The book of health

Staphylococcus aureus

2016-10-23T10:10:00.001-07:00

Staphylococcus is one of the five most common causes of infections after injury or surgery. It affects around 500,000 patients in American hospitals annually. It is abbreviated to “S. aureus” or “Staph aureus” in medical literature. S. aureus was discovered in Aberdeen, Scotland in 1880 by the surgeon Sir Alexander Ogston in pus from surgical abscesses.

Staph infections may cause disease due to direct infection or due to the production of toxins by the bacteria. Boils, impetigo, food poisoning, cellulitis, and toxic shock syndrome are all examples of diseases that can be caused by Staphylococcus.

The name Staphylococcus comes from the Greek staphyle, meaning a bunch of grapes, and kokkos, meaning berry, and that is what staph bacteria look like under the microscope, like a bunch of grapes or little round berries. (In technical terms, these are gram-positive, facultative anaerobic, usually unencapsulated cocci.)

Staphylococcus aureus belongs to the family Staphylococcaceae. It affects all known mammalian species, including humans. Further due to its ability to affect a wide range of species, S. aureus can be readily transmitted from one species to another. This includes transmission between humans and animals.

When S. aureus is isolated from an abscess or boil or other skin lesion, it is usually due to its secondary invasion of a wound rather than the primary cause of disease. S. aureus may similarly be isolated from abscesses, breast absecesses or mastitis, dermatitis or skin infections and genital tract infections.

SIDE EFFECTS

Of the variety of manifestations S. aureus may cause:

Minor skin infections, such as pimples, impetigo etc.;
It may cause boils (furuncles), cellulitis folliculitis, carbuncles;
It is the cause of scalded skin syndrome and abscesses;
It may lead to lung infections or pneumonia;
Brain infections or meningitis;
Bone infections or osteomyelitis;
Heart infections or endocarditis;
Generalized life threatening blood infections or Toxic shock syndrome (TSS), bacteremia and septicaemia.

TRANSMISSION

S. aureus may occur commonly in the environment. S. aureus is transmitted through air droplets or aerosol. When an infected person coughs or sneezes, he or she releases numerous small droplets of saliva that remain suspended in air. These contain the bacteria and can infect others.

Another common method of transmission is through direct contact with objects that are contaminated by the bacteria or by bites from infected persons or animals. Approximately 30% of healthy humans carry S. aureus in their nose, back of the throat and on their skin.

TREATMENT

Staphylococcus aureus causes a variety of manifestations and diseases. The treatment of choice for S. aureus infection is penicillin. In most countries, S. aureus strains have developed a resistance to penicillin due to production of an enzyme by the bacteria called penicillinase.

The first line therapy is penicillinase-resistant penicillins like oxacillin or flucloxacillin. Therapy is often given in combination with aminoglycosides like gentamicin for more serious infections. The duration of treatment depends on the site of infection and on severity.

S. aureus strains may become resistant to penicillin by producing enzymes like penicillinase that destroys the antibiotic. This is a form of β-lactamase which breaks down the β-lactam ring of the penicillin molecule. To overcome this molecules resistant to penicillinase have been developed. These include:

methicillin;
nafcillin;
oxacillin;
cloxacillin;
dicloxacillin;
flucloxacillin.

sources:

http://www.news-medical.net/health/What-is-Staphylococcus-Aureus.aspx

http://www.medicinenet.com/staph_infection/page2.htm

https://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus

http://jbjs.org/content/96/11/882

http://textbookofbacteriology.net/staph_2.html

http://www.slideshare.net/doctorrao/vancomycin-resistant-staphylococcus

http://www.healthline.com/health/mrsa

http://www.slideshare.net/hintsagebreagziabhea/staphylococcus-and-streptococcus

http://www.bacteria.cz/staphylococcus-aureus-infections.html

http://www.medicinenet.com/staph_infection/page5.htm

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Staphylococcus aureus

Streptoccocus Pyogenes

2016-10-16T09:27:00.001-07:00

Streptococcus pyogenes is a beta hemolytic streptococcus group A. serological has all the normal characteristics of streptococci, but was adapted only in humans and only when it causes disease.

He is responsible for the rash in scarlet fever and toxic shock syndrome. Exoenzymes are streptolysin O, streptolysin S, streptokinase, streptodornaza (DNA-aza), NAD - aza, hijalurodinaza, proteinase, amylase, esterase.

S. pyogenes has a capsule made from a hyaluronic acid. This acid is completely equal to the hyaluronic acid of the connective tissue of humans and that the organism does not recognize as foreign. Capsule works antifagocitno.

PATHOLOGY

As a direct result of streptococcal infections were streptococcal inflammation of the nose and throat, streptococcal tonsillitis, scarlet fever, inflammation of the bronchi and lungs, erysipelas, purulent skin infections and puerperal fever. Apart from primary streptococcal disease as a complication of infection streptococci may arise sinusitis, otitis, inflammation of the meninges and negnojne complications in the form of rheumatic fever and glomerulonephritis.

Scarlet fever is the most common of 3 - 15 years of age. The disease begins as streptococcal angina, and after 1 - 2 days, there is a characteristic rash. On zacrvenjenoj skin is small, reddish, speckled rash. The skin rash is covered with dry and rough. The rash is most pronounced in the armpits, in the lower parts of the abdomen and groin. On-site there is no rash. His cheeks were flushed, and around the mouth expressed pallor. In the beginning of the disease the tongue is coated, and after a few days becomes a raspberry, which is typical of scarlet fever. The rash lasts from 6-7 days, after which occurs peeling of the skin in the form of dandruff on the neck and trunk, and on the hands and feet in rags.
Streptococcal inflammation of the nose and throat is less severe streptococcal disease characterized by a slight fever, sore throat, "nasal" speech and redness of the throat. In infants and small children streptococci infection from the nose and throat often spreads to the middle ear and mastoid extension. Lymph nodes in the vStreptokokna inflammation of the nose and ždrelaratu are usually increased.
Erysipelas (erysipelas) is a streptococcal infection of the skin that occurs after streptococcus enters the body through a minimal skin trauma and invisible. The disease begins abruptly with fever, high fever, headache and vomiting. At the same time, the skin appears redness and swelling, which extends to the periphery. The affected skin is clearly limited by healthy skin. The disease is more common in the elderly, and is usually localized to the lower leg, especially with varicose veins.
Impetigo is another manifestation of streptococcal skin infection. It occurs often in young children, especially in unsanitary environments. On the skin surface to create bubbles that burst and quickly spread into the environment and cover crusty yellowish color.
Acute rheumatic fever (ARG) is a late negnojna result of infection of the upper respiratory system. It is vital that this fever occurs only in humans in which the immune response emerged.
Acute glomerulonephritis is a disease which has a similar pathogenesis pathogenesis ARG. Specifically, and in this disease organism "destroys itself" by creating antibodies that harm him. This disease is caused by M type nephrogenic Streptococcus pyogenes - a.

TRANSMISSION

The disease is transmitted via droplets direct or indirect contact with patients or virus carriers. The spread of infection through contaminated object brushed ill persons or carriers and through the dust of minor importance.

There may also be an explosive epidemic of streptococcal angina or scarlet fever after consuming contaminated food, especially milk production and dairy products.

Milk can be contaminated already in the udder cows suffering from streptococcal mastitis or by a person who shakes his hand.

TREATMENT

Streptococcus bacteria were most sensitive to them work well if antibiotics and disinfectants.

Sensitive to all penicillins, cephalosporins, etc. Mainly used penicillin.

sources:

http://www.stetoskop.info/Streptococcus-pyogenes-1906-c57-sickness.htm?b9

http://slideplayer.com/slide/4372261/

http://www.epainassist.com/face-mouth-throat/strep-throat-or-group-a-streptococcus-gas

http://www.bacteria.cz/streptococcus-pyogenes-infections.html

http://slideplayer.com/slide/6124445/

http://pyogenesgonewild.com/

http://www.bacteriainphotos.com/streptococcus_pyogenes_3D.html

http://www.babyrashclinic.com/rash-baby-face-due-to-impetigo/

IF SOMEONE WANTS TO TELL EXPERIENCES, WRITE IN THE COMMENTS.Streptoccocus Pyogenes

Streptoccocus pneumoniae

2016-10-06T04:44:00.000-07:00

Streptococcus pneumoniae are Gram-positive bacteria in the shape of a slightly pointed cocci. They are usually found in pairs (diplococci), but are also found singly and in short chains. S. pneumoniae are alpha hemolytic (a term describing how the cultured bacteria break down red blood cells for the purpose of classification).

Individual bacteria are between 0.5 and 1.25 micrometers in diameter. S. pneumoniae do not form spores and are non-motile, though they sometimes have pili used for adherence. S. pneumonia are found normally in the upper respiratory tract, including the throat and nasal passages. They are mesophillic, living optimally at temperatures between 30 and 35 degrees Celsius.

S. pneumoniae was isolated in 1881 by Louis Pasteur. The species was then known as pneumococcus due to its role in the disease, pneumonia. It was termed Diplococcus pneumonia in 1926 due to its propensity to exist in pairs of cells, and renamed Streptococcus pneumoniae in 1974 because of its formation of chains in liquid.

S. pneumoniae played a significant role in the history molecular genetics, being the subject of the experiments that gave birth to the field. In 1928 Frederick Griffith transformed live, harmless S. pneumoniae into a deadly strain by combining them with an extract from heat-killed, virulent S. pneumoniae.

Further, in 1944, Avery, MacLeod, and McCarthy proved that genetic material is DNA by showing that the transforming factor in Griffith's experiments was not protein, but DNA.

GENOME STRUCTURE

The genome ofS. pneumoniae D39, the virulent strain used in the revolutionary experiments of Griffiths and McCarthy, consists of a single circular chromosome with about 2 million base pairs. Its GC content is 39.7%, and it codes for 1914 proteins and 73 RNAs.

Several surface proteins have been identified that may serve as vaccine candidates. Several different strains of Streptococcus pneumoniaehave been identified, possibly accounting for differences in virulence and the presence of antigens.

S. pneumoniae has shown a significant increase in antibiotic resistance over the past 20 years. This is likely due to its use of a natural transformation system used for genetic exchange.

It can also develop resistance to antibiotics through mutation and natural selection. S. pneumoniae has a relatively fast growth rate and reaches great cell densities in infections environments, conditions which favor natural transformation and natural selection toward antibiotic resistance.

PATHOLOGY

Streptococcus pneumoniae is known to cause bacteremia, otitis media, and meningitis in humans, though it is best known for causing pneumonia, a disease of the upper respiratory tract that causes illness and death all over the world.

Symptoms of pneumonia include a cough accompanied by greenish or yellow mucous, fever, chills, shortness of breath, and chest pain.

