Medical Microbiology

I. THE ADVERSARIES: PARASITES 1. Microbes as Parasites The Varieties of Microbes . Living Inside or Outside Cells . Systems of Classification The Organisms 2. Bacteria 3. Viruses 4. Fungi 5. Protozoa 6. Helminths and Arthropods 7. Prions 8. The Host-Parasite Relationship The Normal Flora . Symbiotic Association . The Characteristics of Parasitism . The Evolution of Parasitism II. THE ADVERSARIES: HOST DEFENSES 9. The Innate Defenses of the Body Defense Against Entry into the Body . Defenses Once the Microorganism Penetrates the Body 10. Adaptive Responses - a Quantum Leap in Effective Defense The Role of Antibodies . The Role of T Lymphocytes/MHC . Extracellular Attack on Large Infectious Agents . Local Defenses at Mucosal Surfaces 11. The Cellular Basis of Adaptive Immune Responses B and T Cell Receptors . Selection & Clonal Expansion of Lymphocytes . Role of Memory Cells . T-independent and T-dependent Antigens . Cytokines . Regulatory Mechanisms . Tolerance Mechanisms III. CONFLICTS 12. Conflicts: Background to Infectious Disease Host-Parasite Relationships . Causes of Infectious Diseases . The Biologic Response Gradient 13. Entry, Exit and Transmission Sites of Entry . Exit and Transmission . Types of Transmission . Transmission from Animals 14. Innate Defenses in Action Complement . C-reactive Protein . Phagocytosis . Cytotoxicity by Lymphocytes and Natural Killer Cells . Cytotoxic Lipids . Cytokines . Fever 15. Spread and Replication Features of Surface and Systemic Infections . Mechanisms of Spread through the Body . Genetic Determinants of Spread and Replication . Other Factors Affecting Spread and Replication 16. Adaptive Immunity in Action 17. Parasite Survival Strategies and Persistent Infections Parasite Survival Strategies . Concealment of Antigens . Antigenic Variation . Immunosuppression . Persistent Infections 18. Pathologic Consequences of Infection Pathology Due to Direct Effects of the Microorganism . Pathologic Activation of Innate Immune Mechanisms . Pathologic Consequences of the Adaptive Immune Response . Skin Rashes . Viruses and Cancer . Microbes & Diseases of obscure origin IV. CLINICAL MANIFESTATIONS AND DIAGNOSIS OF INFECTIONS BY BODY SYSTEM 19. Upper Respiratory Tract Infections The Clinical Manifestations of Infection . The Common Cold . Pharyngitis and Tonsillitis . Otitis and Sinusitis . Acute Epiglottitis . Oral Cavity Infections . Laryngitis and Tracheitis . Diphtheria . Summary 20. Lower Respiratory Tract Infections Acute Infections of the Lower Respiratory Tract . Chronic Infections of the Lower Respiratory Tract . Parasitic Infections of the Lower Respiratory Tract . Summary 21. Urinary Tract Infections Acquisition and Etiology . Pathogenesis of UTIs . Clinical Features and Complications . Laboratory Diagnosis of UTIs . Treatment of UTIs . Prevention of Urinary Tract Infections . Summary 22. Sexually Transmitted Diseases STDs and Sexual Behavior . Syphilis . Gonorrhea . Chlamydial Infection . Other Causes of Inguinal Lymphadenopathy . Mycoplasmas and Non-gonococcal Urethritis . Other Causes of Vaginitis and Urethritis . Genital Herpes . Human Papillomavirus Infection . HIV and AIDS . Opportunistic STDs . Arthropod Infestations . Summary 23. Gastrointestinal Tract Infections Diarrheal Diseases . Helicobacter pylori and Gastric Ulcer Disease . Parasites and the Gastrointestinal Tract . Systemic Infection Initiated in the Gastrointestinal Tract . Hepatitis & other diseases of liver . Summary 24. Obstetric and Perinatal Infections Infections Occurring in Pregnancy . Congenital Infections . Infections Occurring Around the Time of Birth 25. Central Nervous System Infections Invasion of the Central Nervous System . The Body's Response to Invasion . Bacterial Meningitis . Fungal Meningitis . Protozoal Meningitis . Viral Meningitis . Encephalitis . Neurologic Diseases of Possible Viral Etiology . Slow Virus Infection . Brain Absceses . Encephalopathy Due to Scrapie-type Agents . Postvaccinial and Postinfectious Encephalitis . CNS Disease Due to Helminth Parasties . Tetanus and Botulism . Summary 26. Infections of the Eye Conjunctivitis . Infection of the Deeper Layers of the Eye 27. Infections of Skin Infections of the Skin . Bacterial Infections of Skin, Soft Tissue and Muscle . Mycobacterial Diseases of the Skin . Fungal Infections of the Skin . Parasitic Infections of the Skin . Mucocutaneous Lesions Caused by Viruses . Other Infectious Causes of Maculopapular Rashes . Summary 28. Infections of Muscle, Joints, Bone and Hemopoietic System Kawasaki Syndrome . Muscle infections . Joint and Bone Infections . Infections of the Hemopoietic System 29. Worldwide Virus Infections Measles . Mumps . Rubella . Cytomegalovirus Infection . EBV Infection . Other Human Herpesvirus (HHV) Infections . Smallpox . Summary 30. Vector-borne Infections Arboviruses and Hemorrhagic Fevers . Rickettsial Infections . Borrelia Infections . Protozoal Infections . Helminth Infections 31. Zoonoses Arenavirus Infections . Korean Hemorrhagic Fever . Marburg and Ebola Hemorrhagic Fevers . Q Fever . Anthrax . Plague . Yersinia enterocolitica Infection . Tularemia . Pasteurella multocida Infection . Leptospirosis . Rat Bite Fever . Brucellosis . Helminth Infections 32. Fever of Unknown Origin Definitions of Fever of Unknown Origin . Causes of FUO . Investigation of Classical FUO . Treatment of FUO . FUO in Specific Patient Groups . Infective Endocarditis . Summary 33. Infections in the Compromised Host The Compromised Host . Deficient Innate Immunity . Deficient Adaptive Immunity . Pathogens that Infect the Compromised Host . Clinical management of compromised host . Summary V. DIAGNOSIS AND CONTROL 34. Strategies for Control: An Introduction Epidemiologic considerations . Importance of diagnosis . Chemotherapy Versus Vaccination . Control Versus Eradication 35. Diagnosis of Infection and Assessment of Host Defense Mechanisms Aims of the Clinical Microbiology Laboratory . Specimen Protocols . Non-cultural Techniques for the Laboratory Diagnosis of Infection . Cultivation (Culture) of Microorganisms . Identification of Microorganisms Grown in Culture . Antibody Detection Methods for the Diagnosis of Infection . Assessment of Host Defense Systems 36. Attacking the Enemy: Antimicrobial Agents and Chemotherapy Selective Toxicity Discovery and Design of Antimicrobial Agents . Classification of Antibacterial Agents . Inhibitors of Cell Wall Synthesis . Inhibitors of Protein Synthesis . Inhibitors of Nucleic Acid Synthesis . Other Agents That Affect DNA . Inhibitors of Cytoplastic Membrane Function . Antibacterial Agents in Practice . Antiviral Agents . Antifungal and Antiparasitic Agents . Use and Misuse of Antimicrobial Agents . Resistance to Antimicrobials . Summary 37. Boosting Host Defense: Vaccination The Aims of Vaccination . Requirements of a Good Vaccine . Types of Vaccine . Special Considerations . Current Vaccine Practice . Community-based Control by Vaccination . Factors Influencing the Success of Vaccination 38. Passive and Non-specific Immunotherapy Passive Immunization with Antibody . Non-specific Cellular Immunostimulation . Correction of Host Immunodeficiency 39. Hospital Infection: Sterilization and Disinfection Common Hospital-acquired Infections . Important Causes of Hospital Infection . Sources and Routes of Spread of Hospital Infection . Host Factors and Hospital Infection . The Consequences of Hospital Infection . Prevention of Hospital Infection . Investigating Hospital Infection . Sterilization and Disinfection . Deciding Whether Sterilization or Disinfection Should Be Used . Techniques for Sterilization . Controlling Sterilization and Disinfection . Summary Pathogen Review Answers Index Appendix I: Protocols for Specimen Processing Protocols for Specimen Processing . Specimen Collection . Transport of Specimens . Specimen Processing