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65 Cards in this Set

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Commonly associated with consumption of undercooked chicken.
Campylobacter jejuni
(gram negative rod, bacterial species most commonly isolated from diarrheal patients in the US, peak incidence rate occurs in patients <1 y/o and 15-29 y/o; in developing countries, adults develop immunity so C. jejuni only causes symptoms in first 2 years of life; illness begins with fever/headache, followed after half a day by abdominal cramps and BLOODY, loose diarrhea)
Causes "rice-water stool"
V. cholerae
(curved gram negative rod with single polar flagellum, toxin mediated; non-invasive; causes death by dehydration; rehydration is KEY)
Most commonly isolated bacterium found in diarrheal patients in the US
C. jejuni
(multiplies in upper intestine where bile rich environment is found)
20-50% of Guillan Barre syndrome cases are preceded by this bug
C. jejuni
(O antigens possess structures similar to human gangliosides--> neurological syndrome)
What is common about these: flagellae, cytolethal distending toxin, PEB1 antigen?
all virulence factors for campylobacter (PEB 1 antigen: adhesin and vaccine antigen)
Vaccine antigen for campylobacter?
PEB1
Causes acute enteritis, acute colitis, and pseudoappendicitis
C. jejuni
(also can cause reactive arthritis in patients with HLA-B27)
Causes diarrhea, bacteremia, vascular infections, CNS infections
C. fetus
(diarrheal illness indistinguishable from C. jejuni; usually immunocompromised get this bug)
This diarrheal causing bacteria is associated with cattle/sheep
C. fetus
(like C. jejuni, can be diagnosed by stool gram stain - where PMNs and RBCs can be found - and stool culture; give presumptive therapy if there's fever+bloody diarrhea for more than 8 bowel mvmt's/day; antibiobics helpful but REHYDRATION priority)
This bacteria is usually found in gastric mucosa
Helicobacter pylori
(motile, curved, gram negative rod; has highly motile, rapid corkscrew motion)
This bacteria is urease positive and catalase positive
H. pylori
(urease hydrolyzes urea to produce buffering ammonia to help organism survive acidic stomach environment)
What is CagA gene associated with? (H. pylori)
gastric cancer and duodenal ulcers
(if you have H. pylori with cagA you're more likely to get cancer; S1 genotype of vacA strongly associated with cagA positivity)
What is VacA important for in H. pylori?
gene that encodes for vacuolating cytotoxin in H. pylori; VacA is immunosuppressive: downregulates T-cell activation
This bacteria is associated with benign gastric ulcers as well as gastric cancer (severe cases)
H. pylori
(eradication decreases incidence of gastric cancer at antrum and body)
Infection of this bacteria is strongly associated with mucosal-associated lymphoid tumor (MALT)
H. pylori
(eradication improves histology of the tumor)
Treatment options for H. pylori
ion pump inhibitor (omeprazole) + 2 antibiotics (ie. clarithromycin + amoxicillin)
Causes diarrhea for 2 years, but eventually patients get better
Brainerd's diarrhea
Causes Rocky Mountain Spotted Fever
Rickettsia rickettsii
(small gram neg organism, spread by ticks, pass from lymphatics to systemic circulation to infect endothelium, leads to increased vascular permeability and multi-organ failure)
Causes fever, myalgia, headache and a rash that appears after 3-5 days of fever; WBCs normal
Rickettsia rickettsii
(Rocky Mountain Spotted Fever, gram negative organism; rash is important to clinical diagnosis, SEROLOGY is mainstay of daignosis but therapy must be given before results are back; INTRACELLLULAR PATHOGEN WITH NO CELL WALL ==> DOXYCYCLINE is drug of choice)
Type of zoonotic infection that infects WBCs rather than endothelium
Ehrlichia
(gram negative, obligate intracellular org, systemic febrile infection, tick borne disease)
Causes fever, chills, headache, myalgia, about 7 days after tick bite without rash. Also leukopenia and thrombocytopenia present.
