Bacterial & The Diseases They Cause

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Strep pyogenes (Group A strep)

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i. Exotoxin mediated: pharyngitis, Skin infections (cellullitis, impetigo), Scarlet fever, TSS
ii. Immunologic: Rheumatic Fever, Post streptococcal Glomerulonephritis

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Strep agalactiae (Group B strep) - beta hemolytic

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neonatal meningitis, pneumonia, sepsis

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Viridans group Strep (Group B) - alpha hemolytic

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dental plaque, subacute endocarditis (SBE), intraabdominal infections, abscess

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Enterococcus (Group D) - alpha hemolytic - faecialis and faecium

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Urinary, Biliary, Cardiovascular infections, subacute endocarditis (SBE)

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Non-enterococcus (Group D) - S bovis and S equinas

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bacteremia, endocarditis

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Streptococcus pneumoniae - alpha hemolytic

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Lobal pneumonia (major cause in adults), meningitis, otitis media (children), sinusitis

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Staphylococcus aureas - beta hemolytic

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1. Toxin mediated: Scalded skin syndrome (ritter’s syndrome): (if slight pressure displaces the skin (+ Nikolsky’s sign)), blisters contain clear fluid but no organisms or leukocytes, Bullous Impetigo (local form of SSS) food poisoning, toxic shock
2. Suppurative: Impetigo, Folliculitis, Furuncles, Carbuncles, Bacteremia, endocardidits, pneumonia (aspiration), osteomyelitis, septic arthritis

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Staph epidermidis

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nosocomial infections --> prosthetic joints, prosthetic heart valves, sepsis from IV, UTI, frequent contaminant in blood cultures.

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Staph saphrophyticus

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UTIs especially in sexually active women

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Bacillus anthracis (aerobic, non motile, non gamma hemolytic, spore-forming)

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cutaneous anthrax, inhalation anthrax (localized necrosis, round black lesions)

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Bacillus cereus (aerobic, motile, beta hemolytic, nonencapsulated, spore-forming)

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Gastroenteritis: diarrheal (meat, vegetables) and emetic (rice), ocular infections

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Clostridium perferingens (anaerobe, nonmotile, hemolytic, spore-forming)

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- found in colon, vagina, environment

Gastroenteritis (watery diarrhea), cellulitis, fascitis, myonecrosis (gas gangrene), necrotizing enteritis

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Clostridium tetani (anaerobe, motile, spore-forming)

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- found in GI tract, environment

tetanus, risus sardonicus
(tetanus can be generalized, localized, and also affect neonates)

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Clostridium botulinum (anaerobe, motile, spore-forming)

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- found in GI tract, environment

foodborne botulism (associated with canned foods), infant (honey), inhalation or wound botulism (symmetrical cranial neuropathies, ptosis, dilated pupils)

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Clostridium difficile (anaerobe, motile, spore-forming)

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- found in GI

- antibiotic associated diarrhea (notes say nonbloody), pseudomembranous colitis,

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Corynebacterium diphtheriae (Irregular rods, gram-positive, nonmotile, non-sporeforming)

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- found in GI, skin, urogenital, upper resp

- respiratory diphtheria, cutaneous, diphtheria, pseudomembrane on back of throat --> neural and cardiovascular damage

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Corynebacterium jeikeium (Irregular rods, gram-positive, nonmotile, non-sporeforming)

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opportunistic pathogen in immunocompromised patients

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Corynebacterium urealyticum (Irregular rods, gram-positive, nonmotile, non-sporeforming)

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- UTI (has enough urease to make urine alkaline)

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Listeria monocytogenes (Rods, gram-positive, aerobe, facultative intracellular, has LPS!)

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Disease: Listeriosis (flu-like symptoms, N/V/Diarrhea, septicemia, meningitis/meningoencaphalitis, encephalitis, corneal ulcer, pneumonia, intrauterine/cervical infections which may result in spont abort or stillbirth. Surviving neonates may suffer granulomatosis infantiseptica - pyogenic granulomas over body and may suffer from physical retardation.


flu like illness in adults, bacteremia or disseminated disease in pregnant women

Listeria frequently causes meningitis in newborns (acquired transvaginally), so pregnant mothers are told not to eat soft cheeses which may harbor listeria.

