PHMP 211 Lec Complete

Pharmaceutical Microbiology and Parasitology
PHMP 211 LEC | KENNETH JAMES MAGKASI | 2ND YEAR | 1ST SEM | FINALS
TOPIC 1:
VIROLOGY
VIRUS
● The smallest infectious agents (ranging from

about 20 to 300 nm in diameter) contain only one
kind of nucleic acid (can be RNA or DNA) as their
genome. There are some organisms like
retroviridae that start from being RNA then
convert to DNA. Nucleocapsid:
● The entire infectious unit is termed a virion (1 piece ● The protein–nucleic acid complex representing
of virus) the packaged form of the viral genome. The term
● Replicates only in living cells and are inert in the is commonly used in cases in which the
extracellular environment, therefore they cannot nucleocapsid is a substructure of a more
live outside the living cell complex virus particle.
Structural units:
TERMS ● The basic protein building blocks of the coat.
They are usually a collection of more than one
Capsid: nonidentical protein subunit. The structural unit is
● The protein shell, or coat, that encloses the nucleic often referred to as a protomer.
acid genome. Inside the core there is nucleic acid
that can be DNA or RNA. Subunit:
● A single folded viral polypeptide chain.
Capsomeres:
● Morphologic units seen in the electron Virion:
microscope on the surface of icosahedral virus ● The complete virus particle.
particles.
● Capsomeres represent clusters of polypeptides, but
the morphologic units do not necessarily
correspond to the chemically defined structural
units.
Defective virus:
● A virus particle that is functionally deficient in
some aspect of replication. there are some aspects
that if it replicates, hindi na siya sasama
NUCLEIC ACID
Envelope:
● A lipid-containing membrane that surrounds ● DNA viruses – Usually double stranded (ds) but may
some virus particles. It is acquired during viral be single stranded (ss) – Circular or linear
maturation by a budding process through a ● RNA viruses – Usually single stranded, may be
cellular membrane double stranded, may be segmented into separate
● Virus-encoded glycoproteins are exposed on the RNA pieces
surface of the envelope. - ssRNA genomes ready for immediate
● These projections are called peplomers (yung tusok translation are positive-sense
tusok) → Positive-sense RNA contain the
● Non-envelope virus are called naked virus message for translation
● Not all virus have envelope
- ssRNA genomes that must be converted
into properform are negative-sense RNA
→ Negative-sense RNA must be
converted into positive-sense message
in order to undergo translation
San Gabriel, DM., Dela Cruz, DA., Peralta K., Peralta RD., & Pineda, MC. ㅣ1
BASIS OF CLASSIFICATION TAXONOMY OF VIRUSES
● Virion morphology, including size, shape, type of ● Classification of viruses is based on type of nucleic
symmetry, presence or absence of peplomers, and acid, morphological class, and presence or absence
presence or absence of membranes of an envelope.
● Virus genome properties, including type of ● Virus family names end in –viridae; genus end in –
nucleic acid (DNA or RNA), size of the genome, virus.
strandedness (single or double), whether linear or ● A viral species is a group of viruses sharing the same
circular, sense (positive,negative, ambisense), genetic information and ecological niche.
segments (number, size), nucleotide sequence,
percent GC content, and presence of special DNA VIRUSES
features (repetitive elements, isomerization, 5′-
terminal cap, 5′-terminal covalently linked protein,
3′-terminal poly(A) tract).
● Genome organization and replication, including
gene order, number and position of open reading
frames, strategy of replication (patterns of
transcription, translation), and cellular sites
(accumulation of proteins, virion assembly virion
release)
● Virus protein properties, including number, size,
amino acid sequence, modifications
(glycosylation, phosphorylation, myristoylation),
and functional activities of structural and
nonstructural proteins (transcriptase, reverse
transcriptase, neuraminidase, fusion activities).
● Antigenic properties, particularly reactions to H → Hepadnaviridae
various antisera. H → Herpesviridae
● Physicochemical properties of the virion, A → Adenoviridae
including molecular mass, buoyant density, pH A → Anelloviridae
stability, thermal stability, and susceptibility to P → Parvoviridae (smallest virus for DNA family)
physical and chemical agents, especially P → Polyomaviridae
solubilizing agents and detergents. P → Papillomaviridae
● Biologic properties, including natural host range, P → Poxviridae (complex; largest virus)
mode of transmission, vector relationships, y → (wala talaga for the purpose of acronym lang)
pathogenicity, tissue tropisms, and pathology.
Picornaviridae → smallest virus for RNA family
RNA VIRUSES: (PRayFOR PRC)TBB
1. Adsorption: Once they enter the body they will

undergo adsorption, wherein they would attach to
the cell receptors by their spike proteins
2. Penetration: They can now enter the cell where
there would be penetration. Wherein, if it has an
envelope it will fuse the cell membrane and
envelope. But, if there is no envelope or naked, thus
there is no fusion it will just enter.
3. Uncoating: Once the virus is inside the cell there
would be uncoding. Wherein, capsid are released
● Nucleic acid of all DNA viruses are double-stranded, and capsid will release its nucleic acid, may it be the
except Parvovirus RNA or DNA, and including the enzymes.
● While all RNA are single-stranded, except Reovirus 4. Synthesis, Replication and Protein production:
● Most viruses have linear genome, except Once they are released it will find the area where
Papovavirus which have supercoiled, circular they can undergo replication. And then, they will
genomes synthesize and replicate and there will be a protein
production.
● Most viruses with icosahedral symmetry are naked, 5. Assembly and release: After they produce multiple
except Toga, Herpes, Retro and Flavi, Bunya, components they would now undergo assembly.
Hepadna virus. The viral spike proteins are inserted to the cell
● Smallest: Parvovirus, Picornavirus membrane; if it is envelope, and there will be a
● Largest: Poxvirus release which is called “budding” because it binds
to the cell membrane. Unlike non-envelope, only
lysis will occur.
STAGES OF VIRAL REPLICATION
ADSORPTION or ATTACHMENT
● The process in which the virus adheres to the host
cell surface
● This process is selective, in which the virus will
adhere only to selected host cells it can infect

(permissive cells) depending on the receptors found
on the host cell (receptor) and on the viral surface
(anti-receptor).
PENETRATION
● Also called viral entry
● This process follows attachment and happens
almost instantaneous the moment the virus
attaches to the cell.
MEDICALLY IMPORTANT VIRAL INFECTIONS (DNA VIRUS)
● Three (3) types:
1. Viral translocation across the plasma
membrane;
2. endocytosis PARVOVIRIDAE
3. membrane fusion
- Naked viruses only undergoes the first two ● Non enveloped
(Viral translocation and endocytosis), ● Parvoviruses (from Latin
unless there is the presence of the parvus meaning small)
envelope ● Smallest DNA animal virus
● Replication occurs only in
UNCOATING actively dividing cells
● Happens after viral entry wherein the capsid ● capsid assembly takes
protecting the viral genome is removed. place in the nucleus of the
● Removed by degradation by enzymes, whether viral infected cell
or host or by simple dissociation. ● Human parvovirus B19
● This results in the release of the viral nucleic acid. replicates in immature
→ Endocytosis – entire virus is engulfed and erythroid cells and causes
enclosed in a vacuole or vesicle several adverse
→ Fusion – envelope merges directly with consequences, including aplastic crisis, fifth
membrane resulting in nucleocapsid’s entry into disease, and fetal death
cytoplasm
Syndrome Host or Condition Clinical features
SYNTHESIS
● After the genome is liberated, viral parts are now Erythema infectiosum Children (fifth disease) Cutaneous rash
Adults Arthralgia-arthritis
synthesized from the genome.
● The first usual step is the replication of the mRNA Transient aplastic crisis Underlying hemolysis Severe acute anemia
(except for (+) RNA viruses).
● Then the viral mRNA are used to synthesize Pure red cell aplasia Immunodeficiencies Chronic anemia
different proteins needed by the virus.

Hydrops fetalis Fetus Fatal anemia
ASSEMBLY
● Step after the synthesis of viral parts. ● There is no vaccine against human parvovirus,
● All the viral parts needed to complete a virion are although prospects are good that a vaccine can be
assembled. developed.
● There are effective vaccines against animal
RELEASE parvoviruses for use in cats, dogs, and pigs. There
● Viruses are then released form the cell by lysis of the is no antiviral drug therapy
cell (lytic cycle) ● Transmission is through respiratory route blood
→ Lysis – nonenveloped and complex viruses transfusion or vertical transmission (inherited)
released when cell dies and ruptures ● Fifth disease can cause transient aplastic crisis
are treated symptomatically. Severe anemia due
● if the virus is enveloped, by budding. to the latter may require transfusion therapy.
→ Budding – exocytosis; nucleocapsid binds to ● Different from the parvovirus that can be seen in
membrane which pinches off and sheds the viruses animals like dogs and cats.
gradually; cell is not immediately destroyed
POLYOMAVIRIDAE ADENOVIRIDAE
● Nonenveloped, heat-stable, solubilization-resistant ● from Latin adenos meaning gland)

viruses are medium-sized (70–90 nm),
● from Greek poly-(many) and –oma (tumor) (can ● non enveloped viruses exhibiting
cause cancer) and refers to the ability of some of cubic symmetry, with fiber spikes
these viruses to produce tumors in infected hosts protruding from capsomers that aid
● These agents have a slow growth cycle, stimulate in host attachment
cell DNA synthesis, and replicate within the nucleus ● At least 67 types infect humans, especially in
mucous membranes, and some types can persist in
● The most well-known human polyomaviruses lymphoid tissue.
are: ● Adenoviruses can cause acute respiratory
1. JC virus (brain), the causative agent of progressive diseases, conjunctivitis, and gastroenteritis.
multifocal leukoencephalopathy; ● There is no specific treatment for adenovirus
2. BK virus (kidney), associated with nephropathy in infections
transplant recipients
3. Merkel cell virus (skin cancer), found associated
with the majority of Merkel cell skin carcinomas HEPADNAVIRIDAE
● from Latin hepa meaning liver

PAPILLOMAVIRIDAE ● Causes the hepatitis B virus
● Once infected, forever na sa body
● Latin papilla (nipple) and Greek –oma ● Replication involves repair of the single-stranded
(tumor) and describes wart-like lesions gap in the DNA, transcription of RNA, and reverse
produced by these viral infections. transcription of the RNA to make genomic DNA
● causative agents of genital and ● Acid sensitive, causes acute and chronic disease
cervical cancers in humans ● The surface protein is characteristically
(genital warts) overproduced during replication of the virus, which
● Transmission of viral takes place in the liver, and is shed into the
infections occurs by close bloodstream
contact ● Hepadnaviruses such as Hepatitis B virus can cause
● HPV (Human acute and chronic hepatitis; persistent infections
Papillomavirus) type 16 and are associated with a high risk of developing liver
18 are the most common and cancer (hepatocellular carcinoma)
highest cancer risk
● Cryotherapy is done for patients with this virus (In
which it freezes and removes the infected tissue)
VACCINES
1. Gardasil®
- Recombinant vaccine prepared from L1 protein of
HPV type 6, 11, 16 and 18
2. Gardasil® 9
- Recombinant vaccine that targets 9 HPV subtypes,
6,11, 16, 18, 31,33,45,52,58
3. Cervarix®
- Recombinant vaccine prepared from L1 protein of
HV type 16 and 18 (most notorious is 16 and 18)
CLASSIFICATION OF HERPES VIRUS
● HSV-1 and HSV-2 infect epithelial cells and establish

latent infections in neurons.
- Type 1 is classically associated with
oropharyngeal lesions (mouth) and
causes recurrent attacks of “fever
blisters.”
- Type 2 primarily infects the genital
mucosa and is mainly responsible for
genital herpes, though the anatomical
VACCINES specificity of these viruses is diminishing.
1. Engerix B (1mL(20mcg)), Recombivax HB - Both viruses can also cause neurologic
(1mL(10mcg)) disease. HSV-1 is the leading viral cause of
- given 3 doses 1 mL (20 mcg) sporadic encephalitis in the United States.
- 0 month, 1 month and 6 months interval for adults - Both types 1 and 2 can cause neonatal
- For newborn with HBsAg–negative mothers: 0.5mL infections that are often severe.
within 24 hrs
- For newborn with HBsAg-positive mothers: 0.5mL ● VZV causes chickenpox (varicella) on primary
within 12 hrs plus HBIG infection and establishes latent infection in
neurons.
2. Heplisav- B - Upon reactivation, the virus causes herpes
- 2 doses (for 18 years old and above) zoster (shingles).
- 0.5mL IM at 0 and 1 month interval - Adults who are infected for the first time
with varicella-zoster virus can develop
serious viral pneumonia
HERPESVIRIDAE
● CMV replicates in epithelial cells of the respiratory
● Herpesviruses are a family of large viruses 150–200 tract, salivary glands, and kidneys and persists in
nm in diameter. lymphocytes
● The name refers to Latin herpes (creep), describing - It causes an infectious mononucleosis
the spreading nature of skin lesions caused by these (heterophile antibody-negative).
viruses. - In newborns, disseminated cytomegalic
inclusion disease may occur.
● Human herpesviruses include: - CMV is an important cause of congenital
1. Herpes simplex types 1 and 2 (oral and genital defects, neonatal hearing loss, and
lesions), mental retardation.
2. Varicella-zoster virus (chickenpox and shingles), - common in immunocompromised
3. Cytomegalovirus
4. Epstein-Barr virus (infectious mononucleosis and ● EBV aka Kissing disease (tonsils
association with human neoplasms), Human seem to be kissing & can be passed
herpesviruses 6 and 7 (T cell lymphotropic, Roseola through kissing) replicates in
infantum, Sixth disease), epithelial cells of the oropharynx and
5. Human herpesvirus 8 (associated with Kaposi parotid gland and establishes latent
sarcoma). infections in lymphocytes.
- It causes infectious mononucleosis and
can induce human lymphoproliferative
disorders, especially in
immunocompromised patients. → Vaccinia virus may be the product of

genetic recombination, a new species
● HHV-6 infects T lymphocytes. It is typically acquired derived from cowpox virus or variola virus
in early infancy and causes exanthem subitum by serial passage, or the descendant of a
(roseola infantum) as well as infections in now extinct viral genus
immunocompromised patients.
- HHV-7, also a T-lymphotropic virus, has not ● Variola has a narrow host range (only humans and
yet been definitively linked to any specific monkeys); no cure
disease; can also cause roseola infantum. - 2 types of Variola: Variola major and
Variola minor
● HHV-8 is associated with the development of
Kaposi sarcoma, a vascular tumor that is common ● DOC for prophylaxis: Methisazone is a
in patients with AIDS chemotherapeutic agent historically evaluated
against poxviruses. It is effective as prophylaxis but
Image: is not useful in treatment of established disease.
1. Chicken pox - Cidofovir, a nucleotide analog, shows
2. Herpes Simplex Type 1 activity against poxviruses in vitro and in
3. Herpes 6 and 7 vivo; but not a definitive treatment.
4. Human Herpes simplex → It has been used to treat molluscum
8 contagiosum and of virus infections.
POXVIRIDAE
● large brick-shaped or ovoid viruses

● The particle structure is complex, with a lipid-
containing envelope
● from Anglo-Saxon pokkes meaning pouch,
referring to their characteristic vesicular skin MEDICALLY IMPORTANT VIRAL INFECTIONS (RNA VIRUS)
lesions.
● Replication occurs entirely within the cell
cytoplasm. Some are pathogenic for humans PICORNAVIRIDAE
(smallpox, vaccinia, molluscum contagiosum);
● Others that are pathogenic for animals can infect ● Smallest among the RNA virus
humans (cowpox, monkeypox) ● Picornaviruses are small (28–30 nm), ether-resistant
● Most of the poxviruses that can cause disease in viruses exhibiting cubic symmetry
humans are contained in the genera ● The groups infecting humans are enteroviruses
Orthopoxvirus and Parapoxvirus (polioviruses, coxsackieviruses, echoviruses,
● The orthopoxviruses have a broad host range parechoviruses, and rhinoviruses [more than 100
affecting several vertebrates. serotypes causing common colds]) and
- They include ectromelia (mousepox), hepatovirus (hepatitis A).
camelpox, cowpox, monkeypox, ● Rhinoviruses are acid labile and have a high
vaccinia, and variola (smallpox) viruses. density; other enteroviruses are generally acid
(can infect humans) stable and have a lower density;.
- Picornaviruses infecting animals include
- Vaccinia virus, the agent used for foot-and-mouth disease of cattle and
smallpox vaccination, is a distinct species encephalomyocarditis of rodents
of Orthopoxvirus
→ The genome of vaccinia virus are ● Rhinoviruses are the most common cause of
distinctly different from those of cowpox common colds which are self limiting. Therefore, it
virus, which was believed to be its doesn’t need to be treated because our body can
ancestor fight against common colds. We do treat them, but
→ At some time after Jenner’s original use it's only for symptomatic relief. Rhinoviruses are very
of “cowpox” virus, the vaccine virus much contagious, kapag nabahingan mo sila
became known as “vaccinia virus.”
pwede rin sila mahawa. B. NON-PARALYTIC POLIOMYELITIS (ASEPTIC

● Hepatitis A is a food borne infection (nakukuha sa MENINGITIS)
mga sawsawan ng turo turo, contaminated food ● You won’t be paralyzed if this is what you acquired
and water) that can cause Hepatitis (inflammation ● Symptoms of mild disease plus stiffness and pain
of the liver), Among other hepatitis, eto yung mas in the back and neck. (2-10 days)
gumagaling and at the same time its mild ● Rapid recovery
compared to Hepatitis B, C, D, and E.
● Poliovirus is transmitted via mouth. Once it goes to C. PARALYTIC POLIOMYELITIS
the body, they would go to nervous system which ● flaccid paralysis (bigla na lang siya hindi gagana)
can cause paralysis of the muscle. Once muscles are resulting from lower motor neuron damage
paralyzed, atrophy will occur because we do not use ● The virus spreads from person to person and can
our muscles (lumiliit ang muscle kapag hindi infect a person's spinal cord, causing paralysis
ginagamit); Sa mga bata na nagkaroon na ng ● incoordination secondary to brain stem invasion
poliovirus, because they are not able to use their and painful spasms of nonparalyzed muscles may
muscles. hindi lumalaki yung muscles kung saan also occur
man infected yung infection. Thus, ang nangyayari ● Maximal recovery usually occurs within 6 months,
is para silang lumpo paglaki nila. with residual paralysis lasting much longer.
D. PROGRESSIVE POSTPOLIOMYELITIS MUSCLE

