Lyceum of the Philippines University – Cavite Campus

Governors Drive, General Trias, Cavite, Philippines

Portfolio for the Infectious Diseases of the Skin and Eyes

In partial fulfillment for

GMPL23M - General Microbiology and Parasitology

Submitted by:
Abanes, Christine Mae G.
BSN - 203

Submitted to:
Ms. Regine Nicca Dela Torre
Professor

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 BACTERIAL
Skin: Cellulitis
Cellulitis is a common bacterial skin infection that affects the deeper layers of the
skin and the underlying tissues. It typically appears as a red, swollen, and tender area of
skin that may be warm to the touch.

Causative Agent:
Streptococcus pyogenes (also known as group A streptococcus)
Staphylococcus aureus
Streptococcus pneumoniae

Mode of Transmission:
Bacteria are most likely to enter broken, dry, flaky or swollen skin, such as through a
recent surgical site, cuts, puncture wounds, ulcers, athlete's foot or dermatitis.

Clinical Presentation:
1. Redness and swelling: The affected area of skin becomes red, swollen, and may feel
warm to the touch.
2. Pain and tenderness: The area may be tender or painful, especially when touched or
pressed.
3. Skin tightness: The skin may feel tight and stretched due to swelling.
4. Skin changes: The affected area may develop a glossy appearance, and the skin
texture may become pebbled or dimpled.
5. Fever and malaise: In some cases, cellulitis can cause systemic symptoms such as
fever, chills, and a general feeling of being unwell.

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Lab and Clinical Diagnosis:
• The diagnosis of cellulitis is primarily based on clinical evaluation by a healthcare
professional. They will examine the affected area, assess the signs and symptoms,
and consider the person's medical history.

• Laboratory tests such as blood cultures or wound cultures may be done to identify
the causative bacteria and guide treatment, especially if the infection is severe or
does not respond to initial treatment.

Treatment:
The treatment of cellulitis typically involves antibiotics to eliminate the bacterial
infection. The choice of antibiotics depends on the suspected causative agent and the
severity of the infection. In addition to antibiotics, other supportive measures may include:
1. Elevating the affected limb: If cellulitis affects the legs or arms, elevating the limb can
help reduce swelling.
2. Pain relief: Over-the-counter pain medications such as acetaminophen or nonsteroidal
anti-inflammatory drugs (NSAIDs) may be recommended to relieve pain and reduce
inflammation.
3. Warm compresses: Applying warm compresses to the affected area can help alleviate
discomfort and promote healing.
4. Rest and immobilization: If cellulitis affects a joint or limb, rest and immobilization may
be necessary to prevent further complications.

Control and Prevention:

1. Clean and protect wounds: Clean any cuts, scratches, or wounds promptly with soap
and water. Apply an antiseptic ointment and cover with a sterile bandage to prevent
bacteria from entering.
2. Moisturize dry skin: Dry and cracked skin can provide entry points for bacteria. Keep
the skin moisturized to maintain its integrity.
3. Avoid sharing personal items: Do not share items such as towels, razors, or clothing
that may have come into contact with infected skin.
4. Manage underlying conditions: Properly manage any chronic skin conditions, such as
eczema or athlete's foot.

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 Eyes: Bacterial conjunctivitis / Pink Eye
Bacterial conjunctivitis, commonly known as pink eye, is an infection of the
conjunctiva, which is the thin, transparent tissue that covers the white part of the eye and
lines the inside of the eyelids. It is called pink eye because it often causes redness and
inflammation of the conjunctiva, giving the eye a pink or reddish appearance.

Causative Agent:
Staphylococcus aureus
Haemophilus influenzae
Streptococcus pneumonia
Pseudomonas aeruginosa.

Mode of Transmission:
• Direct contact with infected eye secretions, such as from touching or rubbing the
eyes and then touching surfaces or objects that others may come into contact with.

• It can also be transmitted through sharing personal items.

