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176 Cards in this Set
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G+ rods
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Clostridium (anaerobe)
Corynebacterium Listeria Bacillus |
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G+ cocci, catalase +
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staph
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G+ cocci, catalase -
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strep
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G+ cocci, catalase +, coagulase +
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S. aureus
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G+ cocci, catalase +, coagulase -
Novobiocin sensitive |
S. epidermidis
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G+ cocci, catalase +, coagulase -
Novobiocin resistant |
S. saprophyticus
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G+ cocci, catalase -
alpha hemolytic |
S. pneumoniae
viridans strep optochin resistant? capsule? bile soluble? |
OVRPS
optochin sensitive, bile soluble=strep pneumoniae optochin resistant, bile insoluble=viridans |
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G+ cocci, catalase -
beta hemolytic |
Group A (S. pyogenes)
Group B (S. agalactiae) bacitracin sensitive? |
bacitracin sensitive= group A
bacitracin resistant= group B B-BRAS |
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alpha hemolytic bacteria?
colony characteristic? |
S. pneumoniae (cat-, opto sens)
viridans strep (cat-, opto resist) green ring around colonies (blood agar) |
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beta hemolytic bacteria?
colony characteristic? |
S. aureus (cat/coag +)
S. pyogenes (group A, cat-, bacit sens) S. agalactiae (group B, cat-, bacit resist) L. monocytogenes |
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mechanism catalase protects bacteria?
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degrades H2O2 (from PMNs)
H2O2 substrate for myeloperoxidase |
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Protein A
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S. aureus virulence factor
binds Fc-IgG (inh C' fixation, phag) |
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TSST
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S. aureus superAg
binds MHCII and T cell R results polyclonal T cell activation |
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S. aureus clinical manifestations?
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SOFT PAINS--
Skin infection/exfoliative toxin osteomyelitis food poisoning toxic shock pneumonia acute endocarditis infective arthritis necrotizing fasciitis sepsis |
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S. aureus treatment?
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penicillinase resistant penicillin
vancomycin clindamycin |
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prosthetic devices and catheters
normal skin flora treatment? |
S. epidermidis
tx: vancomycin |
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S. pneumoniae clinical manifestations?
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MOPS (Most Optochin Sensitive):
Meningitis Otitis media (children) Pneumonia Sinusitis |
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rusty sputum
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S. pneumoniae
sepsis in Sickle Cell Anemia/splenectomy |
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dental caries
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Strep mutans
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subacute bacterial endocarditis (viridans group)
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S. sanguis
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Strep pyogenes clinical manifestations?
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NIPPLES--
necrotizing fasciitis/myositis impetigo pharyngitis (rhuematic fever, glomerulonephritis) pneumonia lymphangitis erysipelas, cellulitis scarlet fever/strep TSS |
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Strep pyogenes immunologic consequences?
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rheumatic fever (no "rheum" for SPECC)
acute glomerulonephritis (M12) |
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M protein
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Strep pyogenes (group A beta hemolytic)
bacitracin sensitive Ab to M protein enhance host defense BUT can give rise to rheum fever |
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ASO titer
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detects S. pyogenes infection
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rheumatic fever
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SPECC--
subcut nodules polyarthritis erythema marginatum chorea carditis also strawberry tongue, "sandpaper" rash (spares palms/soles) |
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S. pyogenes treatment?
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beta-lactam, erythromycin
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G+, Group B, Bacitracin resistant, beta hemolytic
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S. agalactiae
pneumonia, meningitis, sepsis (mainly babies) |
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S. agalactiae treatment?
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ampicillin with cefuraxime or gentamicin
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What clinical manifestations caused by Enterococci?
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UTI and subacute endocarditis
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What is Lancefield grouping based on?
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diff in C carbohydrate (bacterial cell wall)
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what can grow in 6.5% NaCl?
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Enterococci group D
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high assoc with colon cancer
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Strep bovis
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exotoxin encoded by beta-prophage?
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diphtheria
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diphtheria toxin MOA?
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inh protein syn via ADP ribosylation of EF-2 (A subunit)
B subunit-entry into cardiac/neural tissues like "antihuman antibiotic" sx: pseudomembranous (grayish white) pharyngitis with lymphadenopathy |
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G+ rods with metachromatic granules
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Corynebacterium diphtheriae
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Diphtheria characteristics?