*It is the 3rd most common cause of meningitis in newborns

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Actinomyces (filamentous, gram-positive, facultative anaerobic or strictly anaerobic)

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- found in oral flora

disease: actinomycosis: chronic granulomatous lesions, form abscesses connected by sinus tracts, can form colonies resembling grains of sand called sulfur granules. Mostly oral/facial, related to dental processes, thoracic (following aspiration), endometriosis (associated with intrauterine devices)

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Nocardia (filamentous, gram-positive, rod-shaped, acid-fast, aerobic, catalase +)

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- found in soil
- nocardiosis (usually by inhalation or traumatic introduction)
- Disease: bronchopulmonary disease (especially in immunocompromised pts with T cell deficiencies), Cutaneous nocardosis, actinomycotic mycetoma (painless chronic infection, subQ swelling), lymphocutaenous infections, brain abcess (1/3rd patients)

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Neisseria gonorrhoeae (diplo-cocci, gram-negative, aerobic, doesnt have true capsule but has - charge)

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Gonorrhea (can lead to PID, perihepatitis), conjunctivitis, pharyngitis, opthalmia neonatorum

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Neisseria meningitides (diplo-cocci, gram-negative, aeroboic, capsule)

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2nd most common cause of community-acquired meningitis in adults

- meningitis, Waterhouse-Friderichsen Syndrome (septic shock--> adrenal insufficiency, similar to TSS), pneumonia, arthritis, urethritis

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Moraxella catarrhalis (cocco-bacillus)

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a major cause of otitis media and sinusitis in children

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Haemophilus influenzae (gram negative, short rod, nonmotile, capsule)

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Disease: otits media, sinusitis, bronchitis, pneumonia, type b: meningitis (can lead to residual impairment even if cured e.g. deafness, retardation), epiglottitis (most common cause), cellulitis, arthritis,

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Bordatella pertussis (gram negative, short rod, capsule)

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- whooping cough:
1. catarrhal stage (common cold) - 1-2 weeks
2. paroxysmal stage (impaired mucus clearance, ciliated cells extruded from resp tract)
3. convalescent stage (2-4 weeks, secondary complications)

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Legionella pneumophila (gram negative, aerobe, facultative intracellular,

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Disease: Legionnaire’s Disease (candidates are older men who smoke and drunk), patients with immunocompromised are predisposted to legionnaire’s pneumonia, Pontiac fever (mild form of disease)

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Brucella (gram negative, short rod, aerobic, nonmotile, nonencapsulated, intracellular parasite of RES)

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-found in cows, goats

Disease: brucellosis, undulant fever, GI tract symptoms, osteolytic lesions, joint effusions, respiratory tract symptoms

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Francisella tularensis (gram negative, short rod, aerobe, non motile)

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-found in rabbits, get from tick and deerflies, handling infected rabbits

Tularemia (resembles bubonic plague), ulceroglandular (most common), oculoglandular, typhoidal, pneumonic, oropharyngeal, GI

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Pasteurella multicida (gram negative, short rod, nonmotile)

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- found in oropharynx of healthy animals

- disease: cellulitis and lymphadenitis (animal bite or scratch), exacerbation respiratory disease, systemic infection

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Yersinia enterocolitica (gram neg rod, nonmotile)

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Diarrhea (LRQ pain) due to a enterotoxin similar to heat stable toxin of E coli

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Yersinia pestis (gram neg rod, nonmotile)

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disease: bubonic plague, pneumonic plague

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Escherichia coli (gram neg, facultative anaerobe, motile with flagella)

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Diseases: Septicemia, UTI, neonatal meningitis (K1 capsule, S fimbriae, invasion), gastroenteritis (divided into groups)

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Enteropathogenic E coli (EPEC)

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Disease: Infant diarrhea in undeveloped countries, watery and vomiting, no bloody stool

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Enterotoxigenic E coli (ETEC)

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Disease: Travelers Diarrhea, Infant diarrhea in undeveloped countries, watery and vomiting, nausea, cramping (in conference they said you can have low-grade fever too)

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Enterohemmorrhagic E coli (EHEC)

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Disease: : initial watery diarrhea --> grossly bloody diarrhea --> abdominal cramps --> Hemolytic uremic syndrome (HUS) (associated with Stx-2)

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Enteroinvasive E coli (EIEC)

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similar to shigella

Disease: fever, cramping, watery diarrhea --> dysentery

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Enterobacter (motile, petrichious flagella)

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hospital acquired infections

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Serratia (motile, petrichious flagella, produces bright red pigment)

