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184 Cards in this Set
- Front
- Back
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Staphylococcus aureus Lab ID
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Lab ID
- Gram-positive - Cocci - Positive catalase - Positive coagulase - Positive Manitol - Yellow colonies |
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Staphylococcus aureus Treatment
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Treatment
- Penicillin G (almost 100% resistant) - Methicillin (almost 80% resistant) - Oxacillin - Vancomycin (few resistant strains) |
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Staphylococcus epidermidis Lab ID
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Lab ID
- Gram-positive - Cocci - Positive catalase - Negative coagulase - White colonies - Negative Manitol - Negative novobiocin resistance |
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Staphylococcus saprophyticus Lab ID
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Lab ID
- Gram-positive - Cocci - Positive catalase - Negative coagulase - Negative Mannitol fermentation - Positive novobiocin resistance |
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Staphylococcus aureus Symptoms
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Symptoms
- Food poisoning - Abscess formation - Toxic shock syndrome - Necrotizing pneumonia - Osteomyelitis - Impetigo - Septicemia - Endocarditis - Skin infections |
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Staphylococcus epidermidis Symptoms
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Symptoms
- Infections of catheters and heart valves |
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Staphylococcus saprophyticus Symptoms
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Symptoms
- Cystitis in women - Urinary Tract Infections |
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Streptococcus pyogenes Treatment
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Treatment
- penicillin G |
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Streptococcus pyogenes Symptoms
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Symptoms
- Acute pharyngitis - Acute rheumatic fever - Acute glomerulonephritis - Impetigo - Cellulitis or necrotizing fasciitis/myositis - Puerperal sepsis - Erysipelas - Toxic shock syndrome |
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Streptococcus pyogenes Lab ID
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Lab ID (Group A Strep)
- Gram-positive - Cocci - Positive latex antigen test - small, opalescent colonies surrounded by a large zone of beta-hemolysis (clear area) - Sensitive to bacitracin - Positive ASO test - Positive ADB test |
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Streptococcus agalactiae Lab ID
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Lab ID (Group B Strep)
- Gram-positive - Cocci - Catalase negative - Minor Beta-hemolytic - Large colonies |
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Streptococcus agalactiae Treatment
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Treatment
- Penecillin G - Ampicillin - Bad cases: aminoglycoside |
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Streptococcus agalactiae Symptoms
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Symptoms
- Meningitis in neonates - Endometritis - Septicemia in neonates - Sexually transmitted |
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Streptococcus pneumoniae Lab ID
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Lab ID
- Gram-positive - Cocci, most of the time PAIRED - Nonmotile - Encapsulated - Alpha-hemolytic (green ring) - Inhibited by optochin - Lysed by bile acids - Quellung reaction (capsular swelling when treated with type-specific antisera) |
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Streptococcus pneumoniae Treatment
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Treatment
- Third generation cephalosporins (cefotaxime/ceftriaxone) - Vancomycin Vaccines - PPV - PCV7 |
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Streptococcus pneumoniae Symptoms
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Symptoms
- Sepsis - Otitis media - Meningitis - Acute bacterial pneumonia |
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Enterococcus faecalis/Enterococcus feaecium Lab ID
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Lab ID
- Gram-positive - Cocci - Survives around bile - Hydrolyze the polysaccharide esculin - Grow in 6.5% NaCL - Positive pyrazin amidase (PYR) test - E. faecalis/E. faecium have different fermentation patterns - gamma-hemolytic |
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Enterococcus faecalis/Enterococcus feaecium Treatment
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Treatment
- Synergistic penicillin and streptomycin - Synergistic ampicillin and gentamicin - Vancomycin - Quinupristin and dalfopristin - Some strains have NO COMMERCIAL TREATMENT - E. faecium more likely to be Vancomycin resistant than E. faecalis |
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Enterococcus faecalis/Enterococcus feaecium Symptoms
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Symptoms
- Urinary tract infections - Bacteremia/Septicimia - Subacute bacterial endocarditis Biliary tract infection - Intraabdominal abscesses |
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Streptococcus bovis Lab ID
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Lab ID
- Gram-positive - Cocci - alpha- or nonhemolytic - Survive in presence of bile - Hydrolize esculin - PYR-negative - Does not grow in 6.5% NaCl |
