Diseases in the Cardiovascular and Lymphatic System

Sepsis and Septic Shock

Sepsis and Septic Shock

Signs and Symptoms: Fever, chills, accelerated

breathing and heart rate.

Gram Negative Sepsis

Drotrecogin alfa(Xigris) first to reduce rate of

sepsis case

Modified version of human activated protein C Reducing clotting factor in organ damage Widely prescribed for treatment of gram-negative sepsis and meningococcal meningitis

Gram Positive Sepsis

Enterococci have resistance to pencillin and have

rapidly acquired resistance to other antibiotics

Vancomycin antibiotic to which E. faecium is

sensitive

Puerperal Sepsis
Therapy: Antibiotics, especially penicillin

Bacterial Infections of the Heart

Bacterial Infections of the Heart

Endocardium inner layer that lines the heart muscle

itself and covers the valves

Endocarditis inflammation of the endocardium

Subacute bacterial endocarditis characterized by fever,

general weakness, and heart murmur. ( usually caused by alpha-hemolytic streptococci, enterococci or staphylococci are also involved)

Condition arises from a focus of infections in the body such as the teeth and the tonsils, microorganisms in these parts of the body enters the blood and find their way to the heart

Rheumatic Fever

Rheumatic Fever
Streptococcal infections, such as those cause by S.

pyogenes, lead to rheumatic fever

caused by infection with group A streptococcus

bacteria.
responsible for many cases of damaged heart valves Primarily occurs to ages 4-18

Tularemia

Tularemia
is a rare infectious disease that can attack the skin,

eyes, lymph nodes, lungs and, less often, other internal organs.
Called rabbit fever or deer fly fever caused by the bacterium Francisella tularensis can be treated effectively with specific antibiotics if

diagnosed early.

Brucellosis

Brucellosis
A highly contagious zoonosis caused by ingestion of

unsterilized milk or meat from infected animals or close contact with their secretions.
Can be cause by Brucella abortus, Brucella suis and

Brucella melitensis
Antibiotic therapy is possible. However, treatment

must be very long term, usually at least 6 weeks, involving a combination of at least two antibiotics.

Anthrax

Anthrax
Bacillus anthracis is the bacterium that cause Anthrax Caused by ingestion of undercooked food containing

anthrax endospores.
Symptoms are nausea, abdominal pain, and bloody

diarrhea.
Antibiotics are effective in treating anthrax if they are

administered in time.
Currently recommended drugs are ciprofloxacin or

doxycycline plus one or two additional agents that are known to be active against the pathogen

Gangrene

Gangrene

Gangrene is the death of soft tissue resulting from the loss of blood supply.
Substances released from dying and dead cells provide nutrients for many bacteria. Various species of the genus Clostridium, which are gram-positive, endospore-forming anaerobes. C. perfringens is the species most commonly involved in gangrene

The surgical removal of necrotic tissue and amputation are the most common medical treatments for gas gangrene. When gas gangrene occurs in such regions as the abdominal cavity, the patient can be treated in a hyperbaric chamber which contains a pressurized oxygen-rich atmosphere

Systemic Disease Caused by Bites and Scratches

Systemic Disease Caused by Bites and Scratches

Animal bites can result in serious infections. Cat-Scratch Disease Rat-Bite Fever

Vector transmitted disease

Plague
Caused by a gram negative, rod-shaped

bacteria, Yesinia pestis.

Bubonic Plague Septicemic Plague Pneumonic Plague

The plague can be treated effectively antibiotics

such streptomycin and tetracycline.

Lyme Disease
First outbreak occurred in Lyme, Connecticut Caused by a spirochete, Borrelia burgdorferi Most common tickborne disease in the US. Symptoms include a distinctive bulls-eye rash Can also cause encephalitis, meningitis and facial

paralysis
Can be treated with several antibiotics.

Ehrlichiosis and Anaplasmosis

Human monocytotropic ehrlichiosis is caused by

Ehrlichia chafeensis, a gram negative, rickettsia like, obligately intracellular bacterium.

Aggregates of bacteria called morulae form inside the

cytoplasm of the cells.

It is also a tickborne disease in which the common

vector is the Lone Star tick.

Reservoir is the white tailed deer Can be treated with tetracycline.

Human granulotic anaplasmosis

Caused by Anaplasma phagocytophilum Exhibits a flu like symptom which is identical with

ehrlichiosis.
Can be treated with antibiotics such as tetracycline.

Typhus
Caused by rickettsias, bacteria that are obligate

intracellular parasites of eukaryotes.

Vectors are arthropods.

Epidemic typhus

A louseborne typhus caused by Rickettsia prowazekii in which the vector is the louse Pediculus humanus corporis. Found in the GIT of the louse, it is transmitted to the human body when the bitten host scratches the bite.

