Table of contents Section I Introduction Section II Basic Principles of Medical Microbiology Section III Basic Concepts in the Immune Response Section IV General Principles of Laboratory Diagnosis Section V Bacteriology Section VI Virology Section VII Mycology Section VIII Parasitology Section I 1 Introduction to Medical Microbiology.htm? Section II 2 Bacterial Classification, Structure, and Replication.htm? 3 Bacterial Metabolism and Genetics.htm? 4 Viral Classification, Structure, and Replication.htm? 5 Fungal Classification, Structure, and Replication.htm? 6 Parasitic Classification, Structure, and Replication.htm? 7 Commensal and Pathogenic Microbial Flora in Humans.htm? 8 Sterilization, Disinfection, and Antisepsis.htm? Section III 09 Elements of Host Protective Responses.htm? 10 Humoral Immune Responses.htm? 11 Cellular Immune Responses.htm? 12 Immune Responses to Infectious Agents.htm? 13 Antimicrobial Vaccines.htm? Section IV 14 Microscopic Principles and Applications.htm? 15 In Vitro Culture Principles and Applications.htm? 16 Molecular Diagnosis.htm? 17 Serologic Diagnosis.htm? Section V 18 Mechanisms of Bacterial Pathogenesis.htm? 19 Laboratory Diagnosis of Bacterial Diseases.htm? 20 Antibacterial Agents.htm? 21 Staphylococcus and Related Gram-Positive Cocci.htm? 22 Streptococcus.htm? 23 Enterococcus and Other Gram-Positive Cocci.htm? 24 Bacillus.htm? 25 Listeria and Erysipelothrix.htm? 26 Corynebacterium and Other Gram-Positive Rods.htm? 27 Nocardia and Related Bacteria.htm? 28 Mycobacterium.htm? 29 Neisseria and Related Bacteria.htm? 30 Enterobacteriaceae.htm? 31 Vibrio and Aeromonas.htm? 32 Campylobacter and Helicobacter.htm? 33 Pseudomonas and Related Bacteria.htm? 34 Haemophilus and Related Bacteria.htm? 35 Bordetella.htm? 36 Francisella and Brucella.htm? 37 Legionella.htm? 38 Miscellaneous Gram-Negative Rods.htm? 39 Clostridium.htm? 40 Anaerobic, Non-Spore-Forming, Gram-Positive Bacteria.htm? 41 Anaerobic Gram-Negative Bacteria.htm? 42 Treponema, Borrelia, and Leptospira.htm? 43 Mycoplasma and Ureaplasma.htm? 44 Rickettsia and Orientia.htm? 45 Ehrlichia, Anaplasma, and Coxiella.htm? 46 Chlamydia and Chlamydophila.htm? 47 Role of Bacteria in Disease.htm? Section VI 48 Mechanisms of Viral Pathogenesis.htm? 49 Antiviral Agents.htm? 50 Laboratory Diagnosis of Viral Diseases.htm? 51 Papillomaviruses and Polyomaviruses.htm? 52 Adenoviruses.htm? 53 Human Herpesviruses.htm? 54 Poxviruses.htm? 55 Parvoviruses.htm? 56 Picornaviruses.htm? 57 Coronaviruses and Noroviruses.htm? 58 Paramyxoviruses.htm? 59 Orthomyxoviruses.htm? 60 Rhabdoviruses, Filoviruses, and Bornaviruses.htm? 61 Reoviruses.htm? 62 Togaviruses and Flaviviruses.htm? 63 Bunyaviridae and Arenaviridae.htm? 64 Retroviruses.htm? 65 Hepatitis Viruses.htm? 66 Unconventional Slow Viruses Prions.htm? 67 Role of Viruses in Disease.htm? Section VII 68 Pathogenesis of Fungal Disease.htm? 69 Laboratory Diagnosis of Fungal Diseases.htm? 70 Antifungal Agents.htm? 71 Superficial and Cutaneous Mycoses.htm? 72 Subcutaneous Mycoses.htm? 73 Systemic Mycoses Due to Dimorphic Fungi.htm? 74 Opportunistic Mycoses.htm? 75 Fungal and Fungal-Like Infections of Unusual or Uncertain Etiology.htm? 76 Mycotoxins and Mycotoxicoses.htm? 77 Role of Fungi in Disease.htm? Section VIII 78 Pathogenesis of Parasitic Diseases.htm? 79 Laboratory Diagnosis of Parasitic Disease.htm? 80 Antiparasitic Agents.htm? 81 Intestinal and Urogenital Protozoa.htm? 82 Blood and Tissue Protozoa.htm? 83 Nematodes.htm? 84 Trematodes.htm? 85 Cestodes.htm? 86 Arthropods.htm? 87 Role of Parasites in Disease.htm? Share please!!! Viruses Viruses are the smallest infectious particles, ranging in diameter from 18 to 600 nanometers (most viruses are less than 200 nm and cannot be seen with a light microscope). Viruses typically contain either deoxyribonucleic acid (DNA) or ribonucleic acid (RNA) but not both; however, some viral-like particles do not contain any detectable nucleic acids (e.g., prions; see Chapter 66), while the recently discovered Mimivirus contains both RNA and