Clinical Presentation:
1. Redness: The affected eye(s) appear pink or red due to inflammation of the conjunctiva.
2. Watery or pus-like discharge: The eye may produce a sticky, yellow or greenish
discharge, especially upon waking up in the morning.
3. Eye discomfort or itching: The eye(s) may feel itchy, gritty, or irritated.
4. Swelling of the eyelids: The eyelids may become swollen or puffy.
5. Sensitivity to light: Some individuals may experience sensitivity to bright light
(photophobia).

Lab and Clinical Diagnosis:

• Characteristic symptoms
• Physical examination of the eye

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 • A sample of the eye discharge may be collected and sent for culture and sensitivity
testing to identify the specific bacteria causing the infection and determine the most
effective antibiotic treatment.

Treatment:
The treatment of bacterial conjunctivitis typically involves the use of antibiotic eye
drops or ointments to eliminate the bacterial infection. Commonly prescribed antibiotics
for bacterial conjunctivitis include erythromycin, tobramycin, ciprofloxacin, or gentamicin.
1. Warm compresses: Applying warm compresses to the affected eye(s) can help soothe
discomfort and remove any crusts or discharge.
2. Artificial tears: Over-the-counter lubricating eye drops can provide relief from dryness
and irritation.
3. Avoidance of contact lenses: Contact lens wear may need to be temporarily
discontinued until the infection resolves to prevent further irritation and complications.

Control and Prevention:

1. Practice good hygiene: Wash hands thoroughly and frequently, especially before
touching the face or eyes.
2. Avoid touching or rubbing the eyes: This helps prevent the introduction of bacteria from
hands to the eyes.
3. Avoid sharing personal items: Do not share items such as towels, pillowcases, or eye
makeup that may come into contact with the eyes.
4. Proper contact lens hygiene: If using contact lenses, follow proper hygiene practices,
including regular cleaning and disinfection, as well as proper storage and replacement of
lenses.
5. Stay home: If diagnosed with bacterial conjunctivitis, it is advisable to stay home from
school or work until the infection has resolved or until cleared by a healthcare
professional.

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 VIRAL
Skin: Chicken Pox
It primarily affects children but can occur in people of all ages who have not been
vaccinated or previously infected with the virus. Chickenpox is characterized by a rash
that forms small, itchy blisters on the skin.

Causative Agent:
Varicella-zoster virus (VZV), which belongs to the herpesvirus family. It spreads
from person to person through respiratory droplets or direct contact with the fluid from the
blisters of an infected individual.

Mode of Transmission:
• Through respiratory droplets when an infected person coughs or sneezes.

• It can also spread through direct contact with the fluid from the blisters of an
infected person.

• Touching objects or surfaces contaminated with the virus and then touching the
face can lead to transmission.

Clinical Presentation:
1. Rash: The hallmark symptom of chickenpox is a red, itchy rash that progresses through
different stages. It usually begins as small, red spots that develop into fluid-filled blisters.
Over time, the blisters crust over and form scabs.
2. Itching: The rash is often accompanied by intense itching, which can be very
uncomfortable for the affected individual.
3. Fever: Chickenpox is typically associated with a mild to moderate fever, especially
during the initial days of the illness.
4. Fatigue and malaise: Many individuals experience fatigue, general discomfort, and a
feeling of being unwell.
5. Headache: Some people may have headaches, especially during the early stage of the
illness.

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Lab and Clinical Diagnosis:
• In most cases, chickenpox can be diagnosed based on its characteristic
symptoms, particularly the appearance of the rash.

• Laboratory tests are generally not required for routine cases. However, in certain
situations, such as for adults, pregnant women, or immunocompromised
individuals, blood tests may be conducted to confirm the diagnosis.

Treatment:
The treatment of chickenpox primarily focuses on relieving symptoms and
preventing complications. It typically involves:
1. Symptom relief: Over-the-counter medications such as acetaminophen (paracetamol)
can be used to reduce fever and alleviate discomfort. Calamine lotion or oatmeal baths
may help relieve itching.
2. Hydration: Encouraging the affected individual to drink plenty of fluids helps prevent
dehydration, especially if there is a fever.
3. Avoid scratching: It is important to avoid scratching the blisters to prevent secondary
bacterial infections and scarring. Keeping fingernails short and clean can help minimize
scratching.
4. Isolation: Infected individuals should be isolated and avoid close contact with others,
particularly individuals who are at high risk of severe complications, such as pregnant
women, newborns, and immunocompromised individuals.