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ABCDEFG--
ADP ribosylation Beta prophage Corynebacterium Diphtheriae Elongation Factor-2 Granules |
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bull neck, myocarditis, recurrent laryngeal nerve palsy
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Corynebacterium diphtheriae
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dipicolinic acid in core
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spores (bacterial)
B. anthracis C. perfringens C. tetani B. cereus C. botulinum |
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tanospasmin MOA?
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inhibit release GABA and Glycine (inhibitory NTs) from Renshaw cells in spinal cord
results sustained muscle contraction |
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G+ spore forming, obligate anaerobic bacilli?
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Clostridia
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Botulinum toxin MOA?
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inh ACh release at NMJ
ingestion preformed toxin (adults) ingestion bacterial spores in honey (floppy baby) |
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Do you use antibiotics for botulinum toxin?
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NO
bacterial will lyse and release toxin |
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alpha toxin (lecithinase)
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C. perfringens
myonecrosis (gas gangrene), hemolysis |
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pseudomembranous colitis
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C. difficile exotoxin kills enterocytes
often secondary to ampicillin/clindamycin |
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C. difficile treatment?
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metronidazole, vancomycin BY MOUTH
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C. difficile toxins?
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Toxin A (diarrhea)
Toxin B (cytotoxic to colonic epithelial cells) |
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only bacterium with protein capsule?
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B. anthracis, G+ spore forming rod
protein capsule (contains D-glutamate) |
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mediastinal widening on CXR, flulike symptoms, pulmonary hemorrhage
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B. anthracis
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anthrax toxin encoded on what kind of DNA?
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2 separate plasmids--
1 exotoxin 1 capsule |
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black eschar
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anthrax
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woolsorter's disease
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inhalation of anthrax spores from contaminated wool
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anthrax treatment?
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cipro, doxycycline
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tumbling motility, actin rockets propel organism laterally
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Listeria monocytogenes
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only G+ bacteria with endotoxin?
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listeria
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Listeria monocytogenes clinical manifestations?
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amnionitis, septicemia, spontaneous abortion, granulomatosis infantiseptica, neonatal MENINGITIS, ICH meningitis, mild gastroenteritis (healthy indiv)
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Listerolysin O (beta hemolysin) + phospholipases?
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Listeria monocytogenes
espcale from phagolysosome of macrophage |
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Listeria treatment?
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ampicillin or TMP-SMX
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actinomyces vs nocardia treatment?
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SNAP--
sulfa for nocardia Actinomyces uses penicillin |
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G+ rods forming long branching filaments resembling fungi
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actinomyces, nocardia
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oral/facial abscesses that may drain through sinus tracts
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actinomyces israelii
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"lumpy jaw"
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actinomyces israelii
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pulmonary infection in ICH, weakly acid-fast aerobe in soil
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nocardia
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vertebral body involvement of TB
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Pott's disease
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Ghon focus
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primary TB
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fibrocaseous cavitary lesion (upper lobe)
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secondary TB
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negative PPD test causes?
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no infection/anergic
steroids malnutrition ICH sarcoidosis |
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mycolic acids
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myobacterium
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pulmonary TB like symptoms
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M. kansasii
AIDS patient |
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often resistant to multiple drugs
causes disseminated disease in AIDS related to TB |
M. avium-intracellulare
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TB symptoms?
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fever, night sweats, weight loss, hemoptysis
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organism causing leprosy?
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Mycobacterium leprae (acid fast bacillus)
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armadillos
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leprosy (Hansen's disease)
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leprosy treatment?
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long term oral dapsone
tox: hemolysis, methemoglobinemia |
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2 forms of Hansen's disease?
which one is worse? |
lepromatous (failed cell mediated immunity, worse one)
tuberculoid (self limited) |
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leonine facies
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leprosy
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G- cocci, maltose fermenting, glucose fermenting
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N. meninditides
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G- cocci, maltose non fermenting, glucose fermenting
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N. gonorrhoeae
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G- coccoid rods
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H. influenzae
Bordetella pertussis Pasteurella Brucella |
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G- rod, fast lactose fermenter
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Klebsiella
E. coli Enterobacter |
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G- rod, slow lactose fermenter
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Citrobacter
Serratia |
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G- rod, lactose nonfermenter
oxidase negative |
Shigella
Salmonella Proteus |
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G- rod, lactose nonfermenter
oxidase positive |
Pseudomonas
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Lactose fermenting enteric bacteria?
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MacConKEE'S--
Citrobacter (slow) Klebsiella (fast) E. coli (fast) Enterobacter (fast) Serratia (slow) |
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Which antibiotics G- bugs resistant to?
