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139 Cards in this Set
- Front
- Back
gram - diplococci that ferments glucose only and has pili, IgA protease
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N. gonorrhoeae
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antigenic variation to evade host defenses
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N. gonorrhoeae
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What are some complications of N. gonorrhoeae for a baby? if left untreated?
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baby: ophthalmia neonatorum
untreated: septic arthritis, PID, sterility, Fitz-Hugh-Curtis syndrome |
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Where does N. gonorrhoeae live?
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neutrophils
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Grows on Thayer martin media
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N. gonorrhoeae & N. Meningitidis
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Treatment for N. gonorrhoeae
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ceftriaxone (+ doxy for chlamydia)
erythromycin drops for baby |
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What causes higher incidence of infection of N. gonorrhoeae
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menstruation or IUD
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MC septic arthritis in sexually active people
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N. gonorrhoeae
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gram - diplococci that ferments maltose and glucose
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N. meningitidis
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meningococcemia + petechial rash
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N. meningitidis
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Waterhouse-Friderichsen syndrome
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N. meningitidis
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where does N. meningitidis colonize to infect?
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nasopharynx --> blood --> choroid plexus --> meninges
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how does N. meningitidis get into the blood?
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crosses mucosa via phagocytic vacuoles of non-ciliated cells to release endotoxin which causes rash
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Treatment for N. meningitidis
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PCN G, ceftriaxone
rifampin for prophylaxis vaccine |
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How long are neonates protected?
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6 months - maternal AB then wears off
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What are AB created against in HiB vaccine?
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polyribityribosyl phosphate on polysac capsule
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grows with X and V factors on chocolate agar, gram - coccobacilli, IgA protease, + Quellung
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H. influenzae
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H. influenzae causes
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meningitis, otitis media, pneu, epiglottitis, septic arthritis, cellulitis
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Treatment H. influenzae
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3rd gen cephalosporin & Hib vaccine which is conjugated with Diphtheria toxoid to increase immunogenicity
rifampin for close contacts |
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gram - that poses great threat to asplenic patients
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H. influenzae
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MCC meningitis in children 6 mo - 6 yrs
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S. pneu, N. meningitidis, H. influenzae (decreased with vaccine)
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gram - coccobaclli that is aerobic and can be found in macrophages
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Brucella
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gram - causing undulating fever after eating goat cheese
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Brucella
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pathogenesis of Brucella
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localizes to reticuloendothelial system to cause caseating granulomas and abscess formation with the fever
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Treatment of Brucella
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doxycycline and gentamycin
pasteurize milk |
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MC complication of Brucella
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osteomyelitis
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Gram - coccobaccilli that requires cysteine to grow, PLEOMORPHIC
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F. tularensis
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site specific infection + lymphadenopathy after handling a rabbit in Arkansas, Oklahoma or Missouri
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F. tularensis
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ulcer with black base
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F. tularensis
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pathogensis of F. tularensis
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bacteria phagocytosed to localize to reticuloendothelial system to cause caseating granulomas and regional lymphadenopathy with LONG LASTING fever
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Treatment of F. tularensis
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streptomycin & live attenuated vaccine
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Gram - pleomorphic that is catalase and oxidase +
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Pasteurella multocida
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dog or cat bite leading to cellulitis or osteomyelitis
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Pasteurella multocida
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treatment of Pasteurella multocida
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PCN G & clean and drain wound
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gram - coccobacilli that grows on Bordet-Genou medium
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Bordetella pertussis
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What mediates adherence of Bordetella pertussis to ciliated epithelium in respiratory?
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filamentous hemagglutinin
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whooping cough
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Bordetella pertussis
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How does the exotoxin of bordetella work?
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AB toxin --> ADP-ribosylates and inactivates Gi so uninhibited adenylate cyclase to increase cAMP which causes lymphocytosis and decrease phagocytosis
tracheal cytotoxin kills ciliated epithelial cells |
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Treatment of Bordetella pertussis
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DTaP vaccine (acellular Pertussin antigens) & erythromycin
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gram - coccobacilli that grows on Charcoal with iron and cysteine - can be found in macrophage
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Legionella pneumophilia
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water reservoirs, proliferates in nutrient rich phagosome and weakens MP respiratory burt and prevents phagosome from fusing to lysosome
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Legionella pneumophilia
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silver stain can help visualize or urine antigen detected by radioimmunoassay
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Legionella pneumophilia
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Treatment of Legionella pneumophilia
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erythromycin & fluoroquinolone
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hyponatremia
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Legionella pneumophilia
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community aquired pneumonia in elderly smokers
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Legionella pneumophilia
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gram - rod, lactose fermenting, mucoid appearance
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Klebsiella pneu
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pneumonia in smoker with currant jelly sputum or nosocomial UTI
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Klebsiella pneu
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Where does Klebsiella pneu most frequently colonize?