Poliovirus (Wild poliovirus type 1-3) ATROPHY
● Poliovirus is something that we have to eradicate in ● recurrence of paralysis and muscle wasting has
the past, we have had an epidemic of polio before. been observed in individuals decades after their
And we have three types of polio; polio virus 1 to 3. experience with paralytic poliomyelitis
● Transmitted via mouth which is the portal of ● result of physiologic and aging changes in paralytic
entry patients already burdened by loss of
● Multiplies in the intestine and oropharynx (tonsils, neuromuscular functions
lymph nodes of the neck, peyer's patches, small
intestine)
● The CNS may then be invaded by way of the
circulating blood
- Spread to the axon of the peripheral
nerves (limbs) to the CNS
- where it continues to progress along the
fibers of the lower motor neurons to
increasingly involve the spinal cord or the
brain.
- Poliovirus invades certain types of nerve
cells, and in the process of its intracellular
multiplication, it may damage or
completely destroy these cells
● Muscle atrophy - lumiliit yung muscles
- The changes that occur in peripheral
nerves and voluntary muscles are
2 TYPES OF VACCINE FOR POLIO (board exam question)
secondary to the destruction of nerve cells.
1. Salk - parenteral
Some cells that lose their function may
2. Sabin - oral; commonly used vaccine because easier
recover completely. Inflammation occurs
administration especially for kids.
secondary to the attack on the nerve cells.
(area of affectation, nawawalan ng
● The oral polio vaccine is being used in the global
function)
eradication program
● There are no antiviral drugs for treatment of
A. MILD DISEASE
poliovirus infection, and treatment is symptomatic
● Most common form of disease
● Minor illness, Recovery within days
● affects intestine and tonsils
- S/S: Headache, nausea, vomiting,
constipation, sore throat
Myocarditis
● a serious disease. It is an acute inflammation of the
heart or its covering membranes (pericarditis)
Generalized disease of infants

● an extremely serious disease in which the infant is
overwhelmed by simultaneous viral infections of
multiple organs, including the heart, liver, and
brain
● May be acquired transplacentally, can be acquired
via vertical transmission (disease can be passed to
COXSACKIEVIRUSES mother to offspring)
Divided into groups A and B
Foot-and-mouth Disease (Aphthovirus of cattle)
● Group A: ● This highly infectious disease of cloven-hoofed
- Herpangina (vesicular pharyngitis), animals such as cattle, sheep, pigs, and goats is
- hand-foot-and-mouth disease rare in the United States but endemic in other
- acute hemorrhagic conjunctivitis countries.
● It may be transmitted to humans by contact or
● Group B: ingestion. In humans, the disease is characterized
- Pleurodynia (epidemic myalgia); Myalgia means by fever, salivation, and vesiculation of the
muscle pain mucous membranes of the oropharynx and of the
- myocarditis, skin of the feet.
- pericarditis,
- severe generalized disease of infants
The incubation period of coxsackievirus infection ranges

from 2 to 9 days
Aseptic meningitis: (meningitis → inflammation of the lining

of the brain) ASTROVIRIDAE
● Fever, malaise, headache, nausea, and abdominal
pain are common early symptoms. The disease ● It was named astroviridae because
sometimes progresses to mild muscle weakness it looks like a star
suggestive of paralytic poliomyelitis. Patients ● Astroviruses are similar in size to
almost always recover completely from picornaviruses (28–30 nm), but
nonpoliovirus paresis. particles display a distinctive star-
shaped outline on their surfaces
Herpangina ● These agents are associated with gastroenteritis in
● is a severe febrile pharyngitis (fever, and pananakit humans and neurological disease in some
ng lalamunan) that is caused by certain group A animals
viruses ● The family Astroviridae contains two genera; all
human viruses are classified in the Mamastrovirus
Hand-foot-and-mouth disease genus
● oral and pharyngeal ulcerations and a vesicular ● Astroviruses cause diarrheal illness and may be
rash of the palms and soles that may spread to the shed in extraordinarily large quantities in feces. The
arms and legs viruses are transmitted by the fecal–oral route
through contaminated food or water, person-to-
Pleurodynia person contact, or contaminated surfaces.
● (also known as epidemic myalgia) and stabbing
chest pain are usually abrupt (mabilis lang) in
onset but are sometimes preceded by malaise
(weakness and discomfort), headache, and
anorexia.
● The illness is self-limited and recovery is complete,
although relapses are common
CALICIVIRIDAE Hantavirus:
● “New World” hantaviruses are found in America,
● Caliciviruses are similar to and may cause hantavirus pulmonary syndrome
picornaviruses but slightly larger (27– (HPS).
40 nm). The particles appear to have ● “Old World” hantaviruses are found mostly in
cup-shaped depressions on their Europe and Asia and may cause hemorrhagic
surfaces fever with renal syndrome (HFRS).
Important human pathogens are the: 3. FILOVIRIDAE

1. noroviruses (eg, Norwalk virus), ● Enveloped, pleomorphic viruses that may appear
- the cause of epidemic acute gastroenteritis very long and threadlike
(inflammation of gastrointestinal tract that causes ● Marburg and Ebola viruses cause severe
discomfort, diarrhea, constipation) hemorrhagic fever in Africa. These viruses require
maximum containment conditions
2. Sapovirus, which includes the Sapporo-like
viruses; 5 variants of Ebola virus: (ZaRBuTaS)
- Initially discovered in an outbreak of 1. Zaire (major species that cause Ebola)
gastroenteritis in an orphanage in Sapporo, 2. Reston (least to non pathogenic; monkey
Japan, in 1977 from the Philippines)
3. Bundibugyo
4. Tai Forest
ARBOVIRUSES AND RODENT-BORNE VIRUSES 5. Sudan
● It is called “arbo” because of arthropod viruses ● The incubation period is 3–9 days for Marburg
which can be passed to insect vectors. disease and 2–21 days for Ebola
● Arthropod-borne viruses (arboviruses) and rodent ● They cause similar acute diseases characterized by
borne viruses represent ecologic groupings of fever, headache, sore throat, and muscle pain
viruses with complex transmission cycles involving followed by abdominal pain, vomiting, diarrhea,
arthropods or rodents. and rash, with both internal and external
● Classified under: bleeding, often leading to shock and death.
1. Arenaviridae, ● Ebola virus was discovered in 1976 when two severe
2. Bunyaviridae, epidemics of hemorrhagic fever commonly
3. Flaviviridae, occurred in Sudan and Zaire (now the Democratic
4. Reoviridae, Republic of the Congo); no treatment, and
5. Togaviridae vaccine.
● The outbreaks involved more than 500 cases and
1. ARENAVIRIDAE at least 400 deaths caused by clinical
● pleomorphic, enveloped viruses ranging in size hemorrhagic fever.
from 60 to 300 nm (mean, 110–130 nm). The genome ● In each outbreak, hospital staff became infected
is segmented through close and prolonged contact with
● Most members of this family are unique to tropical patients, their blood, or their excreta.
America ● These subtypes of Ebola virus (Zaire, Sudan) are
● most of them are Rodent Borne diseases highly virulent. The mean time to death from the
onset of symptoms is 7–8 days.
Lassa fever virus
- Transmitted by “multimammate rat” (Sci
name: Mastomys natalensis)
- Non specific symptoms
- Most common complication is deafness
- DOC: Ribavirin, an antiviral drug, has been
used with success in Lassa fever patients
2. BUNYAVIRIDAE
● Bunyaviruses are spherical or pleomorphic, 80- to
120-nm enveloped particles.
● The majority of these viruses are transmitted to There could also be a Petechial rash, which is a small
vertebrates by arthropods bleeding, and Hematoma which is pasa.
● The U.S. Food and Drug Administration (FDA) has non neutralizing heterologous dengue antibody
approved the Ebola vaccine (kakaapprove lang) , caused by a previous infection with a different
ERVEBO®, for the prevention of EVD (only used for serotype of virus.
Zaire species). - Four serotypes (DENV 1-4), Aedes aegypti and
● ERVEBO vaccine has been found to be safe and Aedes albopictus are the vectors
protective against only the Zaire ebolavirus - Associated with bone pain since it affects the blood.
species of ebolavirus Dengue fever was formerly known as “Breakbone
fever”
4. FLAVIVIRIDAE - Vaccine development is difficult because a vaccine
● Mature virions accumulate within cisternae of the must provide protection against all four serotypes of
endoplasmic reticulum virus
● Most members are transmitted by blood-sucking - Dengvaxia (20 yrs) contains attenuated
arthropods. Arthropod borne: Japanese B (weakened) yellow fever viruses that have
encephalitis, Zika, Dengue, West nile, yellow been modified so that they contain
fever proteins from dengue virus
● Hepatitis C virus is a flavivirus with no known - Completed 4 strains
vector; parenterally transmitted or sexually
transmitted. Difficult to manage because there is Unang dengue na may DENV 1 survivable pa siya, pero
no vaccine. kapag nagkaroon ka ulit ng dengue at ang dala dala ay
● Yellow fever virus is the prototype member of the DENV 2 mas nagiging deadly na siya kasi nagkakaroon tayo
Flaviviridae family. It causes yellow fever, an ng antibody dependent enhancement. Ang ibig sabihin
acute, febrile, mosquito borne illness that occurs niyan since mayroon na tayong antibody against DENV 1
in the tropics and subtropics of Africa and South ang aakalain ng antibody mo siya rin yung nag-infect dati
America kaya mag ccause siya ng inflammation or immune
- The incubation period is 3–6 days. At the response. Kaso hindi niya mapapatay yung virus dahil hindi
abrupt onset, the patient has fever, chills, naman siya DENV 1 (DENV 2 siya). Ang gagawin ngayon ng
headache, dizziness, myalgia, and katawan natin is gagawa siya ng antibody against DENV 2,
backache followed by nausea, vomiting, ibig sabihin dala-dalawa yung immune response na
and bradycardia. gumagana. isa, gumagawa ng antibody against DENV 2,
- The disease progresses to a more severe and yung pangalawa it is acting using DENV 1. Kaya
form, with fever, jaundice, renal failure, nagkakaroon ng excessive inflammation reaction.
and hemorrhagic manifestations. The
vomitus may be black with altered blood Unang dengue mild lang, pero as the number of serotypes
→ vomit with blood = hematemesis; increases in your body mas nakakamatay siya.
“Hema” means blood, “temesis” means
vomit ● Hepatitis C (Hepacivirus)
→ phlegm with blood = hemoptysis - Most dangerous hepatitis
● When the disease progresses to the severe stage - Most new infections with HCV are subclinical. The
and is left untreated (hepatorenal failure), the majority (70–90%) of HCV patients develops chronic
mortality rate is high (20% or higher), especially hepatitis, and many are at risk of progressing to
among young children and elderly adults. chronic active hepatitis and cirrhosis (10–20%). In 1–
- Death occurs on day 7–10 of illness. 5% of infected individuals,
- Vaccination is the best preventive - HCV leads to hepatocellular carcinoma, which is
measure (YF-VAX) - required when the fifth most common cause of cancer
traveling to other countries worldwide.
- Commonly transmitted parenteral through blood
● Dengue virus (breakbone fever) transfusion, and sharing of used needles
- mosquito-borne infection caused by a flavivirus - Present in blood, saliva and semen, no known
that is characterized by fever, severe headache, vector
muscle and joint pain, nausea and vomiting, eye - No vaccine, Pegylated interferon combined with
pain, and rash. Severe forms of the disease, ribavirin has been the standard treatment for
dengue hemorrhagic fever and dengue shock chronic hepatitis C.
syndrome, principally affect children.
- A severe syndrome—dengue hemorrhagic fever 5. CALICIVIRIDAE
or dengue shock syndrome—may occur in Noroviruses are the most common cause of nonbacterial
individuals (usually children) with passively gastroenteritis in the United States, causing an estimated
acquired (as maternal antibody) or pre existing 21 million cases annually.
● Known as the stomach flu or stomach bug ● Chikungunya

● This is associated with epidemic outbreaks of - Transmitted via mosquito (same as
waterborne, foodborne, and shellfish-associated dengue vector)
gastroenteritis, low infectious dose (as few as 10 - Infection resembles dengue
virus particles), relative stability in the environment, - Characterized by high fever and severe
and multiple modes of transmission. It survives 10 joint pain
ppm chlorine and heating to 60°C; it can maintain → Treatment: non-aspirin NSAIDS,
viability in steamed oysters. paracetamol and fluids (aspirin is not
● Treatment is symptomatic, no vaccine available given if the patient has fever that is
● Self-limiting caused by a viral infection)
→ in those who have more than two
6. REOVIRIDAE weeks of arthritis, Ribavirin may be
● Reoviruses are medium-sized (60–80 nm), ether- useful
resistant, nonenveloped viruses having → No vaccine available
icosahedral symmetry.
● Reoviruses of humans include rotaviruses, which ● Rubella
have a distinctive wheel-shaped appearance and - Sole member of the genus rubivirus from
cause Gastroenteritis togaviridae
- Rotaviruses are a major cause of - Known as the German measles and 3-day
diarrheal illness in human infants and measles
young animals, including calves and - Characterized by rash and
piglets. Infections in adult humans and lymphadenopathy (inflammation of
animals are also common. Antigenically lymph nodes)
similar reoviruses infect many animals. - transmitted by respiratory secretions
rather than arthropods.
● Coltiviruses (Colorado tick fever virus) - It is the mildest of the common viral
form another species within the exanthems
Reoviridae - infection during early pregnancy may
- Colorado tick fever virus, result in serious abnormalities of the
transmitted by ticks, is able to fetus, including congenital
infect humans can cause fever, malformations and mental retardation.
rash, and systemic symptoms - The consequences of rubella in utero are
in infected patients referred to as the congenital rubella
- spread by the bite of an infected syndrome
Dermacentor andersoni, which - With vaccine (“MMR” = Measles, mumps,
is known as Rocky Mountain wood tick, and rubella, “MMRV” = Measles, mumps,
rubella, and varicella), no specific
● Orbiviruses (blue tongue virus) are a genus within treatment, symptomatic relief only, self
the reovirus family. limiting
- They commonly infect insects, and many ❖ Rubeola = ordinary measles; occurs in the eyes,
are transmitted by insects to conjunctivitis, cough, fever, Koplik spots on buccal
vertebrates mucosa, rash appears at the hairline, and spreads
- Serious animal pathogens cephalocaudally (head to toe) over 3 days
include bluetongue virus of ❖ Rubella = german measles; headache, low grade
sheep and African horse fever, sore throat, coryza, forchheimer spots on soft
sickness virus palate (pathognomonic sign), lymphadenopathy,
- in cattle, constant changing and rash begins on the face and spreads
of position of the feet gives bluetongue the cephalocaudally (from head going down).
nickname the dancing disease ❖ Roseola Infantum = exanthem subitum/tigdas
hangin (infants 6-36 months old); caused by human
7. TOGAVIRIDAE herpesvirus 6; abrupt high fever, rash develops
They have a lipid-containing envelope and are ether starting on the neck and trunk and spreading to the
sensitive, and their genome is single-stranded, positive- face and extremities.
sense RNA, An example is eastern equine encephalitis
Virus, Chikungunya and Rubella virus (has no arthropod
vector)
● Minor antigenic changes in HA and NA, termed

ANTIGENIC DRIFT, occur independently and are
caused by accumulation of point mutations.
● Major antigenic change in HA or NA, called
ANTIGENIC SHIFT, results in a new influenza virus
subtype and is caused by genetic reassortment of
genome segments between human and animal
viruses.
Significant influenza virus A in history:

● H1N1, which caused Spanish Flu in 1918, and Swine
Flu in 2009
● H2N2, which caused Asian Flu in 1957
HEPEVIRIDAE ● H3N2, which caused Hong Kong Flu in 1968
● H5N1, which caused Bird Flu in 2004
Hepeviruses are similar to caliciviruses:
● Causative agent of Hepatitis E Treatment
● The particles are small (32-34 nm) and ether ● Vaccines are available for common flu (given
resistant. the genome is single stranded, positive- yearly)
sense RNA, 7.2 kb in size ● Treatment: Oseltamivir and Zanamivir
- it lacks a genome-linked protein (VPg) - Neuraminidase inhibitors
- human hepatitis E virus belongs to this
group
● HEV is transmitted enterically and occurs in CORONAVIRIDAE
epidemic form in developing countries, where
water or food supplies are sometimes fecally Coronaviruses are enveloped 120- to 160-nm
contaminated particles containing an unsegmented genome
● It was first documented in samples collected during of positive-sense, single stranded RNA
the New Delhi outbreak of 1955, when 29,000 resemble orthomyxoviruses but have petal-
cases of icteric hepatitis occurred after sewage shaped surface projections arranged in a
contamination of the city’s drinking water supply. fringe, similar to a solar corona
● Pregnant women may have a high (20%) ● Classically, human coronaviruses cause mild acute
mortality rate if fulminant hepatitis or acute liver upper respiratory tract illnesses—“colds”—but
failure develops. more recently discovered coronaviruses cause
● No chronic disease, non carcinogenic, non severe acute respiratory syndrome (SARS, SARS-
enveloped Cov2) and Middle East respiratory syndrome
● can be cured (MERS).
Coronaviruses tend to be highly species specific. Most of the

