Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
120 Cards in this Set
- Front
- Back
|
Antigens important for Enterobacteriaceae Serotyping:
|
1) Cell Wall - O Antigen
2) Flagella - H Antigen 3) Capsule - K Antigen |
|
|
General Characteristics of ALL Enterobacteriaceae:
|
1) Gram Neg Rods
2) Facultative Anaerobes 3) Grow on SIMPLE Media 4) ALL Ferment Glucose 5) Motile with Peritrichous Flagella (EXCEPT Shigella and Klebsiella) 6) Oxidase NEGATIVE |
|
|
Coliforms
|
Lactose Fermenting (in addition to Glucose) Enterics (Enterobacteriaceae)
1) Escherichia coli 2) Klebsiella Used as Indicator for FECAL Contaminants |
|
|
Which strains of E. coli are found in the SMALL Intestines?
LARGE Intestines? |
E_EC
Small Intestines = ATP EAEC ETEC EPEC Large Intestines = HI EHEC EIEC |
|
|
***PERSISTENT WATERY DIARRHEA****, Vomiting, Dehydration, Low-Grade Fever, NO Fecal Leukocytes. Associated w/ Chronic Diarrhea and Poor Growth.
AUTOAGGLUTINATE forming ***"STACKED BRICK"*** Appearance |
EAEC - EnteroAggregative E. coli
Location = Sm-Int |
|
|
TRAVELER'S DIARRHEA: Watery Diarrhea WITHOUT Blood, Mucus, or Fecal Leukocytes. Vomiting, cramps, nausea, no or low-grade fever, infection is mild to severe.
|
ETEC - EnteroToxigenic E. coli
Two Toxins: Heat Stable and Heat Labile. Stimulate HYPERSECRETION of Fluids/Electrolytes Location = Sm-Int |
|
|
INFANT DIARRHEA: Watery Diarrhea and Vomiting WITHOUT Fecal Lymphocytes, perhaps fever.
Common outbreak in Nurseries. |
EPEC - EnteroPathogenic E. coli
Attaches to Epithelial Cells/Effacement (shortening or thinning) of Microvillus Location = Sm-Int |
|
|
Watery then GROSSLY BLOODY DIARRHEA (Hemorrhagic Colitis), Vomiting, Cramps, NO FEVER usually, NO Fecal Leukocytes usually.
|
EHEC - EnteroHemoragic E. coli AKA the "Hamburger" Strain AKA O157:H7
Shiga Toxin (Stx1 & Stx2) May become HEMOLYTIC UREMIC SYNDROME (HUS). Antimicrobials might PROVOKE this! Location = Lg-Int |
|
|
***FEVER***, Vomiting, Painful Cramping, Watery Diarrhea. May develop into ***DYSENTERY with SCANT, BLOODY STOOLS & FECAL LEUKOCYTES***
|
EIEC - EnteroInvasive E. coli
Invades and Destroys Colonic Epithelium. Invades and Replicates in Cell Cytoplasm. Thus, it is "SHIGELLA-LIKE" in terms of INVASIVENESS. Usually does NOT GO BEYOND EPITHELIUM. Thus, does NOT GO INTO BLOOD STREAM Anti-Motility Agents CONTRAINDICATED aka DONT USE THEM! Location = Lg-Int |
|
|
Low-Grade Fever, Dysuria, Increased Frequency and Urgency to Urinate.
May include Chills, Sudden fever, back pain, and tender/swollen/hot prostate. Urine may be cloudy, pyuria (pus in urine) Common in Females |
Extraintestinal E. coli Infection of Urethra (can spread)
UTI (could also be symptoms of Klebsiella pneumonia) causing Cystitis, Bladder Infection, Prostatitis. Certain Strains are MORE pathogenic and are more difficult to flush out due to: 1) ADHESIN 2) P-PILI |
|
|
Fever, Listlessness (No NRG), Irritability, Lethargy, Vomiting, NECK RIGIDITY, SEIZURES, Abnormal NEUROLOGIC Findings
Facultative Anaerobic Gram Neg Rod |
Extraintestinal E. coli Infection causing MENINGITIS
Leading cause of Meningitis in Infants < 1 Month Old **Caused by strain with K1 Antigen!** --> Common in GI of Pregnant Women/Newborns |
|
|
Fever, Pain, Chills, SEPTIC SHOCK
|
Extraintestinal E. coli Infection causing SEPTICEMIA
Caused by Intestinal Perforation leading to Intra-abdominal Infection occurring either via: 1) Trauma or 2) Advanced UTI/GI Tract Infections |
|
|
Fever, Shortness of Breath, Increased Secretions and Increased Respiratory Rates
|
Extraintestinal E. coli infection causing PNEUMONIA (rare, but can occur)
Caused by E. coli being aspirated into the lungs. |
|
|
What strains of Salmonella are STRICTLY Human Pathogens(reservoir is HUMANS ONLY)
|
S. typhi and S. paratyphi!
Thus, transferred from Person --> Person ONLY (via food, fomites, etc) |
|
|
Shigella Characteristics
|
Four Species, ALL are Pathogenic!
