Medical Microbiology [9 ed.] 9780323673228, 9780323674508

Table of contents :
Cover
Title Page
Copyright
Contents
Preface
To Our Future Colleagues: The Students
Acknowledgments
Dedication
Section 1: Introduction
Chapter 1: Introduction to Medical Microbiology
Historical Perspective
Viruses
Bacteria
Fungi
Parasites
Immunology
Diagnostic Microbiology
Microbiology and Immunology in the Clinic
Chapter 2: Human Microbiome in Health and Disease
Core Microbiome
Evolution of the Microbiome and Normal Flora
Role of the Microbiome in Disease
Diagnostics and Therapeutics
Probiotics
Perspective
Bibliography
Chapter 3: Sterilization, Disinfection, and Antisepsis
Disinfection
Antisepsis
Mechanisms of Action
Moist Heat
Ethylene Oxide
Aldehydes
Oxidizing Agents
Halogens
Phenolic Compounds
Quaternary Ammonium Compounds
Alcohols
Bibliography
Section 2: General Principles of Laboratory Diagnosis
Chapter 4: Microscopy and In Vitro Culture
Microscopy
Microscopic Methods
Brightfield (Light) Microscopy
Darkfield Microscopy
Phase-Contrast Microscopy
Fluorescent Microscopy
Electron Microscopy
Examination Methods
Direct Examination
Differential Stains
Acid-Fast Stains
Fluorescent Stains
In Vitro Culture
Types of Culture Media
Enriched Nonselective Media
Selective Media and Differential Media
Specialized Media
Cell Culture
Bibliography
Chapter 5: Molecular Diagnosis
Nucleic Acid Amplification Methods
Polymerase Chain Reaction
Transcription-Mediated Amplification
Strand Displacement Amplification
Loop-Mediated Amplification
Nucleic Acid Analysis
Nucleic Acid Sequencing
Restriction Fragment Length Polymorphism
Protein Analysis
Western Blot
Matrix-Assisted Laser Desorption/Ionization–Time of Flight
Bibliography
Chapter 6: Serologic Diagnosis
Methods of Detection
Precipitation and Immunodiffusion Techniques
Immunoassays for Cell-Associated Antigen (Immunohistology)
Immunoassays for Antibody and Soluble Antigen
Serology
Bibliography
Section 3: Basic Concepts in the Immune Response
Chapter 7: Elements of Host Protective Responses
Soluble Activators and Stimulators of Innate and Immune Functions
Cells of the Immune Response
Hematopoietic Cell Differentiation
Polymorphonuclear Leukocytes
Mononuclear Phagocyte System
Dendritic Cells
Lymphocytes
Bibliography
Chapter 8: Innate Host Responses
Soluble Components of Innate Responses
Antimicrobial Peptides and Chelators
Complement
Alternate Pathway
Lectin Pathway
Classical Pathway
Biological Activities of Complement Components
Membrane Attack Complex
Regulation of Complement Activation
Interferons
Cellular Components of Innate Responses
Neutrophils
Mast Cells, Basophils, and Eosinophils
Cells of the Monocyte-Macrophage Lineage
Myeloid and Plasmacytoid Dendritic Cells
Activation of Innate Cellular Responses
Chemotaxis and Leukocyte Migration
Phagocytic Responses
Normal Flora–Associated Responses
Inflammation
Proinflammatory Cytokines
Acute Inflammation
Acute-Phase Response
Sepsis and Cytokine Storms
Bridge to Antigen-Specific Immune Responses
Bibliography
Chapter 9: Antigen-Specific Immune Responses
T Cells
Cell-Surface Receptors of T Cells
Development of T Cells
Initiation of T-Cell Responses
Antigen Presentation to T Cells
Peptide Presentation By Class I and Class II Major Histocompatability Complex Molecules
Activation of CD4 T Cells and Their Response to Antigen
CD4 T-Helper Cell Functions
CD8 T Cells
INNATE T Cells
B Cells and Humoral Immunity
B cells
Immunoglobulin Types and Structures
Immunoglobulin D
Immunoglobulin M
Immunoglobulin G
Immunoglobulin A
Immunoglobulin E
Immunogenetics
Antibody Response
Time Course of the Antibody Response
Bibliography
Chapter 10: Immune Responses to Infectious Agents
Initiation of the Response
Phagocytic Responses
Antigen-Specific Response to Bacterial Challenge
Skin, Intestinal, and Mucosal Immunity
Bacterial Immunopathogenesis
Bacterial Evasion of Protective Responses
Antiviral Responses
Host Defenses Against Viral Infection
Innate Defenses
Interferon
Antigen-Specific Immunity
Humoral Immunity
T-Cell Immunity
Immune Response to Viral Challenge
Primary Viral Challenge
Secondary Viral Challenge
Viral Mechanisms for Escaping the Host Protective Responses
Viral Immunopathogenesis
Specific Immune Responses to Fungi
Specific Immune Responses to Parasites
Evasion of Immune Mechanisms by Parasites
Other Immune Responses
Immunopathogenesis
Hypersensitivity Responses
Cytokine Storm
Autoimmune Responses
Immunodeficiency
Immunosuppression
Hereditary Complement Deficiencies and Microbial Infection
Defects in Phagocyte Action
Deficiencies in Antigen-Specific Immune Responses
Bibliography
Chapter 11: Antimicrobial Vaccines
Passive Immunization
Active Immunization
Inactivated Vaccines
Future Directions for Vaccination
Immunization Programs
Bibliography
Section 4: Bacteriology
Chapter 12: Bacterial Classification, Structure, and Replication
Bacterial Classification
Macroscopic and Microscopic Distinction
Metabolic, Antigenic, and Genetic Distinction
Bacterial Structure
Cytoplasmic Structures
Cell Wall
Gram-Positive Bacteria
Gram-Negative Bacteria
External Structures
Bacteria With Alternative Cell Wall Structures
Structure and Biosynthesis of the Major Components of the Bacterial Cell Wall
Peptidoglycan (Mucopeptide, Murein)
Peptidoglycan Synthesis
Teichoic Acid
Lipopolysaccharide
Cell Division
Spores
Chapter 13: Bacterial Metabolism and Genetics
Metabolic Requirements
Metabolism, Energy, and Biosynthesis
Glycolysis and Fermentation
Aerobic Respiration
Anaerobic Respiration
Pentose Phosphate Pathway
Human Bacterial Metabolism
Bacterial Genes and Expression
Transcription
Translation
Control of Gene Expression
Replication of DNA
Bacterial Growth
Population Dynamics
Bacterial Genetics
Mutation, Repair, and Recombination
Mutations and Their Consequences
Repair Mechanisms of DNA
Gene Exchange in Prokaryotic Cells
Mechanisms of Genetic Transfer Between Cells
Transformation
Conjugation
Transduction
Recombination
Genetic Engineering
Bibliography
Chapter 14: Mechanisms of Bacterial Pathogenesis
Colonization, Adhesion, and Invasion
Pathogenic Actions of Bacteria
Tissue Destruction
Toxins
Exotoxins
Pathogen-Associated Molecular Patterns
Immunopathogenesis
Mechanisms for Escaping Host Defenses
Summary
Bibliography
Chapter 15: Role of Bacteria in Disease
Bibliography
Chapter 16: Laboratory Diagnosis of Bacterial Diseases
Blood
Cerebrospinal Fluid
Upper Respiratory Tract Specimens
Lower Respiratory Tract Specimens
Ear and Eye
Wounds, Abscesses, and Tissues
Urine
Genital Specimens
Fecal Specimens
Bacterial Detection and Identification
Antimicrobial Susceptibility Tests
Bibliography
Chapter 17: Antibacterial Agents
β-Lactam Antibiotics
Penicillins
Cephalosporins and Cephamycins
Carbapenems and Monobactams
Glycopeptides
Lipopeptides
Polypeptides
Isoniazid, Ethionamide, Ethambutol, and Cycloserine
Inhibition of Protein Synthesis
Aminoglycosides
Tetracyclines
Glycylclines
Oxazolidinones
Chloramphenicol
Macrolides
Ketolides
Clindamycin
Streptogramins
Inhibition of Nucleic Acid Synthesis
Quinolones
Rifampin and Rifabutin
Metronidazole
Antimetabolites
Other Antibiotics
Bibliography
Chapter 18: Staphylococcus and Related Gram-Positive Cocci
Capsule and Slime Layer
Peptidoglycan and Associated Enzymes
Teichoic Acids and Lipoteichoic Acids
Surface Adhesion Proteins
Cytoplasmic Membrane
Pathogenesis and Immunity
Regulation of Virulence Genes
Defenses Against Innate Immunity
Staphylococcal Toxins
Cytotoxins
Exfoliative Toxins
Enterotoxins
Toxic Shock Syndrome Toxin-1
Staphylococcal Enzymes
Epidemiology
Clinical Diseases
Staphylococcus Aureus
Staphylococcal Scalded Skin Syndrome
Staphylococcal Food Poisoning
Toxic Shock Syndrome
Cutaneous Infections
Bacteremia and Endocarditis
Pneumonia and Empyema
Osteomyelitis and Septic Arthritis
Staphylococcus Epidermidis and Other Coagulase-Negative Staphylococci
Endocarditis
Catheter and Shunt Infections
Prosthetic Joint Infections
Urinary Tract Infections
Laboratory Diagnosis
Microscopy
Nucleic Acid–Based Tests
Culture
Identification
Antibody Detection
Treatment, Prevention, and Control
Bibliography
Chapter 19: Streptococcus and Enterococcus
Physiology and Structure
Pathogenesis and Immunity
Initial Host–Parasite Interactions
Toxins and Enzymes
Epidemiology
Clinical Diseases
Suppurative Streptococcal Disease
