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Microbiology: A Systems

Approach, 2nd ed.


Chapter 20: Infectious
Diseases Affecting the
Cardiovascular and Lymphatic
Symptoms
20.1 The Cardiovascular and
Lymphatic Systems and Their
Defenses
Cardiovascular System
Blood vessels and heart
Moves blood in a closed circuit
Also known as the circulatory system
Provides tissues with oxygen and
nutrients and carries away carbon
dioxide and waste products
The Heart
Divided into two halves, each half
divided into an upper and lower
chamber
Upper chambers: atria; lower chambers:
ventricles
Covered by the pericardium
Three layers to the wall of the heart
(from outer to inner)
Epicardium
Myocardium
Endocardium
Figure 20.1
Figure 20.2
Lymphatic System
One-way passage
Returns fluids from the tissues to the
cardiovascular system
Figure 14.10
Defenses of the
Cardiovascular and Lymphatic
Systems
Cardiovascular system is highly protected,
however, if microbes do invade they gain
access to every part of the body
Bloodstream infections are systemic
infections; often with the suffix emia
Viremia
Fungemia
Bacteremia
Septicemia (can lead to septic shock)
Defenses in the bloodstream- leukocytes
20.2 Normal Biota of the
Cardiovascular and Lymphatic
Systems
None
Some microorganisms may be
present transiently (filtering out of
tissues) but they do not colonize the
systems in the healthy state
20.3 Cardiovascular and
Lymphatic System Diseases
Caused by Microorganisms
Endocarditis
Inflammation of the endocardium
Usually refers to an infection of the valves of the
heart
Acute and subacute, with similar symptoms (in
subacute the symptoms develop more slowly
and are less pronounced)
Fever, anemia, abnormal heartbeat
Sometimes symptoms similar to heart attack
Abdominal or side pain may be reported
Petechiae over the upper half of the body and
under the fingernails may be present
In subacute cases, may have enlarged spleen
Figure 20.3
Septicemias
Occurs when organisms are actively
multiplying in the blood
Many different bacteria and a few fungi can
cause this condition
Fever- prominent symptom
Patient appears very ill, may have an altered
mental state, shaking chills, and
gastrointestinal symptoms
Often exhibits increased breathing rate and
respiratory alkalosis
Low blood pressure
Plague
Three possible manifestations
Pneumonic plague: respiratory disease
Bubonic plague
Bacterium injected through a flea bite
Enters the lymph and is filtered by a lymph node
Infection causes inflammation and necrosis of the
node
Results in a swollen lesion called a bubo, usually in
the groin or axilla
Incubation period: 2 to 8 days, ending with the
onset of fever, chills, headache, nausea, weakness,
and tenderness of the bubo
Septicemic plague: when the case progresses
to massive bacterial growth in the blood
Figure 20.4
Figure 20.5
Figure 20.6
Tularemia
Sometimes called rabbit fever, because it has
been associated with outbreaks of disease in
wild rabbits
Pathogen of concern on the lists of
bioterrorism agents
Tick bites: most frequent arthropod vector
Incubation period of a few days to 3 weeks
Symptoms: headache, backache, fever,
chills, malaise, and weakness
Further symptoms tied to the portal of entry:
ulcerative skin lesions, swollen lymph glands,
conjunctival inflammation, sore throat,
intestinal disruption, pulmonary involvement
Lyme Disease
Nonfatal
Evolves into a slowly progressive
syndrome that mimics neuromuscular
and rheumatoid conditions
Early symptom: rash a the site of a tick
bite
Other early symptoms: fever, headache,
stiff neck, and dizziness
Second stage: cardiac and neurological
symptoms develop
Figure 20.7
Figure 20.8
Figure 20.9
Figure 20.10
Infectious Mononucleosis
Majority caused by Epstein-Barr virus
(EBV)
Most of the remainder caused by
cytomegalovirus (CMV)
Sore throat, high fever, and cervical
lymphadenopathy
Long incubation period- 30 to 50 days
Also may exhibit a gray-white exudates in the
throat, skin rash, and enlarged spleen and
liver
Sudden leukocytosis
Fatigue
Figure 20.11
Hemorrhagic Fever
Diseases
Caused by viruses in one of four families:
Arenaviridae
Filoviridae
Flaviviridae
Bunyaviridae
Yellow Fever
Capillary fragility
Disrupts the blood-clotting system
Begins with fever, headache, and
muscle pain
Sometimes progresses to oral
hemorrhage, nosebleed, vomiting,
jaundice, and liver and kidney
