Micro - Block 2

Front 1

Streptococcus pneumoniae

Back 1

You visit your normal (normal flora in URT) happy (gram +) stripper (strep pneumoniae) at the strip club. The place is sketchy so you are worried about catching a community acquired or nocosomial disease. Luckily they dance behind a glass wall (cell wall). A stripper walks on stage wearing a lion and tiger bikini (PneumoLYSIN and IgA). The stripper is shaking, coughing, and dancing off rhythm like she can't even hear the music (otitis media). She starts throwing pennies back at you (cough w/ copper sputum). You're afraid the infection has gone to her brain (bacteremia w/ meningitis). Luckily, her performance is treated by the Gangsta Vanco (Penicillin G and Vancomycin). He pulls her off stage and makes her take a Urine Test to make sure she isn't on drugs. For future prevention, adults will view her on Pay Per View (PPV vaccine) and children will be PG-13 (PCV-13 vaccine).

Front 2

Streptococcus pyrogenes

Back 2

A (Group A) happy (gram +) clown. Red face and throat (pharyngitis/Strep throat). He has a secret weapon (virulence factors); a pet Monkey (M protein) named Gee (Protein G) that sits on his shoulder. He perches on a little spaceship Capsule (capsule) and mimes a Wall (cell wall) around himself. He Ostracizes and Spits on the little kids (Streptolysin O and S). He also juggles with special pins on fire (pyrgneics Spc A and Spc C). Gee is deathly afraid of Little Boys with Pens (penicillin and B-lactam) that try to poke him. The tiniest boys, neonates drive him crazy (meningitis in neonates). And only if he's in a really bad mood does he not like Every Child (erythromycin or clindamycin for serious infections).

Front 3

Mycoplasma pneumoniae

Back 3

Little Mico (mycoplasma pneumoniae). He was homeless (no cell wall). He lived out in the cold (cold agglutin - anti IgM autoantibodies for diagnosis). All he wanted was to eat a nice warm breakfast of fried eggs (fried egg colonies on agar growth). He did go to school on occasion (community acquired), but he had no health insurance (not nosocomial - thanks Romney). Luckily he was treated and adopted by old lady Ethyl (Erythromycin). She would walk (walking pneumonia) with him to all the CARDS games. He painted his face and neck red (pharyngitis) for every game.

Front 4

Corynebacterium diptheria

Back 4

Invading Corynebacterium diptheria are a normal (normal flora) happy (gram +), tiny invading army overrunning the throat and building a launching platform (pseudomembrane) on the pharynx. The army quickly constructs exotoxin rockets. From the safety of the pharynx base, they fire off deadly rockets to the heart, cervical lymph nodes (bull neck), and CNS. Patient must receive a. antitoxin, b. erythromycin or penicillin, c. DTaP vaccine - from "Clinical Micro" book

Front 5

Arcanobacterium haemolyticum

Back 5

Archaic (arcanobacterium haemolyticum) bacterium. These ancient people used to eat a lot of cultivated corn (formerly of the Corynebacterium genus). They were also Beef Herders; loved red meat (causes B-hemolytic pharyngitis). Their civilization died out b/c they never discovered fire. They are not pyrogenic people (confused with Strep pyrogenes).

Front 6

Haemophilus influenzae

Back 6

HeMan (Haemophilus influenzae) was a normal (normal flora) black (chocolate agar) guy, except that he was always negative (gram -). He lived behind a wall (capsule) of insecurity. He belonged to the gang HACEK. He had earrings (otitis media), a big necklace (chronic bronchitis), and Mike Tyson face tattoos on his cheek and around his eye (sinusitis and conjunctivitis). On days where HeMan had to do gang related activities, he acquired the name "B" (invasive infections primarily type B). He was in charge of stabbing people in the neck (epiglottitis) and eye (cellulitis). Sometimes these victims would become infected and acquire DIC (septicemia due to endotoxin). HeMan was kinda crazy (meningitis). He would attack people anywhere; in the community or at hospitals (community acquired and nosocomial). Hopefully we can break the cycle of violence by educating his grandchildren (3rd generation cephalosporins). This could all be prevented with educating the children beginning when they have bibs (Hib vaccine).

Front 7

Bordatella pertussis

Back 7

Bordatella pertussis is a negative (gram -) little creature. It's finbriae adhere to all the mucosal surfaces when it is inhaled, beginning in the nasopharynx (pharyngitis) and continuing down the respiratory tract (URT infection). The toxin inhibits monocyte and neutrophils 2 ways by 1. increasing cAMP, thus increasing PKA, which inhibits their activation (lymphocytosis) and 2. increasing adenylate cyclase. The toxin also kills ciliated cells. A nasopharyngeal swab can diagnose it. 10 fimbriae/fingers (10 days max incubation period, end of Catarrhal stage). After 10 days the Paroxysmal occurs, which is the progression to Whooping Cough. How do you treat the board exam (Bordatell)? You treat it with Everything you got (Erythromycin)! Prevention with DTaP in infants (toxoid of pertussis toxin + finbrial hemagglutin). Tdap booster at 12 yrs.