Pharyngitis
Pyoderma
Erysipelas
Cellulitis
Necrotizing Fasciitis
Streptococcal Toxic Shock Syndrome
Other Suppurative Diseases
Bacteremia
Nonsuppurative Streptococcal Disease
Rheumatic Fever
Acute Glomerulonephritis
Laboratory Diagnosis
Microscopy
Antigen Detection
Nucleic Acid–Based Tests
Culture
Identification
Antibody Detection
Treatment, Prevention, and Control
Streptococcus agalactiae
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Early-Onset Neonatal Disease
Late-Onset Neonatal Disease
Infections in Pregnant Women
Infections in Men and Nonpregnant Women
Laboratory Diagnosis
Antigen Detection
Nucleic Acid–Based Tests
Culture
Identification
Treatment, Prevention, and Control
Other β-Hemolytic Streptococci
Viridans Streptococci
Streptococcus pneumoniae
Physiology and Structure
Pathogenesis and Immunity
Colonization and Migration
Tissue Destruction
Phagocytic Survival
Epidemiology
Clinical Diseases
Pneumonia
Sinusitis and Otitis Media
Meningitis
Bacteremia
Laboratory Diagnosis
Microscopy
Antigen Detection
Nucleic Acid–Based Tests
Culture
Identification
Treatment, Prevention, and Control
Enterococcus
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Chapter 20: Bacillus
Bacillus anthracis
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Treatment, Prevention, and Control
Bacillus cereus
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Chapter 21: Listeria and Related Gram-Positive Bacteria
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Neonatal Disease
Infections in Pregnant Women
Disease in Healthy Adults
Meningitis in Adults
Primary Bacteremia
Laboratory Diagnosis
Microscopy
Culture
Identification
Treatment, Prevention, and Control
Erysipelothrix rhusiopathiae
Physiology and Structure
Pathogenesis
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Treatment, Prevention, and Control
Corynebacterium diphtheriae
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Respiratory Diphtheria
Cutaneous Diphtheria
Laboratory Diagnosis
Microscopy
Culture
Identification
Toxigenicity Testing
Treatment, Prevention, and Control
Bibliography
Chapter 22: Mycobacterium and Related Acid-Fast Bacteria
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Immunodiagnosis
Microscopy
Nucleic Acid–Based Tests
Culture
Identification
Treatment, Prevention, and Control
Treatment
Chemoprophylaxis
Immunoprophylaxis
Control
• Other Slow-Growing Mycobacteria
• Rapidly Growing Mycobacteria
Physiology And Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Treatment, Prevention, and Control
• Other Weakly Acid-Fast Bacteria
Bibliography
Case Study and Questions
Chapter 23: Neisseria and Related Genera
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Neisseria gonorrhoeae
Neisseria meningitidis
Laboratory Diagnosis
Microscopy
Antigen Detection
Nucleic Acid–Based Tests
Culture
Identification
Treatment, Prevention, and Control
Other Neisseria Species
Eikenella Corrodens
Kingella Kingae
Bibliography
Chapter 24: Haemophilus and Related Bacteria
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Meningitis
Epiglottitis
Cellulitis
Arthritis
Otitis, Sinusitis, and Lower Respiratory Tract Disease
Conjunctivitis
Chancroid
Other Infections
Laboratory Diagnosis
Specimen Collection and Transport
Microscopy
Antigen Detection
Culture
Identification
Treatment, Prevention, and Control
Aggregatibacter
Pasteurella
For a case study and questions see StudentConsult. com
Bibliography
Chapter 25: Enterobacteriaceae
General Properties
Physiology and Structure
Pathogenesis and Immunity
Endotoxin
Capsule
Antigenic Phase Variation
Type III Secretion Systems
Sequestration of Growth Factors
Resistance to Serum Killing
Antimicrobial Resistance
Escherichia coli
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Gastroenteritis
Enterotoxigenic E. coli
. coli. Two groups of E. coli responsible for enteric disease (enteropathogenic E. coli [EPEC] and some Shiga toxin–producing E....
. coli. Enteroaggregative E. coli (EAEC) are a heterogeneous collection of strains characterized by their autoagglutination in a...
. coli. Nomenclature for this group of E. coli is confusing, referring to them as STEC, verocytotoxin-producing E. coli (VTEC), ...
. coli. EIEC strains are rare in both developed and developing countries. Pathogenic strains are primarily associated with a few...
Extraintestinal Infections
. Most gram-negative rods that produce UTIs originate in the colon, contaminate the urethra, ascend into the bladder, and may mi...
. E. coli and group B streptococci cause the majority of CNS infections in infants younger than 1 month. Approximately 75% of th...
. Typically, septicemia caused by gram-negative rods, such as E. coli, most commonly originates from infections in the urinary o...
Salmonella
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Gastroenteritis
Septicemia
Enteric Fever
Asymptomatic Colonization
Shigella
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Yersinia
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Other Enterobacteriaceae
Klebsiella
Proteus
Enterobacter, Citrobacter, Morganella, and Serratia
Other General Properties
Laboratory Diagnosis
Culture
Biochemical Identification
Serologic Classification
Nucleic Acid Amplification Tests
Treatment, Prevention, and Control
Bibliography
Chapter 26: Vibrio and Related Bacteria
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Vibrio cholerae
Vibrio parahaemolyticus
Vibrio vulnificus
Laboratory Diagnosis
Microscopy
Immunoassays
Nucleic Acid Amplification Tests
Culture
Treatment, Prevention, and Control
Aeromonas
Bibliography
Chapter 27: Pseudomonas and Related Bacteria
Physiology and Structure
Pathogenesis and Immunity
Adhesins
Secreted Toxins and Enzymes
Antibiotic Resistance
Epidemiology
Clinical Diseases
Pulmonary Infections
Primary Skin and Soft-Tissue Infections
Urinary Tract Infections
Ear Infections
Eye Infections
Bacteremia and Endocarditis
Other Infections
Laboratory Diagnosis
Microscopy
Culture
Identification
Treatment, Prevention, and Control
Burkholderia
Stenotrophomonas maltophilia
Acinetobacter
Moraxella
Bibliography
Chapter 28: Campylobacter and Helicobacter
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Microscopy
Antigen Detection
Nucleic Acid–Based Tests
Culture
Identification
Antibody Detection
Treatment, Prevention, and Control
Helicobacter
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Microscopy
Antigen Detection
Nucleic Acid–Based Tests
Culture
Identification
Antibody Detection
Treatment, Prevention, and Control
Bibliography
Chapter 29: Miscellaneous Gram-Negative Rods
Bordetella
Other Bordetella Species
Brucella
Clinical Diseases
Cardiobacterium
Francisella
Legionella
Streptobacillus
Bibliography
Chapter 30: Clostridium
Clostridium difficile
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Treatment, Prevention, and Control
Clostridium perfringens
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Treatment, Prevention, and Control
Clostridium tetani
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Treatment, Prevention, and Control
Clostridium botulinum
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Treatment, Prevention, and Control
Other Clostridial Species
Bibliography
Chapter 31: Non–Spore-Forming Anaerobic Bacteria
Anaerobic Gram-Positive Rods
Actinomyces
Lactobacillus
Mobiluncus
Cutibacterium (Propionibacterium)
Bifidobacterium and Eubacterium
Anaerobic Gram-Negative Cocci
Anaerobic Gram-Negative Rods
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Respiratory Tract Infections
Brain Abscess
Intraabdominal Infections
Gynecologic Infections
Skin and Soft-Tissue Infections
Bacteremia
Gastroenteritis
Laboratory Diagnosis
Microscopy
Culture
Bacterial Identification
Treatment, Prevention, and Control
Bibliography
Chapter 32: Treponema, Borrelia, and Leptospira
Treponema
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Microscopy
Culture
Nucleic Acid–Based Tests
Antibody Detection
Treatment, Prevention, and Control
Borrelia
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Lyme Disease
Relapsing Fever
Laboratory Diagnosis
Microscopy
Culture
Nucleic Acid–Based Tests
Antibody Detection
Treatment, Prevention, and Control
Leptospira
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Microscopy
Culture
Nucleic Acid–Based Tests
