S

e
General Pathology MTY1216 m

2
e

General Pathology of Infectious s

t
e
Diseases Neisseria Gonorrhea
r

CATEGORIES OF INFECTIOUS AGENTS gonorrhoeae

Gram-negative Escherichia coli, Urinary tract
Prions infections Klebsiella infection, wound
- Prions are composed of abnormal forms of a host protein pneumoniae, infection, abscess,
termed prion protein (PrP) Enterobacter pneumonia, sepsis,
Viruses aerogenes, shock, endocarditis
- Viruses are obligate intracellular parasites that depend on Proteus mirabilis,
the host cell’s metabolic machinery for their replication. Serratia
- Shape: Icosahedral/Helical marcescens,
- Extreme genetic simplicity Contain DNA or RNA Replication Pseudomonas
involves disassembly and reassembly aeruginosa,
- Replicate by "one‐step growth” Bacteroides fragilis
Classification of Nucleic Acid
DNA VIRUSES Legionella Legionnaires’
- 1. All are D-S DNA except PARVOVIRUS. pneumophila disease
- 2. All are ICOSAHEDRAL except poxvirus (complex). Clostridial Clostridium tetani Tetanus (lockjaw)
- 3. All are ENVELOPED except PAPOVAVIRUS, ADENOVIRUS infections
AND PARVOVIRUS. Clostridium Botulism (paralytic
- 4. All multiply in the NUCLEUS except POXVIRUS. botulinum food poisoning)
RNA VIRUSES
- 1. All are S-S RNA except REOVIRUS. Clostridium Gas gangrene,
- 2. Generally HELICAL except the POSITIVE SENSE RNA perfringens, necrotizing cellulitis
VIRUS. Clostridium
- 3. All are ENVELOPED except PICORNAVIRUS, CALICIVIRUS septicum
AND REOVIRUS.
- 4. All are NON-SEGMENTED except REOVIRUS, Clostridium difficile Pseudomembranous
ORTHOMYXOVIRUS, BUNYAVIRUS and ARENAVIRUS. colitis
Bacteria Zoonotic bacterial Bacillus anthracis Anthrax
- Peptidoglycan infections
- Thick/ Thin cell walls Yersinia pestis Bubonic plague
- Gram Positive and Gram negative
- Cocci (Spheres) and Bacilli (Rods) Francisella Tularemia
- Aerobic and Anaerobic tularensis
- Flagella and Pilli
Brucella melitensis, Brucellosis
SELECTED HUMAN BACTERIAL DISEASES AND THEIR Brucella suis, (undulant fever)
PATHOGENS Brucella abortus
Microbiologic Frequent Disease
Category Clinical Species Presentation(s) Borrelia recurrentis Relapsing fever
Category
Infections by Staphylococcus Abscess, cellulitis, Borrelia Lyme disease
pyogenic cocci aureus, pneumonia, sepsis burgdorferi
Staphylococcus Treponemal Treponema Syphilis
epidermidis infections pallidum
Mycobacterial Mycobacterium Tuberculosis
Streptococcus Pharyngitis, infections tuberculosis,
pyogenes erysipelas, scarlet M. bovis
fever
Streptococcus Mycobacterium
pneumoniae Lobar pneumonia, leprae Leprosy
meningitis
Neisseria Mycobacterium
meningitidis Meningitis kansasii, Pulmonary disease,
Mycobacterium lymphadenitis,
avium complex

1
of 2
This study source was downloaded by 100000863835483 from CourseHero.com on 06-18-2024 10:42:01 GMT -05:00

