OVERVIEW OF HUMAN

INFECTIOUS DISEASES

Michael James Z. Lat, RMT, MSCLS

CAHS Faculty Member
CATEGORIES OF HUMAN DISEASES

Degenerative Immune Infectious Metabolic

diseases disorders diseases disorders

Nutritional Psychiatric
Neoplasms
disorders disorders
 INFECTIOUS DISEASES

• Only category caused by microbes

TWO GENERAL CATEGORIES:
1. MICROBIAL INTOXICATIONS – due to ingestion of toxin produced outside
the body (in vitro) by a pathogen
2. INFECTION – colonization of some body site by a pathogen

*Some infectious diseases affect more than one anatomical site, and some
pathogens move from one body site to another during the course of a
disease.
INFECTIOUS DISEASES OF THE SKIN

• Intact skin – a type of nonspecific host defense mechanism; a physical

barrier & is a part of the body’s first line of defense

• The indigenous microbiota of the skin, a low pH, and the presence of
chemical substances (lysozyme, sebum) also serve to prevent
colonization of the skin by pathogens.
 IMPORTANT TERMS

• Epidermis – superficial portion

of the skin
• Dermis – inner layer of skin,
containing blood & lymphatic
vessels, nerves, nerve endings,
glands, & hair follicles
• Sebaceous glands – glands in
the dermis that usually open
into hair follicles and secrete
an oily substance (sebum)
 IMPORTANT TERMS

• Dermatitis – inflammation of the skin

• Folliculitis – inflammation of a hair follicle, the sac that contains a hair shaft
• Sty (stye) – inflammation of a sebaceous gland that opens into a follicle of
an eyelash
• Furuncle (boil) – localized pyogenic (pus-producing) infection of the skin,
usually resulting from folliculitis
• Carbuncle – deep-seated pyogenic infection of the skin, usually arising from
a coalescence of furuncles
 IMPORTANT TERMS
Macule – surface lesion that is neither raised nor depressed,
such as the lesions of measles
Papule – surface lesion that is firm and raised, such as the
lesions of chickenpox
Vesicle – blister or small fluid-filled sac, such as is seen in
chickenpox and shingles
Pustule – pus-filled surface lesion
INFECTIOUS DISEASES OF THE EARS
Three pathways for pathogens to enter the ear:

•Through the eustachean (auditory) tube, from the throat and nasopharynx
•From the external ear
•Via the blood or lymph

Usually, bacteria are trapped in the middle ear when a bacterial infection in the
throat and nasopharynx causes the eustachian tube to close.

This results in an anaerobic condition, allowing obligate & facultative anaerobes

to proliferate and cause pressure on the tympanic membrane (eardrum).
 INFECTIOUS DISEASES OF THE EARS

Swollen lymphoid (adenoid) tissues, viral infections, and allergies

may also close the eustachian tube, especially in young children.

OTITIS MEDIA – infection of the middle ear

OTITIS EXTERNA – infection of the outer ear canal

 INFECTIOUS DISEASES OF THE EYES
CONJUNCTIVA – thin, tough lining that covers the inner wall of
the eyelid and the sclera
CONJUNCTIVITIS – infection or inflammation of the conjunctiva

KERATITIS – infection or inflammation of the cornea – the

domed covering over the iris and lens
KERATOCONJUNCTIVITIS – infection that involves both the
cornea and conjunctiva
 INFECTIOUS DISEASES
OF THE RESPIRATORY SYSTEM
• UPPER RESPIRATORY SYSTEM – includes the paranasal sinuses, nasopharynx, oropharynx,
epiglottis, and larynx
• LOWER RESPIRATORY SYSTEM – includes the trachea, bronchial tubes, and alveoli of the
lungs
• Indigenous microbiota of the URT may cause opportunistic infections of the respiratory
system.
• Infectious diseases of the URT (colds, sore throats) are more common than those of the
LRT. They may predispose the patients to more serious conditions (sinusitis, otitis media,
bronchitis, pneumonia).
• LRT infections are the most common cause of death from infectious diseases.
 INFECTIOUS DISEASES
OF THE RESPIRATORY SYSTEM