Antibody Detection
Treatment, Prevention, and Control
Bibliography
Chapter 33: Mycoplasma
Pathogenesis and Immunity
Answers
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Chapter 34: Rickettsia, Ehrlichia, and Related Bacteria
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Microscopy
Nucleic Acid–Based Tests
Culture
Antibody Detection
Treatment, Prevention, and Control
Anaplasmataceae
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Human Monocytic Ehrlichiosis
Human (Canine) Granulocytic Ehrlichiosis
Human Anaplasmosis
Laboratory Diagnosis
Treatment, Prevention, and Control
Coxiellaceae
Coxiella burnetii
Physiology and Structure
Pathogenesis and Immunity
Epidemiology
Clinical Diseases
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Chapter 35: Chlamydia
Chlamydia Trachomatis
Epidemiology
Clinical Diseases
Trachoma
Adult Inclusion Conjunctivitis
Neonatal Conjunctivitis
Infant Pneumonia
Ocular Lymphogranuloma Venereum
Urogenital Infections
Lymphogranuloma Venereum
Laboratory Diagnosis
Antigen Detection
Nucleic Acid–Based Tests
Culture
Antibody Detection
Treatment, Prevention, and Control
Chlamydia Pneumoniae
Chlamydia Psittaci
Bibliography
Section 5: Virology
Chapter 36: Viral Classification, Structure, and Replication
Classification
Virion Structure
Capsid Viruses
Enveloped Viruses
Viral Replication
Recognition of And Attachment to the Target Cell
Penetration
Uncoating
Macromolecular Synthesis
Dna Viruses
Rna Viruses
Viral Protein Synthesis
Assembly
Release
Spread of the Infection
Viral Genetics
Viral Vectors for Therapy
Bibliography
Chapter 37: Mechanisms of Viral Pathogenesis
Infection of the Target Tissue
Viral Pathogenesis
Cytopathogenesis
Lytic Infections
Nonlytic Infections
Oncogenic Viruses
Host Defenses Against Viral Infection
Immunopathology
Viral Disease
Epidemiology
Exposure
Transmission of Viruses
Maintenance of a Virus in the Population
Age
Immune Status
Other Host Factors
Geographic and Seasonal Considerations
Outbreaks, Epidemics, and Pandemics
Control of Viral Spread
Bibliography
Chapter 38: Role of Viruses in Disease
Oral and Respiratory Tract Infections
Flulike and Systemic Symptoms
Gastrointestinal Tract Infections
Exanthems, Hemorrhagic Fevers, and Arthritides
Infections of the eye
Infections of the Organs and Tissues
Infections of the Central Nervous System
Hematologic Diseases
Sexually Transmitted Viral Diseases
Viruses Spread by Transfusion and Transplantation
Viruses Spread by Arthropods and Animals
Syndromes of Possible Viral Etiology
Chronic and Potentially Oncogenic Infections
Infections in Immunocompromised Patients
Congenital, Neonatal, and Perinatal Infections
Bibliography
Chapter 39: Laboratory Diagnosis of Viral Diseases
Cytology
Electron Microscopy
Viral Isolation and Growth
Cell Culture
Viral Detection
Detection of Viral Genetic Material
Genome Amplification
In Situ Analysis
Detection of Viral Proteins
Significance of Virus Detection
Viral Serology
Serologic Test Methods
Limitations of Serologic Methods
Bibliography
Chapter 40: Antiviral Agents and Infection Control
Virion Disruption
Attachment
Penetration and Uncoating
Rna Synthesis
Genome Replication
Protein Synthesis
Virion Assembly and Release
Stimulators of Host Innate Immune Protective Responses
Nucleoside Analogs
Acyclovir, Valacyclovir, Penciclovir, and Famciclovir
Ganciclovir
Cidofovir and Adefovir
Azidothymidine
Dideoxyinosine, Dideoxycytidine, Stavudine, and Lamivudine
Ribavirin
Other Nucleoside Analogs
Nonnucleoside Polymerase Inhibitors
Protease Inhibitors
Antiinfluenza Drugs
Immunomodulators
Infection Control
Bibliography
Chapter 41: Papillomaviruses and Polyomaviruses
Structure and Replication
Pathogenesis
Epidemiology
Clinical Syndromes
Warts
Head and Neck Papillomas and Tumors
Anogenital Warts
Cervical Dysplasia and Neoplasia
Laboratory Diagnosis
Treatment, Prevention, and Control
Polyomaviridae
Structure and Replication
Pathogenesis
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Chapter 42: Adenoviruses
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Acute Febrile Pharyngitis and Pharyngoconjunctival Fever
Acute Respiratory Disease
Other Respiratory Tract Diseases
Conjunctivitis and Epidemic Keratoconjunctivitis
Gastroenteritis and Diarrhea
Other Manifestations
Systemic Infection in Immunocompromised Patients
Laboratory Diagnosis
Treatment, Prevention, and Control
Therapeutic Adenoviruses
Bibliography
Chapter 43: Human Herpesviruses
Structure of Herpesviruses
Herpesvirus Replication
Herpes Simplex Virus
Herpes Simplex Virus Proteins
Replication
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Direct Analysis of a Clinical Sample
Virus Isolation
Genome Detection
Serology
Treatment, Prevention, and Control
Varicella-Zoster Virus
Structure and Replication
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Epstein-Barr Virus
Structure and Replication
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Heterophile Antibody–Positive Infectious Mononucleosis
Chronic Disease
Epstein-Barr Virus–Induced Lymphoproliferative Diseases
Hairy Oral Leukoplakia
Laboratory Diagnosis
Treatment, Prevention, and Control
Cytomegalovirus
Structure and Replication
Pathogenesis and Immunity
Epidemiology and Clinical Syndromes
Congenital Infection
Perinatal Infection
Infection in Children and Adults
Transmission via Transfusion and Transplantation
Infection in the Immunocompromised Host
Laboratory Diagnosis
Histology
Antigen and Genome Detection
Culture
Serology
Treatment, Prevention, and Control
Human Herpesviruses 6 and 7
Pathogenesis and Immunity
Clinical Syndromes
Other Human Herpesviruses
Human Herpesvirus 8 (Kaposi Sarcoma–Associated Herpesvirus)
Bibliography
Chapter 44: Poxviruses
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Smallpox
Vaccinia and Vaccine-Related Disease
Orf, Cowpox, and Monkeypox
Molluscum Contagiosum
Hybrid Poxviruses for Gene Delivery and Vaccines
Bibliography
Chapter 45: Parvoviruses
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Chapter 46: Picornaviruses
Structure
Replication
Enteroviruses
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Poliovirus Infections
Coxsackievirus and Echovirus Infections
Other Enterovirus Diseases
Laboratory Diagnosis
Clinical Chemistry
Culture
Genome and Serology Studies
Treatment, Prevention, and Control
Rhinoviruses
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Chapter 47: Coronaviruses and Noroviruses
Structure and Replication
Pathogenesis and Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Noroviruses
Structure and Replication
Pathogenesis
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Chapter 48: Paramyxoviruses
Structure and Replication
Measles Virus
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Parainfluenza Viruses
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Mumps Virus
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Respiratory Syncytial Virus
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Human Metapneumovirus
Nipah and Hendra Viruses
Bibliography
Chapter 49: Orthomyxoviruses
Structure and Replication
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Thogotoviruses
Bibliography
Chapter 50: Rhabdoviruses, Filoviruses, and Bornaviruses
Physiology, Structure, and Replication
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment and Prophylaxis
Filoviruses
Structure and Replication
Pathogenesis
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Borna Disease Virus
Structure and Replication
Pathogenesis
Clinical Syndromes
Epidemiology
Laboratory Diagnosis
Treatment
Bibliography
Chapter 51: Reoviruses
Replication
Rotaviruses
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Orthoreoviruses (Mammalian Reoviruses)
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Coltiviruses and Orbiviruses
Pathogenesis
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Chapter 52: Togaviruses and Flaviviruses
Structure and Replication of Alphaviruses
structure and Replication of Flaviviruses
Arbovirus Pathogenesis and Immunity
Immune Response
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Rubella Virus
Pathogenesis and Immunity
Immune Response
Congenital Infection
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Chapter 53: Bunyaviridae and Arenaviridae
Structure
Replication
Pathogenesis
Epidemiology
clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Arenaviruses
Structure and Replication
Pathogenesis
Epidemiology
Clinical Syndromes
Lymphocytic Choriomeningitis
Lassa and Other Hemorrhagic Fevers
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Chapter 54: Retroviruses
Classification
Structure
Replication
Human Immunodeficiency Virus
Pathogenesis and Immunity
Epidemiology
Geographic Distribution
Transmission
Populations at Highest Risk
Clinical Syndromes
Lymphadenopathy and Fever
Opportunistic Infections
Malignancies
Dementia Related to AIDS
Laboratory Diagnosis
Genomics
Serology
Immunologic Studies
Treatment, Prevention, and Control
Education
Blood, Blood Product, and Organ Screening
Infection Control
Approaches to Vaccine Prophylaxis
Human T-Cell Lymphotropic Virus and Other Oncogenic Retroviruses
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Endogenous Retroviruses
Bibliography
Chapter 55: Hepatitis Viruses
Hepatitis A Virus
Structure
Replication
Pathogenesis
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Hepatitis B Virus
Structure
Replication
Pathogenesis and Immunity
Epidemiology
Clinical Syndromes
Acute Infection
Chronic Infection
Primary Hepatocellular Carcinoma
Laboratory Diagnosis
Treatment, Prevention, and Control
Hepatitis C and G Viruses
Structure and Replication
Pathogenesis
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Hepatitis G Virus
Hepatitis D Virus
Structure and Replication
Pathogenesis
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Hepatitis E Virus
Bibliography
WHO Alert, Hepatitis C factsheet. www.who.int/mediacentre/factsheets/fs164/en/. Accessed September 21, 2018
Chapter 56: Prion Diseases
Pathogenesis
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Section 6: Mycology
Chapter 57: Fungal Classification, Structure, and Replication
The Importance of Fungi
Fungal Taxonomy, Structure, and Replication
Ascomycota (Ascomycetes)
Basidiomycota (Basidiomycetes)
Glomerulomycota (Mucormycetes, formerly Zygomycetes)
Microspora (Microsporidia)
Classification of Human Mycoses
Supericial Mycoses
Cutaneous Mycoses
Subcutaneous Mycoses
Endemic Mycoses
Opportunistic Mycoses
Summary
Bibliography
Questions
Chapter 58: Pathogenesis of Fungal Disease
Blastomyces Dermatitidis
Modulation of Yeast and Host Immune System Interactions
Presentation of Surface Antigen Modulates the T-Helper Pathway of Immune Response
Coccidioides Immitis
Resistance of Conidia to Phagocytic Killing
Stimulation of an Ineffective TH2 Immune Response by C. immitis
Urease Production
Extracellular Proteinases
Molecular Mimicry
Histoplasma Capsulatum
Histoplasma capsulatum Resides in Host Macrophages
Modulation of the pH of the Phagolysosome
Iron and Calcium Uptake
Alteration of Yeast Cell Wall Composition
Paracoccidioides Brasiliensis
Hormonal Influences on Infection
Role of Cell Wall Glucans in the Pathogenesis of Paracoccidioides brasiliensis
Responses to an Immunodominant Antigen, gp43
Opportunistic Pathogens
Candida Species
Cryptococcus Neoformans
Aspergillus Species
Mycotoxins
Bibliography
Chapter 59: Role of Fungi in Disease
Bibliography
Chapter 60: Laboratory Diagnosis of Fungal Disease
Conventional Laboratory Diagnosis
Specimen Collection and Processing
Stains and Direct Microscopic Examination
Culture
Identifying Characteristics of Various Fungi
Immunologic, Molecular, and Biochemical Markers for Direct Detection of Invasive Fungal Infections
Bibliography
Chapter 61: Antifungal Agents
Azoles
Echinocandins
Antimetabolites
Allylamines
Griseofulvin
Topical Antifungal Agents
Investigational Antifungal Agents
Combinations of Antifungal Agents in the Treatment of Mycoses
Mechanisms of Resistance to Antifungal Agents
Polyenes
Azoles
Echinocandins
Flucytosine
Allylamines
Clinical Factors Contributing to Resistance
Antifungal Susceptibility Testing
Bibliography
Chapter 62: Superficial and Cutaneous Mycoses
Pityriasis (Tinea) Versicolor
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Tinea Nigra
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
White Piedra
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Black Piedra
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Cutaneous Mycoses
Dermatophytoses
Morphology
Ecology and Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Onychomycosis Caused by Nondermatophytic Fungi
Bibliography
Chapter 63: Subcutaneous Mycoses
Lymphocutaneous Sporotrichosis
MORPHOLOGY
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT
Chromoblastomycosis
MORPHOLOGY
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT
Eumycotic Mycetoma
MORPHOLOGY
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT
Subcutaneous Entomophthoromycosis
MORPHOLOGY
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT
Subcutaneous Phaeohyphomycosis
MORPHOLOGY
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT
Bibliography
Chapter 64: Systemic Mycoses Caused by Dimorphic Fungi
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Coccidioidomycosis
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Emergomycosis and Adiaspiromycosis
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Histoplasmosis
Morphology
Epidemiology
Clinical Syndromes
Histoplasmosis Capsulati
Histoplasmosis duboisii
Laboratory Diagnosis
Treatment
Paracoccidioidomycosis
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Talaromycosis (Penicilliosis) marneffei
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Bibliography
Chapter 65: Opportunistic Mycoses
Candidiasis
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Opportunistic Mycoses Caused by Cryptococcus Neoformans and Other Noncandidal Yeastlike Fungi
Cryptococcosis
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Other Mycoses Caused By Yeastlike Fungi
Microsporidia
Physiology and Structure
Pathogenesis
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Aspergillosis
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment and Prevention
Mucormycosis
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Mycoses Caused by Other Hyaline Molds
Phaeohyphomycosis
Pneumocystosis
Bibliography
Chapter 66: Fungal and Fungal-Like Infections of Unusual or Uncertain Etiology
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Chlorellosis
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Lacaziosis (Lobomycosis)
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Protothecosis
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Pythiosis Insidiosi
Morphology
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment
Lagenidiosis
Morphology
Epidemiology
Clinical Syndrome
Laboratory Diagnosis
Treatment
Rhinosporidiosis
Morphology
Epidemiology
Clinical Syndrome
Laboratory Diagnosis
Treatment
Bibliography
Section 7: Parasitology
Chapter 67: Parasitic Classification, Structure, and Replication
Importance of Parasites
Classification and Structure
Protists (Protozoa)
Metamonada: Giardia, Enteromonas, Chilomastix, Retortamonas, Dientamoeba, Trichomonas, Pentatrichomonas
Discicristata: Naegleria, Leishmania, Trypanosoma
Amoebozoa: Acanthamoeba, Balamuthia, Entamoeba, Endolimax, Iodamoeba
Apicomplexa: Babesia, Plasmodium, Cryptosporidium, Cyclospora, Cystoisospora, Sarcocystis, Toxoplasma
Ciliophora: Neobalantidium (Formerly Balantidium) coli
Stramenopila (Formerly Chromista): Blastocystis
Animalia (Metazoa)
Helminths
.The Nematoda clade consists of the roundworms, which have cylindric bodies. The sexes of roundworms are separate, and these org...
.The Platyhelminthes clade consists of the flatworms, which have flattened bodies that are leaflike or resemble ribbon segments....
Arthropoda
.The Myriapoda consist of two classes of medical importance: Chilopoda (centipedes) and Diplopoda (millipedes). Some centipedes ...
.The crustaceans include familiar aquatic forms, such as crabs, crayfish, shrimp, copepods, and pentastomids. Several are involv...
.Within the Chelicerata only the class Arachnida contains medically important species, such as mites, ticks, spiders, and scorpi...
.The Hexapoda of medical importance are contained in the class Insecta and consist of familiar aquatic and terrestrial forms, su...
Physiology and Replication
Protozoa
Animalia (Metazoa)
Helminths
Arthropods
Summary
Bibliography
Chapter 68: Pathogenesis of Parasitic Diseases
Adherence and Replication
