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Medical Microbiology

by: Isabell Harris

Medical Microbiology BIOL 4750

Isabell Harris
GPA 3.88

Susan Goss

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Susan Goss
Class Notes
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This 10 page Class Notes was uploaded by Isabell Harris on Wednesday October 21, 2015. The Class Notes belongs to BIOL 4750 at Tennessee Tech University taught by Susan Goss in Fall. Since its upload, it has received 31 views. For similar materials see /class/225713/biol-4750-tennessee-tech-university in Biology at Tennessee Tech University.


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Date Created: 10/21/15
Introduction to Virology Nature of Viruses NOT cells Obligate intracellular parasites Consist of genome enclosed in protein coat Genome RNA or DNA SS or DS Assembled from component parts Many animal Viruses also contain CHO gp and haVe a lipid envelope Viral Structure Protein coat called protection Nucleocapsid genome protein shell 0 Naked Enveloped Virions Helical or icosahedral Size of Viruses Smallest Viruses 2025 nanometers nm Poliovirus Parvovirus Biggest Viruses 200 300 nm Pox Herpes Viruses Classi cation of Viruses Genome RNA or DNA SS or DS Morphology icosahedral helical complex etc Naked or enVeloped Families PicornaViridae POXViridae HerpeSViridae Genus by genetic similarities HSV VZV Variola In uenza Virus Species by genetic differences HSVl Variola major In uenzaA Viral Replication Basic steps similar for all Viruses Recognition amp attachment penetration uncoating synthesis of Viral macromolecules assembly 0 release Virus Replication Cycle Attachment Attachment step 0 Speci c VAP binds receptor on host cell Rabiesvirus VAP G protein receptor Ach receptor on neurons 0 HIV gp120 binds CD4 on helper T cells Attachment specificity determines and tissue tropism Lymphotropic neurotropic etc Virus Replication Cycle Penetration amp Uncoating Penetration getting Virion or nucleocapsid into host cell 3 mechanisms animal Viruses Fusion Endocytosis ViropeXis Mechanism depends mainly on Whether virus has N DJ Uncoating release of Viral genome into host cell 0 DNA viruses in RNA in Synthesis of Viral macromolecules DNA gt mRNA gt PROTEIN Proteins synthesized on host cell ribosomes Viruses different strategies for making Viral mRNA 0 Baltimore classi cation Most DNA viruses replicate in 0 Most RNA viruses replicate in RNA genome 0 RNA genome is to mRNA Baltimore classi cation of Viruses Overview of Viral protein genome synthesis Many DNA viruses use enzymes for transcription TC amp replication 0 Large DNA viruses code for DNAP TC factors 0 Protein synthesis in phases early gt late 0 Early proteins other replication enz Late proteins DS DNA gt DS DNA Herpesviruses Adenoviruses SS DNA gt DS DNA Parvoviruses RNA Viruses can t use host cell replication enzymes 0 Need RNAdependent RNA polymerase RNA Viruses mRNA gt immed translation Vpol other proteins VRNAP makes a few RNA copies of genome Template for many RNA Poliovirus Coronavirus RNA viruses must have in virion Host cell cannot translate or replicate negative stranded RNA vRNAP makes RNA copies of genome Some act as mRNA gt protein synthesis 0 Others serve as templates for RNA genomes Measles Rabies Ebola viruses DS RNA virions Reoviruses also contain VRNAP RNA are templates for mRNA and new viral RNAs Retroviruses RNA use DNA copy of genome DNA gt nucleus integrates into host cell chromosome 0 Integrated vDNA is transcribed by host RNAP into RNA for mRNA and new viral genomes RNA tumor viruses HIV RT to make DS Final Steps in Viral Replication Cycle Assembly of virions DNA viruses assembled in 0 RNA viruses assembled in Release of virions from cell Lysis 7 many viruses Budding viruses 0 7 some viruses are eXported by a cellular vesicle Kinetics of Virus Replication Early phase attachment penetration uncoating