Infectious diseases

A.Y. 2021/2022
6
Max ECTS
72
Overall hours
SSD
BIO/14 MED/17
Language
English
Learning objectives
The course provides students with knowledge about infectious diseases and the principles of antimicrobial therapy. The student is introduced to the patophysiology, the clinical presentation, the course, the epidemiology and the principles of drug therapy of bacterial, viral, fungal and parasitic infectious diseases of different organs and systems. Vector-borne and emerging/neglected diseases will be also addressed.
Expected learning outcomes
At the end of the course, students should be able to:
-Describe how a patient's social history (travel, HIV risk factors, exposures) can have a significant impact on the differential diagnosis and management of infections
-Describe and analyse a broad range of major syndromes including community and hospital-acquired pneumonia, infective endocarditis, cellulitis, urinary tract infections and the evaluation of fever
-Apply diagnostic services including gram stain and culture, antimicrobial sensitivity testing and other standard microbiology lab techniques
-Discuss and appropriately apply the basic principles of infection control such as contact or respiratory isolation and contact tracing
-Describe exposure to critically ill patients and immunosuppressed patients, as well as an understanding of their specific spectrum of diseases
Course syllabus and organization

Single session

More specific information on the delivery modes of training activities for academic year 2021/22 will be provided over the coming months, based on the evolution of the public health situation.
Prerequisites for admission
To take the Infectious Diseases exam, students must have already passed all the exams of the first and second year (Fundamentals of Basic Sciences, Cells, Molecules and Genes 1 and 2, Human Body, Functions and Mechanisms of Diseases).
Assessment methods and Criteria
Student assessment is based on oral examinations of Pharmacology and Infectious Diseases, that must be taken in the same session. Students will be assessed on all topics listed in the "expected outcomes" of the present syllabus. The final mark is the average of the two oral marks weighted for the credits of each module.
The exam is deemed to be passed successfully if the final grade is equal to or higher than 18/30. In the event of a full grade (30/30) honors (cum laude) may be granted with the consent of all the professors.
During the course we are also planning one or maximum two tests focused on the items presented thus far aimed at understanding the level of the students on the subjects discussed.
Infectious diseases
Course syllabus
MAIN TOPICS
TOPIC 1. ID - Introduction to Infectious Diseases
TOPIC 2. ID - The Respiratory System part 1
Upper respiratory tract infections
TOPIC 3. ID - The Respiratory System part 2
Community-acquired pneumonia
Hospital-acquired pneumonia
Tuberculosis
TOPIC 4. ID - The Respiratory System part 3
Influenza
COVID-19
TOPIC 5. ID - Viral exanthems
TOPIC 6. ID - Skin and soft tissue (SST) infections
TOPIC 7. ID- The Gastrointestinal (GI) System part 1
Infectious diarrohea
C. difficile infection
TOPIC 8. ID - The Gastrointestinal (GI) System part 2
Viral hepatitis
TOPIC 9. Pharm - General principles of antimicrobial therapy
TOPIC 10. Pharm - Antibiotic classification
TOPIC 11. Pharm - General principles of antimicrobial therapy - different clinical scenarios
Selecting and initiating an antibiotic therapy through different clinical settings:
The ID specialist
The clinical pharmacologist
TOPIC 12. ID - Typhoid fever and Listeriosis
TOPIC 13. ID - Infections from animals
Brucellosis
Toxoplasmosis
Leptospirosis
Q fever
Cat Scratch disease
TOPIC 14. ID - Bloodstream and Heart infections
Bacteremia
Endocarditis
Sepsis
TOPIC 15. ID - The Central Nervous System (CNS) part 1
Acute and chronic meningitis
The spectrum of N. meningitidis disease
TOPIC 16. ID - The Central Nervous System (CNS) part 2
Encephalitis
Brain abscess
TOPIC 17. ID - Herpetic infections
TOPIC 18. ID - HIV and AIDS part 1
HIV epidemiology, pathogenesis and prevention
TOPIC 19. ID - HIV and AIDS part 2
Clinical presentation and diagnosis of acute and chronic HIV infection
Clinical presentations and diagnosis of AIDS-defining illnesses
TOPIC 20. ID - HIV and AIDS part 3
HIV therapy and eradication
TOPIC 21. Pharm - Antiviral agents
TOPIC 22. ID - Vector-borne and emerging/neglected diseases part 1
Lyme disease
Leishmaniasis
TOPIC 23. ID - Vector-borne and emerging/neglected diseases part 2
Malaria
TOPIC 24. ID - Case method
Fever of unknown origin