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Disease: UTI, wound infections, pneumonia (associated with contamination of water in respiratory devices)

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Klebsiella pneumoniae (nonmotile, capsule)

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Lobar pneumonia, nosocomial infections, sepsis (often in hospitalized patients), wound and soft tissue infections, UTI

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Klebsiella granulomatis (nonmotile)

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granuloma inguinale (genital and inguinal area)

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Salmonella typhi (motile, petrichious flagella, facultative intracellular)

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- not found in animals, only infected from humans

-disease: typhoid fever, invades regional lymph nodes infecting many organ systems --> can survive intracellularly (facultative intracellular parasite)

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Salmonella enterica (motile, petrichious flagella)

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- found in animal GI tract, associated with foods like cheese

disease: Gasteroenteritis,

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Shigella (gram neg, nonmotile, non-spore forming rod, doesn't ferment lactose - unlike ecoli, doesn't produce H2S - unlike salmonella)

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Shigellosis (infectious disease, watery diarrhea and fever, nausea, vomiting, stomach cramps, flatulence ) stool may contain blood, mucus or pus (dysentery) (S. boydii, S. dysenteriae, S. flexneri, S. sonnei)


dysentery - means infection of enteric system causing blood and mucus in diarrhea

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Proteus mirabilis (motile with petrichious flagella, has urease)

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nosocomial infections, UTI (urine will have alkaline pH)

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Campylobacter jejuni (curved, motile with petrichious flagella, microaerophilic)

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Disease: Guillan-Barre (development of symmetrical weakness), reactive arthritis (painful joint swelling), gastroenteritis (10 or more bowel movements a day, may be bloody)

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Campylobacter fetus (curved, motile with petrichious flagella, microaerophilic)

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Diseases: septicemia, meningitis, gastroenteritis, spontaneous abortion

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Helicobacter pylori (highly motile corkscrew)

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Diseases: gastritis, peptic ulcers, gastric adenocarcinoma, and gastric MALT B cell lymphomas, offers protection against GERD and adenocarcinomas of the lower esophagus and gastric cardia

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Vibrio cholerae (motile, single flagella)

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Disease: cholera (causes non-inflammatory diarrhea, due to toxin causing secretion and prevents reabsorption of electrolytes)

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Vibrio parahemolyticus (motile, single flagella)

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- get it from raw shellfish (needs high salt conc)

Disease: gastroenteritis, wound infection

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Vibrio vulnificus (motile, single flagella)

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- get it from contaminated sea water or bacteremia from contaminated raw oysters

Disease: wound infections (can be fatal) --> have erythema, pain, bullae formation, tissue necrosis and septicemia.

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Pseudomonas aeruginosa (gram negative aerobic rod, non-lactose-fermenter, needs almost nothing to grow, found in hosps, motile, arranged in pairs, oxidase +, blue-green pigment, grapey smell)

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Disease: pulmonary infections (often due to respirators or other abx use, occurs in cystic fibrosis patients), skin infections (especially in burns), folliculitis, UTIs, ear infections, eye infections, bacteremia, endocarditis (R heart valve in IV drug users), osteomyelitis

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Bacteroides fragilis (gram negative Anaerobic rod, capsule)

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- most common cause of serious anaerobic infections

Diseases: intra-abdominal infections, necrotizing fasciitis, bacteremia, genital infections, sepsis, peritonitis, abscesses

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Mycobacterium tuberculosis (acid fast, obligate aerobe, facultative intracellular, nonmotile, no capsule, catalase +)

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-acid fasts stain with Ziehl-Neelsen stain

Disease: tuberculosis --> causeous necrosis; Pulmonary (upper lobe due to high O2), pleural and pericardial infection, lymph node TB (“scrofula”) Kidneys (“sterile pyuria” – bc cant see RBC/WBC in culture cuz it takes weeks to grow) , Skeletal (“Pott’s disease” – destroying intervertebral discs and vertebral bodies), Joints (chronic arthritis), CNS (subacute meningitis + granulomas), miliary TB (tubercles all over body – kidneys, liver, lungs etc.)

