C5. INFECTIOUS DISEASES LEARNING OBJECTIVES

MICROBIAL 1. Compare and contrast various routes of entry of infectious PATHOGENESIS agents (skin, respiratory, gastrointestinal and urogenital tract). Describe mechanisms by which infectious agents evade local defenses. Give examples of microbes that use these routes of entry. 2. Describe routes of dissemination of infectious agents. Give examples of microorganisms that use various modes of dissemination. 3. Describe routes of transmission of infectious agents from person to person. Give examples of pathogens that use various „exit strategies”. 4. Describe routes through which vertical transmission of infectious agents may occur. Give examples of microobes that use these routes of transmission. 5. List mechanisms by which infectious agents damage host tissues. 6. Describe morphologic patterns of tissue responses to with regard to pathogenesis and macro- and microscopic features. Give examples of microorganisms that evoke such responses. C4. Inflammation and Repair

VIRAL 7. Discuss mechanisms by which cause injury to cells. 8. Describe acute viral infections (measels and mumps) in terms of pathogenesis, morphologic features and clinical manifestations. Define Koplik spots and Warthin-Finkeldey cells. 9. Describe latent viral infections (HSV, VZV and CMV) with regard to pathogenesis, morphologic features and clinical manifestations. Define intranuclear inclusions, Cowdry bodies, cold sores, chickenpox and shingles. LEARNING OBJECTIVES

BACTERIAL 10. Discuss mechanisms by which bacteria cause injury to cells. INFECTIONS Give examples of bacteria that use particular mechanisms. 11. Define endotoxins and exotoxins. List types of exotoxins. 12. Describe staphylococcal infections in terms of pathogenesis, morphologic features and clinical manifestations. Define furuncule (boil), carbuncule, hidradenitis, paronychia, felons and staphylococcal scalded-skin syndrome. 13. Describe streptococcal infections with regard to pathogenesis, morphologic features and clinical manifestations. Define erysipelas and scarlet fever. 14. Describe tuberculosis in terms of pathogenesis, the natural history, morphologic features and clinical manifestations. Define primary tuberculosis, secondary tuberculosis, Ghon complex, Ranke complex, tubercle, caseation, Langhans giant cells, miliary pulmonary disease, Pott disease, „cold” abscess, „scrofula”. C4. Inflammation and Repair

15. Define . Describe stages of the disease with their distinct clinical and pathologic manifestations. Define chancre, condyloma latum and syphilitic gumma. 16. Describe manifestations of congenital syphilis. Define Hutchinson triad and Hutchinson teeth. 17. Discuss clostridial infections (gas gangrene, tetanus, botulism and pseudomembranous colitis) in terms of etiopathogenesis, morphologic features and clinical consequences.

LEARNING OBJECTIVES

FUNGAL 18. List major types of fungal infections. INFECTIONS 19. Define yeasts, molds and dimorphic fungi. (MYCOSES) Give examples of fungi that belong to each group. 20. Define hyphae, pseudohyphae, buds and conidia. 21. Describe aspergillosis in terms of etiopathogenesis, morphologic features and clinical consequences. 22. Define aspergilloma, allergic and invasive aspergillosis.

PARASITIC 23. Compare and contrast cysticercosis and hydatid disease with regard to INFESTATIONS etiopathogenesis, life cycle of the tapeworms, intermediate and definitive hosts, morphologic changes and clinical consequences. Define definitive host, intermediate host, scolex and proglottids. 24. Describe enterobiasis in terms of pathogenesis, life cycle of the parasite, morphologic features and clinical consequences.

SPECIAL 25. Give examples of special stains used to visualize various types DIAGNOSTIC of infectious agents. TECHNIQUES REFERENCES

V. Kumar, A. K. Abbas, J. C. Aster: ROBBINS AND COTRAN Chapter 8:  PATHOLOGIC BASIS OF DISEASE HOW MICROORGANISMS CAUSE DISEASE?  HOST DAMAGE  SPECTRUM OF INFLAMMATORY RESPONSES TO INFECTION  SPECIAL TECHNIQUES FOR DIAGNOSING INFECTIOUS AGENTS  VIRAL INFECTIONS (, MUMPS, HERPES SIMPLEX , VARICELLA-ZOSTER VIRUS, )  BACTERIAL INFECTIONS (STAPHYLOCOCCAL INFECTIONS, STREPTOCOCCAL AND ENTEROCOCCAL INFECTIONS, TUBERCULOSIS, SYPHILIS, CLOSTRIDIAL INFECTIONS,)  FUNGAL INFECTIONS (ASPERGILLOSIS)  PARASITIC INFECTIONS (TAPEWORMS)

Chapter 17:  INFECTIOUS ENTEROCOLITIS (PSEUDOMEMBRANOUS COLITIS)  PARASITIC ENTEROCOLITIS (INTESTINAL CESTODES, ENTEROBIUS VERMICULARIS) PHOTOMICROGRAPHS

ACTINOMYCES (PALATINE TONSIL) PHOTOMICROGRAPHS

ACTINOMYCOSIS (SKIN) PHOTOMICROGRAPHS

ACTINOMYCES

 fungus-like branching filamentous bacteria

 reside in the oropharynx, gastrointestinal and female genital tract

 require anaerobic environment for growth (not capable of invasion unless inoculated into deeper tissues)

ACTINOMYCOSIS

 gradually spreading purulent inflammation evoked by proliferation of Actinomyces (most commonly A. israeli) inoculated into deeper tissues (e.g. due to trauma)

 involves cervicofacial, thoracic, abdominal or pelvic region

 purulent exudate contains colonies of filamentous bacteria – basophilic grains with eosinophilic borders (Splendore-Hoeppli phenomenon), grossly resembling sulfur granules

 multiple abscesses (connected by sinus tracts) develop and may eventually penetrate into adjacent organs or onto the external surface

 purulent inflammation is accompanied by chronic inflammatory infiltrate, granulation tissue and fibrosis PHOTOMICROGRAPHS

TUBERCULOSIS (MILIARY LESIONS) PHOTOMICROGRAPHS

TUBERCULOSIS (PULMONARY CAVITY) PHOTOMICROGRAPHS

ASPERGILLOMA (LUNG) PHOTOMICROGRAPHS

ENTEROBIASIS (APPENDIX)