Infectious Disease - Pathogenesis, Prevention, and Case Studies

691 Pages·2009·78.73 MB·English

by  Nandini Shetty

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Infectious Disease:
Pathogenesis, Prevention,
and Case Studies
N. Shetty
Department of Clinical Microbiology,
University College London Hospitals
J.W. Tang
Division of Microbiology/Molecular Diagnostic Centre,
Department of Laboratory Medicine,
National University Hospital,
Singapore
J. Andrews
Department of Clinical Microbiology,
University College London
A John Wiley & Sons, Ltd., Publication
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Infectious Disease:
Pathogenesis, Prevention,
and Case Studies
N. Shetty
Department of Clinical Microbiology,
University College London Hospitals
J.W. Tang
Division of Microbiology/Molecular Diagnostic Centre,
Department of Laboratory Medicine,
National University Hospital,
Singapore
J. Andrews
Department of Clinical Microbiology,
University College London
A John Wiley & Sons, Ltd., Publication
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This edition first published 2009, © 2009 by N. Shetty, J.W. Tang and J. Andrews
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Library of Congress Cataloguing-in-Publication Data
Shetty, N. (Nandini)
Infectious disease : pathogenesis, prevention, and case studies / N. Shetty, J.W. Tang, J. Andrews.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4051-3543-6 (hardcover : alk. paper) 1. Communicable diseases. I. Tang, J.W. (Julian W.)
II. Andrews, J. (Julie) III. Title.
[DNLM: 1. Communicable Diseases–etiology. 2. Communicable Disease Control–methods.
WC 100 S554i 2009]
RC111.S458 2009
616.9–dc22
2008042548
ISBN: 9781405135436
A catalogue record for this book is available from the British Library.
Set in 11/13pt Bembo by Graphicraft Limited, Hong Kong
Printed and bound in Malaysia
1 2009
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Contents
Editors and Contributors, iv
Preface, v
Glossary of abbreviated terms, vii
PART 1 GENERAL PRINCIPLES OF INFECTIOUS DISEASES, 1
1 Microbial etiology of disease N. Shetty, E. Aarons, J. Andrews, 3
2 Structure and function of microbes N. Shetty, E. Aarons, J. Andrews, 15
3 Host defence versus microbial pathogenesis and the mechanisms of microbial escape
N. Shetty, E. Aarons, J. Andrews, 41
4 Diagnosis of microbial infection N. Shetty, M. Wren, E. Aarons, J. Andrews, 85
5 General principles of antimicrobial chemotherapy N. Shetty, E. Aarons, J. Andrews, 124
6 Basic concepts of the epidemiology of infectious diseases N. Shetty, 157
PART 2 A SYSTEMS BASED APPROACH TO INFECTIOUS DISEASES, 177
7 Infections of the skin, soft tissue, bone, and joint N. Shetty, J.W. Tang, 179
8 Gastroenteritis N. Shetty, J.W. Tang, 212
9 Cardiac and respiratory tract infections N. Shetty, J.W. Tang, J. Andrews, 238
10 Infections of the central nervous system N. Shetty, J.W. Tang, 271
11 Infections of the genitourinary system N. Shetty, R. Smith, 294
PART 3 INFECTIONS IN SPECIAL GROUPS, 333
12 Obstetric, congenital and neonatal infections N. Shetty, J.W. Tang, J. Andrews, 335
13 Infections in the immunocompromised host D. Mack, N. Shetty, 363
14 Healthcare associated infections N. Shetty, 393
15 The fever and rash conundrum: rashes of childhood J.W. Tang, 414
PART 4 INFECTIONS OF GLOBAL IMPACT, 435
16 Tuberculosis S. Srivastava, N. Shetty, 437
17 Malaria D. Mack, 458
18 Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome
(AIDS) J.W. Tang, 476
19 Viral hepatitis J.W. Tang, 491
20 Influenza J.W. Tang, P.K.S. Chan, 506
21 Infections in the returning traveler N. Shetty, 521
PART 5 EMERGING AND RESURGENT INFECTIONS, 551
22 Viral hemorrhagic fevers J.W. Tang, 553
23 Emerging infections I (human monkeypox, hantaviruses, Nipah virus, Japanese
encephalitis, chikungunya) J.W. Tang, 567
24 Emerging infections II (West Nile virus, dengue, severe acute respiratory
syndrome-associated coronavirus) J.W. Tang, P.K.S. Chan, 583
25 Diphtheria N. Shetty, 599
26 Agents of bioterrorism J.W. Tang, 607
Answers to test yourself questions, 627
Index, 647
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Editors and Contributors
N. Shetty
Consultant Microbiologist and Honorary Senior Lecturer, Department of Clinical Microbiology, University
College London Hospitals
J.W. Tang
Consultant Virologist, Division of Microbiology/Molecular Diagnostic Centre, Department of Laboratory
Medicine, National University Hospital, Singapore