Asynchronous LEARNING
ID- Bone and joint infections
ID - Principles of antibiotic use, infection control and antimicrobial stewardship
ID - Urinary tract infections (UTI)
Cystitis
Prostatis
Pyelonephritis
ID - Vector-borne and emerging/neglected diseases part 3
Dengue fever
Zika virus infection
Ebola disease
Chikungunia disease
ID - Parasitic diseases
Parasitic infections of the GI tract
Trypanosomiasis, echinococcosis, schistosomiasis
ID - Fungal diseases
Candida spp and Aspergillus spp infections
ID- Sexually transmitted diseases (STD)
N. gonohorrea infections
C. trachomatis infections
Syphilis
ID - Clinical Problem solving
ID - Online course assessment (test)
ID - Written review on ID topic of choice
Pharm- Antifungal agents
Pharm - Therapeutic Drug Monitoring (TDM)

LEARNING OBJECTIVES
A. Understand the following features of the infectious disorders listed below (1-10):
etiology: specific agents which cause disease (pathogens)
epidemiology: distribution, mode of transmission, risk factors
clinical manifestations: signs and symptoms as well as laboratory findings
complications
diagnostic features:
instrumental
microbiological (direct and indirect methods)
principles of prevention infection control measures
principles of treatment
1. RESPIRATORY SYSTEM:
Upper respiratory tract infections (URTI): common cold, sinusitis, pharyngitis, laryngitis and epiglottitis, acute otitis media, bronchitis
Community acquired pneumonia (CAP): S. pneumoniae, M. pneumoniae/C. pneumoniae, L. pneumophila
Hospital acquired pneumonia (HAP)
Influenza
SARS-CoV-2
Tuberculosis
Aspergillosis
2. SKIN AND SOFT TISSUE INFECTIONS:
Viral exanthems: measles, rubella, HSV-1/2, varicella zoster, fifth disease roseola
Skin and soft tissue infections; cellulitis/erysipela, cutaneous abscesses, necrotizing fasciitis, gas gangrene
3. BONE AND JOINTS:
Arthritis
Osteomyelitis
Prosthetic joints
4. GASTROINTESTINAL SYSTEM:
Bacterial infections: S.aureus, E.coli, minor salmonellosis, shigellosis
C.difficile infection
Parasitic infections of the GI tract: amebiasis, giardiasis
Viral hepatitis: HAV, HBV/HDV, HCV, HEV
5. GENITOURINARY SYSTEM:
Lower urinary tract infections (UTI): cystitis, prostatis
Pyelonephritis
Sexually Transmitted Infections (STD): N. gonhorreae, C. trachomatis, T. pallidum
Infections in pregnant women
6. CENTRAL NERVOUS SYSTEM:
Bacterial meningitis
Viral encephalitis
Brain abscess
The clinical spectrum of N. meningitidis infection
7. BLOOD AND CARDIOVASCULAR SYSTEM:
Gram-positive and Gram-negative bacteremia; candedemia
Endocarditis
Sepsis
8. SYSTEMIC INFECTIONS:
Thyphoid fever
Listeriosis
EBV, CMV
Brucellosis
Toxoplasmosis
Understand that the above-mentioned infections may present with variable and aspecific symptomatology, ranging from mild and self-limiting diseases to life-threatning conditions
9. INFECTIONS FROM ANIMALS:
Leptospirosis
Q fever
Cat Scratch disease
10. FEVER IN THE RETURNING TRAVELLER, VECTOR-BORNE AND EMERGING/NEGLECTED INFECTIONS:
Malaria
Leishmania
Lyme Disease
Dengue fever, Zika virus infection, Chikungunya disease
Ebola disease
Trypanosomiasis, echinococcosis, schistosomiasis

