Infectious diseases

Transmission

1st trimester- rubella

3rd trimester toxoplasmosis
Syphilis after 20 weeks
Congenital herpes risk of
transmission at child birth

 Appearance of Rash with Fever = VeRy

Sick Person MaRy Takes Double Tablets
Day
Day
Day
Day
Day
Day
Day

1
2
3
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5
6
7

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Varicella & Rubella

Scarlet Fever
Pox
Measles/ Roseola infantum
Typhus
Dengue
Typhoid

Number
First disease

Other names for the

disease
Rubeola, Measles, Hard
measles, 14-day measles,
Morbilli

Etiology(ies)
Measles virus

Second disease

Scarlet Fever, Scarlatina

Streptococcus
pyogenes

Third disease

Rubella, German measles,

3-day measles

Rubella virus

Fourth disease

Filatow-Dukes' Disease,
Staphylococcal Scalded
Skin Syndrome, Ritter's
disease

Some say the

disease does not
exist1. Others
believe it is due
toStaphylococcu
s aureusstrains
that make
epidermolytic
(exfoliative) toxin
2,3

Fifth disease

Erythema infectiosum
Exanthem subitum,

Erythrovirus
(Parvovirus) B19
Human Herpes

1st day - measles

2nd day scarlet fever
3rd day rubella/ german measles
4th day staph scalded skin syndrome
5th day erythema infectiosum
6th day exanthem subitum/ roseola
infantum
8th day - tetanus

 Horders spots Psittacosis facial

macules
Kopliks spots measles bluish gray
buccal nodules

 Nagayama spots roseola infantum

Rose spots truncal rash in typhoid
patients
Roth spots pale centred retinal
infarcts in SABE

 Inf mononucleosis ampicillin inc

incidence of rash
Roseola infantum rash appears
when fever abates
Erythema infectiosum slapped
cheek appearance, Aplastic crisis

Measles
Paramyxovirus- RNA
Four C's of Prodrome
Measles:Cough,Conjunctivitis,Koplik's Spots,
andCoryza
Rash begins at hairline and descends downwards
leaves behind a browny or furfuraceous
desquamation.
Warthin-Finkeldey Giant Multinucleated Cells
Giant cell pneumonia/ Hechts pneumonia
Koplik Spots(Red spots with blue-white centers
seen on buccal mucosa)

Measles
10th day fever
12th day kopliks spots
14th day rash for 7 days
MC complication bronchopneumonia/ LRTI
MC complication in children otitis media,
diarrhea, Vit A deficiency,
least common is SSPE

SSPE/ Dawnson encephalitis

After 3-8 years of measles. Can also occur after
measles vaccine.
Jabour
Stage 1 abnormal behaviour, poor school performance
Stage 2 seizures
Stage 3 decerebration/ coma
Stage 4 EEG findings, no myoclonus
EEG = burst suppression pattern
Rx: Isoprinosine, intrathecal interferon

Rubella
1. cardiac PDA, Pulmonary Artery
Stenosis, VSD
2. Cataracts
3. Mental Retardation
4. SNHL

 MaculopapularRash first on face, thenmostly on trunk

Red Tonsils with exudate
CervicalLymphadenopathy (post occipital, retro
auricular, post cervical lymph nodes)
Fever, Arthralgias
Myocarditis, meningoencephalitis
IUGR
Salt and pepper retina, chorioretinitis, cataract,
microphthalmia
Diagnosis: Rubella-specific IgM 2-3 days after rash starts

Blueberry muffin rubella; also in

neuroblastoma, CMV

 Forscheimers spots soft palate

lesions in rubella

Roseola infantum
Roseola/ exanthem subitum/ 6th
disease
Cause HHV 6
After defervescence of fever rash
appears
Centripetal trunks to extremities

Erythema infectiosum
5th disease
Cause
Parvovirus B 19
Slapped cheek
Reticular lacy
pattern
extremities
May have aplastic
crisis