Control and Prevention:

1. Isolation: Individuals with chickenpox should avoid contact with others until all the
blisters have crusted over.
2. Hygiene practices: Frequent handwashing with soap and water, especially after contact
with an infected person or their belongings, can help reduce the risk of transmission.
3. Vaccination of susceptible individuals: non-immune individuals who have been
exposed to chickenpox may be eligible for post-exposure prophylaxis with the varicella
vaccine or varicella-zoster immune globulin (VZIG), depending on the situation and
individual risk factors.

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 Eye: Viral Conjunctivitis
Viral conjunctivitis, also known as "pink eye," is an inflammation of the conjunctiva
caused by a viral infection. It is a common condition that can affect one or both eyes. Viral
conjunctivitis is highly contagious and spreads easily, especially in crowded places such
as schools or offices.

Causative Agent:
Adenoviruses.
Herpes simplex virus (HSV),

Mode of Transmission:
• Direct contact with infected eye secretions.

• Touching surfaces or objects that have been contaminated by the virus and then
touching the eyes.

Clinical Presentation:
1. Redness: The affected eye(s) appears pink or red due to inflammation of the
conjunctiva.
2. Watery discharge: Viral conjunctivitis often causes excessive tearing and a watery
discharge from the eyes.
3. Itching and irritation: The eyes may feel itchy, irritated, or have a foreign body
sensation.
4. Swelling: The eyelids may become swollen, puffy, or slightly tender to the touch.
5. Sensitivity to light: Some individuals may experience increased sensitivity to light
(photophobia).

Lab and Clinical Diagnosis:

• The diagnosis of viral conjunctivitis is primarily based on clinical evaluation and the
characteristic symptoms.
• Other samples from the eye may be taken for viral culture.
• Polymerase chain reaction (PCR) testing.

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Treatment:
Viral conjunctivitis is typically a self-limiting condition, and the treatment mainly
focuses on managing the symptoms and preventing the spread of infection. The following
measures can be helpful:
1. Symptom relief: Over-the-counter lubricating eye drops, or artificial tears can provide
relief from dryness, discomfort, and irritation. Cool compresses may also help soothe the
eyes.
2. Hygiene practices: To prevent spreading the infection, individuals should frequently
wash their hands, avoid touching or rubbing their eyes, and use separate towels and
bedding. It is advisable to refrain from wearing contact lenses until the infection has
resolved.
3. Avoidance of irritants: Individuals with viral conjunctivitis should avoid exposure to
irritants such as smoke, dust, and strong chemicals, as these can worsen symptoms.

Control and Prevention:

1. Practice good hygiene: Wash hands frequently with soap and water, especially before
touching the face or eyes.
2. Avoid touching or rubbing the eyes: This helps prevent the introduction of viruses from
hands to the eyes.
3. Avoid sharing personal items: Do not share items such as towels, pillowcases, or eye
makeup that may come into contact with the eyes.
4. Cover coughs and sneezes: Use tissues or the crook of the elbow to cover the mouth
and nose when coughing or sneezing to prevent respiratory droplets from spreading the
infection.
5. Stay home: Individuals with viral conjunctivitis should avoid school, work, or public
places until the infection has resolved or until cleared by a healthcare professional.

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 FUNGAL
Skin: Ringworm
Ringworm, also known as dermatophytosis, is a common fungal infection that
affects the skin, scalp, and nails. Despite its name, ringworm is not caused by a worm but
rather by various types of fungi called dermatophytes. It can appear as a circular or ring-
shaped rash on the skin, which is how it got its name.