The bacteria enter the body most commonly via inhalation of small water droplets. Very young children and the elderly are the most prone to catching pneumonia.

The virulence factors of S. pneumoniae include a plysaccharide capsule that prevents phagocytosis by the host's immune cells, surface proteins that prevent the activation of complement (part of the immune system that helps clear pathogens from the body), and pili that enable S. pneumoniae to attach to epithelial cells in the upper respiratory tract.

TREATMENT

The CDC considers S. pneumoniae a "superbug" of serious concern because some strains have developed resistance to the penicillin and macrolide classes of antibiotics which include amoxicillin and azithromycin, as well as other, less-common drugs.

Today, treatment of pneumococcal diseases generally begins with broad-spectrum antibiotics, such as a cephalosporins or vancomycin, which work against a wide range of bacteria.

On a case-by-case basis, doctors may switch to a more targeted antibiotic once they determine the antibiotic sensitivities of the pneumococcus.

Prevention is the best way to fight S. pneumoniae.

The pneumococcal conjugate vaccine, also known as PCV13, protects against the 13 strains of pneumococcus that cause most of the severe illnesses, as well as some ear infections.
And the pneumococcal polysaccharide vaccine (PPSV23) protects against 23 types of pneumococcal bacteria.

TRANSMISSION

Streptococcus pneumoniae (the pneumococcus) kills ∼1.6 million people annually. Pneumococcal infections predominantly manifest as pneumonia, sepsis, meningitis, and otitis media. S. pneumoniae is also a member of the normal nasopharyngeal flora, colonizing up to 80% of children.

Infection with influenza A virus (IAV) has been associated with both pneumococcal disease and transmission. However, to date no animal model has been available to investigate the role of IAV in the spread of S. pneumoniae. Here we investigate pneumococcal-influenza synergism with a particular focus on the role of IAV on pneumococcal transmission.

Infant mice were colonized with S. pneumoniae and subsequently infected with IAV 3 d later. Using this novel model we show increased pneumococcal colonization and disease in the presence of IAV. Notably, in vivoimaging showed that IAV was essential for the transmission of S. pneumoniae from colonized (“index”) mice to their naive cohoused littermates (“contacts”).

Transmission occurred only when all mice were infected with IAV and was prevented when an IAV-neutralizing antibody was used to inhibit IAV replication in either index mice or contact mice.

Together, these data provide novel insights into pneumococcal-influenza synergism and may indicate a previously unappreciated role of IAV in the spread of S. pneumoniae.—Diavatopoulos, D. A., Short, K. R., Price, J. T., Wilksch, J. J., Brown, L. E., Briles, D. E., Strugnell, R. A., Wijburg, O. L. Influenza A virus facilitates Streptococcus pneumoniae transmission and disease.

sources:

https://microbewiki.kenyon.edu/index.php/Streptococcus_pneumoniae

http://slideplayer.com/slide/5687003/

http://www.slideshare.net/Sanzux/respiratory-disease-ppt-35421084

http://www.everydayhealth.com/streptococcus/guide/

If someone wants to tell experiences, write in the comments.

Streptoccocus Pneumoniae

Streptoccocus agalactiae

2016-10-05T10:27:00.001-07:00

^{Streptococcus agalactiae is a gram-positive bacterium that is a facultative anaerobe ^{Footnote Footnote}. Usually found in pairs or chains of up to 50 cells or more, this ovoid bacterium is usually 0.5-1.0 x 1.0-2.0 µm in size ^{Footnote Footnote}. It is β-hemolytic on blood agar and has 9 different serotypes (Ia, Ib, II, III, IV, V, VI, VII, VIII) ^{Footnote Footnot Footnote}.}
^{Streptococcus agalactiae is most commonly associated with neonatal infections such as sepsis, pneumonia and meningitis ^Footnote. In early onset disease, usually occurring within the first 24-48 hours 1-7 days of life, the newborn may be colonized by the bacterium through the amniotic fluid or during birthing, and 50% of early onset cases show signs of disease at birth .}

Late onset disease which occurs at the age of 1-3 months 7 days to 3 months is more likely to cause bacteremia or meningitis (25% of cases). Focal infections, such as of the bones and joints, can also occur ^{Footnote Footnote}. The risk of death is twice as high in older infants as it is in neonates and, even with appropriate treatment, neonatal infections with Streptococcus agalactiae have a 20% mortality rate ^{Footnote Footnote}.

65% of deaths in neonates are seen in infants weighing less than 2500 grams ^Footnote. In adults, this bacterium can cause peripartum choriomamniotitis and bacteremia in new mothers (0.03% of cases) as well as pneumonia, skin and soft tissue infections, endocarditis, osteomyelitis and UTIs in other adults ^{Footnote Footnote}.

It is only fatal in adults in the immunocompromised or elderly (mortality rate of 15% in patients aged 65 or older) ^{Footnote Footnote}. Neonates who are premature, have a low birthweight or a ruptured amniotic membrane, as well as adults who are elderly, immunocompromised, alcoholic or who have diabetes mellitus, cancer, HIV-AIDS, cirrhosis or stroke are at higher risk for developing a Group B streptococcal infection. ^{Footnote Footnote Footnote.}

Humans (neonates, elderly, immunocompromised, diabetic, alcoholic, and stroke and cancer patients have a higher risk of infection), cattle (mastitis), dogs, cats, rabbits, horses, guinea pigs, and goats have been shown to contain the infectious agent.

Definitions

Colonization was defined as the isolation of microorganisms from clinical specimens other than blood without clinical signs or symptoms.

Infection was defined as the isolation of microorganisms from sterile sites accompanying clinical signs and symptoms.

Specimens from sterile sites included blood, cerebrospinal fluid (CSF), and body fluid or pus taken from normally sterile sites such as joint, chorioamniotic fluid, urine, and peritoneal fluid.

Statistical analysis

Clinical data were presented in numbers (%); mean and standard deviation (SD); and median and interquartile range (IQR) as appropriate. Comparisons of demographic data and clinical characteristics between groups of patients who survived vs. those who died were performed using Student's t-test, Mann-Whitney U test, Chi-square test or Fisher's exact test as appropriate.

Univariate analysis was performed to determine predicting factors for fatal outcome. Variables with p-value < 0.10 from the univariable analysis were then tested in multivariable models. A two-sided test at a p-value of < 0.05 was used to indicate statistical significance. All statistical analyses were performed using Stata statistical software version 10.0 (Stata Statistical Software: Release 10.0, Stata Corporation, College Station, TX, 2007).

SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to 2-5% phenol, 1% sodium hypochlorite, 4% formaldehyde, 2% glutaraldehyde, 70% ethanol, 70% propanol, 2% peracetic acid, 3-6% hydrogen peroxide, and iodine ^Footnote.

Sensitive to moist heat at 55 ºC for 30 minutes ^Footnote. Bacteria are also susceptible to moist heat (121 ºC for at least 15 minutes) and dry heat (160-170 ºC for at least 1 hour) ^Footnote. Fecal streptococci can be inactivated by ozone ^Footnote.

TRANSMISSION

10-30% of women have Group B streptococci in their genital tracts although the bacterium is normally a resident of the gastrointestinal tract .

^Footnote. During birth, the bacterium can colonize the baby via the amniotic fluid or the mucous membranes (oral, nasopharyngeal, vaginal, and anal mucosa, as well as skin) and produce an early onset infection 24-48 hours after birth. ^{Footnote Footnote}

Late onset cases (1-3 months after birth) may be contracted by contact with the mother or the environment

^Footnote. Fecal-oral transmission may occur and sexual contact plays a role in colonization ^Footnote. Hand-to-mouth and aerosol transmission is common for streptococci ^Footnote.

For early onset disease, less than 7 days. For late onset disease, the incubation period is unknown.

TREATMENT

Treatment of S. aureus infections;

• For penicillin / methicillin sensitive organisms – Penicillin or cephalosporin;

• TMP-SMX, rifampicin, Clindamycin, Quinolone;

• Some recommend combination therapy - Amoxicillin & clavulanate (Augmentin) Drug Resistance;

• Methicillin-resistant S. aureus (MRSA) - (esp in hospital settings) – Recently, vancomycin resistant S aureus emerging – CA-MRSA (community-acquired–MRSA) cause about half of the cases – HA-MRSA (Healthcare-Associated-MRSA) 2/9/2015 33 Staphylococcus aureus.

Streptococcus agalactiae (Treatment and prevention)  penicillin G ;alternatives are vancomycin and cephalosporin  Pregnant women should be screened for colonization in the third trimester.

sources:

http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/streptococcus-agalactiae-eng.php

http://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-11-149

http://slideplayer.com/slide/10907981/

http://www.slideshare.net/hintsagebreagziabhea/staphylococcus-and-streptococcus

http://www.cheapsunglasses.cn/?q=nordenergi.org

http://www.sldkcs.org/sastanak-sekcije-mikrobiologa-sld-4/

If someone wants to tell experiences, write in the comments.

^{^{Footnote FootnoteHumans (neonates, elderly, immunocompromised, diabetic, alcoholic, and stroke and cancer patients have a higher risk of infection), cattle (mastitis), dogs, cats, rabbits, horses, guinea pigs, and goats have been shown to contain the infectious agent}FootnoFootnote}^{FootnotFootnote . It is β-hemolytic on blood agar and has 9 different serotypes (Ia, Ib, II, III, IV, V, VI, VII, VIII).}^{FootnoteFootnoFoo.}^{FootnoteFootFootnote}

Salmonella typhi

2016-10-04T08:35:00.000-07:00

There are over 2,000 various groupings (serovars) that comprise S. enterica, each very closely related to each other making Salmonella typhi a prime example of a serovar. Salmonella typhi is a gram negative bacterium that causes systemic infections and typhoid fever in humans. This rod-shaped, flagellated organism’s sole reservoir is humans. It has caused many deaths in developing countries where sanitation is poor and is spread through contamination of water and undercooked food. Eradication seems highly unlikely due to recent emergence of multi drug resistance strains. Salmonella Typhi strain Ct18 was originally isolated from a patient in a hospital in Vietnam. The chromosome sequence is 4,809,037 bp in length with a G+C content of 52.09%. The chromosome was sequenced though the method of shotgun sequencing with 97,000 shotgun reads. Since then, Salmonella typhi has undergone evolutionary change and has become resistant to antibiotics .

CELL STRUCTURE AND METABOLISM

Salmonella typhi is a rod-shaped, gram negative bacteria that contain features that separates itself from other types of bacteria which include: having 2 membranes ( and outer and an inner), periplasm, and a Lipopollysaccharide chain that consists of α-d-galactosyl-(1 → 2)-α-d-mannosyl-(1 → 4)-l-rhamnosyl-(1 → 3)-repeating units, and has short branches of single 3,6-dideoxyhexose residues .