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Streptococcus bovis Treatment
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Treatment
- Penicillin |
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Streptococcus bovis Symptoms
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Symptoms
- Urinary tract infections - Subacute bacterial endocarditis (associated with colon cancer) |
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Streptococcus mutans Lab ID
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Lab ID
- Gram-positive - Cocci - Catalase-negative - alpha/gamma-hemolytic |
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Streptococcus mutans Treatment
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Treatment
- Penicillin |
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Streptococcus mutans Symptoms
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Symptoms
- Dental caries (tooth decay) - Bacteremia - Subacute bacterial endocarditis in patients with abnormal or damaged heart valves |
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Corynebacterium diphtheriae Lab ID
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Lab ID
- Gram-postive - Rods - Selective medium Tinsdale agar -> distinctive black colonies with halos - Methylene blue stain -> characteristic bands and reddish granules |
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Corynebacterium diphtheriae Treatment
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Treatment
- Neutralize toxin with horse serum antitoxin - Erythromycin or Penicillin Prevention - Immunization with toxoid |
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Corynebacterium diphtheriae Symptoms
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Symptoms
- Low-grade fever - Pharyngitis - Cervical adenopathy (swelling of the neck) - Erythema of the pharynx progressing to adherent gray pseudomembranes |
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Corynebacterium diphtheriae Mechanisms
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Mechanisms
- Single exotoxin that inhibits eukaryotic protein synthesis - 2 parts, Part B binds to the cell and allows A to enter - A binds ADPR from NAD+ to EF-2 inactivating it |
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Bacillus anthracis Lab ID
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Lab ID
- Gram-positive - Blunt ended rods, single, double, chain - Spores are centrally located and oval - Large, grayish and non-hemolytic colonies with irregular border - Non-motile - Encapsulated - Direct immunofluorescence assay for antrax |
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Bacillus anthracis Treatment
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Treatment
- Cutaneous: doxcycline, ciprofloxacin, erythromycin - Inhaled: ciprofloxacin, rifampin and vancomycin TOGETHER |
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Bacillus anthracis Symptoms
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Symptoms
- Cutaneous: papule developes into a painless, black and swollen "malignant pustule which crusts over and can lead to septicemia (20% mortality) - Pulmonary anthrax: hemorhagic lymphadenitis (inflammation of lymph nodes) (100% mortality) |
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Bacillus anthracis Mechanisms
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Mechanisms
- Capsule that is anti-phagocytic - Three exotoxins - Edema factor -> a calmodulin-dependent adenylate cyclase - Lethal toxin -> tissue necrosis - Protective antigen -> Mediates cell entry of the other two exotoxins |
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Listeria monocytogenes Lab ID
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Lab ID
- Gram-positive - Rods, diplobacilli, short chains - No spores - catalase positive - Tumbling motility in liquid - Small colony with B hemolysis |
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Listeria monocytogenes Symptoms
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Symptoms
- Septicemia - Meningitis - Granulomatous skin lesions, focal lesions - Can be transfered to newborns from infected mother (common cause of newborn meningitis and fetal abortions) |
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Listeria monocytogenes Treatment
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Treatment
- Ampicillin - trimethoprim/sulfamethoxazole - Proper food prep/handling |
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Listeria monocytogenes Mechanisms
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Mechanisms
- Engulfed via phagocytosis - Escapes vacuole using listeriolysin O - Grows in cytosol - Sets itself up to move from neighboring cell to neighboring cell |
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Neisseria Gonorrhoeae Lab ID
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Lab ID
- Gram-negative - Cocci, pili, lipooligosaccharides (LOS) - nonmotile - resemble a pair of kidney beans - urethral exudate - Grows best under aerobic conditions w/ CO2 - Ferments glucose, but not maltose, lactose or sucrose - Oxidase positive - Gold standard is nucleic acid amplification |
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Neisseria Gonorrhoeae Symptoms
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Symptoms
- Genitourinary tract infections - Pelvic inflammatory disease - Gonococcal salpingitis (leading to infertility) - Rectal infections (male homosexuals) - Pharyngitis (oral sex) - Ophthalmia neonatorum (mother->child) - Disseminated infection (rare), but most common cause of septic arthritis in sexually active adults |