Areas of the body that can be affected by ringworm include:

• Feet (Tinea pedis)
• Groin (Tinea cruris)
• Scalp (Tinea capitis)
• Beard (Tinea barbae)
• Hands (Tinea manuum)
• Toenails or fingernails (Tinea ungnuium)
• Arms or legs (Tinea corporis)

Mode of Transmission:
• From a person who has ringworm

• From an animal that has ringworm

• From the environment

Clinical Presentation:
1. Circular rash: The rash typically appears as a red, scaly, and raised circular patch on
the skin. The edges may be slightly raised and have a clearer center, giving it a ring-like
appearance.
2. Itching and discomfort: The affected area may be itchy, causing discomfort and
irritation.
3. Scaling and flaking: The rash may develop scales or small blisters that can break open
and lead to crusting or oozing.
4. Hair loss (if on the scalp): When ringworm affects the scalp, it can cause patchy hair
loss, leaving bald spots or broken hairs close to the scalp.

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5. Nail changes (if on the nails): Ringworm can affect the nails, causing them to become
thickened, discolored, brittle, or crumbly.

Lab and Clinical Diagnosis:

• The diagnosis of ringworm is usually based on the appearance of the rash and a
physical examination.

• In some cases, a healthcare professional may perform a skin scraping or nail

clipping to obtain a sample for microscopic examination or fungal culture.

Treatment:
The treatment of ringworm typically involves antifungal medications, which can be applied
topically or taken orally, depending on the location and severity of the infection. Commonly
used antifungal agents include:
1. Topical antifungals: Over-the-counter antifungal creams, ointments, or sprays
containing active ingredients such as clotrimazole, miconazole, or terbinafine can be
effective for mild cases of ringworm.
2. Oral antifungals: In more severe or widespread cases, or when the infection affects the
scalp or nails, oral antifungal medications such as terbinafine, griseofulvin, or itraconazole
may be prescribed.

Control and Prevention:

1. Maintain good hygiene: Regularly wash your hands with soap and water, especially
after touching animals or coming into contact with potentially contaminated surfaces.
2. Avoid sharing personal items: Do not share items such as clothing, towels, hairbrushes,
or combs with others, particularly if they have a known fungal infection.
3. Keep the skin clean and dry: Fungi thrive in warm and moist environments, so keeping
the skin dry can help prevent infection.
4. Wear appropriate footwear: When in public areas with a higher risk of fungal
contamination, such as locker rooms or communal showers, wear sandals or other
protective footwear.
5. Treat pets: If your pet has signs of a fungal infection, consult a veterinarian for
appropriate treatment to prevent transmission to humans.

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 Eye: Fungal Keratits

Fungal keratitis is a serious fungal infection of the cornea, which is the transparent
front part of the eye. It occurs when fungi invade the corneal tissue, leading to
inflammation, ulceration, and potential vision loss if left untreated. Fungal keratitis is
considered a sight-threatening condition and requires prompt medical attention.

Causative Agents:
Fungal keratitis is primarily caused by filamentous fungi, such as Fusarium species and
Aspergillus species. However, other fungi like Candida species and yeast-like fungi can
also be responsible for this condition. The specific causative agent may vary depending
on the geographical region.

Mode of Transmission:
• Trauma

• Warmer climates = Prevalence of filamentous fungi

• Debilitated or immunocompromised patients

• Contact lens use

Clinical Presentation:
1. Eye pain: The affected eye is often painful, with varying degrees of severity.
2. Redness and inflammation: The eye appears red, and there may be swelling and
inflammation of the eyelids.
3. Blurred vision: Vision may become blurry or hazy.
4. Photophobia: Sensitivity to light is commonly experienced.
5. Eye discharge: There may be a discharge from the eye, which can be watery or pus-
like.
6. Corneal ulceration: Fungal keratitis often leads to the formation of a corneal ulcer, which
appears as a white or grayish area on the cornea.

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Lab and Clinical Diagnosis:
1. Slit-lamp examination: This allows detailed visualization of the cornea, revealing
characteristic features like infiltrates, ulcers, and fungal filaments.
2. Corneal scrapings: A sample of the corneal tissue or discharge may be collected for
laboratory analysis, including microscopic examination, culture, and identification of the
causative fungus.

