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215 Cards in this Set
- Front
- Back
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Bacteria the produce superantigens (2)
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S. aureus
S. pyogenes |
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Superantigen Mechanism
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Bind non-specifically to MHC II and T-cell receptor
Stimulates release of IL-1 and IL-2 |
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S. aureus Superantigen causes:
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TSST-1: fever, rash shock
Enterotoxin: Rapid onset food poisoning |
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S. pyogenes Superantigen causes:
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Toxic shock like syndrome
(Scarlet fever strain SPE toxin) |
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Bacteria that produce ADP-ribosylating A-B toxins (4)
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Corynebacterium Diptheriae
Vibrio Cholera E. coli Bordatella pertussis |
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Corynebacterium diptheriae A-B toxin mechanism and symptom
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M: Inactivates EF-2 protein
S: Pharyngitis and Pseudomembrane in throat |
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Vibrio cholerae A-B toxin mechanism and symptom
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M: ADP ribosylation of G protein, stimulates adenyl cyclase
S: Increase Cl- and H2O in gut, Rice-water diarrhea |
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E. coli (ETEC) A-B toxin mechanism and symptom
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M: Heat-labile toxin stimulates AC
S: Increase Cl- and H2O in gut, Rice-water diarrhea |
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Bordatella pertussis A-B toxin mechanism and symptom
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M: Inactivates Gi, increase cAMP
S: Whooping cough, lymphocytosis |
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C. perfringes exotoxin and symptom
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T: alpha toxin
S: gas gangrene |
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C. tetani exotoxin mechanism and symptom
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M: block release of inhibitory NT glycine
S: rigidity, lockjaw |
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C. botulinum exotoxin mechanism, symptom, transmission
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M: block release of ACh
S: anti-ACh symptoms, CNS flaccid paralysis T: Spores in canned foods Honey (floppy baby) |
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Bacteria releasing Shiga exotoxin (2), mechanism and symptom
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B: Shigella, E.coli O157:H7
M: cleave host cell rRNA S: Hemolytic Uremic Syndrome |
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S. pyogenes exotoxin mechanism and use
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M: hemolysin (lyses RBCs)
Use: ASO Ab titer in Rheumatic Fever |
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Endotoxin components
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LPS in Gram (-) bacterial wall
1) Lipid A (Toxic) 2) O-Antigen (Antigenic) 3) Core |
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Endotoxin Lipid A functions (3)
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1. Activates Macs (IL-1, TNF, NO release)
2. Activates alternative complement pathway (C3a, C5a release) 3. Activates Hageman Factor (Coag cascade - DIC) |
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Bugs that don't Gram stain well and why (6)
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"These Rascals May Microscopically Lack Color"
1. Treponema (too thin, dark field and Fl Ab staining) 2. Rickettsia (intracellular) 3. Myobacteria (high lipid content, acid fast) 4. Mycoplasma (sterols, no cell wall) 5. Legionella (intracellular, Silver stain) 6. Chlamydia (intracellular) |
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Fermentation pattern of Neisseria species:
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N. meningiditis: Maltose and Glucose
"MeninGococcal" N. gonorrhea: Glucose "Gonococci" |
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Pigment producing bacteria (3)
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S. aureus: yellow (Aureus = gold)
Pseudomonas aeruginosa: Blue-green Serratia: Red pigment |
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IgA proteases: Function and Bacteria that produce them (4)
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F: Allows colonization of mucosal surfaces
S. pneumoniae N. meningitidis N. gonorrhea H. influenzae |
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Chocolate agar, factors V (NAD) and X (hematin)
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H. influenzae
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Thayer-Martin media
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N. gonorrhea
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Bordet-Gengou (potato) agar
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B. pertussis
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Tellurite Plate, Loffler's medium, blood agar
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C. diptheriae
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Lowenstein-Jensen Agar
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M. tuberculosis
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Pink colonies on MacConkey's Agar