N0 infectious virus detected in or out of cell 0 period Late phase begins w protein synthesis amp genome replication 0 period gradual increase in intracellular virus No viruses outside of cell Latent period ends with 1st release of virions size number of viruses released per cell Pathogenesis of Viral Infections 3 possible consequences for infected ill 0 infection failed infection gt no effect 0 infection gt cell lysis and death t infection infection Without cell death infection gt no Virus production or cell death infection gt low level Virus production Tranformation Virus TF cells gt tumor viruses 0 May or may not be viruses produced Type of infection depends on cell Virus Permissive nonpermissive cells Pathogenesis of Viral Infections Consequences of Viral infection for m human 0 infection no SS most Viral infections infection sudden onset major SS shedding of viruses 0 Chronic infection long term SS virus shedding Tumor cancer SS not generally contagious infection at cellular viruses effect on effect on host evel produced Ab omive Cytolytic Persistentchronic transforming DNA How Viruses cause disease Direct effects on host cells effects Inhibit cellular protein synthesis 0 Degradation of cellular DNA Destruction of membrane Inclusions in infected cells Spread celltocell fusion gt syncytia Cause latent or transforming infections 0 Hide from immune response cause cancer Stimulate immunopathological response 0 In ammation inhibit apoptosis Epidemiology Routes of XMT Respiratory route Fecaloral route Contact includes STD Parenteral Vectors Zoonosis Vertical XMT Incubation periods from hours to years Presence absence of Enveloped viruses more fragile Nonenveloped viruses not inactivated in environment important DX of Viral Diseases by Microscopy examination of infected cells from specimen or culture look for CPE Lysis 7 disruption of cell monolayer 7 multinucleated giant cells Inclusions 7 Cowdry Negri bodies etc 0 7 holes in cell monolayer Can use to count viruses in lab Foci 7 lumps ofinfected cells in monolayer Tumor viruses Direct EM to see Virus particles DX of Viral Diseases by Culture Infect animals gt disease death cytopathology Eggs some Viruses form pocks in membranes Cell culture cells form monolayer in dish ask Primary cell cultures from animals humans 0 Secondary 7 passaged a few times 0 Continuous 7 immortal cancer cell lines Counting Viruses assay PFU TCID50 ID50 LD50 animals Growing Viruses in the Lab Cell Culture cells grow in a monolayer can t see Viruses but can see their effects on cells gt cytopathic effects CPE Molecular Dx of Viral Diseases Detection of viral proteins or genes Immunocytochemistry detection by Abs conjugated to fluorochrome FA enzyme ELISA radiolabel RIA Direct 7 detection label on antiviral primary Ab Indirect 7 label on 2nd Ab antilg DNA probes hybridize with viral genome Detection 7 Ab methods PCR amplify viral DNA Dx of Viral Diseases by Serology Detect vs virus in patient serum 0 highest dilution that Rx with viral Ag 0 Acute phase test during SS 0 IgM indicates active infection Convalescent phase 4X rise in titer gt active infection Serological tests for viruses 0 Virus VN 7 ability of pt serum to block virus infection Immunoassay ELISA IFA etc 7 use known viral Ags to detect Abs Abs clump latex particles w viral Ags Hemagglutination inhibition HAI for viruses that clump rbc e g u Find dilution of serum that prevents clumping Western blot combo electrophoresis and ELISA Determine speci city of patient antibodies Disadvantage of serology Dx Indicates exposure to viral Ags doesn t prove active infection Control of Viral Diseases Vaccines most successful if available vaccines lVIMR OPV smallpox Longlasting immunity 7 reversion to virulence can t use in immunocompromised individuals Inactivated vaccines IPV rabies u can t cause disease 7 need multiple boosters Multiple vaccines lVIMR Recombinant vaccines HBV Medical Mycology