infections in ganglia 2. Virus travels down the nerve to the skin and induces vesicle formation
What is the pathogenesis of Herpes-Zoster?
Malaise and fever
Earliest symptoms of varicella
TRUE OR FALSE. No treatment is required for varicella in normal children.
Can prevent the development of systemic disease in varicella-infected immunosuppressed patients
Gamma-Globulin of high varicella-zoster virus antibody titer
Can be used to prevent the development of the illness in patients exposed to varicella
Live attenuated varicella vaccine
What type of vaccine is used against Varicella-Zoster?