ORTHOMYXOVIRIDAE known animal coronaviruses display a tropism for epithelial
cells of the respiratory or gastrointestinal tract
Influenza Viruses A (common), B, and C. ● Viral tropism is the ability of different viruses to
infect different cellular types ultimately to
● Influenza A produce a successful infection
- HA: hemagglutinin - SARS-CoV: 2002, Guandong province,
→ binds virus particles to susceptible China → Bats (yung droppings ng bat
cells and is the major antigen against napunta sa pagkain ng baboy, and nakain
which neutralizing (protective) antibodies yun ng baboy and then pork was eaten by
are directed humans and spreads)
- NA:Neuraminidase - MERS-CoV: 2012, Middle east → Camel
→ functions at the end of the viral - SARS-CoV2: covid19: 2019, Wuhan, China →
replication cycle. It is a sialidase enzyme Under investigation
that removes sialic acid from ● Virions bind to specific receptor glycoproteins or
glycoconjugates glycans via the spike protein (if there is mutation in
→ cuts the bind to fly (ex. balloon with spike protein there will be a production of another
string), makikita ng immune response variant)
natin yung cell kapag hindi pinutol
SARS-CoV2 (COVID-19)
● transmitted via short-range aerosol, direct
contact with eyes, nose and mouth (droplet
transmission)
● infected people appear to be most infectious just
before they develop symptoms (namely 2 days
before they develop symptoms) and early in their
illness.
● Symptoms may appear 2-14 days after exposure to
the virus
SIGNS AND SYMPTOMS

● Fever or chills
● Cough
● Shortness of breath or difficulty breathing
● Fatigue
● Muscle or body aches
● Headache
● New loss of taste or smell
● Sore throat
● Congestion or runny nose
● Nausea or vomiting
● Diarrhea
- If oxygen in our blood is less than 95% we have to
be in oxygen therapy.
Afebrile - wala ng lagnat
PARAMYXOVIRIDAE transmission.
● Hematogenous transplacental transmission
● linear, single stranded, (vertical) can occur when measles occurs during
● nonsegmented, negative-sense RNA pregnancy.
● Particles are pleomorphic ● Vitamin A treatment in developing countries has
● Viruses: decreased mortality and morbidity. MMRV, MMR
- mumps, measles, parainfluenza,
metapneumovirus, and respiratory Parainfluenza virus
syncytial viruses. ● replication in the immunocompetent host
appears to be limited to respiratory epithelia
MUMPS ● a major cause of lower respiratory tract disease in
● “beke” young children infections with types 1 and 2 occur
● an acute contagious disease characterized by at a lower rate, reaching prevalences of about 75%
nonsuppurative enlargement of one or both and 60%, by 5 years of age.
salivary glands (namamaga salivary glands) ● Type 3 is endemic, with some increase during the
● Involvement of the parotid gland is not an spring; types 1 and 2 tend to cause epidemics
obligatory step in the infectious process. during the fall or winter, frequently on a 2-year
● May cause Orchitis in men (inflammation of testis) cycle.
(20-50%) and oophoritis in women (5%) ● transmitted by direct person- to- person contact
(inflammation of ovaries) or by large-droplet aerosols
- Because of the lack of elasticity of the ● No vaccine
tunica albuginea, which does not allow
the inflamed testis to swell, the
complication is extremely painful RHABDOVIRIDAE
- May cause sterility due to atrophy of the
testes as a result of pressure necrosis ● Rabies is an acute infection of the
● The virus is transmitted by direct contact, airborne central nervous system that is
droplets, or fomites contaminated with saliva or almost always fatal
urine - belong to the genus
● With Vaccine (MMRV, MMR) no specific treatment Lyssavirus
- Bullet-shaped
MEASLES (RUBEOLA) ● Rabies virus produces a specific eosinophilic
● acute, highly infectious disease characterized by cytoplasmic inclusion, the Negri body, in infected
fever, respiratory symptoms, and a nerve cells.
maculopapular rash (macules - namumula yung ● There are no tests to diagnose rabies infections in
rashes; papules - butlig butlig) humans before the onset of clinical symptoms
● Humans are the only natural hosts for measles ● The virus is widely distributed in infected animals,
virus, especially in the nervous system, saliva, urine,
● Respiratory tract → multiply locally → spread to lymph, milk, and blood, but
regional lymph nodes → Primary viremia → ● rabies virus has not been isolated from the blood
replication in the reticuloendothelial system → of infected persons, it is thru animal bites
secondary viremia → seeds the epithelial surfaces of
the body, including the skin, respiratory tract, and ● Multiply in the site of inoculation (muscle,
conjunctiva, where focal replication occurs connective tissue) → Enters peripheral nerves and
● The described events occur during the incubation neuromuscular junction → spreads to the nervous
period, which typically lasts 8–15 days but may last system → It multiplies in the central nervous system
up to 3 weeks in adults. and progressive encephalitis develops
● Involvement of the central nervous system is ● The virus then spreads through peripheral nerves
common in measles to the salivary glands and other tissues → The organ
● Symptomatic encephalitis develops in about one with the highest titers of virus is the submaxillary
in 1000 cases A rare late complication of measles is salivary glands
subacute sclerosing panencephalitis (SSPE) (goes ● Other organs where rabies virus has been found
to the brain, very deadly) include pancreas, kidney, heart, retina, and
● Transmission occurs predominantly via the cornea.
respiratory route (by inhalation of large droplets of
infected secretions).
● Fomites do not appear to play a significant role in
1. PRODROMAL PHASE ● This DNA becomes circularized and integrated into

● Fever, malaise, Anorexia, irritability, melancholia host chromosomal DNA.
● Hyperesthesia ● The virus is then replicated from the integrated
- Sensitivity to light and loud noise “provirus” DNA copy.
- Excessive salivation ● Hosts remain chronically infected.
● Abnormal sensation in the inoculating site ● Significant disease: HIV → AIDS
including pruritus and tingling; sign of the presence ● Level of CV4: HIV = > 200; AIDS = < 200
of virus
There are two distinct types of human AIDS
2. EXCITATION PHASE viruses: HIV-1 (common) and HIV-2.
● the excitation phase begins gradually and may
persist to death HUMAN IMMUNODEFICIENCY VIRUS
- Strabismus: failure of the eyes to follow one another ● Blood borne disease that is typically transmitted
in any movement via
- Nystagmus - Sexual route
- Tachy/ bradycardia - Mother to child transmission*
- Hydrophobia and Aerophobia (takot na uminom ng - Shared intravenous paraphernalia
tubig; mahapdi sa balat kapag nahahanginan) ● Immune deficiency is due to the depletion of helper
T lymphocytes (CD4+).
3. PARALYTIC PHASE ● Loss of CD4+ cells results in the development of
● hydrophobia disappears, painful opportunistic infection and neoplastic processes.
swallowing
● Urinary incontinence
Cell virus
● Flaccid paralysis
● Peripheral vascular collapse
● No treatment for for clinical rabies
Immunity:
All vaccines for human use contain only inactivated rabies
virus.
Glycoprotein attaches to CD4
● Human diploid cell vaccine (HDCV)
receptors (entry), once attached
- The rabies virus is grown in the MRC-5
they will merge. And eventually,
human diploid cell line.
the envelope and cell membrane
● Purified chick embryo cell vaccine (PCEC)
will also merge
- prepared from the fixed rabies virus strain
Flury LEP grown in chicken fibroblasts.
Immunoglobulin: Fusion of cell membrane and

● Rabies immune globulin, human (HRIG) envelope (fusion inhibitor
- γ-globulin prepared by cold ethanol enfuvirtide), once fused, the
fractionation from the plasma of capsid will be released
hyperimmunized humans.
● Equine Anti-rabies serum
- Concentrated serum from horses
hyperimmunized with rabies virus
Once capsid is released in the cell,

RETROVIRIDAE it will also release HIV DNA RNA
and Reverse transcriptase. With
● conversion of RNA to DNA the use of the enzyme reverse
● Spherical, enveloped viruses (80–110 nm in transcriptase the RNA will be
diameter) whose genome contains two copies of converted to DNA. The reason
linear, positive-sense, single-stranded RNA behind this is, hindi
● Replication is unique; the virion contains a reverse makakapasok sa nucleus ng CD4
transcriptase enzyme that produces a DNA copy of yung RNA kung hindi siya DNA.
the RNA genome.
Cotrimoxazole
HIV DNA can now be integrated
● PCP (Pneumocystis jiroveci)
to the nucleus with the help of
● Toxoplasmosis (Toxoplasma gondii) and if CD4
enzyme integrase.
count is below 100/uL
● replace cotrimoxazole with DAPSONE for patients
with G6PD
It will now enter and attach to
CD4 cell DNA HAART GUIDELINES (highly active antiretroviral therapy)
● Therapy should involve combinations of drugs
● Two nucleoside-analogue reverse transcriptase
inhibitors combined with either protease
inhibitor or a non nucleoside-analogue-reverse
transcriptase inhibitor (3 drugs are given for first
treatment)
Replication. It will produce HIV ● ART should be given to patients with CD4 below
DNA which is a long chain. 350/uL
● ART should be given to pregnant, patients with
HIV associated nephropathy, Hep B, regardless of
the CD4 count (the early you give the HAART, mas
madaling macontrol yung virus and less effect of
the virus)
- Philippines:
Budding: With the help of
→ LTE (first line treatment): Lamivudine
enzyme protease, it will cut the
(can be given during and after pregnancy,
long chain into short chain in
especially when breastfeeding), Tenofovir
order to produce HIV RNA
disoproxil fumarate, Efavirenz
→ Pre Exposure prophylaxis (PrEP):
Truvada: combination of Emtricitabine
and Tenofovir (high chance that you will
not be infected with your partner having
New cell virus HIV)
● GOAL: UNDETECTED VIRAL LOAD =
UNTRANSMISSIBLE (hindi mapapasa)
DIAGNOSIS
● ELISA test (preliminary test)
● Western Blot assay (confirmatory test); 99.9%
positive for HIV
Prophylaxis for opportunistic infection
Gancioclovir
● Cytomegalovirus
● Reserved for patients with CD4 below 50/uL
Fluconazole
● CD4 below 100/uL
● Histoplasmosis, coccidiodomycosis, candida
Azithromycin/clarithromycin
● CD4 below 50/uL
● Mycobacterium avium (C.A. of tuberculosis in px
with HIV)
TOPIC 2:
2 Kinds of Vaccines against S. Pneumoniae:
MICROBIAL DISEASES OF THE NERVOUS SYSTEM 1. PCV 13 - for baby
2. PPSV - for adult
Common pneumococcal Vaccine:

STRUCTURE AND FUNCTION OF THE NERVOUS SYSTEM
PCV 13 → PPSV 23 (on the next year) → PPSV 23 (after 5 years)
Pneumococcal Conjugate Vaccine (PCV13)
● The central nervous system (CNS) consists of the
Pneumococcal Polysaccharide Vaccine (PPSV23)
brain, which is protected by the skull bones, and the
spinal cord, which is protected by the backbone.
LISTERIOSIS
● The peripheral nervous system (PNS) consists of
● Listeria monocytogenes causes meningitis in
the nerves that branch from the CNS.
newborns, the immunosuppressed, pregnant
women, and cancer patients.
● Acquired by ingestion of contaminated food,
listeriosis may be asymptomatic in healthy
adults.
● L. monocytogenes can cross the placenta and
cause spontaneous abortion and stillbirth
(The baby is dead inside the mothers womb).
TETANUS
● caused by an exotoxin produced by Clostridium
tetani.
● C. tetani produces the neurotoxin
tetanospasmin, which causes
● The CNS is covered by three layers of membranes
spastic paralysis the symptoms of
called meninges (meningitis = more likely dito
tetanus:
nagkakaroon ng inflammatory reaction dahil sa
● Spastic paralysis: contraction of
infection; Ex. encephalopathy which occurs in the
muscles controlling the jaw, and
brain): the dura mater, arachnoid mater, and pia
death resulting from spasms of
mater.
respiratory muscles.
● Cerebrospinal fluid (CSF) circulates between the
● lock jaw - common symptom
arachnoid mater and the pia mater in the
● Causes opisthotonus to babies (arch back)
subarachnoid space.
● Toxoid: Anti-tetanus and tetanus toxoid (given
together, but if pregnant only tetanus toxoid is
given)
BOTULISM
● caused by an exotoxin produced by
C. botulinum growing in foods
(most potent toxin of all toxins)
● Serological types of botulinum
BACTERIAL DISEASES OF THE NERVOUS SYSTEM
toxin vary in virulence; type A is the
most virulent.
The three major causes of bacterial meningitis are:
● The toxin is a neurotoxin that
1. Haemophilus influenzae
inhibits the transmission of nerve
2. Streptococcus pneumoniae
impulses.
3. Neisseria meningitidis
● Blurred vision occurs in 1 to 2 days;
progressive flaccid paralysis
Nearly 50 other species of opportunistic bacteria can cause
(automatic paralysis) follows for 1 to
meningitis.
10 days, possibly resulting in death
from respiratory and cardiac failure.
● Infant botulism (paralysis) results from the growth
of C. botulinum in an infant’s intestines.
● Wound botulism (blood does not flow) occurs
when C. botulinum grows in anaerobic wounds.
● For diagnosis, mice protected with antitoxin are
inoculated with toxin from the patient or foods. fatal, encephalitis called rabies. (bullet-shaped
● Also used for cosmetic use, small amount can virus; Immunoglobulins cannot cross BBB)
induce flaccid paralysis on facial muscles which ● Rabies may be contracted through the bite
induces fine lines or wrinkles. Can also be used if of a rabid animal or invasion through skin.
you are masticating too much and enlargement The virus multiplies in skeletal muscle and
of muscles on the cheeks. connective tissue.
● Use to inhibit hyperhidrosis (sobrang pamamawis; ● Encephalitis occurs when the virus moves
kaya yung iba nag papabotox ng kili kili or kamay) along peripheral nerves to the CNS.
but its effectivity is only 6 months and must be ● Symptoms of rabies include spasms of
injected again with botulinum toxin for it to be mouth and throat muscles followed by
effective again. extensive brain and spinal cord damage and
● Botulinum toxin can be also acquired in bloated death.
canned goods that are infected with clostridium ● Postexposure treatment includes
botulinum which can cause death if ingested administration of human rabies immune
because its toxin is very potent. globulin (RIG) along with multiple
● Diagnosis: Mouse Neutralization Test intramuscular injections of vaccine.
● Pre Exposure treatment consists of
LEPROSY vaccination.
Neurologic disturbances are manifested by Mycobacterium ● Other genotypes of Lyssavirus cause rabies-
leprae like diseases.
● nerve infiltration and thickening, with resultant
anesthesia, neuritis, paresthesia (tusok-tusok ARBOVIRAL ENCEPHALITIS
feeling, tingling sensation sa paa or kuko), trophic ● Symptoms of encephalitis are chills, headache,
ulcers, and bone resorption and shortening of fever, and eventually coma.
the digits. ● Many types of viruses transmitted by mosquitoes
● The disfigurement caused by the skin infiltration (called arbo-viruses) cause encephalitis.
and nerve involvement in untreated cases may be ● The incidence of arboviral encephalitis increases in
extreme - lion face; common organ disfigured the summer months, when mosquitoes are most
are ears and nose. numerous.
● 2 kind of leprosy: tuberculoid leprosy and - Zika virus disease is often mild in adults,
lepromatous leprosy but the virus can cause CNS birth defects if
● DOC: DAPSONE it infects a fetus.
- Control of the mosquito vector is the most
effective way to control arboviral
infections.
FUNGAL DISEASES OF THE NERVOUS SYSTEM

VIRAL DISEASES OF THE NERVOUS SYSTEM
CRYPTOCOCCUS NEOFORMANS MENINGITIS
POLIOMYELITIS
● Also known as cryptococcosis
● The symptoms are usually sore throat and nausea,
● Cryptococcus spp. are encapsulated yeast-like
and occasionally paralysis (fewer than 1% of cases).
fungi that cause cryptococcosis.
● Poliovirus is transmitted by the ingestion of water
● The disease may be contracted by inhaling dried
contaminated with feces.
infected pigeon or chicken droppings.
● Poliovirus first invades lymph nodes of the neck
● The disease begins as a lung infection and may
and small intestine. Viremia and spinal cord
spread to the brain and meninges.
involvement may follow (causes muscle paralysis
● Immunosuppressed individuals are most
which lead to atrophy)
susceptible to cryptococcosis.
● Diagnosis is based on isolation of the virus from
● Diagnosis is based on latex agglutination tests for
feces and throat secretions.
cryptococcal antigens in serum or CSF.
● The Salk vaccine (an inactivated polio vaccine [IPV])
involves the injection of formalin-inactivated viruses
and boosters every few years.
● The Sabin vaccine (an oral polio vaccine [OPV])
contains three live, attenuated strains of poliovirus
and is administered orally.
● Rabies virus (Lyssavirus) causes an acute, usually
PARASITIC DISEASES OF THE NERVOUS SYSTEM

