Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

178 Cards in this Set

  • Front
  • Back
staph aureus
Food 1. Asymptomatic carriage especially on skin and anterior nares
2. Superficial skin infections: folliculitis, abscesses, furuncles, carbuncles
3. Foreign body infections (stitch abscesses, etc.)
4. Soft tissue infections: cellulitis, fasciitis
5. Osteomyelitis
6. Bacteremia
7. Endocarditis


8. Food poisoning
9. Toxic Shock Syndrome

toxin mediated

gram poisitve cocci in clusters
-catalase positive
CNS staph epidermis
10. Device associated infections (iv and other catheters, prostheses)

-catalase negative
strep A
. Pharyngitis and tonsillitis: diagnose with strep screens and throat culture; complications include otitis, abscesses, rheumatic fever (RF), glomerulonephritis (GN)
2. Skin infections: impetigo (crusty mouth thing around mouth), erysipelas, cellulitis, fasciitis, post-op wound infections, GN (NOT RF)
3. Scarlet fever: Pharyngitis + strawberry tongue, rash
4. Toxic shock-like syndrome: shock, renal failure, rash, respiratory failure

5. RF: carditis, polyarthritis, chorea, erythema marginatum (rash with red margin spreading from center),
subcutaneous nodules + arthralgia, fever, high ESR, EKG changes, evidence of Group A strep
6. GN: presents one week after infection edema, hypertension, hematuria, proteinur
strep b
Frequently colonizes female genital tract and gi tract
B. Important cause of neonatal sepsis and meningitis (1-3/1000 live
births, mortality 30-60%)
C. Post-surgical gyn infections
D. Infections in the elderly: uti, bacteremia, pneumonia, skin, wound
E. Automatic screening of all women at 35-37 weeks gestation is recommended
IV. Group C,D,F,G Streptococci
strep c and g
Can cause purulent infections like Group A
B. No clear association with RF or GN
C. Food-borne outbreaks of pharyngitis
strep d
associated with colon
Group F includes Streptococcus milleri, usually part of the viridans group
aggressive tissue abscesses
Streptococcus pneumoniae
Colonization/infection associated with recent viral uri, airway obstruction,
immunosuppression, splenectomy, alcoholism F.
Diseases: pneumonia, otitis (in kids), sinusitis, meningitis (in adults), bacteremia
Viridans group Streptococci
endocarditis, dental infections, abcesses
Diseases: bacteremia, uti, wound and soft tissue infections, endocarditis
E. Important as nosocomial pathogens
F. VRE: vancomycin resistant , also resistant to all other available antibiotics, associated with nosocomial outbreaks
Listeria monocytogenes
A major cause of bacteremia and meningitis in newborns, occasional cause of the same in imrnunocompromised adults. In both of these groups this organism may not be correctly identified: patients may have normal appearing spinal fluid and physicians may think they just have a viral syndrome.
4. The laboratory may misidentify the organism as a Corynebacterium (usually nonpathogenic) or as Group B Streptococcus (another cause of meningitis in newborn) by gram stain and colony morphology
corynebacterium species
Most often contaminants when present in cultures
(b) Can cause endocarditis on prosthetic heart valves
C. jeikeium
lymphadenitis, abscesses, meningitis, skin infections and bacteremia in immunosuppressed patients, especially neutropenic cancer patients.
c. diptheria
Pharyngitis with thick, leathery, gray membrane with surrounding edema. May extend down to larynx, trachea, bronchi. May have cutaneous ulcers instead of pharyngitis. Organism produces a protein exotoxin that affects predominantly myocardium and peripheral nervous system. Exotoxin produced only when organism contains a bacteriophage. Death caused by either asphyxiation or myocarditis.
Erysipelothrix rhusiopathiae
Causes ulcerating, erythematous skin infections called erysipeloid on exposed, abraided skin in fisherman, butchers, veterinarians
Bacillus species
. Found everywhere in the environment and often contaminate cultures
2. Large, gram-positive rods that form spores (unique among aerobic gram-positive rods)
3. Significance
Can cause bacteremia and endocarditis in drug abusers and immunocompromised
very commonly causes food poisoning, usually related to ingestion of Trndefcooked?rtc^)
Cutaneous form is a nonpainful ulcer at a site of inoculation characterized by the formation of a black eschar in the ulcer. Inhalation disease would present with severe shortness of breath and an overall appearance of extreme toxicity with a widenedjnediastinum. GI is extremely rare, would present with abdominal pain arid bloody diarrhea
lactobacillus species
Virtually always protective—infections are associated with failure to see or grow lactobacilli. Rare case reports of endocarditis with lactobacilli exist
Clostridium perfringens
Rare, rapidly progressive infection in traumatic and surgical wounds. Destruction of muscle, gas in tissue, hemorrhagic bullae, foul watery discharge, liver and renal failure, shock and death unless aggressively debrided. Little- inflammation. Mediated by production of toxin - will see massive necrosis of tissue with few inflammatory cells or bacteria.
Clostridium perfringens
Necrotizing fasciitis or cellulitis
-Doesn't involve muscle, more localized and less lethal. Marked inflammation in tissue with many bacteria
Clostridium perfringens
Necrosis of uterus with bacteremia and intravascular hemolysis following incomplete abortion or incomplete removal of products of concept at delivery