 Arthritis, Myocarditis
Non immune hydrops
Papular purpuric glove stock
syndrome
Rx: IVIg (if immunocompromiseed)

Scarlet fever
Group A streptococci
Sandpaper texture first on flexor
most intense on neck, shoulders,
axilla, popliteal skin folds
Pharyngitis, tonsillitis, strawberry
tongue

Strawberry tongue
Strawberry tongueis the appearance of
tongue with inflamed redpapillae, giving an
appearance suggestive to a redstrawberry.
Associated conditions:
It is seen inKawasaki disease, toxic shock
syndrome,andscarlet fever.
It may mimicglossitisorVitamin B12
deficiency.

Hand, foot and mouth disease

Coxsackie A 16 (enterovirus 71)
Palmar, plantar pustules
Haemorrhagic papules

 Acute hemorrhagic conjunctivitis

coxsackie A 24, Enterovirus 70
Herpangina Entero 71

Varicella/ Chickenpox

Centripetal rash trunk first

Prodromal symptoms precede by 1 day
a/c cerebellar ataxia
Cowdry type A
Tzanck Smear(Syncytia- Giant
Mulitnucleated cells)
Breakthrough varicella varicella in
immunized patient

 MC complication secondary
bacterial infection
Avoid aspirin Reyes syndrome
Acyclovir for immunocompromised
Varicella embryopathy:
6-12 weeks limbs affected
16-20 weeks eye and brain
affected

Varicella fetopathy
If mother had varicella in 1 st 20 weeks of
pregnancy 2% develop fetopathy
LMN signs
Sensory nerves scars
Cerebrum microcephaly, hydrocphalus,
intracranial calcification
Optic stalk and Lens vesicle investment
Chorioretinitis, optic atrophy, cataract, micro
ophthalmia

 Congenital varicella syndrome:

Maternal infection near delivery 5
days before or 48 hours after
Scarring of skin
Cutaneous lesion - cicatrix

Impetigo
Group A strep
Bullous lesions caused by Staph
Complication PSGN

Acute bacterial meningitis

0-2 months : E coli, Group B strep,
Listeria
2 months 12 years: S. pneumoniae, N.
meningitides, H. influenzae type B
In alteration of host defence P.
aeruginosa, S. aureus, L.
monocytogenes, CoNS, Mycoplasma

Mumps
Paramyxovirus, rubula virus

Parotitis
Orchitis(infertility rare as it is mostly u/l)
AsepticMeningitis
Meningoencephalitis can precede parotitis
Congenital mumps--> Noncommunicating
Hydrocephalydue toAqueductal Stenosisof
Midbrain
During preg child will have endocardial
fibroelastosis

CMV
Owl Eye Inclusions (Cowdry Type A BodyIntranuclear
Inclusion Bodies)
Binds Beta2-Microglobulin(Required forMHCI)
Only Herpesvirus that crosses Placenta
Use Ganciclovir to treat Retinitis/Infection
MC complication of acquired CMV bleeding
diathesis
Congenital CMV ThrombocytopenicPurpura,Jaundice,Hepatosplenom
egaly, Intracerebral Calcifications, Retinal Infections

CMV
"MRDICS":
-Microcephaly vs. macrocephaly secondary to
hydrocephalus in congenital toxoplasmosis
-MentalRetardation
-Deafness (sensorineural) also seen in congenital
rubella
-ItracranialCalcifications (periventricular) vs. the
intracranial calcifications distributed throughout the
cortex and basal ganglia in congential toxoplasmosis
-Seizures (likely due to the intracranial calcifications)

Toxoplasmosis
Most common opportunistic CNS infection in those with
HIV(Reactivates in them - so see no/nonreactive IgM,
and low IgG titers) or majorImmunosuppression

Presentation:Triad
1.Chorioretinitis
2.Hydrocephalus
3.Intracranial Calcifications (diffuse, punctate and
periventricular)
Headache,Nausea,Vomitingfor several days
IUGR
Thrombocytopenia and bleeding manifestations