Salmonella typhi has a complex regulatory system, which mediates its response to the changes in its external environment. Sigma factors, which are global regulators that alter the specificity of RNA polymerase, are examples of such regulation. Some sigma factors direct transcription to produce stress proteins, which increases the chances of the bacteria surviving environmental changes. RNA polymerase S is produced in response to starvation and changes in pH and temperature. It also regulates the expression of up to 50 other proteins and is also involved in the regulation of virulence plasmids.

In order to survive in the intestinal organs of its hosts where there are low levels of oxygen, Salmonella typhi has to be able to learn to use other sources other than oxygen as an electron acceptor. Therefore, Salmonella has adapted to grow under both an aerobic and anaerobic conditions.

Salmonella’s most common source of electron acceptors is nitrogen. Examples of other electron acceptors are: nitrate, nitrite, fumarate, and dimethlysulphoxide. Global and specific regulatory systems of anaerobic gene expression, like the ones mentioned above, are implemented to make sure that the most energetically favorable metabolic process is used. Evidence shows that the availability of oxygen is an environmental signal that controls Salmonella’s virulence.

ECOLOGY

Salmonella typhi is a food born pathogen and that is increasingly difficult to control. Salmonella’s ability to change its phenotype and genotype in response to environmental changes make it almost impossible to eradicate from the food chain. When a culture of Salmonella was transferred to higher temperatures (60 C), it took 60 minutes to maximize heat resistance. When the pH was lowered, acid resistance increased. The time taken to kill 90% was 4-14 minutes. Salmonella cells experience gradual changes which is why Salmonella thrives in undercooked meat. It is able to adapt to survive the cooking process and also has the ability to cross the gastric acid barrier (this is how they enter the human intestine). A high-fat matrix is protects Salmonella against these stressful environments .

TREATMENT

Without prompt treatment, Salmonella Typhi infection can lead to liver damage, inflammation of the heart, holes in the gut, and internal bleeding.

Treatments antibiotics could be used: Ampicillin, chloramphenicol, trimethoprim- sulfamethoxazole, Amoxicillin and ciprofloxacin if not treated, takes 3 weeks ~ month to be cured only 10% - 30% of untreated cases Intravenous fluids and Electrolytes may be given there are increasing amount of antibiotic resistance, must be careful .

TRANSMISSION

Transmission Salmonella Typhi – original bacteria that only lives in humans People with typhoid fever carry bacteria in their bloodstreams and intestinal Even when people recover from the fever they continue to carry the bacteria can be spread by food or drink that have been handled by people who owns Salmonella Typhi can also spread by the contaminated sewage that extends to water .

sources:

https://microbewiki.kenyon.edu/index.php/Salmonella_typhi

http://www.yourgenome.org/facts/what-is-salmonella

http://slideplayer.com/slide/4441836/

If someone wants to tell experiences, write in the comments.

Salmonella paratyphi

2016-10-03T11:05:00.002-07:00

Salmonella enterica are motile, non-lactose fermenting, non-spore forming, gram-negative, rod-shaped bacterium. Salmonella enterica have the ability to ferment glucose resulting in the production of acid and gas . Within the subspecies, enterica, there are three serotypes; Paratyphi A, B, and C. These serotypes are human pathogens that cause paratyphoid fever. Paratyphis A and B are responsible for more cases of disease than infection from Paratyphi C. In the United States, paratyphoid fever is relatively uncommon, while, an estimated 5.4 million outbreaks occurred in East Asia in 2000. Salmonella enterica serovar Paratyphi, also referred to as Salmonella Paratyphi, causes 3% of invasive Salmonella infections in the U.S and is correlated to poor sanitation and lack of clean drinking water. Prevention entails basic sanitation and education . Symptoms of paratyphoid fever typically include fever peaking around 40°C/, red rash covering the trunk, constipation, severe stomach pain, and loss of appetite. Diagnosing paratyphoid fever is difficult for many health care providers. Although the disease can sometimes be detected through a simple blood culture, a more accurate examination for the disease can be found by a bone marrow culture. Paratyphoid fever and typhoid fever are clinically indistinguishable, thus treatment of the paratyphoid fever is similar to the treatment of typhoid fever. Specific antibiotics can shorten the course of the fever and reduce the chances of death. Paratyphi A infections lead to complications in 10-15% of cases, such as meningitis, endocarditis, hepatic absess, gall bladder cancer, and pancytopenia [2]. Upon infection by Salmonella Paratyphi, the immune system mounts a humoral response predominately producing and utilizing IgA antibodies. Research indicates that a cell-mediated response is also employed. There are currently no vaccines to prevent Salmonella Paratyphi ; however, studies are being conducted concerning the efficacy of the Salmonella Typhi Ty21a-vaccine providing protection from Salmonella Paratyphi as well.

Phatogenesis

The pathogenesis mechanisms of Salmonella Paratyphi bacterium are not completely understood, but there are several key features of the bacterium's ability to infect and colonize a human host. The bacterium is able to survive the low pH of the stomach and enter the intestines. The mechanism which Salmonella Paratyphi uses to adhere to the epithelial cells of the intestines are unknown. Paratyphi B specifically utilizes mechanisms which enable it to cross the intestinal walls and survive in host tissue. A high affinity for iron-uptake utilizing siderophores may also be important regarding the pathogenicity of this particular bacterium .

Salmonella Paratyphi initially colonizes the human gastrointestinal tract, causing enteritis, which may or may not result in diarrhea. The bacteria then pass through the mucosa layer and invade the lymphoid tissues and macrophages. If left untreated, Salmonella Paratyphi begin to divide within these cells and are taken to the lymph nodes. A systemic infection develops 8-14 days after infection and the bacteria can now be found in the liver, spleen and bone marrow

Transmission

Salmonella enterica serovars Paratyphi is transmitted primarily through humans, although there are rare cases of transmission from domesticated animals. The pathogen is most frequently encountered through the ingestion of water, contaminated with feces from an infected individual or an asymptomatic carrier of the disease. Milk, raw vegetables, salads, shellfish, and ice can also transmit the pathogen if not properly washed or prepared. Also, there are rare reports of the disease being transmitted sexually

The infectious dose of Salmonella Paratyphi is generally greater than 1000 organisms. The incubation period of gastroenteritis caused by Salmonella Paratyphi is between one and ten days, however, the incubation period for enteric fever caused by Salmonella Paratyphi is longer, lasting between one and three weeks. Salmonella Paratyphi colonize the intestines, but this can be buffered by stomach acidity. This defense necessitates a greater number of bacteria to be ingested in order to result in symptomatic infection

Treatment

Paratyphoid fever is treated with specific antibiotics to shorten the course of paratyphoid fever and to decrease the chance of death. In most parts of the world ciprofloxacin, a fluoroquinolone, is used to combat the disease. In Indian countries, cases of Paratyphoid fever are more prevalent. In these countries, health officials use cephalosporins for treatment due to increased resistance towards fluoroquinolones and nalidixic acid. Azithromycin has become more commonly used due to the increase of multi-drug resistant strains. After treatment, three to five days may be required for the antibiotic to resolve the fever completely. Some patients may feel worse during the several days of waiting for the fever to end, however, the height of the fever decreases each day. If the fever is not resolved within five days, alternative antibiotics should be considered.

Antibiotic treatment is available and is necessary, particularly in severe cases. Antibiotic treatment can reduce carriage (for example, the bacteria is still present in the bowel and the person has no symptoms by can still pass on the infection to others). People given antibiotics usually begin to feel better within 2 to 3 days and deaths rarely occur. Resistance to available antibiotics is increasing, so it remains important to take care to prevent yourself from being infected.

sources:

https://microbewiki.kenyon.edu/index.php/Salmonella_enterica_serovar_Paratyphi

If someone wants to tell experiences, write in the comments.

Palpitations

2016-10-02T14:18:00.002-07:00

Heart palpitations (pal-pih-TAY-shuns) are the feelings of having rapid, fluttering or pounding heart. Heart palpitations can be triggered by stress, exercise, medication or, rarely, a medical condition.

Although heart palpitations can be worrisome, they're usually harmless. In rare cases, heart palpitations can be a symptom of a more serious heart condition, such as an irregular heartbeat (arrhythmia), that may require treatment.

Symptoms

Heart palpitations can feel like your heart is:

Skipping beats
Fluttering
Beating too fast
Pumping harder than usual

You may feel heart palpitations in your throat or neck, as well as your chest. Heart palpitations can occur whether you're active or at rest, and whether you're standing, seated or lying down.

When to see a doctor

Palpitations that are infrequent and last only a few seconds usually don't require evaluation. If you have a history of heart disease and have frequent palpitations or have palpitations that worsen, talk to your doctor. He or she may suggest heart-monitoring tests to see if your palpitations are caused by a more serious heart problem.

Seek emergency medical attention if heart palpitations are accompanied by:

Chest discomfort or pain
Fainting
Severe shortness of breath
Severe dizziness

Causes

Often the cause of your heart palpitations can't be found. Common causes of heart palpitations include:

Strong emotional responses, such as stress or anxiety
Strenuous exercise
Caffeine
Nicotine
Fever (common rheumatic fever)
Hormone changes associated with menstruation, pregnancy or menopause
Taking cold and cough medications that contain pseudoephedrine, a stimulant
Taking some asthma inhaler medications that contain stimulants
Electrolyte imbalance

Occasionally heart palpitations can be a sign of a serious problem, such as an overactive thyroid gland (hyperthyroidism) or an abnormal heart rhythm (arrhythmia). Arrhythmias may include very fast heart rates (tachycardia), unusually slow heart rates (bradycardia) or an irregular heart rhythm.

Diagnosis

If your doctor thinks you have heart palpitations, he or she will listen to your heart using a stethoscope. Your doctor may also look for signs of medical conditions that can cause heart palpitations, such as a swollen thyroid gland.

Other tests your doctor may perform include:

Electrocardiogram (ECG). In this noninvasive test, a technician will place probes on your chest that record the electrical impulses that make your heart beat.

An ECG can help your doctor detect irregularities in your heart's rhythm and structure that could cause palpitations. The test may be performed while you rest or exercise (stress electrocardiogram).

Holter monitoring. A Holter monitor is a portable device that you wear to record a continuous ECG, usually for 24 to 72 hours. Holter monitoring is used to detect heart palpitations that aren't found during a regular ECG exam. .
Event recording. If you don't have irregular heart rhythms while you wear a Holter monitor, your doctor may recommend an event recorder.You wear an event recorder as much as possible throughout the day, and push a button on a recording device you wear on your belt to record your heartbeat when you have symptoms. You may need to wear an event monitor for several weeks.
Echocardiogram. This noninvasive exam, which includes an ultrasound of your chest, shows detailed images of your heart's structure and function. Ultrasound waves are transmitted, and their echoes are recorded with a device called a transducer that's held outside your body. A computer uses the information from the transducer to create moving images on a video monitor.

