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213 Cards in this Set
- Front
- Back
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What are the alpha hemolytic streptococci?
(Partial hemolysis) - green |
S. Pneumoniae (pneumococcus)
S. Viridans |
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What are the beta hemolytic streptococci?
(total hemolysis) - clear |
S. Pyogenes
S. Agalactiae |
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What are the y-hemolytic streptococci?
(no hemolysis) - red |
Enterococcus:
- S. faecalis - S. Faecium |
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What are (Lancefield) group A streptococci, GAS?
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This is G+ S. pyogenes - responsible for a variety of infections but most famous for the acute rhematic fever and postinfectious glomerulonephritis - in untreated patients
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What are (Lancefield) group B streptococci, GBS?
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G+ S. Agalactiae, causing a variety of infections like septicemia of newborn, mastitis etc...
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What is the most common agent for infectious endocarditis?
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- Streptococcus viridans - from oral cavity (appearantly one can get it from brushing teeth too vigourisly…)
- Staphylococcus aureus in IV abusers (right heart) |
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Streptococci viridans - tell me about it?
Class? Virulence? Clinical? |
Alpha hemolytic streptococci
Low virulence - excrete hyaluronidase for CT dissolvement for its own entrance Most common cause of infective endocarditis |
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What was the group A streptococci again? GAS
What is its virulence factor? |
S. pyogenes
Virulence: Very high - Hyaluronidase - Fibrinolysin |
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What are the most typical infections caused by GAS?
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1. Strep throat AKA pharyngitis
- Bronchopneumonia - Tonsillitis 2. - Impetigo - Cellulitis - Erysipelas |
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What is impetigo?
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Contagious skin disease - caused by s. aureus and sometimes s. pyogenes (here)
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Types of impetigo?
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1. Bullous
- Fluid filled blisters - forming yellow scabs when they rupture - not contagious as long as not ruptured? 2. Non-bullous - Patchy red sores - contagious |
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What is cellulitis?
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Deep, diffuse inflammation of connective tissue of dermis and subcutaneous fat
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What is erysipelas?
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Diffuse superficial infection of upper dermis - caused by streptococcus.
It is always more superficial than cellulitis, and more raised and demarcated |
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What is causative agent behind scarlet fever?
What is it manifested by? |
It is a complication of GAS infection - where an erythrogenic toxin produced by s. pyogenes, manifested by:
- Soar throat - Fever - Sandpaper rash on reddened skin - Red tounge (strawberry tounge) |
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What are the complication of GAS infection?
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- Rheumatic fever
- Post streptococcal glomerulonephritis - Scarlet fever - Toxic shock syndrome |
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What is toxic shock syndrome?
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Life threatening complication of some bacterial toxins - mostly caused by staph aureus but sometimes strept. pyogenes
Has been associated with use of tampons - which declined after certain types was withdrawn from the market. |
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Which bacteria is pneumococcus?
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Streptococcus pneumoniae
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Virulence of s. pneumoniae?
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Quite low, since its part of normal respiratory flora - occurs mostly in immunocompromized patients
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What type of infection does s.pneumoniae cause?
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Pyogenic
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Types of infections in respiratory system with s.pneumoniae?
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- Lobar pneumonia
- Sinusitis - Otitis media - Sinusitis |
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If s. pneumoniae gets to the blood stream - what happens?
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Meningitis & leptomeningitis
Produce a pus-cap on the meninges |
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Streptococcus faecalis cause infections where?
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GIT and urinary tract
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Staphylococci epidermidis:
- Coagulase? - Virulence? - Normal habitat? - What type of infections is it common for? - Penicillin resistance? |
- Coagulase -
- Low virulence - Normally live on the skin - Cause nocosomial infections by creating biofilms on catheters and prostesis |
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Staphylococcus aureus:
- Coagulase? - It has a tendency for what??? |
- Coagulase +
- Has a tendency to form abscesses and also create septicopyemia |
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Definition septicopyemia?
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A septic / infectious emboli in blood, with material from either
- Infectious endocarditis - Thrombophlebitis |
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In septicopyemia - where will the distant abscesses most likely be if originating from I. endocarditis?
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LH:
- Brain - Spleen - Kidneys |
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4 classes of septicopyemia?
