CHAPTER 17 MAJOR VIRAL, BACTERIAL AND FUNGAL DISEASES OF

HUMANS

Infectious diseases of the skin

General information
Terms relating to skin and infectious disease of the skin are as follows:
• Epidermis. The superficial epithelial portion of the skin.
• Dermis. The layer of skin containing blood and lymphatic vessels,
nerves, and nerve endings, glands, and hair follicles.
• Dermatitis. Inflammation of the skin
• Sebaceous Glands. Glands in the dermis that usually open into hair
follicles and secrete an oily substance known as sebum.
• Folliculitis. Inflammation of a hair follicle, the sac that contains the
hair.
• Sty (stye). Inflammation of a sebaceous gland that opens Into a
follicle of an eyelash.
• Furuncle(boil). A localized pyogenic (pus producing) infection of the
skin, usually resulting from folliculitis.
• Carbuncle. A deep-seated pyogenic infection of the skin, usually
arising from a coalescence of furuncle.

Note:
EA – etiologic agent
MT – mode of transmission

SKIN

Viral Infections

• Chicken pox and Shingle – EA: Varicella-zoster virus (VZV);MT:

airborne droplets and direct contact
• German Measles (Rubella) – EA: Rubella virus; MT: airborne
droplets and direct contact
• Measles (Rubeola) – EA: Measles virus; MT: airborne droplets and
direct contact
• Small pox – EA: Variola minor and Variola major; MT: airborne
droplets, person to person
• Warts – EA: Human Papilloma Virus (HPV) ; MT: direct contact, person
to person

Bacteria Infections

• Acne – EA: Propionibacterium spp. ; MT: infected humans, probably not

transmissible
 • Anthrax (Woolsorter’s Diseases) – EA: Bacillus anthracis; MT:
inhalation of endospores, entrance of endospores through breaks in
skin, and ingestion of endospores
• Gas Gangrene (Myonecrosis) – EA: Clostridium perfringens; MT:
entrance of Clostridium spores in open wounds
• Leprosy (Hansen’s Disease) – EA: Mycobacterium lepare; MT:
inhalation of droplets, or entrance of bacteria in open skin
• Staphylococcal Skin Infections (Folliculitis, Furuncles,
Carbuncles, Abscesses, Impetigo, Impetigo of the Newborn,
Scalded Skin Syndrome) – EA: Staphylococcus aureus; MT: direct
skin to skin contact with the purulent lesion
• Streptococcal Skin Infections ( Scarlet Fever, Erysipelas,
Necrotizing Faciitis) – EA: Streptococcus pyogenes; MT: inhalation of
droplets, direct skin to skin contact

Fungal Infections

• Dermatophytosis, Tinea (“Ringworm”) – EA: Dermatophyte fungi;

MT: direct or indirect contact with lesions

EARS

Viral and Bacterial Infections

• Otitis Externa (Swimmer’s Ear) – EA: Pseudomonas aeruginosa,

Proteus vulgaris, Staphylococcus aureus; MT: contaminated swimming
pool water, article inserted in the ear canal
• Otitis Media (Middle Ear Infection) – EA: Streptococcus
pneumoniae, Haemophilus influenzae, Moraxella catarrhalis; MT:
probable not communicable

EYES

Bacterial Infections

• Bacterial Conjuntivitis (“Pinkeye”) – EA: Haemophilus influenzae

and Streptococcus pneumoniae are the common cause; MT: contact
via eye and respiratory discharges
• Chlamydial Conjunctivitis, Inclusion Conjunctivitis,
Paratrachoma – EA: certain serotypes of Chlamydia trachomatis; MT:
contact with genital discharge of infected people, contaminated fingers
to eye, nonchlorinated swimming pools
 • Trachoma, Chlamydia Keratoconjunctivitis – EA: certain serotypes
of Chlamydia trachomatis; MT: direct contact with infectious ocular or
nasal secretions or contaminated articles, also spread by flies
• Gonococcal Conjunctivitis, Gonorrheal Ophthalmia Neonatorum
– EA: Neisseria gonorrhoeae; MT: adult infection via finger-to-eye
contact with infectious genital secretions, newborn via contact with the
infected birth canal during delivery

RESPIRATORY SYSTEM

Upper Respiratory Tract

Viral Infection
• Common Colds, Acute Viral Rhinitis, Acute Coryza – EA: major
cause are Rhinoviruses; MT: inhalation of respiratory droplets, indirect
by hands or fomites

Bacterial Infections
• Diphtheria – EA: Corynebacterium diphtheriae; MT: airborne droplets,
direct contact, contaminated fomites, raw milk
• Streptococcal Pharyngitis, Strep Throat – EA: Streptococcus
pyogenes; MT: direct contact usually by hands, inhalation of aerosol
droplets