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Lactose fermenting enterics
Klebsiella E.coli Enterobacter Citrobacter Serratia |
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Charcoal yeast extract agar + Fe + Cysteine
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Legionella
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Giemsa stain (3)
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Borrelia, Plasmodium, Chlamydia
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PAS
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T. whipplei (Whipple's disease)
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Zhiel-Neelsen stain
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Acid-fast bacteria
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India Ink
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Cryptococcus neoformans (fungus)
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Silver stain (3)
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Legionella
Fungi PCP |
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DNA conjugation
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Transfer from one bacterium to another
Chromosomal or plasmid |
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Transduction
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DNA transferred by a virus from one bacterial cell to another
generalized: lytic phage, parts of bacterial chromosomal DNA is packaged in capsule and transfered to another cell via infection. specialized: lysogenic phage, viral DNA is incorporated into host, when excised, flanking bacterial genes are also excised and transferred via infection to another cell |
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Transformation
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Purified DNA taken up by any competent cell
Any DNA |
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Obligate Aerobes (4 main ex's)
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"Nagging Pests Must Breathe"
Nocardia P. aeruginosa M. tuberculosis (apices of lung) Bacillus |
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Obligate anaerobes (properties)
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-Actinomyces, Bacterioides, Clostridium
"ABCs" -lack catalase +/or SOD, susceptible to oxidative damage -foul smelling, difficult to culture, produce gas in tissue -normal flora in GI tract, pathogenic elsewhere -resistant to Aminoglycosides (need O2 to enter cell) |
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Intracellular Bacteria
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Obligate (can't make ATP): Rickettsia and Chlamydia
"cells stay inside when it's Really Cold" Facultative: Salmonella Neisseria Brucella Myobacterium Listeria Francisella Legionella Yersinia "Some Nasty Bugs May Live FacultativeLY" |
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Bacterial capsule function
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Antiphagocytic virulence factor
Serves as Ag in vaccines (Pneumovax, H. influenzae B, meningococcal) Positive quelling rxn: capsule swells |
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Encapsulated bacteria (4)
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S. pneumoniae
H. influenzae (B serotype) N. meningitidis (no Type B vaccine) Klebsiella |
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Properties of bacterial spores
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-produced by gram (+) when nutrients are limited
-highly resistant to heat and chemicals -dipicolinic acid in core -no metabolic activity -kill by autoclave |
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Bacteria that produce spores (3) :
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Bacillus anthracis (box-car)
C. perfringes C. tetani (tennis rackets) |
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Alpha hemolytic bacteria (2)
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S. pneumoniae
(catalase (-) , optochin S) Viridans streptococcus/S. mutans (catalase (-) , optochin R) |
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Beta hemolytic bacteria (4)
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1. S. aureus (catalase +, coag +)
2. S. pyogenes (Strep A) (catalase (-) , bacitracin S) 3. S. agalactiae (Strep B) (catalase (-) , bacitracin R) 4. L. monocytogenes (tumbling motility, meningitis in newborns, unpast. milk) |
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Bacterial virulence factors
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Promote evasion of host immune response
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S. aureus protein A
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Binds Fc region of Ig
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Group A streptoccocal M protein
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Prevents phagocytosis
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Novobiocin (Staph Identification)
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Saprophyticus - Resistant
Epidermidis - Sensitive "NO StRES" |
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Optochin (Strep Identification)
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Viridans - Resistant
Pneumoniae - Sensitive "OVRPS" (overpass) |
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Bacitracin (Strep Identification)
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group B - Resistant
group A - Sensitive "B-BRAS" |
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Transposition
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Segment of DNA that can jump from one location to another, transferring genes from plasmid to chromosome and vice versa.