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- Central (heart)
- Peripheral (thr.phlebitis) - Portal - Umbilical |
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What are the most typical staphylococcal infections?
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- Skin infections
- Infective endocarditis - Bronchopneumonia - Wound infections - Enteritis |
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Classification of skin infections caused by staphylococci?
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- Furuncles
- Carbuncles - Impetigo - Mastitis puerperalis |
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What is a furuncle?
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Deep suppurative inflammation affecting follicles of dermis.
A reddish spot with yellow spot - and if you squeeze it there is some chronic material coming from the lesion A pimple - or boil |
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What is a carbuncle?
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A collection of furuncles :)
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What is impetigo?
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Superficial contageous inflammation
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What is mastitis puerperalis?
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Inflammation of the breast. Enlarged & red with abscesses.
Comes from breastfeeding - from baby's mouth. |
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Which valves are typically affected by staph. aureus in infective endocarditis?
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Right heart valves - since it usually comes from IV drug abusers - via the venous system!
But in reality it can be both. |
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What is mortality of infective endocarditis with s. aureus?
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Up to 70% - since it destroys the valve and cause pyemia
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What is septicopyemia?
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Septic emboli in blood, originating from inf. endocarditis or thrombophlebitis!
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What is pyemia?
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Septicemia caused by pyogenic bacterias leading to multiple abscesses
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What type of inflammation occurs in staphylococcal enteritis?
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Pseudomembranous inflammation
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Which is pneumococcus?
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Streptococcus pneumoniae
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Which is enterococcus?
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Str. enteritidis
Str. Faecalis |
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Which is gonococcus?
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Neisseria gonorrhae
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Which is Meningococcus?
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Neisseria meningitidis
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What is gonorrhae?
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A STD infection - caused by the diplococci Neisseria Gonorrhae - infecting the urogenital epithelia
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Clinical symptoms of gonorrhae in men?
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- Suppurative urethritis (leukorrhea) with dysuria
- Prositis.. - Seminitis - Epidydimitis - Orchitis … But sometimes it may be asymptomatic!!! |
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Clinical symptoms of gonorrhae in females?
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1. urethritis
2. Cervicitis 3. Endometritis 4. Salpingitis --> Fibrosis, obstruction & infertility / ectopy |
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How does babies get gonorrhae infeciton and where?
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During birth - typically in eyes - as a conjunctivitis
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What was meningococcus again?
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Neisseria meningitides
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Definition of meningitis?
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Inflammation & thus irritation of the meninges - with presence of neutrophils in the CSF
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Clinical symptoms of meningitis?
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- Neck hard to bend
- Septicemia - Adrenal hemorrhagic necrosis |
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How does septicemia manifest?
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- Septic fever (40deg)
- Shock (toxins break down vessels) - DIC - Purpura & petechiae (due to consumptive coagulopathy) |
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What is adrenal hemorrhagic necrosis?
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Adrenal gland failure due to bleeding into it - caused by severe infection by Neisseria meningitidis
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Another name for adrenal hemorrhagic necrosis - and how is this syndrome manifested?
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Waterhouse-Friedriscsen syndrome
- Septicemia - Shock, DIC - purpura - Adrenaodeficiency - Organ failure - Death |
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Mortality of N. Meningitides if untreated?
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Veyr very high!
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Age group affected b N. meningitides?
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Children and young adults of 2-3rd decade
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Where is E.coli natural habitat?
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GIT
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What other bacteria has natural habitat of GIT?
What is their main role there? |
- E.coli
- Proteus (vulgaris) - Pseudomonas (aeroginosa) - Klebsiella (pneumoniae) Role is to contribute to digestion - maybe gas production for better travelling of feaces |
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What happens when these natural habitat GIT bacteria gets somewhere outside of GIT?
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Cause suppurative inflammation
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What infections do all G negatives cause in UTI?
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- Urocystitis
- Pyelitis - Pyelonephritis |
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What infections does all G negatives cause in gall & liver system?
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- CHolangitis
- Cholecystitis (E. coli most common) Cause abscesses in liver |
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Which infant infections does the G- cause?
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Meningitis
Peritonitis (primary) |
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THe most important salmonella serotypes?
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- S. Typhi
- S. paratyphi - S. enteritidis |
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S. typhi cause?