Treatment

Unless your doctor finds that you have a heart condition, heart palpitations seldom require treatment. Instead, your doctor may recommend ways for you to avoid the triggers that cause your palpitations.

The most appropriate way to treat palpitations at home is to avoid the triggers that may cause your symptoms. Some ways to avoid triggers include:

Reduce stress or anxiety. Try relaxation techniques, such as meditation, yoga, or deep breathing or aromatherapy.
Avoid stimulants. Stimulants, including caffeine, nicotine, some cold medicines and energy drinks, can make your heart beat quickly or irregularly.
Avoid illegal drugs. Certain drugs, such as cocaine and amphetamines, can bring on heart palpitations.

Sumplementation:

Magnesium (most important)

Calcium

Potassium

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sources: http://www.mayoclinic.org/diseases-conditions/heart-palpitations/basics/definition/con-2003478

Rickettsia prowazeki

2016-10-01T10:28:00.009-07:00

Rickettsia prowazekii is an intracellular, bacillus bacterium that is the cause of epidemic typhus in humans. In the early 20th century, Howard Ricketts linked typhus to Spotted Fever while Stanislaus von Prowazek discovered typhus was transmitted to humans by the feces of lice, not the bite. Both Ricketts and Prowazek were killed by typhus while working with the disease, so the bacteria was named for them. The genome was fully sequenced by the end of the century. Since World War II the only other major breakout was during the Burundo civil war in the late 1990's. Now, the main point of research regarding R. prowazekii is its linkage to the origin of mitochondria. R. prowazekii has a small genome and is the first alpha-proteobacterial, gram-negative genome to be sequenced.

The R. prowazekii genome is composed of a singular circular chromosome, containing 1,111,523 base pairs and 834 protein coding genes. Also, 24% of R. prowazekiiDNA is non-coding- the largest amount in any microbial genome. No genes code for anaerobic glycolosis, however, complete coding sequences for the tricarboxylicacid (TCA) cycle and respiratory-chain complex are found.

Phatology

R. prowazekii is the cause of epidemic typhus in humans. The disease is passed to humans through the body louse, or lice. Because of this it primarily shows up in areas of overpopulation and poor economy.

Lice do not pass R. prowazekii onto humans directly through their bites. The lice will bite or scratch the human host until the skin is broken but then the bacteria is transferred via feces from the louse left in the wound. The lice may infect multiple human hosts in this manner but will die within 2 weeks of infecting the first host. Because the lice die, and thus the number of organisms that can pass on the disease decrease, R. prowazekii is able to survive in its human hosts for long periods of time and reinfect a "clean" louse so that the cycle will continue.

Epidemic Typhus will cause death in up to 40% of untreated cases. The Center for Disease Control classifies R. prowazekii as a class B bioterrorism agent due to its "ability to be acquired via aerosol (like anthrax another deadly pathogen), efficient anthropod transmission, and severe clinical outcome and death in untreated cases."

Symptoms of epidemic typhus include early onset fever, nausea, muscle pain, and headaches. Also, after a few days after the fever comes, a pink rash will develop first on the extremities and will move to the stomach and buttocks. Eventually the pink will raise up and also become darker.

Treatment

Treatment includes antibiotics such as:

Doxycycline

Tetracycline

Chloramphenicol (less common)

Tetracycline taken by mouth can permanently stain teeth that are still forming. It is usually not prescribed for children until after all of their permanent teeth have grown in.

Patients with epidemic typhus may need intravenous fluids and oxygen.

sources:
http://www.nytimes.com/health/guides/disease/typhus/overview.html
https://microbewiki.kenyon.edu/index.php/Rickettsia_prowazekii

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Pseudomonas aeruginosa

2015-08-07T13:08:00.001-07:00

Pseudomonas infection is caused by strains of bacteria found widely in the environment; the most common type causing infections in humans is called Pseudomonas aeruginosa. Serious Pseudomonas infections usually occur in people in the hospital and/or with weakened immune systems. Infections of the blood, pneumonia, and infections following surgery can lead to severe illness and death in these people.
However, healthy people can also develop mild illnesses with Pseudomonas aeruginosa, especially after exposure to water. Ear infections, especially in children, and more generalized skin rashes may occur after exposure to inadequately chlorinated hot tubs or swimming pools. Eye infections have occasionally been reported in persons using extended-wear contact lenses.

Who gets this infection?

People in the hospital may get this infection. In hospitals, the bacteria can spread through medical equipment, cleaning solutions, and other equipment. They can even spread through food. When they spread to patients who are weak because of illness, surgery, or treatment, they can cause very serious infections. For example, pseudomonas is one of the main causes of pneumonia in patients who are on breathing machines.

Burn victims and people with puncture wounds may get dangerous pseudomonas infections of the blood, bone, or urinary tract. The bacteria can also get into the body through IV needles or catheters.

These bacteria like moist environments, such as hot tubs and swimming pools, where they can cause a skin rash or swimmer's ear.

People who wear contact lenses can get serious eye infections if the bacteria get into their contact lens solutions. This can happen if you aren't careful about keeping your contact lenses and equipment sterile.

What are the symptoms?

Symptoms depend on where the infection is. If it's in a wound, there may be green-blue pus in or around the area. If you have swimmer's ear, your ear aches. If the infection causes pneumonia, you may get a cough. When the infections are elsewhere in the body, you may have a fever and feel tired. But all pseudomonas infections can make you very sick if they spread through the bloodstream (septicemia). A serious infection can cause symptoms of high fever, chills, confusion, and shock.

Treatment

Antimicrobials are the mainstay of therapy. Two-drug combination therapy, such as an antipseudomonal beta-lactam with an aminoglycoside, can be used.

Endocarditis
A high-dose aminoglycoside (eg, tobramycin 8 mg/kg/d) and an extended-spectrum penicillin (eg, ticarcillin 18 g/d) or antipseudomonal cephalosporin (eg, cefepime) are used for 6 weeks.
Renal function and aminoglycoside level should be monitored.
Surgical evaluation is required because many patients with right-sided endocarditis require valvulectomy, especially if the bacteremia is not cleared after 2-6 weeks of antibiotics. For left-sided disease, early surgery is usually required for those with refractory bacteremia or hemodynamic instability.

Pneumonia
Most experts recommend starting with 2 antipseudomonal antibiotics and then de-escalating to monotherapy.
Except in patients with cystic fibrosis, the role of an aerosolized aminoglycoside or ceftazidime is controversial. Efficacy appears to be greater in patients with cystic fibrosis, in whom aerosolized aminoglycosides have been shown to assist clinical improvement and symptom abatement.
Deciding when to switch from combination therapy to monotherapy: According to the American Thoracic Society-Infectious Diseases Society of America guidelines for ventilator-assisted pneumonia, start with combination therapy that includes a beta-lactam and aminoglycoside for 5 days and de-escalate to monotherapy based on organism culture sensitivity.

Bacteremia
Antibiotic therapy is instituted before a specific diagnosis is made.
Once pseudomonal sepsis is suspected in patients with neutropenia, presumptive therapy is a combination of an aminoglycoside and a broad-spectrum antipseudomonal penicillin or cephalosporin. The use of monotherapy ceftazidime, a carbapenem (eg, imipenem-cilastatin, meropenem), or double beta-lactams in patients who are febrile and neutropenic is still controversial. Fluoroquinolones provide an alternative for the beta-lactam–sensitive patient, and the addition of rifampin to the beta-lactam and aminoglycoside combination may improve bacteriologic cure.
Early appropriate antibiotics and aggressive volume replacement have been shown to improve outcome in septic shock. Positive-pressure ventilation may be required.

Meningitis
Ceftazidime is the antibiotic of choice because of its high penetration into the subarachnoid space and the high susceptibility of Pseudomonasto this drug.
Initial therapy in critically ill patients should include an intravenous aminoglycoside. The use of an intrathecal aminoglycoside should be considered, especially in the setting of treatment failure or relapse.
In renal failure or in the setting of beta-lactam allergy, aztreonam may be an effective second-line drug. However, clinical experience is limited, and careful observation is suggested.
Clinical experience with ciprofloxacin and meningitis is limited. Animal models suggest equivalent efficacy to that of ceftazidime and tobramycin, but, for now, combination therapy is suggested.
Therapy is ordinarily continued for 2 weeks. Duration of therapy is determined by the severity of disease. Monitoring serial CSF cultures and cell counts may be useful in evaluating response to treatment.
Undertreatment increases the relapse rate and probably the likelihood of acquired resistance, while overtreatment increases costs and adverse medication effects. In meningitis, overtreatment is obviously preferred.

Ear infections
External otitis is treated locally with antibiotics and steroids.
Malignant otitis requires aggressive treatment with 2 antibiotics and surgery.
Duration of treatment is 4-8 weeks, depending on the extent of involvement.

Eye infections
In cases of small superficial ulcers, topical therapy, consisting of an ophthalmic aminoglycoside solution rather than an ointment, is applied to the affected eye every 30-60 minutes.
An ophthalmic quinolone antibiotic is an alternative. When perforation is imminent, subconjunctival (or subtenon) administration of antibiotics is preferred.
Management of endophthalmitis is quite complex, requiring aggressive antibiotic therapy (parenteral, topical, subconjunctival [or subtenon], and, often, intraocular). Vitrectomy may be required to assist in eyesight preservation.

Urinary tract infections
Parenteral aminoglycosides may remain the antibiotics of choice, although quinolones are often used.
Tobramycin is preferred to gentamicin in patients with renal dysfunction.
UTI can be treated with a single agent, except in cases of bacteremia and upper tract infections with abscess formation.
Alternative antibiotics include antipseudomonal penicillins and cephalosporins, carbapenems (eg, imipenem, meropenem), and aztreonam. Ciprofloxacin continues to be the preferred oral agent.
Duration of therapy is 3-5 days for uncomplicated infections limited to the bladder; 7-10 days for complicated infections, especially with indwelling catheters; 10 days for urosepsis; and 2-3 weeks for pyelonephritis. Longer duration of treatment is necessary for those patients with perinephric or intrarenal abscesses.

GI tract infection treatment includes administration of antibiotics and hydration.

Skin and soft tissue infections
Double antibiotic therapy should be instituted in accordance with the local susceptibility patterns because burn centers may harbor Pseudomonas strains that are resistant to multiple drugs.

Silver sulfadiazine and sodium piperacillin have been shown to be effective in experimental models of burn sepsis.

