DMS. Skin Infections.
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Transcript of DMS. Skin Infections.
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The MycobacteriaThe Mycobacteria
(Acid Fast Bacilli)(Acid Fast Bacilli)
Obligate pathogens
Mycobacterium. tuberculosis- TB Mycobacterium bovis- bovine TB
Mycobacterium. leprae- Hansen's disease (leprosy)
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Emerging DiseasesEmerging Diseases
Hansens Disease(1!") # $eprosy ca%sed byMycobacterium leprae large amo%nts o& mycolic acids on the cell
s%r&ace
m%ltiplies 'ery sloly
mostly in&ects sin* ner'es and m%co%smembranes
ne'er c%lti'ated in laboratory media or cellc%lt%re* b%t has been c%lti'ated in mo%se&oot pads
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Emerging DiseasesEmerging Diseases
$eprosy ro%te o& in&ection is not non* b%t probably 'iarespiratory droplets
most people are resistant and do not de'elop acti'e disease
$ong and close contract ith lepromateo%s patients
+asal secretion
,in lesions
-nhalation
Transmissions.Transmissions.
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Emerging DiseasesEmerging Diseases
$eprosy # the disease process
patients de'elop discolored patches on sin
that do not itch or h%rt
ringorm/lie patches* may ha'e raised edges
patients e0perience loss o& &eeling ithin the
patch o& discolored sin
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LeprosyLeprosy
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Emerging DiseasesEmerging Diseases
$eprosy # other symptoms loss o& eyebros
thic or l%mpy earlobes
loss o& &eeling (b%rns or scars) painless %lcers on the &eet
drop &eet
de&ormities o& hands andor &eet
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Classical facial appearance of advanced leprosy
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$eprosy # diagnosis
in more ad'anced disease patient e0periences
n%mbness or tingling in hands and &eet
enlarged ner'es appear in arms and nec
leprosy bacilli can be &o%nd in sin lesions
painless %lcers become in&ected
in&ected %lcers become necrotic
lac o& pain allos in&ection to become deep and
attac bone
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To main &orms.
12 T%berc%loid leprosy (TT)
32 $epromato%s leprosy ($$)
Others &orms. Borderline leprosy
Low TT BT BB BL LL High
Poor prognosis
Diseases 4rod%ctionDiseases 4rod%ction
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Emerging DiseasesEmerging Diseases
T%berc%loid $eprosy (TT) %s%ally in persons ith relati'ely high
resistance
no bacilli in sin smear
person cannot pass leprosy on to others
sin patches are &e* are 'ariable inappearance* b%t o&ten ha'e raised marginsand &lat centers
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Emerging DiseasesEmerging Diseases
T%berc%loid $eprosy (TT)
%s%ally only in'ol'es loss o& &eeling in sinpatches
hen hands or &eet in'ol'ed it o&ten happensearly and ca%ses loss o& &eeling or strength inonly one hand or &oot
%s%ally responds 5%icly to treatment
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Emerging DiseasesEmerging Diseases
Borderline $eprosy
&e to many bacilli in sin smears
many sin patches* some &eeling loss* patchesabo%t the same on both sides o& the body
se'ere ner'e damage* loss o& &eeling andstrength* de&ormities in both hands and both&eet
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Emerging DiseasesEmerging Diseases
Borderline $eprosy
Depending on here it &alls along the line beteen
the to e0tremes* borderline leprosy is di'ided into.
borderline t%berc%loid (BT)
borderline (BB)
borderline lepromato%s (B$)
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Emerging DiseasesEmerging Diseases
$epromato%s $eprosy ($$)
in persons ith 'ery lo resistance
large n%mbers o& leprosy bacilli in sinpatches
patients are in&ectio%s %ntil treated
n%mero%s sin patches* o&ten ith raisedl%mps or thicened areas
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Emerging DiseasesEmerging Diseases
$epromato%s $eprosy ($$)
&acial sin becomes thic* l%mpy* reddish*especially o'er the eyebros* chees* nose* andears2
bridge o& the nose may grad%ally sin in
ner'e damage and paralysis appear late i& nottreated
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Emerging DiseasesEmerging Diseases
$epromato%s $eprosy ($$)
loss o& &eeling and strength a&&ects both
hands and both &eet e5%ally
response to treatment is o&ten slo
treatment m%st be contin%ed &or at least 3years
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Acid &ast* a%ramine/rhodamine stains
,in lesions or nasal scraping
Anaestheic checs
6ran%lomato%s &ormation
$epromin sin test . not &or $epromato%s leprosy
DiagnosisDiagnosis
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T%berc%loid leprosy.