damage
Dengue Fever
Usually mild
Sometimes it can progress to dengue
hemorrhagic shock syndrome
Causes severe pain in muscles and
joints
Ebola and Marburg
Related viruses, cause similar symptoms
Extreme manifestations of of hemorrhagic
events with extensive capillary fragility
and disruption of clotting
Patients bleed from their orifices, mucous
membranes, and experience massive
internal and external hemorrhage
Often manifest a rash on the trunk in early
stages
Lassa Fever
Most cases asymptomatic
In 20% of the cases a severe
hemorrhagic syndrome develops
Chest pain, hemorrhaging, sore
throat, back pain, vomiting, diarrhea,
and sometimes encephalitis
Patients who recover often suffer
from deafness
Nonhemorrhagic Fever
Diseases
Brucellosis
On the CDC list of possible bioterror agents
Bacteria is carried into the bloodstream by
phagocytic cells, creating focal lesions in
the liver, spleen, bone marrow, and kidney
Fluctuating pattern of fever accompanied
by chills, profuse sweating, headache,
muscle pain and weakness, and weight loss
Figure 20.12
Q Fever
Abrupt onset of fever, chills, head
and muscle ache, and occasionally a
rash
Sometimes complicated by
pneumonitis, hepatitis, and
endocarditis
Figure 20.13
Cat-Scratch Disease
Symptoms start after 1 to 2 weeks
Cluster of small papules at the site of
inoculation
In a few weeks, lymph nodes swell
and can become pus-filled
Only about 1/3 of patients
experience high fever
Figure 20.14
Trench Fever
Highly variable symptoms
5- to 6-day fever
Leg pains, especially in the tibial
region
Headache, chills, and muscle aches
Macular rash can occur
Endocarditis can develop
HGA and HME
Similar signs and symptoms
Acute febrile state
Headache, muscle pain, and rigors
Rocky Mountain Spotted Fever
(RMSF)
2 to 4 days incubation
First symptoms: sustained fever, chills,
headache, and muscular pain
Distinctive spotted rash within 2 to 4
days after the prodrome
In most severe untreated cases,
enlarged lesions merge and become
necrotic
Other manifestations: cardiovascular
disruption; conditions of restlessness,
delirium, convulsions, tremor, and coma
Figure 20.15
Figure 20.16
Malaria
The worlds dominant protozoan disease
10- to 16-day incubation period
First symptoms: malaise, fatigue, vague
aches, and nausea with or without diarrhea
Next symptoms: bouts of chills, fever, and
sweating
Symptoms occur at 48- or 72-hour intervals
The interval, length, and regularity of
symptoms reflect the type of malaria
Figure 20.17
Figure 20.18
Figure 20.19
Anthrax
Can exhibit its primary sumptoms in
various locations of the body
Cutaneous anthrax
Pulmonary anthrax
Gastrointestinal tract
Anthrax meningitis
Cutaneous and pulmonary forms
most common
Figure 20.20
HIV Infection and AIDS
Retrovirus: human
immunodeficiency virus (HIV)
Hybrid virus- genetic sequences from two
separate monkey SIVs
The disease: acquired
immunodeficiency syndrome (AIDS)
Spectrum of clinical disease associated
with HIV infection
Symptoms directly tied to two things:
the level of virus in the blood and the
level of T cells in the blood
Symptoms
Initial infection: vague, mononucleosis-like
symptoms that soon disappear (initial high
levels of virus)
Within days, about 50% of the T helper cells with
memory for the virus are destroyed
Period of asymptomatic infection that varies
in length from 2 to 15 years
During this period the number of T cells in the
blood is steadily decreasing
Once T cells reach low enough levels, symptoms
of AIDS ensue
Initial symptoms of AIDS: fatigue, diarrhea,
weight loss, and neurological changes
Other Symptoms as the
Disease Progresses
Opportunistic infections or neoplasms
Severe immune deregulation, hormone
imbalances, metabolic disturbances
Pronounced wasting of body mass
Protracted fever, fatigue, sore throat,
and night sweats
Lesions in the brain, meninges, spinal
column, and peripheral nerves
Figure 20.21
Figure 20.22
Figure 20.23
Figure 20.24
Figure 20.25
Adult T-Cell Leukemia and
Hairy-Cell Leukemia
Leukemia: general name for at least four
different malignant diseases of the WBC
forming elements originating in the bone
marrow
Some acute, others chronic
Many causes- two of which are thought to
be viral
Adult T-cell leukemia by HTLV-I
Hairy-cell leukemia by HTLV-II
Signs and symptoms include easy bruising
or bleeding, paleness, fatigue, and recurring
minor infections