Diagnosis:
RingEnhancing
LesiontypeBr
ain Lesion
Treatment:
Sulfadiazine+
Pyrimethamine

Syphilis
Treponema Pallidum can easily pass
maternal-fetal barrier
Test for this during First and Third Trimesters
Can cause Abortion, Stillbirth, Birth Defects

Presentation:Hutchinson's Triad: Deafness,

Interstitial Keratitis, Notched Incisors
Saber Shins(Outward Bowing of Anterior Tibias)
Saddle Nose(Flattened Nose)
CNS Damage likeCN VIII Deafness

Hutchinson's Teeth(Notched Incisors)

Mulberry Molars
Perforated Palate
Maculopapular BronzingRash
Interstitial Keratitis(Vascularization
of Cornea)
Neonate + stuffy nose = syphilis
(snuffles)

LATEMANIFESTATIONSOFCONGENITALSYPHILIS

SYMPTOM/SIGN

DESCRIPTION/COMMENTS
Bony prominence of the forehead due to
Olympian brow
persistent or recurrent periostitis
Clavicular or
Unilateral or bilateral thickening of the
Higoum?naki
sternoclavicular third of the clavicle
sign
Saber shins
Anterior bowing of the midportion of the tibia
Scaphoid
Convexity along the medial border of the scapula
scapula
Peg-shaped upper central incisors; they erupt
Hutchinson
during 6th yr of life with abnormal enamel,
teeth
resulting in a notch along the biting surface
Abnormal 1st lower (6yr) molars characterized by
Mulberry
small biting surface and excessive number of
molars
cusps
Depression of the nasal root, a result of syphilitic
Saddle nose*
rhinitis destroying adjacent bone and cartilage

Diphtheria
Neuro triad:
palatal palsy 2nd week
neuropathy 4th week
loss of accomodation 5th week
Cardiomyopathy any time
Bull neck, membrane over tonsils
Descending paralysis
Rx: DOC erythromycin;
prophylaxis - penicillin

Pertussis
Bordetella pertussis Gm ve
coccobacilli
Whooping Cough (Residual Cough
after Treatment)
100 day cough
Lymphocytosis is Prevalent
Incubation period 2-4 weeks
Prodrome catarrhal Paroxysmal
Convalescent

 MC complication - Pneumonia
Plate on Bordet-Gengou Agar
Most easy to isolate during Catarrhal
Stage (Most Infectious Period)

Tetanus
Cause: Clostridium Tetani anaerobic
bacterium
Tetanus bacilli spread through nerves
only
Tetanus toxin can spread through blood,
lymphatics
Incubation period 2-14 days

 TETanus has TETanic Paralysis - BlockGlycine

release fromRenshaw CellsinSpinal CordcausesSpastic Paralysis,Trismus(Lockjaw)
andRisus Sardonicus
Hyperpyrexia
Laryngeal spasms
Rx: human tetanus Ig

Polio
1% non paralytic polio meningeal irritation neck
stiffnes:
1. tripod posture
2. kiss the knee test
3. head drop sign
4. Rope sign

0.1% paralytic polio asymmetric, areflexia preceded

by fever and diarrhea
Descending paralysis
Sup reflexes lost DTR lost weakness

 Poliovirusdestruction ofAnterior
HornofSpinal Cordleading toLower Motor
Neuron Lesion.
Bulbar lesion CN 9,10,11,12
Often die ofSuffocation(Diaphragmstops)
Diagnosis:
Lymphocytic Pleocytosiswith slight
elevation of protein inCSFwith
Lumbar Puncture- no change inGlucose
Find virus in stool or throat
Treatment:

 Any child under 15 years with acute flaccid

paralysis reported
Fecal samples collected and transported to lab
within 72 hours of collection at 4-8 degree celsius
This is called reverse cold chain
Natural polio type 1
VAPP- type 3
Post polio syndrome weakness with muscle pain
(cramps)