Treatment:
1. Antifungal eye drops: Topical antifungal medications, such as natamycin or
voriconazole, are often the mainstay of treatment. The eye drops need to be administered
frequently and for an extended duration.
2. Systemic antifungal medication: In severe cases or when the infection is not responding
to topical treatment, oral antifungal medication (e.g., voriconazole or itraconazole) may
be prescribed to enhance treatment efficacy.
3. Corneal debridement: Surgical debridement of the infected corneal tissue may be
necessary to remove the fungal elements and facilitate the penetration of antifungal
medications.
4. Amniotic membrane transplantation: In some cases, a transplantation of amniotic
membrane onto the cornea may be performed to promote healing and reduce
inflammation.
5. Close monitoring: Regular follow-up appointments with an ophthalmologist are crucial
to monitor the response to treatment and assess the need for any adjustments.

Control and Prevention:

1. Proper contact lens hygiene: Follow strict hygiene practices when handling and caring
for contact lenses, including regular cleaning, disinfection, and proper storage.
2. Avoidance of risky behaviors: Avoid wearing contact lenses while swimming or in
environments with a higher risk of fungal contamination, such as hot tubs or saunas.
3. Protection from eye injuries: Use appropriate eye protection (e.g., goggles or face
shields) during activities that may pose a risk of eye trauma.
4. Avoidance of contaminated materials: Take precautions when working with soil, plants,
or other materials that may carry fungal spores.
5. Prompt treatment of eye infections: Seek medical attention at the earliest signs of any
eye infection and follow the prescribed treatment plan diligently.

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 PARASITIC
Skin: Leishmaniasis
Leishmaniasis is a vector-borne disease caused by the Leishmania parasite. It is
transmitted through the bites of infected female sandflies, which are tiny blood-feeding
insects. Leishmaniasis can affect humans and animals and is found in different parts of
the world, including tropical and subtropical regions.
There are several forms of leishmaniasis, including visceral leishmaniasis cutaneous
leishmaniasis, and mucocutaneous leishmaniasis.

Causative Agent:
Leishmaniasis is caused by various species of the Leishmania parasite, including
Trypanosomatida genus Leishmania.

Mode of Transmission:
• Leishmaniasis is primarily transmitted through the bites of infected female
sandflies belonging to the Phlebotomus and Lutzomyia genera.

• When an infected sandfly bites a human or animal host, it injects the Leishmania
parasites into the skin. The parasites then invade immune cells and replicate within
them, causing infection.

Clinical Presentation:
1. Visceral leishmaniasis: This form affects internal organs such as the spleen, liver, and
bone marrow. Symptoms include prolonged fever, weight loss, fatigue, enlarged liver and
spleen (hepatosplenomegaly), anemia, and a compromised immune system. If left
untreated, visceral leishmaniasis can be fatal.
2. Cutaneous leishmaniasis: It manifests as skin lesions, usually localized at the site of
the sandfly bite. The skin lesions can be single or multiple, and they may develop slowly
over weeks or months. They can be ulcerative, nodular, or papular in appearance and
often heal spontaneously, leaving scars.
3. Mucocutaneous leishmaniasis: This form affects the skin and mucous membranes. It
typically starts with a skin lesion that progresses to involve the mucous membranes of the
nose, mouth, or throat. Mucocutaneous leishmaniasis can cause disfigurement and
severe damage to the affected areas.

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Lab and Clinical Diagnosis:
The diagnosis of leishmaniasis involves a combination of clinical evaluation, microscopic
examination, and laboratory tests. These may include:
1. Microscopic examination: A sample (such as a skin biopsy or aspirate from a lymph
node or bone marrow) is collected and examined under a microscope to detect the
presence of Leishmania parasites.
2. Serological tests: Blood samples may be tested for the presence of antibodies against
Leishmania parasites, although these tests are primarily used for epidemiological
purposes and may not be reliable for individual diagnosis.
3. Molecular techniques: Polymerase chain reaction (PCR) tests can be used to detect
the genetic material of Leishmania parasites in clinical samples, providing accurate and
specific diagnosis.

