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    Micr Biology: Microbial Diseases of The Skin and Eyes

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    Ivy L Vonier
    The document provides information on various microbial diseases that can infect the skin and eyes. It begins by describing the structure and function of normal skin, including its protective barriers against microbes. It then discusses some of the common microbes that make up normal skin flora, including Staphylococcus epidermidis and Candida albicans. The document goes on to describe various skin lesions and infections caused by bacteria such as Staphylococcus aureus and Streptococcus pyogenes. It also discusses viral skin diseases including warts, chickenpox, herpes simplex, and measles.

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    Micr Biology: Microbial Diseases of The Skin and Eyes

    Uploaded by

    Ivy L Vonier
    131 views62 pages
    The document provides information on various microbial diseases that can infect the skin and eyes. It begins by describing the structure and function of normal skin, including its protective barriers against microbes. It then discusses some of the common microbes that make up normal skin flora, including Staphylococcus epidermidis and Candida albicans. The document goes on to describe various skin lesions and infections caused by bacteria such as Staphylococcus aureus and Streptococcus pyogenes. It also discusses viral skin diseases including warts, chickenpox, herpes simplex, and measles.

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    The document provides information on various microbial diseases that can infect the skin and eyes. It begins by describing the structure and function of normal skin, including its protective barriers against microbes. It then discusses some of the common microbes that make up normal skin flora, including Staphylococcus epidermidis and Candida albicans. The document goes on to describe various skin lesions and infections caused by bacteria such as Staphylococcus aureus and Streptococcus pyogenes. It also discusses viral skin diseases including warts, chickenpox, herpes simplex, and measles.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    131 views62 pages

    Micr Biology: Microbial Diseases of The Skin and Eyes

    Uploaded by

    Ivy L Vonier
    The document provides information on various microbial diseases that can infect the skin and eyes. It begins by describing the structure and function of normal skin, including its protective barriers against microbes. It then discusses some of the common microbes that make up normal skin flora, including Staphylococcus epidermidis and Candida albicans. The document goes on to describe various skin lesions and infections caused by bacteria such as Staphylococcus aureus and Streptococcus pyogenes. It also discusses viral skin diseases including warts, chickenpox, herpes simplex, and measles.

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    Microbiology

    AN INTRODUCTION

    B.E Pruitt & Jane J. Stein

    Chapter 21
    Microbial Diseases of the Skin and Eyes
    Structure & function of the skin

    • Epidermis
    • Dermis
    • Keratin
    • Hair follicles
    • Oil glands &
    sebum
    • Sweat glands
    • Mucous
    membranes
    Skin

    • Salt inhibits
    microbes
    • Lysozyme
    hydrolyzes
    peptidoglycan
    • Fatty acids
    inhibit some
    pathogens
    Normal Skin Flora
    • Propionibacterium acnes
    • Corynebacterium sp.
    • Staphylococci
    • Staphylococcus epidermidis
    • Staphylococcus aureus
    • Streptococci sp.
    • Candida albicans (yeast)
    • Many others
    Mucous Membranes

    • Line body cavities


    • Epithelial cells attached to
    an extracellular matrix
    • Cells secrete mucus
    • Some have cilia

    Stomach section
    Skin Lesions
    Vesicle

    • Small, fluid-filled lesions


    Bulla

    • Vesicles larger than 1 cm dia.


    Macule

    • Flat, reddened lesions


    Pustule/Furuncle

    • Raised lesions = papules


    • Containing pus = pustule
    Carbuncle

    • Extensive infection of a group of contagious


    follicles

    • Painful, hard lump

    • Necrosis of intervening skin

    • Large deep ulcer


    Staphylococcal skin infections
    I. Direct infection of skin and adjuscent tissues
    a. Folliculitis: Infections of the hair follicles
    b. Furuncle: Abscess; pus surrounded by inflamed tissue
    c. Carbuncle: Inflammation of tissue under the skin
    d. Ecthyma: bulla on inflamed tissue
    e. Impetigo: crusting (nonbullous) sores, spread by
    autoinoculation

    II. Cutaneous disease due to effect of bacterial


    toxin
    a. Staphylococcal scalded skin syndrome
    b. Toxic shock syndrome
    Staphylococcus aureus
    • Most pathogenic of the genus.
    • One of the most common pathogens in
    hospitals.
    • Produces:
    • coagulase– causes blood clotting.
    • Alpha & delta toxin – lyses human cells.
    • Leukocidin – destroys leukocytes.
    • Exfoliative toxin – skin separates & peels.
    • Toxic shock syndrome toxin – produces TSS.
    • Enterotoxin – food poisoning.
    Staphylococcus aureus
    • Transmission: close contact, fomites, foreign
    body in wound
    • Symptoms: range from superficial lesions to
    systemic infections
    • Treatment: vancomycin or methicillin
    (penicillenase)
    • Problem: methicillin- resistant strains have
    emerged and more strains becoming resistant to
    multiple antibiotics
    Ecthyma
    • Common in children
    • Small bullae or pustules on
    erythematous base
    • Formation of adherent dry crusts
    • Beneath which ulcer present
    • Heals with scar and pigmentation
    • Buttocks, thighs and legs, commonly
    affected
    Furunculosis (Boils)

