Cardiovascular and Lymphatic system

• Septicemia (Sepsis)

  • Blood infection that can lead to septic shock
  • Septic shock is a critical condition caused by an overactive immune response to the infection resulting in inflammation, edema, hypotension, blood clots, organ failure, and death (30~80%).
  • Sepsis usually arises from pneumonia, GI, and UTI infections with Staph and Streptococcus implicated in many cases of bacterial sepsis.
• Septicemia (Sepsis)

  • Signs/Symptoms:
  • Abnormal body temperature (below 97~101’F)
  • Increased breathing (>20/min) and heart rate(>90/min)
  • Abnormally warm or cold skin
  • Hypotension (a BP below 65mmHg). Must have BP 65 or greater to maintain blood flow.
  • Impaired mental status (ex. confusion)
• Puerperal Fever (postpartum infection, childbed fever)

  • An infection of the female reproductive tract, usually by Streptococus pyogenes, and occurring after giving birth or a miscarriage.
  • Prior to antibiotics, about 25% of women who gave birth died from this disease.
  • Signs and symptoms: pelvic/abdominal pain, high fever, and bad-smelly vaginal discharge.
  • Today, women who get a C-cesarean are most at risk and thus are prescribed preventive antibiotics prior to surgery. (In the past, doctor who didn’t wash their hand before giving birth, got bacteria on their hand.)
• Rheumatic Fever

  • Infection caused by Streptococcus pyogenes, usually after a throat infection, and mostly affects 5~15 year old.
  • Due to an immune complex hypersensitivity, it can lead to inflammation in the brain, joints, skin, however, the heart is affected in most cases.
  • Damages to the heart and heart valves are called rheumatic heart disease.
  • Symptoms/signs: tired, chest pain, heart murmur(blood flow backward),
• Endocarditis

  • Painful infection of the endocardium, the membrane lining the inside of the heart.
  • If untreated, it can cause damage to the heart and heart valves.
  • Commonly caused by Staphylococcus, Streptococcus, and Neisseria gonorrhoeae.
  • Signs and Symptoms: flu-like, heart murmur, fatigue, shortness of breath, chest pain, night sweats, edema of legs and abdomen.
  • Most at risk are people with a history of heart problems and heart surgery.
• Anthrax

  • Caused by spore-forming Bacillus anthracis(Thermophile). There are 3 forms of anthrax
  • The toxin produced by the bacteria has multiple effects including
  • cell death
  • vascular integrity, lymph leaking out of blood vessels leading to hypotension and shock
  • Signs/Symptoms: severe flu-like, but if untreated in a timely manner, death is certain
  • People who work with animals have a higher probability of getting anthrax.
• Anthrax

  • Caused by spore-forming Bacillus anthracis(Thermophile). There are 3 forms of anthrax
  • Cutaneous(20% mortality) - Spores enter through cuts on the skin
  • Pulmonary (100% mortality) - Spores enter lungs
  • Gastrointestinal (50% mortality) - Spores are ingested (eat spores)
• Plague

  • Caused by Yersinia pestis, which lives in fleas(saliva). Fleas are parasites of rats, prairie dogs, squirrels, etc. Without timely treatment, death results in most cases.
  • Signs/Symptoms of plague are flu-like (ex. fever, chills), but also extreme weakness, abdominal pain, hemorrhage, shock and death.
  • Skin and other tissues may turn black and die, especially on fingers, toes, and the nose due to lack of blood supply.
• 3 Forms of the plagueBubonic

  • Transmitted via the bite of an infected flea
  • The infection spreads to lymph nodes which swell/becomes inflamed, forming a bubo.

  1. Pneumonic (high death rate) contagious

  • Lung infection due to inhalation of respiratory droplets from an infected person

  1. Septicemic (high death rate)

  • Both bubonic and pneumonic forms can lead to sepsis
• • Consequences of the Plague
  • The Black Death was believed by many Europeans to be a kind of divine punishment - retribution for sins against God.
  • Thousands of Jews were massacred in 1348 and 1349. Many fled to the sparsely populated regions of Eastern Europe, where they could be relatively safe from the ramping mobs.. until WW2.
  • Some people engaged in public displays of penance and punishment by flagellating themselves and one another with heavy lether straps studded with sharp pieces of metal while the townspeople looked on. For 33 1/2 days, the flagellants repeated this ritual 3 times a day.
• • plague and HIV
  • Some survivors of the European plague had genetic mutations that saved them from the plague.
  • Their genetic mutation causes their helper T cells to have amputated CCR5 receptor(glycoprotein), which is needed by both Yersinia pestis and HIV to enter the cell
  • Individuals with mutated CCR5 receptors were less likely to acquire HIV/AIDS.
• Tularemia

  • Caused by Francisella tularensis which is transmitted through (in Yosemite region) :
  • Bites of deer fly or ticks
  • Directly on a cut skin or on the eyes
  • Inhalation of bacterial particles
  • Ingestion of animals (ex. rabbits that are the natural reservoir of the bacteria)
  • Symptoms and signs: flu-like, swollen lymph nodes(bubo), ulcerative lesions
  • If untreated, has a mortality rate of 50%.
• Typhus

