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139 Cards in this Set

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