VIROLOGY 4.

Biosynthesis
- Copying/synthesizing of the viral parts that comes
VIROLOGY from the genome of the original virus.
- Study of virus 5. Assembly
- Virus - smallest microorganism/ infectious agent - The viral particle will be arranged or assembled
(size is from 20 NM — 300 NM) 6. Release
General Characteristics: - either by cell lysis or by budding
- obligate intracellular parasites (requiring host cell) - If the virus is has no envelope/no coat (naked virus)
- composed of protein coat that surrounds genetic it is released by cell lysis
material (DNA/RNA) - If the virus has additional covering (enveloped virus)
- no organelles or ribosomes it is released by budding
- Genetic material: either DNA or RNA (only one)
- Family name: ends in Viridae; Virus species: ends in VIRUS PARTICLES
Virus - Complete viral particle is called “virion”. (capsid,
- Dengue virus: Flaviviridae nucleic acid)
- Composed of RNA or DNA (never both)
VIRAL CONSTITUENTS: - Enclosed in protein coat called “capsid”
1. NUCLEIC ACIDS: DNA or RNA - Replicate only in living cells (obligate intracellular)
- Single stranded or double stranded - Can be observed only in electron microscope
- Nucleic Acid of All DNA viruses EXCEPT (Transmission Electron Microscope, Scanning
PARVOVIRUSES (single stranded) is double stranded Electron Microscope)
- Nucleic Acid of All RNA Viruses is single stranded
EXCEPT REOVIRUS (double stranded) THE 21 VIRUS FAMILIES: DNA VIRUSES (HHAPPPPy)
2. CAPSID (protein coat) - Hepadnaviridae
- Protein that surrounds the genetic material - Herpesviridae
- Capsomeres (basic unit) - Adenoviridae
- Functions: protection; aids in introducing viral - Poxviridae
DNA/RNA into suitable host cell; stimulates the - Papovaviridae
immune system to produce antibodies - Parvoviridae
- Polyomaviridae
PROCESS OF VRIAL LIFE CYCLE
1. Attachment THE 21 VIRUS FAMILIES: RNA VIRUSES (PRAyFOR PRC)TB
- The virus will attach itself into the specific receptor - Picornaviridae
- Ex. Dengue virus will only bind into Dendritic Cells - Reoviridae
2. Entry - Astroviridae
- Means of entering of the virus into the human cell - Arenaviridae
- It is the penetration of the virus - Flaviviridae
Three types of viral entry - Filoviridae
- Translocation - Orthomyxoviridae
- Endocytosis - Retroviridae
- Membrane Fusion - Paramyxoviridae
- Uncoating - Rhabdoviridae
o removal of the coat of the certain virus which is - Caliciviridae
the protein coat or the capsid
- Coronaviridae
o Happens after entry
- Togaviridae
3. Replication
- Bunyaviridae
- Goal: Produce a MRNA that is use in transcription
process (protein synthesis)
GENERAL INFORMATION
- Viral particle will transfer the genetic material into
the nucleus of the human cell - Nucleic acid of all DNA viruses are double-stranded
except Parvovirus (smallest - 18-26 nm)
- Largest virus: Poxvirus (230 x 400 nm)
 - While all RNA are single-stranded except Reovirus - Treatment: Surgical Removal, Liquid Nitrogen, Laser
- Most viruses have linear genome except Vaporization, Use of Cytotoxic Agent
Papovavirus which have supercoiled, circular (PodophyllinortrichloroAcetic Acid)
genomes. - Prophylaxis: HPV vaccine
- Most viruses with icosahedral symmetry are naked A.2. Polyomaviridae (tumor)
except toga, herpes, retro and flavi, bunya, hepadna. - BK virus cystitis (inflammation of bladder) in AIDS
(with enveloped) patient
- Enveloped viruses are released by budding - JC virus PML (Progressive Multifocal
- Naked viruses (aka nucleocapsid) are released by Leukoencephalopathy) is an infection of the brain
cell lysis o first isolated in 1971 from the urine of a renal
- Smallest: Parvovirus transplant patient
- Largest: Poxvirus A.3. Vaculating virus (cytoplasmic vacuoles produces by
some of these viruses)
DNA - endemic to monkey
SS Parvoviridae - (SV-40) – simian virus 40 (simian means monkey)
DS Circular Polymaviridae
Naked
DS Circular Papillomaviridae B. Parvoviridae
Icosahedral
DS Adenoviridae - Common in dogs
DS Circular Hepadnaviridae - Simplest & smallest DNA virus, single-stranded DNA
Enveloped
DS Herpes Viridae
virus
Complex
Complex DS Poxviridae Human parvovirus B19
Coats
o Disease: Erythema infectiosum/ Fifth Disease
- "Slapped cheek" appearance in children
RNA - Arthritis in adults
SS Picorna o Transient aplastic anemia in patients w/ sickle cell
SS Astro disease
Naked
Icosahedral SS Calici - Prophylaxis: Parvovirus B19 vaccine
DS Segmented Reo
Enveloped SS Toga C. Adenoviridae
SS Flavi
- most common cause of colds (w/corona, Rhino)
Unknown SS Segmented Arena
Enveloped - flu-like symptoms
or Complex SS Corona
SS Diploid Retro - Respiratory tract infection (acute respiratory
SS Segmented Ortomyxo disease)
SS Segmented Bunya - Gastroenteritis
SS Borna - conjunctivitis (pink eye)
Helical Enveloped
SS Rhabdo
SS Paramyxo MEDICALLY IMPORTANT DNA VIRUSES
SS Filo
II. Enveloped DNA viruses: HepHeP

MEDICALLY IMPORTANT DNA VIRUSES

I. Naked DNA Viruses: PAPA

A. Papoviridae  anthropod borne (transmitted by an
insect or by an anthropod)
A.1. Papilomavirus (causative agent of warts)
- cutaneous warts common (hands)
- plantar (feet)
- flat (face) congenital warts/ condyloma acuminate
- HPV (human papiloma virus) 16 & 18 risk of cervical
cancer (most common std)
A. Hepadnaviridae
- most of them are considered as RNA virus (Hepatitis
A, C, D, E, & G)
- Hepatitis B – only DNA virus
- Fecal oral – hepatitis can be acquired through eating
contaminated food
- Severe hepatitis is caused by Hepatitis B.
- Primary organ affected by hepatitis is liver.
- You will not acquire Hepatitis D if in the first place
you don’t have Hepatitis B, because Hepatitis D is an
incomplete RNA virus.
- Hepatitis is associated with yellowish skin because of
the deposition of bilirubin.
B.3. Gamma herpes (lymph proliferation group)
B.3.1. Epstein-Barr virus (EBV)
- infectious mononucleosis/ kissing disease
o young adults
o classic clinical triad: Fever, Pharingitis,
Lymphadenopathy
- Burkitt's lymphoma (cancer of the lymphatic system)
B.3.2. HHV-8
- One of the most common causes of Kaposis
sarcosoma (cancer of the lining of blood and lymph
vessels) specifically in AIDS patients, and it can cause
tumour lesions on skin

