CRYPTOCOCCOSIS

Cryptococcus neoformans is encapsulated yeast that can cause menigo encyptylatis

in normal individuals but more frequently in patient with leukeaemia, lymphoma
and systemic lupus erythematosis.
PATHOGENESIS: C.neoformans is present in the soil and in birds particularly pigeons
droppings and infect patient when it is inhaled. 3 properties of C.neoformans are
associated with virulence
1. The capsular polysaccharide
2. Resistance to killing by alveolar macrophages.
3. Production of phenol oxidase. (This enzyme oxidase)
Consume host epinephrine in the synthesis of fungi melanin hence protecting the
fungi from the epinephrine oxidative system present in the host nervous system.
One reason that C.neoformans preferentially infects the brain may be that the CSF
lacks alternative pathway complement component that binds to the carbohydrate
capsule and phagocytize and killing by polymorph nuclear cells.
VIRAL HEPATITIS
The general term virus Hepatitis applies to the liver infection caused by several
unrelated viruses. Two types were initially recognized (A&B). HA is transmitted
through faecal oral route. HB is parenteral route (blood, body fluids) viral hepatitis is
a systemic infection characterized by inflammation and necrosis of the liver.
HEPATITIS A

STRUCTURE AND CLASSIFICATION:- Small non-enveloped, single stranded

RNA virus. It is relatively resistant to ether, to heating at 60 oc for 1 hour and
to acidic condition below pH of 3. It can be inactivated by formalin, it can
remain viable for fairly long period in the environment e.g on kitchen cutting
board. HAV has been classify as enterovirus Type.72 pa only / serotype has
been identity
PATHOGENESIS:- HAV enters body through ingestion it infect the intestinal
epithelium, multiply there and spread through the blood stream to the liver
which is the principal target organ. Beginning as early as 10-14days, virus is
shed copiously in the faeces. Faecal shedding continues into acute phase and
usually ceases at about time jaundice develop. The liver is the only organ
that shows pathologic changes during infection with HA.
EPIDEMIOLOGY:- HAV also called infectious Hepatitis is endemic throughout
the world and causes frequent minor or major outbreak HA is spread by the
feacal-oral route most commonly person to person contact via food or water.
Epidemics are encouraged by condition of overcrowding and poor sanitation.
Common source outbreak are most commonly due to water or food
contaminated by food handler who is shedding virus in the faeces during the
incubation, water borne transmission is not common in industrialized
countries. More often outbreaks can be traced to uncooked food or food that
has been handled after being cooked.

DIAGNOSIS:- Clinically hepatitis resemble other types of viral hepatitis

various serologic test are used to make diagnosis and they include
immunoelectron microscopy, complement fixation, immune adherent
Haemoglutination, Radioimmuno assay, ELISA .
immune adherent haemaglutination is only moderately specific and sensitive.
ELISA is used now (more specific & sensitive) because isolation of the virus in
tissue culture require prolong adaptation therefore not suitable for use.
Prevention and control:- No specific treatment for HA, spread of the disease
can be reduced by simple hygienic measure and sanitary disposal of excreta.
HEPATITS B
Structure and classification:- Belongs to the Hepadnaviridae with a circular.
DNA genome, The envelope an icosahedral core particles that contains the
genome in association with an endogenous DNA dependent DNA polymerase.

In addition to the 42nm complex virion 3 serological markers are detectable in

the blood of patient with HB
1. HB surface antigen which is associated with 22nm spherical particles
(HBsAntigen)
2. The second antigen is the core antigen (HBcAntigen) which usually illicit
the production of core antibody (Anti-HBc)
3. Soluble core antigen known as e antigen (HBeAntigen).
this antigen and its corresponding anti HBe antibody correlate closely with
a number of virus particles and the relative infectivity of serum containing
(HBsAntigen)
There are atleast 10 subtypes of HBvirus based on serologic analysis of HBsA, HBsA
generally carry a common group specific determinant (a) and usually at least 2
mutually exclusive sub determinants, determinant d or y and w or r. The subtypes
are the phenotypic expression of the distinct genotype variant of the virus. 4
principle phenotypes are recognized adw, adr, ayw, ayr
PATHOGENESIS:- HB formally called serum hepatitis is transmitted parenteral the

virus can be transmitted by various body fluid (blood, saliva, menstrual and vaginal
discharges, serum exudates, semen and breast milk). Blood is the most infectious
from the site of inoculation. The virus travels in the blood stream to the liver where
it infects cells and multiplies.
Factors that correlate with chronic disease include anicteric (jaundice), mild
infection, long incubation period, immunosuppression genetic predisposition and
infection early in childhood.