Introduction to clinic Introduction to clinic of infectious diseasesof infectious diseases

Infectio Infectio – Latin word – Latin word ““to infect, to infect, contaminatecontaminate””

Infectious processInfectious process - - interrelation of interrelation of pathogenic microorganism and pathogenic microorganism and macroorganism in environment macroorganism in environment conditionsconditions

D. FracastoriD. Fracastori(1(1478478 - 1 - 1553553))

D. SamoylovychD. Samoylovych(1724 - 1810)(1724 - 1810)

E. JennerE. Jenner(1749 - 1823)(1749 - 1823)

R. KochR. Koch(1843 - 1910)(1843 - 1910)

L. PastureL. Pasture(1822 - 1895)(1822 - 1895)

I. I. I. I. MechnikovMechnikov

(1845 - 1916)(1845 - 1916)

PePeculculiiararities of infectious diseasesities of infectious diseases Contagenicity Contagenicity – – dangerous for surrounding peopledangerous for surrounding people SpecificitySpecificity – – every disease has the specific every disease has the specific

infectious agentinfectious agent Periodicity Periodicity ––

incubation periodincubation period;; initial (prodromal) periodinitial (prodromal) period;; period of acute illnessperiod of acute illness;; period of convalescence or reconvalescenceperiod of convalescence or reconvalescence..

Post-infection immunityPost-infection immunity

CyclicityCyclicity – – ability to epidemic spreading after some ability to epidemic spreading after some period of timeperiod of time

InterrelationsInterrelationsSpecies inherited immunitySpecies inherited immunity

Symbiosis:Symbiosis: Synoikia –Synoikia – mutual being, when one species mutual being, when one species

uses another as a living place without harming ituses another as a living place without harming it Mutualism Mutualism – symbiosis, that is profitable for – symbiosis, that is profitable for

both organismsboth organisms CommensalismCommensalism – one organism gets a benefit – one organism gets a benefit

from other without harming itfrom other without harming it

Parasitism Parasitism – microorganism (parasite) feeds – microorganism (parasite) feeds with the saps or tissues of the host harming it. with the saps or tissues of the host harming it. Most infectious diseases belong to this kind of Most infectious diseases belong to this kind of symbiosissymbiosis

Endogenous diseases (autoinfections) Endogenous diseases (autoinfections) –– caused by human own microflora caused by human own microflora (pathogenic or half-parasites) of the skin, (pathogenic or half-parasites) of the skin, respiratory or alimentary tracts, conjuctive, respiratory or alimentary tracts, conjuctive, genitalsgenitals

Exogenous diseasesExogenous diseases – caused after – caused after penetration of the microorganisms from penetration of the microorganisms from the environment the environment

Basic negative factors affecting Basic negative factors affecting immune system:immune system:

Human demographics and behaviorHuman demographics and behavior Technology and industryTechnology and industry Economic development and land useEconomic development and land use International travel and commerceInternational travel and commerce Microbial adaptation and changeMicrobial adaptation and change Violation of public health measuresViolation of public health measures

Intensity of epidemiologic Intensity of epidemiologic process:process:

SporadicSporadic EpidemicEpidemic PandemicPandemic

Classification of infectious diseases Classification of infectious diseases symptomssymptoms according to their diagnostic according to their diagnostic importanceimportance: (: (byby J. BilibinJ. Bilibin))

I.I. Main symptoms (Main symptoms (pathognostic) pathognostic) : : symptoms which are characteristic for symptoms which are characteristic for one disease onlyone disease only..

II.II. Supporting or optional symptomsSupporting or optional symptoms:: symptomssymptoms, , which are may be present in which are may be present in some infectious diseasessome infectious diseases, , they give they give possibility to differentiate diseasespossibility to differentiate diseases..