Dapsone combined ith ri&in
$epromato%s leprosy.
Dapsone* ri&in and clo&a7imine
Borderline leprosy. ith E+$(erythema nod%s%m lepros%m)
Thalidomine
TreatmentTreatment
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HE84E,9-8-DAEHE84E,9-8-DAE
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H%man Herpes 9ir%sesH%man Herpes 9ir%ses
12 Herpes simples 'ir%s type 12
32 Herpes simples 'ir%s type 32"2 9ariocella 7oster 'ir%s2:2 ;ytomegalo'ir%s,H9)2
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,i&at/si&at 9ir%s Herpes,i&at/si&at 9ir%s Herpes 9irion. spheris* icosahedral capsid
6enom . linear* D+A %ntai ganda 4rotein. ? "< @enis protein pada 'irion En'elope. glioprotein* reseptor Fc
8epliasi. n%cle%s bert%nas dari membran n%clear2
;iri has in&esi 'ir%s herpes.12Menyebaban in&esi laten
32 Menetap secara inde&eniti& pada penderita
"2 ,ering reati& pada imm%nos%ppressed host
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-n&esi 'ir%s herpes pada man%sia-n&esi 'ir%s herpes pada man%sia
12 9ir%s herpes simples tipe 1
- hanya pada man%sia* tida memilii 'etorreser'oir hean- -n&esi laten. ,acral ganglia- sia terin&esi. ana balita- Transmisi pen%laran. onta langs%ng* sali'a
- 6e@ala >linis.a2 -n&2 4rimer.gingingostomatitis* pharyngotonsilitis*
eratocon@%cti'itis* in& neonatal2
b2 8ec%rent in&. &e'er* eratitis2
c2 -n& primer rec%rrent. Herpes %lit di atas pinggang* pd tangan*
si%* herpatic ithlo* ec7ema herpetic%m* genital herpes*
herpes encephalitis* herpes meningitis2
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3232 9ir%s herpes simples tipe 39ir%s herpes simples tipe 3
Tida memilii 'etor rese'oir hean2 sia terin&esi. deasa m%da Transmisi. se0%al 6e@ala linis.12 -n& primer. -n& neonatal32 -n& primer rec%rent. herpes %lit di baah pinggang* pd
tangan* si%* herpetic ithlo* genital herpes* herpes
meningitis2
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"2 9ir%s 9aricella/oster"2 9ir%s 9aricella/oster
A2 9aricella (chicenpo0)Ccacar air
,angat men%lar* ter%tama pada ana m2i . 1/31 hr* transmisi. sal na&as* con@%cti'a 6>. malaise* demam* diaali rash pada badan em%dian pada
a@ah* ai tangan* 3/: hr em%dian m%nc%l ma%la*
pap%la dan er%psi 'esic%lar pada %lit dan m%osa2 >ompliasi. encephalitis* pne%monia2
B2 oster.
-n&esi a%t pada syara& dorsal root ganglion -n&lamasi nyeri hebat pd ganglia %nilateral pada badan*
epala leher2
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H%man herpes 'ir%s =H%man herpes 'ir%s = T/ lymphtropic HH9 =. 1G=2 6>. e0anthema s%bit%m pd in&ant (roseola in&ant%m)
demam* sin rash2
H%man Herpes 9ir%s !
T/lyphotropic HH9 !. 1GG -n& pada ana2 Deat dg si&at cytomegalo'ir%s2
H%man Herpes 9ir%s
Diseb%t @%ga >,H9 (>aposis ,arcoma asscociated Herpes 9ir%s)*s0%ally transmitted2
9ir%s di@%mpai pada G penderita ,arcoma >aposi (t%mor'asc%lar) pd penderita A-D,2
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4OI9-8-DAE4OI9-8-DAE
$argest most comple0 o& 'ir%ses
Three po0 'ir%ses o& medical important.,mallpo0 'ir%s* 'accinia 'ir%s* and moll%sc%m
contagios%m2
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4OI9-8-DAE4OI9-8-DAE
,tr%ct%re composition./ O'al or bric shaped* :nm (length) 0 3"nm (
)
e0ternal s%r&ace shos ridges* contains core lateral
bodies/ ;omposition. D+A (")*protein (G)* lipid(
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,tr%ct%re composition.
/ 9ery resistant to inacti'ation
/ 4arapo0'ir%s. 3=01=nm* smaller than
orthopo0'ir%s
genomes. MJ
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9A;;-+-A 9A8-O$A9A;;-+-A 9A8-O$A
(4o0'ir%s in&ection in h%mans)(4o0'ir%s in&ection in h%mans)
1!G . Nenner introd%ced 'accination ith li'e 'ir%s
1G=! . JHO orldide campaign toeradicate smallpo0
1G . smallpo0 as o&&icially declaredeliminated
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;omposition o& 'accinia 'ariola 'ir%ses.;omposition o& 'accinia 'ariola 'ir%ses.