Treatment:
The treatment of leishmaniasis depends on the form and severity of the disease. It may
involve the use of antiparasitic medications, such as:
1. Sodium stibogluconate
2. Amphotericin B
3. Miltefosine
4. Liposomal amphotericin B

Control and Prevention:

1. Vector control: Reducing the population of sandflies through insecticide spraying, use
of bed nets, and environmental modification.
2. Personal protection: Using insect repellents, wearing protective clothing (long sleeves,
pants), and sleeping under bed nets in endemic areas.
3. Reservoir control: Identifying and treating infected animals (such as dogs) to reduce
the reservoir of Leishmania parasites.
4. Health education: Raising awareness about the disease, its transmission, and
preventive measures among affected communities and healthcare providers.
5. Early diagnosis and treatment: Prompt diagnosis and treatment of infected individuals
to prevent complications and reduce the transmission of the disease.

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 Eyes: Acanthamoebiasis
Acanthamoebiasis is a rare but serious infection caused by the Acanthamoeba
parasite. Acanthamoeba is a microscopic amoeba commonly found in soil, water (such
as lakes, swimming pools, and hot tubs), and other environments. While most people
come into contact with Acanthamoeba at some point, it rarely causes infection. However,
under certain circumstances, it can lead to severe illness.

Causative Agent:
Acanthamoebiasis is caused by the Acanthamoeba parasite, specifically the species
Acanthamoeba castellanii and Acanthamoeba polyphaga.

Mode of Transmission:
• Acanthamoebiasis is typically acquired through exposure of the skin, eyes, or
respiratory tract to contaminated water or soil.

• Wound or a cut, or through contact with the eyes or inhalation of contaminated

dust or aerosols.

Clinical Presentation:
1. Acanthamoebic keratitis: This is the most common form of acanthamoebiasis. It affects
the cornea of the eye and typically occurs in individuals who wear contact lenses.
Symptoms include severe eye pain, redness, blurred vision, sensitivity to light, excessive
tearing, and the feeling of a foreign body in the eye.
2. Acanthamoebic granulomatous encephalitis (AGE): This is a rare but severe form of
acanthamoebiasis that affects the central nervous system. It occurs when the parasites
enter the brain or spinal cord. Symptoms may include headache, fever, nausea, vomiting,
stiff neck, confusion, seizures, and neurological deficits.
3. Cutaneous acanthamoebiasis: Infection of the skin can lead to the formation of skin
lesions, ulcers, or abscesses. This form of acanthamoebiasis is more common in
individuals with weakened immune systems.

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Lab and Clinical Diagnosis:
1. Clinical evaluation: A thorough examination of symptoms, medical history, and risk
factors is important in suspecting acanthamoebiasis.
2. Microscopic examination: Samples of affected tissues, such as corneal scrapings or
skin biopsy specimens, may be examined under a microscope for the presence of
Acanthamoeba trophozoites or cysts.
3. Molecular tests: Polymerase chain reaction (PCR) tests can be used to detect the
genetic material of Acanthamoeba parasites in clinical samples, providing a more specific
diagnosis.
4. Imaging studies: In cases of suspected central nervous system involvement, imaging
studies such as magnetic resonance imaging (MRI) may be performed to evaluate brain
abnormalities.

Treatment:
1. Medications: Antimicrobial medications, such as chlorhexidine, propamidine
isethionate, and hexamidine, are commonly used to treat acanthamoebic keratitis. In
cases of central nervous system involvement, medications like miltefosine, pentamidine,
and azoles may be prescribed.
2. Supportive care: Treatment may involve supportive measures to manage symptoms
and prevent complications, such as pain management, wound care, and monitoring of
neurological status.
3. Contact lens care: In cases of acanthamoebic keratitis, proper care and hygiene of
contact lenses are essential. This includes disinfection and cleaning as per the healthcare
provider's instructions.

Control and Prevention:

1. Proper contact lens hygiene: Follow strict hygiene practices when handling and caring
for contact lenses, including regular cleaning, disinfection, and proper storage.
2. Avoidance of risky water sources: Avoid exposing contact lenses or eyes to potentially
contaminated water sources, such as hot tubs, swimming pools, or non-sterile water.
3. Protection from eye injuries: Use appropriate eye protection (e.g., goggles) during
activities that may pose a risk of eye trauma or exposure to contaminated water.
4. Education and awareness: Healthcare providers and individuals at risk should be
educated about the importance of good contact lens hygiene.

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