• BRONCHITIS – inflammation of the mucous membrane lining of the bronchial

tubes; most commonly caused by respiratory viruses
• BRONCHOPNEUMONIA – combination of bronchitis and pneumonia
• EPIGLOTTITIS – inflammation of the epiglottis (mouth of the windpipe); may
cause respiratory obstruction, especially in children; frequently caused by
Haemophilus influenzae type b (Hib)
• LARYNGITIS – inflammation of the mucous membrane of the larynx (voice box)
 INFECTIOUS DISEASES
OF THE RESPIRATORY SYSTEM
• PHARYNGITIS (sore throat) – inflammation of the mucous membrane and
underlying tissue of the pharynx
Strep throat is caused by S. pyogenes (most “publicized” cause of pharyngitis)
Most cases of pharyngitis are caused by viruses.
• PNEUMONIA – inflammation of one or both lungs; alveolar sacs become filled
with exudate, inflammatory cells, and fibrin; mostly caused by bacteria or viruses
• SINUSITIS – inflammation of the lining of one or more of the paranasal sinuses;
most common causes include Streptococcus pneumoniae & Haemophilus
influenzae; less common causes are Streptococcus pyogenes, Moraxella catarrhalis,
& Staphylococcus aureus
TYPICAL VS ATYPICAL PNEUMONIA
TYPICAL VS ATYPICAL PNEUMONIA
 INFECTIOUS DISEASES OF THE ORAL REGION

Most infections of the oral cavity are caused by

members of the indigenous oral microbiota, sometimes
one member acting independently & other times,
several members acting together.
Several species (Streptococcus salivarius, S. mitis, S.
sanguis, S. mutans, & Actinomyces spp.) often interact to
protect the oral surfaces, but may be involved in oral
disease.
 INFECTIOUS DISEASES OF THE ORAL REGION

DENTAL CARIES – tooth decay or cavities

Dental caries start when the external surface (enamel) of a tooth is
dissolved by organic acids produced by masses of microorganisms
attached to the tooth (dental plaque).
It is followed by enzymatic destruction of the protein matrix,
cavitation, & bacterial invasion.
The most common cause of tooth decay is S. mutans – produces
lactic acid as end-product of glucose fermentation.
 • GINGIVITIS – inflammation of the
INFECTIOUS gingiva (gums)
DISEASES
• PERIODONTITIS – inflammation of the
OF THE ORAL periodontium (tissues that surround &
support the teeth, including the gingiva
REGION & supporting bone); in severe cases,
teeth loosen and fall out

• PERIODONTAL DISEASES – collective

term for oral diseases such as gingivitis,
periodontitis, and trench mouth
INFECTIOUS DISEASES OF THE ORAL REGION
• Oral infections result from a combination of the unique microbial
population, reduced host defenses, improper diet, & poor dental
hygiene.

MICROBIAL ACTIVITIES ASSOCIATED WITH ORAL INFECTION:

1. Formation of dextran from sugars by streptococci
2. Acid production by lactic acid-producing bacteria
3. Deposition of calculus by Actinomyces
4. Secretion of inflammatory substances (endotoxin) by Bacteroides
spp.
INFECTIOUS DISEASES OF THE ORAL REGION

Periodontal diseases can be prevented by maintaining good health, proper oral

hygiene, adequate diet without sugars, & regular fluoride treatments to help
control microbial population.
Severe gingivitis & periodontitis require professional care by a periodontist.

Periodontists use techniques such as scaling and planing to remove tartar that has
accumulated on tooth surfaces up to one fifth of an inch below the gum line.

Post-surgery, periodontists prescribe chlorhexidine mouth rinse as a temporary

substitute for brushing and flossing.
 Most of the microorganisms ingested with
food are destroyed in the stomach and
duodenum by the low pH and are inhibited
from growing in the lower intestines by the
resident microbiota (microbial antagonism).
INFECTIOUS
DISEASES OF
THE GI TRACT
They are then flushed from the colon during
defecation, along with large numbers of
indigenous microbes.
 • COLITIS – inflammation of the colon
• DIARRHEA – abnormally frequent
discharge of semi-solid or fluid fecal
INFECTIOUS matter; some lab workers define diarrheal
specimens as “stool specimens that
DISEASES conform to the shape of the container”
OF THE GI • DYSENTERY – frequent watery stools,
TRACT accompanied by abdominal pain, fever, &
dehydration; may contain blood or mucus
• ENTERITIS – inflammation of the intestines
(usually small intestine)
 • GASTRITIS – inflammation of the mucosal
lining of the stomach
INFECTIOUS • GASTROENTERITIS – inflammation of the
DISEASES mucosal linings of the stomach and
intestines
OF THE GI
• HEPATITIS – inflammation of the liver;
TRACT usually the result of viral infection, but can
be caused by toxic agents
 • URINARY TRACT INFECTIONS (UTIs)
 Upper UTIs – infections of the kidneys
(nephritis or pyelonephritis) & ureters
(ureteritis)
INFECTIOUS  Lower UTIs – infections of the urinary
DISEASES bladder (cystitis), urethra (urethritis), and
OF THE prostate (prostatitis)
GENITOURINARY
SYSTEM UTIs may be caused by a variety of
microorganisms introduced by poor
personal hygiene, sexual intercourse,
insertion of catheters, & other means.
INFECTIOUS DISEASES
OF THE GENITOURINARY SYSTEM