https://www.coursehero.com/file/90087668/Week12-HISTOPATHLEC-General-Pathology-of-Infectious-Diseasespdf/
 General Pathology Lecture
Cellular Responses
disseminated - Flukes
disease
AGENTS OF BIOTERRORISM
Actinomycetal Nocardia Pulmonary disease,
infections asteroides complex brain abscess Category A Diseases and Agents
Anthrax: Bacillus anthracis
Actinomyces Head and neck Botulism: Clostridium botulinum toxin
israelii abscess Plague: Yersinia pestis
Contagious Haemophilus Meningitis, upper- Smallpox: Variola major virus
childhood bacterial influenzae and lower- Tularemia: Francisella tularensis
diseases respiratory tract Viral hemorrhagic fevers: Ebola, Marburg, Lassa, others
infections Category B Diseases and Agents
Brucellosis: Brucella spp.
Bordetella Whooping cough Epsilon toxin of Clostridium perfringens
pertussis Food safety threats: Salmonella spp., Escherichia coli O157:H7,
Shigella, others
Corynebacterium Diphtheria Glanders: Burkholderia mallei
diphtheriae
Melioidosis: Burkholderia pseudomallei
Enteric infections Enteropathogenic Invasive or
Psittacosis: Chlamydia psittaci
E. coli, Shigella noninvasive
Q fever: Coxiella burnetii
spp.,Vibrio cholera, gastroenterocolitis
Ricin toxin from castor beans (Ricinus communis)
Campylobacter
Staphylococcal enterotoxin B
jejuni,
Campylobacter Typhus fever: Rickettsia prowazekii
coli,Yersinia Mosquito-borne encephalitis viruses: Venezuelan equine
enterocolitica, encephalitis, Eastern equine encephalitis, Western equine
Salmonella spp. encephalitis, others
Water safety threats: Vibrio cholerae, Cryptosporidium parvum,
Salmonella enterica Typhoid fever others
serotype Typhi Category C Diseases and Agents
Emerging infectious disease threats: Nipah virus, hantavirus,
Topographic Grouping of Fungi others
- Superficial MICROBIAL PATHOGENESIS
- Cutaneous
- Subcutaneous - Mode of Transmissions
- Systemic o Direct or indirect contact
o True Pathogenic o Respiratory route
o Opportunistic o Fecal‐oral route
Protozoa o Sexual transmission
- Protozoa are single‐celled eukaryotes that are major o Vertical transmission (Placental‐fetal, during
causes of disease and death in developing countries. birth, via maternal milk)
- Protozoa can replicate intracellularly within a variety of o Insect/arthropod vectors
cells (e.g., Plasmodium in red cells, Leishmania in - Pathogens establish infection through:
macrophages) or extracellularly in the urogenital system, o Virulence factors
intestine o Compromised host defenses
Helminths Routes of Entry
- Parasitic worms are highly differentiated by multicellular Skin
organisms. o Defense: intact keratinized epidermis, low pH,
- their life cycles are complex; most alternate between fatty acids
sexual reproduction in the definitive host and asexual o Mechanical defects (punctures, burns, ulcers) –
multiplication in an intermediate host or vector. Thus, S. aureus, C. albicans, P. aeruginosa
depending on the species, humans may harbor. adult o Needle sticks – HIV, hepatitis viruses
worms (e.g., Ascaris lumbricoides), immature stages (e.g., o Arthropod and animal bites – Yellow fever, Lyme
Toxocara canis), or asexual larval forms (e.g., Echinococcus disease, malaria, rabies
spp.) o Direct penetration – Schistosoma
Three Groups: GI Tract
- Roundworms o Transmission by contaminated food or drink
- Tapeworms o Defenses:

S 2 T 1 AGUILAR, MJ
Reference: Robbins Basic Pathology
This study source was downloaded by 100000863835483 from CourseHero.com on 06-18-2024 10:42:01 GMT -05:00
2