Cell and Tissue Damage
Disruption, Evasion, and Inactivation of Host Defenses
Bibliography
Chapter 69: Role of Parasites in Disease
Bibliography
Chapter 70: Laboratory Diagnosis of Parasitic Disease
General Diagnostic Considerations
Parasitic Infections of the Intestinal and Urogenital Tracts
Fecal Specimen Collection
Techniques of Stool Examination
Macroscopic Examination
Direct Wet Mount
Concentration
Permanently Stained Slides
Collection and Examination of Specimens Other Than Stool
Perianal Specimens
Sigmoidoscopic Material
Duodenal Aspirates
Liver Abscess Aspirate
Sputum
Urine
Urogenital Specimens
Parasitic Infections of Blood and Tissue
Blood Films
Specimens Other Than Blood
Alternatives to Microscopy
Immunodiagnostics
Molecular Diagnostic Approaches
Culture
Animal Inoculation
Xenodiagnosis
Bibliography
Chapter 71: Antiparasitic Agents
Drug Resistance
Antiparasitic Agents
Antiprotozoal Agents
Heavy Metals
Quinoline Derivatives
Folic Acid Antagonists
Inhibitors of Protein Synthesis
Diamidines
Nitroimidazoles
Sesquiterpenes
Atovaquone-Proguanil (Malarone)
Miltefosine
Nitazoxanide
Other Antiprotozoal Agents
Anthelmintic Agents
Benzimidazoles
Tetrahydropyrimidines
Piperazines
Avermectins
Pyrazinoisoquinolines
Phenols
Other Anthelmintic Agents
Bibliography
Chapter 72: Intestinal and Urogenital Protozoa
Entamoeba Histolytica
Physiology and Structure
Pathogenesis
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Other Intestinal Amebae
Ciliates (Metamonada [Formerly Flagellates] and Ciliophora)
Giardia Duodenalis (G. Lamblia; G. Intestinalis)
Physiology and Structure
Pathogenesis
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Dientamoeba Fragilis
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Trichomonas Vaginalis
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Neobalantidium Coli
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Sporozoa (Apicomplexa)
Cystoisospora (Formerly Isospora) Belli
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Sarcocystis Species
Cryptosporidium Species
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Cyclospora Species
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Chapter 73: Blood and Tissue Protozoa
Plasmodium Species
Plasmodium Falciparum
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Plasmodium Knowlesi
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Plasmodium Vivax
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Plasmodium Ovale
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Plasmodium Malariae
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Babesia Species
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Toxoplasma gondii
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Sarcocystis lindemanni
Free-Living Amebae
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Leishmania
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Trypanosomes
Trypanosoma Brucei Gambiense
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Trypanosoma Brucei Rhodesiense
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Trypanosoma Cruzi
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, And Control
Bibliography
Chapter 74: Nematodes
Enterobius vermicularis
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Ascaris lumbricoides
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Toxocara and Baylisascaris
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Hookworms
Ancylostoma duodenale and Necator americanus
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Ancylostoma Braziliense
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Strongyloides stercoralis
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Trichinella spiralis
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Wuchereria bancrofti and Brugia malayi
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Loa loa
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Mansonella Species
Mansonella Perstans
Mansonella Ozzardi
Mansonella Streptocerca
Onchocerca volvulus
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Dirofilaria immitis
Dracunculus medinensis
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Bibliography
Chapter 75: Trematodes
Fasciolopsis buski
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Fasciola hepatica
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Clonorchis sinensis
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Paragonimus westermani
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Schistosomes
Schistosoma Mansoni
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Schistosoma Japonicum
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Schistosoma Haematobium
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Cercarial Dermatitis
Bibliography
Chapter 76: Cestodes
Taenia solium
PHYSIOLOGY AND STRUCTURE
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT, PREVENTION, AND CONTROL
Cysticercosis
PHYSIOLOGY AND STRUCTURE
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT, PREVENTION, AND CONTROL
Taenia saginata
PHYSIOLOGY AND STRUCTURE
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT, PREVENTION, AND CONTROL
Diphyllobothrium latum
PHYSIOLOGY AND STRUCTURE
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT, PREVENTION, AND CONTROL
Sparganosis
PHYSIOLOGY AND STRUCTURE
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT, PREVENTION, AND CONTROL
Echinococcus granulosus
PHYSIOLOGY AND STRUCTURE
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT, PREVENTION, AND CONTROL
Echinococcus multilocularis
PHYSIOLOGY AND STRUCTURE
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT, PREVENTION, AND CONTROL
Hymenolepis nana
PHYSIOLOGY AND STRUCTURE
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT, PREVENTION, AND CONTROL
Hymenolepis diminuta
PHYSIOLOGY AND STRUCTURE
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT, PREVENTION, AND CONTROL
Dipylidium caninum
PHYSIOLOGY AND STRUCTURE
EPIDEMIOLOGY
CLINICAL SYNDROMES
LABORATORY DIAGNOSIS
TREATMENT, PREVENTION, AND CONTROL
Bibliography
Chapter 77: Arthropods
Myriapoda
CENTIPEDES (CHILOPODA)
Physiology and Structure
Epidemiology
Clinical Syndromes
Treatment, Prevention, and Control
Crustacea
COPEPODS
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
DECAPODS
Pentastomida
TONGUE WORMS
Physiology and Structure
Epidemiology
Clinical Syndromes
Laboratory Diagnosis
Treatment, Prevention, and Control
Chelicerata (Arachnida)
SPIDERS
Black Widow Spiders
Physiology and Structure
Epidemiology
Clinical Syndromes
Treatment, Prevention, and Control
Brown Recluse Spiders
Physiology and Structure
Epidemiology
Clinical Syndromes
Diagnosis
Treatment, Prevention, and Control
SCORPIONS
Physiology and Structure
Epidemiology
Clinical Syndromes
Diagnosis
Treatment, Prevention, and Control
MITES
Itch Mites
Physiology and Structure
Epidemiology
Clinical Syndromes
Diagnosis
Treatment, Prevention, and Control
Human Follicle Mites
Physiology and Structure
Epidemiology
Clinical Syndromes
Diagnosis
Treatment
Chigger Mites
Physiology and Structure
Epidemiology
Clinical Syndromes
Treatment, Prevention, and Control
TICKS
Clinical Syndromes
Diagnosis
Treatment, Prevention, and Control
Hexapoda (Insecta)
BLOODSUCKING DIPTERA
Mosquitoes
Physiology and Structure
Epidemiology
Clinical Syndromes
Treatment, Prevention, and Control
Gnats and Biting Midges
Physiology and Structure
Epidemiology
Clinical Syndromes
Treatment, Prevention, and Control
Sandflies
Physiology and Structure
Epidemiology
Clinical Syndromes
Treatment, Prevention, and Control
Blackflies
Physiology and Structure
Epidemiology
Clinical Syndromes
Diagnosis
Treatment, Prevention, and Control
HORSEFLIES AND DEERFLIES
MUSCOID FLIES
Physiology and Structure
Epidemiology
Prevention and Control
MYIASIS-CAUSING FLIES
SUCKING LICE
Physiology and Structure
Epidemiology
Clinical Syndromes
Diagnosis
Treatment, Prevention, and Control
FLEAS
Physiology and Structure
Epidemiology
Clinical Syndromes
Diagnosis
Treatment, Prevention, and Control
BUGS
Physiology and Structure
Epidemiology
Clinical Syndromes
Diagnosis
Treatment, Prevention, and Control
STINGING INSECTS
Physiology and Structure
Epidemiology
Clinical Syndromes
Treatment, Prevention, and Control
Bibliography
Answers
Index
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z