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Urease-positive bacteria (4)
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Proteus
Ureaplasma Klebsiella ` H. pylori (breath test) "PUKH" |
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Urease-positive bacteria (4)
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H. pylori (breath test)
Proteus Klebsiella Ureaplasma` |
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Urease-positive bacteria (4)
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H. pylori (breath test)
Proteus Klebsiella Ureaplasma` |
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Catalase
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Degrades H2O2, an antimicrobial product of PMNs.
Staph make catalase, strep do not. |
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Coagulase
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S. aureus: +
S. epidermidis and saprophyticus: - "Staph makes more 'staff' " (catalase +, coagulase +) |
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Staphylococcus aureus Infxns
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1. Inflammatory Disease--skin infxns, abcesses, pneumonia
2. Toxin-mediated Disease--TSS, scalded skin syndome, rapid-onset food poisoning 3. MRSA--nosocomial and community acquired infxns 4. Bacterial Endocarditis, Osteomyelitis |
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S. aureus toxins (3)
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TSST-1
Enterotoxin (pre-formed) Exfoliatin (scalded skin syndrome) |
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S. aureus virulence factor
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Protein A: prevents phagocytosis
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MRSA
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Important cause of serious nosocomial and community-acquired infxns
Resistant to B-lactams due to alterred PBP (penicillin binding protein) |
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S. pyogenes (group A strep) sequelae
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1. pyogenic - pharyngitis, cellulitis, impetigo
2. toxigenic - scarlet fever, TSS 3. immunologic - rheumatic fever, acute glomerulonephritis "PHaryngitis gives you rheumatic PHever and glomerulonePHritis" |
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ASO titer is diagnostic for:
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S. pyogenes infxn
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Rheumatic Fever
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Caused by S. pyogenes. Ab cross-reactivity to heart 2-3 weeks post strep infxn.
"No "RHEUM" for SPECCulation" Subcutaneous Nodules Polyarthritis Erythema marginatum Chorea Carditis |
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S. pneumoniae
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Encapsulated. IgA protease.
Most common cause of "MOPS" Meningitis Otitis Media Pneumonia Sinusitis "S. pneumoniae MOPS are: Most OPtochin Sensitive" |
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"Rusty" sputum, sepsis in sickle cell anemia and splenectomy
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S. pneumoniae
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S. agalactiae (group B strep)
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Bacitracin resistant, B-hemolytic.
Causes in babies: pneumonia meningitis sepsis |
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Entercocci (group D strep)
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Causes:
UTI subacute endocarditis nosocomial infxns (VRE) Grows in NaCl. |
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NaCl in media
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Enterococci (group D strep)
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S. epidermidis
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Biofilms--prosthetic devices and catheters.
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Viridans group streptococci (S. mutans)
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Alpha hemolytic. Optochin resistant. Normal flora of oropharynx.
Causes: dental caries subacute endocarditis |
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Clostridia (4)
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Gram +, spore forming obligate anaerobic bacilli.
C. tetani C. perfringes C. botulinum C. difficile |
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C. tetani
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Rigid paralysis (blocks inhibitory NT)
Vaccine |
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C. botulinum
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Exotoxin: preformed, heat labile Botulinum
Flaccid paralysis Adults: canned foods Babies: Honey |
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C. perfringes
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Exotoxin: alpha toxin
Gas gangrene and hemolysis. |
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C. difficile
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Exotoxin: kills enterocytes
Pseudomembranous colitis watery and bloody diarrhea NOSOCOMIAL Secondary to Abx use (clindamycin) |
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Treat C. difficile with?
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Metronidazole
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Diptheria
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Corynebacterium diptheriae
Exotoxin: ADP A-B toxin (ADP ribosylates EF2) Symptoms: Pseudomembranous pharyngitis (grayish white membrane) Lymphadenopathy Vaccine |
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Anthrax Mechanisms
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Gram + B. Anthracis: Anthrax toxin
1. Contact Malignant pustule (painless ulcer) Bacteremia Death 2. Inhale spores Flu-like Sxs Fever Pulmonary Hemorrhage+Shock Black eschar Wool Sorter's Disease |
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Only bacterium with protein capsule
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B. anthracis
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Eschar
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Black skin lesions, vesicular papules.