B. HIV Infection
Etiology, pathogenesis, epidemiology
Acute HIV infection: clinical presentation and diagnosis
Chronic HIV infection: clinical presentation and diagnosis
AIDS: etiology, clinical presentation and diagnosis of opportunistic infections

C. Principles of antimicrobial therapy use, infection control and antimicrobial stewardship
Antibiotics, antiviral and antifungal agents: classification, pharmacological basis of therapy and antimicrobial resistance
Principles of appropriate antibiotic use
Therapeutic Drug Monitoring (TDM): principles and use in the clinical practice
Illustrate principles of infection control and antimicrobial stewardship programs
Discuss prophylactic measures and isolation procedures for epidemiological control of ID
Teaching methods
The teaching methods will depend on the Covid-19 pandemic instructions.
Infectious diseases- Synchronous learning: online "live" or in presence lectures which will be recorded and made available through the dedicated Microsoft Teams Channel and/or ARIEL website
Asynchronous learning: audio-video based (pre-recorded) lectures, discussion boards ("case method" and "problem-solving), online assessments, written reports/essays for which feedback will be provided
Pharmacology- Synchronous learning: online "live" or in presence lectures which will be recorded and made available through the dedicated Microsoft Teams Channel and/or ARIEL website
Asynchronous learning: students will be asked to prepare and record a brief presentation of a specific antimicrobial drug. A different drug will be assigned to each student. A schema of the presentation will be provided. Recordings produced by the students will be available as in-depth material for the class. A feedback will be provided to each student.

Conjunct lessons with the co-presence of infectious diseases (ID) and pharmacology (PH) teachers will be held that consist in the conjunct discussion of ID clinical cases/scenarios presenting both the ID and the PH perspectives.
Teaching Resources
Mandell, Douglas, and Bennett's, "Principles and Practice of Infectious Diseases"
"Infectious Diseases", edited by Jonathan Cohen, M Sc, FRCP, FRCPath, FRCPE, FMedSci, William G. Powderly, MD and Steven M. Opal, MD
"Malattie Infettive" di Moroni, Esposito, Antinori
Pharmacology
Course syllabus
The course is based on a strong integration of different disciplines, thus the program of the single disciplines cannot be extracted form the program of the whole course which is reported in module Infectious diseases.
Teaching methods
The teaching methods will depend on the Covid-19 pandemic instructions.
Infectious diseases- Synchronous learning: online "live" or in presence lectures which will be recorded and made available through the dedicated Microsoft Teams Channel and/or ARIEL website
Asynchronous learning: audio-video based (pre-recorded) lectures, discussion boards ("case method" and "problem-solving), online assessments, written reports/essays for which feedback will be provided
Pharmacology- Synchronous learning: online "live" or in presence lectures which will be recorded and made available through the dedicated Microsoft Teams Channel and/or ARIEL website
Asynchronous learning: students will be asked to prepare and record a brief presentation of a specific antimicrobial drug. A different drug will be assigned to each student. A schema of the presentation will be provided. Recordings produced by the students will be available as in-depth material for the class. A feedback will be provided to each student.

Conjunct lessons with the co-presence of infectious diseases (ID) and pharmacology (PH) teachers will be held that consist in the conjunct discussion of ID clinical cases/scenarios presenting both the ID and the PH perspectives.
Teaching Resources
Goodman and Gilman's The Pharmacological Basis of Therapeutics, Laurence Brunton, Bjorn Knollmann, Randa Hilal-Dandan
The Sanford guide to antimicrobial therapy. David N Gilbert; Georges M Eliopoulos; Henry F Chambers; Michael S Saag; Andrew Pavia Sperryville, VA, USA: Antimicrobial Therapy, Inc

Review articles on specific topics will be provided.
Infectious diseases
MED/17 - INFECTIOUS DISEASES - University credits: 5
Lessons: 60 hours
Pharmacology
BIO/14 - PHARMACOLOGY - University credits: 1
Lessons: 12 hours
Professor: Pani Arianna