DNA. The viral nucleic acids and proteins required for replication and pathogenesis are enclosed in a protein coat with or without a lipid membrane coat. Viruses are true parasites, requiring host cells for replication. The cells they infect and the host response to the infection dictate the nature of the clinical manifestation. More than 2000 species of viruses have been described, with approximately 650 infecting humans and animals. Infection can lead either to rapid replication and destruction of the cell or to a long-term chronic relationship with possible integration of the viral genetic information into the host genome. The factors that determine which of these takes place are only partially understood. For example, infection with the human immunodeficiency virus, the etiologic agent of the acquired immunodeficiency syndrome (AIDS), can result in the latent infection of CD4 lymphocytes or the active replication and destruction of these immunologically important cells. Likewise, infection can spread to other susceptible cells, such as the microglial cells of the brain, resulting in the neurologic manifestations of AIDS. Thus the diseases caused by viruses can range from the common cold to gastroenteritis to fatal catastrophes such as rabies, Ebola, smallpox, or AIDS. Printed from STUDENT CONSULT: Medical Microbiology 6E (on 21 September 2009) ? 2009 Elsevier Bacteria Bacteria are relatively simple in structure. They are prokaryotic organisms-simple unicellular organisms with no nuclear membrane, mitochondria, Golgi bodies, or endoplasmic reticulum-that reproduce by asexual division. The bacterial cell wall is complex, consisting of one of two basic forms: a gram-positive cell wall with a thick peptidoglycan layer, and a gram-negative cell wall with a thin peptidoglycan layer and an overlying outer membrane (additional information about this structure is presented in Chapter 2). Some bacteria lack this cell wall structure and compensate by surviving only inside host cells or in a hypertonic environment. The size (1 to 20 ?m or larger), shape (spheres, rods, spirals), and spacial arrangement (single cells, chains, clusters) of the cells are used for the preliminary classification of bacteria, and the phenotypic and genotypic properties of the bacteria form the basis for the definitive classification. The human body is inhabited by thousands of different bacterial species-some living transiently, others in a permanent parasitic relationship. Likewise, the environment that surrounds us, including the air we breathe, water we drink, and food we eat, is populated with bacteria, many of which are relatively avirulent and some of which are capable of producing life-threatening disease. Disease can result from the toxic effects of bacterial products (e.g., toxins) or when bacteria invade normally sterile body sites. Printed from STUDENT CONSULT: Medical Microbiology 6E (on 21 September 2009) ? 2009 Elsevier Fungi In contrast to bacteria, the cellular structure of fungi is more complex. These are eukaryotic organisms that contain a well-defined nucleus, mitochondria, Golgi bodies, and endoplasmic reticulum (see Chapter 5). Fungi can exist either in a unicellular form (yeast) that can replicate asexually or in a filamentous form (mold) that can replicate asexually and sexually. Most fungi exist as either yeasts or molds; however, some fungi can assume either morphology. These are known as dimorphic fungi and include such organisms as Histoplasma, Blastomyces, and Coccidioides. Printed from STUDENT CONSULT: Medical Microbiology 6E (on 21 September 2009) ? 