Micro Symptoms

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Most Common Cause of

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• Infected eyelash follicle (stye)

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Staphylococcus aureus

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• Conjunctivitis in children, especially associated with swimming, sharing towels

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adenovirus

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• Eyelid swelling, bilateral with muscle pain and eosinophilia

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Trichinella spiralis

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• Unilateral swelling around one eye

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Trypanosoma cruzi

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• Eye ulcers from extended contact wear

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Pseudomonas aeruginosa

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• Acute otitis media

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Streptococcus pneumoniae, nontypeable Haemophilus, or Moraxella catarrhalis

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• Exudative, erythematous pharyngitis and fever >101°F, cervical lymphadenitis

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Streptococcus pyogenes

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• Pharyngitis with fever < 101°F; negative for bacteria

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adenovirus

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• Pharyngitis and extreme fatigue in teen or young adult; abnormal WBCs

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EBV

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• Common cold

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rhinovirus (summer/fall) and coronavirus (winter/spring)

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• Unvaccinated child with pseudomembrane in throat and heart irregularity

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Corynebacterium diphtheriae

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• Fever, chills, URT symptoms, severe arthralgias and myalgias between Nov. and March in U.S. and Canada

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influenza virus

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• Repetitive cough with inspiratory whoop, often vomiting (whooping cough)

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Bordetella pertussis

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• Croup

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parainfluenza viruses 1 and 2

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• Pneumonia and/or bronchiolitis in young child (3 mo. to 5 y.o.)

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RSV

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• Mild pneumonia in 5-18 y.o.

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Mycoplasma pneumoniae; or Chlamydia pneumoniae

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• Lobar pneumonia in all age groups

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Streptococcus pneumoniae

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• Aspiration pneumonia

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anaerobes including Bacteroides fragilis

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• Pneumonia with dry cough in AIDS patient

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Pneumocystis carinii

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• Pneumonia with purulent sputum in AIDS patient

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Streptococcus pneumoniae

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• Pneumonia in teen with CF

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Pseudomonas aeruginosa

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• Pneumonia in older male, heavy drinker

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likely Legionella pneumophila if environmental source seems likely; might also be Klebsiella pneumoniae (currant jelly sputum)

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• Pneumonia associated with bird excretions

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Chlamydia psittaci

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• Pneumonia after contact with dust containing bird or bat feces, Ohio/Mississippi River Valleys

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Histoplasma capsulatum

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• Pneumonia associated with dust in desert areas of CA/Southwest U.S.

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Coccidioides immitis

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• Viral meningitis

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enteroviruses, some arboviruses, mumps, polio

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• Meningitis in neonates, esp. after prolonged rupture of membranes

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1stStreptococcus agalactiae/ 2nd E. coli/3rd Listeria monocytogenes

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• Meningitis in babies 6 mo. to 2 y.o., unvaccinated

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Haemophilus influenzae

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• Meningitis in young adult, unresponsive and with cutaneous rash

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Neisseria meningiditis

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• Purulent meningitis in all age groups except neonates

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Streptococcus pneumoniae

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• Meningitis in AIDS patient

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Cryptococcus neoformans

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• Meningitis in transplant patients

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Listeria monocytogenes

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• Meningitis in severe neutropenia

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Aspergillus, a mold with acute branched hyphae

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• Encephalitis in young adults, fatal if not treated promptly

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HSV-1

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• Mosquito-borne encephalitis

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Eastern or Western Equine Encephalitis viruses, St. Louis, CA and La Crosse viruses

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Viruses latent in nerves:

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• Sensory ganglia with unilateral reactivation in 1-3 dermatomes

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VZV

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• Trigeminal nerve ganglia

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HSV-1

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• S-2, S-3

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HSV-2

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Neurotoxins producers:

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• Rigid paralysis

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Clostridium tetani

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• Flaccid paralysis

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Clostridium botulinum

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• Dysentery and severe headache

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Shiga toxin of S. dysenteraie type I

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Slow viral diseases affecting brain:

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• Progressive Multifocal Leukoencephalopathy (PML)

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JC virus

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• Subacute sclerosing panencephalitis (SSPE)

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defective measles virus

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• Prion diseases

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Creutzfeld-Jakob disease and kuru

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Food-poisoning; Vomiting and nausea with no fever 1-6 hours after ingestion of food:

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• Cream pastries, ham, potato salad

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enterotoxin of Staphylococcus aureus

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• Fried rice

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heat stable exotoxin of Bacillus cereus

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Noninflammatory diarrhea with longer incubation period

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• Diarrhea and abdominal cramps after eating meat and vegetables, esp. dried foods; 8-16 hr

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Heat-labile toxin of Bacillus cereus

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• Traveler’s diarrhea

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ETEC with heat-labile and/or heat-stable toxins

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• Copious clear diarrhea with mucous flecks after visiting developing country; 1-4 day incub. per

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Vibrio cholerae (cholera toxin)

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• Infantile diarrhea (0 - 2 y.o.); 1-3 day incub. per.

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rotavirus

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• Steatorrheic, foul-smelling diarrhea/ abdominal cramps after camping trip and drinking from stream/ outbreak in daycare center; 1-3 week incub. period

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Giardia lamblia

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• Voluminous watery diarrhea with cramps, flatulence, and weight loss, chronic in AIDS patients

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Cryptosporidium parvum

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• Abdominal cramps and bloody diarrhea without pus; may also be assoc HUS (anemia, thrombocytopenia, and acute renal failure

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E. coli O157:H7

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• Watery diarrhea of infants in developing countries, lasts 2-3 weeks; can become chronic

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EPEC

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Inflammatory diarrhea and dysentery:

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• Most common inflammatory diarrhea in U.S., associated with poultry; oxidase + gram - curved rods

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Campylobacter jejuni

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• Diarrhea associated with poultry; oxidase – gram -, straight rods

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Salmonella species

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• Watery diarrhea, febrile, abdominal cramps; changes in 1-2 days to mucoid stools with or without blood; BMs accompanied by straining and tenesmus; occurs mostly < 10 y.o.

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Shigella

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• Abdominal pain, fever, weight loss generally associated with international travel; mucosal invasion produces flask-shaped ulcers and mucus

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Entamoeba histolytica

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• Antibiotic-associated (clindamycin or ampicillin) diarrhea/ pseudomembranous colitis

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Clostridium difficile

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• Chronic hepatitis leading to cirrhosis

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Hepatitis B, B/D, or C; Shistosoma mansoni

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• Bile duct blockage after surgery, fever, or antibiotics

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Ascaris lumbricoides

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• Acute infectious endocarditis

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Staphylococcus aureus

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• Subacute infective endocarditis in persons with pre-existing heart damage, poor oral hygiene

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viridans streptococci

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• Subacute endocarditis in elderly or those with pre-existing heart condition -

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Enterococcus faecalis

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• Endocarditis in IV drug abusers; likely to involve both left and right heart

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Staphylococcus aureus

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• Enlarged, flabby heart leading to heart failure; associated Central or south America–

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Trypanosoma cruzi

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• Pericarditis or myocarditis

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Coxsackie or other enteroviruses; myocarditis also in later stages of Lyme disease

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• Septicemia and shock, gram + bacteria

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Staphylococcus aureus TSST-1, Strepto-coccus pyogenes SPE-A, or peptidoglycan-teichoic acid fragments of gram +

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• Capillary and small vessel endothelial damage/ vector bite

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Rocky Mountain Spotted Fever (RMSF)

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• Exposure to animals

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Brucella species

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• Anemia seen with infections

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• Paroxysmal febrile disease

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Plasmodium species

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• Pernicious megaloblastic anemia associated with eating fish (from competition for B12)

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Diphyllobothrium latum

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• Microcytic hypochromic anemia from blood loss

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hookworms

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• Arthritis

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o Polyarticular in menstruating female

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Neisseria gonorrhoeae

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o Intermittent after bull’s eye rash/ tick bite

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Borrelia burgdorferia

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• Osteomyelitis

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o Osteomyelitis usually

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Staphylococcus aureus except neonates - could be S. agalactiae or enterobacteriaceae

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o In sickle cell patient

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Salmonella species

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o In IV drug abusers

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S. aureus, P. aeruginosa

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• Cystitis in most people

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Escherichia coli

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o Newly sexual active females

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Staphylococcus saprophyticus

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• Cystitis/bloody urine/rural Africa

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Schistosoma haematobium

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• Vesicles on genitalia

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HSV-2

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• Genital warts

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Human papilloma virus, most common 6 and 11, associated with development of cancer - 16 and 18

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• Male urethritis

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Neisseria gonorrhoeae

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• Women - asymptomatic, vaginitis, cervicitis, or PID

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Chlamydia trachomatis/N. gonorrhoeae

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• Hard chancre, painless

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Treponema pallidum

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• Soft chancre, painful

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Haemophilus ducreyi

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• Malodorous vaginitis

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Trichomonas vaginalis

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• Pruritic painful vulvovaginitis

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Candida albicans

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• Smelly vaginal discharge

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Gardnerella vaginitis

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• Boils and carbuncles

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S. aureus

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• “lumpy” jaw

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Actinomyces israelii