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Typhoid fever
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How common is typhoid fever now?
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Not so much - was more common before ATB. But common in developing countries
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Definition typhoid fever?
Transmission? Manifestations? What is it also called? |
An acute infectious disease caused by S.typhi
Transmitted through food and water - causing fever, cough, intestinal hemorrhage, rose-color skin spots Also called enteric fever |
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There are 4 stages of typhoid fever - what are they?
For how long does each stage last? |
1. Septic phase
2. Infiltration phase 3. Necrotic phase 4. Healing phase Each stage last 1 week |
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Septic phase is manifesting with?
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HIgh fever
'Roseolar typhosa' = rose rash |
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Infiltrative phase is manifesting with?
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Abdominal symptoms:
- Diarrhea Infiltration of lymph tissue: - Of GIT: Peyer's patches - Mesenteric lymph nodes - Replacement of lymphocytes with macrophages and 'typhoid cells' - Infiltration of also the spleen - so massive splenomegaly |
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What are typhoid cells?
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Macrophages containing bacteria - which aggregates in typhoid nodules / typhoid granulomas
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How large can the spleen get in typhoid fever?
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300-500g! Usually 150g
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Manifestation of necrotic stage?
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Ulceration of mucosa of bowel and P-patches
Lead to longitudinal ulcers. (NB! TB has transverse ulcers) ---> Thus blood in diarrhea |
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Manifestation of healing - if patient survive?
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Scarring and healing
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What are the main symptoms of typhoid fever?
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- Fever
- Cough - Intestinal bleeding - Bowel perforation (deep ulcers) - Spleen rupture --> Hemoperitoneum / hemoasces |
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How is paratyphoid fever?
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Similar to typhoid fever - just less severe - and caused by S.paratyphi
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What does S.enteritidis cause?
How is it transmitted? |
Salmonellosis
Transmitted via undercooked food, eggs, meat fish |
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Definition salmonellosis?
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Infection with S.enteritidis causing fever with gastroenteritis:
- Diarrhea and GIT spasms. Run epidemically. |
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What is Yersiniae?
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A antropozoonotic gram negative bacteria, in family of enterobacteriaceae, whereof the most important pathogen is the Yersinia pestis
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What does anthropozoonotic mean?
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Transmitted from animals to humans
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What other famous bacteria is in the enterobacteriacaea family?
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Salmonella
E-coli Klebsiella Shigella Proteus |
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What does Y.pestis cause?
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The plague, or as called in middle ages: "black disease"
(Mor in czech) |
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How does y.pestis infection most often present?
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- Granulomatous lesions (TB-like)
- Necrotic / hemorrhagic lesions of lymph nodes |
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What 3 forms may the human Y.pestis infection take?
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1. Bubonic
2. Pneumonic 3. Septic |
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Bubonic plague?
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Large lymphadenopathy (hemorrhagic / necrotic) with lymphadenitis
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Pneunonic plague?
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Necrotic inflammation of lungs, with expectoration of LUNG tissue!
Very high mortality |
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Septic plague?
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Also very high mortality rate
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How is y.pestis transmitted?
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From flea of rats to humans
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Another important Yersinia?
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Y. Enterolytica
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What cayses Y.enterolytica?
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Lymphadenitis mesenteralis
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What is lymphadenitis mesenteralis?
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Enlargement of mesenterial lymph nodes, causing symptoms similar to appendicitis
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Histology of lymphadenitis mesenteralis of Y.enterolytica?
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Granuloma with central neutrophils (pus), surrounded by epithelioid cells
Small abscesses |
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Typical outcome of Y.enterolytica infection?
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Spontaneous healing
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Cat scratch disease is similar to Y. enterolytica infection. What is different?
Causative agent? Location? Histology? Clinically? |
Agent:
- Bartonella henslae Location - Superficial lymph nodes (axilla, inguinal) Histology - The same Clinically - Enlargement of lymph nodes - patient think he has malignancy |
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What is it called when one has cat scratch disease and lymphadenitis mesenteralis?
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Lymphoreticulitis
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What is Brucellae?
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They are zoonotic gram negative bacteria, working as intracellular parasites - leading to brucellosis
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Classification of brucellosis according to time specter?