Lower Respiratory Tract

Multiple Causes
• Pneumonia – EA: Streptococcus pneumoniae (most common cause of
pneumonia in the world), Haemophilus influenzae, Staphylococcus
aureus, Klebsiella pneumoniae, Legionella pneumophila, etc.; MT:
droplet inhalation, direct oral contact, contact with contaminated
hands or fomites

Viral Infections
• Acute, Febrile, Viral Respiratory Disease – EA: Parainfluenza
viruses, respiratory syncytial virus (RSV), etc.; MT: direct oral contact,
inhalation of droplets, indirect by handkerchiefs, eating utensils,
fomites, some viruses fecal to oral route
• Avian Influenza (Bird flu) – EA: Avian Influenza viruses; MT: bird-to-
human via contact with infected poultry or surfaces contaminated from
infected poultry secretions
• Hantavirus Pulmonary Syndrome (HPS) – EA: five different
hantaviruses (Sin Nombre, Bayou, Black Creek Canal, New York-1,
 Monongahela); MT: inhalation or aerosolized rodent feces, urine, and
saliva
• Influenza, Flu – EA: Influenza viruses, types A, B, and C; MT: via
airborne spread,direct contact
• Severe Acute Respiratory Syndrome (SARS) – EA: SARS-
associated coronaviruses (SARS-CoV); MT: respiratory droplets,
touching the mouth, nose or eye after touching a contaminated surface
or object

Bacterial Infections
• Legionellosis, Legionnaire’s Disease, Pontiac Fever – EA:
Legionella pneumophila; MT: airborne from water and perhaps dust,
probably not person-to-person
• Mycoplasmal Pneumonia, Primary Atypical Pneumonia – EA:
Mycoplasma pneumoniae; MT: droplet inhalation, direct contact with
infected person or articles contaminated with nasal secretions or
sputum
• Tuberculosis, TB – EA: primarily Mycobacterium tuberculosis,
occasionally other Mycobacterium spp.; MT: airborne droplets,
prolonged direct contact with infected persons
• Whooping Cough, Pertussis – EA: Bortedella pertusis; MT: droplets
produced by coughing

Fungal Diseases
• Coccidioidomycosis – EA: Coccidioides immitis; MT: inhalation of
arthrospores
• Cryptococcosis – EA: Cryptococcus neoformans; MT: inhalation of
yeasts
• Histoplasmosis – EA: Histoplasma capsulatum; MT: inhalation of
conidia from soil
• Pneumocystis Pneumonia (PCP), Interstitial Plasma-Cell
Pneumonia – EA: Pneumocystis jiroveci; MT: direct contact, perhaps
transfer of pulmonary secretions from infected to susceptible person,
perhaps airborne

GASTROINTESTINAL TRACT

Viral Infections
• Viral Gastroenteritis, Viral Enteritis, Viral Diarrhea – EA: enteric
adenoviruses, astroviruses, caliciviruses, and rotaviruses; MT: fecal-
oral route, foodborne
• Type A Hepatitis, HAV Infection, Infectious Hepatitis, Epidemic
Hepatitis – EA: Hepatitis A virus (HAV); MT: fecal-oral
• Type B Hepatitis, HBV Infection, Serum Hepatitis – EA: Hepatitis
B virus (HBV); MT: sexual or household contact with an infected
 person, mother to infant before or during birth, injected drug use,
tattooing, needle stick injuries (nosocomial)
• Type C Hepatitis, HCV Infection, Non-A Non-B Hepatitis – EA:
Hepatitis C virus (HCV); MT: primarily parenterally transmitted (e.g. via
blood transfusion)
• Type D Hepatitis, Delta Hepatitis – EA: Hepatitis D virus (HDV); MT:
exposure to infected blood and body fluids, contaminated needles,
sexual transmission, coinfection with HBV is necessary
• Type E Hepatitis – EA: Hepatitis E virus (HEV); MT: fecal-oral
transmission, primarily via fecally contaminated drinking water, also
person to person
• Type G Hepatitis – EA: Hepatitis G virus (HGV);MT: parenteral

Bacterial Infections
• Bacterial Gastritis and Ulcers – EA: Helicobacter pylori; MT:
probably via ingestion, presumed to be either oral-oral or oral-fecal
transmission
• Campylobacter Enteritis – EA: Campylobacter jejuni, less common
Campylobacter coli; MT: ingestion of contaminated food, raw milk and
water, contact with infected animals
• Cholera – EA: Vibrio cholerae serogroup 1; MT: fecal-oral route,
contact with feces or vomitus, ingestion of fecally contaminated water
and foods, flies
• Salmonellosis – EA: Salmonella typhimurium and Salmonella
enteriditis; MT: ingestion of contaminated food, fecal-oral transmission,
contaminated water supplies
• Typhoid Fever, Enteric Fever – EA: Salmonella typhi, less sever
Salmonella paratyphi; MT: fecal-oral route, ingestion of food or water
contaminated by feces or urine of patients or carriers, feces to food by
flies
• Shigellosis, Bacillary Dysentery – EA: Shigella dysenteriae, and
other Shigella spp.; MT: direct or indirect fecal-oral transmission,
fecally contaminated hands and fingernails, ingestion of fecally
contaminated food and water
• Enterohemorrhagic Escherichia coli (EHEC) Diarrhea –EA:
Escherichia coli O157:H7; MT: fecal-oral route, ingestion of
inadequately cook food, fecally contaminated beef, unpasteurized milk,
and fecally contaminated water
• Enterotoxigeic Escherichia coli (ETEC) Diarrhea, Traveler’s
Diarrhea –EA: many different serotypes of Enterotoxigenic E. coli; MT:
fecal-oral route, ingestion of fecally contaminated food or water