https://www.coursehero.com/file/90087668/Week12-HISTOPATHLEC-General-Pathology-of-Infectious-Diseasespdf/
 General Pathology Lecture
Cellular Responses
Acidic gastric secretions
Viscous mucus covering the intestinal
epithelium Sexually Transmitted Infections
Pancreatic enzymes and bile - May become established and spread from the urethra,
detergents vagina, cervix, rectum, or oral pharynx
Mucosal antimicrobial peptides Co‐infections and increased risk factor
(defensins) o Infection with one STI‐associated organism
Normal flora increases the risk for additional STIs.
Secreted IgA antibodies Associated with congenital transmission
Respiratory Tract o STIs can be spread from a pregnant woman to
o Inhalation of microbes in dust or aerosol the fetus and cause severe damage to the fetus
particles. or child.
o Defenses:
DISEASE OR SYNDROME AND POPULATION PRINCIPALLY
Mucociliary clearance
Resident alveolar macrophages AFFECTED
Urogenital Tract Pathogen Males Both Females
o Defenses Viruses
Urination: women more prone to UTI Herpes simplex virus Primary and
Normal vaginal flora: low pH from recurrent herpes,
glycogen catabolism by lactobacilli neonatal herpes
Intact epidermal/epithelial barrier Hepatitis B virus Hepatitis
Spread and Dissemination of Microbes Within the Body Human Cancer of Condyloma Cervical
o Locally – only at the site of initial infection. papillomavirus penis (some acuminatum, anal dysplasia
o Spread to other sites Direct extension or cases) cancer, and cancer,
invasion Transport in the lymphatics, the blood, oropharyngeal vulvar
or nerves. carcinoma cancer
MECHANISMS OF VIRAL INJURY Human Acquired
immunodeficiency immunodeficiency
- A major determinant of tissue tropism is the presence of virus syndrome
viral receptors on host cells. Viruses possess specific cell Chlamydiae
surface proteins that bind to particular host cell surface
Chlamydia Urethritis, Lymphogranuloma Urethral
proteins. Many viruses use normal cellular receptors of the
trachomatis epididymitis, venereum syndrome,
host to enter cells.
proctitis cervicitis,
- The ability of the virus to replicate inside some cells.
bartholinitis
- Physical circumstances, such as chemicals and
, salpingitis,
temperature.
and
- Direct cytopathic effects.
sequelae
- Antiviral immune responses.
Mycoplasmas
- Transformation of infected cells
Ureaplasma Urethritis Cervicitis
MECHANISMS OF BACTERIAL INJURY urealyticum
Bacteria
- Bacterial virulence
- Mobile genetic elements (plasmids and bacteriophages) Neisseria Epididymitis, Urethritis, Cervicitis,
- Bacterial adherence to host cells Adhesins – bacterial gonorrhoeae prostatitis, proctitis, phar endometriti
surface proteins (S. pyogenes) urethral yngitis, s,
o Pili – filamentous proteins on the surface of stricture disseminated bartholinitis
bacteria that act as adhesins (E.coli in UTI) gonococcal , salpingitis,
Bacterial Toxins infection and
o Endotoxins – lipopolysaccharide in Gram sequelae
negative bacterial outer membrane (infertility,
o Exotoxins – bacterial protein secretions ectopic
Enzymes (proteases, hyaluronidases, pregnancy,
coagulases) recurrent
Toxins that alter intracellular signaling salpingitis)
or regulatory pathways Treponema pallidum Syphilis
Neurotoxins Haemophilus ducreyi Chancroid
Superantigens

S 2 T 1 AGUILAR, MJ
Reference: Robbins Basic Pathology
This study source was downloaded by 100000863835483 from CourseHero.com on 06-18-2024 10:42:01 GMT -05:00
3