-Puerperal sepsis
Clostridium perfringens
Sudden onset of nausea, vomiting, abdominal pain within a few hours of ingestion of toxin
Clostridium tetani
involvement, the cranial nerves if inoculation occurs on the head, or generalized. Generalized disease characterized by trismus, stiff neck, difficulty swallowing, rigidity of abdominal muscles, and fever. Severe cases
accompanied by risus sardonicus, and opisthotonis. Some cases associated with autonomic disturbances with fluctuating blood pressure, tachycardia, sweating, hyperthermia and cardiac arrhythmia’s
Clostridium botulinum
weakness, malaise, and dizziness, dry mouth.^.'A constipation, and urinary retention. Descending paralysis follows in one to three days with diplopia, blurred vision, photophobia, dysphonia, dysarthria, and dysphagia first, then weakness of extremities in descending order. Disease should be suggested by a combination of postural hypotension, dilated, unreactive pupils, dry mucous membranes, descending paralysis with progressive respiratory weakness, and the absence of fever
Wound botulism
occur in innocuous appearing lesions from 4 to 14 days after injury and appears similar clinically to food-bourn disease
Infant botulism
20 week old infant with constipation, weak suck, feeble cry, pooling of secretions in the mouth, absent gag reflex, descending flaccidity, ptosis, and ophthalmoplegia. This syndrome has now also been described in adults.
Clostridium difficile
Well recognized association with antibiotic associated pseudomemranous colitis
(ii) Patients receiving antibiotics develop fever, diarrhea, abdominal pain with exudate and ulcer formation in large intestine. Failure to recognize and treat may lead to bowel perforation and peritonitis
Propionibacterium acnes
Common contaminant
Causes infections in prosthetic devices, especially central nervous system shunts
Associated with acne
pneumonia that produces cavities and extends to the chest wall if untreated 50% of patients with infection are immunocompromised, and infection often disseminates to multiple organs, especially brain May also be inoculated directly into skin and cause chronic draining lesions with sinus tracts
Cause infections of mucosal surface areas with some local damage.
Once initiated will continue to borough through tissue planes without treatment.
Drainage that occurs often contains small, yellow-orange, hard colonies of
organisms called sulfur granules.
Sites of infection include mouth and jaw, especially following dental work, lung
with abscess formation and spread to the pleura, abdomen following GI tract
problems, and pelvis, especially of the endometrium in 1UD users
1.Urinary tract infections most common
2. Diarrhea (gastrointestinal)
3. Meningitis (elderly, neonates, neurosurgical patients)
4. Bacteremia (sepsis)
5. Pneumonia (especially hospital acquired)
6. Wounds and abscesses
e. coli
Most commonly encountered enteric rod in the colon
b. Leading cause of opportunistic infections
e. coli
. Most common cause of urinary tract infections (35-90%)
b. Intestinal infections
c. Meningiti
e. coli
are one of the most common causes of neonatal meningitis
Second most common urinary pathogen
b. Pneumonia (Friedlander's pneumonia (red jelly phlem))
c. Nosocomial (hospital) infections - multiple drug resistance a problem in this setting
b.contaminated intravenous solutions
c.Multiple drug resistance is a problem
Some strains may have red pigment
2. Truly an opportunistic pathogen (S. marcescens)
4. Multiresistant
E. Citrobacter
biochemically similar to Salmonella