Produces high and prolonged fever for 2 weeks.

Stupors and a rash of small red spots caused by subcutaneous hemorrhage as the rickettsias invade blood vessel linings.

Treatment includes tetracycline and chloramphenicol.

Vaccines are available for military populations.

Endemic murine typhus

Occurs sporadically than in epidemics. Caused by

Rickettsia typhi carried by a rat flea, Xenopsylla cheopis.

Tetracycline and chloramphenicol are effective for

the treatment of the disease and the best preventive measure is rat control.

Spotted Fevers

Also known as Rocky Mountain spotted fever or tickborne typhus. Caused by Rickettsia ricketsii. Infects ticks via transovarian passage. Vectors are dog ticks which are Dermacentor andersoni in the west and Dermacentor variablis in the east. Produces a macular rash which can be mistaken as measles

Tetracycline and chloramphenicol is effective.

No vaccines.

Burkitts lymphoma
First observed by Denis Burkitt in the 1950s The most common cancer in children in Africa. Discovered by Tony Epstein and Yvonne Barr, the

cancer was caused by a herpes like virus which is the Epstein-Barr virus of human herpesvirus 4.
Can occur in areas infested with malaria.

Infectious mononucleosis

Was identified because of the EB virus. Characterized by fever, sore throat, swollen lymph nodes in the neck. The same virus that caused Burkitts lymphoma also caused infectious mononucleosis.

Death can be caused by a ruptured enlarged spleen.

Recovery can be completed in a few weeks and immunity lasts permanently. The EB virus infects the oropharynx. The term mononucleosis refers to lymphocytes with unsual lobed nuclei that proliferate in the blood during infection.

 The infected B cells produce nonspecific antibodies

called heterophil antibodies.

The most specific diagnostic test is the fluorescent-

antibody diagnostic test.

There are no recommended specific treatments for

most patients.

Chikungunya Disease

Chikungunya
Caused by an alphavirus that is spread by mosquito bites from the Aedes aegypti mosquito. characterized by an abrupt onset of fever frequently accompanied by joint pain. neurological complications such as meningoencephalitis have been reported in a small proportion of patients There is no active treatment against chikungunya Presently treatment is purely symptomatic supportive care and rest and nutrition Analgesics, antipyretics and fluid supplementation are important aspects in managing this infection

PREVENTION
Elimination of stagnant water at home, schools

and work place to avoid breeding of mosquitoes. the body.

Using insect repellents over the exposed parts of

Using mosquito screens or nets in non Air-

conditioned rooms.

Wearing the long sleeved clothes like long trousers

of a light shade for protection against mosquitoes.

Viral Hemorrhagic Fevers

Viral Hemorrhagic Fevers (VHF)

Febrile illnesses caused by RNA viruses from several

virus families
Can lead to potentially lethal syndrome characterized

by fever, malaise, vomiting, mucosal and gastrointestinal bleeding, edema and hypertension.

Types of VHF:
Classic Viral Hemorrhagic Fevers

Zoonotic diseases They have been medically familiar for so long that they are considered Classic Hemorrhagic Fevers. They appear in humans only from infectious contact with their normal animal host

Emerging Viral Hemorrhagic Fevers

They are considered new or emerging hemorrhagic fevers

Classic Viral Hemorrhagic Fevers

Zoonotic viral disease caused

Yellow Fever

by Flavivirus
Endemic in many tropical

areas
Transmitted to humans

through the bite of infected mosquitoes named Aedes aegypti. Symptoms of yellow fever include fever, chills, headache, backache, nausea, and vomiting. Jaundice also occurs.
Vaccination live attenuated

viral vaccine (YF-VAX)

There is NO specific
Mohammed Saleh Hamid (18 years old) in Al-Geneina Teaching Hospital, November 14.

treatment for yellow fever

Hemorrhagic Fevers
Most common mosquito borne viral

Dengue

disease of humans Similar than Yellow Fever but milder viral disease caused by Flavivirus Transmitted to humans through the bite of infected mosquitoes named Aedes aegypti Symptoms of Dengue include high fever, headache, sever joint & muscle pain, nausea, vomiting, skin rash and mild bleeding No specific treatment for Dengue but its advisable to get plenty of bed rest, drink a lot of fluids and take medicines such as pain relievers and anti-pyretics to help with the recovery Dengue hemorrhagic fever(DHF) is a severe form of dengue Occurs when antibodies from previous infections combine with the virus.