Characteristic of Anthrax. |
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Wool Sorter's Disease
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Inhalation of Anthrax spores from contaminated wool.
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Listeria Monocytogenes
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Unpasteurized milk/cheese
Vaginal transmission thru birth NEONATAL MENINGITIS Infxn in pregnant females Meningitis in ICH Mild gastritis in the healthy |
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"Actin Rockets"
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Listeria Monocytogenes
This is how they move from cell to cell |
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Actinomyces v. Nocardia
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Both: Gram + rods, long branching filaments resembling fungi
A. israelii: -anaerobe -oral/facial abscesses, drain through sinus tracts -normal oral flora Nocardia: -weakly acid fast -pulmonary infxn in ICH "SNAP": Sulfa for Nocardia Actinomyces use Penicillin |
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Sulfur granules in sinus tract
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Actinomyces israelii
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Penicillin and Gram (-) Bacteria
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Outer membrane layer inhibits entry of penicillin G and vancomycin.
Penicillin - G Resistant Ampicillin - Sensitive |
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Neisseria
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Gram (-) cocci
Ferment glucose IgA protease |
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N. gonorrhea
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No polysacch capsule
Glucose ferment Sx: gonorrhea septic arthritis neonatal conjunctivitis PID |
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N. meningitidis
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Polysacch capsule
Glucose and Maltose ferment Vaccine Respiratory and oral secretions Causes: Meningitis Waterhouse-Friedrickson |
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Waterhouse Friedrickson Syndrome
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Bilateral adrenal hemorrhage
N. meningitidis |
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How is N. meningitidis spread?
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Respiratory and oral secretions.
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H. influenzae
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Gram (-) coccobacillary rod.
Aerosol transmission. Invasive: Capsular Type B No flu (that's the virus!) "haEMOPhilus" EPIGLOTTITIS Meningitis Otitis media Pneumonia |
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Most common cause of epiglottitis?
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H. influenzae
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H. influenzae vaccine made against:
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Capsular Type B
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N. meningitidis vaccine made against:
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A, C, W-135, Y
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No meningitis vaccine against:
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Type B
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H. influenzae culture medium
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Chocolate agar
Factor V (NAD) Factor X (hematin) "Mom goes to five (V) and dime (X) store to buy chocolate" |
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How to treat H. influenzae meningitis?
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Ceftriaxone.
Rifampin prophylaxis: close contacts |
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Enterobacteriaceae (7)
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"KEEPSSS"
Klebsiella E.coli Enterobacter Proteus Serratia Shigella Salmonella |
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Enterobacteriaceae properties
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Glucose fermenter and oxidase (-)
COFFEe Capsular O-antigen (endotoxin) Flagellar antigen Ferment glucose Enterobacteriaceae |
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Capsular K antigen
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Virulence factor
Enterobacteriacceae |
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Klebsiella
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3 A's:
Aspiration pneumonia Abscess in lungs Alcoholics -Pneumonia in alcoholics and diabetics. -Red currant jelly sputum. -Nosocomial UTIs. |
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Pneumonia in alcoholics and diabetics
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Klebsiella
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Red curry jelly sputum
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Klebsiella
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Lactose-fermenting enteric bacteria
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KEE
Klebsiella E. coli Enterobacter "Lactose is KEE" "Test with MacConKEE's agar" |
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Salmonella typhimurium
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Bloody diarrhea
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Salmonella typhi
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Typhoid fever
Diarrhea, HA, rose spots on abdomen Can remain in gallbladder chronically |
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Diarrhea, HA, rose spots on abdomen
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Typhoid fever.
Salmonella typhi |
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Salmonella
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Non-lactose. Can invade intestinal mucosa and cause bloody diarrhea.