-neonatal meningitis and bacteremia
P. mirabilis, P. vulgaris
causes urinary, wound and bloodstream infections
-swarm" over agar surface
G. Providencia, Morganella
nosocomial spread, especially among patients with indwelling urinary catheters
enterotoxigenic i. coli
contaminated food and water

-no fever
interoinvasive e. coli

Common fever

diarrhea, bloody, Scanty,
etnterohemorrhagic e. coli
bloody diarrhea, no fever
enteropathogenic e. coli
watery diarrhea
Absent blood
enteroaggregative e. coli
Occasional fever
Watery diarrhea

Absent blood
s. Dysentery
Abdominal cramps

b. Tenesmus - painful straining to pass stools

c. Fever

d. Bloody, mucoid stools

b. Systemic symptoms

c. Watery diarrhea

3. -large numbers of fecal leukocytes
-Associated with daycare centers

humans, livestock,

mammals, reptiles, birds and insects

Poultry products including eggs, 75% comes from veggies
nursing homes, hospitals, mental institutions

a) Exotic pet turtles, reptiles
Nausea, vomiting, cramping, diarrhea - "food poisoning"
3) Diarrhea persists 3 to 4 days, resolves spontaneously

4) Fever is present in 50% of patients

5) infecting dose >10 5 bacilli
S. typhimurium, Typhoid Fever (enteric fever)
multiorgan-system. infection
2) - 14 days
3) fever, relative bradycardia, headache

Faint rash occurs with early fever (rose spots)

b) Fever persists for weeks

4) Constipation is more common than diarrhea
5) Bacteremia may lead to infection at other sites
6) Intestinal perforation may occur
7) Infection in biliary tree leads to chronic cami er state
Y enterocolitica

1) Fever

2) Diarrhea

3) Abdominal pain

b. Acute mesenteric lymphadenitis
c. Terminal ileitis
d. Septicemia
Acute mesenteric lymphadenitis

1) Fever
2) Pain
3) Nfimics acute appendicitis
4) Diagnosis is made by isolation of organisms from lymph nodes, less commonly from blood
E. coli 0157:H7
contaminated beef, milk, cider, water, cause HUS (blood in kidneys
e. coli
diarrheal followed by rising serum creatinine after 15 days
Vibrio cholerae
Several hours to 5 days
-Host factors important
about 4.1 Edit
onset is

-8 symptoms sudden

-(a) profound watery diarrhea
(b) initially, stool brown with fecal matter
Vibrio cholerae
-(a) profound watery diarrhea
(b) initially, stool brown with fecal matter
(c) soon becomes pale gray with little solid material
(d) inoffensive, slightly fishy odor
(e) mucus in stool imparts "RICE WATER" appearance
Vibrio cholerae
e) mucus in stool imparts "RICE WATER" appearance
(f) tenesmus is absent--often a decrease in irritability, as enormous amounts of fluid passed effortlessly
(g) vomiting a common occurrence
(h) rapid, faint heart beat
(i) skin is cold, clammy, wrinkled
j)oliguria eventually occurs
(k) may have painful muscle cramps and CNS abnormalities
(1) loss of fluid continues 1-7 days and dehydration may be profound
(m) may have profound complications depending on fluid therapy
-Vibrio parahemolyticus
causes acute gastroenteritis after ingestion of contaminated sea food such as raw fish or shell fish
2. coastal areas (or air transport of fresh fish)
3. self limited disease, may require rehydration
vibrio vulnificus
skin lesions from abraded skin and sea water contact
2. systemic disease, septicemia and death. Major illness occurs in individuals with chronic liver disease who have excess iron storage
3. coastal areas of Gulf of Mexico
Campylobacter jejuni (enteric disease
darting, corkscrew motility
-Contaminated food and water, cases usually sporadic, may be outbreaks
B. Animal reservoirs include fowl, cattle, swine, sheep, dogs, cats, etc.
Campylobacter jejuni (enteric disease
Rapid onset of fever, other constitutional symptoms, B. Abdominal pain in 90% of patients, especially in those with fever and anorexia, C. Some, < 50% have emesis, nausea, malaise, headache, myalgia
-diarrhea usually develops within 1 day of abdominal pain and fever (1-7 day incubation
2.Usually foul smelling, may be frankly bloody
1. Usually profuse, watery, may be mucoid, bile-stained