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Neisseria Gonorrhoeae Treatment
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Treatment
- 20% resistant to penicillin, tetracycline, cefoxitin and spectinomycin - Best choice is thir-generation cephalosporins: ceftriaxone - Second: spectinomycin - Add doxycycline to combat chlamydia because it is a common co-infectant |
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Neisseria Gonorrhoeae Mechanisms
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Mechanisms
- Pili and OMP II facilitate adhesion - IgA proteases that cleave IgA1 |
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Neisseria meningitidis Lab ID
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Lab ID
- Gram-negative - Diplococci, kidney bean shaped - non-motile - Often associated with polys - Cultured on chocolate agar + CO2 - Obtained from CSF or blood which is normally sterile - Oxidase positive - Ferments glucose AND MALTOSE |
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Neisseria meningitidis Symptoms
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Symptoms
- Fever - Purulent meningitis - Joint symptoms and petechical rashes - Headache, rigid neck, vomiting, photophobia, coma - Large purple rash (Waterhouse-Friderichsen syndrome) |
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Neisseria meningitidis Treatment
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Treatment
- High dose penicillin G or ampicillin - Cefotaxime or ceftriaxone - Rifampin used to treat possible carriers Vaccines - MCV4 |
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Neisseria meningitidis Mechanisms
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Mechanisms
- Capsule is anti-phagocytic - LOS released in autolysis and division - IgA protease against IgA1 |
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Moraxella catarrhalis Lab ID
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Lab ID
- gram-negative - diplococci - aerobic - oxidase-positive - do NOT ferment carbohydrates |
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Moraxella catarrhalis Symptoms
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Symptoms
- Infections of respiratory system, middle ear, eye, CNS and joints |
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Acinetobacter Lab ID/Symptoms
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Lab ID
- gram-negative - nonmotile - cocci - oxidase NEGATIVE - do NOT ferment carbohydrates Symptoms - Hospital acquired Disease |
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Clostridium botulinum Lab ID
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Lab ID
- gram-positive - Rods - motile - anaerobic - endospores - Toxin ID |
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Clostridium botulinum Symptoms
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Symptoms
- Food poisoning: problems focusing vision, swallowing, cranial nerve functions - Paralysis of striated muscles -> death in 15% due to respiratory failure - Floppy baby syndrome -> colonies in the colon producing toxin (only in infants) - Wound infections |
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Clostridium botulinum Treatment
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Treatment
- Anti-toxin - Penicilin - Mechanical ventilator |
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Clostridium botulinum Mechanisms
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Mechanisms
- Neurotoxin that causes flaccid paralysis - Toxin types A, B and E are disease causing - Prevents acetylcholine release which prevents contraction of muscles |
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Clostridium perfringens Lab ID
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Lab ID
- Primarily clinical impression - Large gram-positive rods - Anaerobic - Double zone of hemolysis |
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Clostridium perfringens Symptoms
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Symptoms
- Renal failure - Intravascular hemolysis - Gas gangrene -> alpha toxin and other exotoxins are secreted and cause necrosis, breakdown of ground substance spreads the infection, fermentation of carbohydrates yields gas bubbles - Shock |
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Clostridium perfringens Treatment
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Treatment
- Removal of devitalized tissue and exposure of wound to O2 (hyperbaric chamber) - High dosage penicillin - Amputation |
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Clostridium perfringens Mechanisms
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Mechanisms
- Exotoxins: 12 different exotoxins - Alpha toxin: exotoxin, lecithinase that causes lysis of endothelial cells, RBCs, WBCs and platelets - Enterotoxin: small, heat-labile protein binds to receptors in ileum causing ion-transport distruption leading to loss of fluid and intracellular proteins |
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Clostridium tetani Lab ID
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Lab ID
- Clinical diagnosis because of rapid progression of the disease - gram-positive - Long slender rod w/ terminal spore - swarming growth on anaerobic blood agar |
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Clostridium tetani Symptoms
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Symptoms