PHNOM PENH, April 11 At least 1,500 dengue

fever cases were reported in Cambodia in the

First three months of this year

Emerging Viral Hemorrhagic Fevers

Emerging Viral Hemorrhagic Fevers

A rare severe type of hemorrhagic

Marburg Hemorrhagic Disease

fever which affects both human and non-human primates caused by Filovirus, Marburg Virus
Transmitted by direct contact with

the blood, body fluids and tissues of infected persons and handling ill/ dead infected wild animals
Symptoms of

MHD include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction.
The specific treatment is unknown.

However, supportive hospital therapy should be utilized

Transmission electron micrograph of the Marburg virus

Emerging Viral Hemorrhagic Fevers

Also called Lassa Fever
An acute VHF caused an Arenavirus,

Lassa hemorrhagic Fever (LHF)

Lassa Virus
The reservoir of Lassa virus is a rodent

called multimammate rat

Can be transmitted either direct

contact of the urine and droppings of these rodents or person-to-person contact (blood, tissue, secretion or excretion)
Symptoms of LHF include fever,

retrosternal pain, sore throat, back pain, cough, abdominal pain, vomiting, diarrhea, conjunctivitis, facial swelling, proteinuria and mucosal bleeding

Ribavirin, an antiviral drug has been used with success in Lassa Fever Patients Patients should also receive supportive care consisting of maintenance of appropriate fluid and electrolyte balance, oxygenation and blood pressure, as well as treatment of any other complicating infections.

Emerging Viral Hemorrhagic Fevers

A severe, often-fatal disease in

Ebola Hemorrhagic Fever

(Ebola HF)

humans and non-human primates

Caused by infection with a

Filovirus, Ebola virus

A person becomes exposed to

Ebola virus through direct contact with infected animals/ persons.

Symptoms of Ebola HF include

Arthritis, Backache, Chills, Diarrhea, Fatigue, Fever, Headache, Malaise, Nausea, Sore throat, Vomiting There is no known cure. Antivirals do not work well on Ebola virus. Patients usually need intensive care. Bleeding problems may require transfusion of platelets or fresh blood

Emerging Viral Hemorrhagic Fevers

An acute febrile viral illness Caused by an Arenavirus, Junin virus Transmitted to humans by contact with or

Argentine hemorrhagic fever (Argentine HF)

inhalation of aerosolized excreta of infected rodents.

Characterized by chills, fever, headache,

myalgia, anorexia, nausea, vomiting, and a general feeling of malaise

No specific treatment for the disease

other than hydration, rest, warmth, and adequate nutrition

Rarely, IV fluids and dialysis are

necessary. Usually, the prognosis is complete recovery

Emerging Viral Hemorrhagic Fevers

An acute febrile viral illness Caused by an Arenavirus, Machupo virus The vector is a vesper mouse, Calomys

Bolivian hemorrhagic fever (Bolivian HF)

callosus
Transmitted to humans by contact with or

inhalation of aerosolized urine of infected rodents.

Person-to-person infection has been

documented, but it is very rare

Characterized by chills, fever, headache,

muscle ache, anorexia, nausea, and vomiting

IV Ribavirin therapy is used for the

treatment of Bovilian HF

Transmission electron micrograph of the Muchupo virus

Emerging Viral Hemorrhagic Fevers

Whitewater Arroyo Hemorrhagic Fever (WWAHF)

First reports of arenavirus - caused hemorrhagic disease in the Northern

Hemisphere.
Caused by an Arenavirus, Whitewater Arroyo virus Transmitted by white-throated woodrats (Neotoma albigula) Symptoms include fever, headache, myaglia and hemorrhagic manifestation

Emerging Viral Hemorrhagic Fevers

a severe, sometimes fatal, respiratory

Hantavirus pulmonary Syndrome (HPS)

disease in humans
Caused by a Bunyavirus, Sin Nombre virus It primarily affects renal (kidney) function Deer mice (along with cotton rats, rice rats

and the white-footed mouse) are the reservoir of virus

Transmission of virus through direct

contact with these rodents

Rodent excretions containing the virus may

be transmitted airborne

There are no specific treatment, cure or vaccine for the hantavirus infection Infected individuals need Medical care in an intensive care unit at an early stage

Severe HPS Image courtesy D. Loren Ketai, M.D.

Protozoan diseases of the cardiovascular and lymphatic systems

A protozoan disease of the cardiovascular system Caused by Trypanosoma cruzi Triatomine bug (also called kissing bug) is the reservoir of T. cruzi Transmission of parasite through biting of the Triatomine bug leaving the feces at the wounded part It may also be transmitted through blood transfusion, organ transplant, breast milk, accidental lab exposure and eating contaminated food

Chagas Disease
Acute Chagas Disease in a young child. The eye sign of Romana is present. This is frequently seen in acute cases and is presumed to mark the point of entry of the parasite. Credit: WHO/TDR

Benznidazole and Nifurtimox, prescription medications may be of benefit during the ACUTE PHASE of Chagas disease

Toxoplasmosis

TOXOPLASMOSIS
A disease of blood and lymphatic vessels is caused by

the protozoan Toxoplasma gondii - a spore forming protozoan. Cats are an essential part of the life cycle of T.gondii. Signs and symptoms are Swollen lymph nodes, Headache, Fever, Fatigue, Occasionally, a sore throat.

