Table 4.
The most common viral, bacterial, and fungal pathogens known to cause repository infection
| Pathogen | Clinical symptoms (complications) | Respiratory tract infected part | Pathogen entrance mechanism |
|---|---|---|---|
| Viral | |||
| MERS‐CoV | Fever, chills, sore throat, cough, shortness of breath, headache, vomiting, diarrhoea, myalgia (pneumonia, septic shock, severe acute respiratory distress syndrome, respiratory failure, multi‐organ failure). | Upper and lower respiratory tract. | Cell mediated membrane fusion or endocytosis via CD26 receptors.[ 131 ] |
| SARS‐CoV | Fever, chills, myalgia, shortness of breath (pneumonia, fibrosis, severe acute respiratory distress syndrome, respiratory failure). | Upper and lower respiratory tract. | Cell mediated membrane fusion or endocytosis via ACE2 receptors.[ 132 ] |
| SARS‐CoV‐2 (COVID‐19) | Fever, chills, cough, shortness of breath, sore throat, rhinorrhoea, temporary anosmia or ageusia (pneumonia, septic shock, severe acute respiratory distress syndrome, respiratory failure, multi‐organ failure). | Upper and lower respiratory tract. | Cell mediated membrane fusion or endocytosis via ACE2 receptors.[ 133 ] |
| Seasonal influenza | Fever, sore throat, cough, headache, rhinorrhoea, myalgia, headache, (laryngotracheobronchitis, bronchitis). | Upper respiratory tract. | Cell mediated membrane fusion via sialic acid containing receptors and protease cleavage.[ 136 ] |
| Respiratory syncytial virus (RSV) | Fever, sore throat, cough, headache, rhinorrhoea, shortness of breath, wheezing, (laryngotracheobronchitis, bronchitis). | Lower respiratory tract. | Cell mediated envelope fusion via nucleolin containing receptors.[ 137 ] |
| Rhinovirus | Sore throat, cough, rhinorrhoea (bronchitis). | Upper respiratory tract. | Cell mediated endocytosis via ICAM‐1, LDL or CDHR3 receptors.[ 169 ] |
| Bacterial | |||
| Streptococcus pneumoniae | Fever, chills, cough, shortness of breath, chest pain, (pneumonia, septic shock, bacteraemia, meningitis). | Forms part of upper respiratory tract flora but can migrate and cause infection in lower respiratory tract and/or spread systemically. | Extracellular colonization; polysaccharide capsule promotes adherence and protection.[ 144 ] |
| Haemophilus influenzae | Fever, chills, cough, shortness of breath, chest pain, (pneumonia, bronchitis, septic shock, bacteraemia, meningitis). | Forms part of upper respiratory tract flora but can migrate and cause infection in lower respiratory tract and/or spread systemically. | Internalization by epithelial cells via micropinocytosis and rearrangement of epithelial cytoskeleton[ 141 ]; internalization by macrophage and neutralizes lysosomes to prevent detection or lysis.[ 147 ] |
| Mycobacterium tuberculosis | Fever, chills, chest pain, cough, weight loss (meningitis, respiratory failure, multi‐organ failure). | Lower respiratory tract and can spread systemically. | Internalization by macrophages via phagocytosis and neutralizes lysosomes to prevent detection or lysis; able to survive indefinitely but erupts to cause infection when host is immunocompromised.[ 150 , 151 ] |
| Fungal | |||
| Aspergillus (mold; most common species A. fumigatus) | Fever, chills, shortness of breath, wheezing, headache, cough, (Rhinitis, bleeding of the lungs, systemic infection, and multi‐organ failure). | Upper and lower respiratory tract can spread systemically. | Can invade tissues by extending hyphae through endothelial and epithelial barriers.[ 142 , 168 ] |
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