Ehrlichia
(Hallmark: moruli can be seen replicating inside WBCs; SEROLOGY is mainstay of diagnosis but must treat before diagnosis is made; intracellular org. so DOXYCYCLINE is drug of choice)
Found in the normal flora in both dogs and cats; associated with overwhelmiing sepsis in splenectomized patients following cat/dog bites
capnocytophaga canimorsus
(common colonizer of oropharynx of dogs and sometimes cats)
Associated with cat bites that commonly leads to skin/soft tissue infection (progressing to necrotizing fascitis)
Pasturella multocida
(gram neg zoonotic infection, may also cause septic arthritis/osteomyelitis, tends to disseminate in patients wiht underlying liver disease, can cause meningitis; treat with beta-lactam + beta-lactamase inhibitor)
Causes "fever unknown origin" and transmitted by human contact with wide variety of mammals (horses, goats, other hooved animals); commonly seen in travelers from Mexico; patient claims he recently ate unpasteurized cheese
Brucellosis
(gram neg zoonotic & intracellular organism, can get infected through direct contact with infected animals, inhaled aerosols, ingestion of unpasteurized dairy products-- cheese)
Causes clinical presentation that is "Great imitator": can be acute or insiduous, fever, sweats, headache, most commonly back pain, and can involve any organ system
Brucellosis
(Dx: SEROLOGY useful when cultures are negative)
Causes infection usually by ticks or by direct contact with infected animals (ie. rabbits); ULCERATION follows a bite; risk factors: skin/soft tissue infection with prominent lymphadenopathy, pharyngitis unresponsive to penicillin, fever of unknown origin, pneumonia of unknown origin
Francisella tularensis
(small gram-neg coccobacillus, highly virulentmost commonly at risk are hunters, trappers, food handlers, farmers, veterinarians; Dx: SEROLOGY)
Patient presents with fevers, chills, headaches, leg pain, swollen lymph nodes in right groin. Notes that his home has lots of fleas
Yersinia pestis
(historically important gram neg zoonosis, usually transmitted by fleas & pneumonic form spread by human-human contact, high risk: hunters, trappers, persons with flea exposure; if infection goes to bloodstream ==> septicemia; if it goes to lungs can get pneumonic; Dx: Serology)
Using a lot of Carbapenem leads to resistance and increase of which bacteria?
Stenotrophomonas maltophila
(non-fermenting gram-neg, agent of ventilator-associated pneumonia and other nosocomial infections)
Main way to treat Rickettsial disease (Rocky Mountain Spotted Fever)
Doxycycline
Bullous impetigo is characteristic of:
S. aureus
(gram pos cocci)
"Hot tub" folliculitis
Pseudomonas aeruginosa
(gram neg rod, sharp demarcation at water line)
Carbuncles are almost always associated with this bacteria
S. aureus
Disfiguring infection affecting the apocrine sweat glands that involves the axilla, groin & perineum.
Hidradenitis Suppurativa
(commonly seen in African Americans; usually need surgical debridement)
Lymphangitis usually associated with this bacteria
S. pyogenes
Vast majority of simple cellulitis due to:
S. pyogenes
Associated with cat scratch that gets infected, leading to cellulitis
Pasteurella multocida
(treatable by amoxicillin)
Pus associated with cellulits (complicated soft tissue infections)
S. aureus
Dx of cellulitis
Rx of Uncomplicated cellulitis
Dx: culture between toes
Rx: bed rest with elevation of extremity, antibiotics, treat athlete's foot
What does a positive D-test mean for you?
the patients S. aureus was resistant to arithrymycin and susceptibility to clindamycin. this test tells you that the bacteria has inducible clindamycin. so you CAN'T give clindamycin, you have to use TRIMETHYLPRIM SULFA (oral antibiotic)
characterized by foul discharge and gas in the wound
anaerobic cellulitis
Pt with spontaneous mild necrosis in the muscle (myonecrosis)
C. perfringens, C. novyi, or C. septicum
(gram positive rods; gas producing bacteria in the tissue; gram stain shows missing leukocytes bc organisms produce toxins that disrupt WBCs;)
Myonecrosis associated with underlying systemic maligancy
C. septicum
(surgery, antibiotics, writeup for cancer)
Associated with consumption of raw oysters; patients develop shock with metastatic cutaneous and soft tissue infections; associated with salt-water
Necrotizing soft tissue infection due to Vibrio species
(in healthy people, can get it from contamination of superficial wounds while swimming, fishing in seawater)
Soft tissue infection (cellulitis or necrotizing fasciitis) associated with trauma related with fresh water exposure
Aeromonas hydrophila
(infection also can occur as a result of medicinal uses of leeches in surgical procedures)
patients with diabetes or leukemia that get necrotizing perineal infection
fournier's gangrene
(must perform surgery and put patients on broad-spectrum antibiotics)
Causes gangrene from thrombosis of digital arteries
diabetic macroangiopathy (diabetic vascular disease)
Vast majority of foot infection in diabetics due to: neuropathy or angiopathy?