If someone wants to tell experience, write it in the comments.

sources:

http://www.cdc.gov/hai/organisms/pseudomonas.html

http://emedicine.medscape.com/article/226748-treatment

http://www.webmd.com/a-to-z-guides/pseudomonas-infection-topic-overview

Copyright and informations

2014-09-23T05:28:00.000-07:00

Some texts are taken from other sites and the authors (or link to authors) of the text are listed below each post. If someone recognizes that a post violates the copyright, please contact me (in comment) and the post will be deleted immediately. All information is for informational purposes and can not be a substitute for proper diagnosis. Contact your doctor if you suspect that you are infected.

Thanks,
The Book Of Health, authors

Proteus

2014-05-20T13:25:00.000-07:00

The genus Proteus are two types : Proteus mirabilis and Proteus vulgaris . Both species belong to the group of Gram -negative bacteria , filamentous form .They have the ability to synthesise a capsule . It is easy to cultivate on simple nutrient media . Like other bacteria of the family Eneterobacteriaceae grow and reproduce both aerobic as well as anaerobic conditions (facultative anaerobes ) . Culture Proteus has a bad smell to rot .

Pathological ( medical) significance
Proteus are widely widespread in nature , are present in soil, water and food . Custom made and parasitic lifestyle. Typical representatives of opportunistic bacteria , which means to start to reproduce the immune system when it falls . Included in the microbial flora of the digestive tract . P.mirabilis often causes illness in humans than P.vulgaris . Significant 's medical problem is caused by Proteus urinary tract infections , meningitis and infections of wounds and in particular nosocomial infections such as soft tissue infection , pneumonia , pulmonary abscess , septicemia etc. .

Microbiological diagnosis
Bacteriological - serological diagnosis is examination of material removed from the patient, urine , cerebrospinal fluid , wound swab , sputum , blood , etc. . Material was plated on an appropriate nutrient medium - the most common nutrient broth , Endo agar and blood agar , and microscopic examination is conducted , a physiological - biochemical and antigenic properties .

Treatment
Although the majority of strains sensitive to ampicillin , cephalothin , and aminoglycoside antibiotics , non- rare strains resistant to a number of antibiotics and / or chemotherapeutics . It is therefore necessary result of microbiological analysis.

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Nocardiae

2014-05-20T13:07:00.001-07:00

Nocardiae are Gram -positive, filamentous bacilli, partly Acid-fast . Slow growth on artificial substrates . Three species are pathogenic to humans : N.asteroides , N.brasiliensis and N.caviae .

Way of transmission
Spread in droplets and usually infects the lungs , but can attack the brain and skin. Frequently sick people with weakened immune systems (HIV , organ transplants , long-term corticosteroid therapy) as well as those with chronic lung disease and smokers .

Pathological ( medical) significance
Humana nocardiosis is usually manifested in the lung in patients with defective immune system . And metastasis are possible in the skin as a result of hematogenous dissemination . Symptoms of respiratory tract symptoms resemble other pneumonia ( pneumonia ) : chest pain , shortness of breath , rapid breathing , productive cough and coughing up blood , shortness of breath .

In addition to these symptoms occur and nausea , vomiting , weight loss , hepatosplenomegaly ( enlarged liver and spleen) , joint pain , headache , confusion , dizziness , fever, night sweats , fatigue . The skin may appear rash , abscesses , cellulitis , enlarged lymph nodes .

Microbiological diagnosis
Lifetime isolation of Nocardia is rare , and the diagnosis is based on history , clinical presentation , radiography of heart and lungs , CT - a ( scanner ) , bronchial lavage , bronchoscopy .

Treatment
The treatment used antibiotics ( the antibiotic ) , the response is sometimes slow , and therapy should be administered three to six months.

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Neisseria meningitidis

2014-05-20T12:58:00.000-07:00

Neisseria meningitidis ( " meningococcus " ) , upper respiratory tract inhabits a well known group of the 13 serogroups . In our country, the most common serogroups B , C and to a lesser extent , rarely Y or W 135th Meningococcus its appearance resembles a coffee bean , and the average size is 0.8 - 1μ . Per gram of the color negative. He aerobic bacilli , and it is not resistant to the external environment . Is sensitive to light and moisture.

By activation of a trigger ( loss of immunity , previous viral upper respiratory tract inflammation , and the like . ) Can occur with a moving Neisseria meningitidis pharyngeal mucosa into the blood stream , which leads to the initiation of the immune mechanisms of the body and the condition being menigococcus called sepsis . Special affinity Neisseria meningitidis is the covering of the brain ( meninges ) and so the common cause of meningitis .

Way of transmission
The source of infection is the man , more often than patients asimptomathic carriers . Transmission of infection is a drip though less likely to be direct contact .

Pathological ( medical) significance
Meningococcal meningitis can vary in clinical presentation from light to severe ending lethal within 24 to 48 hours . Secondary severe form of the disease can begin in two ways . In some patients preceded meningitis nasopharyngitis or catarrh of the upper respiratory tract . This stage lasts for 2 days or more , patients complain of pain behind the nose , pain on swallowing , coughing , and their temperature is raised . In other cases, the disease begins abruptly with fever , high fever . In both cases shortly after the aforementioned symptoms occur headache , pain all over the body , nausea and vomiting, and other specific and general symptoms of purulent meningitis ( meningeal syndrome) , also appear some symptoms that are characteristic of meningococcal meningitis . The skin occurs as a result of damage to the capillaries during bacteremia , rash in the form of petechiae or ecchymosis , and in severe cases leads to the abundant bleeding . Rash occurs in 25-60 % of cases , can range from rare to markedly thick . On the skin can also occur, and herpes febrilis who is in meningococcal meningitis is relatively common to the diagnostic importance. Occurs between 3 and 5 days of illness . Other events that accompany meningococcal meningitis can be divided into three groups :

Events that occur due to the spread of infection from the primary foci : sinusitis , otitis media , bronchopneumonia , etc. .

Events as a result of bacteremia : they may be very numerous, and are practically important changes in the joints , heart , eye , and adrenal glands . Arthritis usually occurs later in the disease , often affecting large joints , clinically manifested by pain in the joints , swelling and the inability to run passive and active movements . At the heart are frequent and myocarditis, pericarditis , endocarditis, while the less common . Changes in the eye in terms of iridocyclitis and horioiditisa . Adrenal glands often sustain damage within meningococcal sepsis .
Changes with regard to the inflammatory process in the central nervous system and nerves : inflammation of the meninges may extend to the inner ear and cause damage to the vestibular or cochlear structures . Deafness occurs in 5 % of cases , it may be complete or partial , unilateral or bilateral , and how it occurs early in the disease before treatment its frequency is decreased use of antibiotics . Also due to the pressure of exudate on brain nerve comes to their paralysis , most commonly afflicted VII , VI , or III and IV nerve paresis can hit and spinal nerves. Forecast of the paresis is good . Among the other changes that may occur due to the pressure of exudate on the surface of the brain, thrombosis , vascular changes , brain abscess , etc. . It should be mentioned hemiparesis , convulsions , etc. . The consequences of meningococcal meningitis are rare , some are usually deafness , blindness , hydrocephalus , nerve paralysis and epilepsy .

Acute or fulminant meningococcal sepsis may occur with meningitis or as an independent disease . It can occur in two forms : one starts suddenly with a high fever , disorders of consciousness , convulsions and other symptoms of encephalitis ; In another form of dominated the clinical picture of extensive bleeding in the skin and mucous membranes and symptoms of cardiovascular collapse (tachycardia , hypotension , tachypnea and cyanosis ) with preserved consciousness ( adrenal form) . This form is called a meningococcal sepsis and Waterhouse - Friderichsen syndrome , occurs mainly in young children . Both forms of meningococcal sepsis end fatal within 6 to 24 hours ( three days ) . A decline in vascular resistance , cardiac output and blood pressure . Main patho-anatomical changes a vasculitis that is stronger in postencephelatic forms expressed in the brain, and in the form of the adrenal gland, adrenal . Acute inflammatory changes can manifest in other organs : joints , myocardium , pericardium , and in other places where it is meningococcus .

Subacute meningococcal sepsis begins gradually and is manifested by vague general infectious symptoms. Later, the rash can occur ( rozeoliformni , morbilliform or hemorrhagic ) or inflammation of an organ . In blood, the meningococcus can be demonstrated , as well as possible from the skin efflorescences .

Microbiological diagnosis
The diagnosis is testing that is performed in a hospital setting : a complete and differential blood count, blood culture , Gram staining , biopsy of skin lesions and Gram stain , urinalysis , coagulation tests .

Treatment
For the treatment of meningococcal meningitis is applied penicillins because most meningococcal strains become resistant to sulphonamides . Since the low pass penicillins have blood-brain barrier high doses are administered in order to achieve sufficient concentrations in the cerebrospinal fluid . Treatment should be done 10-12 days , a timely and rights therapy reduced the mortality rate to only 5 % .

With meningococcal sepsis are also given penicillin , and fulminant forms and are administered corticosteroids and heparin .

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Neisseria gonorrhoeae

2014-05-20T12:46:00.001-07:00

Neisseria gonorrhoeae is a gram negative diplococci kidney-shaped with the convex side facing outwards . It is always in pairs under a microscope resembles a coffee bean . The size is 1.5 * 0.8 microns . Has an affinity for the columnar epithelium , especially genital and rectal . Other mucous membranes are less sensitive .

Way of transmission

The infection occurs most often in adults during sexual intercourse , less commonly through infected items (sponges , clothes , towels, catheters ) . In children, the infection usually transmitted indirectly , rarely directly with sexual abuse. Conducive to the spread of infection by various factors such as: physical exertion, menstruation , instrument procedures , alcohol and promiscuity .

Pathological ( medical) significance

Neisseria gonorrhoeae causes gonorrhea ( clap , clap ) , the most common sexually transmitted disease .

Gonorrhea in men

Urethritis gonorrhoica anterior acuta - inflammation affects the frontal part of the urethra ( the urethra , the tube that drains urine from the bladder to the external environment ) . It starts burning when urinating and it follows from the urethra highlight first serous and abundant purulent secretion. Painful urination and the erection. May be affected regional lymph nodes , which are enlarged and painful, once the body temperature elevated.

Urethritis gonorrhoica acuta totalis - a continuation of the previously described urethritis , frequent urge to urinate , there is hematuria (blood in urine ), and pain in the perineum.

Urethritis gonorrhoica Chronicle symptoms are less pronounced , secretion is deficient , there is a " morning drop" before voiding is the result of not cured and incorrectly treated forms .

Gonorrhea in women

Less recognized is the lower of symptoms and frequent secretion of other etiology . Is expressed as :

Urethritis gonorrhoica - characterized by poor discharge, less pronounced frequent urination , burning and itching .

Cervicitis gonorrhoica - with scant purulent secretion which is drained from the cervical (neck of the uterus ) channel. The lining of the cervix is very red, swollen and erosion.