https://www.coursehero.com/file/90087668/Week12-HISTOPATHLEC-General-Pathology-of-Infectious-Diseasespdf/
 General Pathology Lecture
Cellular Responses
Calymmatobacterium Granuloma Culture All classes
granulomatis inguinale DNA probes All classes
(donovanosis)
Protozoa VIRAL INFECTIONS
Trichomonas Urethritis, Vaginitis Acute/ transient infections
vaginalis balanitis Measles
- Dilated skin vessels, edema and a mononuclear
HISTOLOGIC PATTERNS OF TISSUE REACTION IN perivascular infiltrate blotchy, reddish brown rashes
INFECTIONS - Koplik spots – ulcerated mucosal lesions in the oral cavity
- Suppurative (purulent) inflammation - lymphoid organs – marked follicular hyperplasia, large
- Mononuclear and granulomatous inflammation germinal centers and Warthin‐Finkeldey cells.
- Cytopathic‐cytoproliferative reaction Mumps
- Tissue necrosis - Parotid glands (Mumps parotitis)
- Chronic inflammation and scarring o Gross appearance
Suppurative (purulent) inflammation Parotid glands are enlarged, have a
- Increased vascular permeability Leukocyte infiltration doughy consistency, and are moist,
Chemoattractants from bacteria Pus formation glistening, and reddish‐brown •
- Caused by: extracellular gram‐ positive cocci and gram‐ o Microscopic appearance
negative rods Interstitium is edematous and diffusely
Mononuclear and granulomatous inflammation infiltrated by mononuclear cells
- Mononuclear cell infiltrates Cell‐ mediated immune - Testicles (Mumps orchitis)
response to pathogens Granulomatous inflammation o Marked testicular swelling caused by edema,
- Common to chronic inflammation mononuclear cell infiltration, and focal
- If acute: response to viruses, intracellular bacteria or hemorrhages
intracellular parasites. o can lead to testicular scarring, atrophy, and
Cytopathic‐cytoproliferative reaction sterility
- Viral transformation of cells Cell necrosis or
proliferation viral inclusion bodies, multinucleation or Latent infections
focal cell damage Linked to neoplasia. Most frequently caused by herpesviruses
Tissue necrosis o α‐group viruses (HSV‐1, HSV‐2, and VZV)
- Toxin or lysis mediated destruction Lack of inflammatory o β‐group viruses (CMV, HHV‐6 [exanthem
cells Rapidly progressive processes. subitum], HHV‐7)
- C. perfringens and C. diphtheriae – secrete powerful toxins o γ‐group (EBV and KSHV/HHV‐8 [Kaposi sarcoma])
that cause rapid and gangrenous necrosis. HSV‐1 and HSV‐2
- E. histolytica – colonic ulcers and liver abscesses - HSV‐infected cells – contain large, pink to purple
characterized by extensive tissue destruction with intranuclear inclusions
liquefactive necrosis. - Fever blisters or cold sores in facial skin around mucosal
Chronic inflammation and scarring orifices
- Repetitive injury fibrosis Loss of normal parenchyma - Gingivostomatitis – vesicular eruption extending from the
- Chronic HBV infection – may cause cirrhosis of the liver tongue to the retropharynx
- Tuberculosis – constrictive fibrous pericarditis - Genital herpes – vesicles on the genital mucous
- Schistosomal eggs – “pipestem” fibrosis of liver or fibrosis membranes
of bladder wall VZV
- Acute: chicken pox
SPECIAL TECHNIQUES FOR DIAGNOSING INFECTIOUS
- Latent: shingles
AGENTS Cytomegalovirus
Techniques Infectious Agents - Latently infects monocytes and their bone marrow
Gram stain Most bacteria progenitors
Acid-fast stain Mycobacteria, nocardiae - Reactivated when cellular immunity is depressed
(modified) - Transmission
Silver stains Fungi, legionellae, o Transplacental, neonatal, through saliva, genital,
Pneumocystis organ transplants or blood transfusions
Periodic acid-Schiff Fungi, amebae - Infected cells – enlarged, with cellular and nuclear
Mucicarmine Cryptococci pleomorphism
Giemsa Campylobacter, leishmaniae, o intranuclear basophilic inclusions and with clear
malaria parasites perinuclear halo
Chronic productive infections
Antibody stains All classes

S 2 T 1 AGUILAR, MJ
Reference: Robbins Basic Pathology
This study source was downloaded by 100000863835483 from CourseHero.com on 06-18-2024 10:42:01 GMT -05:00
4