    Causative agent:
    Staphylococcus aureus
    Furunculosis
    • Bacterium invades hair follicle
    • Generally originates from nasal cavity
    • Infected follicle of eyelash is a sty
    • Serious infection of follicle is boil … type of
    abscess ( region of pus surrounded by
    inflamed tissue)
    Scalded Skin Syndrome
    Causative agent:
    strains of Staphylococcus
    aureus
    Scalded Skin Syndrome
    • S. aureus lysogenized by phage produces
    exotoxin….
    • Causes necrosis of epidermal layer
    • Within 2 days, epidermal layer peels off in
    sheets
    • Starts at nose & mouth, then spreads
    • Penicillin-resistant
    • Effects esp. newborns as complication of
    staph infection
    Scalded Skin Syndrome/TSS

    • Characteristic of late stage of


    Toxic Shock Syndrome
    • Known from use of absorbent
    tampon
    • Toxin enters bloodstream from
    around tampon
    • Other TSS from nasal surgery,
    surgical incisions, following
    birth
    Streptococcal skin infections
    • Streptococcus
    pyogenes
    • Group A beta-hemolytic
    streptococci
    • Hemolysins
    • Hyaluronidase
    • Stretolysins
    • M proteins
    Impetigo

    Causative agent:
    Streptococcus pyogenes
    Impetigo

    • Mostly the very young


    • Spreads largely thru contact … hands, fomites….
    Highly contagious
    • Enters thru abrasion/wound
    • Lesions blister, break, crust over (brown sugar)
    • Seldom serious
    Impetigo
    • Problem in schools, hospitals, camps, nurseries
    • Drug of choice: penicillin & erythromycin
    Necrotizing faciitis

    Causative agent:
    Streptococcus pyogenes
    Necrotizing Fasciitis“Flesh Eating Strep”

    Streptococcus pyogenes (Group A Strep)


    • Tissue digesting enzymes
    • Hyaluronidase
    • Streptokinase
    • Streptolysins
    • Rapidly spreading
    cellulitis may lead
    to loss of limb
    Necrotizing Fasciitis
    • Disease starts as localized infection
    • Pain in area, flu-like symptoms
    • Invasive and spreading
    • May lead to toxic shock (drop in blood
    pressure)
    • Incidence 1-20/100,000
    • 30-70% mortality
    • Surgical removal, antibiotics
    Infections by Pseudomonads

    The model of opportunistic


    pathogens:

    Pseudomonas aeruginosa
    Pseudomonas aeruginosa
    •Gram-negative, aerobic rod
    •Pyocyanin produces a blue-green pus
    •Has pili for adherence
    •Slime layer interferes with phagocytosis
    •Rarely a problem for the healthy
    Pseudomonas aeruginosa
    • Burn patients esp. high risk:
    • 80% of burn fatalities due to infections
    (P.aeruginosa most commonly)
    • Burn wounds may exude blue-green pus
    • If infection becomes blood-borne, patient may die
    from shock
    • Prevention: scrupulous cleanliness, proper burn
    debridement
    Pseudomonas aeruginosa

    • Also causes: 10-20% of nosocomial infections


    • Transmission: fomites
    • Symptoms: range from superficial rash to fatal
    systemic infections
    And, in addition……
    • Pseudomonas dermatitis….
    • Rash lasting about 2 weeks
    • Associated with pools, hot tubs, etc
    • Bacteria enter hair follicles
    • Otitis externa – “swimmer’s ear”
    • Infection of external ear canal
    Acne

    • Propionibacterium
    acnes: Gram + rod
    • Digests sebum
    • Attracts neutrophils
    • Neutrophil digestive
    enzymes cause lesions,
    Microscopy “pus pockets”
    Acne

    • Most common
    skin disease in
    humans
    • Oil-based
    cosmetics worsen
    disease
    • No effects of diet
    Acne Treatments

    • Benzoyl peroxide dries plugged


    follicles, kills microbes
    • Tetracycline (antibiotic)
    • Accutane – inhibits sebum
    formation
    • Blue light – kills P. acnes
    Viral Diseases of the Skin
    Warts (Papillomas)
    • Papillomaviruses (50 known types)
    • Treatment:
    • Removal
    • Cryotherapy
    • Electrodesiccation
    • Burn with acid
    • Topical application of prescription drugs
    • Imiquimod (stimulate interferon production)
    • Interferon
    Virus Infections of the Skin: Vesicles

    Vesicular or pustular rash


    (elevated lesions filled with fluid)

    Smallpox (Human Pox virus)