TREATMENTS

Trimethoprim/sulfamethoxazole is the drug of choice to prevent toxoplasmosis, but is not the drug to treat.

For Acute Taxplasmosis

Pyrimethamine

Sulfadiazine
Clindamycin Spiramycin

Medications prescribed for Latent toxoplasmosis:

Atovaquone clindamycin

Malaria

MALARIA
It begins with the bite from an infected female

anopheles mosquito which introduces the protist through saliva in the circulatory system.
Plasmodium vivax cause of the most prevalent

form of malaria. Referred to as benign

Plasmodium ovale and Plasmodium malariae

cause a relatively benign malaria.

Plasmodium falciparum most dangerous

signs and symptoms

A high temperature (fever) of 38C (100.4F) or above

(occurs at regular times)

Vomiting Sweating and shivers (also known as rigors) Body & Muscle pains Headaches

Diarrhoea

In some cases, it can affect the brain or kidneys.

MEDICATIONS

Amodiaquine Lumefantrine Mefloquine sulfadoxine/ Dihydroartemisinin Piperaquine

Severe malaria requires the parenteral administration of antimicrobial drugs

Leishmaniasis

LEISHMANIASIS

Phlebotomus is considered the vector of leishmaniasis.

Drugs used to treat leishmaniasis include

pentavalent antimony compounds such as sodium stibogluconate and meglumine antimoniate, as well as pentamidine isethionate and amphotericin B.

Babesiosis

BABESIOSIS

Babesiosis is a tick-borne disease caused by malaria-like parasites of the genus Babesia. Tracking Babesia infections is difficult due to the number of asymptomatic infections. Babesiosis was first reported as "Texas cattle fever" around the turn of the century.

Ixodes species- tick vectors Babesia equi and Babesia microti-causative agent

Treatment is antibiotics, usually clindamycin and quinine or atovaquone and azithromycin.

How do people get infected with Babesia?

The main way is through the bite of an infected tick: Babesia microti is spread by Ixodes scapularis ticks, which are commonly called blacklegged ticks or deer ticks. (Although white-tailed deer are the most important food source for the adult stage of the tick, deer are not infected with B. microti.) The parasite typically is spread by the young nymph stage of the tick. Nymphs are most apt to be found during warm months in areas with woods, brush, or grass. Infected people might not recall a tick bite because I. scapularis nymphs are very small (about the size of a poppy seed). Other possible ways of becoming infected with Babesia include: receipt of a contaminated blood transfusion (no tests have been licensed yet for donor screening); or

transmission from an infected mother to her baby during pregnancy or delivery.

Schistosomiasis

Schistosomiasis
What causes schistosomiasis?
Parasites of the genus Schistosoma (S. mansoni, S. mekongi, S. intercalatum, S. hematobium, and S. japonicum) cause the disease.. Humans enter freshwater areas that contain snails that grow Schistosoma sporocysts that develop into freeswimming cercariae.

What are the symptoms and signs of schistosomiasis?

Fever Abdominal pain (liver/spleen area) Bloody diarrhea or blood in the stools

Cough
Malaise Headache

Rash
Body aches

What is the treatment for schistosomiasis?

Currently, the drug used in most people is praziquantel(Biltricide); however, it only is effective against adult worms and does not affect eggs or immature worms Other drugs (oxamniquine, metrifonate, artemisinins, and trioxolanes) have been used in some patients but have limited effectiveness. New drugs are in development.

Swimmers Itch

What is swimmer's itch?

Swimmer's itch, also called cercarial dermatitis, is a skin rash caused by an allergic reaction to infection with certain parasites of birds and mammals.

What are the signs and symptoms of swimmer's itch?

Within minutes to days after swimming in contaminated water, you may experience tingling, burning, or itching of the skin. Small reddish pimples appear within 12 hours. Pimples may develop into small blisters. Itching may last up to a week or more, but will gradually go away.

Treatment

Corticosteroid cream cool compresses bath with baking soda baking soda paste to the rash anti-itch lotion Calamine lotion colloidal oatmeal baths, such as Aveeno* Try not to scratch. Scratching may cause the rash to become infected. If itching is severe, your health care provider may prescribe lotion or creams to lessen your symptoms