https://www.coursehero.com/file/90087668/Week12-HISTOPATHLEC-General-Pathology-of-Infectious-Diseasespdf/
 General Pathology Lecture
Cellular Responses
- Persistent viremia if the immune system is unable to Acute infections: exudative pattern of
eliminate virus inflammation with numerous
- Examples: HIV and HBV neutrophils
o Anthrax
Transforming viral infections Necrotizing inflammatory lesions in the
- Oncogenic viruses – transform infected cells into benign skin or gastrointestinal tract or
or malignant tumor cells systemically
- Examples: EBV, HPV, HBV, and HTLV‐1 Major forms
Epstein‐Barr virus (EBV) • Cutaneous anthrax,
- Causes infectious mononucleosis Inhalational anthrax,
- Associated with certain lymphomas and nasopharyngeal Gastrointestinal anthrax
carcinoma Gram-Negative
- Peripheral blood: absolute lymphocytosis with atypical Neisserial Infections
lymphocytes - N. meningitidis – bacterial meningitis among adolescents
- Lymph nodes – typically discrete and enlarged throughout and young adults
the body - N. gonorrhoeae – sexually transmitted disease
- Splenomegaly – vulnerable to rupture - Adhere (via pili) to and invade nonciliated epithelial cells at
- Hepatomegaly the site of entry
BACTERIAL INFECTIONS - Use antigenic variation to escape the immune response
Pertussis
Gram-Positive - Acute, highly communicable illness characterized by
Staphylococcal infections paroxysms of violent coughing followed by a loud
- causes skin lesions (boils, carbuncles, impetigo, and inspiratory “whoop”
scalded‐ skin syndrome) as well as abscesses, sepsis, - B. pertussis colonizes the brush border of the bronchial
osteomyelitis, pneumonia, endocarditis, food poisoning, epithelium and also invades macrophages
and toxic shock syndrome Pseudomonas Infection
- Virulence factors: enterotoxins, cytolytic toxins, exfoliative - Frequent, deadly pathogen of people with cystic fibrosis,
toxins, protein A severe burns, or neutropenia
Streptococcal and Enterococcal Infections - Causes a necrotizing pneumonia that is distributed
- Cause suppurative infections of the skin, oropharynx, through the terminal airways
lungs, and heart valves o striking pale necrotic centers and red,
- Also cause postinfectious syndromes, including rheumatic hemorrhagic peripheral areas
fever, immune complex glomerulonephritis and erythema
nodosum FUNGAL INFECTIONS
- Morphology DISEASE ETIOLOGIC AGENT
o Erysipelas Mycetoma Madurella mycetomatis
caused by exotoxins from superficial Aspergillosis Aspergillus fumigatus, A.
infection with S. pyogenes flavus, A. niger
rapidly spreading erythematous Blastomycosis Blastomyces dermatiditis
cutaneous swelling Candidiasis Candida albicans
o Streptococcal pharyngitis Coccidioidomycosis Coccidioides immitis
major antecedent of poststreptococcal Cryptococcosis Cryptococcus neoformans
glomerulonephritis Histoplasmosis Histoplasma capsulatum
edema, epiglottic swelling, and
Rhinosporidiosis Rhinosporidium seeberi
punctate abscesses of the tonsillar
Superficial mycosis Microsporum, Trichophyton,
crypts
Epidermophyton
o Scarlet fever
Candidiasis
associated with pharyngitis caused by
- produces superficial infections of the skin and mucous
S. pyogenes
membranes (oral thrush, candidal vaginitis, cutaneous
punctate erythematous rash in the
candidiasis).
trunk, arms and legs
Cryptococcosis
o Listeriosis
- cause meningoencephalitis in healthy individuals
causes severe food‐borne infections in
- opportunistic pathogen in people with AIDS, leukemia,
vulnerable hosts
lymphoma, systemic lupus erythematosus or sarcoidosis
Gram‐positive, mostly intracellular
- Virulence factors
bacilli in the CSF

S 2 T 1 AGUILAR, MJ
Reference: Robbins Basic Pathology
This study source was downloaded by 100000863835483 from CourseHero.com on 06-18-2024 10:42:01 GMT -05:00
5