MICROBIAL DISEASES OF THE URINARY AND
AFRICAN TRYPANOSOMIASIS REPRODUCTIVE SYSTEMS
● caused by the protozoa Trypanosoma brucei
gambiense and Trypanosoma brucei rhodesiense
(east and west african sleeping sickness) and is STRUCTURE AND FUNCTION OF THE URINARY SYSTEM
transmitted by the bite of the tsetse fly.
● The disease affects the nervous system of the ● The urinary system regulates the chemical
human host, causing lethargy (nanglalata) and composition and volume of the blood and
eventually coma. It is commonly called sleeping excretes nitrogenous waste and water.
sickness. ● Urine is transported from the kidneys through
● Vaccine development is hindered by the ureters to the urinary bladder and is eliminated
protozoan’s ability to change its surface antigens. through the urethra.
● Valves prevent urine from flowing back to the
AMEBIC MENINGOENCEPHALITIS urinary bladder and kidneys.
● Encephalitis caused by the protozoan Naegleria ● The flushing action of urine and normal urine itself
fowleri (has 3 morphology; amebic infections that have some antimicrobial value.
can cross BBB) is almost always fatal. ● micturition = umiihi
● Granulomatous amebic encephalitis, caused by
Acanthamoeba keratitis (common; amebic
infections that can cross BBB) and Balamuthia
mandrillaris, is a chronic disease.
● Can be in brain (trophozoite, cyst, flagella)
NERVOUS SYSTEM DISEASES CAUSED BY PRIONS
● Degenerative central nervous system diseases —

kuru, CJD, Gerstmann-Sträussler-Scheinker
syndrome, fatal familial insomnia of humans,
scrapie of sheep, transmissible encephalopathy of
mink, bovine spongiform encephalopathy of cattle,
and chronic wasting disease of deer—have similar
pathologic features. ● Adrenal gland - produces cortisol and hormones
● These diseases are described as transmissible and ● Kidneys - filters the blood and bring it back to
cause spongiform encephalopathies (when it's in systemic circulation
our brain, it can destroy our brain to the point that
the brain looks like a sponge). First symptom is
forgetfulness which is somehow compared to STRUCTURE AND FUNCTION OF THE REPRODUCTIVE
Alzheimer's disease. SYSTEMS
● The causative agents are not conventional viruses;
infectivity is associated with proteinaceous material ● The reproductive system produces gametes for
devoid of detectable amounts of nucleic acid. reproduction and, in the female, supports the
growing embryo.
● The female reproductive system consists of two
ovaries, two uterine tubes, the uterus, the cervix,
the vagina, and the external genitals.
Bovine Spongiform Encepalopathy is also known as mad

cow disease which does not affect human beings.
● Kuru, tribo siya na para makasali ka kailangan mo
kumain ng utak. May nakakain ng prion dahil doon
nagkaroon sya ng spongiform encephalopathy.
● Opportunistic gram-negative bacteria from the

intestines often cause urinary tract infections.
- Healthcare-associated infections of the
urinary system can occur following
catheterization.
- Dehydration
- Improper wiping of vagina: anus to
vagina; which transfers E. coli to vagina
which becomes potent because of the
change of environment.
● Treatment of urinary tract infections depends on
isolation and antibiotic sensitivity testing of the
causative agents.
● The male reproductive system consists of two ● DOC: Cotrimoxazole (uncomplicated UTI caused by
testes, ducts, accessory glands, and the penis; E. coli); fluoroquinolones and ceftriaxone
seminal fluid (semen) leaves the male body (complicated UTI)
through the urethra.
CYSTITIS
● Inflammation of the urinary bladder, or cystitis, is
common in females.
● The most common etiologies are E. coli and
Staphylococcus saprophyticus (tampons -
honeymoon cystitis: S. saprophyticus)
PYELONEPHRITIS
● Inflammation of the kidneys, or pyelonephritis, is
usually a complication of lower urinary tract
infections (Upper urinary tract infection: galing siya
sa lower then umakyat siya sa upper which is called
“ascending pathway”)
● About 75% of pyelonephritis cases are caused by E.
NORMAL MICROBIOTA OF THE URINARY AND
coli
REPRODUCTIVE SYSTEMS
LEPTOSPIROSIS
Microbial diseases of these systems can result from infection
● The spirochete Leptospira interrogans is the cause
from an outside source or from opportunistic infection by
of leptospirosis.
members of the normal microbiota.
● After an incubation period of 1–2 weeks, there is a
● Gram-positive bacteria predominate in the urinary
variable febrile onset during which spirochetes are
tract.
present in the bloodstream.
● Lactobacilli dominate the vaginal microbiota;
● They then establish themselves in the
actinobacteria dominate the microbiome of the
parenchymatous organs (particularly liver and
seminal vesicle.
kidneys), producing hemorrhage and necrosis of
tissue and resulting in dysfunction of those organs
(jaundice, hemorrhage, nitrogen retention).
BACTERIAL DISEASES OF THE URINARY SYSTEMS ● prophylaxis and treatment: Doxycycline
● (1) Urethritis (inflammation of urethra);

● (2) Cystitis (inflammation of the bladder); and
MICROBIAL DISEASES OF THE REPRODUCTIVE SYSTEMS
● (3) Ureteritis (inflammation of the ureter) are
inflammations of tissues of the lower urinary tract
● Most infections of the reproductive system are sexually
and causes uncomplicated urinary tract
transmitted infections (STIs). The incidence of STIs is at an
infections
all-time high.
● Most STIs can be prevented by the use of condoms.
● Once it reaches the kidney its called
● Most common: C. trachomatis followed by N. gonorrhea
“Pyelonephritis” can result from lower urinary tract
infections or from systemic bacterial infections and
which causes complicated urinary tract infections
GONORRHEA
● Neisseria gonorrhoeae causes gonorrhea. SYPHILIS

● Gonorrhea is a common reportable communicable ● caused by Treponema pallidum, a
disease in the United States. spirochete that has not been cultured
● N. gonorrhoeae attaches to mucosal cells of the oral- in vitro. Laboratory cultures are grown
pharyngeal area, genitals, eyes, and rectum by means of in rabbits or cell cultures.
fimbriae. ● Primary lesion is a small, hard-based
● N. gonorrhoeae causes the sexually transmitted disease chancre (painless) at the site of
gonorrhea and is characterized by purulent cervicitis in infection. The bacteria then invade the blood and
women and purulent (pus) urethral discharge in men. lymphatic system, and the chancre spontaneously heals.
Infants born to women infected at the time of delivery ● Secondary lesion = “copper penny rash”; patchy alopecia;
may develop purulent conjunctivitis. condylomata lata (looks like human papillomavirus
condyloma acuminata)
● Symptoms in men are painful urination and pus ● Diagnosis: Venereal Disease Research Laboratory
discharge. (VDRL)
- Blockage of the urethra and sterility are ● DOC: Benzathine penicillin
complications of untreated cases. ● The appearance of a widely disseminated rash on the skin
● Women might be asymptomatic unless the infection and mucous membranes marks the secondary stage.
spreads to the uterus and uterine tubes. Spirochetes are present in the lesions of the rash.
● Gonorrheal endocarditis, gonorrheal meningitis, and ● The patient enters a latent period after the secondary
gonorrheal arthritis are complications that can affect lesions spontaneously heal.
both sexes if gonorrheal infections are untreated. ● At least 10 years after the secondary lesion, tertiary lesions
● DOC: Ceftriaxone or azithromycin called gummas can appear on many organs; can also
● Gonorrhea is diagnosed by ELISA or NAATS. acquire neurosyphilis that can cause blindness,
dementia, etc. which is irreversible.
OPHTHALMIA NEONATORUM ● Congenital syphilis, resulting from T. pallidum crossing
● Ophthalmia neonatorum is an eye the placenta during the latent period, can cause
infection acquired by infants during neurological damage in the newborn.
passage through the birth canal of an ● T. pallidum is identifiable through darkfield microscopy
infected mother. of fluid from primary and secondary lesions.
● DOC: Erythromycin (1%), silver nitrate (used in the past) ● Many serological tests, such as VDRL (Venereal Disease
Research Laboratory Test), RPR (rapid plasma reagin
NONGONOCOCCAL URETHRITIS (NGU) test), and FTA-ABS (Fluorescent Treponemal Antibody
● Most cases of nongonococcal urethritis (NGU), or Absorption Test), can be used to detect the presence of
nonspecific urethritis (NSU), are caused by Chlamydia antibodies against T. pallidum during any stage of the
trachomatis (vertically transmitted). disease.
● C. trachomatis infection is the most common STI.
● Ureaplasma urealyticum (mapanghi ihi; it has a LYMPHOGRANULOMA VENEREUM
capability of converting Urea to ammonia) and ● C. trachomatis causes
Mycoplasma genitalium also cause NGU. lymphogranuloma venereum
● Symptoms of NGU are often mild or lacking, although (LGV), which is primarily a disease
uterine tube inflammation and sterility may occur. of tropical and subtropical
● C. trachomatis can be transmitted to infants’ eyes at regions.
birth (trachoma) ● The bacteria are spread in the
● Diagnosis is based on detection of chlamydial DNA in lymph system and cause
urine. enlargement of the lymph nodes,
obstruction of lymph vessels, and swelling of the external
PELVIC INFLAMMATORY DISEASE (PID) genitals.
● Extensive bacterial infection of the female pelvic organs, ● Diagnosis is by ELISA or NAAT.
especially of the reproductive system, is called pelvic
inflammatory disease (PID). CHANCROID
● PID is caused by N. gonorrhoeae, C. trachomatis, and ● Chancroid (soft chancre;
other bacteria. Infection of the uterine tubes is called common in africa), a swollen,
salpingitis. painful ulcer on the mucous
membranes of the genitals or
mouth, is caused by
Haemophilus ducreyi.
BACTERIAL VAGINOSIS
Topic 2 = done transcribing :)) goodluck!!!
● Bacterial vaginosis is an infection
without inflammation caused by
Gardnerella vaginalis.
● Diagnosis of G. vaginalis is based
on the presence of clue cells.
HERPES SIMPLEX VIRUSES

● Herpes simplex viruses (HSV-1 and HSV-2)
cause oral and genital herpes.
● type 1 = oral
● type 2 = genital
● Symptoms of the infection are painful
urination, genital irritation, and fluid-filled
vesicles.
● vertically transmitted (pwede mahawa yung bata)
● The virus might enter a latent stage in nerve cells. Vesicles
reappear following trauma and hormonal changes.
● Neonatal herpes is contracted during fetal development
or birth. It can result in neurological damage or infant
fatalities.
GENITAL WARTS
● Human papillomaviruses
(condyloma acuminata; If
syphilis = condylomata
acuminata) cause warts.
● Some human papillomaviruses
that cause genital warts cause cancer.
ACQUIRED IMMUNODEFICIENCY SYNDROME

● AIDS is a sexually transmitted disease of the immune
system.
● Other viral STIs that do not infect the genitourinary
system include hepatitis B, hepatitis C, and Zika virus
disease.
● No cure and vaccine
CANDIDIASIS
● Candida albicans (opportunistic infection) causes NGU in
men and vulvovaginal candidiasis, or yeast infection, in
women.
● Vulvovaginal candidiasis is characterized by lesions that
produce itching and irritation (treated with antifungal
tablet like ketoconazole)
● Predisposing factors are pregnancy, diabetes, and broad-
spectrum antibacterial chemotherapy.
● Diagnosis is based on observation of the fungus and its
isolation from lesions.
TRICHOMONIASIS
● Trichomonas vaginalis causes trichomoniasis when the
pH of the vagina increases.
● Diagnosis is based on observation of the protozoa in
purulent discharges from the site of infection.
● can be find in vagina (women); and prostate (men)
● Trichimonas vaginalis DOC: Metronidazole
TOPIC 3:
2) HORDEOLUM AND CHALAZION
MICROBIAL DISEASES OF THE EYES AND SKIN
Hordeolum - stye or “guliti”, could be
● ̈ The Etiological agents that may affect the eyes will because of bacteria in that area or the
vary depending on the area and type of tissue hair follicle in the specific area is
affected blocked (i.e., due to mascara); has pus
formation
● Disease spread may be divided into:
- Eyelids and tissue surrounding the eyes Chalazion - cystic parang bukol, occurs
- Conjunctiva after stye; stye can develop as chalazion if left
- Cornea untreated. Antibiotics are given. Do not pluck eyelash.
- Intraocular area
Etiological agents:
● Generally Staphylococcus aureus, but may also be
caused by Pseudomonas aeruginosa and Proteus sp.
EYELIDS AND TISSUE SURROUNDING THE EYES
Diagnosis:
1) BLEPHARITIS
● Obstruction of the orifice of a gland (Meibomian, Zeis,
or Moll) seems to be the primary pathological event in
Etiological agents:
the formation of hordeolum (Stye)-.
● Demodex folliculorum (a mite)
● A red nodule that is quite painful develops and is
● followed by bacterial infection Staphylococcus
surmounted with a yellowish top as the lesion matures.
aureus or Staphylococcus epidermidis
● The histopathology is typical of acute suppurative
inflammation
Diagnosis:
- Chalazion evolves from hordeolum that do
● due to an allergic reaction to the mite which resides
not drain spontaneously or are not incised.
in the eyelash or the eyebrow (mangangati then
- There is usually persistent chronic
maiinfect ng S. aureus sa loob, developing
inflammation, and granuloma formation
ulcerations)
(scarring) may occur as sebaceous secretions
● Abscesses may form in and around the follicles,
are impounded.
destroying the follicles, with the loss of lashes and
the formation of ulcers.
Treatment:
● Erythromycin: for susceptible strains and for
Treatment:
prevention of corneal and conjunctival infections
● Glucocorticoid for the allergic reaction (topicals
● Cephalexin: for acute hordeolum
such as Betamethasone and Clobetasol; we don’t
● Doxycycline: may be added if there recurrent lesions
give glucocorticoids as oral immediately because it
or significant meibomitis
can affect the systemic circulation)
● Tx of Staph infections: Tetracyclines such as
3) PERIORBITAL CELLULITIS
Doxycycline or Minocycline ( C/I in children and
pregnant)
Etiological agents:
- Doxycycline/Tetracycline is C/I to children less than
● Staphylococcus aureus (most
8 y/o because it can affect their bone formation
common) S. pneumoniae, H.
● Azithromycin ( alternative)
influenzae
There may be a history of itching and scaling of
Diagnosis:
the lid since early childhood. The patient
● Characterized by acute eyelid erythema (ery
describes an incessant urge to pull on the lashes
meaning redness) and edema (namamanas, with
in an attempt to remove the scales
fluid)
● Also known as PERISEPTAL CELLULITIS
Treatment:
● Clindamycin as empirical therapy; clindamycin
when given for a long time can cause P. colitis
● Doxycycline, cotrimoxazole: alternative therapy
4) ACUTE DACROCYSTITIS CONJUNCTIVA
Etiological agents: 1) PINK EYE CONJUNCTIVITIS / sore

● S. aureus, S. epidermidis, eyes
Streptococcus pneumoniae
Etiological agent:
Diagnosis: ● BE question: Haemophilus
● This is an infection of the lacrimal aegypticus (common) and/or
sac, almost always secondary to Moraxella lacunata
obstruction of the lacrimal duct (tear ducts).
● occurs when both the upper and lower ends of the Diagnosis:
drainage system become partially or totally ● The only symptoms are conjunctivitis, either
obstructed. The major symptom is pain in the tear chronic or acute, redness, “nagmumuta”, and
sac area. There are also erythema, edema, a severe inflammation of the cornea. Diagnosis is via
purulent discharge and epiphora isolation of the organism (a Gam-negative slender
❖ Usually, when S. aureus is present, there is pus rod).
formation. ● This can be transmittable through person-to-
person contact. Ex., kinamot ng taong infected
Treatment: yung mata nya then nakipag-shake hands sayo
● Coamoxiclav, Sultamicillin (Ampicillin + Sulbactam), tapos ikaw kinamot mo mata mo, there becomes
Levofloxacin inoculation on your end. Merely looking or staring at
● Tobramycin ophthalmic someone with sore eyes won’t pass you the sore
● Tobramycin (aminoglycoside) plus eyes.
dexamethasone (corticosteroid - inhibits
inflammation, immunosuppresants) ophthalmic Treatment:
- When there is too much inflammation, combination ● Topical sulfacetamide,
of tobramycin and dexamethasone is given. ● erythromycin, ciprofloxacin, gatifloxacin or
- However, too much glucocorticoids, especially when ofloxacin
taken orally, can cause significant ● NEW agent: besifloxacin - ophthalmic suspension
immunosuppressing activity in the body which will
render the patient immunocompromised. 2) OCULAR LYMPHOGRANULOMA VENEREUM
5) CHRONIC DACRYOCYSTITIS Etiological agent:

● Chlamydia trachomatis
Etiological agents:
● Streptococcus pneumoniae Diagnosis:
● Haemophilus influenzae ● This is a chlamydial disease
● Candida albicans transmitted to the fetus during
● Aspergillus sp. passage down the birth canal.
● Actinomyces sp ● Inflammation begins about five days after birth and
never results in follicle formation (thus, it differs
- Acute dacryocystitis was left untreated from trachoma and inclusion conjunctivitis).
- Chronic dacryocystitis is usually caused by a single ● Corneal scars, conjunctival scars, and
site of partial or complete obstruction within the micropannus formation occur.
lacrimal sac or within the nasolacrimal duct. The ● It is rarely a cause of blindness.
infection is usually the result, and not the cause, of ● There will be inclusions in the epithelial cells of the
obstruction conjunctiva.
● If the mother has C. trachomatis, there could be
Obstruction may due to: vertical transmission.
1. Trauma - ex. due to accident or rubbing
2. Tumors Treatment:
3. Foreign bodies ● Azithromycin (safe for children), Erythromycin
4. Delayed canalization in neonates ● Doxycycline (safe for mother but not for children)
5. Closure of canal in post menopausal women (DOC) but caution in children
3) TRACHOMA
● Caused by Chlamydia trachomatis ● Corneal Opacity
● This disease is limited to man, infecting only - Could cause blindness
epithelial cells of the eye and possibly the - Easily visible corneal opacity over the
nasopharynx; no systemic involvement has been pupil
described. It is found worldwide, and is the greatest - The pupil margin is blurred viewed
single cause of blindness. through the opacity. Such corneal opacities cause
● Scarring of the conjunctiva may cause the eyelids to significant visual impairment ( less than 6/18 or 0.3
turn inward so that the lashes scratch the cornea vision) and visual acuity (normal is 20/20) should
● Distortion of the structures of the external eye also also be measured
interferes with normal lacrimal flow, growth of
lashes, and function of glands; as a result, bacterial ● Treatment:
infections of trachomatous eyes are common - Based on WHO SAFE strategy:
➔ Azithromycin
● Normal Tarsal Conjunctiva: ➢ DOC for trachoma
- Pink, smooth, thin and transparent. ➔ 1% tetracycline ointment
Over the whole area of the tarsal - Alternative for Azithromycin
conjunctiva, there are large deep-
lying blood vessels that run 4) VIRAL CONJUNCTIVITIS
vertically.
- No infection - like sore eyes but caused by viral infection
● (TF)Trachomatous Inflammation-FOLLICULAR: Etiological agent:

- Presence of five or more follicles in ● Adenovirus, types 3,7 and 8
the upper tarsal conjunctiva ● Human Herpesvirus 1 (Herpes simplex 1 virus)
➔ Follicles are round swellings ● Human Herpesvirus 2 (Herpes simplex 2 virus)
that are paler than the ● Varicella-Zoster virus
surrounding conjunctiva, ● Cytomegalovirus
appearing white, grey or yellow
➔ O.5mm in diameter Diagnosis:
● Bilateral conjunctivitis (both eyes have sore eyes)
● (TI)Trachomatous Inflammation-INTENSE: which is usually self limited. It may be recurrent
- Pronounced inflammatory with herpesvirus. No constitutional symptoms are
thickening of the tarsal conjunctiva present, compared to bacterial.
that obscures more than half of the
normal deep tarsal vessels Treatment:
➔ The tarsal conjunctiva ● For Symptomatic relief
appears red, rough and thickened, with - Artificial tears
numerous follicles which may be covered - Azalastine ophthalmic
by the thickened conjunctiva ➔ Competes with H1 receptors
(inhibits release of mast cells so
● Trachomatous scarring (TS) no inflammation occurs)
- The presence of scarring in the - Ketotifen
tarsal conjunctiva ➔ Relatively selective H1 receptor
- Scars are visible as white lines or antagonist that inhibits the
sheets in the tarsal conjunctiva. release of mast cells
They are glistening and fibrous in - if it is due to herpesvirus infection in which case it
appearance. is severe and affects other parts of the body,
- Scarring, especially diffuse fibrosis, may obscure Acyclovir or Valacyclovir may be given
the tarsal blood vessels - Ganciclovir may be given for cytomegalovirus
● Trachomatous Trichiasis (TT)

- At least one eyelash rubs on the
eyeball
- Evidence of recent removal of
inturned eyelash should also be graded as trichiasis
for 12 yrs and older, does not kill

adult O. vulvulus, only inhibits
further progression
➢ Doxycycline:
★ Adjunct therapy
★ may be used to
eliminate the
endosybiotic bacteria
Woblachia (helps O.
volvulus grow in the
body); this disrupts
production of
microfilariae by the
adult female worm
Allergic rhinitis may lead to allergic conjunctivitis (give ● Loa loa
antihistamine, neozep contains chlorpheniramine). - African eye worm
Bacterial conjunctivitis = nagmumuta ➔ Transmitted by Chrysops deer fly
Viral conjunctivitis = self-limiting, namumula ➔ Treatment:
➢ Diethylcarbamazine
5) FUNGAL CONJUNCTIVITIS ★ Available only through
CDC
Etiological agent: ★ Serves as inhibitor of
● Candida albicans, Sporothrix schenckii, arachidonic acid
Allescheria sp., Aspergillus sp., Mucor sp metabolism in
microfilaria
Diagnosis: ➢ Albendazole
● An uncommon disease which can be acute or ★ For treatment of
chronic. Often secondary to fungal infections of symptomatic loaiasis
other parts of the body. Often aggravated by with parasitemia of
glucosteroids and initiated after antibiotic therapy. 8000 microfilariae/mL
● Diagnosed by isolation of the etiological agent
Treatment: CORNEA
● Natamycin: Initial drug for fusarium disease
● Amphotericin B: First agent of choice for corneal 1) OPHTHALMIA NEONATORUM
infections due to yeast such as candida
● Azoles: For Fusarium, Aspergillus, Curvilaria and Etiological agent:
Candida ● Neisseria gonorrhoeae
● Flucytosine: Active against Candida and
Cryptococcus Diagnosis:
● Voriconazole (azole that inhibits conversion of ● The disease is contracted (vertical transmission)
lanosterol to ergosterol): DOC for aspergillus, from a mother with gonorrhea as the fetus passes
Fusarium Blastomyces, Coccidiodes, Curvularia down the birth canal. Infection does not occur in
and other fungal infection utero. At one time about 10% of all cases of blindness
in the United States was due to this disease. Corneal
6) PARASITIC CONJUNCTIVITIS inflammation is the major clinical sign.
- River blindness, usually acquired by people na
naglalaba sa river Treatment:
● Onchocerca volvulus ● Erythromycin oral or
- Onchocerciasis: transmitted by simulium ointment
blackflies - Systemic
➔ Second leading cause of blindness in the treatment is
world necessary
➔ Treatment: ● Silver nitrate drops ( rarely used now)
➢ Ivermectin: Drug of choice - May be used to prevent disease, but also
➢ Moxidectin: a macrolytic lactone causes discoloration
2) BACTERIA KERATITIS - Surgical Treatment:

● Inflammation of the cornea ➔ For unresponsive to treatment
➢ Some cases, even surgery will not
Features: restore vision
● Rapid progression, must be addressed ASAP ➢ May include corneal
● Corneal destruction may occur in 24-48 hours transplantation
● Corneal ulceration that could develop to blindness,
stromal abscess formation, surrounding corneal
edema and anterior segment inflammation INTRAOCULAR
Etiological agent: UVEITIS

● Streptococcus, Pseudomonas, ● Nonpurulent uveitis seldom involves the entire
Enterobacteriaceae (Klebsiella, Enterobacter, uveal tract but may occur predominantly in the
Serratia and Proteus), Staphylococcus anterior segment (iritis, iridocyclitis) or the
posterior segment (posterior uveitis, retinitis)
Treatment (Medical): ● Common causes of Anterior uveitis:
● Tobramycin (14mg/mL) - Mumps virus, Human Herpesvirus 3 (Varicella-
- 1 drop every hour alternating with fortified Zoster virus), Rubella virus, Rubeola virus, Human
cefazolin or vancomycin Herpesvirus 1 (Herpes simplex 1 virus)
● Fourth generation fluoroquinolones (should not ● Common causes of Posterior uveitis:
be given to patients less than 18 y/o; they impede - Toxoplasma gondii - from cat feces (25% of all
bone growth) cases) Toxocara sp., Cryptococcus neoformans,
- Moxifloxacin and Gatifloxacin Histoplasma capsulatum, Mycobacterium
➔ Moxi: penetrates better than Gati tuberculosis, Cytomegalovirus, Herpes simplex 1
● New fluoroquinolone virus, Human immunodeficiency virus
- Besifloxacin
- Approved in 2009 for bacterial
conjunctivitis
3) FUNGAL KERATITIS
● ̈Aspergillus species is the
most common isolate in
fungal keratitis world wide,
followed by Fusarium then
Penicillium marneffei
● More common in men than in
women
● ̈May be acquired through unhygienic contact lens
use. Sleeping with contact lenses can cause
blindness. Make sure the solution you are using is
MICROBIAL DISEASE OF THE SKIN
not expired and is isotonic. Hard contact lenses last
longer than soft contact lenses, but there is a high
chance that it results in affectation.
● This may extend from the cornea to the sclera and STRUCTURE AND FUNCTION OF THE SKIN
intraocular structures
- May cause scleritis, endophthalmitis, ● The skin is a physical barrier against microorganisms.
panophthalmitis ● Moist areas of the skin support larger populations of
➔ Very difficult to treat and may result to bacteria than dry areas (kapag hinayaan natin na dry
visual loss and loss of eye yung skin natin it will cause breakage to the skin
● Treatment: where it can be the portal of entry)
- Amphotericin B: Drug of choice to treat patients
with fungal keratitis caused by yeast 1. Epidermis
- Natamycin: for filamentous organisms 2. Dermis
➔ The only commercially available topical
opthalmic antifungal preparation Components:
➔ Useful against Fusarium ● Keratin - waterproofing portion of
the skin
● Sebum - produces oil which moisturizes our skin 4) SEBUM

● Perspiration - regulates body temperature ● Secreted by oil glands
● A mixture of lipids (unsaturated fatty acids; usually
1) EPIDERMIS linoleic acid), proteins, and salts
● The outer portion of the skin ● Prevents skin and hair from drying out
● Composed of several layer of epithelial cells ● Too much sebum can be used by Cutibacterium
- The outermost layer, the stratum corneum (siya yung acnes para humayo at magpakarami. Kapag na clog
nappeel off kapag may dead skin cells tayo) consists yung pore and naipon yung sebum, at yung oil natin
of many rows of dead cells that contains a hindi nakalabas magkakaroon tayo ng accumulation
waterproofing protein called keratin of anaerobic bacteria which would now cause acne
● ̈Effective physical barrier against mo
● Our skin peels every 28 days except if we have 5) MUCOUS MEMBRANE a.k.a. mucosa
autoimmune diseases like psoriasis wherein after 5 ● Lines the body cavities that open to the exterior, i.e.
days it already peels off. Hindi pa mature yung skin gastrointestinal, respiratory, urinary, and genital tracts
nagppeel off na siya nag mumukha tuloy kaliskis + (Siya ang dahilan kung bakit hindi nasisira yung
hindi siya nakakahawa. gastric acid natin)
● Consists of sheets of tightly packed epithelial cells
attached at their bases to a layer of extracellular
material called basement membrane
● Many secretes mucus
● ̈Other mucosal cells have cilia, i.e. respiratory system
● ̈Often acidic
● Membranes of the eyes are mechanically washed by
tears, and the lysozymes in tears destroys the cell
walls of certain bacteria
NORMAL MICROBIOTA OF THE SKIN
● Microorganisms that live on skin are resistant to

desiccation and high concentrations of salt.
● ̈Gram-positive cocci predominate on the skin.
● Washing does not completely remove the normal
skin microbiota.
● Members of the genus Cutibacterium metabolize
oil from the oil glands and colonize hair follicles.
● Malassezia furfur yeast grows on oily secretions
and may be the cause of dandruff (seborrhoeic
2) DERMIS dermatitis).
● The inner, relatively thick portion of skin ● The majority (90%) of skin microbiota consist of
● Composed mainly of connective tissue coagulase-negative Staphylococcus epidermidis.
● The hair follicles, sweat gland ducts, and oil gland
ducts in the dermis provide passage- ways through DIFFERENT TERMS FOR RASHES AND LESIONS
which microorganisms can enter the skin and ● Vesicles are small fluid-filled lesions
penetrate deeper tissues. ● Bullae are vesicles larger than 1 cm
● Kapag nasira makakapasok na yung microorganisms ● Macules are flat, reddened lesions (can be other
and if penetrates further it can damage tissues. color)
● Papules are raised lesions
3) PERSPIRATION ● Pustules are raised lesions containing pus
● Provides moisture and some nutrients for microbial
growth
● Also contains salt which inhibits many micro-
organisms
● Contains the enzyme lysozyme, which is capable of
breaking down the cell walls of certain bacteria; and
antimicrobial peptides.
● Regulates temperature
STAPHYLOCOCCUS AUREUS
● Resident microbiota of the nasal passage
● Forms golden-yellow colonies
● Almost all pathogenic strains of S. aureus produce
coagulase
● Some strains have an impressive array of virulence
factors and means of evading host defenses (hindi
lang sa skin, it can also cause food poisoning, pero
depende kung anong strain. Pero commonly sa
skin)
● Localized infections (sties, pimples, and boils)

result from entry of S. aureus through openings in
the skin.
- Sties = kuliti
- Boils = pigsa
● Carbuncle is a furuncle which extensively damages

BACTERIAL DISEASE OF THE SKIN
neighboring tissues
- Produce a hard, round deep inflammation of
tissue under the skin
STAPHYLOCOCCUS - Patient can exhibit general illness with fever
● ̈Staphylococci are spherical gram-positive ● Impetigo is a highly contagious skin infection

bacteria that form irregular grape-like clusters caused by Staphylococci. Characterized by isolated
● Divided into those that produce coagulase, and yellow pustules that become crusted (para siyang
those that do not: natutuyong sugat, common sa mga bata)
● Coagulase-positive
- S. aureus ● Toxemia occurs when toxins enter the
● Coagulase-negative bloodstream; staphylococcal toxemias include
- S. epidermidis scalded skin syndrome and toxic shock
syndrome.
STAPHYLOCOCCUS EPIDERMIDIS - S. aureus produces exfoliative toxins:
● Coagulase-negative ➔ Exfoliatin A – causes localized,
● Very common on the skin bullous impetigo
● Generally pathogenic only when the skin barrier ➔ Exfoliatin B – causes the
is broken or is invaded by medical procedures, e.g. systemic infection of
insertion and removal of catheters into veins (Ex. scalded skin syndrome
kapag nagkaroon ng open heart surgery tapos
nakapasok siya sa sugat papunta sa heart, edi - Scalded skin syndrome is also
magkakaroon ka ng opportunistic infection) characteristic of the late stages of
toxic shock syndrome (TSS). PSEUDOMONAS

➔ Potential life-threatening condition, fever,
vomiting, and a sunburn-like rash PSEUDOMONAS AERUGINOSA
➔ Followed by shock and sometimes organ ● Aerobic gram-negative rod
failure (especially kidney failure) ● Resistant to many antibiotic and
➔ Caused by a staphylococcal toxin called disinfectant (most common nosocomial
TSST-1 infection)
● ̈Can survive in any moist environment,
traces of unusual organic matter such
STREPTOCOCCUS as soap films, cap liner adhesives (lalo na
sa hospital kahit anong linis nila sobra
● Streptococci are gram-positive spherical bacteria dami pa rin, kaya mag ingat kayo guys
that usually grow in chains. and take vitamins always <3)
- Prior to division, the individual cocci elongate on ● Diseases caused by P. aeruginosa include otitis
the axis of the chain, and then the cells divide. externa (inflammation of the external part of the
● Causes a wide range of disease conditions including ear), respiratory infections, burn infections, and
meningitis, pneumonia, sore throat, otitis media, dermatitis (inflammation of the skin)
endocarditis, puerperal fever, and even dental ● Produces an endotoxin and several exotoxins
caries.
● Streptococci are classified according to their OTHER BACTERIA
hemolytic enzymes (hemolysin) and cell wall
antigens. Mycobacterium ulcerans
- Hemolytic activity (destruction of RBC) ● Causes deep-tissue ulceration or Buruli ulcer
➔ Alpha (partial), beta (complete), gamma
Cutibacterium acnes
(non hemolytic)
● Formerly known as Propionibacterium acnes
- Cell wall antigen
● Its metabolic products (fatty acids) cause
➔ Group A to T
inflammatory acne
- Comedonal (mild) acne = produces
STREPTOCOCCUS PYOGENES
pustular type of acne
● Group A beta-hemolytic streptococci (GAS)
- Inflammatory (moderate) acne
produce a number of virulence factors: M protein,
- Nodular cystic (severe) acne = malaking
deoxyribonuclease, streptokinases, and
acne na hindi nag pproduce ng pus but
hyaluronidase.
can produce severe inflammation na
● Cause severe and rapid tissue destruction.
nagiging cystic na siya na more than 5cm.
Hindi enough ang antibiotic dito dahil sa
Erysipelas
extensive inflammation that happens in
● Skin erupts into reddish patches with raised
the skin that causes scarring.
margins
➔ last line treatment for acne:
● Can progress to local tissue destruction and even
isotretinoin
enter the bloodstream causing sepsis (Which could
→ which inhibits the sweat gland
affect our heart and will produce prematic heart
and sebaceous gland; once it
disease and at the same time pwede rin mag cause
inhibits the production of oil, wala
sa kidney ng acute glomerulitis); (Eto din yung nag
na silang food-source kaya
ccause ng Scarlet fever which is called as strawberry
maeeradicate na yung acne +
tongue)
hindi basta basta binibigay
● Usually appears first on the face
because it can also induces
● High fever is common
suicidality and it is teratogenic
which means it can cause
Necrotizing fasciitis
malformation of embryo kaya
● Invasive group A streptococcal infection that
kailangan talaga ng special
destroys tissue and initially resembles TSS
prescription
● “Flesh-eating bacteria” (common for patients who
→ This medication dries skin,
are bedridden cuz of bedsores)
tongue, nose, etc
● Causes by pyrogenic toxins, streptococcal M-
protein types (act as superantigens)
● Associated with streptococcal TSS
VIRAL DISEASE OF THE SKIN ● The species is varicella-zoster, or officially, human

herpesvirus (HHV-3).
● HHV-3 is transmitted by the respiratory route and is
localized in skin cells after about 2 weeks.
WARTS
● The infected skin is vesicular for 3 to 4 days.
● Complications of chickenpox include encephalitis
PAPILLOMAVIRUSES
and Reye’s syndrome.
● which causes what we call the HPV
● Kapag viral infection huwag bibigyan ng aspirin
means Human papillomavirus
kapag nilalagnat which can cause reye’s syndrome
infection (common strain 16 and 18;
which can cause damage to kidneys.
commonly seen in genitalia)
● cause skin cells to proliferate and produce a benign
Shingles
growth called a wart or papilloma.
● Characterized by a vesicular rash along the affected
● Warts are transmitted from one person to another
cutaneous sensory nerves.
by direct contact, even sexually.
● After chickenpox, the virus can remain latent in
● After infection, there is an incubation period of
nerve cells and subsequently activate as shingles.
several weeks before the warts appear.
● Only affects one part of the body, usually found in
● Warts may regress spontaneously or be removed
cutaneous sensory nerves
chemically or physically.
Treatment
● Nonpharmacologic Treatment
● HHV-3 can be treated with acyclovir.
- Cryotherapy = freeze then tutuklapin
● An attenuated live vaccine is available.
- Electrodessication = cauterize
- Acid treatment = very common
- Laser
● Pharmacologic Treatment HERPES SIMPLEX
- Salicylic acid = ginagamit kadalasan sa
mga maliliit na warts ● ̈Herpes simplex viruses (HSV) can be separated
- Podofilox = for genital warts into two identifiable groups:
- Imiquimod = for genital warts - HSV-1 (or human herpesvirus 1) = cold sores
- Bleomycin = for genital warts - HSV-2 (or human herpesvirus 2)=genital
Cold sores
● Herpes simplex (HSV-1) infection of mucosal cells
VARIOLA
● Painful, short-lived vesicles that occur near the
outer red margin of the lips
● Variola, also known as smallpox, is caused by an
● pwede makuha kapag nakipagchukchakan ka sa
orthopoxvirus known as smallpox (variola) virus.
infected
● Variola virus causes two types of skin infections:
● Kapag may baby na kayo guys wag niyo papakiss
variola major (common) and variola
kung kani kanino baka mahawa sila lalo na kapag
minor.
may balbas
● Smallpox is transmitted by the
respiratory route, and the virus is
moved to the skin via the bloodstream.
● ̈The growth of the virus in the epidermal
layers of the skin causes lesions that
become pustular after 10 days or so.
● Smallpox has been eradicated as a result of a
vaccination effort by the World Health
Organization.
● Last case is 1978
● HSV-1 is transmitted primarily by skin contact, oral