Why? |
Penicillin G (and its derivatives), vancomycin
G- outer membrane layer inhibits entry |
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Which Neisseria species has capsule? what kind?
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Meningococci, polysaccharide capsule
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Which neisseria species ferments maltose?
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Meningococci
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N. gonorrhoeae clinical manifestations?
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gonorrhea
septic arthritis neonatal conjunctivitis PID |
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N. meningococci clinical manifestations?
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meningococcemia, meningitis, Waterhouse-Friderichsen syndrome
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Which neisseria species has vaccine and what does it cover?
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Meningococci, covers all types except B
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Which neisseria species has antigenic variation via pili?
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N. gonorrhoeae
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Neisseria treatment?
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ceftriaxone
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H. influenzae clinical manifestations?
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EMOP--
epiglottitis meningitis otitis media pneumonia also septic arthritis (infants), sepsis (pt without spleen) |
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H. influenzae culture?
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chocolate agar with Factor V (NAD) and X (hematin)
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H. influenzae treatment and prophylaxis?
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treat with ceftriaxone
prophylax close contacts with rifampin |
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describe H. influenzae vaccine?
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contains type B capsular polysaccharide (most invasive one) conjugated to diphtheria toxoid/other protein to improve immune recognition, promote class switching
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Legionella pneumophila causes what two diseases?
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Legionnaires disease (severe pneumonia with non productive cough)
Pontiac fever (mild influenza, self lim) |
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silver stain, grows on charcoal yeast extract cultured with iron+cysteine
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Legionella pneumophila
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AC units, water tanks, grocery mist
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Legionella pneumophila
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Legionella pneumophila treatment?
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erythromycin, rifampin
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Pseudomonas disease associations?
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pneumonia (CF pt)
sepsis (black lesions) external otitis (swimmer's ear) UTI drug use diabetic osteomyelitis hot tub folliculitis burn victim |
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blue green pigment
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pseudomonas
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endotoxin (fever, shock)
exotoxin A (inactivates EF-2) |
pseudomonas
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pseudomonas treatment
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aminoglycoside+extended spectrum penicillin (ticarcillin, piperacillin)
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Enterobacteriaceae characteristics
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somatic (O) Ag (polysaccharide of endotoxin)
capsular K Ag flagellar H Ag |
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Enterobacteriaceae organisms
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E. coli
Salmonella Shigella Klebsiella Enterobacter Serratia Proteus |
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pneumonia in alcoholics/diabetics
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klebsiella
also cause nosocomial UTI |
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red currant jelly sputum
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klebsiella
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aspiration pneumonia
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klebsiella
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G- rod, nonlactose fermenter, oxidase negative
invade intestinal mucosa--bloody diarrhea |
salmonella
shigella |
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produces H2S, has flagella
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salmonella
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Do you treat salmonella with antibiotics?
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yes, but may prolong symptoms
cipro, ceftriaxone |
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fever, diarrhea, headache, rose spots on abdomen
can remain in gallbladder chronically |
salmonella typhi
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Salmonella virulence factors
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motile (H Ag)
capsule (VI Ag) protects from intracellular killing siderophore |
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Shigella virulence factor
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Shiga toxin inactivates 60S rRNA
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osteomyelitis in sickle cell patient
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salmonella
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transmitted from pet feces, contaminated milk, pork
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Yersinia enterocolitica
also outbreaks in daycare centers can mimic crohn's, appendicitis |
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H. pylori treatment?
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BMT--
bismuth metronidazole (disulfiram like reaction with EtOH) tetracycline/amoxicillin |
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causes gastritis and 90% duodenal ulcers
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H. pylori
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spirochetes
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Borrelia (big)
Leptospira Treponema |
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Which spirochete can be visualized with LM?
With darkfield? |
LM using aniline dyes (Wright's or Giemsa)--Borrelia
darkfield microscopy--Treponema |
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question mark shaped bacteria found in water contaminated with animal urine
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Leptospira interrogans
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Weil's disease
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icterohemorrhagic leptospirosis--
severe form with jaundice, azotemia from liver/kidney dysfunction |
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leptospira treatment?
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penicillinc G, doxycycline
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Ixodes tick
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Borrelia burgdorferi
Babesia |
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erythema chronicum migrans, expanding "bull's eye" red rash with central clearing
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Lyme's disease
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3 stages of Lyme disease
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1--erythema chronicum migrans, flulike sx
2--neuro/cardiac manifestations 3--chronic monoarthritis, migratory polyarthritis |
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what animals involved with Lyme disease reservoir?