J. Andrews
Consultant Microbiologist, Department of Clinical Microbiology, University College London
E. Aarons
Consultant Virologist, University College London, UK
P.K.S. Chan
Professor, Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital,
Hong Kong
D. Mack
Consultant Microbiologist, Barnet & Chase Farm Hospitals, London, UK
R. Smith
Consultant Microbiologist, The Royal Free Hospital, London, UK
S. Srivastava
Specialist Registrar in Microbiology, Royal Devon and Exeter Hospitals, Exeter, Devon, UK
M. Wren
Consultant Biomedical Scientist, University College London Hospitals, UK
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Preface
Infectious Disease: Pathogenesis, Prevention, and Case Studies is a new textbook written in the modern era of
widespread and ready access to internet resources. The book is aimed at university students with interest in
infectious diseases. The level of the text is at an intermediate to senior undergraduate college level and will
give the student a sense of the many areas of infectious disease in which he/she may want to specialize
further, e.g. an infectious disease clinician, a public health physician, a basic science researcher, or perhaps
even a medical journalist specializing in infectious diseases.
Topics covered include hospital-acquired infections, emerging and re-emerging infections, infections in
the immunocompromised, in pregnancy and in children. The multidisciplinary text makes it suitable for
clinical (and perhaps some more basic) microbiology, public health and infectious disease epidemiology
courses. A special feature is the extensive use of illustrative clinical cases (many of them based on real cases
seen by the authors), which have been included to reinforce some of the concepts touched upon in that
chapter.
The text is organized into chapters on infections of specific organ systems as well as chapters on specific
organisms. This has been done to allow the text to be used on a wide variety of different courses, as well as
by different student learning strategies. The style as well as the detail of the text varies from chapter to
chapter, reflecting the specialties of the individual authors, but also includes standard items, i.e. sections on
epidemiology, pathogenesis, clinical features, diagnosis and treatment, as well as Q&A sections (with answers
in the back) and boxes describing specific areas of interest and relevance in each chapter theme. Other boxes
are designed to encourage students to think about certain issues, and here, answers are not provided and the
student is encouraged to read further.
The textbook is sufficient for a complete course in infectious diseases, covering all the major pathogen
groups (i.e. bacteria, fungi, parasites, and viruses). It can also be used in specialist modules that may
last only one or two semesters, e.g. on hospital-acquired infections, emerging infections, infections of
childhood, pregnancy, returning travelers, or the immunocompromised. Teaching can be organized at an
organ system level, with specialist modules on specific organisms, e.g. respiratory infections with further
detail in a chapter on influenza or infections of the immunocompromised with a specialist chapter on HIV.
Although there is extensive cross-referencing between the chapters, each chapter has been written to also
stand alone, and the book does not necessarily need to be read in the order in which the chapters are
presented.
Since the worldwide severe acute respiratory syndrome (SARS) outbreaks of 2003, the ongoing
HIV/AIDS pandemic, and the more recent preparedness for a possibly approaching influenza pandemic,
internet resources for infectious diseases have become invaluable for tracking and updating information on
infectious diseases worldwide. These include comprehensive, easily navigated websites at the Center for
Disease Control and Prevention (CDC: http://www.cdc.gov/), the World Health Organization (WHO:
http://www.who.int/), and email alert systems like ProMED (http://www.promedmail.org/). In addition,
there are now excellent online medical resources, such as eMedicine (www.emedicine.com/) and Medscape
(www.medscape.com/).
This text incorporates some of these online resources as part of the recommended ‘Further Reading’ in
many of the chapters, as it is understood by the authors that the reference journal articles and textbooks,
which are also listed, may be less accessible to many readers.
