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- Gram negative, aerobic (can also be facultatively anaerobic), rod-shaped bacterium with unipolar motility; an opportunistic pathogen
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Family: Herpesviridae; Genus: Simplexvirus
- Able to infect damaged tissues or people with reduced immunity
Genome: enveloped dsDNA
- A variety of infections can occur[skin infections, pneumonia, septic shock, urinary tract infections, GI infections
- Burn victims and patients with wounds infections are at risk for developing skin and soft tissue infections Ecthyma ga ngrenos um.

 
- Often associated with the skin lesion, ecthyma gangrenosum
- Contagious
- 60% fatality rate; fatality rates have declined as a result of better wound treatment
- Usually acquired during childhood, may also be sexually transmitted
- Transmitted via contact with an infectious area of skin or by direct skin-to-skin contact with another infected person
R   


- Transmission can occur during symptomatic or asymptomatic infections, and during the latent period
- Adherence to epithelial cells is mediated by type IV pili and flagella
- Extacellular virulence factors secreted by P. aeruginosa are controlled by a complex regulatory circuit involving cell-to-cell signaling systems that


allow the bacteria to produce the factors in a coordinated, cell-denity-dependent manner, which may allow P. aeruginosa to overcome host defense
- HSV-1 causes cold sores, usually around and in the mouth
mechanisms.
- Symptoms resulting from primary infection are usually much more severe than subsequent outbreaks since the body has not produced antibodies yet
- First outbreak of oral herpes carries a low risk of developing aseptic meningitis - P. aeruginosa can only secrete extracellular factors when they can be produced at high enough levels to overcome host defenses[ This alters the
balance between host defenses and production of bacterial toxins, leading to invasion of blood vessels, dissemination, systemic inflammatory-
response syndrome, and death


- Entry into the host cell involves interactions of glycoproteins on the surface of the virus with receptors on the surface of the host cell - Exotoxin A is produced by most strains that cause clinical infections (acts like the diphtheria toxin)[Catalyzes ADP-ribosylation and inactivates the
elongation facts 2 in the host cell which causes the ribosome activity to shut down, ultimately shutting off protein synthesis (responsible for local
- Viral and host membranes merge, forming a hemi-fusion state
tissue damage, bacterial invasion, and immune-suppression)
- A pore is formed via glycoprotein interactions, allowing viral capsid to enter into the host cell
- HSV enters the cytoplasm and is then transported to the nucleus where the capsid ejects its DNA contents via the capsid portal

 
- The virion host shutoff protein (VHS or UL41) shuts off protein synthesis in the host, degrades host mRNA, helps in viral replication, and regulates gene expression of
- Resistant to a large number of antibiotics due to efflux pumps; can also develop acquired resistance due to mutations or horizontal gene transfer of
viral proteins
antibiotic resistance determinants
- HSV proteins (immediate-early, early, and late) are produced[early proteins are used in the regulation of genetic viral replication; late proteins aid in forming the
- Antibiotics that are successful must be given by injection
capsid and the viral surface receptors
- Packing of the genome, core, and capsid occurs in the nucleus
- HSV undergoes primary and secondary envelopment[primary envelope acquired via budding into the inner nuclear membrane which then fuses with the outer
nuclear membrane, releasing a naked capsid into the cytoplasm; secondary envelope via budding into the cytoplasmic vesicles; the virus then exits the cell via budding
The cel l -to-cel l s i gnal ing
R   

s ys tem control s the O
cel l -
The cel l -to-cel l s i gnal ing s ystems a re compos ed of two
- HSV can persist in a latent period in which the virus gets through epithelial cells to the sensory neurons genes . The I gene encodes a n a uto-i nducer s yntha s e a nd
to-cel l s i gna li ng system i n a
hi era rchy cascade. The
- During latency, virus expresses Latency Associated Transcript (LAT) RNA which interferes with natural cell death mechanisms, preserving a reservoir of the virus, the R gene encodes a tra ns cri pti onal a cti vator protei n (R- La s R/3-oxo-C12-HSL
allowing subsequent ͞outbreaks͟ protei n). The a uto-i nducer s yntha s e i s respons ible for compl ex a cti va tes the
the s ynthes i s of a n a utoi nducer mol ecul e (AI), whi ch
- Viral shedding occurs to produce further infections cros s es the cel l membra ne. W i th i ncrea s i ng cel l-dens ity
tra ns cripti on of O
, a nd 3-
oxo-C12-HSL bl ocks the
- Infection can be re-activated by colds, influenza, emotional and physical stress, fatigue or injury, or menstruation the i ntra cel l ul ar concentra tion of AI rea ches a thres hol d a cti va ti on of Rhl R by C4-
l evel , a nd compl ex R-protei n/AI a cti va tes the expres s i on HSL.
of s peci fi c ta rget genes .

 
- HSV establishes life-long infections and cannot be eradicated from the body
- Antiviral drugs (acyclovir or valacyclovir) that interfere with viral replication can be used which reduces the physical severity of out-break associated lesions and lower
the chance of transmission to others


    




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- Sarcoptes is a genus of skin parasites and part of the larger family of mites, known as ͞scab mites͟ !




  
- The organism has 8 legs
- The mites are distributed around the world, equally infecting all ages, races, and socioeconomic classes in different climates

       

- Multicellualr fungi with smooth, thin walls
- The parasite is very small and not usually directly visible   






    
   




 
- Most common cause of athlete͛s foot (tinea pedis)
- Contagious
- Transmitted via direct skin-to-skin contact with an infected person; can also be transmitted from objects 


  


  - Can be found on many locations, including: floors in gyms, locker rooms, swimming pools, nail salons, and
socks
- Can be spread by scratching an infected area






 - Transmission via direct skin-to-skin contact with an infected person; or by contact with the aforementioned
objects

!