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Acute
Subacute Chronic |
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Acute brucellosis?
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Mostly sepsis
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Subacute brucellosis?
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Intermittent fever (febris undulans)
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Chronic brucellosis?
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- Fever
- Muscular pain - Erythema |
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Other names for brucellosis?
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Malta fever, mediterranian fever, Bang's disease….
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What does the Brucella bacterias cause in animals?
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Always spontaneous abortion
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Which type of inflammation does brucella cause?
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Granulomatous inflammation
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List 3 Brucella species and what animal they belong to?
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B.Canis - dog
B. suis - pigs B.abortus - cattle |
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What is tularemia and what is it caused by?
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So-called rabbit plague, caused by Francisella tularensis
Typically a wound on hand that fails to heal - lead to axillary lymphadenopathy & necrotic / hemorrhagic lymphadenitis |
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3 ways of transmitting tularemia?
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1. Wounds
2. Eyes 3. Lungs (inhalation --> pneumonia) |
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If primary lesion of tularemia is on eye it leads to?
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Ulcers on conjunctiva
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What may one die of in tularemia infection?
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Septicemia
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Anthrax is caused by?
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Bacillus anthracis
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How is the most lethal type of anthrax infection?
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Ulcerative lesion called "pustula malgina", also leading to:
- Necrotizing pneumonia - Septicemia with splenomegaly |
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Most dangerous corynebacterium?
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C. diphteria
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C. Diptheriae cause what?
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1. Suppurative pseudomembranous infection
2. Produce toxin leading to myocarditis & heart failure |
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How is appearance of spirochetes?
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Thin walls
Flexible Spiral rods |
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3 most famous spirochetes?
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1. Treponema pallidum
2. Borrelia burgdorferi 3. Leptospira interrogan |
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Treponema pallidum cause?
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Syphilis
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Borrelia burgdorferi cause?
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Lyme disease
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B. Burgdorferi is transmitted by?
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Ticks
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3 stages of Lyme disease?
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1. Erythema migrans
2. Nervous system involvement 3. Arthritis |
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What is erythemia migrans?
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Bullseye rash - with red spot and enlarging red circle
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What nervous system involvements are there in lyme disease?
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1. Meningitis
2. Encephalitis 3. Peripheral neuritis |
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Which joints suffers from arthritis in Lyme disease?
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Large joints like knee
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Leptospira interrogan cause what?
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Leptospirosis
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What is leptospirosis?
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A febrile disease, sometimes mild symptoms like fever, headache and muscle ache - other times with more severe symptoms like meningitis
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What is leptospirosis + hepatitis called?
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Weil's disease
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What are the objective clinical symptoms of leptospirosis?
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- Uremia (nephritis)
- Jaundice (hepatitis) - Muscle pain (myositis) |
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If the muscle is necrotic in leptospirosis - what is it called?
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Zenker necrosis - lead to 20% mortality
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How is leptospirosis spread?
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By rodents (rat-family) urine in the soil
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How do we classify mycoses?
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1. Primary mycoses
2. Secondary mycoses 3. Myocotic-like diseases |
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Definition primary mycosis?
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A mycosis of a healthy individual, coming from the environment
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Typical primary mycotic agent?
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Cryptococcus neoformans
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Morphology of c. neoformans?
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Globular shaped with mucin coat - stain with PAS
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Transmission of c. neoformans?
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Through pigeon droplets, which mixes with dust in the air - and inhaled by lungs and goes to brain via circulation
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Diseases caused by c.neoformans?
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1. Pulmonary cryptococcosis
2. Meningeal cryptococcosis 3. Wound cryptococcosis 4. Encephalitis |
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Which fungi are typically causing fungal encephalitis in immunocompromized patients?
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- Candida
- Aspergillus - Mucor - Cryptococcus |
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What is secondary mycosis?
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A mycosis caused by a true fungi, often in a immunocompromized patient
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Examples of fungi causing secondary mycosis?
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- Candida
- Aspergillus - Mucor |
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Morphology of the secondary mycosis species?
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Either as:
1. Hyphae (threads) 2. Spores (globular) |
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Classification of mycosis according to depth of infection?
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Superficial
Deep |
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Superficial mycosis infection is called?
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Dermatomycosis
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Dermatomycosis of head is called?