- Spastic paralysis, often near wound - Lockjaw common early (mouth can't open) - Eventually other voluntary muscles cease function - Noise/bright light trigger spasms - Death by respiratory failure (chest muscles paralyze) |
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Clostridium tetani Treatment
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Treatment
- Antitoxin + Penicillin - Vaccine to tetanus toxoid is common in developed countries, needs booster every 10 years |
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Clostridium tetani Mechanisms
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Mechanisms
- Tetanospasmin - AB toxin that inhibits inhibitory neurotransmitters causing constant excitatory impulses |
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Clostridium difficile Lab ID
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Lab ID
- Detection of toxins A and B in stool is best - Colonies can be isolated from stool - gram-positive rods |
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Clostridium difficile Symptoms
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Symptoms
- Clostridial antibiotic-associated diarrhea - Colitis - Pseudomembranous colitis (PMC) |
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Clostridium difficile Treatment
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Treatment
- Stop predisposing antibiotics - Rehydrate - Vancomycine, metronidazole |
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Clostridium difficile Mechanisms
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Mechanisms
- Toxin A is an enterotoxin: causes excessive fluid secretion - Toxin B is a cytotoxin: distrupts protein synthesis and disorganizes the cytoskeleton - After antibiotic course, C. difficile overpopulates - Commonly associated with treatment by: Ampicillin, Amoxicillin, Cephalosporins, and clindamycin |
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Bacteroides fragilis Lab ID
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Lab ID
- gram-negative - rod - anaerobic - Gas chromatography can ID short chain fatty acids produced - Unique sugar fermentation pattern |
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Bacteroides fragilis Symptoms
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Symptoms
- Septicemia - Abdominal abscesses - Peritonitis |
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Bacteroides fragilis Treatment
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Treatment
- Drug resistance is common - Choice antibiotic is metronidazole - surgical drainage of abscesses to increase effectiveness of antibiotics |
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Escherichia coli Lab ID
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Lab ID
- gram-negative - short rods - faculative anaerobe - ferments glucose - most strains ferment lactose - catalase-positive - oxidase-negative - Culture on MacConkey agar |
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Enterotoxigenic E. coli Symptoms/Mechanisms/Treatment
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Symptoms
- Watery diarrhea Mechanisms - Hyper excretion of Cl- and water, inhibition of Na+ reabsorption - Heat-stable toxin (ST) increases cGMP - Heat-labile toxin (LT) increases cAMP Treatment - Use antibiotics |
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Enteropathogenic E. coli
Symptoms/Mechanisms/Treatment |
Symptoms
- Long duration of watery diarrhea - Mostly in infants Mechanisms - Destruction of microvilli in small intestine - Shiga-like toxins cause destruction Treatment - Utilize antibiotics |
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Enterohemorrhagic E. coli
Symptoms/Mechanisms/Treatment |
Symptoms
- Bloody diarrhea in absence of mucosal invasion or inflammation - Acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia - Hemolytic uremic syndrome (HUS) Mechanisms - Bind to large intestine and produce the exotoxin verotoxin or shiga-like toxin Treatment - Avoid antibiotics because of HUS |
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Escherichia coli extraintestinal Symptoms
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Symptoms
- Urinary Tract Infections - Neonatal meningitis - Sepsis/bacteremia - Endotoxic shock - Pneumonia |
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Escherichia coli extraintestinal Treatment
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Treatment
- UTI: Ciprofloxacin, Trimethoprim/ sulfamethoxazole - Neonatal meningitis: Cefotaxime |
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Salmonella enterica Lab ID
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Lab ID
- gram-negative - short flagellated rods - faculative anaerobes - ferment glucose - do NOT ferment lactose - catalase-positive - oxidase-negative - Culture on MacConkey agar |
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Salmonella enterica enteriditis and typhimurium Symptoms
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Symptoms
- Gastroenteritis - nausea, vomiting and nonbloody diarrhea |
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Salmonella enterica typhi Symptoms
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Symptoms
- Typhoid fever - fever + abdominal symptoms - chills, sweats, headache, anorexia, weakness, sore throat, cough myalgia and either diarrhea or constipation - 30% have rose spots (rash on trunk) |
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Salmonella enterica Treatment
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Treatment
- Gastroenteritis: no antibiotics needed - Typhoid fever: B-lactams (Ceftriaxone, Ciprofloxacin) |