Descending paralysis
Polio
Botulism
Diphtheria

PCP
No prodrome, very acute onset
Severe hypoxia, cyanosis
Diffuse Bilateral Interstitial Pneumonia
CXR ground glass appearance
Biopsy shows Honeycomb Exudate with
Silver StainingCystsin Alveolar Lavage

 Most Common Infection in HIV

positive patients with < 200 CD4
PCP presents as Fluffy Infiltrates
DOC for PCP is
Sulfonamide/Trimethoprim (TMPSMX)

Paediatric HIV
2 major + 2 minor Criteria
MAJOR:
Weight loss of failure to thrive
Chronic diarrhoea > 1 month}
Prolonged fever > 1 month } Major
MINOR SIGNS:
Generalised lymphadenopathy
Oropharyngeal candidiasis
Recurrent common infections
Generalised dermatitis
Recurrent invasive bacterial infection
Confirmed maternal HIV infection

Paed AIDS
MC tumor in children NHL
Recurrent bacterial infection
3 Ps Parotid enlargement,
polyclonal hyperglobulinemia,
lymphocytic interstitial pneumonitis
ELISA only after 18 months

 Prevent MTCT NVP, Zidovudine

combination therapy ??
Prophylaxis
P. carinii cotrimoxazole
TB- INH
Atypical mycobacterium Clarithromycin
BCG, OPV cant be given in AIDS. BCG given
in HIV + mothers.

ATT and side effects

INH peripheral neuritis, optic neuritis, hepatitis,
aplastic anemia, hypersensitivity
Rifampicin hepatotoxic, dermatitis, flu like
syndrome, thrombocytopenia, hemolytic anemia
Pyrazinamide hepatotoxic
Ethambutol- retrobulbar neuritis, color blindness
Streptomycin auditory or vestibular dysfunction

HBV
Infant born to HBsAg +ve women
vaccine at birth, 1-2 months and 6
months of age + immunoglobulins
HBIg 0.5 ml at first dose
Vaccine Recombivax HB, Engerix B
at first dose

Infectious mononucleosis
Cause: EBV(Inc risk of NP Cancer)

Blood Smear Commonly shows B Cells (put rarely

shows T Cells)
Hyperemia of Pharynx, Tonsillar Exudates,
Splenomegaly, Cervical Lymphadenopathy,
Penicillin (Ampicillin) causes Maculopapular Rash

Diagnosis:
Heterophile Antibody
Paul Bunnel test +
Atypical Lymphocytes, Lymphocytosis
EBV Serology (EBV Antibody Titers)
Monospot test for screening

Variant:
Heterophil-Negative Mononucleosis(No Antibodies)
- caused byCMV,Toxoplasma Gondii,Listeria

Dengue
Dengue Fever Virus:
-Dengue Fever: breakbone fever (flu-like +
severe joint/muscle pain)
-Dengue Hemorrhagic Fever (Dengue Fever +
Hemorrhage,shock)
If second infection by different serotype ->
antibodiesagainst 1st serotype increase ->
cross-react to formimmune complexes->
type III hypersensitivity reaction->
hemorrhage, shock (Dengue Hemorrhagic
Fever)

Listeria
Neonatal meningitis
Low protein, sugar and high chloride
in CSF
Tumbling motility, umbrella type
formation below surface

Infant botulism
Botulinum toxin
causing paralysis by blocking the
release of acetylcholine at the
neuromuscular junction.
floppy infant
Bulbar palsies, generalized
weakness, hypotonia
Symmetric, descending, flaccid
paralysis

IMNCI
Diarrheal disease
ARI
Malaria

SIRS
Systemic inflammatory response syndrome
Finding
Value
<36 C(96.8F)or >38
Temperature
C(100.4F)
Heart rate
>90/min
>20/min orPaCO2
Respiratory rate
<32mmHg (4.3kPa)
<4x109/L (<4000/mm),
>12x109/L
WBC
(>12,000/mm), or 10%
bands

 Risus sardonicus tetanus

Rope sign polio
Coma vigil, organomegaly, acute
abdomen enteric fever
Mumps acute pancreatitis

 Delayed umbilical cord detachment

with purulent discharge,
leukocytosis, recurrent infections
leukocyte adhesion defect, lazy
leukocyte sybdrome

 Polyoma virus - hemorrhagic cystitis

JC Virus- causesPMLwithHIV
Vaccine predisposing to malignancy hep B
EBV NHL
EBV complication Perceptual distortions of sizes,
shapes, and spatial relationships, known as the Alice
in Wonderland syndrome (metamorphopsia)

Stains
Acid fast ziel neelson, Kinyoun, Auramine
Rhodamine
Acridine orange DNA
Methanamine silver pneumocystis cysts
Wright and giemsa blood parasites (plasmodium,
babesia, leishmania)
Trichome stools for parasites

 agar disk diffusion method

(Bauer-Kirby method)
antibiotic susceptibility
E test for MIC
Periodic Fever, Aphthous Stomatitis,
Pharyngitis, and Adenitis Marshall
syndrome

 Relative tachycardia toxins, non

infectious disease
Relative bradycardia typhoid,
brucellosis, leptospirosis
Fever with petechiae
meningococcus, Hib

 SIRS, CARS (compensated anti inflammatory

response syndrome), MARS (mixed anti
inflammatory)
Hyper Ig E combined B and T whereas
Hyper Ig M antibody deficiency
Ecthyma gangrenosa is a necrotic ulcer
covered with a gray-black eschar. It is usually a
sign of P. aeruginosa sepsis and usually occurs in
LAD patients (immune compromised)

 CGD defect in NADPH oxidase function of

neutrophils
T. gondii complicates heart transplants
Antibiotic lock or dwell therapy, with
administration of solutions of high
concentrations of antibiotics or ethanol that
remain in the catheter for up to 24hr, may
improve outcome when used as an adjuvant to
systemic therapy.

 peritoneal cavity (ventriculoperitoneal [VP] shunt)

or right atrium (ventriculoatrial [VA] shunt)
Chronic VA shunt colonization may cause
hypocomplementemic glomerulonephritis due to
antigen-antibody complex deposition in the
glomeruli, which is commonly called shunt
nephritis; clinical findings include hypertension,
microscopic hematuria, elevated blood urea
nitrogen (BUN) and serum creatinine levels, and
anemia.

Staphylococcal Scalded Skin

Syndrome
Staphylococcal Scalded Skin Syndrome (Ritter Disease)
7 'S' of SSSS

1. Staphylococcal group 2
2. Skin tenderness
3. Scarlatiform diffuse erythema
4. Sign : Nikolsky
5. Sterile intact bulla ( non contagious )
6. Subcorneal granular split of epidermis (BIOPSY)
7. Skin moistened and cleaned with isotonic saline &
antibiotics (Rx)

 TSS - Staphylococcus AureusTSST1Superantigen

bullous impetigo
Strep - non bullous impetigo, quellungs
exotoxins of strep pyogenes super antigens;
PANDAS
Pneumococcal polysaccharide vaccinesconjugated to CRM 197

 Quinupristin/dalfopristin for
vancomycin resistant enterococci
Actinomycosis yellow sulfur granules
3 sites cervicofacial (lumpy jaw), abdo,
pelvic, pulmonary
Pseudo appendicitis yersinia
enterocolitis

 Modified kinyouns Nocardia beaded pattern

Madura foot- actinomadura madurae
GBS assoc with meningococcal vaccination
Gonococcus - Dissemination from the fallopian
tubes through the peritoneum to the liver
capsule results in perihepatitis (Fitz-Hugh
Curtis syndrome).

