Bacterial Infection Dx

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Common cause of infection in pts with catheters, prosthetic cardiac valves, and drug addicts

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Staphylococcus epidermidis

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Common cause of UTIs in young women

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Staphylococcus saprophyticus

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Growth pattern of Staphylococci

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Bunches (like grapes)

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Uses surface receptors for fibrinogen and fibronectin to form bridge adhesions to endothelial cells

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Staphylococcus aureus

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Protein on bacterial surface that binds the Fc portion of immunoglobulins, rendering them ineffective

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Protein A

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Mechanism of alpha toxin in S. aureus

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Pore-forming protein that depolarizes plasma membranes of host cells

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Mechanism of beta toxin in S. aureus

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Sphingomyelinase

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Mechanism of delta toxin in S. aureus

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Detergent-like peptide

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Mechanism of gamma toxin in S. aureus

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Lyses erythrocytes

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Mechanism of leukocidin in S. aureus

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Lyses phagocytic cells

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Mechanism of A and B toxins (NOT alpha and beta) in S. aureus

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Serine proteases that cleave desmoglyein 1, one of the desmosomes that hold epithelial cells together (hence bullous impetigo)

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Mechanism of Toxic Shock Syndrome and food poisoning in S. aureus

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Superantigens binding to T-cell receptor BETA chains.

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Major cause of furuncles (boils), carbuncles, hidradenitis (axillary apocrine glands), paronychia (nail beds), and felons (finger pads).

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S. aureus

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What is Ritter disease?

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Staphylococcal scalded skin syndrome

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Major cause of erythema nodosum, immune complex glomerulonephritis, and rheumatic fever

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Streptococcus

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Beta-hemolytic species

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Streptococcus pyogenes, Streptococcus agalactiae

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Prominent Alpha-hemolytic species

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Streptococcus pneumoniae

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Group A Strep: species and diseases

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Streptococcus pyogenes: pharyngitis, scarlet fever, erysipelas, impetigo, rheumatic fever, TSS, glomerulonephritis

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Group B Strep: species and diseases

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Streptococcus agalactiae: (female genital tract), sepsis and meningitis in neonates and chorioamnionitis in pregnancy

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Common streptococcal cause of pneumonia and meningitis in adults: species and classification

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Streptococcus pneumoniae: Alpha hemolytic

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The major cause of dental caries

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Streptococcus mutans

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Strep strains with capsules

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S. pyogenes, S. agalactiae, S. pneumoniae

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3 defense/virulence mechanisms of S. pyogenes

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M surface protein (prevents phagocytosis), complement C5a peptidase, and pyrogenic exotoxin

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Cause of scarlet fever

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Streptococcus pyogenes

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"Flesh-eating bacteria" (rapid necrotizing fasciitis)

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Streptococcus pyogenes

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Def. of pneumolysin

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Toxin in S. pneumoniae: cytosolic protein released upon lysis. Inserts into host membranes and lyses them. Uses up complement system (via classical pathway).

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Cause of erysipelas

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Streptococcus pyogenes (skin infection). Often butterfly rash.

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The major antecedent of poststreptococcal glomerulonephritis

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Streptococcal pharyngitis

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Mechanism of Corynebacterium dyphtheriae toxin

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Single phage-encoded A-B toxin; blocks host protein synthesis by ADP-ribosylating Elongation Factor 2 (EF-2). (Necessary for translation).

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Mechanism of cell entry for L. monocytogenes

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Listeria monocytogenes expresses leucine-rich 'internalins' on its surface, which bind to E-cadherins on host epithelial cells, inducing internalization

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Mechanism of cell-to-cell spread of L. monocytogenes

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Listeria contains ACTA, which binds to host cytoskeletal proteins and induces actin synthesis, propelling the bacterium through cell membranes.

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Major protecting factor against Listeria

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IFN-gamma from NK cells and T-cells.

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CSF showing gram-positive, intracellular organisms is diagnostic of what?

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Meningitis of Listeria monocytogenes

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Large, spore-forming, gram-positive rod

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Bacillus anthracis

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Gram-positive rod typically acquired through contact with animal products (wool, hides)

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Bacillus anthracis

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Three types of Bacillus anthracis infections

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cutaneous (common), inhalation (frequent death) , and GI (uncommon, mortality >50%)

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Mechanism of cell entry of Bacillus anthracis

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7 B subunits ('protective antigen') bind to cell receptor & polymerize. Host cleaves part of each. A subunit (Lethal Factor and Edema Factor) binds B's, cell endocytoses.

