Presented by:

SIR JOMAR P. RONQUILLO, RN, MANc

MICROPARASITOLOGY AND HUMAN

DISEASES
MICROBIAL DISEASES OF THE SKIN
AND THE EYES
THE SKIN

 Consists of 2 parts:
 Epidermis
 Dermis
THE SKIN
THE SKIN

 Skin structures and secretions that are

favorable for microbial growth
 Glands
 Perspiration
 Sebum
THE SKIN

 Mucous membranes
 Lines the body cavities
 Consists of tiny packed epithelial cells
 Secretes mucus
 Contains cilia
THE SKIN
THE SKIN

 Has normal microbiota

 Most are gram-positive bacteria
 Vigorous handwashing can reduce their
numbers
 Areas of the body with more moisture have
higher microbial population
THE SKIN

 Other normal microbiota:

 Proprionibacterium acnes
 Secretes proprionic acid
 Corynebacterium xerosis
 Pityrosporum ovale
 Responsible for scaling condition
MICROBIAL DISEASE OF THE SKIN
 SKIN LESIONS:
 Vesicles
 Bullae
 Macules
 Papules / Pustules
Vesicles
Bullae
Macules
Papules
Pustules
 Not all rashes and lesions necessarily indicate
skin infection
 Exanthem
 Enanthem
BACTERIAL DISEASES OF THE
SKIN
 Two most common causes of bacterial skin
infections:
 Staphylococcus
 Streptococcus
STAPHYLOCOCCAL SKIN
INFECTIONS
STAPHYLOCOCCAL SKIN
INFECTIONS
 Staphylococci are spherical gram-positive
bacteria that form irregular clusters like
grapes.
 2 types of strains:
 Coagulase-positive
 Staphylococcus epidermidis
 Coagulase-negative
STAPHYLOCOCCAL SKIN
INFECTIONS
 Staphyloccocus aureus is the most pathogenic
 Produces:
 Coagulase
 Leukocidin
 Exfoliative toxin
 Enterotoxins
 Is a common problem in the hospital environment,
and is difficult to get rid of
STAPHYLOCOCCAL SKIN
INFECTIONS
 Staphyloccocus aureus
 Most favorable environment: Nasal passages
 Enters the body through natural opening in the
skin
 Infections:
 Folliculitis
 Sty
 Furuncle
 Carbuncle
STAPHYLOCOCCAL SKIN
INFECTIONS
 Staphylococci are the primary cause of
troublesome problems in hospital nurseries
 Impetigo of the newborn
 Can produce “toxemia”
 Scalded skin syndrome
 TSS
STREPTOCOCCAL SKIN
INFECTIONS
STREPTOCOCCAL SKIN
INFECTIONS
 Streptococci are gram-positive spherical
bacteria that usually grow in chains.
 Causes a wide variety of diseases:
 Meningitis, pneumonia, sore throats, otitis media,
endocarditis, puerperial fever
 Secretes toxins and enzymes
 Hemolysins
 alpha, beta, and gamma
STREPTOCOCCAL SKIN
INFECTIONS
 GAßHS is the most important type
 Can cause Erysipelas
 Skin eruption with reddish patches and raised
margins and can even cause sepsis
 Sensitive to ß-lactam-type antibiotics
 Can also cause impetigo
 Isolated pustules that become crusted and rupture
STREPTOCOCCAL SKIN
INFECTIONS
 Can produce substances that promote rapid
spread of infection:
 Streptokinases
 Hyaluronidase
 Deoxyribonucleases
 Leukocidins
STREPTOCOCCAL SKIN
INFECTIONS
 Other infections:
 Myositis
 Necrotizing fascitis
INFECTIONS BY PSEUDOMONAS
INFECTIONS BY PSEUDOMONAS

 Pseudomonads are gram-negative rods that

are widespread in soil and water.
 Resistant to many antibiotics and
disinfectants
 Pseudomonas aeruginosa
INFECTIONS BY PSEUDOMONAS