    Chickenpox/Shingles (Human Herpesvirus-3)
    Cold Sores (Human simplex 1 and 2)
    Varicella (chickenpox)
    Causative agent:

    Varicella-zoster virus
    (Human herpesvirus 3)
    Chickenpox
    • Humans only known host
    • Transmitted via inhalation or direct contact
    • Acquired via respiratory system
    • Multiplies in respir. epithelium, travels by blood to
    skin of trunk and face
    • Infection localizes in skin cells after about 2 weeks
    Chickenpox
    • Infected skin is
    vesicular for 3-4 days
    (vesicles fill w/pus,
    rupture, & scab before
    healing)
    • Accompanied by fever,
    intense itching, &
    malaise
    • Secondary bacterial
    infections may occur
    due to scratching
    • Confers lifelong
    immunity, usually
    Chickenpox

    • More serious in adults – high mortality rate


    • Is the 3rd most common reportable inf. disease in
    U.S. (after gonorrhea & chlamydia infections)
    • Virus persists as latent infection in nerve ganglia
    • Reactivation may occur as herpes zoster
    (shingles)
    Initial infection, chickenpox (varicella)
    Recurrence of infection, shingles
    (herpes zoster)
    herpes zoster - Shingles
    Herpes simplex 1
    Human herpesvirus 1 (HSV-1)
    and
    Herpes simplex 2
    Human herpesvirus 2 (HSV-2)
    Herpes Simplex 1
    • Human herpesvirus 1
    • Cold sores or fever
    blisters (vesicles on
    lips)
    • Herpes gladiatorum
    (vesicles on skin) -
    wrestlers
    • Herpes whitlow
    (vesicles on fingers) -
    health care
    • HSV-1 can remain
    latent in trigeminal
    nerve ganglia
    Herpes Simplex 2

    • Human herpesvirus 2
    • Genital herpes
    • HSV 1 & 2 can cause
    Herpes encephalitis
    (HSV-2 has up to a
    70% fatality rate)
    • HSV-2 can remain
    latent in sacral nerve
    ganglia
    • Acyclovir may lessen
    symptoms
    Virus Infections of the Skin: Rashes
    Maculo-papular rashes
    (flat to slightly raised colored bump)
    Measles virus (Rubeola)
    Rubella virus (German Measles)
    Roseola (Human Herpesvirus-6)
    Fifth Disease (Human Parvovirus B19)
    Rubeola (measles)
    Causative agent:

    Rubeola virus
    Measles

    • Transmission via
    respiratory system.
    • Droplets, person-person.
    • Incubation 10-12 days.
    • Multiplies in respiratory
    mucosa….
    • Moves via blood to skin.
    Measles

    • Infection begins in
    upper resp. sys. (sore
    throat, headache,
    cough).
    • Fever, malaise.
    • Then macular rash
    appears on skin
    (beginning on face,
    spreading to trunk &
    extremities) .
    • Rash lasts 4-5 days.
    Measles

    • Extremely contagious
    disease
    • Humans only reservoir
    • Can result in encephalitis &
    pneumonia
    • More severe in infants and
    adults than in children
    • Confers lifelong immun.
    • Immunization part of MMR
    (mumps-measles-rubella)
    at 12-15 mo. age.
    Measles World Wide
    • Measles is the leading cause of vaccine-preventable
    death among children
    • In developed, measles death rates range from 1-5%,
    but among malnourished children, the death rate
    reaches 10-30%
    • Over 500,000 children under the age of five die each
    year.
    • Measles causes health complications, including
    pneumonia, diarrhea, encephalitis, and corneal
    scarring.
    • The primary reason for ongoing high childhood
    deaths is the failure to deliver at least one dose of
    measles vaccine to all infants.
    Measles (Rubeola)

    Figure 21.13
    Rubella (German measles)
    Causative agent:

    Rubella virus
    Rubella
    • Portal of entry –
    respiratory system
    • Respiratory droplets
    person-person
    • Incubation: 12-23 days
    • Much milder than
    measles – often goes
    undetected
    • Usual symptoms –
    macular rash of small
    red spots & light fever
    • Complications rare
    Rubella

    • Connection between serious birth defects &


    maternal infection during first trimester (virus
    crosses placenta)
    • Congenital rubella syndrome:
    • Deafness
    • Eye cataracts
    • Heart defects
    • Mental retardation
    • Death (15% of CRS die 1st yr)
    The Eye

    • Normal flora
    sparse
    • Similar to skin flora
    • Tears have
    lysozyme, IgA
    • Most infections
    from contact lens
    solutions or eye
    make up
    Bacterial eye infection resulting from injury
    is a medical emergency!
    Infections of the Eye

    Viral: Herpesvirus Keratitis (Human simplex 1)

    Bacterial infections of the eye


    Chlamydia trachomatis causes trachoma and can lead to
    blindness.
    Neissaria gonorrhea is passed from infected mother to child
    during birth (opthalmia neonatorum).

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