Front 8

Pseudomonas aeruginosa

Back 8

Moaning Myrtle (Pseudomonas aseruginosa) was a negative (gram -) little ghost that lived in the dirty toilet (inhabits the water and soil) in Hogwarts. In the community (community acquired) she liked to pick on the weak kids (the kids with CF). She would throw their own mucus (mucoid capsule) back at them. Sometimes, she would even pick on the children in the infirmary (nosocomial), throwing slime (slime layer capsule) at them from the toilet. There were usually too many kids in the infirmary at once for her to handle so she needed help from her friends S-Mona and Burt (Stenotropomonas maltophilia and Burkholderia cepacia). She was a real nasty girl that avoided capture b/c she was elastic (elastase exotoxin) and could slide through the piping and wore a very putrid colored blue/green dress (blue/green pigment exotoxin) that was like camoflage in the water. The only way to treat her was if you approached her with a mean ol' smile (aminoglycoside) and an anti-Moning Myrtle (anti-pseudomonal B-lactam) attitude of course! When she got bored of being in Hogwarts, she would fly through the air (Aeromonas hydrophila) and head down to the lake where she would poke and prod at the cuts on swimmers.
BE PSEUDO
Burns, Endocarditis, Pneumonia, Sepsis, External malignant otitis media, UTI, Diabetic osteomyelitis/Dermatitis

Front 9

Acinetobacter baumanni

Back 9

Some people in the U.S. think its "a sin" (Acinetobacter baumanni) to continue the war in the middle east. A new problem facing the soldiers out there is this bacteria that inhabits the soil/water infecting their wounds. They become hospitalized with it and spread it to others (nosocomial). The republicans will do anything to continue the war, so instead of pulling our troops out, Bill O'Reilly suggests we feed our troops more carbs (carbapenums) to help fight the bacteria. What an ass.

Front 10

Legionella pneumonophila

Back 10

In the mysterious world of spies, there is a legion (Legionella pneumophila) of men that can do work and even scuba dive (grow in water) for the government. They are a very serious, negative (gram -) bunch that can do anything. When the government has a problem, the solution is always to say "a maybe (amoeba) the legion can do it, they are able to spread and proliferate anywhere!" Whether its penetrating somewhere in the community (community acquired) or even in someplace safe like a hospital (nosocomial), they can infiltrate anywhere. Sometimes however, they might accidently inhale some water while diving and it gets into the lungs (acute pnuemonia). This is not a micro problem, its macro (replication in macrophages). They call it Legionnaire's Disease. When they are still sick with a fever and can't dive, they still have a need to live on the edge, so they drive fast in their Pontiacs (Pontiac Fever). Before they return to the field, the gov makes them take a Urine Test to make sure they are clean. These tough guys are completely resistant to your average Bad Layman (B-Lactam resistance). Only the macro (Macrolides) guys who possess all the works from a to z (azithromycin) can touch the legion.

Front 11

Atypical Pneumonia

Back 11

negative gram stain. No response to penicillin.
1. Legionella 2. Mycoplasma pneumoniae 3. Chlamydia pneumoniae

Front 12

Cryptococcus

Back 12

Tales from the Crypt (Cryptococcus neoformans). There was a koala bear named Gatti (C. Gattii). He lived in his eucalyptus tree (eucalyptus tree material). High up in his tree he built a shelter (capsule). He loved living in Australia where it was warm all the time (can grow at 37 degrees C). Gatti was kinda crazy (meningitis) and loved to attack any person who passed his eucalyptus tree. He would throw eucalyptus seeds at the people's faces, in the hopes they would inhale them into their lungs. The seeds would then grow into little granules (yeast balls) in their lungs (necrotizing granulomas) and eventually grow into tiny eucalyptus trees. Gatti had a pet pigeon who also lived in his tree named Neo (Cryptococcus neoformans). Neo like to poop on those people he deemed to be weak (immunocompromised) from his perch atop the eucalyptus tree since he was too small to attack anyone else. Neo was also kinda crazy (meningitis). The only treatment for their attack was to set up a Bee hIVe with AMPle time to spare (IV amphotericin B) and orally play a flute to drive at least 5 bees up the tree (oral 5 fluctosine). The only prevention to keep Gatti and Neo out of the eucalyptus tree would be to kill the fungus they ate in the tree (antifungal prophylaxis).

Front 13

Pneumocystis

Back 13

Pneumocystis sounds like a normal (normal flora) organism, except that it isn't really normal at all. It doesn't contain ergosterol in its cell wall, thus it is special, deserving special treatment and a high five (pentamide)! Pneumocystis thinks its so special and hip, so that little hipster smokes PCP (Pneumocystis pneumonia). Too bad that one time when he was high out of his mind he hooked up with a shady character and got AIDS (PCP observed in AIDS patients). Despite this bad fortune, Pneumocystis still walks around yielding his trophy (trophozoites in lungs) for being so special.