VARICELLA-ZOSTER and respiratory routes.
● The virus remains latent in nerve cells, and cold
● Chickenpox (varicella) is a relatively mild disease sores can recur when the virus is activated.
when contracted, as it usually is, in childhood. ● Mahirap na gamutin kapag nagkaroon ka ulit
● It is the initial infection of a herpesvirus
Varicellovirus.
HERPES ENCEPHALITIS ● Causes by human parvovirus B19

● occurs when herpes simplex viruses (HSV-1 and ● Characterized by symptoms similar to mild
HSV-2) infect the brain. influenza and a “slapped-cheek facial rash” that
slowly fades
Treatment
● Acyclovir has proven successful in treating herpes ROSEOLA
encephalitis. ● Mild, very common childhood disease caused by
HHV-6 and HHV-7 (Human Herpesvirus 6 or 7;
● Kapag HHV-8; eto naman si Kaposi's sarcoma,
MEASLES which is usually seen patients with
Immunocompromised and with HIV
● Measles (Rubeola)
● Caused by measles virus HAND-FOOT-AND-MOUTH DISEASE
● An extremely contagious viral ● An infection in young children in day care,
disease transmitted by the preschool, and kindergarten
respiratory route ● Caused by several enteroviruses
● Vaccination (MMR vaccine; ● Spread by contact with mucous or saliva of an
Measles, mumps, and rubella infected person
vaccine) against measles provides ● Characterized by sore throat, then rashes
effective long-term immunity appearing on hands, feet, mouth, tongue, and
● After the measles virus has incubated (10-12 days) interior cheeks
in the upper respiratory tract, the following signs
and symptoms appear.
- Symptoms (like fever) similar to common FUNGAL INFECTION
cold.
- Macular lesions appear on the skin. Fungal infections or mycoses cause a wide range of diseases
- Koplik’s spots appear on in humans.
the oral mucosa. 1. Superficial Infection
● Complications of measles include 2. Cutaneous Infection
middle ear infections, pneumonia, 3. Subcutaneous Infection
encephalitis, and secondary 4. Deep mycosis
bacterial infections.
● Measles can go without treatment, SUPERFICIAL FUNGAL INFECTION
pero kapag nilalagnat kailangan natin bigyan ng ● DOC: Azoles (If dry use ointment, if wet use cream)
paracetamol. Pero kapag yung nag aalaga hindi pa
nagkakaroon ng tigdas, huwag niyo paalagaan A. Pityriasis versicolor
dahil mahahawa kayo for sure. ● Common superficial mycosis, which is
characterized by hypopigmentation or
hyperpigmentation of skin of the neck,
RUBELLA shoulders, chest, and back
● Due to Malassezia furfur which
● Rubella (German measles) involves only the superficial keratin
● The rubella virus is transmitted by layer
the respiratory route and causes a
red rash and light fever. B. Black Piedra
● Congenital rubella syndrome can ● A superficial mycosis due to Piedraia
affect a fetus when a woman contracts rubella hortae which is manifested by a small
during the first trimester of her pregnancy (pwede firm black nodule involving the hair
mag karoon ng problema sa hearing yung baby) shaft
● MMR Vaccination with live, attenuated rubella
virus provides immunity of unknown duration. C. White piedra
● Due to Trichosporon beigelii is
characterized by a soft, friable, beige
OTHER VIRAL DISEASES nodule of the distal ends of hair shafts
FIFTH DISEASE
● Also known as erythema infectiosum
D. Tinea Nigra CUTANEOUS FUNGAL INFECTION

● Most typically presents as a brown to ● Diagnosis is based on the microscopic examination
black silver nitrate-like stain on the of skin scrapings or fungal culture.
palm of the hand or sole of the foot and
and is caused by Phaeoannellomyces A. Dermatomycoses
werneckii ● Cutaneous infections due to other fungi, the most
common of which are Candida albicans.
E. Dermatophytoses ● C. albicans causes infections of mucous
● Caused by fungi (Microsporum, Trichophyton, and membranes and is a common cause of oral thrush
Epidermophyton) that colonize the outer layer of and vaginitis.
the epidermis cause dermatomycoses
● Also known as ringworm, or tinea SUBCUTANEOUS FUNGAL INFECTION
● These fungi grow on keratin-containing epidermis, A. Sporotrichosis
such as hair, skin, and nails ● Results from a soil fungus (Sporothrix
schenckii) that penetrates the skin
through a wound
● Common among gardeners or people working
with soil
B. Chromoblastomycosis
● Subcutaneous mycosis characterized by
verrucoid lesions of the skin
● Most common causes are:
- Fonsecaea pedrosoi (Pedroso’s
disease)
- Fonsecaea compacta
(Fonseca’s disease)
● DOC for Tinea capitis: anti-fungal shampoo - Cladosporium carionii (Cladosporiosis)
- Phialophora verrucosa
C. Madura foot (mycetoma)

● Chronic infection of the skin and
underlying tissues by both bacteria
(actinomycetoma) and fungi
(eumycetoma).
● Suppurative and granulomatous
subcutaneous mycosis
● Occur most often in farmers, hunter-gatherers,
and field laborer
PARASITIC INFESTATION OF THE SKIN
SCABIES
● ̈Involves intense local itching

● Caused by a tiny mite Sarcoptes
scabiei burrowing (binubutas yung
Kapag fungal infection mas matagalan yung gamutan skin mo kaya ka nagkakaroon ng
neto compared sa mga bacterial infection na 7 days lang. if burrowing) and laying eggs
left untreated kakalat lang ng kakalat yan. Kaya dapat underneath your skin (thus, hindi
hygienic tayo. nakukuha to kapag yung panty mo basa pa siya madali patayin dahil nandon siya
tas susuutin mo (yak) pwede mag harbor jan yung fungi. ew sa deeper layer ng skin natin nag
(tamang culture lang sa kepkep) haharbor)
● The mite is transmitted by intimate contact
● Mite lives ~25 days, but by that time eggs have
been laid and hatched

● Diagnosis
- Microscopic examination of skin scrapings
● Treatment
- Topical permethrin
- Oral ivermectin
PEDICULOSIS
● Infestation by the head lice

Pediculus humanus
capitis (Kuto sa ulo)
● Lice are easily transferred
by head-to-head contact
TOPIC 4:
MICROBIAL DISEASES OF THE DIGESTIVE SYSTEM
ANATOMY AND NORMAL MICROBIOTA OF THE

DIGESTIVE SYSTEM
● Normal microbiota exist in our GIT. Sila yung

tumutulong para madigest yung food, metabolized
medications, to increase the production of vitamin
K, and they play the vital role in the overall wellness
of the human body.
● Infections and intoxications of the gastrointestinal
tract can cause general symptoms such as nausea,
vomiting, diarrhea, and fever (itong mga
symptoms ay compensatory mechanisms ng ● Feces are undigested food particles na kailangan
katawan natin para malabanan yung infection) natin ilabas because they don't have use anymore.
● Localized inflammation of the GI tract can result in And feces are nutritious enough for the bacteria to
gastritis, enteritis, gastroenteritis, hepatitis, or grow kaya dapat may sanitary disposal tayo ng
colitis, and damage to epithelial cells of the colon feces.
can lead to dysentery. (once na masira yung ● Infections or microbial toxins in the oral cavity
epithelial cells natin it will be the portal of entry to can cause tooth decay, periodontal disease, and
damage our GIT) various types of ulcers
● The digestive tract, consisting of the oral cavity, - kapag nagkakaroon tayo ng periodontal
pharynx, esophagus, stomach, small intestine, diseases, nagkakaroon tayo ng tartar build
and large intestine, has a normal microbiota that is up, then mabubulok ipin which could
important for health affect our gums and others.
- Normal microbiota helps in the symbiosis
of the systems, however some organisms
may be inoculated there thru the portal of
entry (ex. naka inom ng tubig na may
infection)
● Foodborne illness refers to infections or
● The constant movement of materials through the
intoxications that originate with pathogens or
gastrointestinal canal, the protective layer of
toxins ingested in contaminated food or water.
mucus, the normal microbiota, and the harsh
chemical environment in the stomach and small
intestine help to prevent colonization by
pathogens DENTAL CARIES
- ex. Stomach acid - yung stomach acid
Dental caries, tartar, and gingivitis are caused by
natin is very acidic to the point nagiging
overgrowth of oral bacteria, usually Streptococcus and
pH 1 na. the reason why hindi nabubutas
Actinomyces species, as a result of insufficient dental
yung tiyan natin is because we have a
hygiene. (kailangan din natin toothbrushin yung tongue
protective layer of mucus made of
natin kasi naghaharbor din jan yung bacteria which can
prostaglandins. Kaya yung mga tao na
cause bad breath, and dapat nagdedental floss din tayo and
mahilig uminom ng NSAIDs, prone sila sa
mouthwash to further protect out oral cavities)
NSAID induced ulcer. Because NSAIDs
inhibit the production of prostaglandins
GINGIVITIS
and part of it will be the protective layer of
Gingivitis can worsen, allowing Porphyromonas,
mucus. Kaya kapag nawala yung
Streptococcus, and Actinomyces species to
protective layer natin sa stomach pwede
spread and cause periodontitis (namamaga and
ka magkaroon ng ulcerations. kasi yung
nabubulok yung gums) When Prevotella
stomach acid natin malulusaw niya yung
intermedia, Fusobacterium species, and
pinakastomach lining kasi wala ng mucus
Treponema vicentii are involved, it can lead to
protection. On the other hand, reversible
acute necrotizing ulcerative gingivitis
ito once you stop taking NSAID.
- acute = mabilis lang
- necrotizing = nabubulok
- ulcerative = nagkakaroon ng ulcerations (sore) collapse, and anuria.

- gingivitis = namamaga gums ● However, sporadic or mild cases are not readily
differentiated from other diarrheal diseases. The El
HERPETIC GINGIVOSTOMATITIS Tor (most dangerous strain) biotype tends to cause
The herpes simplex virus type 1 (also the milder disease than the classic biotype.
causative agent of cold sores) can cause ● Cholera increases our cAMP means it increases the
lesions of the mouth and throat called excretion of chloride, kasama ni chloride si sodium.
herpetic gingivostomatitis kapag lumalabas ang tubig sa katawan lagi
- stomatitis = oral thrush (singaw) sinusundan yan ng asin. kaya nagkakaroon tayo ng
rice watery stool. people with cholera dies due to
dehydration. cholera ay common sa mga taong
ORAL THRUSH mahilig uminom ng antacid, proton pump inhibitor,
Other infections of the mouth include oral H2 receptor blockers. dahil mas nag tthrive yung
thrush, a fungal infection caused by cholera sa basic medium.
overgrowth of Candida albicans (esp
immunocompromised) yeast, and mumps, a E. COLI ASSOCIATED DIARRHEAL DISEASES
viral infection of the salivary glands (causes to ● Different strains of E. coli cause different illnesses
swell) caused by the mumps virus, a with varying degrees of severity.
paramyxovirus.
EPEC, EIEC Infant and children diarrhea, Dysentery
GASTROINTESTINAL ILLNESS ETEC Traveler’s Diarrhea
Major causes of gastrointestinal illness include Salmonella EHEC (worst Blood Diarrhea, Hemolytic Uremic
spp., Staphylococcus spp. (causes bacterial superantigen), strain) Syndrome
EAEC
Helicobacter pylori (causes peptic ulcer), Clostridium
perfringens, Clostridium difficile (clostridium causes
pseudomembranous colitis), Bacillus cereus (causes rice PEPTIC ULCER
food poisoning), and Yersinia bacteria (causes bubonic ● Helicobacter pylori causes an
plague). inflammatory response with
neutrophils, lymphocytes,
CLOSTRIDIAL INFECTIONS plasma cells, and
● Clostridium difficile is an important macrophages within the
cause of hospital acquired infection and mucosal layer and causes
teratogenic infection because of the use epithelial cell degeneration
of antibiotics specifically clindamycin and injury (H. pylori has enzyme known as urease
(clindamycin is very powerful that is which makes the stomach basic)
able to wipe out all the normal flora - binubutas ni H. pylori yung stomach natin and then
except for clostridium difficile) dun sya papasok sa tissue and dun sya
● Careful antibiotic use is required to reduce the risk maghaharbor ng infections, and mahirap na siya
of causing C. difficile infections and when treating gamutin)
antibiotic-resistant infections. ● Complications include:
● DOC: metronidazole or vancomycin (has to be - unabated symptoms, bleeding, perforation,
taken orally) penetration, gastric outlet obstruction, and gastric
malignancy (adenocarcinoma and MALT
CHOLERA lymphoma).
● Vibrio cholerae causes cholera, which can be a ● Tests: Urea Breath test - carbon 13 and 14
severe diarrheal illness. ● DOC: Triple therapy = omeclamox, helidac,
● About 50% of infections with classic V. cholerae are combination of metronidazole, amoxicillin,
asymptomatic, as are about 75% of infections with penicillin based medications, bismuth
the El Tor biotype. subsillicate, etc.
● There is a sudden onset of nausea and vomiting and
profuse diarrhea with abdominal cramps. Stools, TYPHOID FEVER
which resemble “rice water” contain mucus, Salmonella enterica serotype typhi:
epithelial cells, and large numbers of vibrios. ● contracted by ingestion of contaminated food or
● There is rapid loss of fluid and electrolytes, which water that must survive the gastric pH barrier in the
leads to profound dehydration, circulatory stomach prior to adherence in the small intestine
● enter the submucosal region of the small bowel by PROTOZOAL INFECTIONS

either direct penetration into the epithelial tissue
mediated by the cystic fibrosis transmembrane ● Giardiasis (Giardia lamblia), cryptosporidiosis
conductance regulator (CFTR) or via the M-cell, a (Cryptosporidium parvum), amoebiasis
specialized lymphoid epithelial cell (entamoeba histolytica), and cyclosporiasis are
● once within the submucosa, the bacterium causes intestinal infections caused by protozoans.
hypertrophy of the Peyer’s patches ● Protozoan intestinal infections are commonly
● Abdominal symptoms, pain, nausea, vomiting, transmitted through contaminated food and water.
constipation/diarrhea, intermittent confusion, ● Treatment varies depending on the causative
apathetic affect agent, so proper diagnosis is important.
● pwede kumalat sa dugo natin yung S. typi which ● Microscopic examination of stool or biopsy
would now go to our brain. specimens is often used in diagnosis, in
combination with other approaches.
VIRAL GASTROENTERITIS
HELMINTHIC INFECTIONS
● Helminths often cause intestinal infections after

transmission to humans through exposure to
contaminated soil, water, or food. Signs and
symptoms are often mild, but severe complications
may develop in some cases.
ASCARIS LUMBRICOIDES
● Ascaris lumbricoides eggs are transmitted through
Take note! contaminated food or water and hatch in the
intestine.
VIRAL HEPATITIS ● Juvenile larvae travel to the lungs and then to the
● Hepatitis may be caused by several unrelated pharynx, where they are swallowed and returned to
viruses: hepatitis viruses A, B, C, D, and E. the intestines to mature. These nematode
- A & E = foodborne roundworms cause ascariasis.
- B, C, D = blood transfusion, sexually transmitted ● If left untreated pwede siya kumalat kahit saan
infections bubutasin nya mga organs natin.
● The hepatitis viruses differ in their modes of ● DOC: pyrantel pamoate or mebendazole
transmission, treatment, and potential for chronic
infection.
TRANSMISSION PREVENTION AND
TREATMENT
HEPA A → Fecal-oral route, → Vaccine: Havrix and Vaqta

→ Caused by RNA person-person for children 12mos-18yrs
virus → Ig: post-exposure
→ Picornaviridae
HEPA B → Transmitted →Vaccine which uses HBsAg