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MEDICAL MICROBIOLOGY

NOTE TO INSTRUCTORS: Contact your Elsevier Sales Representative for teaching ­resources, including slides and image banks, for Medical ­Microbiology, 9e, or request these supporting materials at: http://evolve.elsevier.com/Murray/microbiology/

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Medical Microbiology NINTH EDITION

Patrick R. Murray, PhD, F(AAM), F(IDSA) Vice-President, Microbiology Sparks, Maryland; Adjunct Professor, Department of Pathology University of Maryland School of Medicine Baltimore, Maryland

Ken S. Rosenthal, PhD Professor of Immunology Augusta University/University of Georgia Medical Partnership Athens, Georgia; Emeritus Professor, Northeastern Ohio Medical University Rootstown, Ohio

Michael A. Pfaller, MD, F(CAP), F(AAM), F(IDSA) Consultant JMI Laboratories North Liberty, Iowa Professor Emeritus University of Iowa College of Medicine Iowa City, Iowa

Edinburgh London New York Oxford Philadelphia St Louis Sydney 2021

iii

© 2021, Elsevier Inc. All rights reserved. First edition 1990 Second edition 1994 Third edition 1998 Fourth edition 2002 Fifth edition 2005 Sixth edition 2009 Seventh edition 2013 Eight edition 2016 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).