In addition, many of the images used in the book are from freely available online resources, particularly
the CDC Public Health Image Library (http://phil.cdc.gov/phil/home.asp), which allows students to
download such images (after having been directed to them by the main text) for their own use, either as
revision and aidé-memoirs, or for their own presentations. A CD is also included containing other images
created specially for this book for similar purposes.
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vi Preface
This text has been reviewed by teaching staff at many universities. The authors have taken the
feedback/comments seriously and made appropriate amendments to the text to enhance its quality for both
accuracy and student teaching.
Nandini Shetty, Julie Andrews (University College London)
Julian Tang (National University Hospital, Singapore)
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Glossary of abbreviated terms
AAC N-acetyltransferases
AAD antibiotic associated diarrhea
Ab antibody
ADCC antibody-dependent cellular cytotoxicity
ADE antibody-dependent enhancement
ADEM acute disseminated encephalomyelitis
ADPR adenine diphosphate ribose
AIDS acquired immune deficiency syndrome
ALT alanine amino transferase
ANT O-adenyltransferases
APC antigen presenting cell
APH O-phosphotransferases
ARDS acute respiratory distress syndrome
ART antiretroviral therapy
ASP amnesic shellfish poisoning
ATP adenosine triphosphate
ATS American Thoracic Society
AZT azidothymidine
BAL bronchoalveolar lavage
BBB blood–brain barrier
BCG Bacille Calmette Guerin
BCYE buffered charcoal yeast extract
BL Biosafety Level
BOOP bronchiolitis obliterans organizing pneumonia
BSAC British Society for Antimicrobial Chemotherapy
BSE bovine spongiform encephalopathy
BSI bloodstream infections
BTWC Biological and Toxin Weapons Convention
BV bacterial vaginosis
CAP community acquired pneumonia
CCHF Crimean-Congo hemorrhagic fever
CDC Centers for Disease Control and Prevention
CF cystic fibrosis
CFA colonizing factor antigen
CGD chronic granulomatous disease
CLSI Clinical and Laboratory Standards Institute
CMV cytomegalovirus
CNS central nervous system
CoNS coagulase negative staphylococci
COPD chronic obstructive pulmonary disease
CoV coronaviruses
CPE cytopathic effect
CRC congenital rubella syndrome
CRF circulating recombinant forms
CRP C reactive protein
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viii Glossary of abbreviated terms
CSF cerebrospinal fluid
CSF colony-stimulating factor
CT computed tomography
CTL cytotoxic T lymphocytes
CVS congenital varicella syndrome
CWD chronic wasting disease
d4T stavudine
DAP diaminopimelic acid
DDC zalcitabine
DDI didanosine
DDT dichloro-diphenyl-trichloroethane
DFA direct fluorescent assay
DHF dengue hemorrhagic fever
DHF dihydrofolate
DIC disseminated intravascular coagulation
DIN Deutsches Institut für Normung (English: the German Institute for Standardization)
DNA deoxyribonucleic acid
DSP diarrheic shellfish poisoning
dsRNA double-stranded ribonucleic acid
DSS dengue shock syndrome
DTH delayed-type hypersensitivity
EAEC entero-aggregative E. coli
EB elementary body
EBV Epstein–Barr virus
ECL electrochemiluminescence
EEG electroencephalography
EF elongation factor
EGD esophagogastroduodenoscopy
EHEC enterohemorrhagic E. coli
EIA enzyme-linked immunoassay
EIEC enteroinvasive E. coli
EKG electrocardiogram
ELISA enzyme-linked immunosorbent assay
ELONA enzyme-linked oligonucleotide assay
EM electron microscopy
EPEC entero-pathogenic E. coli
EPP exposure-prone procedures
ER emergency room
ESBL extended spectrum beta-lactamase
ET exfoliatin toxin
ETEC entero-toxigenic E. coli
EV enterovirus
FDA Food and Drug Administration
FPA fluorescence polarization assay
FRET fluorescence (or Forster) resonance energy transfer
G6PD glucose-6-phosphate dehydrogenase deficiency
GABHS group A beta-hemolytic streptococci
GBS group B beta-hemolytic streptococci
G-CSF granulocyte-colony stimulating factor
GE gastroenteritis