Host ./ 'ariola . only h%mans moneys
/ 'accinia . broad host range* incl%ding
rabbits mice 6ro on chorioallantoic membrane o& 1/13 days
old chic embryo* b%t 'ariola prod%ces m%ch
smaller pocs
6ro in se'eral types o& chic primate cell
lines
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4athogenesis o& smallpo0.4athogenesis o& smallpo0.
-4ortal o& entry . m%co%s membranes o& %pper
respiratory tract
- A&ter 'iral entry .
12 primary m%ltiplication in the lymphoid tiss%e draining the site o& entry
32 transient 'iremia and in&ection o& retic%lo/
endothelial cells thro%gho%t the body "2 secondary phase o& m%ltiplication in those cells
:2 secondary* more intense 'iremia
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;linical &indings .;linical &indings .
-nc%bation period o& 'ariola (smallpo0) C 13 days
12 Fe'er malaise . 1/< days32 E0anthems appear . / pap%lar (1/: days)
/ 'esic%lar (1/: days)
/ p%st%lar (3/= days)
"2 ;r%sts &ormed (3/: ees a&ter 1st
sign o& lesion) and lea'ing pin that &aded sloly
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$aboratory diagnosis.$aboratory diagnosis.
a2 -solation identi&ication . / sin lesions specimen (choice &or 'iral isolation)
/ direct e0am (electron microscope) .
rapid identi&ication o& 'iral particles (P 1 hr) di&&erentiate po0'ir%s in&ection &rom
chicenpo0
/ 'iral isolation is carried o%t by inoc%lation o& 'esic%lar &l%id onto the chorioallantoic
membrane o& chic embryos
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$aboratory diagnosis.$aboratory diagnosis.
/ in 3/" days 'accinia pocs are large ith
necrotic centers* hereas 'ariola pocs are
m%ch smaller
/ cell c%lt%res also be %sed &or 'iral isolation
(orthopo0* parapo0'ir%ses)
/ agar gel precipitation K detect 'iral antigen*
identi&ies orthopo0'ir%ses as a gro%p
b2 ,erology . H-* +t* E$-,A* 8-A orimm%no&l%orescence tests
/ antibodies appear a&ter 1stee in&ection
/ cannot disting%ish among orthopo0'ir%ses
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Moll%sc%m contagios%m (M;9)Moll%sc%m contagios%m (M;9)
M;9. transmitted by close personalcontact* incl%ding se0%ally2 The disease is 5%ite common in children*
and the lesions can be ide spread in
patients ith red%ced cell%rar imm%nity2
-n imm%nocompetent patients* the lesionsare sel&/limited b%t may last &or month2
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;linical Findings.;a%ses small* pin* pap%lar* artliebenign t%mors o& the sin or m%co%s
membranes2 The lesions ha'e a
characteristic c%p/shaped crater ith a
hite core2
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4apo'a'iridae4apo'a'iridae
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-mportant properties o& 4apo'a'ir%ses-mportant properties o& 4apo'a'ir%ses
9irion. -cosahedral ;omposition. D+A (1)* protein (G) 6enome. ds D+A* circ%lar* MJ "/< million En'elope. none
8eplication. n%cle%s O%tstanding characteristic./ ,tim%late cell D+A synthesis
/ 4olyoma'ir%ses are signi&icant ca%ses o& h%man disease
/ 9iral oncoprotein interact ith cell%lar t%mor s%pressor proteins
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-mportant properties o& 4apo'a'ir%ses-mportant properties o& 4apo'a'ir%ses
Oncogenic potential t!or in natral host "eslt o# natral in#ection$ Benign t!or (wart) Target tisse$ %r#ace epithelia
Most signi&icant h%man illness$ %&in wartslaryngeal papillo!as cervical carcino!a !portant ani!al isolates$ Papillo!avirses #ro!
cows and rabbits
4 ill i4 ill i
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4apilloma'ir%s4apilloma'ir%s ;a%se. sin arts* plantar arts* &lat arts*
genital condylonmas* laryngeal papillomas inh%man2
H49 ./ se0%ally transmitted genital lesions*
/ premalignant and malignant disease o&
'%l'a* cer'i0* penis and an%s2
/ genital condylomas* dysplasia to
in'asi'e cer'ical cancer (H49 type 1=* 1*
and 11* "1* ""* "
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Than Qo%RThan Qo%R