Notices Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds or experiments described herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. ISBN: 978-0-323-67322-8 E-ISBN: 978-0-323-67450-8

Content Strategist: Jeremy Bowes Content Development Specialist: Joanne Scott Project Manager: Andrew Riley Design: Brian Salisbury Illustration Manager: Paula Catalano Marketing Manager: Michele Milano Printed in the USA Last digit is the print number: 9 8 7 6 5 4 3 2 1

Contents Preface, vii Acknowledgments, ix Dedication, xi

SECTION 1 Introduction, 1 1 Introduction to Medical Microbiology, 2 2 Human Microbiome in Health and Disease, 6 3 Sterilization, Disinfection, and Antisepsis, 12  SECTION 2 General Principles of Laboratory Diagnosis, 17

19 Streptococcus and Enterococcus, 191 20 Bacillus, 210 21 Listeria and Related Gram-Positive Bacteria, 217 22 Mycobacterium and Related Acid-Fast Bacteria, 226

23 Neisseria and Related Genera, 241 24 Haemophilus and Related Bacteria, 250 25 Enterobacteriaceae, 257 26 Vibrio and Related Bacteria, 271 27 Pseudomonas and Related Bacteria, 278

4 Microscopy and In Vitro Culture, 18

28 Campylobacter and Helicobacter, 286

5 Molecular Diagnosis, 24

29 Miscellaneous Gram-Negative Rods, 293

6 Serologic Diagnosis, 30 

30 Clostridium, 307

SECTION 3 Basic Concepts in the Immune Response, 37

31 Non–Spore-Forming Anaerobic Bacteria, 318 32 Treponema, Borrelia, and Leptospira, 327

7 Elements of Host Protective Responses, 38

33 Mycoplasma, 340

8 Innate Host Responses, 49

34 Rickettsia, Ehrlichia, and Related Bacteria, 343

9 Antigen-Specific Immune Responses, 64

35 Chlamydia, 353 

10 Immune Responses to Infectious Agents, 83 11 Antimicrobial Vaccines, 104  SECTION 4 Bacteriology, 113 12 Bacterial Classification, Structure, and Replication, 114

SECTION 5 Virology, 361 36 Viral Classification, Structure, and Replication, 362

37 Mechanisms of Viral Pathogenesis, 378 38 Role of Viruses in Disease, 388

13 Bacterial Metabolism and Genetics, 127

39 Laboratory Diagnosis of Viral Diseases, 396

14 Mechanisms of Bacterial Pathogenesis, 142

40 Antiviral Agents and Infection Control, 403

15 Role of Bacteria in Disease, 152

41 Papillomaviruses and Polyomaviruses, 411

16 Laboratory Diagnosis of Bacterial Diseases, 161

42 Adenoviruses, 421

17 Antibacterial Agents, 169

43 Human Herpesviruses, 428

18 Staphylococcus and Related Gram-Positive

44 Poxviruses, 450

Cocci, 178

v

vi

Contents

45 Parvoviruses, 456

65 Opportunistic Mycoses, 649

46 Picornaviruses, 461

66 Fungal and Fungal-Like Infections of Unusual or

47 Coronaviruses and Noroviruses, 472 48 Paramyxoviruses, 478 49 Orthomyxoviruses, 490 50 Rhabdoviruses, Filoviruses, and Bornaviruses, 500

51 Reoviruses, 507 52 Togaviruses and Flaviviruses, 515 53 Bunyaviridae and Arenaviridae, 527 54 Retroviruses, 533 55 Hepatitis Viruses, 550 56 Prion Diseases, 565  SECTION 6 Mycology, 571 57 Fungal Classification, Structure, and Replication, 572

Uncertain Etiology, 675 

SECTION 7 Parasitology, 685 67 Parasitic Classification, Structure, and Replication, 686

68 Pathogenesis of Parasitic Diseases, 693 69 Role of Parasites in Disease, 697 70 Laboratory Diagnosis of Parasitic Disease, 699 71 Antiparasitic Agents, 708 72 Intestinal and Urogenital Protozoa, 716 73 Blood and Tissue Protozoa, 729 74 Nematodes, 750 75 Trematodes, 768 76 Cestodes, 779 77 Arthropods, 791

58 Pathogenesis of Fungal Disease, 578

SECTION 8

59 Role of Fungi in Disease, 587

78 Microbial Connections by Body System

60 Laboratory Diagnosis of Fungal Disease, 589 61 Antifungal Agents, 600

and Disease

BONUS electronic-only chapter. Access via your included activation code

62 Superficial and Cutaneous Mycoses, 612

Answers

63 Subcutaneous Mycoses, 622

Index, 809

64 Systemic Mycoses Caused by Dimorphic Fungi,

632

Preface Our knowledge about microbiology and immunology is constantly growing, and by building a good foundation of understanding in the beginning, it will be much easier to understand the advances of the future. Medical microbiology can be a bewildering field for the novice. We are faced with many questions when learning microbiology: How do I learn all the names? Which infectious agents cause which diseases? Why? When? Who is at risk? Is there a treatment? However, all these concerns can be reduced to one essential question: What information do I need to know that will help me understand how to diagnose and treat an infected patient? Certainly, there are a number of theories about what a student needs to know and how to teach it, which supposedly validates the plethora of microbiology textbooks that have flooded the bookstores in recent years. Although we do not claim to have the one right approach to teaching medical microbiology (there is truly no one perfect approach to medical education), we have founded the revisions of this textbook on our experience gained through years of teaching medical students, residents, and infectious disease fellows, as well as on the work devoted to the eight previous editions. We have tried to present the basic concepts of medical microbiology clearly and succinctly in a manner that addresses different types of learners. The text is written in a straightforward manner with, it is hoped, uncomplicated explanations of difficult concepts. In this edition, we challenged ourselves to improve the learning experience even more. We are using the new technology on StudentConsult.com (e-version) to enhance access to the material. In the previous edition, we added chapter summaries and learning aids in the beginning of each of the microbe chapters, and on the e-version these are keyed to the appropriate sections in the chapter. In the e-version of the ninth edition, we added an infectious disease chapter that lists the microbes by organ system and disease with hyperlinks to the appropriate chapter in the text. This will facilitate access to the microbes for those in organ-system or disease/case-based curricula. As in previous editions, there are new and enhanced figures to assist learning. Details are summarized in tabular format rather than in lengthy text, and there are colorful illustrations for the visual learner. Clinical Cases provide the relevance that puts reality into the basic science. Important points are emphasized in boxes to aid students, especially in their review, and the study questions, including Clinical Cases, address relevant aspects of each chapter. Each section (bacteria, viruses, fungi, parasites) begins with a chapter that summarizes microbial diseases, and this also provides review material. Our understanding of microbiology and immunology is rapidly expanding, with new and exciting discoveries in all areas. We used our experience as authors and teachers

to choose the most important information and explanations for inclusion in this textbook. Each chapter has been carefully updated and expanded to include new, medically relevant discoveries. In each of these chapters, we have attempted to present the material that we believe will help the student gain an interest in as well as a clear understanding of the significance of the individual microbes and their diseases. With each edition of Medical Microbiology we refine and update our presentation. There are many changes to the ninth edition, both in the print and e-versions of the book. The book starts with a general introduction to microbiology and chapters on the human microbiome and epidemiology of infectious diseases. The human microbiome (that is, the normal population of organisms that populate our bodies) can now be considered as another organ system with 10 times as many cells as human cells. This microbiota educates the immune response, helps digest our food, and protects us against more harmful microbes. Additional chapters in the introductory section introduce the techniques used by microbiologists and immunologists and are followed by chapters on the functional immune system. Recent developments in rapid microbial identification are highlighted. The immune cells and tissues are introduced, followed by an enhanced chapter on innate immunity and updated chapters on antigen-specific immunity, antimicrobial immunity, and vaccines. Each of the sections on bacteria, viruses, fungi, and parasites is introduced by the relevant basic science chapters and then a summary chapter that highlights the specific microbial diseases before proceeding into descriptions of the individual microbes, “the bug parade.” Each chapter on the specific microbes begins with a summary (including trigger words), which is keyed to the appropriate part of the chapter in the e-version. As in previous editions, there are many summary boxes, tables, clinical photographs, and original clinical cases. Clinical Cases are included because we believe students will find them particularly interesting and instructive, and they are a very efficient way to present this complex subject. Each chapter in the “bug parade” is introduced by relevant questions to excite students and orient them as they explore the chapter. Finally, students are provided with access to the new Student Consult website, which provides links to additional reference materials, clinical photographs, animations, and answers to the introductory and summary questions of each chapter. Many of the figures are presented in step-bystep manner to facilitate learning. A very important feature on the website is access to more than 200 practice exam questions that will help students assess their mastery of the subject matter and prepare for their course and licensure exams. In essence, this edition provides an understandable text, details, questions, examples, and a review book all in one. vii