Protozoal Infections
• Amebiasis – EA: Entamoeba histolytica; MT: ingestion of focally
contaminated food and water with oocysts
 • Cryptosporidiosis – EA: Cryptosporidium parvum; MT: fecat-oral,
ingestion of contaminated food and water
• Giardiasis – EA: Giardia lamblia; MT: fecal-oral, ingestion of cysts in
fecaly contaminated water or food

CIRCULATORY SYSTEM

Viral Infections
• Human Immunodeficiency Virus (HIV) Infection, Acquired
Immune Deficiency Syndrome (AIDS) – EA: Human
Immunodeficiency Virus (HIV); MT: direct sexual contact, sharing of
contaminated needles and syringes
• Mumps, Infectious Parotitis – EA: Mumps virus; MT: droplet spread,
direct contact with saliva of infected person
• Viral Hemorrhagic Diseases – EA: Ebola virus and Marbug virus; MT:
direct contact with infected blood, secretions, internal organs, or
semen, also by needstick

Bacterial Infections
• Lyme Disease – EA: Borrelia burgdorferi; MT: via tick bite
• Plague, “Black Death”, Bubonic Plague, Pneumonic Plague,
Septicemic Plague – EA: Yersinia pestis; MT: via flea bite (rodent to
to flea, flea to human)
• Tularemia, Rabbit Fever – EA: Francisella tularensis; MT: via tick
bite, entry of organism into wounds, ingestion of contaminated meat or
drinking water

GENITOURINARY TRACT

Viral STDs
• Anogenital Herpes Viral Infections, Genital Herpes – EA: herpes
simplex virus, type 2 (HSV 2); MT: direct sexual contact, oral-genital,
oral-anal, or anal-genital contact during presence of lesion, mother to
fetus during pregnancy, mother to neonate during birth
• Genital Warts, Genital Papillomatosis, Condyloma Acuminatum
– EA: Human Papilloma viruses (HPV), HPV genotypes 16 and 18 have
been associated with cervical cancer; MT: direct contact, usually
sexual, through breaks in the skin or mucous membranes, from mother
to neonate during birth

Bacterial STDs
 • Genital Chlamydia Infections, genital Chlamydiasis – EA: certain
serotypes of Chlamydia trachomatis; MT: direct sexual contact, mother
to neonate during birth
• Gonorrhea – EA: Neisseria gonorrhoeae; MT: direct mucous to
mucous membrane contact, usually sexual contact, mother to neonate
during birth
• Syphilis – EA: Treponema pallidum; MT: direct contact with lesions,
body secretions, mucous membranes, semen, saliva, and vaginal
discharges of infected people, usually during sexual contact, also
through blood transfusion, transplacentally from mother to fetus

Protozoal Infection
• Trichomoniasis – EA: Trichomonas vaginalis; MT: sexual intercourse

CENTRAL NERVOUS SYSTEM

Viral Infections
• Poliomyelitis, Polio, Infantile Paralysis – EA: Polioviruses; MT:
fecal-oral route
• Rabies – EA: Rabies virus; MT: bite of rabid animal
• Viral encephalitis, Arthropodeborne Viral Encephalitis – EA:
West Nile virus, EEE virus, California encephalitis virus, LaCrosse
encephalitis virus, St. Louis encephalitis virus, WEE virus; MT:
arthropod vector (mosquito)

Bacterial Infections
• Botulism – EA: Clostridium botulinum; MT: ingestion of food with toxin
(food poisoning), entrance of spores in wounds (wound infection)
• Listeriosis – EA: Listeria monocytogenes; MT: ingestion of
contaminated food
• Tetanus, Lockjaw – EA: Clostridium tetani; MT: entrance of spores in
puncture wound, burns or needlestick injury

Protozoal Infections
• African Trypanosomiasis, African Sleeping Sickness – EA:
Trypanosoma brucei; MT: bite of infected tsetse fly
• American Trypanosomiasis – EA: Trypanosoma cruzi; MT: bite of
reduviid bigs
• Babesiosis – EA: Babesia microti; MT: by tick bite
• Malaria – EA: four different species of Plasmodium (vivax, malariae,
ovale, falciparum); MT: injection of sporozoites by infected female
Anopheles mosquito