→ DNA Virus sexually, → Recombivax HB and
→ parenterally, Engerix-B
Hepadnaviridae perinatally → Twinrix = HAV and HBV
(adult)
→ Comvax and Pediarix
(children) NECATOR AMERICANUS AND ANCYLOSTOMA
→ 1st line therapy options =
Interferon (IFN)-a2b, DUODENALE
Lamivudine, Telbivudine, ● cause hookworm (old and new world hookworm)
Adefovir, Entacavir,
Pegylated IFN-a2a infection when larvae penetrate the skin from soil
contaminated by dog or cat feces. They travel to the
HEPA C → Injection drug use → Interferon-alpha, Ribavirin, lungs and are then swallowed to mature in the
→ RNA Virus → Blood Transfusions No vaccine
→ Flaviviridae → Chronic → Primary goal is to eradicate intestines.
Hemodialysis HCV infection
→ Resolving infection prevents
devt of sequelae
STRONGYLOIDES STERCORALIS
● Strongyloides stercoralis are transmitted from soil
through the skin to the lungs and then to the TRICHURIS TRICHIURA
intestine where they cause strongyloidiasis. ● Whipworm can be transmitted
● Autoreinfection through soil or fecal contamination and
● DOC: Ivermectin cause trichuriasis. After ingestion, the
eggs travel to the intestine where the
larvae emerge and mature, attaching to
the walls of the colon and cecum.
ENTEROBIUS VERMICULARIS
● are nematode pinworms transmitted by the fecal-
oral route. After ingestion, they travel to the colon
where they causes enterobiasis.
● Diagnose: Eosinophilia and IgE TRICHINELLA SPIRALIS
● Scotch tape method ● is transmitted through undercooked
● Makati sa pwet tuwing gabi meat. Larvae in the meat emerge from
cysts and mature in the large intestine.
They can migrate to the muscles and form
new cysts, causing trichinosis.
● penetrates the muscles
● avoid eating medium rare, rare, cold cuts
TAENIA SPP. AND DIPHYLLOBOTHRIUM LATUM

● tapeworms transmitted through undercooked HELMINTHIC INFECTIONS
food or the fecal- oral route. Taenia infections cause
taeniasis. Tapeworms use their scolex to attach to ● Echinococcus granulosus is a cestode transmitted
the intestinal wall. Larvae may also move to muscle through eggs in the feces of infected animals,
or brain tissue. especially dogs.
● Taenia solum can lay eggs in the brain which ● After ingestion, eggs hatch in the small intestine,
causes cysticercosis, mabubutas yung brain and and the larvae invade the intestinal wall and travel
cause death. must be treated immediately. through the circulatory system to form dangerous
cysts in internal organs, causing hydatid disease.
● Flukes (trematodes) are transmitted through

aquatic plants or fish. Liver flukes cause disease by
interfering with the bile duct. Intestinal flukes
develop in the intestines, where they attach to the
intestinal epithelium.
MICROBIAL DISEASES OF THE CARDIOVASCULAR AND

LYMPHATIC SYSTEMS
STRUCTURE OF THE CARDIOVASCULAR SYSTEMS
● The heart, blood, and blood

vessels make up the
cardiovascular system.
● right side = deoxygenated blood
(wala ng oxygen), dumederecho
and naiipon, dedeliver nya sa
pulmonary artery and
magkakaroon ng exchange of
gas where in malalagyan ng oxygen yung
deoxygenated bloods, and then babalik na siya sa
heart natin na may oxygen na. si heart ippump nya
sa systems natin yung mga oxygenated blood.
● left side = oxygenated bloods going to our organs
STRUCTURE OF THE LYMPHATIC SYSTEM demonstrated that puerperal sepsis was

transmitted by the hands and instruments of
● Lymph, lymph vessels, lymph midwives and physicians.
nodes, and lymphoid organs ● DOC for septic shock: levophed or norepinephrine
constitute the lymphatic
system.
● responsible for immune BACTERIAL INFECTIONS OF THE HEART
response
● lymph nodes produces ● The inner layer of the heart is
immune responses (kulani) the endocardium.
● kapag namamaga kulani
means may infection duon. ● Subacute bacterial
● Ayoko na endocarditis is usually caused
by alpha-hemolytic
streptococci, staphylococci, or enterococci.
FUNCTION OF THE LYMPHATIC AND CARDIOVASCULAR - The infection arises from a focus of infection, such
SYSTEMS as a tooth extraction.
● Plasma transports dissolved substances. Red blood ● Pre-existing heart abnormalities are predisposing
cells carry oxygen. White blood cells are involved in factors.
the body’s defense against infection. - Signs include fever, weakness, and heart
● Fluid that filters out of capillaries into spaces murmur.
between tissue cells is called interstitial fluid.
● Interstitial fluid enters lymph capillaries and is ● Acute bacterial endocarditis is usually caused by
called lymph; vessels called lymphatic return lymph Staphylococcus aureus.
to the blood. - The bacteria cause rapid destruction of
● Lymph nodes contain fixed macrophages, B cells, heart valves.
and T cells.
● Acute = within 1 day to 1 week
● Subacute = more than a week but less than a
SEPSIS AND SEPTIC SHOCK month
● Chronic = more than a month
● Sepsis is an inflammatory response caused by the
spread of bacteria or their toxin from a focus of
infection (may infection ka sa dugo and kumakalat RHEUMATIC FEVER
na)
- Septicemia is sepsis that involves proliferation of ● Rheumatic fever is an autoimmune complication of
pathogens in the blood. streptococcal infections/ streptococcus pyogenes.
- Bacteremia, nasa dugo mo na siya pero hindi pa (nakikita kadalasan sa inflammation ng pharynx or
kumakalat pharyngitis)
● Gram-negative sepsis can lead to septic shock, ● kapag nasswallow natin yung laway na may S.
characterized by decreased blood pressure. pyogenes, it will travel to the bloodstream, and yung
Endotoxin causes the symptoms. blood dumadaan sa puso natin kaya naiiwan na dun
- Treatment of gram-negative bacteremia and yung S. pyogenes, dumidikit sila sa heart valves
impending septic shock requires rapid institution of mamamaga yun ngayon. kaya kapag nag oopen
antimicrobial therapy, restoration of fluid and and close yun nahihirapan na ang puso kaya
electrolyte balance, and treatment of tinawag na rheumatic fever.
disseminated intravascular coagulation. ● Signs and symptoms: fever, malaise, a migratory
● Antibiotic-resistant enterococci and group B nonsuppurative polyarthritis, and evidence of
streptococci cause gram-positive sepsis. inflammation of all parts of the heart
● Streptococcus pyogenes is the most frequent - Antibodies against group A beta-
cause of puerperal sepsis. (eto yung nakikita natin hemolytic streptococci react with
kapag nagkakaroon ng abortion, or nanganak) streptococcal antigens deposited in joints
- Puerperal sepsis begins as an infection of the uterus or heart valves or cross-react with the
following childbirth or abortion; it can progress to heart muscle.
peritonitis or septicemia. - The onset is often preceded by S pyogenes
- Oliver Wendell Holmes and Ignaz Semmelweiss pharyngitis 1–4 weeks earlier, although the
infection may be mild and may not be ● Diagnosis is based on isolating and identifying the
detected. bacteria.
➔ In general, however, patients with more
severe streptococcal sore throats have a
greater chance of developing rheumatic GANGRENE
fever.
● Caused by Clostridium perfringens
(anaerobic)
TULAREMIA ● Soft tissue death from ischemia (loss of
blood supply) is called gangrene.
● caused by Francisella tularensis. The - AKA Clostridial myonecrosis
reservoir is small wild mammals, ● foul-smelling discharge, rapidly
especially rabbits. progressing necrosis, fever, hemolysis,
● Regional lymph nodes enlarge and toxemia, shock, and death (common sa
may become necrotic, sometimes mga diabetic and sa mga taong may
draining for weeks (ulceroglandular tularemia). blood clots)
- Inhalation of an infective aerosol results - Treatment is with early surgery
in peribronchial inflammation and (amputation) and antibiotic
localized pneumonitis (pneumonic administration.
tularemia).
- Oculoglandular tularemia can develop
when an infected finger or droplet touches SYSTEMIC DISEASES CAUSED BY BITES AND SCRATCHES
the conjunctiva.
Pasteurella multocida, introduced by the bite of a dog or
cat, can cause septicemia.
BRUCELLOSIS ● Anaerobic bacteria infect deep animal bites.
● Cat-scratch disease is caused by Bartonella
● Also known as undulant fever henselae.
● can be caused by Brucella abortus, B. melitensis, ● Rat-bite fever is caused by Streptobacillus
and B. suis. moniliformis and Spirillum minus.
● The common routes of infection in humans are the
intestinal tract (ingestion of infected milk), mucous VECTOR-TRANSMITTED DISEASES
membranes (droplets), and skin (contact with ● Plague is caused by Yersinia pestis. The vector is
infected tissues of animals). usually the rat flea (Xenopsylla cheopis) (eto yung
- The bacteria enter through minute breaks nauso dati dahil hindi hygienic yung tao dati and
in the mucosa or skin, reproduce in maraming rats dati) (yung kuto ng daga may
macrophages, and spread via lymphatics yersinia pestis)
to liver, spleen, or bone marrow. ● Relapsing fever is caused by Borrelia recurrentis.
- The onset is insidious, with malaise, fever, and transmitted by soft ticks.
weakness, aches, and sweats. ● Lyme disease is caused by Borrelia burgdorferi
- The fever usually rises in the afternoon; its and is transmitted by a tick (Ixodes).
fall during the night is accompanied by ● Human ehrlichiosis (meron to sa aso and
drenching sweat (night sweat). commonly sakit ng aso) and anaplasmosis are
caused by Ehrlichia and Anaplasma and are
transmitted by Ixodes ticks.
ANTHRAX ● Typhus is caused by rickettsias, obligate
intracellular parasites of eukaryotic cells.
● Bacillus anthracis causes anthrax. In soil,
endospores can survive for up to 60 years. BURKITT’S LYMPHOMA
● Grazing animals (wool of sheep) acquire an ● Epstein-Barr virus (EB virus, HHV-4) causes
infection after ingesting the endospores. Burkitt’s lymphoma (kissing disease)
● Humans contract anthrax by handling hides from ● Burkitt’s lymphoma tends to occur in patients
infected animals. The endospores enter through whose immune system has been weakened; for
cuts in the skin, respiratory tract, or mouth. example, by malaria or AIDS.
● Entry through the skin results in a (black eschar) ● can also cause cancer
papule that can progress to sepsis. Entry through
the respiratory tract can result in septic shock.
INFECTIOUS MONONUCLEOSIS (common in costa rica)

● Infectious mononucleosis is ● Signs and symptoms include fever, chills,
caused by Epstein-Barr headache, nausea, and jaundice.
virus. ● Diagnosis is based on the presence of virus-
● The virus multiplies in the neutralizing antibodies in the host.
parotid glands and is present ● No treatment is available, but there is an
in saliva. It causes the attenuated, live viral vaccine.
proliferation of atypical
lymphocytes. DENGUE
● The disease is transmitted by the ingestion of saliva ● Dengue (breakbone fever = masakit siya sa buto, it
from infected individuals. can affect the production of blood in bone marrow)
● Diagnosis is made by an indirect fluorescent- is caused by the dengue virus and is transmitted by
antibody technique. the Aedes mosquito (aedes aegypti and aedes
● EB virus may cause other diseases, including albopictus)
cancers and multiple sclerosis. - mosquito-borne infection caused by a flavivirus
● mamaga tonsils to the point nag uumpugan na sila. - Signs and symptoms: fever, severe headache,
eto yung pinakamasakit na sore throat. muscle and joint pain, nausea and vomiting, eye
pain, and rash.
OTHER DISEASES AND EPSTEIN-BARR VIRUS ➔ Severe forms of the disease, dengue
● EB virus is associated with certain cancers and hemorrhagic fever and dengue shock
autoimmune diseases. syndrome, principally affect children.
● Cytomegalovirus Infections - Vaccine: Dengvaxia (made for 20 years for 4
- CMV (HHV-5) causes intranuclear serotypes - DENV 1 to 4)
inclusion bodies and cytomegaly of host
cells.
- CMV is transmitted by saliva and other EMERGING VIRAL HEMORRHAGIC FEVERS
body fluids.
- can cause problem in the eyes MARBURG, EBOLA, AND LASSA FEVER VIRUS
● CMV inclusion disease can be asymptomatic, a Human diseases caused by Marburg, Ebola, and Lassa fever
mild disease, or progressive and fatal. viruses were first noticed in the late 1960s.
Immunosuppressed patients may develop ● Ebola Virus is found in fruit bats; Lassa fever viruses
pneumonia which can lead to death. are found in rodents. Rodents are the reservoirs for
● If the virus crosses the placenta, it can cause Argentine and Bolivian hemorrhagic fevers.
congenital infection of the fetus, resulting in
impaired mental development, neurological HANTAVIRUS PULMONARY SYNDROME AND
damage, and stillbirth. HEMORRHAGIC FEVER
Hantavirus pulmonary syndrome and hemorrhagic fever
CHIKUNGUNYA FEVER with renal syndrome are caused by Hantavirus.
● The chikungunya virus, which causes fever and ● The virus is contracted by inhalation of dried
severe joint pain, is transmitted by Aedes rodent urine and feces.
mosquitoes. ● The disease begins with fever, headache, and
- Clinically, the infection resembles dengue fever. The myalgia followed by rapidly progressive pulmonary
disease is characterized by high fever and severe edema, often leading to severe respiratory
joint pain; asymptomatic infections are rare. There compromise.
is no vaccine available.
- can be sexually transmitted and vertical
transmission PROTOZOAN DISEASES OF THE CARDIOVASCULAR AND
- kapag yung bata nagkaron ng chikungunya LYMPHATIC SYSTEMS
nagkakaroon sila ng microcephaly, means maliit
yung ulo ng bata yung utak niya underdeveloped. CHAGAS DISEASE
Namamatay din sila agad hindi sila tumatanda. ● Also known as American
Trypanosomiasis
● Trypanosoma cruzi causes Chagas
CLASSIC VIRAL HEMORRHAGIC FEVERS disease. The reservoir includes many
wild animals. The vector is a reduviid,
● Yellow fever is caused by the yellow fever virus. the “kissing bug”
The vector is the Aedes aegypti mosquito. ● aka SLEEPING DISEASE
TOXOPLASMOSIS sanitation and snail eradication are used to prevent

● Caused by Toxoplasma gondii. it.
● T. gondii undergoes sexual reproduction in the
intestinal tract of domestic cats, and oocysts are
eliminated in cat feces. DISEASE OF UNKNOWN ETIOLOGY
● In the host cell, sporozoites reproduce to form either
tissue- invading tachyzoites or bradyzoites. KAWASAKI SYNDROME
● Humans contract the infection by ingesting ● characterized by fever, rash, and swollen lymph
tachyzoites or tissue cysts in undercooked meat nodes in the neck. The cause is unknown.
from an infected animal or contact with cat feces. ● Causes viral strawberry tongue
● Congenital infections can occur. Signs and
symptoms include severe brain damage or vision
TOPIC 4 = DONE
problems.
Mag refer din kayo sa previous transes natin para mas
● DOC: METRONIDAZOLE
detailed
MALARIA
● The signs and symptoms of malaria are chills, fever,
vomiting, and headache, which occur at intervals of
2 to 3 days.
● Malaria is transmitted by Anopheles mosquitoes.
The causative agent is any one of four species of
Plasmodium.
● Sporozoites reproduce in the liver and release
merozoites into the bloodstream, where they infect
red blood cells and produce more merozoites.
LEISHMANIASIS
● Leishmania spp., which are transmitted by
sandflies, cause leishmaniasis.
● The protozoa reproduce in the liver, spleen, and
kidneys.
● DOC: treated with liposomal amphotericin B.
BABESIOSIS
● caused by the protozoan Babesia microti and is
transmitted to humans by ticks.
- Human babesiosis is more severe in the elderly than
in the young, in splenectomized individuals, and in
AIDS patients.
- may resemble falciparum malaria, with high fever,
hemolytic anemia, hemoglobinuria, jaundice, and
renal failure; infections are sometimes fatal.
SCHISTOSOMIASIS
● Species of the blood fluke Schistosoma cause
schistosomiasis.
● Eggs eliminated with feces hatch into larvae that
infect the intermediate host, a snail. Free-
swimming cercariae are released from the snail and
penetrate the skin of a human.
● The adult flukes live in the veins of the liver or
urinary bladder in humans.
● Granulomas are from the host’s defense to eggs
that remain in the body.
● Observation of eggs or flukes in feces, skin tests, or
indirect serological tests may be used for diagnosis.
● Chemotherapy is used to treat the disease;
TOPIC 5:
MICROBIAL DISEASE OF THE RESPIRATORY SYSTEM
STRUCTURE AND FUNCTION OF THE RESPIRATORY