-May last 2-9 days, but usually 3-5 days
urease activity, gastritis, peptic ulcer
campylobacter jejuni
most common cause of diarrhea in us, oral fecal
anaerobic (Bacteroides

Fusobacterium )
. Head and Neck Chronic sinusitis, chronic otitis, space infections, Ludwig's angina, periodontal abscess, brain abscess, subdural empyema

B. Pulmonary Aspiration pneumonia, necrotizing pneumonia, lung abscess, empyema

C. Intraabdominal Peritonitis and abscesses, liver abscess

D. OB-Gyn Salpingitis, tub ovarian abscess, vulvovaginal abscess, septic abortion, and endometritis

E. Skin and soft tissue
Cellulitis, necrotizing fasciitis, myonecrosis, decubitis ulcers, diabetic foot ulcers, vascular insufficiency ulcers, bite wounds
anaerobic (Bacteroides

Fusobacterium )
Infections contiguous to mucosal surfaces

B. Foul smell (only 50%)

C. Severe tissue necrosis with fasciitis, abscesses, and gangrene

D. Gas in tissue
anaerobic (Bacteroides

Fusobacterium )
Needle and syringe aspirate of abscesses and normally sterile body fluids
(b) Transtracheal aspirate or direct lung aspirate of pulmonary sources
(c) Culdocentesis and possibly double-lumen-protected swabs of endometrial contents.
(d) Suprapubic aspiration of urine
(e) Biopsies of normally sterile tissue
anaerobic cocci ; Peptococcus / Peptostreptococcus.
Common infections include postoperative wounds, orofacial, skin, pleuropulmonary, intraabdominal, and pelvic infections, brain abscess, and diabetic foot ulcers.
NON-FERMENTERS; pseudomonas aeruginosa
Distributed widely in soil and water
2. Often associated with plants and vegetables (moist enviornments
3. Frequent inhabitants of hospital environments, especially water sources
4. Common colonizing flora of humans, usually without disease
NON-FERMENTERS; pseudomonas aeruginosa
Opportunistic infections in trauma, burn, and immunocompromised patients
6. May contaminate commercial products from contact lens solutions to cosmetics to germicides to other solutions
NON-FERMENTERS; pseudomonas aeruginosa
Aerobic, gram-negative rod, slimmer that enteric bacteria
2. Produces a number of pigments
a. Pyocyanin: green to blue-green
NON-FERMENTERS; pseudomonas aeruginosa
is oxidase positive
NON-FERMENTERS; pseudomonas aeruginosa
Fruity odor, like grapes or corn tortillas
NON-FERMENTERS; pseudomonas aeruginosa
Burn wounds
b. Otitis extema-"swimmer's ear" and malignant otitis in diabetics
c. Pneumonia: ventilators in ICU patients
d. Eye infections: conjunctivitis, keratitis, endophthalmitis with contact lenses
e. Bacteremia: can have disseminated infection with characteristic purple to black skin lesions called ecthyma grangrenosum
NON-FERMENTERS; pseudomonas aeruginosa
Cystic fibrosis: colonizes respiratory tract, doesn't invade, but strains develop alginate, a thick, mucopolysaccharide that makes secretions tenacious and adherent
g. Skin infections: folliculitis from hot tubs, swimming pools
h. Osteomyelitis: nail puncture wounds
i. Urinary tract infections in hospitalized patients
Common species seen in US is cepacia