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Tinea capitis
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Dermatomycosis of beard is called?
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Tinea barbae
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Dermatomycosis of body is called?
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Tinea corporis
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Dermatomycosis of foot / toes is called?
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Tinea pedis
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Nail fungal infection is called?
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Onychomycosis
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External auditory meatus fungal infection is called?
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Otomycosis
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How does a deep tissue mycosis develop?
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From endogenous infection - from ones own tissue
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Acute deep mycosis produce?
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Pus (suppurative)
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Chronic deep mycosis produce?
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Ganulomas
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Name of most famous candida species?
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Candida albicans
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What type of bacteria is candida albicans?
What is the name of infection? |
Saprophyte - candidiasis
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Where is the natural habitat of candida?
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- Oral cavity
- Esophagus - Vagina |
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3 types of lesions caused by candida?
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1. Acute pseudomembranous
2. Erythematous candidiasis 3. Hyperblastic candidiasis |
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What is acute pseudomembranous candidiasis?
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Superficial infection / soar occuring in oral cavity in immunosuppressed patients.
Presents as white cover easy to peel off, consisting of fibrin & cell debris |
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What is erythematous candidiasis?
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Atrophy of tounge papillary structures - with overgrowth of candida
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What is the thought causes of erythematous candidiasis?
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1. ATB treatment
2. Asthma patients inhaling corticosteroids |
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What is hyperblastic candidiasis?
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Leukoplakia - a keratinized layer to protect itself
Hyperkeratosis with possible dysplasia |
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Examples of deep candidiasis?
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1. Thrombophlebitis if it reaches the veins
2. Infective endocarditis if it colonize valves |
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Candida in vagina leads to?
What comorbidity is common? |
Mycotic vulvitis / kolpitis
Comorbidity : - HIV - DM |
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Candidiasis is very typical for which common disease in western world?
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DM
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Which typical immunosuppressions favour candida proliferation?
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- DM
- HIV - Post chemotherapy - Post radiotherapy |
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What are the mycotic granulomatous inflammations?
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- Aspergillus /=> Aspergilloma
- Mucor |
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2 types of aspergillus funghi?
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1. A. fumigatus
2. A. flavus |
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Why is it called aspergillus?
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Due to it's shape - look like the aspergillum which you spread the holy water with if you are a roman catholic
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Natural habitat of aspergillus?
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Respiratory system:
- Lungs - Paranasal sinuses |
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A. fumigatus cause?
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Aspergillosis - overgrowth of the fungi at different locations… Or deep infection by granulomas
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What is a aspergilloma?
When is it found? |
A granulomatous inflammation composed of millions of fibers, resembling a tumor, looking yellow and greasy.
Found in bronchiectasis and maxillary sinuses |
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A. flavus will cause?
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Liver cirrhosis and potentially hepatocellular carcinoma, due to the alpha toxin
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What is mucor?
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A fungi found on gone out vegetables and breads
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What does mucor infection cause?
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Mucormycosis / phycomycosis
Potentially fatal infection of: - Brain - Lungs - GIT Have a tendency to open vessels (lungs) and bleed with hemoptysis |
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What are mycosis-like diseases?
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Organisms between bacteria and fungi
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Definition bacteria?
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One-celled prokaryotic organism, appearing either spherical, spiral, rod shaped - single or in chains
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Definition fungi?
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Single celled or complex multicellular , EUkaryotic organism - living as hyphae or spores
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What are the 2 main mycotic-like organisms? (I think they are bacteria)
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1. Actinomycetes
2. Nocardia |
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Actinomycosis is caused by?
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Actinomyces israelii
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Characteristics of A. israelii?
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Gram +
Fibroid rods |
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Natural habitat of A. israelii?
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Oral cavity
Crypts of tonsils |
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What is actinomycosis?
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Abscess formation - with a central colony of bacteria in LM (& lymphocytic infiltrative background)
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Most common sites of actinomycosis?
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1. Oral cavity
2. Thoracic (pleura, mediastinum) 3. Abdominal near caecum 4. Uterus in intrauterine devices not changes (3y) |
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How are the actinomycosis abscesses?
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1. CT proliferative
2. Suppurative - Small abscesses containing bacteria - contain sulphur granules |
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How is the actinomycosis abscesses connected to surface?