quot 39 r J by budding Blastoconidia Molds have amp Sporangiospores Conidia Arthrospores Hyphae septate or aseptate coenocytic Hyaline or dematiaceous Aerial hyphae gt Vegetative hyphae in medium soil fungi Yeasts in tissue molds in environment Fungi cause 3 types of damage 7 caused by toxic products alkaloids St Anthony s re Claviceps purpurea A atoxins iAspergillus avus Psychotropic agents LSD Hypersensitivity 7 allergic RX to mold spores 39 39 quot and growth in tissues Tissue damage obstruction in ammation Chemotherapy for Fungal Diseases Polyenes bind ergosterol in membrane Amphotericin B used for systemic mycoses Nystatin topical for yeast infections Azoles inhibit ergosterol synthesis Ketoconazole clotrimazole etc Nucleoside analogs inhibit DNA synthesis 5 uorocytosine Oral topical agents for ringworm GriseofulVin Tolnaftate DX of fungal diseases bV 39 V amp culture Cytology stained tissue slides HampE PAS GMS KOH prep skin hair nail fungi India ink prep capsules Germ tube test Wet mount 7 lactophenol cotton blue Culture on Sabouraud Dextrose Agar SAB etc Yeasts N bacterial colonies Super cial Mycoses tinea versicolor 7Malassezz39afurfur Spaghetti amp meatballs Tinea nigra 7 Exophiala werneckz39i Black piedra 7 Piedraz39a hortae White piedra 7 Trichosporon beigelz39z39 DX clinical SS microscopy KOH prep Cutaneous Mycoses Caused by fungi M icrosporum Trichophyton Epidermophyton Tinea capitis t pedis t cruris t corporis onychomycosis t unguiam XMT geophilic zoophilic or anthropophilic DX ringworm Clinical SS KOH prep 7 can t tell species Hair ectothrix or endothrix Culture selective medium Microconidia and macroconidia Trt ringworm topical oral azoles griseofulVin Subcutaneous Mycoses XMT trauma usually Localized abscesses Sporotrichosis 7 gardeners etc Sporothrz39x schenckz39i 7 DX yeasts in tissues mold on plate Trt oral KI Chromoblastomycosis Phialophora etc dematiaceous fungi DX microscopy Trt surgery oral 5FC Mycetoma lumpy foot Many fungi actinomycete bacteria Pseudallescheria boydiz39 Differential DX important Systemic Mycoses Histoplasmosis H istoplasma capsulatum 7 dimorphic pathogen aka or Darling s disease XMT resp mold form gt macs gt yeasts multiply in macs SS variable can be fatal if disseminated DX microscopy culture Tissue phage yeasts Culture phase mold conidia Exoantigen test or DNA probe to ID mold Trt Amphotericin B Systemic Mycoses Blastomycosis Blastomyces dermatitidis 7 dimorphic pathogen N American blastomycosis Gilchrist Chicago disease XMT N histo but yeasts don t live in macs SS variable 7 systemic disease gt skin bones DX cytology 7 yeast 1 bud Mold form not unique 7 no macroconidia Trt Amphotericin B SVstemic Mvcoses PW 39 quot 39 PW 39 quot 39 brasiliensis 7 dimorphic South American blastomycosis XMT resp 7 inhale spores gt yeast in lungs SS lesions mostly on face DX micro in tissues Culture gt mold mostly sterile hyphae Trt ketoconazole etc Systemic Mycose Coccidioidomycosis Coccidioides immitis 7 dimorphic pathogen San Joaquin Valley fever XMT resp 7 inhale gt yeast in lungs SS ulike granulomas can be fatal if disseminated DX yeast in sputum or tissues Culture gt mold w Trt Amphotericin B Systemic Mycoses Cryptococcosis Cryptococcus neoformans 7 Pigeon fancier s disease XMT resp can cause chronic meningitis SS headache fever skin bone lesions DX csf 7 encapsulated yeasts Latex agglutination for antigens csf Culture yeast ID biochem Trt Amphotericin B 5FC Onnortunistic MVcoses C quot quot Candida albicans 7 Most common clinical fungus XMT 7 r J39 r 39 factors SS many forms of candidiasis Onychomycosis paronychia 7 7 oral Chronic mucocutaneous candidiasis UTI vaginitis Systemic disease DX microscopy 7 yeasts amp Culture BAP SAB test presumptive ID Trt correct predisposing factor Topical CTA for skin vaginal yeast infections Amphotericin B azoles 5FC for systemic disease


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