Disease	Etiologic Agent	Pathogenesis & Transmission	Symptoms	Lab Tests	Prevention and treatment
Bacterial Infections of the Blood Vascular System
Acute bacterial endocarditis	Staph. aureus S. pneumoniae	rapid development, valve destruction, myocardial abscess, heart failure	fever, fatigue, heart failure		demonstration of continuous infection- immediate multi-drug antimicrobial therapy including nafcillin
SBE Subacute bacterial endocarditis	enterococcus; alpha strep Strep viridans-nutritionally deficient strep Staph. epidermidis Coxiella burnetti (Q fever)	dental procedures, especially susceptible are abnormal valves biofilm and adhesion, immune complexes cause circulatory problems Q= livestock & cat exposure	fatigue, irregular fever,heart murmur, may result in aneurysm or glomerulo-nephritis		prophylaxis for dental work enterococcal resistance aminoglycosides multi-drug bacteriocidal drugs Q=doxycycline or erythromycin
Gram negative sepsis	Entero-bacteriaceae Anaerobic GNR	Most infections are nosocomial infection elsewhere in body spreads (e.g.bedsores, pyelonephritis), immunosuppressed Endotoxic shock	shaking, chills, fever, shock (50% mortality)		endotoxin monoclonal antibody

Disease	Etiologic Agent	Pathogenesis	Symptoms	Transmission	Prevention and treatment
Bacterial Infections of the Lymphatic System
Tularemia GNR	Francisella tularensis	Exposure to wild animals (hunting, skinning), tick or insect bite, can penetrate mucus membranes enters skin, ulceration, invades lymph, sepsis, lives in macrophages, pneumonia=30% mortality	Ulcer & lymph node swelling, chills fever, myalgia		Rubber gloves, insect repellants, vaccine for high risk gentamicin tetracycline ciprofloxacin
Undulant Fever Brucellosis small GNR	Brucella sp. named by mammalian host - Zoonosis	ingesting contaminated milk products, assoc. with animals can penetrate mucus membranes, invades lymph, sepsis, lives in macrophages, osteomyelitis	vague, insidious mild fever (reoccurring), sweating, myalgia		Vaccine Caution w/ infected mammals & contaminated dairy products. In lab highly infectious via aerosolization; biosafety level-3 precautions. tetracycline
Plague Black Death Bubonic Fever	Yersinia pestis bipolar staining GNR	Bubonic - bitten by infected flea Pneumonic - airborne virulence related to plasmids coding for interference with phagocytosis & host cellular proteins antiphagocytic capsule & intracellular ability	Bubonic - enlarged tender lymph nodes - buboes, fever, sepsis, petechia, shock, pneumonia		vector control, reservoir control, vaccine, gentamicin, doxycycline, ciprofloxacin
Disease	Etiologic Agent	Pathogenesis	Symptoms	Transmission	Prevention and treatment
Viral Infections of the Blood Vascular System
Mononucleosis Kissing Disease	Epstein Barr Virus Herpes family	long incubation, from mucosal membrane enters blood and lymph -> infects B cells (latent or acute)	fever, sore throat, enlarged spleen and lymph nodes, exhaustion, T-cells increase		many have abs with no disease saliva
Dengue fever	flavivirus	Aedes mosquito bite enters via bite, infects blood, -> hemorragic DIC	Breakbone fever fever, headache, myalgia, rash, nausea, vomiting		vector control bioengineered mosquito does not support virus
Disease	Etiologic Agent	Pathogenesis	Symptoms	Transmission	Prevention and treatment
Fungal Infections of the Blood Vascular System
Candidiasis or other yeast	Candida albicans Candida pseudotropicalis	Extremely immuno- suppressed patients	common to sepsis		fluconazole, replace or remove catheters
Protozoal Infections of the Blood Vascular System
Malaria	Plasmodium sp. intracellular parasite	Mosquito vector Anopheles Mostly imported recent outbreak in Florida infects blood cells and liver, reproduces->paroxysm associated with cell destruction	flu-like, fever, headache, chills, myalgia, cyclic paroxysm		Most common serious world-wide infection Prophylaxis with mefloquine, doxyxcline, Malarone, Chloroquine/ brand name Aralenpotential vaccine
Trypanosomiasis South American Chagas' Disease	Trypanosoma cruzi	Bite of Glossinia Kissing Bug infects blood via bite->heart damage	affects heart and nervous system		Nifurtimox late treatment no help

Blood Cultures Chapter 55