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JUN CARY V. SUITOS, SN

Arellano University - 0900252
College of Nursing - Batch 2011

REVIEWER IN MICROBIOLOGY – PARASITOLOGY (FINAL EXAM)

Prof. Alexander John Tadeo, MD

I. POX VIRUS
• Smallpox (variola)
- Person – person via infectious respiratory droplets and fragments of scalp from skin
lesion.
- Most infections w/ rash onset til 4 weeks
- Complications: pneumonia, dermatitis corneal ulcer; encephalitis
- Prophyloxis: active vaccination discovered by Jeisner
• Vaccinia or caupou
• Molluscum Contagionism

II. Herpes Virus

• Herpes simplex
- skin, mucous membrane, eyes, CNS affected via skin, mouth, and sexual contact
- primary infection
1. gingivastomolitis: 1 – 6 y/o, gum swollen – visible on buccal mucosa, tongue, lips
2. Vulvovaginistis – labia & vagina
3. meningoencephalitis
4. keratoconjunctivitis
5. eczema herpeticum
- recurrent infection:
1. herpes labialis – type I (oral)
2. herpes progenitalis – type II (genital)
• virus reside in the ganglia of sensory nerves innervating the affected area of the
skin and not in the skin itself.
• Varicella (chickenpox)
- incubate: 15 – 18 days w/ prodrame , they rash w/c is vesicular; spread on trunk to
centripetal extremities
- infection in adult: more intensive than in childhood
- capable of crossing the placenta during pregnancy infecting fetus
- prevention: vaccine
• Herpes Zoster (shingles)
- reactivation of latest virus of vaicella in patient who are immunodeficient
- common site: sensory nerve; innervated by the thoracic ganglia
- Affects cranial nerve 5 (trigeminal)
- Very painful – post herpetic neuralgia
- Lesions are vesicular, unilateral only at area affected by sensory or cranial nerves.
• Cytomegalovirus
- transmitted in saliva and sexual intercourse, human milk
- cause: congenital infection
• Epstein Bain Virus (EBV)
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- malignant burkitts affecting children
- involves the jaw
- neoplastic cell have starry sky appearance

• Infectious mononucleosis (glandular fever)