Gonorrhea in children

Vulvovaginitis gonorrhoica infantum - the mucous membranes of the vulva and vagina is red, swollen , with erosion , accompanied by abundant seroznognojavom secretion , inflammatory changes are in the inguinal region ( groin ) and thigh . Urination is frequent with burning and severe pain .

extragenital gonorrhea

Conjuctivitis gonorrhoica - infection can occur accidentally , usually with dirty hands . More commonly seen in infants infected during delivery of sick mothers. Manifested by redness of the conjunctiva , swelling of the eyelids and purulent secretion. The eyelids are closed and glued together . Possible complications in the form of corneal haze , corneal ulceration and even blindness .

Microbiological diagnosis

Diagnosis is made by microscopic detection of bacteria in the secretions that are in routine testing in men afraid of methylene blue . Precious is a characteristic finding , the layout of the gonococci . In doubtful cases and in women using Gram stain .

The isolation of Neisseria gonorrhoeae using a special nutrient medium ( Thayer -Martin medium) for its cultivation . Identify the bacteria can be through immunofluorescence.

Treatment

Neisseria gonorrhea is sensitive to a number of antibiotics , but is usually the drug of choice penicillin . When penicillin allergy and may be administered tetracycline , erythromycin, cephalosporins , sulfonamides . Be sure to simultaneously treat sexual partners .

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Mycoplasma hominis and Mycoplasma genitalium

2014-05-20T12:30:00.002-07:00

Mycoplasma hominis and Mycoplasma genitalium are conditionally pathogenic bacteria , as forming part of the normal flora of the lower female genital tract . These microbes have a cell wall typical of bacteria , one of the most important features of their multitude of antigenic serotypes ( characterized by the antigenic diversity ) , the establishment of a permanent immunity seems practically impossible . Therefore, repeated microbial infections in this group is very common.

Way of transmission
Transmitted by sexual contact and intimate social contact ( in places where it comes into contact with other people's undergarments , towels , with masseurs , beauticians , solarium ) .
M. genitalium is known to cause non-specific urethritis in both sexes and genital infections and is an integral part of a complex microbial flora that is found in bacterial vaginosis . The newborn can be transiently infected during passage through an infected birth canal mother . Neonatal colonization is transient.

Pathological ( medical) significance
If it is an asymptomatic infection , in which a slight vaginal discharge , mycoplasmas are usually prove swab of the vagina , and is rarely found in the smear of the cervix or urethra . Contrary to almost saprophitic behavior of mycoplasmas in the vagina and cervix in part , settling the uterine cavity , fallopian tubes , or the spread of mycoplasmal infections in the small pelvis reflects their full pathogenic significance . Symptoms that can occur at the same time are nonspecific and include pain or tension in the lower abdomen , vaginal discharge , pain of intercourse etc. . Can cause nausea and vomiting , fever , irregular bleeding and interfere with urination ( burning and frequent urination ) . It seems that women pathogenic Mycoplasma hominis , while men more problems caused by Ureaplasma urealyticum . In men, symptoms occur soon after infection - increased accumulated discharge yellowish , or serous and mucous secretion from the urethra , purulent discharge from the penis and redness .

Microbiological diagnosis
Diagnosis is made by isolation of the bacteria from swabs of the cervix and identification after culturing on solid and liquid nutrient media or detection antibody .
Interpretation of the results is often difficult due to the fact that it is a bacterial species that are part of the normal flora of the lower female genital tract .

Treatment
The drugs of choice for treating infections caused by mycoplasma tetracycline and makrolizi . Treat both partners simultaneously. While the treatment is completed , it is necessary to abstinence from sexual intercourse , otherwise there is a risk of re-infection for sexually active person there is no absolutely safe way to avoid this type of sexually transmitted disease . Anything that disrupts vaginal pH and bacterial balance of the vagina can lead to infection . Avoid chemical irritants , shampoo, tampons etc.

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Mycobacterium tuberculosis

2014-05-20T12:20:00.001-07:00

Mycobacterium tuberculosis belongs to the genus Mycobacterium , and family Mycobacteriaceae . Inability discoloration of alcohol and acid ( acidoalkohholorezistence ) and a wealth of cell wall lipids are the main characteristics of the genus .

Mycobacteria are real or easily bent slender cast , it's hard to paint Gram ( Gram -positive bacilli ) , but it is easy to color carbol fuchsin technique Ziehl - Neelsen and then can not remove by alcohol and acid. Mycobacteria are intracellular parasites that cause chronic disease with the formation of granulomatous lesions .

Way of transmission
The most common source of infection is tuberculosis bacilli man . Rarely it may be farm animals , and extremely poultry and birds . The most common source of infection in the lungs of people suffering from tuberculosis , and rarely diseased lymph nodes , bones and joints , urine of patients with renal tuberculosis , uterovaginal secretions and feces in intestinal tuberculosis . If domestic animals are the source of infection , mainly to cattle . The infection spreads through uncooked milk and dairy products , but this method of transmission is now almost off .

Pathological ( medical) significance
Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis . Symptoms that accompany tuberculosis may initially be nonspecific , such as elevated body temperature , fatigue , loss of weight , mild cough , night sweats , diarrhea . However , medical examinations comes to detecting specific symptoms characteristic of this disease . When listening with a stethoscope to hear the sound of breathing altered , it may cause hearing loss , swollen lymph glands , chest pain and joint pain . When coughing very often in sputum notes fresh blood . Characteristic symptoms of tuberculosis in children 's body temperature is around 39 ° C , cough , shortness of breath , rapid breathing .

Microbiological diagnostics
The materials from which to isolate tuberculosis bacilli may be ( sputum , laryngeal swab , gastric washings , blood , bone marrow , cerebrospinal fluid , synovial fluid , pus , pleural fluid , bronchial washings ) . The identification is based on microscopic , cultural and biochemical characteristics of the isolated bacteria . To give the time can be used the following methods : direct microscopic preparations , radiometric methods , detection of mycobacterial antigens , serological , gas chromatography and mass spectrometry , DNA probes and PCR .

Treatment
Tuberculosis is treated with drugs called antituberculosis drugs , and the goal is the prevention and cure of infection . Treatment is carried out by combining several medications , usually shared use of rifampicin , isoniazid and pyrazinamide . Usually treatment of disease duration of 6 months , even when the disease is caught and other organs . The treatment continues and 3 months after the sputum culture finds Koch's bacillus .

To prevent the spread of the disease , patients are often hospitalized and up to the moment when the patient is no longer contagious to the environment , usually 2-4 weeks after starting therapy . After this period, the patient can continue with normal life activities . In addition to drug therapy , doctors advise and healthy lifestyle , relaxation, proper diet rich in vitamins , primarily vitamin C.

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Mycobacterium leprae

2014-05-20T12:13:00.001-07:00

Mycobacterium leprae belongs to the genus Mycobacterium and family Mycobacteriaceae . Inability discoloration of alcohol and acid and a wealth of cell wall lipids are the main characteristics of the genus . Mycobacteria are real or easily bent slender cast , it's hard to paint Gram ( Gram -positive bacilli ) , but it is easy to color carbol fuchsin technique Ziehl - Neelsen and then can not odbojiti alcohol and acid. M.leprae can not be cultivated on artificial feeding . Mycobacteria are intracellular parasites that cause chronic disease with the formation of granulomatous lesions .

Way of transmission
Infection is responsible for prolonged contact with diseased . Factors that contribute to morbidity are poor hygiene , poor diet , malnutrition due other diseases , higher density housing , etc. Infectious secretions from the nose , sputum , content from diseased lesions , blood, urine , breast milk , semen , vaginal secretions . Direct method of infection is more common than indirect .

Pathological ( medical) significance
Leprosy or leprosy is a chronic infectious disease that is often discussed in areas with humid and hot climate .

The incubation period is long several months to several years . Describes the many forms of leprosy . A common characteristic of them start with unspecified changes in the skin and mucous membranes .

Leprosy lepromatoses ( Type L ) is the hardest , highly contagious form of the disease because the cause lies in the large number of changes . Manifested by the presence of nodular ( knot ) or squamous infiltrate in a symmetrical arrangement . The changes are painful and not sensitive to temperature . Localized predominantly in the head , the skin of the face, the nose, the ear cups , but also in other parts of the body . Jobs are more severe damage to the hair , other hair and nails . The most common is mucous membranes of the nose (chronic atrophic rhinitis ), which is followed by difficulty breathing , destruction of the nasal septum , nasal recess . After the disappearance of the changes remain scars . Lepromatous changes can develop in other organs and systems of the patients ( respiratory , eye , bones ) . The lymph nodes are usually enlarged . Occur and neurological changes, accompanied by paralysis . In the course of therapy , especially in the beginning of the expression can be called . " Leprosy reactions " in the form of worsening symptoms with high febrile illness that may be fatal to the patient . Frequent headaches , fever , joint pains .

Forecast of all forms of leprosy depends on taking the therapy in relation to the evolution of the disease . The prognosis is worst in lepromatous leprosy .

Microbiological diagnosis
Isolation of patients in need while bacteriological positive . A large number of patients suffering from leprosy classical serological reactions for syphilis were positive . Lepromin test ( Mitsuda reaction) proves the immune status of patients , which is not a prediction of dijagnostic importance . This test is performed ubrizgavajnem crushed suspension leproznog tissue that serves as the antigen . Prognostic good character development positivity Mitsuda reactions . The reaction was positive in more than 90 % of patients tuberkuloid leprosy ( sign of a good immune status of the organism ) , and negative in patients with lepromatous leprosy .

Treatment
It consists of administering a large number of drugs . The most commonly used dose of dapsone 50-100 mg daily for a period that is long , about 3 years . Therapeutically useful and tuberculostatics , rifampicin and clofosamin . The best results are achieved by treatment of tuberkuloid forms of leprosy . Isolation of patients in need while bacteriological positive .

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Listeria monocytogenes

2014-05-20T12:04:00.000-07:00

Listeria is a Gram- positive , weakly pathogenic bacteria . No capsule and creates a slow , deep AGRU creates a semi-solid formation that resembles the umbrella . It grows in most culture media under aerobic or micro-aerobic conditions . A significant characteristic of L. monocytogenes to grow and is at a temperature of 4 ° C , which means that keeping food in the fridge does not have a significant effect on preventing the growth of bacteria .

Way of transmission
Transmitted : contaminated food, by sucking through the navel and congenitally , AEROGEN , hematophagous insects , through the damaged lining of the mouth . Listeria monocytogenes can get into food over land or water , and animal carriers of these bacteria can be a source of contamination of meat and dairy products. Because these bacteria can often be found in many food products , although they are properly stored at low temperatures in unpasteurized milk , cheese , ice cream, raw vegetables , meat products , raw and kuvanoj mercury , all types of raw meat and raw and smoked fish . Infection occurs intrauterine or child during childbirth contact with listeriosis mother . As low listeria pathogens in adults occurs in people with a weakened immune system ( diabetes , alcoholism , cirrhosis of the liver disease lymphoreticular system with immunodeficiency ) .