SYSTEM
● Infections of the upper respiratory system are the

most common type of infection
- yung iniinhale natin na hangin it would go
to the lungs. yung cillia natin sa ilong it is
not enough to protect from
microorganisms esp. yung mga maliliit na
mo like covid-19
● Left lung is divided into two; upper and middle lobe
● Pathogens that enter the respiratory system can
● Right lung is divided into three; upper, middle, and
infect other parts of the body.
lower lobe
● In case we have to remove a portion of the lungs it
UPPER RESPIRATORY SYSTEM
is called lobectomy
The upper respiratory system consists of the nose, pharynx,
● If our lungs collapsed it is called atelectasis
and associated structures, such as the middle ear and
● Sa alveoli dito nagkakaroon ng exchange of gas,
auditory tubes.
oxygenated gas natin mapupunta sa blood
capillaries wherein maaattach yung oxygen sa
dugo. And then yung carbon dioxide naman na
galing sa blood capillaries mapupunta naman siya
sa alveoli para kapag nag exhale tayo marerelease
natin yung carbon dioxide.
● Kapag nagkaroon tayo ng sakit na COPD (Chronic
obstructive pulmonary disease) There is 2 types:
Chronic bronchitis wherein the affectation is in
bronchi or bronchioles, which is sa daanan ng
hangin. Enfisema, sa alveoli naman ang affectation.
● Lahat ng veins natin ang dala dala nilang dugo ay
deoxygenated blood
● kapag artery ang dala dala nila ay oxygenated
blood
● Tonsils are able to block some mo that could go to ● Except: Pulmonary vein, ang dala dala niyang
our lungs. but if you are compromised, pwede ka rin dugo ay oxygenated blood. Pulmonary artery ang
magkaroon ng tonsilitis, etc. daladala naman deoxygenated blood.
● Coarse hairs (cillia)in the nose filter large particles ● Diaphragm = breathing muscles, tumutulong para
from air entering the respiratory tract. makahinga. kapag buntis nahihirapan huminga
- kapag yung kulangot natin kulay itim dahil na iipit yan ng baby.
more likely yung iniinhale natin na hangin ● The ciliary escalator of the lower respiratory system
ay madumi. but we have to be careful helps prevent microorganisms from reaching the
kapag nangungulangot because lungs.
sometimes it could puncture the nose. ● Microbes in the lungs can be phagocytized by
● The ciliated mucous membranes of the nose and alveolar macrophages (searches and kills infection
throat trap airborne particles and remove them in alveoli)
from the body. ● Respiratory mucus contains IgA antibodies.
● Lymphoid tissue, tonsils, and adenoids provide
immunity to certain infections. They also releases
immune defense. NORMAL MICROBIOTA OF THE RESPIRATORY SYSTEM
LOWER RESPIRATORY SYSTEM The normal microbiota of the nasal cavity and throat can
The lower respiratory system consists of the larynx, trachea, include pathogenic microorganisms.
bronchial tubes, and alveoli (where exchange of carbon
dioxide and oxygen happens; pinakadulo ng lungs)
MICROBIAL DISEASES OF THE UPPER RESPIRATORY ● Symptoms include a red rash, high fever, and a red,
SYSTEM enlarged tongue (bacterial strawberry tongue)
● if Bacterial strawberry tongue it is caused by
Specific areas of the upper respiratory system can become Streptococcus pyogenes
infected to produce pharyngitis, laryngitis, tonsillitis, ● If viral strawberry tongue it is caused by kawasaki
sinusitis, and epiglottitis (“-itis” = may inflammation) disease (common in children)
DIPHTHERIA
● Caused by exotoxin-producing Corynebacterium
diphtheriae.
● Exotoxin is produced when the bacteria
are lysogenized by a macrophage.
● A membrane, containing fibrin and dead
human and bacterial cells, forms in the
throat and can block the passage of air.
● The exotoxin inhibits protein synthesis,
and heart, kidney, or nerve damage may
result.
● Laboratory diagnosis is based on isolation of the
with strep inf Pharyngitis Epiglottitis bacteria and the appearance of growth on
● These infections may be caused by several bacteria differential media.
and viruses, often in combination. Most respiratory ● Routine immunization in the United States includes
tract infections are self- limiting. diphtheria toxoid in the DTaP vaccine (Diphtheria-
● Haemophilus influenzae type b can cause Tetanus-Pertussis Vaccine).
epiglottitis (common in children less than 5 years ● Slow-healing skin ulcerations are characteristic of
old) cutaneous diphtheria (makikita sa skin ng tao)
● Covid-19 can invade the fat cells. It is aerosol. ● There is minimal dissemination of the exotoxin in
the bloodstream.
DISEASES OF THE UPPER RESPIRATORY SYSTEM OTITIS MEDIA

● Earache, or otitis media, can occur as a
complication of nose and throat infections.
● Pus accumulation causes pressure on the eardrum.
BACTERIAL DISEASES OF THE UPPER RESPIRATORY
● Namamaga yung gitna ng tenga
SYSTEM
● Bacterial causes include Streptococcus
pneumoniae, non- encapsulated Haemophilus
STREPTOCOCCAL PHARYNGITIS
influenzae, Moraxella catarrhalis, and
● Also known as strep throat
Streptococcus pyogenes.
● This infection is caused by group A
beta-hemolytic streptococci, the
group that consists of
VIRAL DISEASES OF THE UPPER RESPIRATORY SYSTEM
Streptococcus pyogenes.
● Symptoms of this infection are inflammation of the
COMMON COLD
mucous membrane and fever; tonsillitis and otitis
● Any one of approximately 200 different viruses,
media (namamaga yung middle area ng tenga)
including rhinoviruses, coronaviruses, and EV-
may also occur.
D68, can cause the common cold.
● Rapid diagnosis is made by enzyme
● We tend to accumulate immunities against these
immunoassays.
viruses during our lifetime.
● Immunity to streptococcal infections is type-
● The symptoms include sneezing, excessive nasal
specific.
secretion, and congestion.
● The incidence of colds increases during cold
SCARLET FEVER
weather, possibly because of increased
● Strep throat, caused by an
interpersonal indoor contact or physiological
erythrogenic toxin-producing S.
changes (kapag mababa ang temperature like
pyogenes, results in scarlet fever.
naulanan ka, nagkakaroon ng modifications sa
● Streptococcus pyogenes produces
katawan natin wherein our immune system lowers
erythrogenic toxin when lysogenized
down, also ung mga opportunistic infections,
by a phage.
lumalakas effect nila sa katawan kaya nagiging TUBERCULOSIS

pathogenic siya) ● caused by Mycobacterium tuberculosis (common)
● Mycobacterium bovis causes bovine tuberculosis
and can be transmitted to humans by
DISEASE OF THE LOWER RESPIRATORY SYSTEM unpasteurized milk.
● M. avium-intracellulare complex infects patients
in the late stages of HIV infection (avium = birds)
● An infectious disease caused by the bacterium M.
MICROBIAL DISEASE OF THE LOWER RESPIRATORY
tuberculosis, a thin rod and an obligate aerobe
SYSTEM
(needs air)
● Pulmonary TB = Bacterial infection in the lungs
● Many of the same microorganisms that infect the
● Miliary TB = occurs when tubercle bacilli enter the
upper respiratory system also infect the lower
bloodstream and disseminate to all parts of the
respiratory system.
body (nasa labas na siya ng lungs; hindi ka
● Diseases of the lower respiratory system include
magkakaron ka lang neto kapag lumala na yung
bronchitis and pneumonia.
pulmonary TB)
● The rods grow slowly (20-hour or longer generation
time), sometimes form filaments, and tend to grow
in clumps.
● Mycobacteria stained with carbol fuchsin dye

cannot be decolorized with acid-alcohol and are
therefore classified as acid-fast.
● This is due to their high lipid cell wall containing
mycolic acid.
● It is responsible for the resilient
characteristic of the bacterium, i.e.,
resistant to drying, antiseptics and
disinfectants.
● M. tuberculosis may be ingested by
alveolar macrophages; if not killed,
the bacteria reproduce in the
macrophages.
● Bronchitis = inflammation of bronchioles ● Lesions formed by M. tuberculosis
are called tubercles; macrophages
and bacteria form the caseous
BACTERIAL DISEASES OF THE LOWER RESPIRATORY lesion (mukhang cheese) that might
SYSTEM calcify and appear in an X-ray image as a Ghon’s
complex.
PERTUSSIS ● Liquefaction of the caseous lesion results in a
● Also known as whooping cough (BD ques) tuberculous cavity in which M. tuberculosis can
● Pertussis is caused by Bordetella pertussis. grow.
● The initial stage of pertussis resembles a cold and
is called the catarrhal stage.
● The accumulation of mucus in the trachea
and bronchi causes deep coughs
characteristic of the paroxysmal (second)
stage.
● The convalescence (third) stage can last
for months.
● Regular immunization for children has
decreased the incidence of pertussis.
● DTap = for children
● Tdap (Tetanus Diphtheria Pertussis) = for adult
TREATMENT
● Chemotherapy usually involves three or four
drugs taken for at least 6 months; multidrug-
resistant M. tuberculosis is becoming prevalent:
RIPE = Rifampin, Isoniazid, Pyrazinamide, &
Ethambutol
● BCG vaccine (Bacillus Calmette–Guérin) for
tuberculosis consists of a live, avirulent culture of
M. bovis (for miliary TB infection only)
BACTERIAL PNEUMONIAS
PNEUMONIA
● An infection that inflames your lungs' air sacs
(alveoli). The alveoli may fill up with fluid or pus,
causing symptoms such as a cough, fever, chills
and trouble breathing (compensatory mechanism
of our body is to cough)
do not skip images!
CLINICAL DISEASE
A) Primary infection involves the
mid or lower lung field, and the
focus is usually single.
B) Active tuberculosis may
develop as a progression of ● Typical pneumonia (two-thirds of cases) is caused
primary infection or as a by pneumococci. Atypical pneumonias are caused
reactivation of a quiescent infection. by other microorganisms.
C) Miliary (disseminated) tuberculosis involves new
foci of infection which can develop when a caseous PNEUMOCOCCAL PNEUMONIA
lesion ruptures and releases bacteria into blood or ● Caused by encapsulated Streptococcus
lymph vessels. pneumoniae.
● S. pneumoniae is a gram-positive, ovoid bacterium
DIAGNOSIS that usually appears in pair.
● A positive tuberculin skin test can indicate either
an active case of TB, prior infection, or vaccination Symptoms:
and immunity to the disease. ● Pneumococcal pneumonia involves both the
● Active infections can be diagnosed by detection of bronchi and the alveoli. Symptoms include high
IFN-γ or rapid PCR test for M. tuberculosis. fever, breathing difficulty, and chest pain.
● The sputum is often rust colored from blood
coughed up from the lungs.
Diagnosis:
● Optochin test Treatment:

● Bile solubility test ● Azithromycin
● Latex indirect agglutination test ● Macrolide antibiotics
Treatment: PSITTACOSIS
● Antibiotic ● Chlamydophila psittaci, the bacterium that causes
● Vaccine (conjugated pneumococcal, psittacosis (AKA “ornithosis”), is transmitted by
pneumococcal polysaccharide) contact with contaminated droppings and
- Kapag bata tayo binibigyan tayo ng PCV- exudates of fowl (parrot)
13, then after a year PPSV-23, and then ● C. psittaci, is a gram-negative, obligate
after 5 years, another PPSV-23 ulit intracellular bacterium.
HAEMOPHILUS INFLUENZAE PNEUMONIA CHLAMYDOPHILA PNEUMONIAE

● Children under 5 and adults over 65 are most ● Chlamydophila pneumoniae causes pneumonia; it
susceptible to Haemophilus influenzae is transmitted from person to person.
pneumonia.
● H. influenzae is a gram-negative coccobacillus. Q FEVER
● common for children ● Caused by the obligate intracellular parasitic
bacteria Coxiella burnetii.
Treatment: ● This bacteria naturally infects some animals, such as
● 3rd generation cephalosporins (cefotaxime, goats, sheep, and cattle.
ceftazidime, cefdinir, ceftriaxone, cefpodoxime, and ● People can get infected by breathing dust
cefixime) contaminated with secretions from these animals.
● Hib vaccine (Haemophilus influenzae vaccine type
B); influenza vaccine for less than 5 years and more
than 65 years old
MYCOPLASMA PNEUMONIAE
● causes mycoplasmal pneumonia. AKA “walking
pneumonia”; it is an endemic disease.
● M. pneumoniae lacks cell wall.
● The symptoms, which persist for 3 weeks or longer,
are low-grade fever, cough, and headache.
● Other terms for the disease are primary atypical
and walking pneumonia.
LEGIONELLOSIS
● Also known as Legionnaire’s disease, is caused by
the aerobic gram-negative rod Legionella
pneumophila.
● Unknown until an outbreak in 1976 during
American Legion Convention in Philadelphia.
● Characterized by a high fever of 40.5°C, cough, and MELIOIDOSIS
general symptoms of pneumonia.
● L. pneumophila is also responsible for Pontiac ● Infection caused by Burkholderia pseudomallei
fever, which is essentially another form of ● Transmitted by inhalation, ingestion, or through
legionellosis. puncture wounds
● Its symptoms include fever, muscular aches, and ● Symptoms include pneumonia, sepsis (kumalat sa
usually a cough. The condition is mild and self- dugo yung infection), and encephalitis
limiting. (inflammation in the brain).
● During outbreaks of legionellosis, both forms may
occur.
VIRAL DISEASES OF THE LOWER RESPIRATORY SYSTEM
Diagnosis:
● Culture on Charcoal-Yeast extract medium VIRAL PNEUMONIA
● Serological test ● Several viruses can cause pneumonia as a
complication of infections such as influenza.
● The etiologies are not usually identified in a clinical COCCIDIOIDOMYCOSIS

laboratory because of the difficulty in isolating and ● Results from inhaling the airborne arthroconidia of
identifying viruses. Coccidioides immitis.
● Most cases are clinically occult or mild infections.
RESPIRATORY SYNCYTIAL VIRUS (RSV) ● But some patients have progressive pulmonary
● A common respiratory virus that usually causes infection and may suffer dissemination to the brain,
mild, cold-like symptoms. bone, and other sites.
● The most common cause of bronchiolitis and
pneumonia in infants. PNEUMOCYSTIS PNEUMONIA
● Pneumocystis jirovecii is found in healthy human
INFLUENZA (FLU) lungs. However, it causes disease in AIDS patients
● Caused by Influenza and other immunosuppressed patients.
Virus and is characterized
by chills, fever, headache, BLASTOMYCOSIS
and general muscular ● Also known as North American Blastomycosis
aches. ● Blastomyces dermatitidisis the causative agent of
● Hemagglutinin (HA) and blastomycosis
neuraminidase (NA) ● The infection begins in the lungs and can spread to
spikes project from the outer lipid bilayer of the cause extensive abscesses
virus.
● Viral strains are identified by antigenic differences OTHER FUNGI INVOLVED IN RESPIRATORY DISEASE
in their protein coats (A, B, and C); influenza A is ● Opportunistic fungi can cause respiratory disease in
further subdivided by differences in the HA and NA immunosuppressed hosts, especially when large
spikes. numbers of spores are inhaled.
● Antigenic shifts (mutation) and antigenic drift ● Among these fungi are Aspergillus, Rhizopus, and
enable the virus to evade natural immunity. Mucor.
● Multivalent vaccines are available.
● Zanamivir and oseltamivir are effective drugs
Transes super duper done!!! goodluck!!! fighting!!!
against influenza A virus.
FUNGAL DISEASES OF THE LOWER RESPIRATORY

SYSTEM
● Fungal spores are easily inhaled; they

may germinate in the lower respiratory
tract.
● The incidence of fungal diseases has
been increasing in recent years. The
mycoses in the following sections can be treated “pharmacy is sorcery”
with itraconazole (azole which inhibits conversion
of lanosterol to ergosterol)
HISTOPLASMOSIS
● Histoplasma capsulatum causes a subclinical
respiratory infection that only occasionally
progresses to a severe, generalized disease.
● May be associated with a chronic inflammatory
process known as fibrosing mediastinitis.
● The disease is acquired by inhaling airborne
conidia.
● Isolating or identifying the fungus in tissue samples
is necessary for diagnosis.
● can shift one form to another

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Pharmaceutical Microbiology and Parasitology

● The smallest infectious agents (ranging from

BASIS OF CLASSIFICATION TAXONOMY OF VIRUSES

RNA VIRUSES: (PRayFOR PRC)TBB

1. Adsorption: Once they enter the body they will

STAGES OF VIRAL REPLICATION

adhere only to selected host cells it can infect

different proteins needed by the virus.

● Nonenveloped, heat-stable, solubilization-resistant ● from Latin adenos meaning gland)

● from Latin hepa meaning liver

CLASSIFICATION OF HERPES VIRUS

● HSV-1 and HSV-2 infect epithelial cells and establish

immunocompromised patients. → Vaccinia virus may be the product of

● large brick-shaped or ovoid viruses

pwede rin sila mahawa. B. NON-PARALYTIC POLIOMYELITIS (ASEPTIC

D. PROGRESSIVE POSTPOLIOMYELITIS MUSCLE

Generalized disease of infants

The incubation period of coxsackievirus infection ranges

Aseptic meningitis: (meningitis → inflammation of the lining

Important human pathogens are the: 3. FILOVIRIDAE

● Known as the stomach flu or stomach bug ● Chikungunya

● Minor antigenic changes in HA and NA, termed

Significant influenza virus A in history:

Coronaviruses tend to be highly species specific. Most of the

SIGNS AND SYMPTOMS

Afebrile - wala ng lagnat

1. PRODROMAL PHASE ● This DNA becomes circularized and integrated into

● No treatment for for clinical rabies

Immunoglobulin: Fusion of cell membrane and

Once capsid is released in the cell,

Prophylaxis for opportunistic infection

Common pneumococcal Vaccine:

FUNGAL DISEASES OF THE NERVOUS SYSTEM

PARASITIC DISEASES OF THE NERVOUS SYSTEM

NERVOUS SYSTEM DISEASES CAUSED BY PRIONS

● Degenerative central nervous system diseases —

Bovine Spongiform Encepalopathy is also known as mad

● Opportunistic gram-negative bacteria from the

● (1) Urethritis (inflammation of urethra);

● Neisseria gonorrhoeae causes gonorrhea. SYPHILIS

HERPES SIMPLEX VIRUSES

ACQUIRED IMMUNODEFICIENCY SYNDROME

4) ACUTE DACROCYSTITIS CONJUNCTIVA

Etiological agents: 1) PINK EYE CONJUNCTIVITIS / sore

5) CHRONIC DACRYOCYSTITIS Etiological agent:

● (TF)Trachomatous Inflammation-FOLLICULAR: Etiological agent:

● Trachomatous Trichiasis (TT)

for 12 yrs and older, does not kill

2) BACTERIA KERATITIS - Surgical Treatment:

Etiological agent: UVEITIS

● Sebum - produces oil which moisturizes our skin 4) SEBUM

NORMAL MICROBIOTA OF THE SKIN

● Microorganisms that live on skin are resistant to

● Localized infections (sties, pimples, and boils)

● Carbuncle is a furuncle which extensively damages

● ̈Staphylococci are spherical gram-positive ● Impetigo is a highly contagious skin infection

toxic shock syndrome (TSS). PSEUDOMONAS

VIRAL DISEASE OF THE SKIN ● The species is varicella-zoster, or officially, human