B. Similar to P. aeruginosa in colonizing solutions, commercial products, and hospital supplies
C. More resistant to antibiotics that P. aeruginosa
D. Drug of choice sulfa-trimethoprim
E. Infections in lung, bloodstream
F. Common infection in cystic fibrosis assoc with decreased survival
Gram-negative coccobacilli
B. Oxidase negative
C. Non-motile
D. Faint blue-tinted colonies on MacConkey agar
E. Infections: pneumonia, urinary tract infections, soft tissue infections
Second most frequently isolated nonfermenter
B. Oxidase negative
C. Lavender green colonies
D. Utilizes maltose and glucose
E. Opportunistic infections, very resistant to antibiotics in hospitals that use meropenems
Yellow pigmented colonies
B. Long, filamentous gram-negative rods
C. Non-motile
D. Associated with neonatal meningitis/bacteremia
Brucella abortus Acute Disease
undulant fever most prevalent

Not a serious disease, case fatality is low. Recovery spontaneous after 1-3 months. Morbidity is quite high. Blood cultures are positive in the first 2-3 weeks, negative after building up of antibodies. Relapse frequent-blood cultures become again positive.
Subacute or Latent Disease brucells
May be weakly symptomatic. Blood cultures rarely positive. Agglutinins usually positive. Transient-usually clears up after a while with no further symptoms
Chronic Disease brucella
Persistent form of disease- 1-20 years. Nocturnal sweats with intermittent fever, anorexia. Undulating attacks. Probably an allergic response to the microorganism and its products.
complications of brucella
Osteomyelitis; acute inflammation of any of the viscera; focal lesions of the lungs; lymph nodes; spleen; kidneys; biliary tract; urinary tract; genital organs.
a. Intracellular disease-progresses from portal of entry via the lymphatics to the thoracic duct then to the bloodstream then to parenchymatous tissue.
b. Cattle-abortus

ingestion (raw milk)
b: direct contact
c. Inhalation
d. Inoculation (Laboratory
-ELISA test

c. Swine-suis
d. Dogs-canis
francisella tularensis
1. lymphatic system, but also can present as a
a. Ulceroglandular: most commonly observed. Primary site of invasion usually from direct contact or insect bite (usually a tick)
“ tick tularemia”
b. Oculoglandular: contact usually from disease animal to hands to eye
c. Glandular: initial ulcer not obvious. May be in the pharynx. Contact probably from consumption of poorly cooked wild game
d. Typhoidal: Contact from inadequately cooked wild game
f. Pulmonary
i. Extension from the systemic disease
II. Rarely from aerosois
francisella tularensis
An intracellular parasite
2. Phagocytized but not destroyed by the phagocytic mechanisms
3. Mortality rate low. Untreated 5-7%
4. Morbidity rate very high. Highly infectious Edit
3 modes of Transmission 1. Direct contact
2. Insect vector transmission
a. Deer flies
b. Ticks
Reservoir of infection for rodent populations
3. Human to human transmission highly improbable, but increasing
reports of cat to human spread'
Yersinia pestis; bubonic plague
Disease of the .. lymphatics