- severe sorethroat; lymphadenepethy; mild hepatitis; skin rash
- ( + ) heterophil antibody by Paul and Bunnell test
III. Adenovirus
• Caused infant and children respiratory infection, conjunctival, intestinal epithelium, reguenil
lymphaid tissues
.1 Papovavirus
• Associated w/ neoplasm
1. papillomaviruses – human warts, planter and hand warts (verrucae plantaris et vulgeria),
genital warts, flatwarts (verruca plasma)
2. endocrine and immunodeficiency influence growth
V. Enteroviruses
1. Herpangina Loxackie A – ulcerative lesion of mucosa on posterior pharynx and soft palate
2. Pleurodynia Loxackie B – extreme myalgia, chest pain, headache, infant ill paralysis
3. Polioneyelitis – paralytic disease caused by type I (brumhilde) & type 3 (Leon)
- incubation: 2 – 6 days
- virus replicate in pharynx and GIT = febrile episode, then hematogenous route to CNS
to anterior hormone cell to paralysis of extremities (lower is more affected than upper) is
asymmetrical & result to atroplug after 4 – 8 weeks.
- Prevention: OPV 1,2,3 (salk & sabin – oral)
VI. Orthomyxovirus
.1 Influenza virus – replication in superficial respiratory cells, destruction of ciliated columnar
epithelium & denudation of tiacluobroullival tree = severe sore throat & substernal pain; cough
dyspnia; aerosol, colder mouths
VII. Paramyxovirus
.1 Parainfluenza virus type 1 – laryncgotrachcobraclitis (croup); type 3 – brocholitis & pneumonia
in infant
.2 mumps – parotitis 5 – 10 y/o
- transmitted by saliva of infected person through upper respiratory tract
- incubation: 14 – 21 days
- viremia occurs & results to salivary gland inflammation esp parotid glands
- most severe, CNS manifestation is past infectious encephalitis
- most common complication is testes inflammation = orchitis in postpubertal males w/c
may result to sterility.
- Self-limiting, confers lifetime immunity
- Prevention: MMR
.i Psuedonyxovirus
.2 Measles (Rubiola)
- incubation: 10 – 14 days
- prodrone: cough, cocyza, conjunctivitis, fever, 3days later maculopapulae rash
- koplik spots on lateral buccal mucosa is pathognomonic
- rash begins post auricular, forehead, neck, trunk, and lower extremities.
- Complications: otitis media & pneumonia but the most dreadful is encephalomyelitis
.3 Respiratory Synctial virus (RSV) – respiratory tract pathogen of infant and children (e.g.
brochioritis & pneumonitis)
- breast feeding provides protection
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X. Togavirus
.1 Rubella (german measles)
- mild rash principally at children but seen at all ages.
- Incubation: 18 days
- Rash on the face, neck, all over the body and disappered on 3rd day.
- Congenital rubella result to deafness, congenital heart disease, cataract, glaucoma,
retinitis, growth and mental retardation
- Intrauterine rubella may result to fetal death, abortion, and neonatal death esp if
acquired in the 1st trimester of pregnancy
- Prevention: MMR
X. Arbovirus (Arthropod borne)
1. Cause: fever; rash; arthnalgia
- dengue fever: abrupt fever, headache, myalgia, mascular rash w/c blemishes w/
pressure
- self-limiting
- vector: aedes gegypti
2. causes encephalitis
• western & eastern equine – culix
• California – aedes
• St. louise – culix
• Powassan – Tick
• Venezuelan – culix
• Japanese B – culix
3. causes hemorrhagic fever: aedes
- yellow fever: sudden fever, severe headache, photophobia, conjunctivitis & later liver
involvement, kidney, heart resulting to jaendice and shock.
- Dengue hemorrhagic fever: epistaxis, ( + ) in Tourniquet test
XI. Rhabdovirus
1. Rabies – saliva of rabied animals
- Paresthesia, hydro & aerophobia
- ( + ) Negro bodies in brain tissue
- bites over the head and neck are more likely to result in disease due to more nerve
ending provide more neurologic pathways to go to CNS for fixation & also shorter
distance
- incubation; 2 – 8 weeks
- death is inevitable
- prevention: passive & active immunization
2. Ebola
- from body fluid and tissues of green monkeys
- named after the river in Zaire where the outbreak occurred.
- S/s: fever, vomiting, LBM, abdominal pain, conjunctivitis, maculopapular rash, severe
bleeding, shock and death
3. Vesicular stomatitis virus
- vesicles in gums; buccal mucosa and herpes
- self-limiting
a. Arena virus
2. Lymphocyticchoreomeningitis
- from house mice
- benign meningiencephalitis
3. Hemorrhagic
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- argentinian – junin virus
- Bolivian – machupo virus
- West Africa – Lassa fever
XIII. Rhinovirus (nose virus)
- UPI: common colds
XIV. Reovirus – GI & respiratory infection
XV. Rotavirus – epidemic diarrhea of newborn
XVI. Corona virus – grows only in human tachea
- associated w/ upper respiratory tract in adult and lower respiratory tract in children
- may cause gastroenteritis in pigs and cows
- Severe Acute Respiratory Syndrome (SARS): originated in China
XVII. Slow virus – infection of CNS
- unconventional
a. kuru “shaking disease” w/mild cerebellar ataxia & dementia
b. Creutzfeld – Jacob’s disease (CJD)
- Conventional - children and adolescence
a. SSPE – gradual personality & intellectual changes, impaired memory, speech difficulty
XVIII. Hepatits
1. Hepa A
- Infectious
- Short incubation: 15 – 50 days
- Oral – fecal
- Sudden onset
- Jaundice; anorexia; fever; vomiting
2. Hepa B
- serum hepa
- parenteral; sexual
- insidious
- same s/s as hepa A (except for jaundice w/c is not intense)
- Dx: HBsA, anti – HBV 2gm, SGPT
- Tx: supportive
- Prevention: vaccine for hepa B; immunoglobulin for hepa A
XIX. Miscellaneous
1. Roscola Infantum – herpes virus G: 6th disease <2 y/o w/ sudden fever & 3days after rash
occurs
2. Erythma infectionism – porvo virus: 5th disease
- molar rash “slapped cheek”
- moculopopular rash generalized

AIDS
- Acquired immunodeficiency Syndrome
- A syndrome because it consist of several s/s
- 1st case was in 1981
- pathogen: Human Immunodeficiency Virus (HIV) - an RNA retrovirus
a. HIV 1
- 1st invade dendritic cells in the genital & oral mucosa then fuse w/ CO4 & lymphocytes
(helper T cells)
b. HIV 2
- Reservoir: humans
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- Transmission: direct sexual contact, homosexual or heterosexual, sharing of contaminated
needles & syringes by IV drug abusers, contaminated blood transfusion, transplacental,
breast feeding, needlesticks, scalpel
- Incubation: 3 months to 10 yrs.
- Concentration: high in blood semen and vaginal secretion; saliva, tears, breast milk
- Virus is not very active so it must be high in concentration to cause infection.
- Signs & symptoms:
a. HIV: fever, rashes, headache, lympadenopathy, pharyngitis, myalgia, arthmalgia,
aseptic meningitis, depression, GI distress, night sweat, oral and genital ulcers.
b. AIDS: severe life-threatening, late clinical stage of infection w/ HIV. CD4 <400/ml leads
to immunosuppression, so the patient’s immune system will be unable to produce
antibodies against T-descendent antigen.
- Infections:
a. cytomegalovirus – herpes simplex
b. cryptosporidum & toxoplasma
c. mycobacteria – TB
d. candoda, cryptococcus, pneumocystis
- Complications:
.1 pneumonia – pneumocystis; non-productive cough of weeks duration; dyspnea, fever,
tachypnea.
.2 kaposis sarioma – rare vascular tremor in the lower limbs
.3 CNS – dementia, meningitis, focal lesions, retinitis
.4 GI Disease – diarrhea, esophagitis caused by cryptosporidium
.5 Lymphora – non hodg skin
.6 Fever of unknown origin
- Dx: screening – ELISA test (2x)
• Confirmatory – western blot
• Others: T4 cell count
- Tx: Anteretroviral drugs
• Prophylaxis to opportunistic infection
- Goal: prolong survival of HIV infected person
• There is NO TREATMENT for AIDS.