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Salmonella enterica Mechanisms
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Mechanisms
- Invade epithelial cells of the small intestine - Can survive in phagocytic cells - Travel around the body in macrophages |
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Campylobacter jejuni Lab ID
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Lab ID
- Gram-negative - Curved, spiral or S-shaped rods - Single polar flagellum, darting motion - Microaerophilic - Do not ferment carbohydrates - Culture on antibiotic medium to supress other bacteria growth |
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Campylobacter jejuni Symptoms
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Symptoms
- Food poisoning - Fever, headache, myalgia - Guillain-Barre syndrome - Reactive arthritis - Abdominal cramping and diarrhea - Pseudoappendicitis - Septic abortion |
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Campylobacter jejuni Treatment
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Treatment
- Ciprofloxacin |
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Campylobacter fetus Treatment
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Treatment
- ampicillin and third generation cephalosporins |
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Shigella sonnei Lab ID
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Lab ID
- gram-negative rods - Nonmotile - nonencapsulated - can not ferment lactose - Most strains do not produce gas in fermentation of glucose - Culture on selective media like Hektoen agar |
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Shigella sonnei Symptoms
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Symptoms
- Bacillary dysentery - Abdominal cramping - Diarrhea with blood, mucus |
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Shigella sonnei Treatment
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Treatment
- Ciprofloxacin - Azithromycin - wide spread resistance |
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Shigella sonnei Mechanisms
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Mechanisms
- Destroy mucosa of the large intestine - exotoxin: Shiga toxin - Enter cells via endocytosis, and replicate out of reach of macrophages, spread to near by cells - Mucosal abscess forms as cells die |
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Vibrio cholera Lab ID
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Lab ID
- Gram-negative - short, curved rods - Very motile with single polar flagellum - Faculative anaerobe - May require stimulation by NaCl - Culture on blood or MacConkey agar |
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Vibrio cholera Symptoms
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Symptoms
- Massive loss of fluid and electrolytes - Hypovolemic shock |
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Vibrio cholera Treatment
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Treatment
- Replace fluids/electrolytes - doxycycline (drug of choice) |
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Vibrio cholera Mechanisms
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Mechanisms
- Infects small intestine - Enterotoxin (AB toxin) that causes an outpouring of fluid by increasing the concentration of cAMP in cells |
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Vibrio parahaemolyticus Symptoms
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Symptoms
- gastrointestinal illness caused by ingestion of contaminated seafood |
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Yersinia enterocolitica/pseudotuberculosis Lab ID
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Lab ID
- Gram-negative - motile - no capsule - cultured on MacConkey or CIN media - Also can look for anti bacterial antibodies |
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Yersinia enterocolitica/pseudotuberculosis Symptoms
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Symptoms
- Entercolitis: fever, abdominal pain, diarrhea - Ulcerative lesions in the terminal ileum, necrotic lesions on Peyer patches - Enlargement of mesenteric lymph nodes - Sepsis |
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Yersinia enterocolitica/pseudotuberculosis Treatment
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Treatment
- Systemic disease: ciprofloxacin or trimethoprim/sulfamethoxazole - Enterocolitis: questionable use of antibacterials |
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Helicobacter pylori Lab ID
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Lab ID
- Gram-negative - curved or spiral rods - multiple polar flagella allowing for rapid corkscrew motility - urease positive |
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Helicobacter pylori Symptoms
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Symptoms
- Diarrhea - Acute gastritis - Duodenal and gastric ulcers |
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Helicobacter pylori Treatment
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Treatment
- Amoxicillin + clarithromycin + proton pump inhibitor (omeprazole) - gains resistance rapidly |
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Enterobacter Lab ID
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Lab ID
- Gram-negative rods - motile - Lac+ |
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Enterobacter Symptoms
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Symptoms
- Colonize in hospital patients - Associated with antibiotic treatment - Infect catheters, burns, wounds, respiratory/urinary tracts |