 

 - Some people may be more susceptible to the fungus, but the exact cause of this predisposition is unknown
- The parasite burrows under the host͛s skin, causing the skin infection, scabies
- Scabies- intense itching, superficial burrows[the burrow tracts are linear, with a neat ͞line͟ of 4 or more closely and equally spaced mosquito-like ͞bites͟  





 
 - When the feet stay moist and warm, fungus can thrive and infect the upper layers of the skin; without this
moist and warm environment, the fungus cannot easily infect the skin
- Superficial burrows usually occur on the hands, feet, wrists, elbows, back, buttocks, and external genitalia
- Burrows are created by excavation of the adult mite in the epidermis 

!



  



- Acropustulosis, blisters and pustules on the palms and soles of feet, are symptoms of scabies in infants
- Infected immune-suppressed people suffer from crusted scabies where the host is a more fertile breeding ground for the mites, which spread all over the
 




    - Many people with athlete͛s foot are asymptomatic; many think they simply have dry skin
- Common symptoms include: various degrees of itching and burning
host͛s body except for the face[scaly rashes, slight itching, thick crusts of skin that contain thousands of mites; eradication of mites is difficult because the   



  - Skin may frequently peel, crack, and bleed; rarely athlete͛s foot blisters
crusts protects the mites from topical miticides


 

!
 - Three main types of athlete͛s foot:
1. ͞Moccasin type͟- soles of the feet


- Pregnant female mites tunnel into the stratum corneum and deposit eggs in the burrows; the eggs hatch in 3-10 days 




 2. ͞Interdigital type͟- in between the toes
3. ͞Inflammatory type͟- blistering References :
- The young mites move about on the skin, before maturing as adults which live 3-4 weeks in the host͛s skin
- Males roam on top of the skin, sometimes burrowing into the skin

  
 Ni r-Pa z, R., H. El i na v, G. E. Pi era rd, D. W a l ker, A. Ma l y, M. Sha pi ro,
R. C. Ba rton, a nd I. Pol a check. "Deep Infecti on by Tri chophyton
R
 
- IgE antibodies are present in the serum and the site of infection, which react to multiple protein allergens on the mite; mite proteins are also present in mite͛s



 
!
 - When skin is injured by the fungus, the protective skin barrier is broken, allowing bacteria and yeasts to evade,
Rubrum i n a n Immunocompromi s ed Pa ti ent." ù
O
 


O 
 41.11 (2003): 5298-301.; Depa rtment of Bi ol ogy.
feces which are deposited under the skin "Tri chophyton." O   . 2007. W eb. 27 Ma y 2011.
- The allergic reaction is both cell-mediated and antibody-mediated[ Initial infections require 2-6 weeks to become symptomatic; re-infection manifests 

  

 causing a secondary infection
- Trichophyton use a wide variety of acid proteases, elastases, and keratinases to invade the epidermis
<http://www.bi o.da vi ds on.edu/peopl e/s os a ra fova/As sets /Bi o307/
jel a hre/i ndex.html >.
symptoms in 1-4 days





 - Fungus remains in the stratum corneum[the lack of vascularity in this layer of the epidermis doesn͛t allow the
Lycza k, Jeffery B., Ca rol yn L. Ca nnon, a nd Gera l d B. Pi er.
immune system to fight effectively once beyond the physical barrier of the skin

 
- Many effective medications including: permethrin (topical; most effective) and ivermectin (oral; used to treat crusted scabies)


   


   2.9 (2000):
- Reproduction occurs asexually through thin membrane-like hyphae that form reproductive spores, called
"Es ta bl i s hment of Ps eudomona s Aerugi nos a Infection: Les s ons
from a Vers a ti l e Opportuni s t." O 
conidiophores 1051-060.



 
  Scha ber, J. A., W . J. Tri ffo, S. J. Suh, J. W . Ol i ver, M. C. Ha s tert, J. A.

   
 
- Make the area of infection less suitable for the fungus to grow[keep the area clean and dry
Gri s wol d, M. Auer, A. N. Ha mood, a nd K. P. Rumba ugh.
"Ps eudomona s Aerugi nos a Forms Bi ofilms i n Acute Infecti on



 


 - Antifungal creams and washes are effective
Independent of Cel l -to-Cel l Si gna l i ng."   

 75.8
(2007): 3715-721.
- If the fungal infection has spread to the toe nails, the nails must also be treated to avoid re-infection of the feet
- Topical corticosteroid creams can act as fertilizers for fungus, worsening the fungal infection Ari l a n, La rry G., Ja mes J. Arends , a nd Ma jori e S. Morga n.
"Immunol ogi c Cros s -Rea cti vity a mong Va ri ous Stra ins of Sa rcoptes
Sca bi ei ."  ù
O
  O

 82.1 (1996): 66-72.

Jones , Cl i nton. "The Herpes Si mpl ex Vi rus Type 1 La tency-

As s oci ated Tra ns cript Ca n Protect Neuron-Deri ved C1300 a nd
Neuro2A Cel l s from Gra nzyme B-Induced Apoptos i s a nd CD8 T-Cel l
Typi ca l s cabies i nfection. Burrowed Sa rcoptes s ca biei . Crus ted s ca bi es i nfection. Ki l l i ng." ù
O
 O
 85.5 (2011): 2325-332.