 Infections:
 Pseudomonas dermatitis
 Self-limiting rash of about two weeks duration,
often associated with swimming pools and hot tubs
 Otitis externa
 P. aeruginosa are frequent causes of
nosocomial infections
 Drugs: Fluoroquinolones, ß-lactam
antibiotics, silver sulfadiazine
ACNE
ACNE

 Most common skin disease in humans

 3 categories:
 Comedonal
 Inflammatory
 Nodular cystic
ACNE

 Acne develops when normal channels for the

passage of sebum to the skin surface are
blocked.
 Topical agents does not affect sebum
production
 Comedonal acne treatment:
 Azelaic acid, salicylic acid preparations, retinoids
ACNE

 Inflammatory acne arises from bacterial

action, esp. P. acnes, which metabolizes
sebum.
 Neutrophils attack at the site
 Treatment:
 Isotretinoin (Accutane)
 Caution: Teratogenic!
 Antibiotics (Benzoyl peroxide, benzamycin)
 Clear light system
ACNE

 Nodular cystic acne

 Characterized by nodules or cysts filled with pus
VIRAL DISEASES OF THE SKIN
WARTS

 Benign skin growths caused by viruses

 It was only in 1949 that viruses were
identified as a cause of warts.
 Treatment:
 Cryotherapy
 Electrodessication
 Podofilox
 Imiquimod (Aldara)
 Injected interferons, lasers
SMALLPOX (VARIOLA)

 During the middle ages, 80% of European

population contracted smallpox.
 Caused by an orthopox virus known as
smallpox (variola) virus
 2 basic forms:
 Variola major
 Variola minor
SMALLPOX (VARIOLA)

 Transmitted via the respiratory route

 The first disease to be eradicated from the
human race
 Would be an especially dangerous agent for
bioterrorism
 Vaccination in the U.S. ended in the 1970’s
CHICKENPOX (VARICELLA)

 A relatively mild childhood disease

 95% of US population has been infected
 Mortality rate is low
 A live attenuated vaccination was licensed in
1995
 Results from an initial infection with the
herpesvirus varicella-zoster
 The virus enters the respiratory system
CHICKENPOX (VARICELLA)

 Lesions appear as pus-filled vesicles that

rupture and forms a scab
 Reye’s syndrome may occur
 Has the ability to remain latent in the body
 The immune system fails to disturb latent
viruses
 Latent viruses may be reactivated
 post-herpetic neuralgia
HERPES SIMPLEX

 Can be simplified into 2 identifieable forms:

 HSV-1
 HSV-2
 HSV-1 transmitted via the oral and
respiratory routes
 Cold sores: Painful, short-lived vesicles that occur
near the outer red margin of the lips
HERPES SIMPLEX

 Cold sores is often confused with canker sores

 HSV-1 usually remain latent in the trigeminal
nerve
 Triggers for recurrence:
 UV radiation
 Stress
 Hormonal changes
HERPES SIMPLEX

 HSV-1 can be transmitted by skin contact

among wrestlers
 Nurses, physicians, and dentists are also at
risk
HERPES SIMPLEX

 HSV-2:
 Transmitted via sexual contact
 Genital herpes
 Latent in the sacral nerve ganglia
 Either types can cause herpes encephalitis
 Acyclovir
MEASLES (RUBEOLA)

 Is an extremely contagious viral disease that

is spread by the respiratory route
 Can be potentially eradicated through MMR
 The development is similar to smallpox and
chickenpox
 There is development of Koplik’s spots
 It is an extremely dangerous disease
RUBELLA (GERMAN MEASLES)

 Much wilder viral disease than rubeola

 A macular rash of small red spots and a light
fever disease are the usual symptoms
 Complications are rare
 Transmission is via the respiratory route
 Recovery gives firm immunity
 Congenital rubella syndrome
RUBELLA (GERMAN MEASLES)

 It is therefore important to identify women of

childbearing age who are not immune to
rubella.
 Thru blood tests
 Rubella vaccine
FUNGAL INFECTION OF THE SKIN