B. Herpesviridae medium size virus C. Poxviridae very large, complex, brick-shaped

B.1 Alpha herpes (herpes simplex group) C.1. Variola Virus: Smallpox 1st disease to be declared
B.1.1. HSV-1 & HSV-2 (Herpes simplex virus eradicated
- HSV-1: lesions of upper body Herpes labialis/ cold C.2. Vaccinia virus: cow pox from earth vaccine for small
sore/ Fever blister (saliva) pox
- HSV-2: lesions of lower body Genital Herpes (sexual)
o Tx. Acyclovir (DOC) RNA VIRUS
- Herpes simplex virus can caused Herpetic Simplex Positive – Stranded Negative - Stranded
Keratitis that is a form of keratitis caused by RNA can act as mRNA Needed to be converted
recurrent HSV infection in the cornea. (transcription) into positive strand
B.1.2. Varicella-zoster virus (VZV) Picorna Rhabdo
- Incubation period: 2 weeks Corona Paramyxo
- Primary Infection: Varicella/ Chickenpox (common Toga Ortho
in children) Calici Bunya
o Exanthema (rash + fever) fluid-filled blister Flavi Arena
(virus-containing) Retro Filo
- Reactivation: Herpes Zoster / Shingles (common in
adults, wherein it is more severe that chickenpox) I. POSITIVE STRANDED RNA VIRUSES
clustered dermatomal surrounding a single A. Picornaviridae
o Shingles can caused infertility. Can affect the A.1. Enteroviruses transmitted via fecal – route
fertility of the male patient. A.1.1 Poliovirus → attacks the peyer patches in our small
o Spinal nerve Neuralgia intestine
o Treatment: Famciclovir, Valacyclovir - Poliomyelitis attacks lower motor neurons of spinal
- Varicella: chicken pox cord
- Zoster: shingles - Flaccid, asymmetrical paralysis Respiratory paralysis
(most common death)
B.2. Beta herpes (cytomegalovirus group) - Prevention: Jonas Salk killed virus, IM; Albert Sabin
B.2.1. Human Cytomegalovirus / CMV live attended virus (oral)
- Giant, multinucleated host cell
- Retinitis & Pneumonia in Immunocompromised MEDICALLY IMPORTANT RNA VIRUSES
- Mononucleosis syndrome A.1.2. COXSACKIE VIRUS – causes aseptic meningitis
- Fever, muscle pain, Lymphadenopathy (fever, headache, malaise)
- Most common cause of inflammation - Type A – herpangina is characterized by muscle
B.2.2. HHV-6 & HHV-7 (Human Herpes Virus) weakness), hand-foot and mouth disease is
- Roseola infantum/ Exanthem subitum/ sixth disease characterized by oral and pharyngeal ulcerations
o High fever and rashes in infants (skin and mucous membrane)
o Rashes occur when temperature returns to
normal.
 - Type B – pleurodynia/ epidemic myalgia that is is
characterized by fever/stabbing chest pain,
myocarditis, pericarditis (heart, pancrea, liver)
I. POSITIVE STRANDED RNA VIRUSES
A.1.3. Echovirus
- Enteric cytopathic human orphan virus
- cytopathogenic viruses that mainly infect the
Intestinal tract
- Rhinovirus – common cause of colds
- Hepatovirus: common cause of Hep A
B. Togaviridae
B.1. Alpha viruses arthropod - borne (Arboviruses)
B.1.1 Eastern equine encephalitis virus
B.1.2 Western equine encephalitis virus
B.1.3. Venezuela equine encephalitis virus
B.1.4.Chikungunya equine encephalitis virus – common
in horse and humans that is associated with fever and
joint pain (similar to Dengue)
- Equine means horse because most of the alpha
viruses cause encephalitis in horse.
- Encephalitis – inflammation in brain
B.2. Rubiviruses
B.2.1. Rubella virus
- 3 days measle
- Rubella/German measles
- generalized maculopopular rash
C. Flaviviridae
- most are Arbovirus
C.1. Yellow Fever virus – yellowish discoloration of the
skin that is caused by the deposition of bilirubin.
C.2. St. Louis encephalitis
- Japanese encephalitis
- Russian encephalitis
C.3. Dengue virus (breakbone fever)
- Aedes aegypti mosquito (day biter)
- Dengue hemorrhagic fever (peetechiae)
- 4 o’clock habit (stop, look, listen)
C.4. Hepatitis C virus
C.5. Zika Virus
- Similar symptoms with dengue the only difference is
the conjunctivitis
- Transmitted by Aedes aegypti
D. Caliciviridae
D.1. Norwalk virus epidemic acute gastroenteritis (most
common cause of diarrhea in adults). It attacks the
stomach and it is also known as Norovirus
D.2. Hepatiits E virus
E. Coronaviridae (SARS, MERSCOV, SARSCOV 2)
- Posses distinctive arrangements of spikes
(peplomers) on the viral surface
- crown-like (sars - severe acute resp.syndrome -
2000)
- common cold syndrome (manifestation)
- SARSCOV-2 VIRUS - causes coronavirus disease 2019
first detected in Wuhan, China in 2019.
o Cough, fever, headache, difficulty breathing,
aches, sweats and chills.
- Natural reservoir are bats
- MERSCOV – Middle East Respiratory Syndrome
Coronavirus
F. Retroviridae
- possess reverse transcriptase (RNA-dependent DNA
polymerase)
- It has the capability to be converted to DNA
F.1. Human Immunodeficiency virus (HIV)
- leads to AIDS (Acquired immunodeficiency
syndrome)
- virus attack CD4+ T-helper
- Treatment: HAART (Highly Active Antiretroviral
Therapy)
- ELISA enzyme-linked immunosorbent assay is used
to detect HIV (gold standard to identify HIV)
- Western blot technique a confirmatory test for HIV
- Southern Blot technique used to identify unknown
microorganism by using Nucleic Acid Hybridization
II. Negative Stranded RNS viruses
A. Rhabdoviridae
- bullet - shaped viruses with a spiked envelope
A.1. Rabies virus saliva of infected animals (bites/
scratches) hydrophobia, excessive saliva, hyperacidity
- Histopathological Finding: Negribodies dark part/
area
A.2. Vesiculovirus → vesicular stomatitis virus
- virus of horses, cattle
- Stomatitis → sore or inflammation inside the mouth
Rhabdoviridae
- Rabies virus, genus lyssavirus
- Acute infection of CNS causing nervous system
dysfunction
- Rabies spread by animal bite (bat, fox, cat, skunk,
dog)
o The farther away from brain, the longer virus
takes to spread.
 - It produces a specific eosinophilic cytoplasmic
inclusion, negri bodies → nucleocapsid
- Spreads through peripheral nerves to the salivary
and other tissues.
- Incubation period: 1-2 months up to 19 years
- Death caused by respiratory paralysis
THREE STAGES OF RABIES
Short Malaise (muscle weakness), Anorexia,
Prodromal fever, Photophobia, Sore throat, Nausea
Phase and Vomiting
Nervous system dysfunction,
nervousness, apprehensions and
Acute
Neurologic
hallucination
- sympathetic overactivity (inc.
Phase
salivation and perspiration)
- hydrophobia (fear of water)
Coma Respiratory paralysis and death
How the virus spreads?
1. Virus enters tissue from saliva of biting animal
2. Virus replicates in muscle near bite
3. Virus moves up peripheral nervous system to CNS
4. Virus ascends spinal cord
5. Virus reaches brain and causes fatal encephalitis
6. Virus enters salivary glands and other organs of
victim
- If bitten by a possibly rabid animal: capture the
animal and observe for 10 days; destroy animal and
examine brain negri bodies (+); treat immediately
II. NEGATIVE STRANDED RNA VIRUSES
B. Filoviridae
- Marburg virus - 88% fatality. It is associated with
prolonged exposure to mines or caves inhabited by
Rousettus bat colonies. Originated from west Africa
- Ebola virus severe hemorrhagic fever, that
originated from west africa (bats)
o both of them cause severe hemorrhagic fever
- Good prevention: Practice good hygiene, avoid
contact with infected person and avoid touching
animals and don’t touch body fluids.
C. Orthomyxoviridae
- Influenza virus — “Uncomplicated influenza that is
characterized by flu-like symptoms
- Pneumonia
- Reyes Syndrome: swelling in the liver / brain
INFLUENZA VIRUS
- Enveloped virus contains Hemagglutinin(ha) and
neuraminidase(na), that are consider as protein
present in influenza virus.
- 15 ha subtypes and 9 NA subtypes found in birds
- H1,H2,H3, H5, N1 N2- recovered from humans
- H1,H3- swine  intermediate host of influenza
- H5N1- first documented infection of humans by
avian influenza a virus
Types of Influenza
- Influenza Type A – human and animal strain, and it
can cause massive epidemic and pandemic
- Influenza Type B – found in human strain
- Influenza Type C – found in human and swine
- Why there is H1N1(1918), H5N1(2003)? Because of
the antigenic mutation
o Antigenic Drift – minor change within the
subtype that results to new antigenic structure
that may cause epidemic (A,B,C)
o Antigenic Shift – major change within the
subtype that results to totally that results in
pandemic. (A)
D. Paramyxoviridae
D.1. Parainfluenza virus - influenza-like manifestation
- lower & upper respiratory tract infection
- common cold
- Respiratory synctial virus (RSV)  associated with
infants less than 6 months (pneumonia)
D.2. Mumps virus
- mumps’ infections parotitis
- parotid salivary gland
- Complications: Orchitis AKA inflammation of testes
D.3. Rubeola virus
- Hard measles
o Maculopapular rash, Kopliks spots (Oral lesions
w/ bluish white center & red margin that usually
appears 2-3 days before rashes.
o Common symptom: Coryza (inflammation of the
mucous membrane of the nose), cough,
conjunctivitis
E. Arenaviridae
- causes Lassa Fever infecting bush rats in western
Africa
o DOC: Rivabirin
o bush rats aka Mastomys Rats
o can affect the Liver, Kidney, Spleen
o Transmitted by handling rats
OTHER RNA VIRUS HUMAN CANCER VIRUSES
Reoviridae
- Rotavirus – most common cause of severe diarrhea
in infants and children; known for stomach flu