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Preface

To Our Future Colleagues: The Students On first impression, success in medical microbiology would appear to depend on memorization. Microbiology may seem to consist of only innumerable facts, but there is also a logic to microbiology and immunology. Like a medical detective, the first step is to know your villain. Microbes establish a niche in our bodies; some are beneficial and help us to digest our food and educate our immune system, while others may cause disease. Their ability to cause disease, and the disease that may result, depend on how the microbe interacts with the host and the innate and immune protective responses that ensue. There are many ways to approach learning microbiology and immunology, but ultimately the more you interact with the material using multiple senses, the better you will build memory and learn. A fun and effective approach to learning is to think like a physician and treat each microbe and its diseases as if it were an infection in your patient. Create a patient for each microbial infection and compare and contrast the different patients. Perform role-playing and ask the seven basic questions as you approach this material: Who? Where? When? Why? Which? What? and How? For example: Who is at risk for disease? Where does this organism cause infections (both body site and geographic area)? When is isolation of this organism important? Why is this organism able to cause disease? Which species and genera are medically important? What diagnostic tests should be performed? How is this infection managed? Each organism that is encountered can be systematically examined. Use the following acronym to create a clinical case and learn the essential information for each microbe: DIVIRDEPTS. How does the microbial disease present in the patient and the differential diagnosis? How would you confirm the diagnosis and identify the microbial cause of disease? What are the virulence properties of the organism that cause the disease? What are the helpful and harmful aspects of the innate and immune response to the infection? What are the specific conditions or mechanisms for replicating the microbe?

 What are all the disease characteristics and consequences? What is the epidemiology of infection? How can you prevent its disease? What is its treatment? What social issues are caused by the microbial infection? Answering the DIVIRDEPTS questions will require that you jump around in the chapter to find the information, but this will help you learn the material. Get familiar with the textbook and its bonus materials and you will not only learn the material but also have a review book to work from in the future. For each of the microbes, learn three to five words or phrases that are associated with the microbe—words that will stimulate your memory (trigger words, provided in the chapter summary) and organize the diverse facts into a logical picture. Develop alternative associations. For example, this textbook presents organisms in the systematic taxonomic structure (frequently called a “bug parade,” which the authors think is the easiest way to introduce the organisms). Take a given virulence property (e.g., toxin production) or type of disease (e.g., meningitis) and list the organisms that share this property. Pretend that an imaginary patient is infected with a specific agent and create the case history. Explain the diagnosis to your imaginary patient and also to your future professional colleagues. In other words, do not simply attempt to memorize page after page of facts; rather, use techniques that stimulate your mind and challenge your understanding of the facts presented throughout the text and it will be more fun. Use the summary chapter at the beginning of each organism section to review and help refine your “differential diagnosis” and classify organisms into logical “boxes.” No textbook of this magnitude would be successful without the contributions of numerous individuals. We are grateful for the valuable professional help and support provided by the staff at Elsevier, particularly Jeremy Bowes, Joanne Scott and Andrew Riley. We also want to thank the many students and professional colleagues who have offered their advice and constructive criticism throughout the development of this ninth edition of Medical Microbiology. Patrick R. Murray, PhD, F(AAM), F(IDSA) Ken S. Rosenthal, PhD Michael A. Pfaller, MD, F(CAP), F(AAM), F(IDSA)

Acknowledgments We would like to acknowledge all the editors and staff who helped in the development and production of this text.

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To all who use this textbook, that they may benefit from its use as we did in its preparation

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SECTION

1 Introduction

SECTION OUTLINE

1 Introduction to Medical Microbiology



2 Human Microbiome in Health and Disease



3 Sterilization, Disinfection, and Antisepsis

1

1

Introduction to Medical Microbiology

Historical Perspective

Viruses

Imagine the excitement felt by the Dutch biologist Anton van Leeuwenhoek in 1674 as he peered through his carefully ground microscopic lenses at a drop of water and discovered a world of millions of tiny "animalcules." Almost 100 years later, the Danish biologist Otto Muller extended van Leeu­ wenhoek's studies and organized bacteria into genera and species according to the classification methods of Carolus Linnaeus. This was the beginning of the taxonomic classifi­ cation of microbes. In 1840, the German pathologist Fried­ rich Henle proposed criteria for proving that microorganisms were responsible for causing human disease (the "germ the­ ory" of disease). Robert Koch and Louis Pasteur confirmed this theory in the 1870s and 1880s with a series of elegant experiments proving that microorganisms were responsible for causing anthrax, rabies, plague, cholera, and tuberculo­ sis. Other brilliant scientists went on to prove that a diverse collection of microbes was responsible for causing human disease. The era of chemotherapy began in 1910, when the German chemist Paul Ehrlich discovered the first antibacte­ rial agent, which was a compound effective against the spi­ rochete that causes syphilis. This was followed by Alexander Fleming's discovery of penicillin in 1928, Gerhard Domagk's discovery of sulfanilamide in 1935, and Selman Waksman's discovery of streptomycin in 1943. In 1946, the American microbiologist John Enders was the first to cultivate-:viruses in cell cultures, leading the way to the large-seale produc­ tion of virus cultures for vaccine development. ThQusands of scientists have followed these pioneers, each building on the foundation established by his or her predesessors, and each adding an observation that expanded our understanding of microbes and their role in disease. Our knowledge and practice of microbiology is undergo­ ing a remarkable transformation founcled in the rapid tech­ nologic advances in genome analysis. Molecular diagnostic tests have been simplified and are sufficiently inexpensive to allow rapid detection and identification of organisms. Previ­ ously unappreciated insights about pathogenic properties of organisms, taxonomic relationships, and functional attri­ butes of the endogenous flora are being revealed. The com­ plexity of the medical microbiology we know today rivals the limits of the imagination. We now know that there are thousands of different types of microbes that live in, on, and around us, hundreds of which cause serious human diseases. To understand this information and organize it in a useful manner, it is important to understand some of the basic aspects of medical microbiology. To start, microbes can be subdivided into the following five general groups: viruses, bacteria, archaebacteria, fungi, and parasites, with each hav­ ing its own level of complexity. Archaebacteria do not seem to cause disease but arthropods may have a disease-causing relationship with man, and they are discussed in this book.

Viruses are the smallest infectious particles, ranging in diameter from 18 to 600 nm (most viruses are