neuropathy (loss of temp sensitivity, absent/diminished ankle reflexes, calluses on bottom of toe and on top hammer toe; calluses increase risk of ULCERATION)
List 5 major gram negative bacteria causing zoonosis infections in the US.
Rickettsia, Ehrlichia
Pasturella, Capnocytophagis
Brucellosis
Francisella tularensis
Yersenia pestis
an acute, spreading pyogenic inflammation of the dermis & subcutaneous tissue.
cellulitis
a superficial form of cellulitis with prominent lymphatic involvement, with redness and pain at the advancing margins.
Erysipelas
an acute, rapidly developing infection of the deep fascia:
necrotizing fasciitis
(Type I - mixed infection of anaerobes + facultative species like strept or enterobacteriaceae)
(Type II - infection with group A streptococcus)
type of cellulitis produced by either clostridia or non-spore-forming anaerobes (Bacteroides sp., Peptostreptococcus & Peptococcus) either alone or mixed with facultative bacteria.
Crepitant cellulitis
(cellulitis produced by anaerobes causing release of gas --> crepitus (crackly/popping sound) produced with cellulitis)
Rx: surgical debridement and IV antibiotics
produce necrosis of subcutaneous tissues & overlying skin.
gangrenous cellulitis
gas gangrene due to Clostridium sp.
anaerobic (clostridial) myonecrosis
(invasion of healthy muscle by C. perfringens, C. novyi or C. septicum; Rx: surgical debridement/amputation, high dose penicillin, clindamycin to interfere with protein synthesis)
Vast majority of uncomplicated skin infections like erysipelas, impetigo, cellulitis, or necrotizing fasciitis are due to:
S. pyogenes
(Group A streptococcus, gram positive cocci, beta hemolytic, bacitracin susceptible)
vast majority of uncomplicated skin infections like impetigo, folliculitis, furuncles, carbuncles, cellulitis and abscesses are due to:
S. aureus
(gram positive cocci, clustered, catalase positive, coagulase-positive)
deep-seated infections around hair follicles
furuncles = "boils"
(treat with hot compresses/antibiotics)
women who have undergone mastectomy with axillary lymph node dissection are at risk for?
erysipelas
vast majority of erysipelas due to?
S. pyogenes (and groups B, C, G streptococci)
Associated with isolation of Group A streptococcus from either a normally sterile or nonsterile site, hypotension, and variety of other signs (renal impairment, liver involvement, soft tissue necrosis)
Streptococcal toxic shock syndrome
(surgical debridement/amputation, IVIG, treat with penicillin + clindamycin)
Patient presents with superficial skin lesions on exposed parts of arms, legs, face with papul-vesicle-pustule-crust sequence and honey-colored exudate. What does the patient have and also, what bacteria is most liking causing it?
IMPETIGO caused by combination of S. aureus and S. pyogenes
(diagnosis usually made by clinical appearance, lesions highly contagious, Rx: topical antibiotics (bacitracin) or oral antibiotics (clindamycin))
Pt has an infection within an obstructed hair follicle. What does he have and what is causing it?
FOLLICULITIS caused by S. aureus

folliculitis ==> furuncles (deep inflammatory nodules) ==> carbuncles (more extensive process- clusters of furuncles)
_____ bites associated with tearing of tissues; _____ bites produce deep puncture wounds.
Dog; cat
2 sources of bacteria in an animal bite wound are:
1. organisms on patient's skin inoculated into wound by bite (S. aureus, S. pyogenes)
2. mouth of animal causing bite (anaerobes)
Causes "athlete's foot"
Candida albicans
(Rx: topical antifungal agents, regular shoe/sock changing, careful drying of toes)