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Via fistulas - that drain the pus
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Main organism of Nocardia?
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Nocardia asteroids
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What does N. asteroids cause?
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Nocardiosis = abscesses of lung and brain
- Pneumonia |
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How does nocardia infection look?
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Like TB and actinomycetes (grnaulomas & necrosis)
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Definition Rickettsial diseases?
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Severe acute infections by any rickettsia species - main diseases are:
- Typhus - Q fever |
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What is the agent behind these typhus?
How is it transmitted? |
Rickettsia prowasekii
Transmitted by lice, ticks etc |
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Basic characteristics of Rickettsia Prowasekii?
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Gram negative, small cocc-rod shaped
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What is Q-fever?
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Endemic in australia, caused by coxiella burnetii - leading to pneumonia and encephalitis
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Another name for typhus?
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Spotted fever - since it persents with these red skin spots
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Why does typhus present with red skin spots?
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Since it damages endothelium of capillaries, leading to bleeding
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Worst case complications of typhus fever?
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- Encephalitis
- Myocarditis |
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Chlamydia diseases are caused by?
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C. trachomatis
C. psittacis C. pneumoniae |
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3 diseases caused by C.trachomatis?
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1. Trachoma
2. Lymphogranuloma venerum 3. NGU = non-gonococcal urethritis |
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Definition trachoma?
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Inflammation of cornea & conjunctiva
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Definition lymphogranuloma venerum?
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A veneral disease with manifestation of granulomatous inflammation of inguinal lymph nodes
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Definition NGU?
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Inflammation of urethra, not caused by gonorrhea - classified for treatment purposes
Caused by a variety of pathogens - chlamydia among them |
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What is Reiter syndrome?
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A syndrome causing:
- Arthritis - Conjunctivitis - NGU Most often caused by chlamydia (veneral) |
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What is psittacosis?
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Parrot-born pneumonia with flu-like symptoms - caused by chlamydia psittaci
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What is chlamydia pneumoniae causing?
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Atypical pneumonia - one of the most common causes
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Pathogenesis of primary TB?
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1. Inhalation in lungs
2. Mycobacteria proliferate in macrophages - but usually controlled 3. Create a single granulomatous lesion (Ghon focus) 4. Spread to hilar lymph nodes (Ghon complex) 5. If no progress (mostly) - there is scarring & calcification |
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Complications of primary TB?
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1. Tuberculous pneumonia
2. Miliary tuberculosis |
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What is the MOST IMPORTANT difference between primary and secondary TB?
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Primary
- No contact with TB before Secondary - Already been in contact with TB |
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How many people are killed by TB every year?
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About 3 million :/
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Pathogenesis of secondary TB?
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1. Reactivation of dormant bacilli
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Location of these dormant TB bacili, usually?
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In apexes of lungs
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Secondary TB may progress to?
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1. Cavitary fibrocaseous tuberculosis
2. Tuberculous pneumonia 3. Miliary TB |
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Symptoms of secondary TB?
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Fever
Weight loss Productive cough with blood streaked sputum / hemoptysis |
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Definition disseminated / miliary TB?
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TB spread in blood
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Main organs TB spreads to?
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- Liver
- Spleen - Kidneys - Bone marrow |
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If isolated organ only has a TB spread - which is it usually?
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- Adrenal gland
- Kidneys - Bone - Female genital tract |
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What are the 2 main types of mycobacterium?
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1. M. tuberculosis
2. M. leprae |
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2 types of leprosy?
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1. Tuberculoid leprosy
2. Lepromatous leprosy |
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What is tuberculoid leprosy?
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Disease similar to TB - but not the same
- Affect skin nerves quickly, but with few bacilli - so it is not contageous |
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Clinically - tuberculous leprosy?
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Depigmented areas of skin - with patches of no sensation (anesthesized)
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Histology of tuberculous leprosy?
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Granulation tissue withOUT casseous necrosis
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What is lepromatous leprosy?
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Multiple subcutaneous nodules on face and hands (lepromas) - slow nerve damage with many bacilli - so it is very contageous!
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Histology of a lepromatous leprosy nodule? (leproma)
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Histiocytes are found (granulomas) with foamy cytoplasm
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