1)Infection at ..
-the point of bite of flea.
Yersinia pestis; pneumonic plague
Secondary to the lymphatic plague
-humans to humans has not been seen since 1900, in US)
-mortality rate 100%
Yersinia pestis; terminal stage
fulminating septicemia.
-Subcutaneous hemorrhage results in petechial spots, necrosis
Yersinia pestis
Flea infected from infected rat host
2. Growth of organism in the gut of the flea
3. Injection into the capillary bed upon feeding
4. Fleas find human host when rat not available
Yersinia pestis
Primarily a disease of rodents
-intermediate host is indian fat flea
yersinia pestis
seroogic test for antibodies against F1
fastidious obligate intracellular parasites
Properties of Rickettsiae
Pleomorphic, small, coccobacilli
2. Stain blue with Giemsa stain
3. Cell walls are similar to gram-negative bacteria
thypus group
spotted fever group
found in the cytoplasm; in the nucleus
rickettsia pathogenic
maintained in nature in an arthropod-animal reservoir-arthropod cycle.
-accidental host in this cycle.
epidemic typhus
human- body louse cycle
Rocky Mountain Spotted Fever-Rickettsia rickettsii *
e. Rickettsialpox- Rickettsia akari'
Spotted Fever Group
. Epidemic Typhus-Rickettsia prowazekii *
b. Murine Typhus - Rickettsia typhi
2. Typhus Group
Pathogenesis of Rickettsial Infection
- enter the body through skin via the
bite of an infected arthropod vector. Once in the bloodstream multiply in the endothelial cells of small blood vessels and produce vasculitis.
Rocky Mountain Spotted Fever 1
a. parasite of ticks
1) . the wood tick (Dermacentor andersoni) is the vector
2) the dog tick (Dermacentor variabilis) is the vector
3) the Lone Star tick (Amblyomma americanum) is the vector
Most important rickettsial disease in North America
-Rickettsia rickettsii is a
-In the western U.S
-In the eastern U.S.
-In the southwest
2-6 days after bein in woods Fever, headache and rash
rash starts on wrists and ankles initially as macules, on the 2nd or third day, then petechiae; trunk
3) Rash on the palms and soles is typical
malaise, myalgias, vomiting, photophobia
-rash on outside usually means bad stuff on inside; Central nervous system abnormalities, respiratory failure, myocarditis, abdominal pain/diarrhea, renal failure, disseminated intravascular coagulation
Sulfonamides are contraindicated
Louse-borne typhus: prototype of the typhus group caused by R. prowazekii
begins on the trunk in the axillary folds and moves distally until the
entire body is covered
R. prowazekii
disease spread by the body louse.
The southern flying squirrel
recrudescent form of the disease called R. prowazekii
the painless bite of the mouse mite; urban as opposed to rural disease
Eschar forms at the bite site 3-7 days before the onset of fever, chills and headache. Rash that follows is papulovesicular (bumps that turn into blisters), not petechial
Compared to RMSF, disease is mild.
- same as above.
Murine typhus
flea bites.
Caused by R. typhi and found worldwide; most cases in the U.S. are found in southern
Texas and California.
2. Transmitted to humans by
EHRLlCHIA chaffeensis- (Human Monocytic Ehrlichiosis
transmitted by tick vector
-fever, headache, nausea, vomitin, chills
-8X more frequen than rmsf
2. Rash is infrequent
-doxycyclin, chloramphenicol is not effective
ANAPLASMA Phaqocytophilum (Formerly Human Granulocytic Ehrlichiosis
deer tick Ixodes scapularis and the dog tick
A. Coxiella burnetii, Q FEVER
is not an obligate intracellular parasite
Coxiella burnetii, Q FEVER
transmitted to humans by inhalation of contaminated particles, usually in association with cattle, sheep, goats or through ingestion of raw or contaminated milk.
Coxiella burnetii, Q FEVER (acute disease)
Incubation period 2 to 6 weeks, followed by abrupt onset of fever (>38.5°C), severe headache, malaise, myalgias. , rash is absent. include atypical pneumonia and hepatitis.
Coxiella burnetii, Q FEVER (chronic)
Endocarditis is the most frequently described entity.
b. Most patients have predisposing valvular heart disease
tx for most zoonoges
BARTONELLA bacilliformis
)Oroya fever: Severe anemia
2)Verruga Peruana: Hemangiomatous nodules
1. Bartonellosis
Transmitted by bites of sand flies that inhabit the high Andes of Peru
1. Bartonellosis
bacteria adhere to red blood cells and deform them, producing anemia
f.1) chloramphenicol
2) blood transfusions for severe anemia
B. quintana
trench syndrome; of louse infestation of soldiers "in the trenches
B. quintana
) relapsing high fever
2) generalized myalgias with focal shin pain
3) headache
Bartonella hense/ae and Bartonella c/arridgeiae
cat-associated fleas may be important
-cat scrathces
Bartonella hense/ae and Bartonella c/arridgeiae
3-10 days after the cat scratches a pustule or papule forms at the site of inoculation
2) low grade lever, malaise and fatigue may occur
Bartonella hense/ae and Bartonella c/arridgeiae
regional lymphadenopathy

develops in 1 to 7 weeks
and resolves over several months
Bartonella hense/ae and Bartonella c/arridgeiae
contact with cat
-+ blood test
-neg for other causes of lymphadenopathy
-histopahtology of skin node
Bartonella. quintana
endocarditis in homeless man ; immunocompetent pt no history of valvular hisease (maybe scabies or fleas)
B. henselae
endocarditis w/ history of valvular disease and contact w/ cants
-bartonella quintana
-bartonella henselae
imunocompromised AIDS
-angiomatosis;a proliferative disease of small blood vessels of the skin and
peliosis;characterized by numerous blood-filled cystic structures of the
viscera especially the liver and spleen
CSD—usually self-limiting illness and antibiotics are given only in severely ill or
complicated cases; choice of antimicrobial therapy is unclear (pen doesnt work)
Treponema pallidllm and syphilis
One of the major sexually transmitted diseases worldwide
B Associated with lower socioeconomic status
Primary syphilis
Occurs 3-4 weeks after exposure
-Consists of a skin lesion called a chancre. Shallow ulcer with raised edges that is soft and painless. Usually occurs in the genital area, but can be in other locations including the lip, oral mucosa, and rectum. Ulcer lasts 1- 5 weeks and heals
Secondary syphilis
6-8 weeks after exposure (up to 6 months)
-Consists of generalized rash and systemic flu-like illness. The rash is called a papulosquamous rash with discrete lesions a few millimeters up to 1 cm in diameter that have a scaly surface. This rash includes the palms and soles. Patients may also experience fever, myalgias, arthralgias, headache, hair loss, and mucous patches in the mouth and on genitalia during this stage. This stage also spontaneously resolves after 1-2 weeks.
Early latent syphilis
after secondary syphilis and lasts up to 4 years. There are no symptoms, but tests for syphilis will be positive
Late (tertiary) syphilis
4-20 years after exposure . Only 1/3 of untreated patients will have active disease.
- infiltrative process with proteinaceous material in various body locations, usually superficial.
Can be disfiguring, but usually doesn't cause major illness.
test for syphilis
Direct examination: a wet prep from a chancre viewed with a darkfield
Nontreponemal serologic tests (VDRL, RPR
There are biologic false positive results with this test, hence a positive must be confirmed with additional testing.
Tests begin to turn positive 4-6 weeks after infection, hence some with primary disease will still have negative results. By secondary disease, all tests are positive. Nonspecific tests may revert to negative over time in untreated disease whether it remains active or not. Specific tests remain positive for life. Rough guidelines are
Interpretation of syphylis tests
-when turn positive?
-what happens to non-specific tests?
-specific tests
Borrelia burgdorferi -Lyme disease)
-Diagnosis is -by clinical history that includes appropriate rash, tick exposure, and serology
-New England, upper Atlantic coast, and upper Midwest. Rare to nonexistent in Utah
Borrelia burgdorferi primary,
rash called Erythema Chronicum Migrans (unique, has circles), a discrete red rash that increases in size over a 1-2 week period to be several centimeters in size
Borrelia burgdorferi secondary,
cardiac manifestations mostly heart block or neurological manifestations most often individual peripheral nerve palsies
Borrelia burgdorferi tertiary
Of patients with primary disease: 10-20% will have secondary disease; of those with secondary disease 10- 20% will have tertiary disease. The entire clinical illness rarely lasts longer than I year
Borrelia burgdorferi ;relationship bw primary/secondary
-duration of entire illness
B. Borrelia recurrentis
1 Endemic in other parts of the world, not U.S.
2 Transmitted to humans by ticks or lice
3 Clinical illness is characterized by relapsing fever: patient has shaking chills and high fever for 3-5 days, feels well for 4-10 days, then experiences the fever again. Relapses correlate with changes in the surface protein of the organism to the extent that the body believes it is a new infection.
-diagnosed by seeing spirochete on blood smear
Neisseria gonorrhoeae
3 Proctitis
4 Pharyngitis
5. Dermatitis/arthritis/tenosynovitis (passive and active motion hurt) (disseminated infection; lesions)
6. Ophthalmitis in newborns
Neisseria gonorrhoeae
Ophthalmitis in newborns
Neisseria gonorrhoeae
7. Fitz-Hugh-Curtis Syndrome: migration of infection via fallopian tube in women to liver
Tl and T2 subtypes have the pili that increase their ability to attach to cells and cause infection
Neisseria gonorrhoeae with pilli
joint pain
differentiates gonnhereia from staph
Neisseria gonorrhoeae