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right upper lobe
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When does Klebsiella pneu cause UTI?
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when all other bacteria were killed off in the hospital
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Treatment of Klebsiella pneu
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3rd generation cephalosporin
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What are other similar nosocomial infections to Klebsiella pneu?
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serratia marcescens and Enterobacter
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gram - rod, lactose fermenting, indole +
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E. coli
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What are the 3 antigens of E. coli?
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K antigen = Kapsule (aids in infection from nasopharynx to GI - virulence for neonatal meningitis; blocks complement, phagocytosis and other host repsonse)
O antigen = LPS H antigen = flagella |
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What does the endotoxin of E. coli do?
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lipid A component of LPS causes septic shock
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Pathogenesis of ETEC
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non invasive, heat labile toxin and heat stabile --> travelers diarrhea
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What causes the blood diarrhea of EHEC?
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Shiga-like toxin
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What causes HUS?
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shiga-like toxin
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Which E.coli invades?
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EIEC invades the mucosal layer and secretes SLT 1 and 2 which caues dysentery
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What kind of food can E.coli be found on?
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undercooked beef
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How does E. coli LT toxin work?
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similar to cholera toxin AB toxin ADP ribosylates Gs which activates adenylate cyclase and increase cAMP so crypt cells secrete more Cl- and villous cells absrob less Na --> osmotic loss of water
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How does E. coli ST toxin work?
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similar to Yersinia enteroclitica toxin - activates guanylate cyclase which increases cGMP which decreases cotransport of NaCl to cells --> diarrhea
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How does E. coli SLT toxin work?
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aka verotoxin INACTIVATE 60S RIBOSOME UNIT TO BLOCK PROTEIN SYNTHESIS
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light purple on MacConkey agar
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E. coli
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What is the most virulent strain of EColi
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O157:H7
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fever, hemolytic anemia, thrombocytopenia, acute renal failure
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HUS
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gram - rod, non-lactose fermenting, oxidase -, urease +
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Proteus mirabilis
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staghorn calculi
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Proteus mirabilis
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O antigen on proteus is used for
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Weil-Felix reaction
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What allows for Proteus mirabilis motility?
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lots of flagella
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what does urease do?
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split urea to form ammonium hydroxide which increase pH which precipitates ammonium magnesium phosphate
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"swarming growth"
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Proteus mirabilis
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alkaline urine
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Proteus mirabilis
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Treatment of Proteus mirabilis
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TMP-SMX and ampicillin
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gram - rod, non-lactose fermenting, oxidase -, H2S negative, non motile
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Shigella dysenteriae
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small innoculation causes infection
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Shigella dysenteriae
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Where does Shigella dysenteriae replicated
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intracellularly and spreads cell to cell causing mucosal bleeding
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Shiga toxin mechanism
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INACTIVATES 60S RIBOSOME
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Treatment for Shigella dysenteriae
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fluoroquinolone
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What org other than E.coli causes HUS?
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Shigella dysenteriae
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Transmission of Shigella dysenteriae
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Fingers, flies, food, feces
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gram - rod, non-lactose fermenting, oxidase -, H2S producer, H antigen (flagella), endotoxin, Vi capsule
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salmonella
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large inoculum causes gastroenteritis
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salmonella enteritidis
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Turtles or uncooked chicken
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salmonella enteritidis
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Where does salmonella typhi infect specifically?
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penetrates mucosal barrier in distal ileum or colon
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Why can salmonella typhi live in Peyers patches?
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Vi polysaccharide
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rose spots on abdomen, fever, diarrhea, abdominal pain
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salmonella typhi
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can hide in gallbladder
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salmonella typhi
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treatment of salmonella typhi
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ceftriaxone for resistant
ciprofloxacin or ampicillin for carriers & cholecystectomy oral vaccines |
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Who has trouble clearing salmonella typhi?
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asplenic Sickle cell patients
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gram - comma shaped, non-lactose fermenting, oxidase +, glucose +
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vibrio cholera
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rice water diarrhea MOA
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vibrio attaches to proximal small intestine and releases AB toxin which ribosylates Gs keeping adenylate cyclase active and increasing cAMP so crypt cells secrete more Cl- and vilous cells less Na+ so there is an osmotic loss of water to lumen
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flat yellow colonies on TCBS agar
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vibrio cholera
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what increases sensitivity to vibrio cholera infection?
