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Human Diseases Caused by Bacteria Prescott−Harley−Klein: X. Microbial Diseases and 39. Human Diseases © The McGraw−Hill Microbiology, Fifth Edition Their Control Caused by Bacteria Companies, 2002 CHAPTER 39 Human Diseases Caused by Bacteria The toll of tetanus. The bacterial genus Clostridium contains many pathogenic species, including the species responsible for tetanus (C. tetani). Sir Charles Bell’s portrait (c. 1821) of a soldier wounded in the Peninsular War in Spain shows the suffering from generalized tetanus. Outline 39.1 Airborne Diseases 900 Lymphogranuloma Diphtheria 900 Venereum 917 Legionnaires’ Disease and Mycoplasmal Pontiac Fever 901 Pneumonia 917 Meningitis 902 Nongonococcal Mycobacterium Urethritis 918 avium–M.intracellulare Peptic Ulcer Disease and Pneumonia 902 Gastritis 918 Pertussis 903 Psittacosis (Ornithosis) 919 Streptococcal Diseases 903 Staphylococcal Diseases 919 Tuberculosis 906 Syphilis 923 39.2Arthropod-Borne Tetanus 924 Diseases 908 Trachoma 925 Ehrlichiosis 909 Tularemia 926 Epidemic (Louse-Borne) Sexually Transmitted Typhus 909 Diseases 926 Endemic (Murine) 39.4 Food-Borne and Typhus 909 Waterborne Diseases 926 Lyme Disease 910 Botulism 929 Plague 911 Campylobacter jejuni Q Fever 912 Gastroenteritis 929 Rocky Mountain Spotted Cholera 930 Fever 913 Listeriosis 931 39.3 Direct Contact Salmonellosis 931 Diseases 913 Shigellosis 931 Anthrax 913 Staphylococcal Food Bacterial Vaginosis 914 Poisoning 932 Cat-Scratch Disease 914 Traveler’s Diarrhea and Chancroid 914 Escherichia coli Chlamydial Pneumonia 914 Infections 932 Gas Gangrene or Clostridial Typhoid Fever 933 Myonecrosis 915 39.5 Sepsis and Septic Genitourinary Mycoplasmal Shock 933 Diseases 915 39.6 Dental Infections 933 Gonorrhea 915 Dental Plaque 933 Inclusion Conjunctivitis 916 Dental Decay (Caries) 936 Leprosy 916 Periodontal Disease 936 Prescott−Harley−Klein: X. Microbial Diseases and 39. Human Diseases © The McGraw−Hill Microbiology, Fifth Edition Their Control Caused by Bacteria Companies, 2002 900 Chapter 39 Human Diseases Caused by Bacteria Concepts Table 39.1 Some Examples of Human Bacterial 1. Bacterial diseases of humans can be discussed according to their mode of Diseases Recognized Since 1973 acquisition/transmission. Year Bacterium Disease 2. Most of the airborne diseases caused by bacteria involve the respiratory system. Examples include diphtheria, Legionnaires’ disease and Pontiac 1977 Legionella pneumophila Legionnaires’ disease fever, Mycobacterium avium–M. intracellulare pneumonia, pertussis, streptococcal diseases, and tuberculosis. Other airborne bacteria can 1977 Campylobacter jejuni Enteric disease (gastroenteritis) cause skin diseases, including cellulitis, erysipelas, and scarlet fever, 1981 Staphylococcus aureus Toxic shock syndrome or systemic diseases such as meningitis, glomerulonephritis, and 1982 Escherichia coli O157:H7 Hemorrhagic colitis; hemolytic rheumatic fever. uremic syndrome 3. Although arthropod-borne bacterial diseases are generally rare, they are of 1982 Borrelia burgdorferi Lyme disease interest either historically (plague) or because they have been newly 1982 Helicobacter pylori Peptic ulcer disease introduced into humans (Lyme disease). Most of the rickettsial diseases are 1986 Ehrlichia chaffeensis Human ehrlichiosis arthropod-borne. The rickettsias found in the United States can be divided 1992 Vibrio cholerae O139 New strain associated with into the typhus group (epidemic typhus caused by R. prowazekii and murine epidemic cholera in Asia typhus caused by R. typhi) and the spotted fever group (Rocky Mountain 1992 Bartonella henselae Cat-scratch disease; bacillary spotted fever caused by R. rickettsii and ehrlichiosis caused by Ehrlichia angiomatosis chaffeensis), with Q fever (caused by Coxiella burnetti) being an exception 1993 Enterococcus faecium; Colitis and enteritis because it forms endosporelike structures and does not have to use an insect vancomycin-resistant vector as with other rickettsias. enterococci 4. Most of the direct contact bacterial diseases involve the skin, mucous 1994 Ehrlichia spp. Human granulocytic ehrlichiosis membranes, or underlying tissues. Examples include anthrax, bacterial 1995 Neisseria meningitidis Meningococcal supraglottitis vaginosis, cat-scratch disease, chancroid, gas gangrene, leprosy, peptic ulcer disease and gastritis, staphylococcal diseases, and syphilis. Others can 1997 Kingella kingae Pediatric infections become disseminated throughout specific regions of the body—for example, gonorrhea, staphylococcal diseases, syphilis, tetanus, and tularemia. Three chlamydial species cause direct contact disease: Chlamydia pneumoniae causes chlamydial pneumonia; Chlamydia trachomatis causes inclusion conjunctivitis, lymphogranuloma venereum, nongonococcal urethritis, and trachoma; and C. psittaci causes psittacosis. Three species of mycoplasmas chlamydiae, mycoplasmas, and rickettsias that are pathogenic are human pathogens: Mycoplasma hominis and Ureaplasma urealyticum to humans. The microorganisms involved in dental infections cause genitourinary tract disease, whereas M. pneumoniae is a major cause are also described. of acute respiratory disease and pneumonia. 