Pathological ( medical) significance
Listeriosis is a disease caused by Listeria monocytogenes , which can be manifested by various symptoms or syndromes that vary depending on the pathogenesis , the port of entry causes the affected person ages .

Incubation with listeriosis is 7-30 days. If the disease is triggered before birth may end in miscarriage , premature birth to a dead child or the death of a child in a pregnance . If infection ensue during childbirth then manifests meningitis 1-3 weeks after birth . Meningitis is characterized fontanelle tension , irritability , convulsions and coma .

In infants the disease often has septicemic form known as granulomatosis infantiseptica . It may have discrete symptoms or go under a picture of septicemia with increased liver and spleen and purulent meningitis .

Acquired listeriosis older children and adults usually passes as purulent meningitis or encephalitis . Meningitis starts suddenly with headache , high fever , vomiting . In severe cases may be disturbed consciousness, convulsions and paralysis of eye muscles drivers . CSF may be blurred .

Encephalitis ( inflammation of the brain ) is more common in listeriosis than other purulent meningitis and can occur in almost 20 % of cases , however, is clinically indistinguishable from encephalitis another origin . It starts with high fever, disorders of consciousness , neurological ( brain nerve paralysis of the extremities ) , and convulsions . CSF is a clear , possible only slightly increased the number of lymphocytes . Sepsis is characterized by a fever . If fever persists can reach localization of symptoms ( pneumonia , endocarditis , meningitis , etc. ) .

Localized forms - Glandular or anginal form is similar to infectious mononucleosis with angina , enlarged lymph nodes in the neck and an increase in spleen . Ocular shape - purulent conjunctivitis and swollen lymph nodes in front of the ear . Cutaneous form - are particularly vulnerable vets , most commonly occurs on the hands and forearms. Urinary form - is manifested as an inflammation of the urinary tube and is transmitted through sexual contact .
Listeriosis pregnant women - are often latent , but may manifest itself as an inflammation of the kidneys , it is unclear febrile condition , grip , etc. .

Microbiological diagnostics
Diagnosis of listeriosis is complicated , serological diagnostic methods are inaccurate and not useful , so the only way to secure the diagnosis of fecal testing and antigenic material monospecific sera .

Treatment
The success of treatment depends on the speed of diagnosis . In therapy were equally successful penicillin G and ampicillin . Therapy should be carried out even 3-4 weeks after symptoms are gone .

An ideal solution for the prevention of listeriosis are preventing the possibility of any contamination during food production and processing . Pregnant women and people with weakened immune systems should be carefully adhere to the following rules : avoiding consumption of unpasteurized milk and dairy products , as well as all kinds of ready-made food that is not heated before use. It also requires heat you up all kinds of meat products , especially processed products such as sausages and sausages . Any remnants of meat products that were stored in the refrigerator should be a good warm up , and raw vegetables before use should be thoroughly washed.

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Leptospira interrogans

2014-05-20T11:34:00.000-07:00

Leptospira are thin , mobile spirochetes curving body tucks with hooks on the end so under a microscope to see the shape of the letter J and S. Causes leptospirosis .

Way of transmission

The natural reservoir and source of infection are rodents ( rats , mice , voles ) , domestic animals (dogs , cattle , pig , horse ) , wild animals ( jackals , foxes , blind mice ) . Infected animals excrete leptospires in the urine in the external environment where people can be infected through injury to the skin , and rarely through the mucous membranes of the respiratory tract , digestive tract or conjunctiva . For these reasons, the occupational disease leptospirosis often people who work in the rice fields , butchers , farmers , fishermen . Human-human transmission is extremely rare .

Pathological ( medical) significance

Leptospirosis acute infectious febrile disease of the zoonosis that is characterized by multiorgan damage caused by the developed vasculitis .

After an incubation period of 7-14 days disease flows through two phases .

The first phase of the disease is septicemic phase . It lasts 4-9 days and is characterized by the abrupt onset of the disease in the form of fever , chills , septic type of temperature , headache and muscle pain . Pain in the calf muscles and loin that occur are very pathognomonic . Present anorexia and vomiting . Can occur and signs of liver damage , central nervous symptoms , kidneys , lungs , gastrointestinal tract . The appearance of the patient at this stage is distinctive . Strong blood flow in the conjunctiva reminiscent of rabbit eyes . The patient is dehydrated, with reduced blood pressure . At the end of this phase, the temperature will drop quickly , resulting transitory asymptomatic period of 1-3 days.

Weil 's disease - a severe form of infection in which Leptospiral next severe symptoms occur signs of liver dysfunction and kidney from the third to the sixth day of illness . It starts suddenly jump temperatures up to 40 degrees , dread , pain in the muscles . They appear jaundice , liver enlargement , increase in bilirubin and aminotransferase . Renal damage is manifest as proteinuria , azotemia and pyuria (presence of protein , nitrogen compounds and pus in the urine ) . Haemorrhagic manifestations are podledica diffuse vasculitis occur in the form of epistaxis ( nosebleeds ) , hemoptysis ( coughing up blood ) , hematemesis ( vomiting blood ) , melena ( blood in stool) , hematuria ( blood in urine ) .

Microbiological diagnostics

For bacteriological diagnosis can take blood , cerebrospinal fluid and urine . To demonstrate using the reaction of agglutination , hemagglutination and CFT .

Treatment

Funerals are penicillin , and in susceptible applied doxycycline.

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Legionellae

2014-05-20T10:52:00.001-07:00

Legionellae are Gram- negative , aerobic bacilli that grow slowly on special nutrient media . Show affinity for the lung tissue . These are intracellular parasites , causing acute pneumonia ( Legionnaire's disease ) and flu -like syndrome. The most common causes legionellosis Legionella pneumophila . Possess endotoxin which is distinct from other gram-negative bacteria and the exotoxin hemolysin and cytotoxin baktricidnu that reduce the activity of phagocytes .

Way of transmission

Very often the source of infection contaminated aquatic ecosystems in which water circulates in a closed system ( air humidifiers ) . By air , aerosols containing Legionella can reach the lungs where Legionella cause inflammation and multilobar consolidation .

Pathological ( medical) significance

Legionellosis are newly discovered bacterial disease of the respiratory tract whose discovery place after epidemic occurrence of respiratory disease among the participants of the meeting of American Legionnaires .

After incubation for 2-10 days beginning the clinical manifestations of the disease . Start with the disease is sudden jump in temperature, dread , exhaustion . Soon the patient begins to breathe rapidly , the first unproductive coughs , but with possible coughing up blood . Feels pain in his chest , complaining of a severe headache , pain in the joints . It often occurs mental confusion , and hallucinations are also possible . As a consequence of toxemia present the relative bradycardia ( slow heartbeat ) , nausea , vomiting , watery diarrhea .

In untreated patients disease incrase to very serious complications in the form of respiratory failure , septic shock , renal insufficiency .

Pontiac fever - a much milder form of legionella infection , which is characterized by influenza -like illness ( flu -like syndrome ) . After a short incubation period of a few hours to two days illness begins fever , headache , muscle and joint pain , cough , chest pain . Passes for seven days with healing .

Microbiological diagnostics

For bacteriological diagnosis taken sputum ( mucus ) , bronchial secretions , pleural effusion , blood , urine , tissue obtained by biopsy of lung . Coloring can be used with silver impregnation technique . For rapid diagnosis used to test direct fluorescent antibody , RIA , ELISA and latex agglutination .

Treatment

Use erythromycin , rifocin , penicillin G or third-generation cephalosporins.

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Klebsiella

2014-05-20T10:31:00.002-07:00

The genus Klebsiella belongs to the family Enterobacteriaceae and covers four types : Kl.pneumoniae , Kl.oxytoca , Kl.terrigena and Kl.planticola . Type Kl.pneumoniae is further divided into four subtypes - subspecijesa :
Kl.pneumoniae ss . pneumoniae
Kl.pneumoniae ss . ozaenae
Kl.pneumoniae ss . rhinoscleromatis
Kl.pneumoniae ss . aerogenes
All Klebsiellae are Gram negative bacilli with rounded ends . Allocated individually or as couples . They do not have flagella and are immovable . Fimbriae with adherent properties and capsules are important virulence factors . Have somatic O - antigen and capsular K - antigen .

Way of transmission
It belongs to a group of opportunistic bacteria and diseases caused predominantly in patients with reduced defensive ability .

Pathological ( medical) significance
Klebsiella pneumoniae ss . pneumoniae has the largest medical significance . In children and adults above 50 years of age causing severe respiratory infections , such as pneumonia ( pneumonia ) , lung abscess . For respiratory tract infections can be extended to the mucous membrane of the paranasal sinuses , and increasingly to describe cases of meningitis and septicemia . In children causes enteritis and enterocolitis that and severity resemble dysentery . It also causes urinary infections that are characterized by severe and treatment of frequent recurrences.
Kl.pneumoniae ss . ozaenae causes chronic atrophic disease localized to the nasal mucosa , which carries nazoiv marries or rhinitis atrophicans . The disease is characterized by the creation of sewage odor .
Kl.pneumoniae ss . rhinoscleromatis causes rinosklerom , chronic disease of the skin and mucous membranes usually localized to the mucous membranes of the nose , oral cavity , pharynx and larynx , as well as on the skin of the nostril . The disease is characterized by the appearance of hypertrophic and tumorous changes in which are observed under a microscope the presence of mononuclear cells filled with a multitude of encapsulated gram-negative bacilli - Mikulicz cells .
Kl.pneumoniae ss . aerogenes in immunodeficient patients , especially in the hospital environment , can be the cause of urinary tract infections , bronchopneumonia , wound infections and septicemia .

Microbiological diagnostics
Diagnosis is made by identifying pathogens isolated from sputum , throat swabs , nasal swabs , wound swabs , urine , faeces , cerebrospinal fluid , blood and other clinical samples . The material zasejava on nutrient media broth , endo agar and blood agar . Examining the microscopic , culturally , biochemical and antigenic properties .

Treatment
Given the potential for rapid development and spread of resistance to certain antibiotics and chemotherapeutics , choice and dosage of antibacterial therapy should be done in accordance with the results of susceptibility testing .

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Helicobacter pylori

2014-05-14T11:17:00.000-07:00

Helicobacter pylori (HP ) is very small, in the form of a comma highly motile and Gram negative bacilli . Helicobacter pylori is a spiral bacterium that is found in the gastric mucosa . The only bacteria that can survive in the highly acidic gastric contents , with very little oxygen , at a temperature of 37 C. In addition to the gastric mucosa , was detected and sores on the oral mucosa, in plaque , saliva , and has been proven in a chair .