Motile and can disseminate hematogenously. "SALMONella swim" Produce H2S |
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Produce H2S
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Salmonella
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Salmonellosis treatment
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Nothing! Abx prolong disease.
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Shigella
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Non-bloody diarrhea
More virulent than Salmonella Non-motile Lactose, Indole (-) |
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Yersinia enterocolitica
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Mimic Chron's or appendicitis.
Transmitted by pet feces, milk, pork Outbreaks in day care centers |
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Contaminated Seafood
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Vibrio parahaemolyticus
Vibrio vulnificans |
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Vibrio vulnificus
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Wound infxns from contact with contaminated water or shellfish.
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Reheated rice
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B. cereus
"Food poisoning from reheated rice? BE CEREUS! " |
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Food poisoning starts and ends quickly (2)
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S. aureus and B. Cereus
(preformed toxins) |
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Meats, mayo, custard
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S. aureus
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Reheated meat dish
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C. perfringens
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Undercooked meat
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E.coli O157:H7
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Undercooked Poultry, Meat, Eggs
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Salmonella
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Bloody Diarrhea (8)
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Camplyobacter jejuni
Salmonella Shigella Enterohemorrhagic E.coli Enteroinvasive E.coli Yersinia enterocolitica C. difficile Entamoeba histolytica |
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Camplyobacter jejuni
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Watery or Bloody Diarrhea
Oxidase + S-shaped Growth at 42C Guillan-Barre Syndrome |
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EHEC
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Bloody Diarrhea, HUS
O157:H7 Shiga-like toxin |
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ETEC
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Traveler's Diarrhea
ST and LT toxins |
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Yersinia enterocolitica
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Bloody Diarrhea
Pseudoappendicitis Day-care outbreaks |
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Watery Diarrhea (8)
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ETEC
Vibrio cholerae C. perfringens Giardia (protozoa) Cryptosporodium in ICH (protozoa) Rotavirus Adenovirus Norwalk/Norovirus |
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Traveler's Diarrhea
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ETEC
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ST and LT toxins
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ETEC
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Vibrio cholerae
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Rice water diarrhea
Comma-shaped |
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cAMP inducers (4)
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Vibrio cholera--activated Gs
Pertussis toxin--inhibits Gi E.coli--heat labile toxin B. anthracis--edema factor (bacterial adenylate cyclase) |
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Legionella
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Gram (-), but poor stain
Silver stain Contaminated water (AC) Legionairre's = severe pneumonia Pontiac's Disease=mild flu |
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Legionella treatment
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Erythromycin
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Pseudomonas aeruginosa
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AERobic
Gram (-) rod Non-lactose Exotoxin A (inactivates EF2) Wound Infxns (Burn Pts) Pneumonia (CF Pts) External otitis Hot tub folliculitis |
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P. aeruginosa transmission?
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Water source
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Treat P. Aeruginosa?
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Aminoglycoside
+ extended spectrum penicillin |
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Burn Pts?
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P. aeruginosa
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Heliobacter pylori
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Gram (-)
Alkaline envt. Urease Breath Test Duodenal/Peptic Ulcers Gastritis Adenocarcinoma, Lymphoma |
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Urease Breath Test
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H. pylori
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H.pylori treatment
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bismuth
metronidazole tetracycline or amoxicillin MORE COSTLY omeprazole metronidazole clarithromycin |
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Zoonotic bacteria (6)
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"Big Bad Bug From Your Pet"
Bartonella henselae Borellia burdorferi Brucella Francisella tularensis Yersinia pestis Pasturella multocida |
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Cat Scratch Fever
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Bartonella henselae
"Simpsons-Bart-Scratchy" -- Dedicated to Saba |
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Lyme Disease
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Borellia burgdorferi
Tick bite (Ixodes) |
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Ixodes Tick
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Lyme Disease (B. burgdorferi)
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Undulant Fever
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Brucella
dairy products contact with animals |
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Tularemia
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Francisella tularensis
Tick bite, rabbits, deer |
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Rabbits
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Francisella tularensis
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Plague
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Yersinia pestis
Flea bite, rodents and prairie dogs |
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Cat bite cellulitis
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Pasturella multicoda
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Gardnerella vaginallis
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Gram (-) rod
Clue cells non-painful vaginosis vaginal discharge with fishy smell |
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Clue cells
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Gardnerella vaginallis
vaginal epithelial cells covered with bacteria |
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Treat Gardenella?
