Lecture 14- Dr. Cohen I Pathogenic Microbiology

Lecture 14- Dr. Cohen I Pathogenic Microbiology -...

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Unformatted text preview: Pathogenic Microbiology from a Clinicians Perspective Clinical Vignettes: Clinical Vignettes: Oropharyngeal Oropharyngeal and and Gastrointestinal Gastrointestinal Infections Infections October 2010 October 2010 Daniel L. Cohen, MD, FRCPCH, FAAP Department of Pediatrics Department of Pediatrics Uniformed Services University of the Health Uniformed Services University of the Health Sciences Sciences and and Department of Cell Biology and Molecular Department of Cell Biology and Molecular Genetics Genetics University of Maryland University of Maryland Background Background Most pathogenic microbiology courses are encyclopedia-like Lectures are typically organism-specific Repetitious format Stove Pipe Necessary and Appropriate Undergraduates have minimal exposure to broader context of illness Clinicians however look at illnesses very differently- Kaleidoscopically Kaleidoscopically Clinical Kaleidoscope Clinical Kaleidoscope Patients do not present with complaints of Gp. A Streptococcal pharyngitis or Entertoxigenic E. coli diarrhea They present with histories, clinical symptoms, and physical signs/findings consistent with illnesses possibly caused by a variety of microorganisms or of non-infectious etiologies Social history especially important in evaluation The Clinical Kaleidoscope Clinical Kaleidoscope is the tool for dissection of this conundrum 4 Immunization Recommendations CDC 2010 Immunization Recommendations CDC 2010 5 Immunization Recommendations CDC 2010 Immunization Recommendations CDC 2010 6 Immunizations Recommended for Immunizations Recommended for University Students University Students Tetanus-diptheria-acellular Pertussis Tetanus-diptheria-acellular Pertussis vaccine: Tdap vaccine: Tdap Meningococcal vaccine (MCV4) Meningococcal vaccine (MCV4) HPV vaccine series- HPV vaccine series- for women (for men for women (for men under consideration) under consideration) Influenza vaccine (Trivalent) Annual Influenza vaccine (Trivalent) Annual Also H1N1 which is apart from Trivalent Also H1N1 which is apart from Trivalent Normal Oropharyngeal Anatomy Normal Oropharyngeal Anatomy 8 Oropharyngeal Infectious Agents Oropharyngeal Infectious Agents ~ ~ 20-30% are Bacterial- Streptococcus pyogenes (Gp A-15- 30%), Gp C (5%), Corynebacterium diphtheriae , Arcanobacterium hemolyticum , Mycoplasma pneumonia (in adolescence), Chlamydia pneumonia , Neisseria gonorrhea ~ ~ 70-80% are Viral- Rhinoviruses (20%), Coronaviruses (5%), Adenoviruses (5%), Herpes simplex viruses 1&2 (4%), Cytomegalovirus, Parainfluenza viruses, Influenza viruses, Coxsackie A, Epstein-Barr Virus, HIV Type 1 Uncommon Parasitic- Toxoplasma gondii Rare Fungal- Candida albicans ( immunocompromised) 9 Other Oropharyngeal Inflammations Other Oropharyngeal Inflammations Autoimmune/Toxic- Stevens Johnson Syndrome Drug induced- systemic or local caustic Neoplastic- Leukemias/Lymphomas...
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This note was uploaded on 01/24/2011 for the course BSCI 424 taught by Professor Staff during the Fall '08 term at Maryland.

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Lecture 14- Dr. Cohen I Pathogenic Microbiology -...

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