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achlorhydria or use of PPI
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Treatment of vibrio cholera
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tetracycline
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Where is cholera toxin carried on?
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bacteriophage
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Who is more vulnerable to vibrio cholera?
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blood group O
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gram - bacilli, non-lactose fermenting, oxidase +, capsule
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pseudomonas aeruginosa
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What causes hot tub folliculitis?
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pseudomonas aeruginosa
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osteomyelitis in diabetics or IV drug users
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pseudomonas aeruginosa
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pneumonia in CF patient
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pseudomonas aeruginosa
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What toxins are important for pseudomonas spread?
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exotoxin A: ADP ribosylates host EF2 to paralyze host cell protein machinery (like diphtheria)
phospholipase C --> damages host cell membrane and liberates phospholipids to feed organism elastase: cleaves elastin to dismmeinate endotoxin: shock pyocynanin: generates ROS |
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ecthyma gangrenosum
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pseudomonas aeruginosa
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Treatment of pseudomonas aeruginosa
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antipseudomonal PCn + aminoglycoside or fluoroquinolones
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What is the difference in pseudomonas aeruginosa when it infects lungs of CF patients
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does not make toxins makes antiphagocytice capsule and does not invade
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gram - rod, non-lactose, motile at 25 but not at 37
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Yersinia enterocolitica
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mesenteric adenitis or bloody diarrhea
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Yersinia enterocolitica
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What is the exotoxin secreted by Yersinia enterocolitica similar to?
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E. coli ST toxin
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Treatment for Yersinia enterocolitica
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self-limiting or gentamicin or chlormaphenicol for septicemia (rare)
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What HLA is Yersinia enterocolitica associated with?
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HLA B27 the arthrities
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How does Yersinia enterocolitica manifest in different ages?
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< 5 is blood diarrhea vs. > 5 is bloody diarrhea + appendicits like pain vs. adult is bloody diarrhea + arthritis
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gram - rod, non-lactose fermenting, BIPOLAR staining, Capsular F-1 antigen
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Yersinia pestis
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safety pin
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Yersinia pestis
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carried in fleas on rats
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Yersinia pestis
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regional lymphadenitis (buboes)
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Yersinia pestis
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Treatment for Yersinia pestis
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streptomycin, tetracycline
vaccine: killed & attenuated avail |
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How does Yersinia pestis become an aerosol infection?
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from septicemia which seeds into alveoli to cause pneu
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gram - spiral shaped, grows on campy agar, urease +
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H. pylori
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duodenal ulcers
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H. pylori
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Where does H. pylori prefer to live in stomach?
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antrum
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How does H. pylori protect itself from acid?
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uses urease to make ammonia --> host inflammatory response causes mucosal damage
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antral gastritis can lead to...
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decrease somatostatin production by antral D cells --> acid hypersecretion
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pangastritis leads to...
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acid hyposecretion --> gastric ulcers and gastric carcinomas
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How to dx H. pylori?
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C-labeled urea breath test or IgG titer
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Treatment of H. pylori
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PPI + amoxicillin + clarithromycin or
PPI + BMT (bismuth, metronidazole, tetracycline) |
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What do the ulcers of H. pylori look like?
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"punched out" appearance and smooth borders
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assoc with MALT and gastric adenocarcinoma
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H. pylori
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gram - S shaped rod that grows on Campy agar, urease -
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Campylobacter jejuni
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bloody diarrhea after eating undercooked chicken meat or unpasterurized milk
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Campylobacter jejuni
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The enterotoxin released by Campylobacter jejuni resembles what toxin?
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cholera toxin
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grows best at 42C - microerophilic
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Campylobacter jejuni
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Treatment of Campylobacter jejuni
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erythromycin or ciprofloxacin
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major complication of Campylobacter jejuni
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Guillain Barre syndrome
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What are the most common causes of diarrhea in the world?
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rotavirus, ETEC, Campylobacter jejuni
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gram - rod, strict anaerobe, large capsule that appears mucoid, inactive LPS
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Bacteroides fragilis
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peritonitis or GI/pelvic abscesses
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Bacteroides fragilis
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part of normal GI flora
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Bacteroides fragilis
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catalase + and superoxide dismutase +
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Bacteroides fragilis
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makes vitamin K for host
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Bacteroides fragilis
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grows on eosin methylene blue agar plates
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e.coli
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