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Metronidazole
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PPD+
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Current infxn
Past exposure BCG |
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PPD-
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No infxn
Anergic (steroids, ICH) |
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Ghon complex
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TB granuloma
lobar, perihilar LN involvement Primary infxn/exposure |
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TB outcomes:
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1. Heals by fibrosis, PPD+
2. Progressive Lung Disease (HIV, malnutrition), Death 3. Bacteremia, Miliary Tuberculosis, Death 4. Hematogenous dissemination, dormant tubercle in organs REACTIVATION (secondary TB) |
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Secondary TB
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Reactivation of TB in Lungs
Cause extrapulmonary TB |
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Myobacteria (5)
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Acid fast.
M. tuberculosis M. kanasii MAC (avium-intracellulare) M. scrofulaceum M. leprae |
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TB symptoms
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Fever
Night sweats Weight Loss Hemoptysis |
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M. kanasii
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Pulmonary TB-like Sx's
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M. scrofulaceum
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Cervical lymphadenitis in kids
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M. avium-intracellulare
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disseminated disease in AIDS
multi-drug resistant |
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Hansen's Disease
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Leprosy
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M. leprae
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Leprosy/Hansen's Disease
2 forms: lepromatous+tuberculoid "LEpromatous = LEthal" cool temps infects skin, superficial nerves can't be grown in vitro armadillo reservoir in US |
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Armadillos
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M. leprae
Leprosy/Hansen's Disease |
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R. rickettsii
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Rocky Mt. Spotted fever
Rash on hands and feet Tick |
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Rash on hands and feet, moves inwards to trunk
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Rocky Mt. Spotted Fever
R. rickettsii "Rickettsia on the wRists, Typhus on the Trunk" |
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R. typhi
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Endemic typhus
(fleas) |
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R. prowazekii
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Epidemic typhus
(human body louse) |
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Endemic typhus
(fleas) |
R. typhi
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Epidemic typhus
(human body louse) |
R. prowazekii
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Rocky Mt. Spotted fever
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R. rickettsii
rash on palms and soles migrating inwards to trunk East coast |
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Erlichia
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Erlichiosis
(tick) |
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Coxellia burnetii
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Q-fever
(inhaled aerosols) "Q fever is *****" no rash, no vector, (-) Weill-Felix |
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Q-fever
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Coxellia burnetii
No vector! |
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Weil-Felix rxn
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Assay for anti-rickettsial Abs
cross reacts with Proteus Ag +: typhus, Rocky Mt. Spotted Fever - : Q-fever |
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Rickettsial Diseases and Vectors (5)
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R. rickettsii (tick)
R. typhi (fleas) R. prowazekki (louse) Erlichia (tick) Coxiella burnetii (no vector) |
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Treatment for Rickettsial Diseases
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Tetracycline
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Chlamydiae
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Intracellular, can't make ATP
2 forms: 1. Elementary body, enters vis endocytosis 2. Reticulate body, replicates in cell by fission |
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Chlamydiae (3)
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C. trachomatis
C. pneumoniae C. psittaci |
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Treatment of chlamydiae
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Erythromycin or Tetracycline
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Chlamydia trachomatis
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Conjunctivitis
Arthritis Urethritis PID |
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Chlamydia pneumoniae
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atypical pneumoniae
transmitted by aerosol |
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Birds, atypical pneumonia
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C. psittaci
avian reservoir |