• CYSTITIS – inflammation of the urinary bladder; most

common type of UTI
 Most common cause: Escherichia coli
 Other common causes: Klebsiella, Proteus, Enterobacter,
Pseudomonas, Enterococcus, Staphylococcus saprophyticus,
Staphylococcus epidermidis, Candida albicans
• NEPHRITIS – general term for inflammation of the kidneys;
PYELONEPHRITIS is inflammation of renal parenchyma
 Most common cause: Escherichia coli
 INFECTIOUS DISEASES
OF THE GENITOURINARY SYSTEM

• URETERITIS – inflammation of one or both ureters; usually caused

by the spreading of infection upward from the urinary bladder or
downward from the kidneys
• URETHRITIS – inflammation of the urethra; usually transmitted
sexually
 Most common cause: Chlamydia trachomatis
 Other causes: Neisseria gonorrhoeae, ureaplasmas, mycoplasmas
• PROSTATITIS – inflammation of the prostate gland; not an
infectious disease most often
 INFECTIOUS DISEASES
OF THE GENITAL TRACT

• Adult vaginal microbiota: Lactobacillus, Staphylococcus, Streptococcus,

Enterococcus, Neisseria, Clostridium, Actinomyces, Prevotella, diphtheroids,
enteric bacilli, Candida

• The balance among the mentioned microbes depends on the estrogen

levels & pH of the site.
Ex: Use of antibiotics may kill the resident lactobacilli and allow overgrowth
of Candida albicans, causing yeast vaginitis
 • BARTHOLINITIS – inflammation of the
Bartholin ducts in women
• CERVICITIS – inflammation of the cervix
INFECTIOUS • ENDOMETRITIS – inflammation of the
DISEASES endometrium
• EPIDIDYMITIS – inflammation of the
OF THE epididymis
• PELVIC INFLAMMATORY
GENITAL TRACT DISEASE/SALPINGITIS – inflammation of the
fallopian tubes
• VAGINITIS – inflammation of the vagina
Three most common causes of vaginitis:
C. albicans, T. vaginalis, and a mixture of bacteria
(Mobiluncus, Gardnerella – BACTERIAL VAGINOSIS)
• VULVOVAGINITIS – inflammation of the
vulva & the vagina
 • Formerly called venereal disease (VD);
includes any of the infections transmitted
by sexual activities
SEXUALLY • STDs affect not only the genital tract, but
TRANSMITTED also the skin, mucous membranes, blood,
DISEASES lymphatic & digestive systems, & many
OF THE other anatomic sites.
GENITAL • EPIDEMIC STDs: AIDS, chlamydial & herpes
infections, gonorrhea, syphilis
TRACT
• Diseases such as hepatitis B, amebiasis,
and giardiasis can also be transmitted by
sexual activities.
 • Consists of the cardiovascular system &
the lymphatic system
INFECTIOUS • ENDOCARDITIS – inflammation of the
DISEASES endocardium: endothelial membrane
that lines the cavities of the heart
OF THE • MYOCARDITIS – inflammation of the
CIRCULATORY myocardium: muscular walls of the
heart
SYSTEM
• PERICARDITIS – inflammation of the
pericardium: membranous sac around
the heart
 INFECTIOUS DISEASES
OF THE CIRCULATORY SYSTEM
The presence of bacteria in a person’s bloodstream is known as
BACTEREMIA. It may or may not be a sign of disease.

TRANSIENT BACTEREMIA – temporary; often results from dental

extractions, wounds, bites, & damage to the intestinal,
respiratory, or reproductive tract mucosa
SEPTICEMIA – disease in which the patient experiences chills,
fever, & prostration (extreme exhaustion) & has bacteria and/or
their toxins in their bloodstream
 TESTS PERFORMED ROUTINELY
ON DONOR BLOOD (US):
 Treponema pallidum antigen
INFECTIOUS  HIV-1 antibody
DISEASES  HIV-2 antibody
OF THE  HTLV-I & HTLV-II antibody
CIRCULATORY  Hepatitis B surface antigen
SYSTEM  Hepatitis B core antibody
 Hepatitis C antibody
 NAT for HIV-1, HCV, & West Nile Virus
 Antibody test for Trypanosoma cruzi
 • LYMPHATIC SYSTEM – consists of
lymphatic vessels, lymphoid tissue
(lymph nodes, tonsils, thymus, &
INFECTIOUS spleen) and lymph (liquid that
circulates through the lymphatic
DISEASES system)
OF THE • LYMPHADENITIS – inflamed and
CIRCULATORY swollen lymph nodes
SYSTEM • LYMPHADENOPATHY – diseased
lymph nodes
• LYMPHANGITIS – inflamed lymphatic
vessels
INFECTIOUS DISEASES OF THE CNS