5. The food-borne and waterborne bacterial diseases are contracted when contaminated food or water is ingested. These diseases are essentially of two types: infections and intoxications. An infection occurs when a pathogen enters the gastrointestinal tract and multiplies. Examples include Of all the known bacterial species, only a few are pathogenic Campylobacter gastroenteritis, salmonellosis, listerosis, shigellosis, traveler’s to humans. Some human diseases have been only recently recog- diarrhea, Escherichia coli infections, and typhoid fever. An intoxication occurs because of the ingestion of a toxin produced outside the body. nized (table 39.1); others have been known since antiquity. In the Examples include botulism, cholera, and staphylococcal food poisoning. following sections the more important disease-causing bacteria 6. Some microbial diseases and their effects cannot be categorized under a are discussed according to their mode of acquisition/transmission. specific mode of transmission. Two important examples are sepsis and septic shock. Gram-positive bacteria, fungi, and endotoxin-containing gram-negative bacteria can initiate the pathogenic cascade of sepsis leading to septic shock. 39.1 Airborne Diseases 7. Several bacterial odontopathogens are responsible for the most common bacterial diseases in humans—tooth decay and periodontal disease. Both are the result of plaque formation and the production of lactic and acetic Most airborne diseases caused by bacteria involve the respiratory acids by the odontopathogens. system. Other airborne bacteria can cause skin diseases. Some of the better known of these diseases are now discussed. Soldiers have rarely won wars.They more often mop up after the Diphtheria barrage of epidemics.And typhus, with its brothers and sisters— Diphtheria [Greek diphthera, membrane, and ia, condition] is plague, cholera, typhoid, dysentery—has decided more campaigns an acute contagious disease caused by the gram-positive than Caesar, Hannibal, Napoleon, and all the . generals of history. Corynebacterium diphtheriae (see figure 24.8). C. diphtheriae The epidemics get the blame for the defeat, the generals the credit for is well adapted to airborne transmission by way of nasopharyn- victory.It ought to be the other way around.... geal secretions and is very resistant to drying. Diphtheria —Hans Zinsser mainly affects poor people living in crowded conditions. Once within the respiratory system, bacteria that carry the prophage ␤ containing the tox gene (see section 17.5) produce diphtheria he first four parts of this textbook cover the general bi- toxin, an exotoxin that causes an inflammatory response and the ology of bacteria. Chapters 19 through 24 specifically formation of a grayish pseudomembrane on the respiratory mu- T review bacterial morphology and taxonomy. Chapter cosa (figure 39.1). The pseudomembrane consists of dead host 39 continues the coverage of bacteria by discussing some of cells and cells of C. diphtheriae. The exotoxin is also absorbed the more important gram-positive and gram-negative bacteria, into the circulatory system and distributed throughout the body, Prescott−Harley−Klein: X. Microbial Diseases and 39. Human Diseases © The McGraw−Hill Microbiology, Fifth Edition Their Control Caused by Bacteria Companies, 2002 39.1 Airborne Diseases 901 Extension of pseudomembrane Airborne transmission Enlarged lymph Membranous nodes and pharyngitis swollen neck (pseudomembrane) Extension of pseudomembrane Toxemia Figure 39.2 Legionnaires’Disease. Legionella pneumophila, the (exotoxin in blood) Esophagus causative agent of Legionnaires’ disease, with many lateral flagella; ϫ Trachea Damage to SEM ( 10,000). Nervous Kidneys system Heart The bacterium responsible for the outbreak was described as Legionella pneumophila, a nutritionally fastidious aerobic gram- Figure 39.1 Diphtheria Pathogenesis. Diphtheria is a well-known negative rod (figure 39.2). It is now known that this bacterium is exotoxin-mediated infectious disease caused by Corynebacterium part of the natural microbial community of soil and aquatic diphtheriae. The disease is an acute, contagious, febrile illness ecosystems, and it has been found in large numbers in air- characterized by local oropharyngeal inflammation and conditioning systems and shower stalls. pseudomembrane formation. If the exotoxin gets into the blood,
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