https://www.coursehero.com/file/90087668/Week12-HISTOPATHLEC-General-Pathology-of-Infectious-Diseasespdf/
 General Pathology Lecture
Cellular Responses
o Polysaccharide capsule, Melanin production, Strongyloidiasis
Enzymes (Serine proteinase & Mannitol - infect humans when larvae penetrate the skin, travel in
dehydrogenase) the circulation to the lungs, and then travel up the trachea
Aspergillosis to be swallowed
- causes allergies (allergic bronchopulmonary aspergillosis) Cysticercus cyst in the skin
in healthy people Trichinella spiralis larvae within skeletal muscle
- causes serious sinusitis, pneumonia and invasive disease in Schistosoma hematobium infection of the bladder
immunocompromised individuals Pipe-stem fibrosis of the liver caused by S. japonicum
- Virulence factors: adhesins, antioxidants, enzymes, and
EMERGING INFECTIOUS DISEASES
toxins
Year Agent Disease
PARASITIC INFECTIONS
Identified
DISEASE ETIOLOGIC AGENT 1973 Rotavirus Infantile diarrhea
PROTOZOAL DISEASES 1975 Parvovirus B19 Aplastic crisis in chronic
Chaga’s disease Trypanosoma cruzi haemolytic anemia
(Trypanosomiasis) 1976 Cryptosporidium Acute and chronic
Leishmaniasis (Kala-azar) L. tropica, L. braziliensis, L. parvum diarrhea
donovani 1977 Ebola virus Ebola haemorrhagic
Malaria Plasmodium vivax, P. fever
falciparum, P. ovale 1977 Legionella Legionnaire’s disease
Toxoplasmosis Toxoplasma gondii pneumophila
Pneumocystosis Pneumocystis carinii 1977 Hantaan Virus Haemorrhagic fever with
Amoebiasis Entamoeba histolytica renal syndrome (HRFS)
Giardiasis Giardia lamblia 1980 HTLV-1 T-cell lymphoma-
HELMINTHIC DISEASES leukemia
Ascariasis Ascaris lumbricoides 1982 E Coli O157:H7 HUS
Enterobiasis (oxyuriasis) Enterobius vermicularis 1982 Borrelia Lyme disease
Hookworm disease Ancylostoma duodenale burgdorferi
Trichinosis Trichinella spiralis 1982 HTLV-2 Hairy cell leukemia
FIlariasis Wuchereria bancrofti 1983 HIV AIDS
Viscerla larva migrans Toxocara canis 1983 H. pylori Peptic ulcer disease
Cutaneous larva migrans Strongyloides stercoralis 1986 BSE Agent Bovine spongiform
Schistosomiasis (Bilharziasis) Schistosoma haematobium encephalopathy in cattle
Clonorchiasis Clonorchis sinensis (Mad cow disease)
Fascioliasis Fasciola hepatica 1988 HHV-6 Exanthem subitum
Echinococcosis (Hydatid Echinococcus granulosus 1988 Hepatitis E Virus Enterically transmitted
disease) non-A, non-B hepatitis
Cysticercosis Taenia solium 1989 Hepatitis C Virus Parenterally transmitted
Malaria non-A, non-B liver
- Giemsa‐stained PBS hepatitis
o Identification of the asexual stages of the 1992 Vibrio cholerae New strain associated
parasite within infected red cells O139 with epidemic cholera
- Splenomegaly 1992 Bartonella Cat scratch diseases
o congestion and hyperplasia of the red pulp henselae
- Cerebral malaria (P. falciparum) 1995 HHV-8 Associated with Kaposi’s
o brain vessels are plugged with parasitized red sarcoma in AIDS patients
cells 1996 Prion CJD
- Nonspecific focal hypoxic lesions in the heart 1997 Influenza A virus Avian fly (Bird flu)
- Pulmonary edema or shock with disseminated (H5N1)
intravascular coagulation 2003 Corona Virus SARS
Babesiosis 2009 H1N1 Pandemic A (H1N1)
- Giemsa‐stained PBS Influenza
o Superficially resemble P. falciparum ring stages, Severe Acute Respiratory Syndrome (SARS)
but lack hemozoin pigment, exhibit greater - Started in China
pleomorphism and form characteristic tetrads Zika Virus
(Maltese cross) - Yap Island, Federated Stated of Micronesia

S 2 T 1 AGUILAR, MJ
Reference: Robbins Basic Pathology
This study source was downloaded by 100000863835483 from CourseHero.com on 06-18-2024 10:42:01 GMT -05:00
6

https://www.coursehero.com/file/90087668/Week12-HISTOPATHLEC-General-Pathology-of-Infectious-Diseasespdf/
 General Pathology Lecture
Cellular Responses
- French Polynesia
- Brazil and COlombia
Chikungunya
- Outbreaks
Cholera
- Zimbabwe
- Haiti
H1N1 Influenza
- Pandemic
Measles
- Democratic Republic of Congo
Ebola
- Outbreaks in West Africa
Middle East Respiratory Syndrome (MERS)
- Outbreaks

S 2 T 1 AGUILAR, MJ
Reference: Robbins Basic Pathology
This study source was downloaded by 100000863835483 from CourseHero.com on 06-18-2024 10:42:01 GMT -05:00
7

https://www.coursehero.com/file/90087668/Week12-HISTOPATHLEC-General-Pathology-of-Infectious-Diseasespdf/
Powered by TCPDF (www.tcpdf.org)