• CNS – consists of the brain, spinal cord, & the three membranes (meninges) that
cover the brain and the spinal cord
• There is no indigenous microbiota of the nervous system.
• Microbes gain access to the CNS through trauma (fracture or medical procedure), via
the blood & lymph to the CSF, or along the peripheral nerves.
• ENCEPHALITIS – inflammation of the brain
• ENCEPHALOMYELITIS – inflammation of the brain & spinal cord
• MENINGITIS – inflammation of the membranes (meninges) that surround the brain &
spinal cord
• MENINGOENCEPHALITIS – inflammation of the brain & meninges
• MYELITIS – inflammation of the spinal cord
 MENINGITIS
Causes: ingestion of poisons, ingestion or injection of drugs, reaction
to vaccine, or a pathogen
• VIRAL MENINGITIS – caused by a virus (chickenpox, measles, or
rubella viruses) or the immune reaction; sometimes referred to as
“aseptic meningitis”; less serious than bacterial meningitis
• Other causes of viral meningitis – enteroviruses, coxsackieviruses,
echoviruses, mumps virus, arboviruses, poliovirus, adenoviruses,
measles virus, herpes simplex, & varicella virus
 MENINGITIS
• 3 Major Causes of BACTERIAL MENINGITIS (historically):
 Haemophilus influenzae (children)
 Neisseria meningitidis (adolescents)
 Streptococcus pneumoniae (elderly)

• Vaccination of children with Hib vaccine has drastically reduced the

incidence of H. influenzae meningitis in children (US)
• Other causes: S. aureus, P. aeruginosa, Salmonella, Klebsiella
• Major causes in neonates: S. agalactiae, E. coli & others from
Enterobacteriaceae, L. monocytogenes
• Diagnosis: patient symptoms, physical examination, CSF Gram stain &
culture
 MENINGITIS
• Free-living amebas may cause meningoencephalitis including
Naegleria & Acanthamoeba.
• Other protozoa that may invade the meninges: Toxoplasma,
Trypanosoma
• Occasionally, fungal pathogens (Cryptococcus neoformans) may
cause meningitis.

• Several CNS diseases are caused by toxins. Examples of bacterial

neurotoxins are botulinal toxin, & tetanospasmin.
 OPPORTUNISTIC INFECTIONS
• Infections that normally would not • Aspergillosis & other mould infections
occur in healthy, immunocompetent • Candidiasis
individuals or would, at most, cause
only mild infections; relatively • CMV infection
common in immunosuppressed • HSV infection
individuals and often contribute to
• Malaria
their death
• Mycobacterium avium complex
• Pneumocystis pneumonia
• Toxoplasmosis
• Tuberculosis (TB)
 EMERGING & RE-EMERGING
INFECTIOUS DISEASES

CAUSES OF EMERGING DISEASES

 Changes in human demographics & behavior
 Ecological changes (dams, deforestation, climate change)
 Increased international travel
 Increased exposure to exotic animals
 Misuse of antibiotics & other antimicrobial agents
 Breakdown of public health measures
 Infectious diseases that
have emerged in the last
30 years:
 Lassa fever
 Avian influenza (“bird
flu”)  Legionellosis
 Cryptosporidiosis  Lyme disease
EMERGING &  E. coli O157 infections  Marburg hemorrhagic
RE-EMERGING (HUS)
 Ebola hemorrhagic 
fever
Nipah virus encephalitis
INFECTIOUS fever  Severe acute
DISEASES  Hantavirus pulmonary
syndrome
respiratory syndrome
(SARS)
 Hendra virus infection  Variant Creutzfeldt-
Jakob disease
 HIV infection and AIDS
 West Nile virus
 Human monkeypox encephalitis
 EMERGING & RE-EMERGING
INFECTIOUS DISEASES
CAUSES OF REEMERGING
INFECTIOUS DISEASES
 Pathogen mutations & genetic Population shifts
recombination
 War and civil conflicts
 Acquired drug resistance
 Famine
 Decreased compliance with
vaccination policies & other  Floods
breakdowns in public health  Droughts
measures  Bioterrorism
 • Infectious diseases that have
reemerged or shown up in new
geographic areas in recent years:
 Cholera
EMERGING &  Dengue fever
RE-EMERGING  Diphtheria
 Malaria
INFECTIOUS  Rift Valley fever
DISEASES  TB
 Yellow fever
 MRSA infections (& other
superbugs)