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Klebsiella pneumoniae/oxytoca Lab ID
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Lab ID
- Gram-negative - Rods - Luxurious capsules - Lac+ |
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Klebsiella pneumoniae/oxytoca Symptoms
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Symptoms
- necrotizing lobar pneumonia in compromised patients - K. pneumoniae: UTI, bacteremia |
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Proteus, Providencia and Morganella Symptoms
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Symptoms
- UTI and other extraintestinal infections - Urease positive |
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Haemophilus influenzae Lab ID
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Lab ID
- Gram-negative - Pleomorphic in shape (coccobacilli to long slender filaments) - Obligate parasites requiring hemin (X factor) and NAD+ (V factor) to grow - Thick capsule - Culture on chocolate agar |
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Haemophilus influenzae Symptoms
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Symptoms
Contiguous spread - Otitis media - Broncho-pneumonia Disseminated spread - Meningitis in young children - Osteomyelitis - Septic arthritis - Epiglottitis - Sepsis |
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Haemophilus influenzae Treatment
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Treatment
- ceftriaxone or cefotaxime - Ampicillin+clavulanate (inactivates B-lactamases) - Trimethoprim-sulfamethoxazole |
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Haemophilus influenzae Mechanisms
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Mechanisms
- Transmitted by respiratory droplets - IgA proteases - Contiguous spread via respiratory tract normally by capsuleless strains - Disseminated spread via blood normally require Type b capsule to invade |
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Bordetella pertussis Lab ID
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Lab ID
- Gram-negative rod - non-motile single or pair - Only grows on special media containing starch (Bordet-Gengou), or charcoal (Regan-Lowe) to remove fatty acids - Encapsulated - Aerobic - PCR and Serology (look for antibody against) |
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Bordetella pertussis Symptoms
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Symptoms
- Catarrhal stage: runny nose, sneezing, fever, conjunctivitis - Paroxysmal stage: Non-stop coughing, coughing spell can last 30 seconds, "whooping" cough, may cough so much they may become anoxic |
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Bordetella pertussis Treatment
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Treatment
- Erythromycin (old standard) - Azithromycin (new standard) - Trimethoprim/sulfamethoxazole |
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Bordetella pertussis Mechanisms
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Mechanisms
- Filamentous hemagglutin: Facilitates attachment of bacteria to epithelial cells - Adenylate cyclase toxin: lower chemotaxis - Tracheal cytotoxin: Inhibits cilia movement and regneration of damaged cells - Pertussis Toxin (AB): sensitization to histamin - Agglutinogens: Higher bacterial adhesion - Dermonecrotic toxin: vasoconstriction and ischemic necrosis |
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Legionella pneumophila Lab ID
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Lab ID
- Gram-negative rod - Gimenez stain is better than Gram stain - Fastidious - Faculative, intracellular parasite - Unencapsulated - Single polar placed flagella - Culture requires specialized media - Requires cysteine - Urinary antigen test using ELISA |
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Legionella pneumophila Symptoms
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Symptoms
- Legionnaires disease: Varies from mild to severe pneumonia characterized by fever, cough and progressive respiratory distress - Pontiac fever: Mild febrile illness w/o pneumonia |
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Legionella pneumophila Treatment
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Treatment
- Macrolides: erythromycin or azithromycin - Fluoroquinolones: Levofloxacin Prevention - Culture hospital water supplies - UV light used on water |
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Legionella pneumophila Mechanisms
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Mechanisms
- Acquired via aspiration of water containing the organism - Lung macrophages phagocytose L. pneumophila, but lysosomes fail to fuse allowing them to replicate within the macrophage |
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Pseudomonas aeruginosa Lab ID
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Lab ID
- Gram-negative - Rods - Motile (polar flagella) - Encapsulated - Produces diffusible green/blue pigments - Oxidase positive - Oxidizes but does not ferment lactose - Culture on MacConkey agar |
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Pseudomonas aeruginosa Symptoms
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Symptoms
Localized infection - Eye, ear, skin infections - Pustular rashes, UTI, respiratory infections, GI tract infections - Meningitis Systemic - bacteremia, endocarditis - secondary pneumonia - bone and joint infections |
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Pseudomonas aeruginosa Treatment
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Treatment
- