BODY PARTS : Site of Infection DISEASE DESCRIPTION and CLINICAL MANEFESTATIONS ETIOLOGIC AGENTBloodstream Infections

•Intravascular (originate within the cardiovascular system)

Infective endocarditis Infection of the endocardium commonly caused by bacteria.

Viridians StreptoccociNutritionally deficient streptococci (Abiotrophia spp. And Granulicatella spp.EnterococciStreptococci Staphylococcus aureusEnterobacteriaceaePseudomonas spp.Haemophilus spp. Particularly H. aphrophilus

Mycotic aneurysm Infection that causes inflammatory damage and weakening of an arterial wall.

Similar to those that cause endocarditis

Suppurative thrombophlebitis Inflammation of a vein wall. Increasing use of IV cathetersIntravenous (IV) Catheter-Associated Bacteremia

Occur primarily by two routes1st route: catheter skin entry-external surface of the catheter-catheter tip2nd route: inside of the catheter(lumen)-catheter tip

Staphylococcus epidermidisOther coagulase-negative staphylococciStaphylococcus aureus EnterobacteriaceaePseudomonas aeruginosaCandida spp.Corynebacteruim spp.Other gram-negative rods

•Extravascular (result from bacteria entering the blood circulation through the lymphatic system) -Meninges, epiglottis, periorbital region-Meninges, sometimes the lung-Meninges-Reticuloendothelial system-Small intestine, regional lympp nodes of the intestines, reticuloendothelial system

Septicemia or Sepsis -Infection that result from bacteria entering the blood circulation through the lymphatic system

Haemophilus influenzae type bStreptococcus pneumoniaNeisseria meningitidis and ListeriaBrucella sppSalmonella typhi

Infections of the Lower Respiratory TractBRONCHITIS:Acute

Chronic

-Characterized by acute inflammation of the tracheobronchial tree.- Maybe preceded by an upper respiratory tract infection such as influenza or the common cold. -Characterized by cough, variable fever, sputum production.

-Common condition affecting about 10% to 25% of adults. -Excessive mucus production -Patients with chronic bronchitis can suffer from acute flare-ups of infection.

Bordatella pertusis, B. paraperussis, Mycoplasm pneumoniaie Chlamydophilia pneumonia

Mycobacterium tuberculosis M. avium-intracellulare M. kansaii

Bronchiolitis -Inflammation of the smaller diameter bronchioloar epithelial surfaces-occur during the first two years of life-clinical manifestations include onset of wheezing and hyperventilation, cough, rhinorrhea, tachypnea, respiratory distress.

Respiratory syncytial virus Parainfluenza viruses, types 1-3RhinovirusesAdenovirusesInfluenza virusesEnterovirusesHuman metapneumovirus

PNEUMONIA:

•Community-acquired (acquired infection outside the hospital setting)

•Hospital-, Ventilator-, and Healthcare-Associated Pneumonia ( acquired infection within the hospital setting)

Chronic Lower Respiratory Tract Infection

-Inflammation of the lower respiratory tract involving the lung’s airways and supporting structures.*major cause of illness and death-symptoms are fever, chills, chest pain and cough. H. influenzae, S. pneumonia, S. aureus ( Children)

M. pneumonia, C. pneumonia ( school age)Mycoplasm pneumonia (Young adults)Streptococcus pneumonia ( Adults)

P. aeruginosa, Enterobacter spp,. Klebiella spp., other Enterobacteriaceae, S. aureus, Acinebacter spp., S. pneumonia, anaerobes, Legionella, and H. influenza. Other agents: RSV, adenovirus, and Influenza A.

Mycobacterium tuberculosisUpper Respiratory Tract Infections and Other

Infections of the Oral Cavity and NeckLarynx Laryngitis -associated with the common cold or influenza

syndromes-patients complain of hoarseness and lowering or deepening of the voice.

Parainfluenza virusesRhinovirusesAdenoviruses Coronovirus Human metapneumovirus

Laryngotracheobronchitis or Croup -relatively common illness in young children -Characterized by variable fever, inspiratory stridor, hoarseness, and a harsh, barking , nonproductive cough which lasts for 3-4 days.

Parainfluenza virus is the major etiologic agentInfluenza virusesRespiratory syncytial virusAdenovirusMycoplasm pneumoniaeRhinovirusesEnterovirus

Epiglottis Epiglottitis -infection of the epiglottis and other tissues above the vocal cords.

Haemophilus influenza type b

-characterized with fever, difficulty in swallowing because of pain, drooling, and respiratory obstruction with inspiratory stridor.

Pharynx and tonsils Pharyngitis and Tonsillitis -Depending on the causative microorganism, either inflammatory exudates (fluid with protein, inflammatory cells, and cellular debris, vesicles, (small blisterlike sacs containing liquid) and mucosal ulceration, or nasopharyngeal lymphoid hyperplasia ( swollen lymph nodes) may be observed.

Streptococcus pyogenes ( or group A beta-hemolytic streptococci)Group C and G beta hemolytic streptococciArcanobacterium (Corynebacteruim) haemolyticumNeisseria gonorrhoeaeCorynebacteruim ulceransMycolplasm pneumoniaYersinia enterocolitica Human immunodeficiency virus-1

Tonsils Peritonsillar Abscesses -Complication of tonsillitis Non-spore forming anaerobes, including Fusobacteruim (especially F. necrophorum), Bacteroides (including the B. fragilis group), and anaerobic cocci. Streptococcus pyogenes and viridians streptococci may also be involved.

Nasal Mucous membrane or lining Rhinitis -Inflammation of the nasal mucous membrane or lining-Depending on the etiologic agent, rhinitis is characterized by variable fever, increased mucous secretions, inflammatory edema of the nasal mucosa, sneezing and watery eyes.

RhinovirusesCoronovirusesAdenovirusesParainfluenza and influenza virusesRespiratory syncytial viruses

Oral cavity Stomatitis -Inflammation of the mucous membranes of the oral cavity

Herpes virus

Oral cavity Thrush or Candidiasis -Is suspected if whitish patches of exudate on an area of inflammation are observed on the buccal mucosa, tongue, or orophanrynx.

Candida spp.EnterobacteriaceaeS. aureus

Oral cavity-salivary gland Acute suppurative parotitis -Inflammation of the salivary glands -Seen in very ill patients, especially those who are dehydrated, malnourished, elderly, or recovering from surgery.-associated with painful, tender swelling of the parotid gland; purulent drainage maybe evident at the end opening of the duct of the gland in the mouth.

Staphylococcus aureusEnterobacteriaceaeOther gram negative bacilliOral anaerobesMumps virus

Neck Neck infections- Mediastinitis, Purulent pericarditis and Pleural empyema.

-Infection of the deep spaces of the neck PeptostreptococcusVarious BacteriodesPrevotellaPorphyromonasFusobacteruim spp.Atinomyces

Meningitis and other infections of the Central Nervous System

Meningitis:

•Purulent Meningitis

•Aseptic Meningitis

-Infection within the subarachnoid space or throughout the leptomeninges.

-marked acute inflammatory exudates with large numbers of ploymorphonuclear cells (PMNs)-maybe acute or chronic-Acute cases are characterized by fever, stiff neck, headache, nausea, and vomiting, neurologic abnormalities, change in mental status.-Chronic cases occur in patients who are immunocompromised (not always the case)Characterized by insidious onset of disease.

-Characterized by an increase of lymphocytes and other mononuclear cells (pleocytosis)

H. influenzae Neisseria meningitidesStreptococcus pneuomoniae

-Viral infections

Encephalitis/Meningoencephalitis

•Viral

•Parasitic

-Inflammation of the brain parenchyma-Concomitant meningitis that occurs with encephalitis id know as meningoencephalitis

enteroviruses (coxsackieviruses A and B, echoviruses), mumps virus, herpes simplex virus, and arbovirus ( West Nile virus, togavirus bunyavirus, equine encephalitis, St. Louis encephalitis, and other encephalitis viruses

Naegleria fowleriAcanthamoeba spp.

Infections of the Eyes, Ears and SinusesEyes Blepharitis -Inflammation of the margins of the eyelids

-symptoms include burning, itching, sensation of a foreign body, and crushing of the eyelids.

Staphylococcus aureusS. epidermidis

Eyes Conjuctivitis -Inflammation of the conjunctiva.-symptoms vary according to the etiologic agent but most patients have swelling of the conjunctiva, inflammatory exudates, and burning and itching.

Streptococcus pneumoniaHaemophilus influenzaS. aureusHaemophilus sppChlamydia trachomatisNeisseria gonorrhoeaeStreptococcus pyogensMoraxella spp.Corynebacteruim spp.

Eyes Keratitis -Inflammation of the cornea-most patients complain of pain and usually some decrease in vision, with or without discharge from the eye.

S. aureusS. pneumoniaPseudomonas aeruginosaMoraxella lacunataBacillus spp.

Eyes Keratoconjunctivitis -Infection involving both conjunctiva and cornea. Refer to agents for Keratitis/conjunctivitisEyes Chorioentinitis and uveatis -Inflammation of the retina and underlying

choroid or the uvea.-Infection can result in loss of vision.

Mycobacteruim tuberculosisTreponema pallidumBorella burgdorferi

Eyes Endophthalmitis -Infection of the aqueous or vitreous humor,-Develops suddenly and progresses rapidly, often leading to blindness. Pain, especially while moving the eye, and decreased vision are prominent features.

S. aureus S. epidermidisS. pneumoniaeOther streptococcal spp.P. aeruginosaOther gram negative organisms

Eyes Lacrimal infections; canalicultits -A rare, chronic inflammation of the lacrimal canals in which the eyelids swells and there is a thick, mucopurulent discharge.

ActoranomycesPropionibacterium propionicum

Eyes Dacryocystis -Inflammation of the lacrimal sac that is accompanied by pain, swelling, and tenderness of the soft tissue in the medial canthal region.

S. pneumoniaeS. aureusS. pyogenesHaemophilus infleunzae

Eyes Dacryoadenitis -Acute infection of the lacrimal gland-accompanied by pain, redness, and swelling of the upper eyelid and conjunctival discharge.

S. pneumoniaeS. aureusS. pyogenes

Ears Otitis Externa (External Ear Infections) -Acute infection of the skin around the ear that occurs in the form of a pustule or furuncle.-Chronic infection causes irritation of drainage from middle ear, necrotizing infection of soft tissues and cartilage, and bone.

S. aureusS. pyogenesP. aeruginosaGram – bacilliAnaerobes

Ears Otitis Media (Middle Ear Infections)