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mice--reservoir
deer--tick life cycle |
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lyme disease treatment?
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doxycycline
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Lyme disease clinical manifestations?
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BAKE a Key LYME pie--
Bell's palsy Arthritis Kardiac block Erythema migrans |
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yaws
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Treponema pertenue
infection of skin, bone, joints, heals with keloids, severe limb deformities |
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jarisch herxheimer phenomenon
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symptoms worsen initially after starting antibiotics for syphilis
killed organisms release pyrogen |
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syphilis treatment?
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penicillin G
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painless chancre
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primary syphilis
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maculopapular rash (palms/soles), condylomata lata
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secondary syphilis
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gummas, aortitis, neurosyphilis, argyll robertson pupil
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tertiary syphilis
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saber shins, saddle nose, CN VIII deafness, Hutchinson's teeth
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congenital syphilis
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broad-based ataxia, Romberg+, Charcot joints, stroke without HTN
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tertiary syphilis
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specific test for treponemes?
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FTA-ABS--
most specific earliest positive remains positive longest |
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VDRL false positives
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VDRL--
viruses (mono, hepatitis) drugs rheumatic fever lupus/leprosy |
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cat scratch
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Bartonella henselae
cat scratch fever stellate granulomas |
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tick bite, ixodes
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Borrelia burgdorferi
Lyme disease |
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dairy products, contact with animals
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Brucella spp.
brucellosis/undulant fever |
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tick bite, rabbits/deer
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Francisella tularensis
Tularemia |
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flea bite, rodents esp prairie dogs
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Yersinia pestis
Plague |
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animal bite
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Pasteurella multocida
cellulitis |
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off-white/gray vaginal discharge, fishy smell
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gardnerella vaginalis
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Mobiluncus
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anaerobe involved with gardnerella infection
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Is Gardnerella an STD?
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No, overgrowth of vaginal bacteria
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Gardnerella treatment?
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metronidazole
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clue cells, vaginal epithelial cells
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Gardnerella
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headache, fever, rash (vasculitis)
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Rickettsiae
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Why is Coxiella different?
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Q fever
no rash no arthropod vector (transmitted aerosol) |
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Rickettsial infection treatment?
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tetracycline
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Rocky mountain spotted fever
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tick
Rickettsia rickettsii |
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endemic typhus
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fleas
R. typhi |
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epidemic typhus
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human body louse
R. prowazekii |
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Ehrlichiosis
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tick
Ehrlichia |
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Q fever
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inhaled aerosols
Coxiella burnetii |
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progression of Rickettsial rash?
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start on hands/feet
"Rickettsia on wRists, Typhus on Trunk" |
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progression typhus rash?
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starts centrally and spreads out
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Weil-felix reaction
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use Proteus Ag whcih cross reacts with antirickettsial Abs
typhus, Rocky Mountain spotted fever negative for Q fever |
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palm/sole rash organisms?
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CARS--
Coxsackievirus A Rocky Mountain spotted fever Syphilis S. aureus (TSS) |
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lacks muramic acid, no peptidoglycan layer
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chlamydia
cannot use penicillin/cell wall inhibitor |
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2 forms of Chlamydia
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Elementary body (entry via endocytosis)
Reticulate body (replicates via binary fission) |
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Chlamydia lab diagnosis?
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cytoplasmic inclusions on Giemsa or fluorescent Ab-stained smear
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Chlamydia trachomatis clinical manifestations?
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reactive arthritis
conjunctivitis nongonococcal urethritis PID |
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C. pneumoniae, C. psittaci cause what?
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atypical pneumonia
aerosol transmission |
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Chlamydia types A, B, C
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Africa
Blindness Chronic infection |
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Chlamydia types L1, L2, L3
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lymphogranuloma venereum (acute lymphadenitis-positive Frei test)
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Chlamydia types D-K
|
urethritis/PID
ectopic pregnancy neonatal pneumonia neonatal conjunctiviits |
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Chlamydia treatment?
|
oral erythromycin
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walking pneumonia
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mycoplasma pneumoniae
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no cell wall, membrane contains cholesterol
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Mycoplasma
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Grown on Eaton's agar
Cold Agglutinins (IgM) |
mycoplasma
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Mycoplasma treatment?
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tetracycline or erythromycin
penicillin resist because no cell wall |
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frequent outbreaks in military recruits/prisons
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Mycoplasma pneumoniae
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