PACOP BREAK
Club shaped surface projection
Corona Virus
causing common colds
A purine nucleoside analog used in
Ribavirin
Lassa fever
A virus mainly infects intestinal
Echo Virus tract. Enteric cytopathogenic
human orphan virus - Sarcoma – malignant tumor in mesodermal tissue
Coryza, Mouth symptoms of measles - Lymphoma – malignant tumor of lymphoid tissue
Koplik’s Spot - Carcinoma – malignant tumor of epithelial cell
A virus resulting to premature labor
Measle REVIEW
and spontaneous abortion
VZV, Influenza, Viruses with outer envelope of Poxviridae Largest virus
HIV lipoprotein Parvoviridae Smallest virus
Viruses with enveloped RNA. Each Parvoviridae Single stranded DNA virus
Measles or Reoviridae Double stranded RNA virus
has single antigenic type that is
Rubella
transmitted by respiratory aerosols. Capsid The protein coat of a virus
Viruses with enveloped RNA. Virions Togaviridae, Examples of arbovirus
Influenza & containing RNA polymerase. Bunyaviridae
Rabies Vaccines containing killed Papovaviridae A virus with circular DNA
microorganism. Budding Enveloped virus are released via
Non-enveloped RNA. Has multiple Negri bodies Viral nucleocapsid of rabies virus
Polio virus and
antigenic type. Does not integrate Alpha Treatment for hepatitis.
Rhino virus
their genome into DNA host cell. interferon
Adenoviridae Childhood URTI Face HSV 1 can be seen in
Arbovirus Other vector-borne viral disease Shingles Aka zoster
(arthropod Epstein-Barr A virus causing burkitt's lymphoma
borne viruses) virus
Colorado tick fever caused by Hep D requires hep ____ to be
Hepatitis B
coltivirus pathogenic
Reoviridae Take note: Colorado tick fever can Hepadnaviridae Family of hep B virus
cause mild febrile disease without
rash and myalgia reverse Enzyme present in retroviridae
Togaviridae Chikunguya (fever and joint pain) transcriptase converting RNA To DNA
Sandfly fever (3 day fever or kaposi's sarcoma HSV 8 can cause
Bunyaviridae pappataci fever  influenza like Vector for dengue and yellow
symptoms) caused by phlebovirus aedes aegypti
fever
Diarrhea outbreak and koplik spot The common sign of measle.
Atrovirus
gastroenteritis in children Togaviridae Rubella is under what family?
Influenza virus is under what
orthomyxoviridaea
family?
Target of polio virus in the
Peyer’s patches
intestine
Stomach Norwalk virus affects
Marburg and ebola is under
filoviridae
what family?
 Chikungunya is under what MUCOUS MEMBRANE A.K.A. MUCOSA
Togaviridae
family? - Lines the body cavities that open to the exterior, i.e.
A family of virus causing lassa gastrointestinal, respiratory, urinary, and genital
Arenrscviridae
fever tracts
Respiratory RSV means? - Consists of sheets of tightly packed epithelial cells
syncytial virus attached at their bases to a layer of extracellular
Papillomavirus HPV is under what family? material called basement membrane
Coronavirus A virus causing SARS. - Many secretes mucus
CD4 cells Type of cell lowered in HIV. - Other mucosal cells have cilia, i.e. respiratory system
- Often acidic
- Membranes of the eyes are mechanically washed by
MICROBIAL DISEASE OF THE SKIN AND EYES tears, and the lysozymes in tears destroys the cell
walls of certain bacteria
Structure and Function of the Skin
- The skin is a physical barrier against microorganisms. NORMAL MICROBIOTA OF THE SKIN
- Moist areas of the skin support larger populations of
bacteria than dry areas. - Microorganisms that live on skin are resistant to
desiccation and high concentrations of salt.
1. Epidermis - Gram-positive cocci predominate on the skin.
2. Dermis - Washing does not completely remove the normal
- Components: Keratin, Sebum, Perspiration skin microbiota.
- Members of the genus Cutibacterium metabolize oil
EPIDERMIS from the oil glands and colonize hair follicles.
- The outer portion of the skin - Malassezia furfur yeast grows on oily secretions and
- Composed of several layer of epithelial cells may be the cause of dandruff.
- The outermost layer, the stratum corneum, consists - The majority (90%) of skin microbiota consist of
of many rows of dead cells that contains a coagulase-negative Staphylococcus epidermidis.
waterproofing protein called keratin
- Effective physical barrier against microorganisms. MICROBIAL DISEASES OF THE SKIN

DERMIS Different Terms for Rashes and Lesions

- The inner, relatively thick portion of skin
- Composed mainly of connective tissue
- The hair follicles, sweat gland ducts, and oil gland
ducts in the dermis provide passageways through
which microorganisms can enter the skin and
penetrate deeper tissues.
PERSPIRATION
- Provides moisture and some nutrients for microbial
growth
- Also contains salt which inhibits many
microorganisms
- Contains the enzyme lysozyme, which is capable of
breaking down the cell walls of certain bacteria; and
antimicrobial peptides.
- Vesicles are small fluid-filled lesions
- Bullae are vesicles larger than 1 cm
- Macules are flat, reddened lesions
- Papules are raised lesions
- Pustules are raised lesions containing pus
BACTERIAL DISEASES OF THE SKIN
STAPHYLOCOCCUS
Staphylococci are spherical gram-positive
bacteria that form irregular grape-like clusters. Divided
into those that produce coagulase, and those that do not
- Coagulase-positive: S. aureus
- Coagulase-negative: S. epidermidis

SEBUM Staphylococcus epidermidis

- Secreted by oil glands
- A mixture of lipids (unsaturated fatty acids),
proteins, and salts
- Prevents skin and hair from drying out
- Coagulase-negative
- Very common on the skin
- Generally pathogenic only when the skin barrier is
broken or is invaded by medical procedures, e.g.
insertion and removal of catheters into veins
Staphylococcus aureus
- Resident microbiota of the nasal passage
- Forms golden-yellow colonies
- Almost all pathogenic strains of S. aureus produce
coagulase
- Some strains have impressive array of virulence
factors and means of evading host defenses
- Localized infections (sties, pimples, and boils) result
from entry of S. aureus through openings in the skin.
- Carbuncle is a furuncle which extensively damages
neighboring tissues
o Produce a hard, round deep inflammation of
tissue under the skin
o Patient can exhibit general illness with fever
- Impetigo is highly contagious skin infection caused
by Staphylococci. Characterized by isolated yellow
pustules that become crusted.
- Toxemia occurs when toxins enter the bloodstream;
staphylococcal toxemias include scalded skin
syndrome and toxic shock syndrome.
S. aureus produces exfoliative toxins:
- Exfoliatin A – causes localized, bullous impetigo
- Exfoliatin B – causes the systemic infection of
scalded skin syndrome
Scalded skin syndrome is also characteristic of the late
stages of toxic shock syndrome (TSS).
- Potential life-threatening condition, fever, vomiting,
and a sunburn-like rash
- Followed by shock and sometimes organ failure
(especially kidney failure)
- Caused by a staphylococcal toxin called TSST-1
STREPTOCOCCUS
- Streptococci are gram-positive spherical bacteria
usually grows in chains.
o Prior to division, the individual cocci elongate on
the axis of the chain, and then the cells divide.
- Cause a wide range of disease conditions including
meningitis, pneumonia, sore throat, otitis media,
endocarditis, puerperal fever, and even dental
caries.
- Streptococci are classified according to their
hemolytic enzymes (hemolysin) and cell wall
antigens.
- Hemolytic activity: Alpha, beta, gamma
- Cell wall antigen: Group A to t
Streptococcus pyogenes
- Group A beta-hemolytic streptococci (GAS) produce
a number of virulence factors: M protein,
deoxyribonuclease, streptokinases, and
hyaluronidase.
- Cause severe and rapid tissue destruction.
Erysipelas
- Skin erupts into reddish patches with raised margins
- Can progress to local tissue destruction and even
enter the bloodstream causing sepsis
- Usually appears first on the face
- High fever is common
Necrotizing fasciitis
- Invasive group A streptococcal infection that
destroys tissue and initially resembles TSS
- “Flesh-eating bacteria”
- Causes by pyrogenic toxins, streptococcal M-protein
types (act as superantigens)
- Associated with streptococcal TSS
PSEUDOMONAS
Pseudomonas aeruginosa
- Aerobic gram-negative rod
- Resistant to many antibiotic and disinfectant
- Can survive in any moist environment, traces of
unusual organic matter such as soap films, cap liner
adhesives
- Diseases caused by P. aeruginosa include otitis
externa, respiratory infections, burn infections, and
dermatitis
- Produces an endotoxin and several exotoxins
OTHER BACTERIA
Mycobacterium ulcerans
- Causes deep-tissue ulceration or Buruli ulcer
Cutibacterium acnes
- Formerly known as Propionibacterium acnes
- Its metabolic products (fatty acids) cause
inflammatory acne
- Comedonal (mild) acne
- Inflammatory (moderate) acne
- Nodular cystic (severe) acne
VIRAL DISEASES OF THE SKIN
WARTS
- Papillomaviruses cause skin cells to proliferate and
produce a benign growth called a wart or papilloma.
- Warts are transmitted from one person to another
by direct contact, even sexually.
- After infection, there is an incubation period of
several weeks before the warts appear.
- Warts may regress spontaneously or be removed
chemically or physically.
- Nonpharmacologic Treatment
o Cryotherapy
o Electrodessication
o Acid treatment
o Laser
- Pharmacologic Treatment
o Salicylic acid
o Podofilox
o Imiquimod
o Bleomycin
VARIOLA
- Variola, also known as smallpox, is caused by an
orthopoxvirus known as smallpox (variola) virus.
- Variola virus causes two types of skin infections:
variola major and variola minor.
- 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 becomes pustular after 10
days or so.
- Smallpox has been eradicated as a result of a
vaccination effort by the World Health Organization.
VARICELLA-ZOSTER
- Chickenpox (varicella) is a relatively mild disease
when contracted, as it usually is, in childhood.
- It is the initial infection of a herpesvirus
Varicellovirus.
- 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.
- The infected skin is vesicular for 3 to 4 days.
- Complications of chickenpox include encephalitis
and Reye’s syndrome.
Shingles
- Characterized by a vesicular rash along the affected
cutaneous sensory nerves. After chickenpox, the
virus can remain latent in nerve cells and
subsequently activate as shingles.
- Treatment: HHV-3 can be treated with acyclovir. An
attenuated live vaccine is available.
HERPES SIMPLEX
- Herpes simplex viruses (HSV) can be separated into
two identifiable groups:
- HSV-1 (or human herpesvirus 1)
- HSV-2 (or human herpesvirus 2)
- HSV-1 is transmitted primarily by skin contact, oral
and respiratory routes.
- The virus remains latent in nerve cells, and cold sores
can recur when the virus is activated.
Cold sores
- Herpes simplex (HSV-1) infection of mucosal cells
- Painful, short-lived vesicles that occur near the outer
red margin of the lips
Herpes encephalitis
- occurs when herpes simplex viruses (HSV-1 and HSV-
2) infect the brain.
- Treatment: Acyclovir has proven successful in
treating herpes encephalitis.
MEASLES
Measles (Rubeola)
- Caused by measles virus
- An extremely contagious viral disease transmitted by
the respiratory route
- Vaccination (MMR vaccine) against measles provides
effective long-term immunity
- After the measles virus has incubated (10-12 days) in
the upper respiratory tract, the following signs and
symptoms appear.
- Symptoms (like fever) similar to common cold.
- Macular lesions appear on the skin.
- Koplik’s spots appear on the oral mucosa.
- Complications of measles include middle ear
infections, pneumonia, encephalitis, and secondary
bacterial infections.
RUBELLA
Rubella (German measles)
- The rubella virus is transmitted by the respiratory
route and causes a red rash and light fever.
- Congenital rubella syndrome can affect a fetus when
a woman contracts rubella during the first trimester
of her pregnancy.
- Vaccination with live, attenuated rubella virus CUTANEOUS FUNGAL INFECTION
provides immunity of unknown duration. Dermatophytoses
- Caused by fungi (Microsporum, Trichophyton, and
OTHER VIRAL DISEASES Epidermophyton) that colonize the outer layer of the
Fifth disease epidermis cause dermatomycoses
- Also known as erythema infectiosum - Also known as ringworm, or tinea
- Causes by human parvovirus B19 - These fungi grow on keratin-containing epidermis,
- Characterized by symptoms similar to mild influenza such as hair, skin, and nails
and a slapped-cheek facial rash that slowly fades
Roseola
- Mild, very common childhood disease caused by
HHV-6 and HHV-7
Hand-foot-and-mouth disease
- An infection in young children in day care, preschool,
and kindergarten
- Caused by several enteroviruses
- Spread by contact with mucous or saliva of an
infected person
- Characterized by sore throat, then rashes appearing
on hands, feet, mouth, tongue, and interior cheeks

FUNGAL DISEASES OF THE SKIN AND NAILS

FUNGAL INFECTION
Fungal infections or mycoses cause a wide range of - Diagnosis is based on the microscopic examination of
diseases in humans. skin scrapings or fungal culture
1. Superficial Infection
2. Cutaneous Infection SUBCUTANEOUS FUNGAL INFECTION
3. Subcutaneous Infection Sporotrichosis
4. Deep mycosis - Results from a soil fungus (Sporothrix schenckii) that
penetrates the skin through a wound
SUPERFICIAL FUNGAL INFECTION - Common among gardeners or people working with
Pityriasis versicolor soil
- Common superficial mycosis, which is characterized Chromoblastomycosis
by hypopigmentation or hyperpigmentation of skin - Subcutaneous mycosis characterized by verrucoid
of the neck, shoulders, chest, and back lesions of the skin
- Due to Malassezia furfur which involves only the - Most common causes are:
superficial keratin layer - Fonsecaea pedrosoi (Pedroso’s disease)
Black Piedra - Fonsecaea compacta (Fonseca’s disease)
- A superficial mycosis due to Piedraia hortae which is - Cladosporium carionii (Cladosporiosis)
manifested by a small firm black nodule involving the - Phialophora verrucosa
hair shaft Madura foot (mycetoma)
White Piedra - Chronic infection of the skin and underlying tissues
- Due to Trichosporon beigelii is characterized by a by both bacteria (actinomycetoma) and fungi
soft, friable, beige nodule of the distal ends of hair (eumycetoma).
shafts - Suppurative and granulomatous subcutaneous
Tinea Nigra mycosis
- Most typically presents as a brown to black silver - Occur most often in farmers, hunter-gatherers, and
nitrate-like stain on the palm of the hand or sole of field laborer
the foot and and is caused by Phaeoannellomyces
werneckii
 PARASITIC INFESTATION OF THE SKIN
Scabies
- Involves intense local itching
- Caused by a tiny mite Sarcoptes scabiei burrowing
and laying eggs in the skin
- 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
- Lice are easily transferred by head-to-head contact
MICROBIAL DISEASE OF THE EYES
STRUCTURE OF THE EYES
Conjunctiva
- The mucous membrane, made of epithelial cells,
lining the eyelid and covering the eyeball
- A transparent layer of living cells replacing the skin
Conjunctivitis
- Inflammation of the eye membranes (conjunctiva)
- Conjunctivitis is caused by several bacteria and can
be transmitted by improperly disinfected contact
lenses
Cornea
- The transparent convex portion of the anterior eye.
Keratitis
- Inflammation of the cornea
- Main symptoms: red eyes, profuse tearing,
photophobia, corneal clouding, intense pain
BACTERIAL INFECTION
- Bacterial microbiota of the eye usually originate from
the skin and upper respiratory tract.
Ophthalmia neonatorum
- Caused by the transmission of Neisseria gonorrheae
from an infected mother to an infant during its
passage through the birth canal.
- Causes suppurative conjunctivitis that results to
corneal ulceration (may also lead to blindness) if not
treated.
- Treatment: Silver nitrate solution (1%),
Erythromycin, Dilute povidone-iodine solution
Inclusion conjunctivitis
- An infection caused by Chlamydia trachomatis to
the conjunctiva
- Transmitted to infants during birth and is
transmitted in unchlorinated swimming water
- Resolve spontaneously in a few weeks or months,
but in rare cases it can lead to scarring of the cornea
- Treatment: Tetracycline ophthalmic ointment
Trachoma
- A serious eye infection, one of the major cause of
preventable blindness
- Caused by a certain serotype of C. trachomatis
- Conjunctivitis transmitted by hands, fomites, and
perhaps flies
- Repeated infections cause inflammation leading to
trichiasis.
- Can be corrected surgically.
- Secondary infections by other bacterial pathogens
are also a factor in the disease.
- Treatment: Oral azithromycin, Improve sanitary
practices and health education
FUNGAL INFECTION
- Fusarium, Candida, and Aspergillus fungi can infect
the eye especially in Africa and Asia.
VIRAL INFECTION
Herpetic keratitis
- Caused by the same herpes simplex type 1 virus
(HSV-1) that causes cold sore and trigeminal
neuralgia
- An infection of the cornea, causes deep ulcers
- One of the cause of infectious blindness
PARASITIC INFECTION
Acanthamoeba keratitis
- Painful corneal infection caused by Acanthamoeba
protozoa
- Can cause a serious form of keratitis as to require a
corneal transplant or even removal of the eye
- Can be transmitted via water
- Contributing factors include inadequate disinfecting
procedures of contact lenses
- Using homemade saline solutions
- Wearing contact lenses overnight
- Wearing contact lenses while swimming
- Diagnosis is confirmed by the presence of
trophozoites and cysts in stained scrapings if the
cornea
- Treatment: Chlorhexidine 2% solution, Propamidine
isethionate eye drops, Topical neomycin
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.
- Pathogens that enter the respiratory system can
infect other parts of the body.
The Upper Respiratory System
- The upper respiratory system consists of the nose,
pharynx, and associated structures, such as the
middle ear and auditory tubes.
- Coarse hairs in the nose filter large particles from air
entering the respiratory tract.
- The ciliated mucous membranes of the nose and
throat trap airborne particles and remove them from
the body.
- Lymphoid tissue, tonsils, and adenoids provide
immunity to certain infections.
- The lower respiratory system consists of the larynx,
trachea, bronchial tubes, and alveoli.
- The ciliary escalator of the lower respiratory system
helps prevent microorganisms from reaching the
lungs.
- Microbes in the lungs can be phagocytized by
alveolar macrophages.
- Respiratory mucus contains IgA antibodies.
- The normal microbiota of the nasal cavity and throat
can include pathogenic microorganisms.
MICROBIAL DISEASE of the upper respiratory system
- Specific areas of the upper respiratory system can
become infected to produce pharyngitis, laryngitis,
tonsillitis, sinusitis, and epiglottitis.
- These infections may be caused by several bacteria
and viruses, often in combination.
- Most respiratory tract infections are self-limiting.
- H. influenzae type b can cause epiglottitis.
BACTERIAL DISEASES of the Upper Respiratory System
Streptococcal Pharyngitis
- This infection is caused by group A beta-hemolytic
streptococci, the group that consists of
Streptococcus pyogenes.
- Symptoms of this infection are inflammation of the
mucous membrane and fever; tonsillitis and otitis
media may also occur.
- Rapid diagnosis is made by enzyme immunoassays.
- Immunity to streptococcal infections is type-specific
Scarlet Fever
- Strep throat, caused by an erythrogenic toxin-
producing S. pyogenes, results in scarlet fever.
- S. pyogenes produces erythrogenic toxin when
lysogenized by a phage.
- Symptoms include a red rash, high fever, and a red,
enlarged tongue.
Diphtheria
- Diphtheria is caused by exotoxin-producing
Corynebacterium diphtheriae.
- Exotoxin is produced when the bacteria are
lysogenized by a phage.
- 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
bacteria and the appearance of growth on
differential media.
- Routine immunization in the United States includes
diphtheria toxoid in the DTaP vaccine.
- Slow-healing skin ulcerations are characteristic of
cutaneous diphtheria.
- There is minimal dissemination of the exotoxin in the
bloodstream.
Otitis Media
- Earache, or otitis media, can occur as a complication
of nose and throat infections.
- Pus accumulation causes pressure on the eardrum.
- Bacterial causes include Streptococcus pneumoniae,
non- encapsulated Haemophilus influenzae,
Moraxella catarrhalis, and Streptococcus pyogenes.
VIRAL DISEASES of the Upper Respiratory System
The Common
- Any one of approximately 200 different viruses,
including rhinoviruses, coronaviruses, and EV-D68,
can cause the common cold.
- The incidence of colds increases during cold weather,
possibly because of increased interpersonal indoor
contact or physiological changes.
MICROBIAL DISEASE of the lower respiratory system
- Many of the same microorganisms that infect the
upper respiratory system also infect the lower
respiratory system.
- Diseases of the lower respiratory system include
bronchitis and pneumonia.
BACTERIAL DISEASE of the lower respiratory system
Pertussis
- Pertussis is caused by Bordetella pertussis.
- 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.
Tuberculosis
- Tuberculosis is caused by Mycobacterium
tuberculosis.
- Mycobacterium bovis causes bovine tuberculosis
and can be transmitted to humans by unpasteurized
milk.
- M. avium-intracellulare complex infects patients in
the late stages of HIV infection.
- M. tuberculosis may be ingested by alveolar
macrophages; if not killed, the bacteria reproduce in
the macrophages.
- Lesions formed by M. tuberculosis are called
tubercles; macrophages and bacteria form the
caseous lesion that might calcify and appear in an X-
ray image as a Ghon’s complex.
- Liquefaction of the caseous lesion results in a
tuberculous cavity in which M. tuberculosis can
grow.
- New foci of infection can develop when a caseous
lesion ruptures and releases bacteria into blood or
lymph vessels; this is called miliary tuberculosis.
- A positive tuberculin skin test can indicate either an
active case of TB, prior infection, or vaccination and
immunity to the disease.
- Active infections can be diagnosed by detection of
IFN-γ or rapid PCR test for M. tuberculosis.
- Chemotherapy usually involves three or four drugs
taken for at least 6 months; multidrug-resistant M.
tuberculosis is becoming prevalent.
- BCG vaccine for tuberculosis consists of a live,
avirulent culture of M. bovis.
Bacterial Pneumonias
- Typical pneumonia is caused by S. pneumoniae.
- Atypical pneumonias are caused by other
microorganisms.
- Pneumococcal pneumonia is caused by encapsulated
Streptococcus pneumoniae.
- Children under 5 and adults over 65 are most
susceptible to H. influenzae pneumonia.
- Mycoplasma pneumoniae causes mycoplasmal
pneumonia; it is an endemic disease.
- Legionellosis is caused by the aerobic gram-negative
rod Legionella pneumophila.
- Chlamydophila psittaci, the bacterium that causes
psittacosis (ornithosis), is transmitted by contact
with contaminated droppings and exudates of fowl.
- Chlamydophila pneumoniae causes pneumonia; it is
transmitted from person to person.
- Obligately parasitic, intracellular Coxiella burnetii
causes Q fever.
Melioidosis
- Melioidosis, caused by Burkholderia pseudomallei, is
transmitted by inhalation, ingestion, or through
puncture wounds.
- Symptoms include pneumonia, sepsis, and
encephalitis
VIRAL DISEASE of the lower respiratory system
Viral Pneumonia
- A number of viruses can cause pneumonia as a
complication of infections such as influenza.
- The etiologies are not usually identified in a clinical
laboratory because of the difficulty in isolating and
identifying viruses.
Respiratory Syncytial Virus (RSV)
- RSV is the most common cause of pneumonia in
infants.
Influenza (Flu)
- Influenza is caused by Influenzavirus and is
characterized by chills, fever, headache, and general
muscular aches.
- Hemagglutinin (HA) and neuraminidase (NA) spikes
project from the outer lipid bilayer of the virus.
- Viral strains are identified by antigenic differences in
their protein coats (A, B, and C); influenza A is further
subdivided by differences in the HA and NA spikes
- Antigenic shifts and antigenic drift enable the virus
to evade natural immunity.
- Multivalent vaccines are available
- Zanamivir and oseltamivir are effective drugs against
influenza A virus.
FUNGAL DISEASE 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. 3. The mycoses in the following
sections can be treated with itraconazole.
Histoplasmosis
- Histoplasma capsulatum causes a subclinical
respiratory infection that only occasionally
progresses to a severe, generalized disease.
- The disease is acquired by inhaling airborne conidia.
- Isolating or identifying the fungus in tissue samples
is necessary for diagnosis.
Coccidioidomycosis
- Inhaling the airborne arthroconidia of Coccidioides
immitis can result in coccidioidomycosis.
Pneumocystis Pneumonia
- Pneumocystis jirovecii is found in healthy human
lungs.
- P. jirovecii causes disease in immunosuppressed
patients.
Blastomycosis
- Blastomycosis Also known as North American
Blastomycosis
- Blastomyces dermatitidis is the causative agent of
blastomycosis
- The infection begins in the lungs and can spread to
cause extensive abscesses
OTHER FUNGI INVOLVED IN RESPIRATORY DISEASE
- Opportunistic fungi can cause respiratory disease in
immunosuppressed hosts, especially when large
numbers of spores are inhaled.
- Among these fungi are Aspergillus, Rhizopus, and
Mucor
MICROBIAL DISEASE OF THE DIGESTIVE SYSTEM
Anatomy and Normal Microbiota of the Digestive
System
- The digestive tract, consisting of the oral cavity,
pharynx, esophagus, stomach, small intestine, and
large intestine, has a normal microbiota that is
important for health.
- The constant movement of materials through the
gastrointestinal canal, the protective layer of mucus,
the normal microbiota, and the harsh chemical
environment in the stomach and small intestine help
to prevent colonization by pathogens.
- Infections or microbial toxins in the oral cavity can
cause tooth decay, periodontal disease, and various
types of ulcers.
- Infections and intoxications of the gastrointestinal
tract can cause general symptoms such as nausea,
vomiting, diarrhea, and fever. Localized
inflammation of the GI tract can result in gastritis,
enteritis, gastroenteritis, hepatitis, or colitis, and
damage to epithelial cells of the colon can lead to
dysentery.
- Foodborne illness refers to infections or
intoxications that originate with pathogens or toxins
ingested in contaminated food or water.
MICROBIAL DISEASES OF THE MOUTH AND ORAL
CAVITY
Dental caries
- Dental caries, tartar, and gingivitis are caused by
overgrowth of oral bacteria, usually Streptococcus
and Actinomyces species, as a result of insufficient
dental hygiene.
Gingivitis
- Gingivitis can worsen, allowing Porphyromonas,
Streptococcus, and Actinomyces species to spread
and cause periodontitis. When Prevotella
intermedia, Fusobacterium species, and Treponema
vicentii are involved, it can lead to acute necrotizing
ulcerative gingivitis.
Herpetic gingivostomatitis
- The herpes simplex virus type 1 can cause lesions of
the mouth and throat called herpetic
gingivostomatitis.
Oral thrush
- Other infections of the mouth include oral thrush, a
fungal infection caused by overgrowth of Candida
yeast, and mumps, a viral infection of the salivary
glands caused by the mumps virus, a paramyxovirus.
BACTERIAL INFECTIONS OF THE GASTROINTESTINAL
TRACT
Gastrointestinal illness
- Major causes of gastrointestinal illness include
Salmonella spp., Staphylococcus spp., Helicobacter
pylori, Clostridium perfringens, Clostridium difficile,
Bacillus cereus, and Yersinia bacteria.
Clostridium
- C. difficile is an important cause of hospital acquired
infection.
Cholera
- Vibrio cholerae causes cholera, which can be a
severe diarrheal illness.
E. coli
- Different strains of E. coli, including ETEC, EPEC, EIEC,
and EHEC, cause different illnesses with varying
degrees of severity.
Peptic Ulcer
- H. pylori is associated with peptic ulcers.
Typhoid fever
- Salmonella enterica serotypes can cause typhoid
fever, a more severe illness than salmonellosis.
Treatment
- Rehydration and other supportive therapies are
often used as general treatments.
- Careful antibiotic use is required to reduce the risk of
causing C. difficile infections and when treating
antibiotic-resistant infections.
VIRAL INFECTIONS OF THE GASTROINTESTINAL TRACT
Viral gastroenteritis
- Common viral causes of gastroenteritis include
rotaviruses, noroviruses, and astroviruses.
Viral hepatitis
- Hepatitis may be caused by several unrelated
viruses: hepatitis viruses A, B, C, D, and E.
- The hepatitis viruses differ in their modes of
transmission, treatment, and potential for chronic
infection.
PROTOZOAN INFECTIONS of the gastrointestinal tract
Protozoal Infections
- Giardiasis, cryptosporidiosis, amoebiasis, and
cyclosporiasis are intestinal infections caused by
protozoans.
- Protozoan intestinal infections are commonly
transmitted through contaminated food and water
- Treatment varies depending on the causative agent,
so proper diagnosis is important.
- Microscopic examination of stool or biopsy
specimens is often used in diagnosis, in combination
with other approaches.
HELMINTHIC INFECTIONS of the gastrointestinal tract
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 eggs are transmitted through
contaminated food or water and hatch in the
intestine. Juvenile larvae travel to the lungs and then
to the pharynx, where they are swallowed and
returned to the intestines to mature. These
nematode roundworms cause ascariasis.
- Necator americanus and Ancylostoma doudenale
cause hookworm infection when larvae penetrate
the skin from soil contaminated by dog or cat feces.
They travel to the lungs and are then swallowed to
mature in the intestines.
- Strongyloides stercoralis are transmitted from soil
through the skin to the lungs and then to the
intestine where they cause strongyloidiasis.
- Enterobius vermicularis are nematode pinworms
transmitted by the fecal-oral route. After ingestion,
they travel to the colon where they cause
enterobiasis.
- Trichuris trichiura can be transmitted through soil or
fecal contamination and 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.
- Trichinella spp. is transmitted through undercooked
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.
- Taenia spp. and Diphyllobothrium latum are
tapeworms transmitted through undercooked food
or the fecal- oral route. Taenia infections cause
taeniasis. Tapeworms use their scolex to attach to
the intestinal wall. Larvae may also move to muscle
or brain tissue.
- Echinococcus granulosus is a cestode transmitted
through eggs in the feces of infected animals,
especially dogs. After ingestion, eggs hatch in the
small intestine, and the larvae invade the intestinal
wall and travel through the circulatory system to
form dangerous cysts in internal organs, causing
hydatid disease.
- Flukes 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 DISEASE OF THE CARDIOVASCULAR AND
LYMPHATIC SYSTEM
Structure and Function of the Cardiovascular and
Lymphatic Systems
- The heart, blood, and blood vessels make up the
cardiovascular system.
- Lymph, lymph vessels, lymph nodes, and lymphoid
organs constitute the lymphatic system.
- Plasma transports dissolved substances. Red blood
cells carry oxygen. White blood cells are involved in
the body’s defense against infection.
- Fluid that filters out of capillaries into spaces
between tissue cells is called interstitial fluid.
- Interstitial fluid enters lymph capillaries and is called
lymph; vessels called lymphatics return lymph to the
blood. Lymph nodes contain fixed macrophages, B
cells, and T cells.
 BACTERIAL DISEASES OF THE CARDIOVASCULAR AND
LYMPHATIC SYSTEMS
Sepsis and Septic Shock
- Sepsis is an inflammatory response caused by the
spread of bacteria or their toxin from a focus of
infection. Septicemia is sepsis that involves
proliferation of pathogens in the blood.
- Gram-negative sepsis can lead to septic shock,
characterized by decreased blood pressure.
Endotoxin causes the symptoms.
- Antibiotic-resistant enterococci and group B
streptococci cause gram-positive sepsis.
- Puerperal sepsis begins as an infection of the uterus
following childbirth or abortion; it can progress to
peritonitis or septicemia.
- Streptococcus pyogenes is the most frequent cause
of puerperal sepsis.
- Oliver Wendell Holmes and Ignaz Semmelweiss
demonstrated that puerperal sepsis was transmitted
by the hands and instruments of midwives and
physicians.
BACTERIAL INFECTIONS OF THE HEART
- The inner layer of the heart is the endocardium.
- Subacute bacterial endocarditis is usually caused by
alpha- hemolytic streptococci, staphylococci, or
enterococci.
- The infection arises from a focus of infection, such as
a tooth extraction.
- Preexisting heart abnormalities are predisposing
factors.
- Signs include fever, weakness, and heart murmur.
Acute bacterial endocarditis is usually caused by
Staphylococcus aureus.
- The bacteria cause rapid destruction of heart valves
Rheumatic Fever
- Rheumatic fever is an autoimmune complication of
streptococcal infections.
- Rheumatic fever is expressed as arthritis or
inflammation of the heart. It can result in permanent
heart damage.
- Antibodies against group A beta-hemolytic
streptococci react with streptococcal antigens
deposited in joints or heart valves or cross-react with
the heart muscle.
- Rheumatic fever can follow a streptococcal infection,
such as streptococcal sore throat. Streptococci might
not be present at the time of rheumatic fever.
- Prompt treatment of streptococcal infections can
reduce the incidence of rheumatic fever.
- Penicillin is administered as a preventive measure
against subsequent streptococcal infections.
Tularemia
- Tularemia is caused by Francisella tularensis. The
reservoir is small wild mammals, especially rabbits.
- Signs include ulceration at the site of entry, followed
by septicemia and pneumonia.
Brucellosis
- Also known as undulant fever
- Brucellosis can be caused by Brucella abortus, B.
melitensis, and B. suis.
- The bacteria enter through minute breaks in the
mucosa or skin, reproduce in macrophages, and
spread via lymphatics to liver, spleen, or bone
marrow.
- Signs include malaise and fever that spikes each
evening (undulant fever).
- Diagnosis is based on serological tests
Anthrax
- Bacillus anthracis causes anthrax. In soil, endospores
can survive for up to 60 years.
- Grazing animals acquire an infection after ingesting
the endospores.
- Humans contract anthrax by handling hides from
infected animals. The endospores enter through cuts
in the skin, respiratory tract, or mouth.
- Entry through the skin results in a papule that can
progress to sepsis. Entry through the respiratory
tract can result in septic shock.
- Diagnosis is based on isolating and identifying the
bacteria.
Gangrene
- Soft tissue death from ischemia (loss of blood supply)
is called gangrene.
- Microorganisms grow on nutrients released from
gangrenous cells.
- Gangrene is especially susceptible to the growth of
anaerobic bacteria such as Clostridium perfringens,
the causative agent of gas gangrene
- C. perfringens can invade the wall of the uterus
during improperly performed abortions.
- Surgical removal of necrotic tissue, hyperbaric
chambers, and amputation are used to treat gas
gangrene.
SYSTEMIC DISEASES CAUSED BY BITES AND SCRATCHES
- Pasteurella multocida, introduced by the bite of a
dog or cat, can cause septicemia.
- Anaerobic bacteria infect deep animal bites.
- Cat-scratch disease is caused by Bartonella henselae.
- Rat-bite fever is caused by Streptobacillus
moniliformis and Spirillum minus.
 VECTOR-TRANSMITTED DISEASES
- Plague is caused by Yersinia pestis. The vector is
usually the rat flea (Xenopsylla cheopis).
- Relapsing fever is caused by Borrelia spp. and
transmitted by soft ticks.
- Lyme disease is caused by Borrelia burgdorferi and is
transmitted by a tick (Ixodes)
- Human ehrlichiosis and anaplasmosis are caused by
Ehrlichia and Anaplasma and are transmitted by
Ixodes ticks.
- Typhus is caused by rickettsias, obligate intracellular
parasites of eukaryotic cell
VIRAL DISEASES OF THE CARDIOVASCULAR AND
LYMPHATIC SYSTEMS
Burkitt’s Lymphoma
- Epstein-Barr virus (EB virus, HHV-4) causes Burkitt’s
lymphoma.
- Burkitt’s lymphoma tends to occur in patients whose
immune system has been weakened; for example, by
malaria or AIDS
Infectious Mononucleosis
- Infectious mononucleosis is caused by EB virus.
- The virus multiplies in the parotid glands and is
present in saliva. It causes the proliferation of
atypical lymphocytes
- The disease is transmitted by the ingestion of saliva
from infected individuals.
- Diagnosis is made by an indirect fluorescent-
antibody technique.
- EB virus may cause other diseases, including cancers
and multiple sclerosis
OTHER DISEASES AND EPSTEIN-BARR VIRUS
- EB virus is associated with certain cancers and
autoimmune diseases.
- Cytomegalovirus Infections
- CMV (HHV-5) causes intranuclear inclusion bodies
and cytomegaly of host cells.
- CMV is transmitted by saliva and other body fluids.
- CMV inclusion disease can be asymptomatic, a mild
disease, or progressive and fatal.
Immunosuppressed patients may develop
pneumonia.
- If the virus crosses the placenta, it can cause
congenital infection of the fetus, resulting in
impaired mental development, neurological
damage, and stillbirth.
Chikungunya Fever
- The chickungunya virus, which causes fever and
severe joint pain, is transmitted by Aedes mosquito
Classic Viral Hemorrhagic Fevers
- Yellow fever is caused by the yellow fever virus. The
vector is the Aedes aegypti mosquito.
- Signs and symptoms include fever, chills, headache,
nausea, and jaundice.
- Diagnosis is based on the presence of virus-
neutralizing antibodies in the host.
- No treatment is available, but there is an attenuated,
live viral vaccine.
Dengue
- Dengue is caused by the dengue virus and is
transmitted by the Aedes mosquito.
- Signs are fever, muscle and joint pain, and rash.
- Severe dengue is characterized by bleeding and
organ failure.
- Mosquito abatement is necessary to control the
disease.
Emerging Viral Hemorrhagic Fevers
- Human diseases caused by Marburg, Ebola, and
Lassa fever viruses were first noticed in the late
1960s.
- Ebolavirus is found in fruit bats; Lassa fever viruses
are found in rodents. Rodents are the reservoirs for
Argentine and Bolivian hemorrhagic fevers.
Hantavirus
- Hantavirus pulmonary syndrome and hemorrhagic
fever with renal syndrome are caused by Hantavirus.
The virus is contracted by inhalation of dried rodent
urine and feces
PROTOZOAN DISEASES OF THE CARDIOVASCULAR AND
LYMPHATIC SYSTEMS
Chagas Disease
- Also known as American
- Trypanosomiasis Trypanosoma cruzi causes Chagas
disease. The reservoir includes many wild animals.
The vector is a reduviid, the “kissing bug.”
Toxoplasmosis
- Toxoplasmosis is caused by Toxoplasma gondii.
- T. gondii undergoes sexual reproduction in the
intestinal tract of domestic cats, and oocysts are
eliminated in cat feces.
- In the host cell, sporozoites reproduce to form either
tissue- invading tachyzoites or bradyzoites.
- Humans contract the infection by ingesting
tachyzoites or tissue cysts in undercooked meat from
an infected animal or contact with cat feces.
- Congenital infections can occur. Signs and symptoms
include severe brain damage or vision problems.
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.
- Leishmaniasis is treated with liposomal amphotericin
B.
Babesiosis
- Babesiosis is caused by the protozoan Babesia
microti and is transmitted to humans by ticks.
HELMINTHIC DISEASE OF THE CARDIOVASCULAR AND
LYMPHATIC SYSTEMS
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;
sanitation and snail eradication are used to prevent
it.
DISEASE OF UNKNOWN ETIOLOGY
Kawasaki Syndrome
- Kawasaki syndrome is characterized by fever, rash,
and swollen lymph nodes in the neck. The cause is
unknown.
MICROBIAL DISEASE OF THE NERVOUS SYSTEM
Structure and Function of the Nervous System
- The central nervous system (CNS) consists of the
brain, which is protected by the skull bones, and the
spinal cord, which is protected by the backbone.
- The peripheral nervous system (PNS) consists of the
nerves that branch from the CNS
- The CNS is covered by three layers of membranes
called meninges: the dura mater, arachnoid mater,
and pia mater. Cerebrospinal fluid (CSF) circulates
between the arachnoid mater and the pia mater in
the subarachnoid space.
- The blood–brain barrier normally prevents many
substances, including antibiotics, from entering the
brain.
- Microorganisms can enter the CNS through trauma,
along peripheral nerves, and through the
bloodstream and lymphatic system.
- An infection of the meninges is called meningitis. An
infection of the brain is called encephalitis
BACTERIAL DISEASES OF THE NERVOUS SYSTEM
Bacterial Meningitis
- The three major causes of bacterial meningitis are
Haemophilus influenzae, Streptococcus
pneumoniae, and Neisseria meningitidis.
- Nearly 50 other species of opportunistic bacteria can
cause meningitis.
- H. influenzae is part of the normal throat microbiota.
It requires blood factors for growth; serotypes are
based on capsules.
- H. influenzae type b is the most common cause of
meningitis in children under 4 years old.
- An Hib conjugated vaccine directed against the
capsular polysaccharide antigen is available.
- N. meningitidis causes meningococcal meningitis.
This bacterium is found in the throats of healthy
carriers and is transmitted by droplet aerosols or
direct contact with secretions.
- Meningococci probably gain access to the meninges
through the bloodstream. The bacteria may be found
in leukocytes in CSF.
- A purified capsular polysaccharide vaccine
- S. pneumoniae is commonly found in the
nasopharynx.
- Young children are most susceptible to S.
pneumoniae meningitis. Untreated, it has a high
mortality rate.
- A S. pneumoniae conjugated vaccine is available.
- Listeria monocytogenes causes meningitis in
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.
Tetanus
- Tetanus is caused by an exotoxin produced by
Clostridium tetani.
- C. tetani produces the neurotoxin tetanospasmin,
which causes the symptoms of tetanus: spasms,
contraction of muscles controlling the jaw, and death
resulting from spasms of respiratory muscles.
- Acquired immunity results from DTaP immunization.
- Following an injury, an immunized person may
receive a booster of tetanus toxoid. An unimmunized
person may receive (human) tetanus immune
globulin
- Debridement (removal of tissue) and antibiotics may
be used to control the infection.
Botulism
- Botulism is caused by an exotoxin produced by C.
botulinum growing in foods.
- Serological types of botulinum toxin vary in
virulence; type A is the most virulent.
- The toxin is a neurotoxin that inhibits the
transmission of nerve impulses
- Blurred vision occurs in 1 to 2 days; progressive
flaccid paralysis follows for 1 to 10 days, possibly
resulting in death from respiratory and cardiac
failure.
- C. botulinum will not grow in acidic foods or in an
aerobic environment. Endospores are killed by
proper canning. Adding nitrites to foods inhibits
growth of C. botulinum.
- The toxin is heat labile and is destroyed by boiling
(100°C) for 5 minutes.
- Infant botulism results from the growth of C.
botulinum in an infant’s intestines.
- Wound botulism occurs when C. botulinum grows in
anaerobic wounds.
- For diagnosis, mice protected with antitoxin are
inoculated with toxin from the patient or foods
Leprosy
- Leprosy, or Hansen’s disease, is caused by
Mycobacterium leprae or M. lepromatosis.
- These bacteria have never been cultured on artificial
media. They can be cultured in armadillos and mouse
footpads
- The tuberculoid form of the disease is characterized
by loss of sensation in the skin surrounded by
nodules.
- In the lepromatous form, disseminated nodules and
tissue necrosis occur.
- Leprosy is not highly contagious and is spread by
prolonged contact with exudates.
- Untreated individuals often die of secondary
bacterial complications, such as tuberculosis.
- Laboratory diagnosis is based on observations of
acid-fast rods in a skin biopsy.
VIRAL DISEASES OF THE NERVOUS SYSTEM
Poliomyelitis
- The symptoms of poliomyelitis are usually sore
throat and nausea, and occasionally paralysis (fewer
than 1% of cases).
- Poliovirus is transmitted by the ingestion of water
contaminated with feces.
- Poliovirus first invades lymph nodes of the neck and
small intestine. Viremia and spinal cord involvement
may follow.
- Diagnosis is based on isolation of the virus from feces
and throat secretions.
- Poliovirus first invades lymph nodes of the neck and
small intestine. Viremia and spinal cord involvement
may follow. Diagnosis is based on isolation of the
virus from feces and throat secretions.
- Poliovirus first invades lymph nodes of the neck and
small intestine. Viremia and spinal cord involvement
may follow. Diagnosis is based on isolation of the
virus from feces and throat secretions.
Rabies
- Rabies virus (Lyssavirus) causes an acute, usually
fatal, encephalitis called rabies.
- Rabies may be contracted through the bite of a rabid
animal or invasion through skin. The virus multiplies
in skeletal muscle and connective tissue.
- Encephalitis occurs when the virus moves along
peripheral nerves to the CNS.
- Symptoms of rabies include spasms of mouth and
throat muscles followed by extensive brain and
spinal cord damage and death.
- Laboratory diagnosis may be made by DFA tests of
saliva, serum, and CSF or brain smears.
- Reservoirs for rabies in the United States include
skunks, bats, foxes, and raccoons.
- Domestic cattle, dogs, and cats may get rabies.
Rodents and rabbits seldom get rabies.
- Postexposure treatment includes administration of
human rabies immune globulin (RIG) along with
multiple intramuscular injections of vaccine.
- Preexposure treatment consists of vaccination.
- Other genotypes of Lyssavirus cause rabies-like
diseases.
Arboviral Encephalitis
- Symptoms of encephalitis are chills, headache, fever,
and eventually coma.
- Many types of viruses transmitted by mosquitoes
(called arbo-viruses) cause encephalitis.
- The incidence of arboviral encephalitis increases in
the summer months, when mosquitoes are most
numerous.
- Zika virus disease is often mild in adults, but the virus
can cause CNS birth defects if it infects a fetus.
- Control of the mosquito vector is the most effective
way to control arboviral infections
FUNGAL DISEASE OF THE NERVOUS SYSTEM
Cryptococcus neoformans
- Meningitis Also known as cryptococcosis
- Cryptococcus spp. are encapsulated yeastlike fungi
that cause cryptococcosis.
- The disease may be contracted by inhaling dried
infected pigeon or chicken droppings.
- The disease begins as a lung infection and may
spread to the brain and meninges.
- Immunosuppressed individuals are most susceptible
to cryptococcosis.
- Diagnosis is based on latex agglutination tests for
cryptococcal antigens in serum or CSF.
PROTOZOAN DISEASES OF THE NERVOUS SYSTEM
African Trypanosomiasis
- African trypanosomiasis is caused by the protozoa
Trypanosoma brucei gambiense and T.b.
rhodesiense and is transmitted by the bite of the
tsetse fly.
- The disease affects the nervous system of the human
host, causing lethargy and eventually coma. It is
commonly called sleeping sickness.
- Vaccine development is hindered by the protozoan’s
ability to change its surface antigens.
Amebic Meningoencephalitis
- Encephalitis caused by the protozoan Naegleria
fowleri is almost always fatal.
- Granulomatous amebic encephalitis, caused by
Acanthamoeba spp. and Balamuthia mandrillaris, is
a chronic disease.
NERVOUS SYSTEM DISEASES CAUSED BY PRIONS
- Prions are self-replicating proteins with no
detectable nucleic acid.
- Diseases of the CNS that progress slowly and cause
spongiform degeneration are caused by prions
- Transmissible spongiform encephalopathies are
caused by prions that are transferable from one
animal to another.
- Creutzfeldt-Jakob disease and kuru are human
diseases similar to scrapie. They are transmitted
between humans
DISEASES CAUSED BY UNIDENTIFIED AGENTS
- The causes of acute flaccid myelitis, Bell’s palsy, and
chronic fatigue syndrome have not been definitively
established, but viruses have been implicated.
MICROBIAL DISEASE OF URINARY & REPRODUCTIVE
SYSTEM
Structure and Function of the Urinary System
- The urinary system regulates the chemical
composition and volume of the blood and excretes
nitrogenous waste and water.
- Urine is transported from the kidneys through
ureters to the urinary bladder and is eliminated
through the urethra
- Valves prevent urine from flowing back to the
urinary bladder and kidneys.
- The flushing action of urine and normal urine itself
have some antimicrobial value.
Structure and Function of the Reproductive Systems
- The reproductive system produces gametes for
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.
- The male reproductive system consists of two testes,
ducts, accessory glands, and the penis; seminal fluid
leaves the male body through the urethra.
Normal Microbiota of the Urinary and Reproductive
Systems
- Microbial diseases of these systems can result from
infection from an outside source or from
opportunistic infection by members of the normal
microbiota.
- Gram-positive bacteria predominate in the urinary
tract.
- Lactobacilli dominate the vaginal microbiota;
actinobacteria dominate the microbiome of the
seminal vesicle
 BACTERIAL DISEASES OF THE URINARY SYSTEM
- Urethritis, cystitis, and ureteritis are inflammations
of tissues of the lower urinary tract.
- Pyelonephritis can result from lower urinary tract
infections or from systemic bacterial infections.
- Opportunistic gram-negative bacteria from the
intestines often cause urinary tract infections.
- Healthcare-associated infections of the urinary
system can occur following catheterization.
- Treatment of urinary tract infections depends on
isolation and antibiotic sensitivity testing of the
causative agents.
Cystitis
- Inflammation of the urinary bladder, or cystitis, is
common in females.
- The most common etiologies are E. coli and
Staphylococcus saprophyticus.
Pyelonephritis
- Inflammation of the kidneys, or pyelonephritis, is
usually a complication of lower urinary tract
infections.
- About 75% of pyelonephritis cases are caused by E.
coli.
Leptospirosis
- The spirochete Leptospira interrogans is the cause of
leptospirosis.
- The disease is transmitted to humans by urine-
contaminated water.
- Leptospirosis is characterized by chills, fever,
headache, and muscle aches.
MICROBIAL DISEASES OF THE REPRODUCTIVE SYSTEMS
- Most infections of the reproductive system are
sexually transmitted infections (STIs). The incidence
of STIs is at an all-time high.
- Most STIs can be prevented by the use of condoms.
BACTERIAL DISEASES OF THE REPRODUCTIVE SYSTEMS
Gonorrhea
- Neisseria gonorrhoeae causes gonorrhea.
- Gonorrhea is a common reportable communicable
disease in the United States.
- N. gonorrhoeae attaches to mucosal cells of the oral-
pharyngeal area, genitals, eyes, and rectum by
means of fimbriae
- Symptoms in men are painful urination and pus
discharge. Blockage of the urethra and sterility are
complications of untreated cases.
- Women might be asymptomatic unless the infection
spreads to the uterus and uterine tubes (see pelvic
inflammatory disease).
- Gonorrheal endocarditis, gonorrheal meningitis, and
gonorrheal arthritis are complications that can affect
both sexes if gonorrheal infections are untreated.
- Ophthalmia neonatorum is an eye infection acquired
by infants during passage through the birth canal of
an infected mother.
- Gonorrhea is diagnosed by ELISA or NAATS
Nongonococcal Urethritis (NGU)
- Most cases of nongonococcal urethritis (NGU), or
nonspecific urethritis (NSU), are caused by
Chlamydia trachomatis.
- C. trachomatis infection is the most common STI.
- Symptoms of NGU are often mild or lacking, although
uterine tube inflammation and sterility may occur.
- C. trachomatis can be transmitted to infants’ eyes at
birth.
- Diagnosis is based on detection of chlamydial DNA in
urine.
- Ureaplasma urealyticum and Mycoplasma
genitalium also cause NGU.
Pelvic Inflammatory Disease (PID)
- Extensive bacterial infection of the female pelvic
organs, especially of the reproductive system, is
called pelvic inflammatory disease (PID).
- PID is caused by N. gonorrhoeae, C. trachomatis, and
other bacteria. Infection of the uterine tubes is called
salpingitis.
Syphilis
- Syphilis is caused by Treponema pallidum, a
spirochete that has not been cultured in vitro.
- Laboratory cultures are grown in rabbits or cell
cultures
- The primary lesion is a small, hard-based chancre at
the site of infection. The bacteria then invade the
blood and lymphatic system, and the chancre
spontaneously heals
- The appearance of a widely disseminated rash on the
skin and mucous membranes marks the secondary
stage. Spirochetes are present in the lesions of the
rash
- The patient enters a latent period after the
secondary lesions spontaneously heal.
- At least 10 years after the secondary lesion, tertiary
lesions called gummas can appear on many organs
- Congenital syphilis, resulting from T. pallidum
crossing the placenta during the latent period, can
cause neurological damage in the newborn.
- T. pallidum is identifiable through darkfield
microscopy of fluid from primary and secondary
lesions.
- Many serological tests, such as VDRL, RPR, and FTA- - Vulvovaginal candidiasis is characterized by lesions
ABS, can be used to detect the presence of that produce itching and irritation.
antibodies against T. pallidum during any stage of the - Predisposing factors are pregnancy, diabetes, and
disease broad-spectrum antibacterial chemotherapy.
Lymphogranuloma Venereum (LGV) - Diagnosis is based on observation of the fungus and
- C. trachomatis causes lymphogranuloma venereum its isolation from lesions.
(LGV), which is primarily a disease of tropical and
subtropical regions. PROTOZOAN DISEASE OF THE REPRODUCTIVE
- The bacteria are spread in the lymph system and SYSTEMS
cause enlargement of the lymph nodes, obstruction
of lymph vessels, and swelling of the external Trichomoniasis
genitals. - Trichomonas vaginalis causes trichomoniasis when
- Diagnosis is by ELISA or NAA the pH of the vagina increases.
Chancroid (Soft Chancre) - Diagnosis is based on observation of the protozoa in
- Chancroid, a swollen, painful ulcer on the mucous purulent discharges from the site of infection.
membranes of the genitals or mouth, is caused by
Haemophilus ducreyi
Bacterial Vaginosis
- Bacterial vaginosis is an infection without
inflammation caused by Gardnerella vaginalis.
- Diagnosis of G. vaginalis is based on the presence of
clue cells

VIRAL DISEASES OF THE REPRODUCTIVE SYSTEMS

Genital Herpes
- Herpes simplex viruses (HSV-1 and HSV-2) cause
genital herpes.
- Symptoms of the infection are painful urination,
genital irritation, and fluid-filled vesicle
- 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 cause warts.
- Some human papillomaviruses that cause genital
warts cause cancer.
AIDS
- 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.

FUNGAL DISEASE OF THE REPRODUCTIVE SYSTEMS

Candidiasis
- Candida albicans causes NGU in men and
vulvovaginal candidiasis, or yeast infection, in
women.