Diagnostic methodsDiagnostic methods:: ClinicalClinical: :

• investigationinvestigation• epidemiological anamnesisepidemiological anamnesis

LaboratoryLaboratory::• virologicalvirological• bacteriologicalbacteriological• parasitologicalparasitological• serologicalserological• allergicallergic• biologicalbiological• immunoenzyme etcimmunoenzyme etc,,

Points of epidemiological Points of epidemiological anamnesis:anamnesis:

Life style and living conditions of the Life style and living conditions of the patientpatient

Patient’s occupationPatient’s occupation Previous diseases and preventive Previous diseases and preventive

vaccinationsvaccinations

Basic symptoms of infectious Basic symptoms of infectious diseasesdiseases::

1.1. FeverFever

2.2. RashRash

3.3. DiarrheaDiarrhea

4.4. Respiratory syndromeRespiratory syndrome

5.5. JaundiceJaundice

6.6. Meningeal signsMeningeal signs

7.7. Lymphoadenopathy etcLymphoadenopathy etc

Fever conditions:Fever conditions: Fast (acute) temperature riseFast (acute) temperature rise – patient – patient

clearly fix the hour of the disease onsetclearly fix the hour of the disease onset Gradual riseGradual rise

Subfebrile (37,0 – 37.9 Subfebrile (37,0 – 37.9 00C)C) Moderate (38,0 – 39,9 Moderate (38,0 – 39,9 00C)C) High (40,0 – 40,9 High (40,0 – 40,9 00C)C) Hyperpyrexia (41 Hyperpyrexia (41 00C and higher)C and higher)

Classification of fevers:Classification of fevers:

Types of fever curves:Types of fever curves:

Constant fever (febris continua)Constant fever (febris continua) Remittent fever (febris remittens)Remittent fever (febris remittens) Intermittent fever (febris intermittens)Intermittent fever (febris intermittens) Recurrent fever (febris recurrens)Recurrent fever (febris recurrens) Undulant fever (febris undulans)Undulant fever (febris undulans) Hectic fever (febris hectica)Hectic fever (febris hectica) Distorted fever (febris inversa)Distorted fever (febris inversa) Acute undulating fever (febris undulans acuta)Acute undulating fever (febris undulans acuta) Relapsing fever (febris recidiva)Relapsing fever (febris recidiva)

Elements of exanthema:Elements of exanthema:

RoseolaRoseola MaculaMacula PapulaPapula ErythemaErythema TuberculumTuberculum NodusNodus Urtica (hives)Urtica (hives) VesiculaVesicula PustulaPustula HerpesHerpes

Bulla (blister)Bulla (blister) Hemorrhage (petechiae, Hemorrhage (petechiae,

purpura, ecchimosis)purpura, ecchimosis) ErosioErosio UlcusUlcus Dyschromia cutisDyschromia cutis SquamaSquama CrustaCrusta CicatrixCicatrix

RoseolaRoseola

Red or purple-redRed or purple-red Diameter 2-5 mmDiameter 2-5 mm Spherical formSpherical form

MaculaMacula

Similar to roseolaSimilar to roseola Diameter 5-20 mmDiameter 5-20 mm Color same as Color same as

roseola’sroseola’s

PapulePapule

Red or purple-redRed or purple-red Diameter 1-20 mmDiameter 1-20 mm Proliferation of Proliferation of

epidermis with epidermis with vasodilatationvasodilatation

ErythemaErythema

Result of large Result of large maculae joiningmaculae joining

Inflammatory fieldsInflammatory fields Diameter from 2 cm Diameter from 2 cm

and higherand higher

TuberculumTuberculum

Formations without Formations without cavitiescavities

Granulematous Granulematous inflammatory infiltrateinflammatory infiltrate

NodeNode

Limited dense Limited dense formationformation

Diameter 1-5 cmDiameter 1-5 cm Spherical or oval form Spherical or oval form

VesiculaVesicula

Small cavity formation Small cavity formation containing serous or containing serous or serouse-hemorrhagic serouse-hemorrhagic fluidfluid

Half-round elementHalf-round element Diameter from 1 to 5 Diameter from 1 to 5

mmmm After damaged After damaged

erosion developserosion develops

Bulla (Blister)Bulla (Blister)

Cavity formation Cavity formation Dimension up toDimension up to

10 cm10 cm

HemorrhagesHemorrhages

Extravasation into the Extravasation into the skinskin

Different kinds and Different kinds and dimensionsdimensions

UlcerUlcer

A deep defect of the A deep defect of the skin (epidermis, skin (epidermis, derma, underline derma, underline tissues)tissues)

Enanthema Enanthema – rashes on the mucous – rashes on the mucous membranesmembranes

Thanks For Your Thanks For Your Attention!Attention!