 H. influenzae is a fastidious, gramnegative, pleomorphic coccobacillus

that requires factor X (hematin) and
factor V (phosphopyridine
nucleotide) for growth.
Chancroid- buboes, painful, Rx:
azithro

Pertussis
filamentous hemagglutinin (FHA), some
agglutinogens (especially fimbriae [Fim] types 2
and 3), and pertactin (Pn) are important for
attachment to ciliated respiratory epithelial cells.
Tracheal cytotoxin, adenylate cyclase, and PT
appear to inhibit clearance of organisms.
Stainer-Scholte broth or Regan-Lowe semisolid
transport medium
showing perihilar infiltrate or edema (sometimes with
a butterfly appearance) and variable atelectasis.
Lymphocytosis (T and B cells) in Pertussis

Bartonella
Both B. henselae and B. quintana cause
vascular proliferative disease called bacillary
angiomatosis (BA) and bacillary peliosis in
severely immunocompromised persons,
primarily adult patients with AIDS or cancer
and organ transplant recipients.
Subcutaneous and lytic bone lesions are
strongly associated with B. quintana, whereas
peliosis hepatis is associated exclusively with
B. henselae.

 neuroretinitis with papilledema and stellate

macular exudates, encephalitis
development of granulomatous osteolytic
lesions
Warthin-Starry and Brown-Hopps tissue stains
Leukocytoclastic vasculitis

Gianotti-Crosti syndrome
also known as papular acrodermatitis of childhood:
immunologic reaction to viral infections and
immunizations
initially associated with primary liver infection by
hepatitis B virus.
seen in children after immunizations (hepatitis A,
others) and in patients infected with Epstein-Barr virus
(most common association), coxsackievirus A16,
parainfluenza virus, and other viral infections.
Lines of papules (Koebner phenomenon) may be
noted on the extremities. skin lesions appearing on
lines of trauma

Rickettsia
TRIAD OF HEADACHE, FEVER, RASH.
Rickettsia Rickettsii(
Rocky Mountain Spotted Fever) withTickVector
Rickettsia Akari-Vesicular Rash(like
Chickenpox) esp on Trunk, Smaller Eschars at
site ofMiteBite
Rickettsia Typhi(Endemic Typhus)
withFleavector
Rickettsia Prowazekii Epidemic Typhus
with Human BodyLouse

 Erlichia(Ehrlichiosis) viaTick
PneumoniawithCoxiella
Ricketsia Japonicum, R. Slowaki spotted fever
Coxiella Burnetii(Q Fever) via Inhaled Aerosols
-Queersince it has no rash, no vector and
negativeWeil-Felixand its causative organism
can live outside for along time and is not called
a Rickettsia, Can causeAtypical Pneumonia,
can be inhaled with dust, or fromTicks.

 Shigella reiters, Ekiri syndrome or

lethal toxic encephalopathy,
pseudomembranous colitis
E. coli HUS (O157: H7)due to shiga
toxin; fecal leucocyte positive
Travellers diarrhea - ETEC

 Campylobacter GBS;
C. fetus extraint manifestation
Y. pseudotuberculosis - gm ve coccobacilli, is
associated with a Kawasaki diseaselike illness
(coronary aneurysm)
Psudomonas CF more prone to infection;
Phenacin blue
Flurosin red
cause ecthyma gangrenosum,

Burkholderia
Glanders is a severe infectious disease of horses and other
domestic and farm animals due to Burkholderia mallei.
Burkholderia cepacia is a filamentous gram-negative rod.
requiring an enriched, selective media oxidation fermentation
base supplemented with polymyxin Bbacitracin-lactose agar
(OFPBL)
common in CF
Burkholderia Pseudomallei (Melioidosis)
Diabetes mellitus is a risk factor for severe melioidosis.
traveler or immigrant from south east asia, pneumonia like
symptoms. may present as a single primary skin lesion
(vesicle, bulla, or urticaria).
grown on Ashdown's medium

Francisella tularensis
Purulent conjunctivitis with ipsilateral
preauricular or submandibular
lymphadenopathy is referred to as
Parinaud oculoglandular syndrome.
Ulceroglandular disease
Pneumonia
Typhoidal tularemia
Needs cysteine to grow