  • Issued in LA county a few years ago.
  • Caused by Rickkettsia sps. and is transmitted via:
  • Mites (scrub typhus)
  • Fleas (murine typhus)
  • Lice (epidemic typhus) - common
  • Symptoms of epidemic typhus: severe headache, high fever, the rash that begins on the back or chest and spreads, severe muscle pain, hypotension, photophobia, confusion, and stupor.
  • Without treatment, epidemic typhus can have a mortality rate of 50%.
  • Endemic and scrub typhus are milder than epidemic typhus.
• Rocky Mountain Spotted Fever

  • This Rickettsial disease is specifically transmitted by ticks
  • Symptoms/Signs: similar to typhus, but less pronounced: headache, fever, rash abdominal and joint pain, nausea, vomiting, muscle pain, loss of appetite, and diarrhea.
  • Although initially diagnosed around the rocky mountains, the disease is more common in the eastern and southern United States.
• Lyme Disease

  • Cause by a spirochete called Borrelia burgdorferi and is transmitted by the bit of the deer tick
  • Symptoms/signs: vary from asymptomatic to chronic fatigue, joint pain, neuropathic/cognitive disorders, and cardiovascular problems.
  • One sign of infection is the appearance of a bull’s rash that spreads from the bite site.
  • Pull out the tick(using Twizzer), then it is unlikely to have bacteria in you.
• Schistomiasis

  • Problematic for someone who lives in Egypt(especially around the Nile river)
  • Fluke(flatworm) disease primarily affects the poor in developing countries. The fluke targets the colon and urinary bladder
  • Signs/Symptoms: abdominal pain, blood in urine and stool, and bladder cancer.
  • Like leprosy, This is a debilitating disease rather than a fatal one.
  • cause bladder cancer…
• Lymphatic Filariasis (Elephantiasis)

  • Nematode (roundworm) disease transmitted by the bite of mosquitoes
  • The nematode lives in the lymphatic duct and prevents the normal flow of lymph, especially in the lower legs, causing edema(by blocking the lymphatic system) of the lower extremities(feet and legs) leading to swelling of the legs and the skin to thicken, sag and disfigured.
  • Doesn’t kill you, but hardens your life.
• Dengue Fever (break-bone fever)

  • Caused by a virus that is transmitted by the mosquito, Aedes egypti
  • Most cases are asymptomatic but about 5% experience fever, severe muscle and joint pain, headache and rashes, vomiting, and abdominal pain/diarrhea.
  • In rare cases, this can lead to dengue hemorrhagic fever(your immune system overreacts), shock, and death.
• Yellow Fever

  • Caused by a flavivirus in the same group as the dengue virus and is also transmitted by A.aegypti.
  • Originally endemic to tropical and subtropics of Africa(90% of cases) but now can be found in S.America
  • symptoms: mostly mild, but in some can include fever, muscle ache, nausea, loss of appetite, and photophobia. In more serious cases, extensive liver damage can occur leading to severe jaundice and hemorrhaging (fatality up to 50%)
  • FYI, the vaccine is available and effective(95%) and may confer immunity for up to 30 years.
• Epstein Barr Virus

  It is a ubiquitous human virus associated with:

  • Mononucleoisis (kissing disease)
  • Hodgkin’s lymphoma - Cancer of T lymphocytes
  • Burkitts lymphoma
  • Cancer of B lymphocytes
  • Occurs mainly in male children in Africa who are malnourished and have malaria
  • Nasopharyngeal carcinoma
  • Cancer of the nose/throat
  • Rare in the US but more prevalent in men of Southeast Asia and North African descent
• Malaria

  • Malaria has killed more humans that any other disease with an annual death toll of over 1 million people, mostly children
  • Caused by 5 pieces of plasmodium(organism that causes malaria) which are transmitted by female Anopheles mosquitoes.
  • In the body, the parasite attacks/reproduces first in the liver and then in the red blood cells.
  • Signs and symptoms: high fever, chills, body and headache, jaundice, anemia, nausea/vomiting, black urine.
  • Death due to blood clots in the brain and other viral organs AND due to accumulation of RBC toxins in the blood.
• Babeosis

  • Caused by the protozoan Babesia which is related to Plasmodium the cause of malaria.
  • Similar health problems as malaria (ex. headache, nausea, fever, dark urine, fatigue, and hemolytic anemia BUT unlike plasmodium, the protozoan is transmitted by ticks and does not invade the liver, only red blood cells.)
  • Half of those infected are asymptomatic, but in others malaise fatigue, low platelet counts, and anemia are common.
• Leishmaniasis

  • Caused by protozoan Leishmania sps. which are transmitted by the bite of a sand fly.
  • Signs/symptoms of the cutaneous form are skin bumps and ulcers that do not heal.
  • Signs of the visceral(organs) form include weight, both low RBC and WBC count, damage to the spleen and liver, and bone marrow