1-4 Day Onset Shiga Toxin (Phage Encoded Gene in Chromosome) Survives LOW pH (ACIDIC ENVIRONMENTS) LOW INFECTIOUS DOSE!!! Thus, SPREADS EASILY! Associated w/ Bacillary Dysentery |
|
|
Sudden onset of Severe Abdominal Cramping, Large Volume of Watery Diarrhea, High Fever, Vomiting (Emesis)
Develops Into: ***ACUTE BLOODY DIARRHEA WITH MUCUS*** (***BACILLARY DYSENTERY***) Straining (Tenesmus), Abdominal Pain, Fecal Incontinence, Urgency, Possible Dehydration |
Shigella!
Invades M Cells (Peyer's Patches) and Replicates in Host Cell Cytoplasm. Does NOT PROGRESS BEYOND EPITHELIUM. Thus, does NOT GO INTO BLOOD STREAM. |
|
|
Pathophysiology of Salmonella
|
Attach to M Cells (Peyer's Patches) and replicated in Epithelial Cells and Lymphoid Tissues.
TYPHOIDAL STRAINS spread ACROSS epithelial layer to other ORGANS and into the BLOOD STREAM |
|
|
0-2 Day onset of Nausea, headache, vomiting, profuse NON-Bloody diarrhea w/ few leukocytes in Stool, Transient low grade fever.
Spontaneously resolves in 2-7 days. |
Enterocolitis caused by Non-Typhoidal Salmonella (S. typhimurium, S. enteritidis)
Most common Salmonella infection High Infectious Dose Required Self-Limiting. Treatment may PROLONG illness! ONLY TREAT AT RISK PATIENT! |
|
|
Rapid onset of high fever, increased heart rate and respiratory rate, may be transient or persistent.
Usually NO Gastroenteritis Symptoms Possible Focal Lesion in Any Organ |
Bacteremia/Septicemia (with Focal Lesions) caused by S. choleraesuis, S. typhi, S. paratyphi
Ingested, and INVADES BLOODSTREAM EARLY |
|
|
10-14 Day Incubation Period (Fairly SLOW), followed by:
Low-grade fever increases to High-grade fever in step wise fashion. Malaise (discomfort), Frontal Headache, Dry Cough. Constipation (initially) or ***SPLIT PEA SOUP*** Diarrhea develops after approx 1 week of symptoms. Abdominal tenderness and pain. ***"ROSE SPOTS"*** may appear on ABDOMEN, BACK, or ARMS. |
Typhoid/Enteric Fever caused by S. typhi (most sever), S. paratyphi
LOW INFECTIOUS DOSE = SPREADS EASILY! |
|
|
When (if possible) can the following cultures be taken to Diagnose SALMONELLA as the Cause for A) Enterocolitis, B) Septicemia, and C) Typhoid/Enteric Fever?
1) Stool Culture 2) Blood Culture 3) Urine Culture |
1) Stool Culture:
A) Enterocollitis - Soon After Onset of Symptoms B) Septicemia - X C) Typhoid/Enteric Fever - After 1st Week 2) Blood Culture: A) Enterocollitis - X B) Septicemia - During High Fever C) Typhoid/Enteric Fever - 1st through 2nd Week of Disease 3) Urine Culture A) Enterocolitis - X B) Septicemia - X C) Typhoid/Enteric Fever - Sometimes |
|
|
Widal Test
|
Serology Test for Salmonella typhi O & H Antigens!
|
|
|
Acute onset of high fever, chills, flu-like symptomsm productive cough, ***THICK, STICKY, BLOOD TINGED SPUTUM (CURRENT JELLY)***
UNI-lateral chest signs, predominantly UPPER lobe Common in MIDDLE-AGED ALCOHOLICS or INDIVIDUALS w/COMPROMISED PULMONARY FUNCTION |
Community-Acquired Pneumonia caused by KLEBSIELLA PNEUMONIA
|
|
|
What do Fever & Chills from a UTI indicate?
|
System Infection from Pyelonephritis or Prostatitis
|
|
|
Most common in Older Men
INCREASED Urine pH (more alkaline) UTI & ***RENAL STONES*** |
Proteus mirabilis, a member of the Enterobacteriaceae Family
Produces Urease, which forms Ammonia --> INCREASE Urine pH |
|
|
What is one notable predisposing factor (there are many) for ANAEROBIC Bacterial Infections?
|
Diabetes!
|
|
|
Bacteria Associated w/ Abscess (Indolent aka Painless Localized Infection) or Fascitis (Progressive and Lethal Infection) Formation. Can be rapid and distressing in onset, but are Slowly progressive.
Gram Negative ***Safety Pin Appearance*** Growth stimulated on ***BILE***! ***Resistant to Penicilin G!!!!*** |
Bacteroides fragilis
MOST Common and Important Anaerobic Pathogen! Habitat = COLON Has a CAPSULE! |
|
|
Indolent (Painless) Pneumonia, Foul Breath
In Lab Dx, BLACK COLONIES due to pigment REQUIRES Vitamin K and Hemin to grow Gram Neg Coccobacillary in appearance |
Prevotella melaninogenica
Habitat = Oral Cavity (thus, common in homeless people) |
|
|
Most commonly causes lung abscesses, involved in pleuro-pulmonary infections.
Gram Negative ***NEEDLE SHAPED BACILLI*** |
Fusobacterium nucleatum
Habitat: Oral Cavity |
|
|
Most common cause of Gas gangrene (endogenous infection). Seen on microscopy.
DOUBLE ZONE of Hemolysis on Blood Agar Common cause of short lived food poisoning (exogenous intoxication) Associated most often with Wound Infections! Gram Stain ***"BOX CAR APPEARANCE"*** |
Clostridium perfringens!
Habitat: Soil and Intestinal Tract of Man! |
|
|
Diarrhea with or without the presence of pseudomembranes and fecal leukocytes
Common in those with prolonged, high use of Antibiotics (but NOT necessary) Dx via Stool assessment of Toxin presence: Toxin A (Enterotoxin) and Toxin B (Cytotoxin) |
Clostridium difficile
Produces both Toxins A and B! Habitat: Colon NORMAL FLORA OF HUMANS, thus Toxins in STOOL are assessed for disease! ELISA test is used clinically. |
|
|
FLACCID MUSCULAR PARALYSIS causing both Autonomic and Voluntary Nervous System Effects
|
Clostridium botulinum
Habitat: Ubiquitous in Environment Produces 7 Heat-Labile Neurotoxins (A-G): A, B, or E cause MOST HUMAN disease. Toxin INHIBIT the release of ACh at the NMJ Food Borne Botulism (intoxication), Wound Botulism (rarest form), Infant Botulism (giving babies Honey) |
|
|
Hyperflexia and Muscle Spasms, Associated with "LOCK-JAW" aka Trismus
|
Clostridium tetani
Habitat: Ubiquitous in Environment, Especially Soil (NOT IN THE RUST ON NAILS) Produces Extremely Potent Neurotoxic Exotoxin, TETANOSPASMIN, which spreads along mostly MOTOR nerves, blocking release of INHIBITORY NTs, preventing their Post-Synaptic Inhibition. Toxin, Tetanospasmin, is treated w/ Tetanus Immune Globulin (TIG) |
|
|
Main factors contributing to reactivation of Asymptomatic TB Infection:
|
Diabetes
***HIV*** <-- most important! |
|
|
What is the ONLY definitive Dx of TB?
|
Grow it on Lowenstein-Jensen Media!
Takes a LONG time (4-8 Weeks) |
|
|
When is a Tuberculin Skin Test (Intradermal Mantoux Test) POSITIVE under the following conditions:
A) 5 mm or Greater B) 10 mm or Greater C) 15 mm or Greater D) Induration Size Changes over Time (Conversion from Neg --> Pos) |
A) 5 mm or Greater:
1) Close contact to patients with TB 2) Person w/ HIV 3) Person w/ Fibrotic Lesions on Chest X-Ray 4) Person w/ Organ Transplants or Immunosuppressed B) 10 mm or Greater 1) Recent immigrant (5 years) from High Prevalence Countries 2) Injection Drug Users 3) High risk crowded facilities (jails, nursing homes, homeless shelters) 4) Mycobacteriology Lab Personnel 5) Persons w/ Medical Risk Factors which increase risk of TB once infected 6) Children younger than 4 or infants/children/adolescents exposed to adults at high risk C) 15 mm or Greater = ALWAYS POSITIVE D) Induration increases 10 mm or Greater within 2 Years *Positive = Infection, Could be Active OR Inactive!* |
|
|
Bacteria associated with ***DISSEMINATED DISEASE***
Major Problem in people with ***AIDS*** |
Mycobacterium avium intracellulare
|
|
|
Bacteria found in tissue cooler than 37 degrees Celsius such as skin, ***PERIPHERAL NERVES***, Anterior portion of eye, respiratory passage above larynx, hands, feet.
First signs are usually hypo or hyper pigmented skin lesions that are often anesthetic or paresthetic. Then develops into more advanced forms with various cutaneous lesions. Common carrier = Armadillos. CANNOT be cultured on synthetic media. Acid-Fast Bacilli |
Mycobacterium leprae aka Hansen's Disease
Treated by those with SPECIAL EXPERTISE! |
|
|
Forms of Leprosy:
1) Lepromatous 2) Tuberculoid 3) Borderline or Dimorphous |
PERIPHERAL NERVE INVOLVEMENT IN ALL FORMS!
1) Lepromatous - Lack of Cellular Immunity, Extensive DIFFUSE tissue involvement. DIFFUSE INFLAMATION DISSEMINATED reaction with large Macrophages filled with organisms. 2) Tuberculoid - Few Skin Lesions which are SHARPLY DEMARCATED. Pronounced neurologic involvement. Lymphocytes, epithelioid cells with some giant cells. Bacilli are FEW. 3) Borderline or Dimorphous - Mixture of the Two above! |
|
|
Chronic destructive abscess formation often with sinus tracts, presence of ***SULFA GRANULES***
Multiple forms including: 1) Cervicofacial - ***"LUMPY JAW"*** 2) Thoracic 3) Abdominal 4) Miscellaneous - Brain Abscess, Endocarditis, Other Abscesses NOT Acid Fast! Anaerobic or Microaerophilic |
Actinomyces (Actinomyces israelii, Actinomyces bovis)
***NORMAL MOUTH & GUT FLORA!*** |
|
|
Pulmonary, Disseminated Nocardiosis, Wound Infection Related
Soil Inhabitants Orange to White, Smooth or Rough colonies on Agar with Hyphae Gram Positive Branching Rods Acid Fast to Partial Acid Fast |
Nocardia (Nocardia asteroides, Nocardia brasiliensis)
|
|
|
Pathogenic Treponema:
1) Treponema pallidum subspecies pallidum 2) Treponema pallidum subspecies pertenue 3) Treponema pallidum subspecies endemicum 4) Treponema carateum |
1) pallidum - Causes SYPHILIS
2) pertenue - Causes YAWS 3) endemicum - Causes ENDEMIC SYPHILIS 4) carateum - Causes PINTA |
|
|
Gummatous Syphilis
|
1 of 3 Forms of Tertiary Syphilis
Granulomatous lesions consisting of accumulations of lymphocytes and macrophages reacting to presence of Treponema pallidum. Immune response can cause marked Tissue Destruction and Pathology. Can occur anywhere in body. |
|
|
Neurosyphilis
|
1 of 3 Forms of Tertiary Syphilis
Long-term infection of CNS Causes 1) PARESIS (infection of brain w/psychological effects) and 2) TABES DORSALIS (infection of lower spinal column with loss of sensory and motor function in the lower extremities) |
|
|
Cardiovascular Syphilis
|
1 of 3 Forms of Tertiary Syphilis
Infection of CV system, in particular the Aorta. Can cause AORTIC ANEURISMS |
|
|
Symptoms arising in early teens, consisting of:
1) Bone and Tooth Deformities 2) WRINKLED SKIN (Rhagades) 3) Interstitial Keratitis 4) Deafness 5) Mental Impairment |
Caused by LATE CONGENITAL SYPHILIS
|
|
|
What is the ONLY DEFINITIVE Dx of Syphilis?
|
Detection of Treponema pallidum via DARKFIELD MICROSCOPY!
|
|
|
Nontreponemal vs Treponemal Tests
|
Nontreponemal Tests:
-Detect Ab for Cardiolipin! -Ex: VDRL, RPR Tests -SCREENING Test Treponemal Tests: -Detect Ab against Treponema pallidum! -Ex: FTA-ABS, MHA-TP -CONFIRMATORY Test |
|
|
Jarisch-Herxheimer Reaction (Fever and Chills)
|
Can be caused by Penicillin treatment of a Fulminant Syphilis Infection (e.g. Secondary Syphilis)
|
|
|
Non-destructive skin lesions and, after a period of latency, DISFIGURING BONE DEFORMITIES
Common in Tropical Areas of Africa and Asia (common in Borneo) |
YAWS - Treponema pallidum Subspecies pertenue
|
|
|
Chronic, Depigmented Skin Lesions on Distal extremities WITHOUT lesions in other organs.
Present in Primitive areas of Latin America |
PINTA (latin for "spot") - Treponema carateum
|
|
|
Inflammation, retraction of Gums, Exposure of Tooth Root
Severe Forms (Acute Necrotizing Gingivitis or TRENCH MOUTH) - Bone Resorbtion and Tooth Loss |
PERIDONTAL DISEASE
Caused by accumulation of Normal Flora, including Oral Spirochetes (Treponema vincentii, Treponema denticola) and Fusiform Anaerobic Bacteria in the Gingival Crevices around teeth Most people get it at some point in their life! |
|
|
Louseborne Relapsing Fever
|
Borrelia recurrentis - Spread from HUMAN to Human by LICE
More Severe than Tickborne and has More Relapses |
|
|
Tickborne Relapsing Fever
|
Borrelia hermsii - Spread from RODENTS to Humans by TICKS
|
|
|
Rigors, High Fever, Headache, Nausea, Muscle and Joint Pain, Conjunctivitis, Macular and/or Petechial Rash
Patient improves after 3-5 days, then RELAPSES CYCLE can repeat 2-5 Times! |
Borrelia Infection!
Cyclic Disease w/Relapses due to Antigenic Variation of Variable Major Protein (VMP) - each bacteria contains up to 30 diff VMPs! |
|
|
Red Rash with Expanding Margins - ERYTHEMA MIGRANS (Stage 1 of Infection)
Neurologic symptoms including Neuritis, Bell's Palsy, Mild Encephalitis, Cardiac Arrhythmias, Multiple Skin Lesions (Stage 2 of Infection) Arthritis, Chronic Neuro Problems, Raised Skin Lesions (Stage 3 of Infection) Common in Northeastern US and Great Lake States Infection transmitted to Humans via hard bodied ticks of the Ixodes Genus which use Deer as a required host |
Borellia burgdorferi - Lyme Disease
|
|
|
Southern-Tick-Associated Rash Illness (STARI)
|
Transmission via Amblyomma americanum (lone star) ticks and may involve Borrelia lonestari
Seen in Patients w/ Erythema migrans-like lesions in Southern States |
|
|
7-14 days after contact, there is an abrupt onset of High Fever, headache, chills, severe myalgias of legs and back, confusion, conjunctival suffusion, skin rash may occur
Secondary or Immune phase may follow with recurrence of fever, meningismus, and CSF pleocytosis Caused by contact with ***URINE*** or WATER (contaminated w/ Urine) of Infected Animals (***Rats***, ***Dogs*** common) Associated w/ Abbatoirs (Slaughter House Workers), Veterinarians, Dairy Workers, Sewer Workers |
Leptospira Infection
|
|
|
Weil's Syndrome
|
Leptospira interrogans serovar icterohaemorrhagiae can cause this
Severe illness with hemorrhage, azotemia (high levels of Nitrogen containing compounds), jaundice |
|
|
Nausea, Vomiting, Abdominal Cramps, Profuse and Watery Diarrhea containing ***FLAKES OF MUCUS aka "RICE-WATER STOOLS"***, but no blood or inflammatory cells, No Fever (Afebrile)
Progresses to Dehydration (Isotonic Fluid Loss), Hypokalemia, Hypovolemic Shock (Potassium Loss), Metabolic Acidosis (Bicarbonate Loss), with Cardiac Arrhythmia and Renal Failure Common in ***FRESH WATER SYSTEMS*** (low salt content) and associated with ***SHELLFISH*** Endemic to Southern Asia |
Cholera caused by Vibrio cholerae O1 and/or O139
Non-Invasive and Colonizes Small Intestines Produces Heat-Labile Enterotoxin = Choleragen (Encoded on Lysogenic Bacteriophage) |
|
|
Hallmark Treatment for Cholera
|
Rapid Fluid/Electrolyte Replacement!
|
|
|
Gastroenteritis
Associated w/consumption of Raw or Uncooked Seafood |
Vibrio cholerae non-O1 and non-O139
Generally do NOT produce Choleragen, but do produce related enterotoxins. |
|
|
Gastroenteritis, explosive watery diarrhea (similar, but less severe than Cholera) with No blood or mucus, fever, chills, headache
Associated with consumption of Raw Seafood Cause of Wound infections associated w/exposure to contaminated Water Halophilic (salt loving) |
Vibrio parahaemolyticus
Produce Thermostable Direct Hemolysin (TDH) |
|
|
INVASIVE through GI Tract to cause a ***FULMINATING SEPTICEMIA***, usually in Immunosuppressed or Compromised Hosts (especially Hepatic Cirrhosis)
ALso cause Rapidly progressing Wound Infections ALMOST ALWAYS associated w/ Seawater - initial swelling, erythema, pain followed by development of VESICLES or BULLAE and eventually leads to Tissue Necrosis |
Vibrio vulnificus
|
|
|
Cause of Wound Infection associated with Marine Water
***EXTERNAL OTITIS*** Normal Flora member of Marine Life! Collagenase is a Virulence Factor! |
Vibrio alginolyticus
|
|
|
Cause of Wound Infection associated with Marine Water
Always found in ***UPPER TEXAS GULF COAST*** Cytolysin mediated and can be rapidly fatal! |
Vibrio damsela
|
|
|
Acute Gastroenteritis - Acute diarrhea w/BLOOD and NEUTROPHILS. Can have 10 or more bowel movements/day. Stools may be BLOODY. Malaise, fever, and abdominal pain common. Destruction of mucosal surfaces of the jejunum, ileum and colon are common.
Associated with consumption of CONTAMINATED WATER or FOODS - especially MILK, POULTRY, MEAT PRODUCTS Thermophilic (Optimal Temp = 42 Degrees Celsius) Reservoir = Birds, Mammals Associated w/ Guillain-Barre Syndrome |
Campylobacter jejuni
FLAGELLA implicated in pathogenesis (one of few organisms to have this trait)! Most are SELF-LIMITING! |
|
|
Guillain-Barre Syndrome
|
Associated w/ Campylobacter jejuni
Immune Disorder of the PNS! |
|
|
Initial Gastroenteritis followed by Bacteremia w/ Dissemination to Multiple Organs (septic thrombophlebitis, arthritis, septic abortion and meningitis)
Debilitated and immunocompromised individuals most susceptible! Reservoir = Cattle and Sheep Optimal Growth = 37 Degrees Celsius Often FATAL! |
Campylobacter fetus
Capsular like S Protein = Evades Immune Response |
|
|
***TYPE B GASTRITIS*** -Persistent inflammation. Chronic Gastritis and ***PEPTIC ULCER*** Disease. Nausea, anorexia, vomiting, epigastric pain, belching.
Some develop Atrophic Gastritis (risk factor for Gastric Adenocarcinoma and Gastric MALT B-Cell Lymphoma). |
Helicobacter pylori
Lives in Mucus Layer of Stomach, get there via 5-6 Polar Flagella! Most infected persons suffer NO clinical manifestations! Reservoir = Humans! |
|
|
Helicobacter pylori Strains:
|
Type 1: Express 1) Vacuolating Cytotoxin (VacA) and 2) Cytotoxin-Associated Gene A (CagA) --> Duodenal Ulcers
Type 2: Do NOT express VacA NOR CagA --> Still cause persistent Inflammation |
|
|
Convulsive coughing and a characteristic "whooping" sound as infected individuals try to breathe
Increased percentage of lymphocytes! Spread by airborne droplet nuclei! |
Bordetella pertussis
Reservoir = Humans 5 Toxins: Pertussis Toxin, Adenylate Cyclase/Hemolysin, Tracheal Cytotoxin, Dermonecrotic Toxin, Endotoxin (LPS) |
|
|
Three Stages of Whooping Cough Infection (Bordetella pertussis)
|
1) CATARRHAL - Resembles common cold, profuse and mucoid rhinorrhea for 1-2 weeks, malaise, fever, sneezing, anorexia. MOST Infectious Stage.
2) PAROXYSMAL - Episodes of convulsive coughing for 2-4 weeks. "Whooping" heard after coughing, often followed by vomiting. Absolute lymphocytes reaches Peak! Ciliated epithelial cells are extruded and clearance of mucus is impaired --> airway restriction and characteristic cough 3) CONVALESCENT - Gradual decrease in coughing and other symptoms. Secondary complications can occur, such as pneumonia, seizures, and encephalopathy |
|
|
Regan-Lowe Media
|
Hallmark Special Chocolate agar media for Bordetella pertussis
Contains charcoal, horse blood, and cephalosporin |
|
|
Responsible for Respiratory disease in Dogs, Swine, Laboratory Animals, Occassionally Pertussis-like symptoms in Humans
|
Bordetella bronchiseptica
|
|
|
Causes Legionnaire's Disease and Pontiac Fever, which are Lower Respiratory Tract Infections --> High fever, cough, chills, headache, myalgia, chest pain, confusion
Common in Late Summer to Early Fall Found in Natural Aquatic Bodies, Polluted Water, Moist Soil, ***HOT WATER TANKS (grow in Amoebae and Ciliated Protozoa)***, ***AIR CONDITIONING SYSTEMS***, ***CRUISE SHIPS***, ***HOT TUBS***, Water Pipes (Grows in Biofilms) |
Legionella!
Spread by Aerosolization! |
|
|
High fever, cough, chills, headache, myalgia, chest pain, confusion
***SEVERE PNEUMONIA*** - Pneumonia w/ Multilobar Consolidation and Inflammation and Microabscesses in the Lung Tissue ***INTRA-ALVEOLAR EXUDATE of 1) PMNs and 2) Macrophages*** Multiorgan Disease involving GI Tract, CNS, Liver, Kidneys Can also cause diarrhea, mild renal disease or renal failure! |
LEGIONNAIRE'S DISEASE
1 of 2 Clinical Manifestations of Legionella Infection |
|
|
High fever, cough, chills, headache, myalgia, chest pain, confusion
***INFLUENZA-LIKE ILLNESS*** - Markedly debilitating for 2-5 days, then recover. ***NORMAL Chest X Rays*** |
PONTIAC FEVER
1 of 2 Clinical Manifestations of Legionella Infection Self-Limiting! |
|
|
What virulence factors of Neisseria gonorrhoeae undergo Antigenic/Phase Variation?
|
LOP
1) Lipooligosaccharide (LOS) 2) Opa 3) Pilus |
|
|
In Men, ***ACUTE URETHRITIS***, Urethral Discharge and Dysuria. Initially Mucoid, then within 1-2 days becomes Overtly Purulent.
|
Neisseria gonorrhoeae
Invasion via Epididymitis |
|
|
In Women, ***URETHRITIS and/or CERVITICIS***, Increased Vaginal Discharge, Intermenstrual Bleeding.
Can lead to Infertility, Ectopic Pregnancy, Scarring of Fallopian Tubes |
Neisseria gonorrhoeae
Invasion via Pelvic Inflammatory Disorder (PID) Spread along Fallopian Tubes and into Pelvic Cavity to produce Peritonitis. |
|
|
Fitz-Hugh-Curtis Syndrome
|
Caused by Invasion of Blood Stream by Neisseria gonorrhoeae
Almost exclusively in WOMEN Development of Perihepatitis is associated w/ PID |
|
|
Ophthalmia Neonatorum
|
Infection of Newborns during Vaginal Delivery with Neisseria gonorrhoeae (goes into blood stream)
|
|
|
Thayer-Martin Medium
|
Classic Medium for Neisseria gonorrhoeae!
Selective medium! |
|
|
Inflammatory disease of CNS caused by growth of bacteria in and adjacent to the Leptomeninges.
Dissemination throughout the leptomeninges, brain, spinal cord may be extremely rapid Predominantly a Pediatric Illness! Normal Flora! |
Neisseria meningitidis
B serotype is MOST common in the USA - NO Vaccine available for this Serotype! Pathogenic IF it can colonize the Nasopharynx! Reservoir = Humans! |
|
|
Stages of Neisseria meningitidis infection after entering blood stream (Meningococcemia)
|
1) TRANSIENT BACTEREMIA - No Sequelae
2) CHRONIC MENINGOCOCCEMIA - Transient episodes of Bactermia, arthritis, pustular dermatitis, low-grade fever, petechial skin lesions 3) ACUTE MENINGOCOCCEMIA - Invasion of Meninges and Other Organs - Several days of Upper Respiratory symptoms followed by Abrupt onset of fever, unprecedented headache, stiff neck, stupor, coma, vomiting, petechial skin lesions, meningitis, pericarditis, arthritis, conjunctivitis 4) FULMINANT MENINGOCOCCEMIA (Waterhouse-Friderichsen) - Intravascular Coagulation, Circulatory Collapse, and Death within a few hours |
|
|
Flea bite, most likely due to a rodent. Rapid rise in temperature, primary sore at bite site and regional enlarged lymph node surrounded by edema with intense inflammatory changes followed by necrosis and suppuration (usually at groin). Can progress to bacteremia and septic shock and die within hours or days of symptoms.
Gram Neg Rods |
Bubonic Plague caused by Yersinia pestis
|
|
|
Papule at inoculation site that becomes pustular and then ulcerates. Regional lymph nodes become enlarged and tender.
Acute onset of headache, fever, and toxicity. Pneumonia frequently occurs Small, Faintly Staining Gram Neg Coccobacillus which requires Sulfhydryls for growth (cysteine) |
Ulceroglandular tularemia caused by Francisella tularensis
Most Common Manifestation of F. tularensis! Low mortality if untreated |
|
|
Follows ingestion of an organism, perhaps with presence of a cutaneous lesion
Mucosal ulcerative lesions may occur including buccal, pharyngeal, and intestinal. May present as gastroenteritis or typhoid fever. Severely il with fever, toxicity, stupor, delirium, coma Small, Faintly Staining Gram Neg Coccobacillus which requires Sulfhydryls for growth (cysteine) |
Enteric form of Tularemia aka Typhoidal Tularemia caused by Francisella tularensis
Fatal if left untreated |
|
|
Headache, fever, malaise, nonproductive cough, substernal discomfort
X-ray shows pulmonary infiltrate and HILAR ADENOPATHY Small, Faintly Staining Gram Neg Coccobacillus which requires Sulfhydryls for growth (cysteine) |
Pulmonary Tularemia caused by Francisella tularensis
Fatal if left untreated |
|
|
What Zoonotic bacteria is associated with Deer Flies (in addition to ticks)?
|
Francisella tularensis
|
|
|
Common in people who work in ***MEAT PROCESSING INDUSTRIES***
Associated with UNPASTEURIZED DAIRY PRODUCTS, INFECTED MEAT or PLACENTAS, inhalation |
Brucellosis caused by infection by Brucella!
|
|
|
Yersinia pestis (plague) Virulence Factors:
|
Yop Proteins - Eukaryotic-Like Proteins
1) YopH = Cytotoxicity by disrupting Actin Filaments 2) YopE = Contact-Dependent Cytotoxicity by Depolymerizing the Actin Microfilament Network 3) YopM = Prevents Platelet Aggregation by interacting w/ Thrombin |
|
|
Affect Immunocomprimised Patients, except in ***SWIMMERS EAR*** and ***HOT-TUB FOLLICULITIS***
Also associated with Otitis, Eye Infections, Osteomyelitis, UTIs, Burns, Pneumonia, Bacteremia ***PIGMENTED*** ***GRAPE LIKE ODOR*** Gram Neg Rod w/ Polar FLagella |
Pseudomonas aeruginosa
Presence of Cytochrome Oxidase differentiates it from Enterobacteriaceae! |
|
|
Meningitis (children 2 months - 3 years) or ***EPIGLOTITIS***(2-5 years old)
|
Encapsulated Hib Serotype of Haemophilus influenzae
|
|
|
Nonencapsulated Haemophilus requiring Hematin (X) and/or NAD (V) and CO2 for growth
Associated with Bacteremia, Endocarditis, Opportunistic Infections |
Haemophilus parainfluenzae
|
|
|
STD resulting in a "Chancroid" - Genital Ulcers
Cyclical problem in US and Europe. More of a problem in Africa and Asia |
Haemophilus ducreyi
Nonencapsulated, requires Hematin (X) and/or NAD (V) and CO2 for growth |
|
|
Strain 19 Disease
|
An avirulent variant of Brucella abortus used to vaccinate calves and workers in the cattle industry CAN cause infection!
|
|
|
Chlamydia Life Cycle: EB and RB
|
Elementary Body (EB):
-Small -EXTRAcellular -Metabolically INACTIVE -CANNOT Proliferate -Infectious Reticulate Body (RB): -Large -INTRAcellular -Metabolically ACTIVE -Divides by Binary Fission -NONinfectious |
|
|
Trachoma
|
Caused by Chlamydia trachomatis Infection of Serotypes A, B, C
NOT a STD Most important cause of preventable blindness worldwide! |
|
|
LGV (Lymphogranuloma Venereum)
|
Caused by Chlamydia trachomatis Infection of Serotypes L1, L2, L3
STD Mostly correlated with Man-Man Sex (correlated with HIV Positive Men) Most frequent Symptom = Proctitis (Inflammation of Rectum) |
|
|
STD Related Urogenital Infections
|
Caused by Chlamydia trachomatis Infection of Serotypes D-K
STD Both Sexes = Urethra, Conjunctiva, Systemic Women = Bartholin's Gland, Cervix, Fallopian Tube, Liver Capsule Men = Epididymus, Rectum, ***REITER'S SYNDROME*** |
|
|
Reiter's Syndrome
|
USUALLY in Men!
Caused by nonviable Chlamydia trachomatis in Joints, leading to Reactive Arthritis |
|
|
Transmitted from infected BIRDS worldwide, can cause Pneumonia.
Sometimes called the "Parrot Disease" |
Chlamydia psittaci infection causing Psittacosis
|
|
|
Pharyngitis, bronchitis, pneumonia, sinusitis
Associated with ***ATHEROSCLEROSIS*** |
Chlamydia pneumoniae Infection
Only Chlamydia type that can efficiently invade Smooth Muscle cells and is associated with Atherosclerosis! |
|
|
***ROCKY MOUNTAIN SPOTTED FEVER***: classic triad (persistant fever, headache, macular to petechial rash - (***CENTRIPETAL*** = Periphery --> Center) begins on wrists/ankles, spreads to trunk), No eschar (scab); myalgias; vascular lesions lead to complications (cardiac, neurologic, pulmonary, etc)
Western Hemisphere, Especially Mid-Atlantic to South Central states in the US |
Rickettsia rickettsii
Reservoir = Rodent + Tick |
|
|
***RICKETTSIAL POX***: biphasic (1) papule at bite site progresses to eschar w. systemic spread. (2) abrupt fluctuating high fever, severe headache, chills, sweats, myalgias, photophobia. Rash (papulovesicular) develops and crusts over.
USA (***NY***), Ukraine, Croatia, Korea |
Rickettsia akari
Reservoir = Mouse + Mite |
|
|
***EPIDEMIC TYPHUS*** aka Louse-Borne Typhus: abrupt onset of fever, severe headache, centrifugal rash (trunk to extremities) sparing face, palms/soles. maculoPaPular rash;
Worldwide |
Rickettsia prowazekii
Humans + Louse (Flying Squirrels) |
|
|
Brill-Zinsser Disease
|
Recurrent or recrudescent Epidemic Typhus, more mild.
Caused by Rickettsia prowazekii |
|
|
***ENDEMIC (MURINE) TYPHUS***: mild form of epidemic, ~50% do not have rash. If rash is present, CENTRIFUGAL (Center --> Periphery).
Common in GUlf Coast states and California in warm months |
Rickettsia typhi
Reservoir = Rodents + Flea |
|
|
***Q FEVER***:
Acute; high fever, headache, myalgias, shaking chills, dry cough but usually no rash. self-limiting. Chronic: endocarditis (pre-existing heart disease or other conditions) |
Coxiella burnetii
Reservoir = Animals + Soil |
|
|
***EHRLICHIOSIS***: High fever, headache, malaise, myalgieas. Nausea/vomiting common. Rash is rare, but if present it developes later.
Leukopenia & thrombocytopenia in most (may be mild to severe). ***DECREASED WBC & platelets*** |
Ehrlichia chaffeensis
|
|
|
***CAT SCRATCH DISEASE***: pustule, regional adenopathy (single node), fever; ***Parinaud's oculoglandular syndrome***
|
Bartonella henselae
Reservoir = Cat or Cat Flea |
|
|
***TRENCH FEVER*** (5-day fever): fever, sever headache, weakness, pain in long bones (esp tibia); infect erythrocytes at 5 day intervals. Immunocompromised (HIV) recurrent fever +bacterimia
|
Bartonella quintana
Reservoir = Humans + Louse |
|
|
Pelvic Inflammatory Disease, Pyelonephritis (Kidney Scarring), Postpartum Fever
Colonizes Respiratory Tract and Genitourinary Tract in MALES |
Mycoplasma hominis
|
|
|
Non-Gonococcal Urethritis
|
Ureaplasma urealyticum
|
|
|
All Enterobacteriaceae are motile with peritrichous flagella EXCEPT for 3. Which are they?
|
(Your Stationary Kinds)
1) Yersinia 2)Shigella 3) Klebsiella |
|
|
Which Pathogenic E. coli strains should you NOT use the following with:
1) Antimicrobials 2) Antimotility Agents |
1) Antimicrobials - EHEC, may cause Hemolytic Uremic Syndrome (HUS)
2) Antimotility Agents - EIEC |
|
|
Indolent (Painless) Pneumonia, Foul Breath
ASACCHAROLYTIC (cannot break down sugars) - also found in Genitourinary Tract In Lab Dx, BLACK COLONIES due to pigment REQUIRES Vitamin K and Hemin to grow Gram Neg Coccobacillary in appearance |
Porphyromonas asaccharolytica and gingivalis
Just like Prevotella in every way EXCEPT that it is Asaccharolytic and also found in the GU Tract |
|
|
Common characteristic of Aerobes and Facultative Anaerobes?
|
Typically Oxidase POSITIVE!
Exception: Enterobacteriaceae - a facultative anaerobe that is Oxidase NEGATIVE! |