H. pylori infection is followed by humoral and cellular immune response . However , the host organism fails to eliminate this microorganism . Once created H. pylori infection , if left untreated , can persist for decades , probably for life. It is characteristic that the majority of infected there is no occurrence of symptoms of the disease , while a small percentage of symptomatic developing gastritis, peptic ulcer disease , gastric cancer , and of MALT lymphoma .

Way of transmission
Method of transmission of HP infection has not yet been fully explored . All previous findings speak in favor of the infections transmitted directly from an infected person to a healthy person , and in three main ways :
stomach - the mouth , when the vomit of an infected person , which contain a large amount of bacteria , they get into the mouth of a healthy person ;
mouth - the mouth , the mouth when an infected person passes the bacteria in the mouth of healthy individuals ;
chair - mouth when bacteria from the stool of an infected person , dirty hands , go to the mouth healthy .
There are indications of other routes of infection ( from the environment through water or over cats , dogs , etc. . ) , But it still needs to be confirmed , more detailed research .

The fastest way to infect young children who live in poor socio - economic conditions . HP infection is most common in children who share a bed with their parents or other children in the communities where the mother chews the food you give your child , or your child's pacifier previously placed himself in the mouth . Infection is more common in children who are placed in institutions of various types .

Pathological ( medical) significance
The aggressiveness of the bacteria with a sensitivity of the host and on the other hand , is likely responsible for some of the infected patients remain free of symptoms of disease ( only a gastric mucosal inflammation - gastritis, determined overview ) , while in developing a variety of other diseases such as ulcers , or even a tumor ( carcinoma or lymphoma of the stomach ) .

The most common symptom is pain , which is generally smooth and dull . It appears and disappears at intervals of several days to several weeks. In duodenal ulcer occurs a few hours after a meal or in the middle of the night on an empty stomach , and stops food intake . When ulcer pain usually increases after the intake of food . In addition to pain , which is the most dominant symptom is still occurring and the loss of body weight caused by aversion to food or anorexia , bloating , belching , nausea and vomiting . The symptoms can be very mild or does not appear. Bleeding is a common complication and is found in about 25 % of cases .

Microbiological diagnosis
Diagnostic procedures for detection of HP infection were classified into two groups :
invasive (overview probe - endoscopy with targeted sampling (biopsy - quick urease test , histology and culture) ,
non-invasive ( no examination of the probe ) - methods that reveal the presence of HP
blow - proving the activity of bacteria urea breath test ,
saliva or a blood - the presence of specific antibodies in serum and / or saliva of infected individuals ( this is a good method when the already consuming therapy ) ,
stool - evidence of bacteria ( antigens HP ) in the stool of patients .

Treatment
Gastric ulcers induced by H. pylori bacteria are treated with preparations which destroy pathogens and reduce the acidity of the stomach lining and the stomach lining of the protective layer . H. pylori damages the antibiotic , but in view of the acidic environment in which the live bacteria should result in reduction of acid secretion .

In the market there are two groups of drugs to continue to decrease gastric acidity
H2 - antagonists ( ranitidine, famotidine , cimetidine )
proton pump inhibitors ( omeprazole, pantoprazole , lansoprazole )
Therapy is combined with antibiotics , blockers of acid secretion and the protective effect of drugs on the mucous membranes. Currently the most reliable so . two triple therapy with antibiotics against H. pylori infection in combination with a drug which blocks the secretion of acid or protectives ( e.g., azithromycin omeprazole + amoxicillin + ) . Thus relieve the symptoms of ulcers , eliminate its cause in more than 90 % of cases prevents recurrence ( relapse ) . Checking the effects of drugs on H. pylori perform an endoscopic examination or review of breathless 4 weeks after therapy . Antacids are used to remove the symptoms of the disease and as an adjunct therapy . If the ulcer is caused by H. pylori is not necessary to take antibiotics , it is sufficient to take blockers of acid secretion .

Complications of gastric ulcer may be bleeding or perforation when required to carry out endoscopy or surgery .

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Haemophilus influenzae

2014-05-14T10:49:00.001-07:00

Genus Haemophilus are small , immobile , asporogeni Gram negative bacilli , whose cultivation is essential blood in medium with factors X and V. Haemophilus influenzae outer membrane and has produced endotoxin . Based on the structure of the polysaccharide capsule forms are divided into six serotypes .

Way of transmission
H.influenzae is common, almost regular inhabitant of the upper respiratory tract . Pneumoniae is a very rare, but was much higher percentage of the so-called . household contacts . Source of infection is a man who through droplets ejected from H.influenzae .

Pathological ( medical) significance
Haemophilus influenzae is a bacterium that causes a range of serious diseases . Purulent meningitis is the most common disease and usually occurs in infants and young children , rarely in adults. The disease may start in two ways . The first far more common place to another with the events that follow respiratory diseases . After 2-3 days there are signs of affection of the CNS - a ( central nervous system ) - lethargy , hard fontanelle , rigidity, irritability . In rare cases, the disease can begin as septic shock and can even be found , and rash . Complications are quite common and almost 30 % of patients have subdural effusion . A frequent companion of the convulsions .

H.influenzae also causes : pneumonia , inflammation of the cartilage cap in the throat ( epiglottitis ), which causes shortness of breath and choking , sepsis - the presence of bacteria in the blood which leads to more severe conditions : fever, malaise , shortness of breath , pallor , cold hands and legs , vomiting , sore joints, rhinopharyngitis , sinusitis , otitis media , conjunctivitis , etc. .

Microbiological diagnosis
Isolated from sputum , throat swab and nasal , eye , CSF , blood . It can be shown by reaction slide agglutination test . It is easy to identify in the laboratory using a phenomenon stelitizma .

Treatment
The treatment was conducted once penicillin but the increase in resistance to this antibiotic more important place belongs to the third generation cephalosporins . It also recommends a combination of chloramphenicol and ampicillin.

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Haemophilus ducreyi

2014-05-14T10:04:00.000-07:00

Haemophilus ducreyi is a gram negative , immobile , asporogeni , facultative anaerobic bacillus , length of 1.5 to 2 microns , which is pathogenic for humans.

Way of transmission

The only source of infection is the man . Transmitted almost exclusively through sexual contact or direct contact through injured skin or mucous membranes , usually genital region . This is the disease of people who live in poor socio - economic conditions , more common in men than in women .

Pathological ( medical) significance

Haemophilus ducreyi causes ulcus molle (soft chancre ) - an acute infectious venereal disease localized mainly on the genitals.

The incubation period is 1 - 7 days (usually 3 - 5 days) , but sometimes women can take weeks . Penetration at the site of pathogen occurs papules surrounded by redness, which is converted , after 24-48 hours of pustules ( slurry ) , and then the erosion and ulceration of the small dimensions . From the fourth to the fifth day Shancroidisis gets the typical appearance : ulceration is round or oval , with a diameter of 3 to 15 mm . The edges are jagged ulceration and undermined , the bottom is uneven, highly vascularized and bleeds on touch. Covered with pus and around the ulcer is eritemni edge . Ulcus molle poorly infiltrating , soft and pasty . On palpation was painful .

Localized usually on the genitals , and sometimes the surrounding skin . In men occurs in the glans , the urethral orifice area , the inner foreskin and frenulum list . Less frequent localization in the region of the scrotum , mons pubis and perianal . In women, the most common localization of the large lips and the entrance to the vagina . Number of lesions was different. Half of the patients having more than one ulcer , and a lesion resulting from the autoinoculation pathogens . Cases have been described with the 50 to 60 ulceration .

During the first two weeks of the disease in 50 % of cases occurring in regional lymphadenopathy , usually unilateral . Usually they are affected by the inguinal lymph nodes and to the same side , and wherein the soft chancre . The lymph nodes are increased , become painful , coalesce with each other and with the skin that covers them . The skin over the affected nodes is eritemna and shiny. There is fluctuation leads to perforation and purulent discharge contents through the skin .

Microbiological diagnosis

Diagnosis is based on staining , culture, causes and autoinokulacionim test. Diagnosis is complicated, and it can be indirectly set the intradermal test (using suspensions of killed bacilli purified ) .

Treatment

Antibiotic therapy . Ceftriaxone is a drug of choice may be used , and sulfonamides , and in some cases good results and provide tetracycline compositions . Patients are advised to rest. It is necessary at the same time and to treat a sexual partner.

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Gardnerella vaginalis

2014-05-14T09:44:00.002-07:00

Gardnerella vaginalis is a small Gram- negative bacillus immobile . In normal conditions, is in the uterus , as well as the large intestine , and in its excessive proliferation ( stress, sexual partners of changes , loss of natural flora ) occurs disease - bacterial vaginosis or amine colpitis . Gardnerella vaginalis , a leading cause of bacterial vaginosis , most likely the production of succinate to the growth and multiplication of others, usually 4 - 6 anaerobic bacterial species ( Bacteroides spp , Peptococcus spp , Peptostreptococcus spp , Fusobacterium nucleatum , Mobiluncus spp , Veillonela parvula ) .

Pathological ( medical) significance

The disease can flow without symptoms or feature sparse / abundant , whitish , rarely brushed unpleasant and characteristic odor ( smell of fish ) . In some cases, it appears irritated after intercourse .

The characteristic odor ooze coming from amines cadaverine and putrescine forming anaerobic bacteria . The population of lactobacilli is completely suppressed and these natural inhabitants of the uterus are only individually .

Bacterial vaginosis is considered a risk factor in the development of spontaneous abortion and premature labor , other infection during pregnancy , as well as complications of surgery . Are often associated infections with gonococci , chlamydia and trichomonas .

Gardnerella vaginalis in men may cause balanoposthitis , but its presence in the penile urethra in men is usually not associated with clinical manifestations. Symptoms in men include rashes , burning and itching of the penis .

Microbiological diagnosis

Sets the inspection of the vaginal wall , look and smell of vaginal discharge, vaginal degree of purity. For microbiological diagnostics take two swabs of vaginal secretions or secretions from the male urethra . One is for the preparation of ( native or Gram stained ) , while the second surface to nasađuje the insulation as quickly as possible after taking the sample. For the diagnosis of significant clinical aspect of leucorrhoea , odor , pH above 4.5 , the disappearance or reduction of the number of lactobacilli , the absence of polymorphonuclear cells clue .

Microscopic cells are typical - clue cells or Schlüsselzellen - vaginal epithelial cells covered with a multitude of bacteria that look like they are dusted with powdered sugar .

Treatment

The drugs of choice are the derivatives of 5 - nitromidazola such as metronidazole and tinidazole ornidazol , or clindamycin . During treatment is recommended abstinence or protected sexual intercourse ( condom ) . It is important to note that both partners are treated simultaneously

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