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URT (pharyngitis (adeno
sero 1-7
(dsDNA, delivery vehicle for gene…
URT
pharyngitis
adeno
- sero 1-7
(dsDNA, delivery vehicle for gene therapy)
- Cowdry type B nuclear inclusion (dense basophilic)
- often children, spread via pharynx and feces
- pharyngitis and coryza (5-7d) mild flu
- pharyngoconjunctival fever (nonpurulent conjunctivitis), summer camp w/ pool (2-3wks)
- acute resp dz (4,7): cervical LAD. military recruit, oral "enteric coated" vaccine*
- keratoconjunctivitis: occupational hazard/dust/foreign body, pain & blurry vision
-
- HSV-1: pharyngotonsilitis (adult)
- Mono caused by EBV/CMV
S. pyogen
- M protein (adhesion), protein F (fibronectin on mucosa), inhibit AlternativeCP
- hyaluronidase: tissue spreading
- hyaluronic acid polysac capsule: antiphagocytic
- streptokinase: "clot buster" ativate plasminogen
- C5a peptidase (interfere PMN leukocyte chemotaxis)
- streptolysin O (hemolysin for Fe acquisition (=B hemolytic)) -> ASO Ab
- erythrogenic toxin A, C: superantigen: T cell prolf, B cell supp, encoded by bacteriophage -> +strep throat = scarlet fever (strawberry tongue)
- strep throat (5-15yr): pharyngitis, tosilar exudate
- rheumatic ever,acute glomerulonephritis
cornybacterium diph
- A-b toxin (A: ADP ribosyl transferase on EF-2 inhibit protein synthesis) B directs where to bind (oropharyngeal, heart, nerve) made by cornephage beta
- respiratory diph: 2-6d incubation, thick, dirty white pseudomembrane (can't be scraped) -> bull neck
- disseminate -> laryngeal nerve palsy, myocarditis
DTap for prevention (inativated diph toxoid)
- Loeffler coagulated serum medium
- tellurite medium (unqiuely grows C. diph while other URT microbes don't by reducing K to elemental -> brown/thick media)
laryngitis
paramyxo
parainfluenza
- HN: binds sialic acid & F protein -> virus-host fusion
- F: inserts to cell mem for virus to bud thru, induce cell-cell fusion: synctia/multinucleated giant
- has 4 serotype (instead of one in other paramyxo). no vaccine
- Croup (laryngotracheobronchitis) in infant. Steeple sign, subglottal swelling, stridor, seal bark cough
- spread to LRT -> pneumonia, bronchiolitis
-
papilloma
- HPV 6,11 low risk
- recurrent respiratory papillomatosis (3-5yr)
Bordetella pertusis
- only infect human, direct contact
- adhesin: attaches to ciliated resp epith via filamentous H, pertussis toxin, pertactin 37C BvgS
- Pertusis toxin (A-b toxin): A inhibit Gia - AC dec -cAMP inc -> lymphocytosis, hypoglycemia
- AC toxin: activated by calmodulin in cell -> inc cAMP -> inhibit phagocytosis and immune fx
- tracheal cytotoxin: ciliastasis, kills
- pertussis: catarrhal (contagious, rhinnoria)->paroxysmal (whoop, lymphocytosis) -> convalescent
- dTaP, acellular pertusis (aP) component = filamentosu H, pertactin, fimbrae, pertussis toxoid. booster ~11yo
- Regan-Lowe
-
epiglottis
Hib
- polyribotol phosphate capsule
- dysphagia, drooling, distress
- cherry red epiglottis
- tripod posture
-
LRT
pneumonia
bacterial
- alpha hemolytic, optochin SN
- igA protease x1000 virulence
- in lung, pneumolysin O (pore-forming) binds cholesterol in cell -> inflammatory, exudative fluid, hemorrhage
- (25% meningitis)
- infant: conjugate 4 dose <2yo
- 65+: conjugate + pneumovax 23 12 mo later
H. inf
- polyribitol phosphate
- Hib most pathogenic
- <2y.o. in unvaccinated children
- thick capsule, IgA protease
S. aureus
- Protein A (Fc bind IgG), evade immune
- a-toxin (poreforming) & panton valentine leukocidin (PVL) -> Necrotizing pneumonia (damage RBC, leuko). Most commonly acquired from community acquired-MRSA after influenza
-
pseudomona aeruginosa
- motile (unipolar flagellum), aerobic. Biofilm
- nosocomial, opportunistic, major.
- grape- tortilla like odor
- foundin water (faucet, drain), resp equipment, raw vege, flower, slimy bar soap
- pyocyanin = antibx that induce oxidative stress; pyoverdine is Fe+3 chelator/siderophore inc survival
- LPS released fro dying cell
- alginate (slime layer)
- exotoxin A: ADPrt - EF2, stop protein synthe (like C-dip)
- Elastase (damage immunoglobin, elastin, collagen)
viral
-
Measles
- giant cell pneumonia (also interstitial) in immunocmopromised
- WArthin Finkeldey giant cell (synctia) of fused lymphocytes in lymph node due to F glycoprotein
- 2dary bacterial/viral pneumonia common (immunosuppression induced after infection)
-
Herpes
- CMV: interstitial pneumonia, owl's eyes
- VZV: interstitial in 2-30% adult w/ primary VZV