Front 14

Aspergillus

Back 14

Casper (Aspergillus) the ghost haunts the house. He likes to stay in the attic most of the time b/c its so warm (can grow at 40 degrees C). Casper is a virulent character b/c he thinks he is the alpha male (aflatoxin) of the house. He can float through walls at 45 degree angles (hyphae in lungs at 45 degree angles) and is only halted by people that show no signs of being scared and remain neutral (blocked by neutrophils). He likes to annoy you, kicking up dust around the house and causing your allergies to flare up (hypersensitivity pneuemonitis). If you are a local inhabitant (local infection) of the house, and are weakened (weakened by a previous disease) by the thought of ghosts, then Casper likes to make loud (otomycosis) snaps (CNAP- granulomatous lesion). If you are not a local, but instead and invasive intruder of the house, then Casper gets upset and likes to get drunk on IPAs (invasive pulmonary aspergilosis into bloodstream of the weak). Only Voric (Voriconazole) the warlock can help treat you and teach you how to deal with Casper. Otherwise you cannot prevent his attacks, only try to protect yourself (anti-fungal prophylaxis).

Front 15

Zygomycetes

Back 15

Zygo (Zygomyectes) the zebra lived on the African plains. He ate the grass on the plains (lives in organic matter). One day Zygo drank from the wrong watering hole. The water had become polluted with acid rain, and the pH was extremely low (low pH decreases phagocytic chemotaxis and oxidative bursts - uncontrolled diabetics and ketoacidosis). This really aggitated Zygo and he began taking his anger out on anyone he came across on the plains. He stumbled upon a black rhino. Zygo kicked him in the nose and head, poked him in his face, and gave him a black eye (rhinocerebral manifestation - black necrotic lesions). The rhino thought he had broken his nose b/c it was now pointing at a 90 degree angle (non-septae hyphae w/ 90 degree branching). This really hurt the rhino's feelings and he took it to heart (angioinvasion) and he put it in his memory (spread to brain/CNS). He was so upset he couldn't even eat (necrotic ulcers). The rhino vowed to find Zygo and give him the treatment he deserved! He was gonna be more Aggressive (aggressive surgical debreidment), Pose (Posaconazole) a real threat, and stop being so Amphipathic (amphotericin B). He would be prepared next time by protecting himself.

Front 16

Mycobacterium

Back 16

Tom the tuber (mycobacterium tuberculosis) was a rod shaped potato. He was a quick-witted little guy (acid fast), but was limited by his lack of appendages and his requirement to breath (obligate aeorobe - grows in upper lung lobe). But not only was he smarter than the other tubers, he was also special b/c he had a very thick skin (very long mycolic acids in cell wall). This made Tom the macro potato (macrophages are host cells). One thing that particularly annoyed Tom was Rhody (Rhodococcus) the rabbit with AIDS (chronic lung disease in AIDS patients) who was nocturnal (Nocardia) and tried to eat him. One night, Rhody was successful. He ate Tom, straight up. But Rhody didn't know that Tom was rotten. This initiated a primary infection in Rhody's lungs (multiplication in macrophages, spread to lymph nodes, bloodstream dissemination, and tubercle formation). Rhody was particularly susceptible b/c he had AIDS. He later underwent a secondary infection (caseous centers spill into bronchus, fever, fatigue, cough, and sputum). He spread the disease to his community (community acquired) and later went to the hospital where he spread it there (nosocomial). The next stage was miliary which invaded and seeded different organs through blood and lymph. It can cause meningitis that way. Rhody died in the hospital. Had they done a PPD skin test (tests wall secreted protein products) earlier they maybe could have treated him. A blood test would probalby have been a false negative b/c he had AIDS. Treatment requires 4 different drugs. Only prevention is the BCG vaccine which isn't really used in US b/c of the occassional conversion to skin test positive. AIDS patients are given prophylaxis antibiotics.

Front 17

Histoplasma, Blastomyces, Coccidioides

Back 17

Histo: birds. Like TB; replicate in macrophages, pneumonitis w/ granulomatous lesions. Dissemination can occur in immunocompromised. Cavitary pulmonary histo can occur in COPD patients.
Blastomyces: soil/organic debris. Like TB/Histo; replicate in macrophages, pneumonitis w/ granulomatous lesions. Dissemination can occur in immunocompromised. But more acute and purulent. Also, the skin is the most common site of extrapulmonary infection.

Coccidioides: Illness representing a bacterial pneumonia. The replicating spherules in the lungs remain extracellular though, b/c they are so big. Productive cough w/ sputum. May develop lung nodules. Also, the skin is the most common site of extrapulmonary infection. Meningitis is a lethal complication.Histo can be tested for in urine or IgM titer. Blastomyces can be test for in IgM titer. Treatment is itraconazole.