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Mechanism of LF and EF (A subunits) of Bacillus anthracis

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LF: binds and inhibits Mitogen-Activated Protein Kinase Kinase (MAPKK), causing death.
EF: binds calcium and calmodulin to create adenylcyclase, ^^ cAMP -> water efflux from cell (edema)

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Common gram-positive lung infection of immunocompromised hosts

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Nocardia asteroides

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Common gram-positive skin infection of immunocompromised hosts

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Nocardia brasiliensis

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Histo: gram-positive, branching, beaded chain

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Nocardia

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Histo: gram-neg, flattened on adjoining sides (coffee bean)

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Neisseria

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Significant gram-neg cause of meningitis in 5-19 year olds

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Neisseria meningitidis

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Important gram-neg cause of PID in women and urethritis in men

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Neisseria gonorrhoeae

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Important cause of neonatal blindness, preventable by antibiotic drops

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Neisseria gonorrhoeae

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Mechanism of toxin of Bordetella pertussis

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Pertussis toxin, consisting of 5 peptides, ADP-ribosylates and inactivates host G-proteins, inhibiting signals.

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Important gram-negative cause of mortality in patients with cystic fibrosis, neutropenia, or severe burns

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Pseudomonas aeruginosa

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Important gram-neg cause of nosocomial infections

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Pseudomonas aeruginosa

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Can cause corneal keratitis in contact lens wearers

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Pseudomonas aeruginosa

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Mechanism of P. aeruginosa Exotoxin A

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ADP-ribosylates Elongation Factor-2 (EF-2). (like diphtheria toxin A)

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Mechanism of P. aeruginosa Exoenzyme S

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ADP-ribosylates G-proteins (like B. pertussis)

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Mechanism of P. aeruginosa Phospholipase C

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Lyses RBCs and degrades pulmonary surfactant

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Name of P. aeruginosa's slimy protective biofilm

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Alginate (in cystic fibrosis pts)

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Gram-neg cause of vasculitis accompanied by hemorrhage and thrombosis

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Pseudomonas aeruginosa

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Mechanism of phagocyte inactivation in Yersinia pestis

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Via a type III secretion system (syringe-like), "Yops" (Yop E, H, T, & PJ) are injected into the host cell. YopPJ inhibits blocks LPS-initiated cytokine pathways

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Location difference between primary and secondary Mycobacterium tuberculosis

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Primary: lower and middle lobe consolidation.
Secondary: Apex of upper lobes

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Lymphocyte and cytokine most actively involved in Mycobacterium tuberculosis rxn

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Th1 cells producing IFN-Gamma

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Common systemic symptoms of Mycobacterium tuberculosis

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Low grade fever only in late afternoons, night sweats.

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Pseudonym given to the combination of lung and lymph node involvement in primary Mycobacterium tuberculosis

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Ghon complex (caseation of parenchymal lung and nodes)

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Almost exclusively found in AIDS patients, this infection causes drenching night sweats, weight loss, fever, and hepatosplenomegaly

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Mycobacterium avium-intracellulare complex (MAC)

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Mycobacteria: intracellular or extracellular?

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Intracellular

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Form of Mycobacterium leprae with raised, red borders and a "healed center". Major neuronal involvement, leading to autoamputation and atrophy

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Tuberculous leprosy

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Bacterium that prefers to grow in cooler temperatures, often leaving vital organs untouched

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Mycobacterium leprae

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Form of Mycobacterium leprae with maculopapular lesions on the face, wrists, elbows, and knees. "Leonine facies". Anesthesia along ulnar and peroneal dist.

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Leperomatous leprosy

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The immunological difference between the two forms of Mycobacterium leprae

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Tuberculous leprosy has a Th1 reaction w/ IL-2 and IFN-Gamma.
Leperomatous leprosy has no Th1, but Th2 with IL-4,5, and 10.

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Organism of syphilis

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Treponema pallidum subspecies pallidum

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Sx: firm, nontender, raised, red lesion at site of invasion, usually on or around sexual organs

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Primary syphilis (Treponema pallidum)

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Sx: Scaly or maculopapular lesions on palms or soles, broad-based, elevated plaques in moist areas, silver superficial erosions on mucous membranes.

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Secondary syphilis (Treponema pallidum)

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Condition causing aortic valve insufficiency and aneurysms of proximal aorta

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Tertiary syphilis (Treponema pallidum): Syphilitic aortitis

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Condition causing demyelination of dorsal spinal columns, general paresis of the brain, elevated CSF protein and decreased CSF glucose

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Tertiary syphilis (Treponema pallidum): Neurosyphilis

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Tabes dorsalis

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Demyelination and loss of sensation in dorsal columns, affecting vibration, discriminatory touch, and proprioception. (T. pallidum)

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Triad of congenital syphilis

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Hutchinson's teeth, interstitial keratitis (like cataracts), eighth nerve deafness

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Cause of relapsing fever

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Borrelia recurrentis

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Carrier of Borrelia recurrentis

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Ornithodorus ticks (endemic) or louses

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Pseudonym of a reaction to antibiotic tx of B. recurrentis which causes low bp, fever, rigors, and leukopenia

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Jarisch-Herxheimer Reaction