2009 Elsevier Parasites Parasites are the most complex microbes. Although all parasites are classified as eukaryotic, some are unicellular and others are multicellular (see Chapter 6). They range in size from tiny protozoa as small as 1 to 2 ?m in diameter (the size of many bacteria) to tapeworms that can measure up to 10 meters in length and arthropods (bugs). Indeed, considering the size of some of these parasites, it is hard to imagine how these organisms came to be classified as microbes. Their life cycles are equally complex, with some parasites establishing a permanent relationship with humans and others going through a series of developmental stages in a progression of animal hosts. One of the difficulties confronting students is not only an understanding of the spectrum of diseases caused by parasites, but also an appreciation of the epidemiology of these infections, which is vital for developing a differential diagnosis and an approach to the control and prevention of parasitic infections. Printed from STUDENT CONSULT: Medical Microbiology 6E (on 21 September 2009) ? 2009 Elsevier Microbial Disease One of the most important reasons for studying microbes is to understand the diseases they cause and the ways to control them. Unfortunately, the relationship between many organisms and their diseases is not simple. Specifically, most organisms do not cause a single, well-defined disease, although there are certainly ones that do (e.g., Treponema pallidum, syphilis; poliovirus, polio; Plasmodium species, malaria). Instead, it is more common for a particular organism to produce many manifestations of disease (e.g., Staphylococcus aureus-endocarditis, pneumonia, wound infections, food poisoning) or for many organisms to produce the same disease (e.g., meningitis caused by viruses, bacteria, fungi, and parasites). In addition, relatively few organisms can be classified as always pathogenic, although some do belong in this category (e.g., rabies virus, Bacillus anthracis, Sporothrix schenckii, Plasmodium species). Instead, most organisms are able to establish disease only under well-defined circumstances (e.g., the introduction of an organism with a potential for causing disease into a normally sterile site such as the brain, lungs, and peritoneal cavity). Some diseases arise when a person is exposed to organisms from external sources. These are known as exogenous infections, and examples include diseases caused by influenza virus, Clostridium tetani, Neisseria gonorrhoeae, Coccidioides immitis, and Entamoeba histolytica. Most human diseases, however, are produced by organisms in the person's own microbial flora that spread to inappropriate body sites where disease can ensue (endogenous infections). The interaction between an organism and the human host is complex. The interaction can result in transient colonization, a long-term symbiotic relationship, or disease. The virulence of the organism, the site of exposure, and the host's ability to respond to the organism determine the outcome of this interaction. Thus the manifestations of disease can range from mild symptoms to organ failure and death. The role of microbial virulence and the host's immunologic response is discussed in depth in subsequent chapters. page 4 page 5 The human body is remarkably adapted to controlling exposure to pathogenic microbes. Physical barriers prevent invasion by the microbe; innate responses recognize molecular patterns on the microbial components and activate local defenses and specific adapted immune responses that target the microbe for elimination. Unfortunately, the immune response is often too late or too slow. To improve the human body's ability to prevent infection, the immune system can be augmented either through the passive transfer of antibodies present in immune globulin preparations or through active immunization with components of the microbes (antigens). Infections can also be controlled with a variety of chemotherapeutic agents. Unfortunately, many microbes can alter their antigenic complexion (antigenic variation) or develop resistance to even the most potent antibiotics. Thus the battle for control between microbe and host continues, with neither side yet able to claim victory (although the microbes have demonstrated remarkable ingenuity). There clearly is no "magic bullet" that has eradicated infectious diseases. Printed from STUDENT CONSULT: Medical Microbiology 6E (on 20 September 2009) ? 2009 Elsevier Diagnostic Microbiology