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Chlamdyia Dx
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Cytoplasmic inclusions on Giemsa
Fl Ab-stained smear |
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Chlamydia trachomatis Serotypes
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A,B,C:
chronic infxn, blindness in Africa "ABC=Africa/Blindess/ Chronic Infxn" D-K: urethritis/PID, neonatal pneumonia + conjunctivitis, ectopic pregnancy L1, L2, L3: Lymphadenitis |
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Spirochetes (3)
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BLT. B is Big
Borellia (large size) Leptospira Treponema |
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Treponema visualization
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Dark field microscopy
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Leptospira interrogans
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? shaped
Water contaminated with animal urine Tropics Leptospirosis: Flu-like Fever HA Jaundice Weil's Disease: icterohemorrhagic leptospirosis |
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Water contaminated with animal urine
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Leptospira interrogans
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Lyme Disease
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B. burdorferi, Ixodes tick
Mice, deer are reservoirs NE US, summer months 3 stages: 1. Erythema migrans (bulls eye) Flu-like Sx 2. Neuro, cardiac Sx's 3. Arthritis "BAKE a Lyme pie" Bell's Palsy Arthritis Kardiac Erythema Migrans |
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Treponema palladium
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Syphillis
Primary: Painless chancre Secondary: Systemic Maculopapular rash (palms + soles) Condyloma lata Many treponemes (primary also) Tertiary: Gummas, Neuro Argyll Robertson pupil |
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Syphillis
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T. paladium
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Treat Lyme?
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Doxycycline
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Congenital Syphillis
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Saber shins
saddle nose CN VII deafness Hutchinson's teeth |
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Signs of Neuro Syphillis
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Broad based ataxia
+ Romberg Charcot joints stroke w/o HTN |
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Argyll Robertson pupil
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Tertiary syphillis
Constricts with accommodation Not reactive to light |
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Diagnose Syphyllis?
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VDRL and FTA-ABS
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FTA-ABS
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Dx syphyllis
"FTA-ABS= Find the Ab-Absolutely" 1. most specific 2. earliest + 3. remains + the longest |
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VDRL vs FTA-ABS
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Active Infxn: V+, F+
False positive: V+, F- Successfully treated: V-, F+ |
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VDRL false positives
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Non-specific Ab that reacts with beef cardiolipin
Can be + for many diseases: "VDRL" Viruses Drugs Rheumatic Fever Lupus, Leprosy |
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Mycoplasma pneumoniae
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Atypical, Walking pneumonia
X-ray looks worse than Pt No cell wall, no gram stain Only bacterial wall with cholesterol Outbreaks in military and prison |
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Treatment for Mycoplasma pneumoniae
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tetracyclin or erythromycin
penicillin resistant (no cell wall) |
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Congential Infxns
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TORCHeS
Toxoplasma gondii Other: Listeria, E.coli, group B strep Rubella CMV HIV, HSV-2 Syphillis |
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Bug hints (if all else fails)
Pus, empyema, abcess |
S. aureus
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Bug hints (if all else fails)
Peds infxn |
H. influenzae
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Bug hints (if all else fails)
Pneumonia in CF Burn infxn |
P. aeruginosa
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Bug hints (if all else fails)
Branching rods in oral infxn |
Actinomyces israelii
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Bug hints (if all else fails)
Surgical wound |
S. aureus
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Bug hints (if all else fails)
Neonatal sepsis/meningitis |
group B strep
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Guillan-Barre Syndrome
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Autoimmune neuropathy associated with C. jejuni
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Treat C. difficile?
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Metronidazole
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Pseudomembranous pharyngitis
Lymphadenopathy |
C. diptheriae
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Positive quelling rxn
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Tests for encapsulated organisms
Capsules swell |
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Hypopigmented skin lesions
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Leprosy (Hansen's disease)
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