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Mycobacterium avium-intracellulare (MAI)

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affects bids, AIDS patients and immunocompromised

- chronic wasting. The bacteria can be found in liver, spleen, bone marrow, intestine (chronic diarrhea)

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Mycobacterium leprae (catalase +, nonmotile, acid fast, aerobic, rod)

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-involves cooler areas of body
Disease:
Lepromatous leprosy - low cell mediated immunity, organisms found organs and blood, skin nerves eyes and testes involved bilaterally, multiple skin bumps and lesions, leonine facies, saddle nose, peripheral neuropathy, digit absorption, testicular damage (infertility).

Tuberculoid leprosy - strong ab response but defect in the cellular response, bacteria observed in dermal macro and schwann cells. Leads to superficial skin and nerve involvement --> loss of sensation in lesions, and no hair growth on lesions. (CBMRS says that these patients CAN mount a cell-mediated response).

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Mycobacterium bovis

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only affects cattle
Live attenuated strain of M. bovis is Bacillus Calmette- Guerin (BCG) vaccine

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Rickettsia ricketsii (nonmotile, no flagella)

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tick is reservoir

Diseases: Rocky Mountain Spotted Fever (replication in endothelial cells  damage hemorrhages, thrombi  leaky blood vessels, hypovolemia, hypoproteinemia), can have focal vasculitis (plugged vessels), Rash which moves inward from the extremities (starts at wrist, ankles, palms, and soles), DIC, fever, conjunctival redness, severe headache (often occurs in spring, early summer)

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Rickettsia akari

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ricketssialpox, transmitted via mites on house mice; bump(papule)--> blister --> fever and headache + more blisters

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Rickettsia prowazekii

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-human body louse or flea transmit it to us from flying squirrels etc.;

endemic typhus, fever + headache --> small pink macules on upper trunk  quickly cover body (unlike RMSP this doesn’t affect soles, palms, face), may have delirium; Brill Zinsser Disease (reactivation of epidemic typhus),

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Rickettsia typhi

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-transmitted via rat fleas, rodents are the primary reservoir

endemic/murine typhus; fever + headache + maculopapular rash, (chest and abd symptoms)

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Orientia tsutsugamushi

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scrub typhus; transmitted by mites larvae (chiggers); high fever + headache + scab at bite site, macular-papular rash in trunk and spreads to extremities, CNS and cardiovascular complications can occur.

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Bartonella quintana

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trench fever; louse born febrile disease; similar to Rickettsia but NOT an obligate intracellular organism; high fever, rash, headache, severe back and leg pains; multiple relapses and apparent recoveries (Quintana due to 5 days in between relapses); like epidemic typhus, this reaches epidemic proportions during war (due to human louse)

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Bartonella henselae

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 cat-scratch disease and bacillary angiomatosis; cat scratch disease: due to cat bite/scratch; lymph node enlarges --> low grade fever and malaise; bacillary angiomatosis --> proliferation of small blood vessels in skin/organs of AIDS pts.

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Ehrlichia chafeensis

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- get it from ticks

human monocytic ehrlichiosis --> similar to RMSF: fever headache, malaise (and rarelya rash)

*ehrlichiosis is a disease of dogs usually due to e. canis. humans can get the disease by exposure to e. canis or others

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Ehrlichia ewingii

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Canine granulocytic ehrlichiosis

*ehrlichiosis is a disease of dogs usually due to e. canis. humans can get the disease by exposure to e. canis or others

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Anaplasma phagocytophilum

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- ixodes tick vector

Human anaplasmosis (aka human granulocytic ehrlichiosis aka human granulocytic anaplasmosis) - (pathology is due to macro activation)

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Coxiella burnetii

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Q fever; multiplication initiated after the bacteria are phagocytized (“endospore”)--> phagolysome forms --> acidic environment activates host machinery. Small Infectious dose

- Q fever (often presents as SBE); abrupt fever and soaking sweats occur 2-3 wk post infection along with pneumonia; transmitted from cattle, sheep, goats. Main organ involved is the lung (may also lead to hepatitis)

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Chlamydia trachomatis (intracellular, nonmotile)

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- Chlamydia have a unique developmental cycle involving elementary bodies (spore form resisting harsh environments) and metabolically active noninfectious reticulate bodies

- Trachoma (loss of vision), adult inclusion conjunctivitis, neonatal conjunctivitis, infant pneumonia, ocular lymphogranuloma venereum, urogenital infections [like urethritis], Reiter’s syndrome, Lymphogranuloma Venereum (primary lesion occurs at the site of infection), Fitz-Hugh Curtis syndrome(perihepatitis)

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Chlamydia pneumoniae (TWAR)

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- Respiratory route

- . Disease: Atypical pneumoniae, bronchitis, sinusitis, play a role is atherosclerosis (infect and grow in smooth muscle cells, coronary arteries, and macros)

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Chlamydia psittaci

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- from birds and poultry

Disease: Psittacosis (parrot fever) --> viral like atypical pneumoniae with fever and dry non productive cough. replication occurs in the respiratory tract --> focal necrosis --> inflammation --> edema, thickening of the alveolar wall, occasional hemorrhage. Mucus plugs can develop in the bronchioles.