-Women may have initial asymptomatic infection, then have it flair and disseminate
-Except in newborns this is a sexually transmitted disease
2. Humans are the only host (need contact)
3. -Women and men may be asymptomatic and can transmit the infection
4. -Women may have initial asymptomatic infection, then have it flair and disseminate during menses
-capsule meningococci only:
Gram negative diplococci
2. Pathogenic species are often/always intracellular
3.Oxidase positive
4. Pathogenic species more fastidious:

-Capsule: prevents phagocytosis
Neisseria meningitidis

organism in upper respiratory tract, spreads to blood stream, may cause only mild symptoms or fever, may also be associated with meningitis, petechial rash, overwhelming infection including peripheral vasospasm and loss of digits
Neisseria meningitidis
One of the major bacterial pathogens in all except newborns
Waterhouse-Frederichsen Syndrome
overwhelming, rapidly progressive meningococcemia with shock, purpura fulminans, multiple organ failure, adrenal necrosis, and death
Neisseria meningitidis
Lives as nomal flora in the upper respiratory tract of 5-15% of young adults
Neisseria meningitidis
-Colonization rates increase in closed populations
-after colonization if it happens at all sporadically and in epidemics

6. Groups B, C, and Y 5.
. complement deficiencies, especially of C6, C7, or C8
neiserria miningitidis

infection usually occurs
-Infections occur both
-groups _____ cause the most and most severe disease
-Recurrent or severe disease in an individual is often associated with ....
A polysaccharide vaccine against types A, C, Y, and W135 exists; there is no B vaccine
2. Prophylaxis for CLOSE contacts of cases is usually given: rifampin is the most common agent used.
tx of niesseria
Chlamydia trachomatis; associated with types A, B, C, not seen in US
Trachoma: conjunctivitis that can lead to blindness

what types
Chlamydia trachomatis;
-by types D-K,
Inclusion Conjunctivitis: Most common cause of neonatal conjunctivitis in US (2-6% ofnewboms), caused by
-acute copious purulent discharge
Chlamydia trachomatis; d-k
STD: urethritis, epididymitis, cervicitis, salpingitis just like gc
-can be transmitted to infants during delivery causing conjunctitis above or pneumonitis
Amplification now the most sensitive for most common syndromes.
Diagnosis of Ct infections
Chlamydia psittaci
, high fever, severe diffuse headache, malaise, muscle aches, dry hacking cough, interstitial lung infiltrates with hilar adenopathy, hepatosplenomegaly. May be complicated by myocarditis, hepatitis, and encephalitis
-has parrots
C. Chlamydia pneumoniae (TW AR
Outbreaks occur in closed populations
2 Clinical manifestations
Pharyngitis, laryngitis, bronchitis, sinusitis, pneumonia, ± association with coronary artery disease
Mycoplasma and Ureaplasma
B. Different from other bacteria by lack of a cell wall

-insensitive to cell wall active antibiotics such as 13-lactams
C. Smallest free-living microorganisms
Mycoplasma pneumoniae
Low infectious dose: < 100 CFU
3. Accounts for 20% of cases of community acquired pneumonia (CAP)
Mycoplasma pneumoniae
Organism attaches to the cilia and microvilli of cells lining the bronchial epithelium
Mycoplasma pneumoniae
Incubation period is 2-3 weeks
2 Mild tracheobronchitis is the hallmark of infection ("walking pneumonia")
b. cough
c. headache
d. malaise
5.Non-purulent otitis media
Mycoplasma pneumoniae
Pneumonia develops in 1/3
a. chest x-ray-unilaterallower lobe or bilateral patchy infiltrates; pleural effusion occurs in 25%
b extrapulmonary complications
1) meningoencephalitis
2)other CNS manifestations
3) hemolytic anemia
4) pericarditis
5) arthritis
-real bad chest pain
Mycoplasma pneumoniae
. cold agglutinins-nonspecific
-mononuclear cells but no organisms
Mycoplasma hominis
post¬partum or post-abortal fever
B Clinical Manifestations
ureaplasma urealyticum
nongonococcal, nonchlamydial urethritis in men