Brucella
Brucella Suis -Pigs
Brucella Melitensis- Goats
Brucella Abortus- Cattle
Unpasteurized Milk Intermittent Fever, Profound
Muscle Weakness, GNB in blood, BMMicrogranuloma, Serum agglutination test +ve
Brucellosis/Undulant Fever
Bang's Disease
Malta Fever

Legionella
Legionaires disease - Severe
Atypical Pneumonia- stays IC in macrophages Spreads with Air Conditioning Exposure with
Fever, (Common in those over 50 yrs old,
Smoking,Alcoholism) - Dx: Direct Fluorescent
Antibody = Tx:Erythromycin
Pontiac disease flu like illness
Diarrhea + decreased PO4 + decreased Na +
Renal dysfunction + abnormal LFT

Bartonella bacilliformis
Oroya fever, a severe, febrile
hemolytic anemia, and verruca
peruana (verruga peruana), an
eruption of hemangioma-like lesions.
Bartonellosis is also called Carri?n
disease

 Trench fever bartonella quintana

Relapsing fever borellia recurrentis

Louse-borne (epidemic) relapsing fever is
caused by Borrelia recurrentis and is transmitted
from person to person by Pediculus humanus
Tick-borne (endemic) relapsing fever is
caused by several species of Borrelia and is
transmitted to humans by Ornithodoros ticks.

Borellia burgdorferi
Lyme disease
Erythema migrans
Jarish herxheimer reaction
papilledema, cranial neuropathy
(especially cranial nerve VII)
Conduction block

 Vincent angina, also known as acute necrotizing

ulcerative gingivitis or trench mouth, is an acute,
fulminating, mixed anaerobic bacterial-spirochetal
infection of the gingival margin and floor of the mouth.
It is characterized by gingival pain, foul breath, and
pseudomembrane formation. Fusobacteria +
spirochetes
Ludwig angina is an acute, life-threatening cellulitis of
dental origin of the sublingual and submandibular
spaces. Infection spreads rapidly in the neck and may
cause sudden airway obstruction.
fusobacteria

 Lemierre syndrome, or postanginal sepsis, is a

suppurative infection of the lateral pharyngeal space, of
apparent increasing prevalence, that often begins as
pharyngitis. It may complicate Epstein Barr Virus or
other infections of the pharynx. It usually manifests as a
unilateral septic thrombophlebitis of the jugular venous
system with septic pulmonary embolization. Clinical
signs include unilateral painful neck swelling, trismus,
and dysphagia culminating with signs of sepsis and
respiratory distress. Fusobacterium necrophorum is the
most commonly isolated organism, although
polymicrobial infection may occur.

Clostridium
Clostridial necrotizing enteritis(CNE), also
calledenteritis necroticansandpigbel, is
an often fatal type offood poisoningcaused
by a-toxinofClostridium perfringensType C.
Clostridium perf A food poison
myonecrosis
Clostridium septicum - rapidly fatal gas
gangrene

 M. marinum fish tank/ swimming

pool granuloma
M. ulcerans Buruli ulcers
Rx: azithro, rifampicin

Leptospirosis
Weil's Disease (Acute Icteric Disease)
fulminant hepatic failure
Non icteric disease
Fever, Headache and Vomiting 1
week after camping on Island
(Hawaii)
Animal Urine gives lesser disease
Warthin-Starry silver staining

 Mollarets meningitis Herpes

simplex
Eosinophilic meningitis Angiostrongylus cantonensis

Shipyard conjunctivitis Adenovirus,

enterovirus

 Pleurodynia (bronholm disease) coxsackie B1- B5

thoracic pain

Myocarditis Coxsackie B5/ Entero 71

Enterovirus Rx of choice Pleconarin

rhombencephalitis involving the midbrain, pons, and
medulla
dermatomyositis-like syndrome, hepatitis, arthritis,
myocarditis, or disseminated infection