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Treponema pallidum (anaerobes, motile, spirochete, cant be cultured outside of host, flagellated)

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Disease: syphilis
1. painless skin chancres and regional nontender lymph nodes
2. disseminated lesions all over body, rash on palms and soles, condyloma latum in warm moist-areas, CNS, eyes, bones, kidneys, joints, patchy bald spots and loss of eyebrows
3. all tissues involved, gummas of skin and bone, cardiovascular (aortic aneurysm), neurosyphilis (meningitis, vascular dmg/occlusion), tabes dorsalis, general paresis
Congenital syphilis - bc it can cross placenta- “snuffles”-runny nose, lymph node, liver, spleen enlargement and bone osteitis. Late congenital Syphilis  neurosyphilis, bone and teeth involvement (Hutchinson’s teeth), saddle nose, eye disease

Jarisch-Herxheimer Phenomenon

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Jarisch-Herxheimer Phenomenon:

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patients with syphilis may develop worsening of symptoms after treatment with antibiotics.

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Treponema pallidum subspecies endemicum

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Endemic Syphilis (Bejel): Africa/Mid East, by sharing eating utensils; skin lesions of oral mucosa and gummas of skin and bone may follow

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Treponema pallidum subspecies pertenue

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 Yaws; found in tropics; spread person to person via open ulcers; papule grows and becomes wartlike; secondary lesions follow and may develop gummas in skin and long bones

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Treponema pallidum subspecies carateum

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Pinta; purely sin disease found in Latin America; papule develops after direct contact; secondary eruption of numerous red lesions that turn blue in sun  1 year later they de-pigment and turn white (look as if they were painted on)

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Borrelia burgdorferi (microaerophilic, 7-20 periplasmic flagella)

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Lyme's disease:
1. Erythema chronicum migrans (ECM) - single lesion with red border and blue/necrosed center
2. multiple smaller ECMs, neurologic (aseptic meningitis, cranial nerve palsies (eg bells), peripheral neuropathy), cardiac (transient heart block / attack), arthritis attacks
3. encephalopathy (memory impairment, irritability, somnolence), chronic arthritis (many pts have HLA-DR 1+4)

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Borrelia recurrentis (microaerophilic, 7-20 periplasmic flagella)

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- louse vector (the only one that is louse rather than tick)

Disease: louse-borne relapsing fever --> high fever with chills headaches and myalgia --> recurring fever every 8days, fevers break with drenching sweats, rash and splenomegaly, occasional meningeal involvement

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Leptospira interrogans (aerobic, periplasmic flagella)

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- zoontic, often transmitted via contact w/ animal urine

Disease: Leptospirosis
i. Phase 1 (leptospiremic): organisms in blood and CSF --> high temperatures --> headache, severe muscle aches (esp thighs and lower back), malaise, red conjunctiva and photophobia
--after 1 week theres afebrile period between phases--
ii. Phase 2 (immune): IgM, reoccurance of above symptoms + neck pain, meningismus, CSF will have elevated WBC
iii. Weil’s Disease (“infective jaundice”) severe case --> renal failure, hepatitis w/ jaundice, mental status changes, and hemorrhage

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Mycoplasma pneumoniae (aerobic, motile, very small, no cell wall, cell membrane has lots of sterols)

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Disease: a mild self-limiting Pneumonia (“walking-pneumonia” cuz not very sick), tracheo-bronchitis, Stevens Johnson Syndrome

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Ureaplasma urealyticum (has urease, motile, very small, no cell wall, cell mebrane has sterols)

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- normal flora in 60% sexually active women; loves swimming in urine and produces urease to break down urea (urealytic) (its also called T-strain mycoplasma)

Diseases: Non gonococcal urethritis --> burning on urination with a yellow mucoid discharge (Neisseria gonorrhoeae and Chlamydia trachomatis are the other 2 bacteria that cause urethritis)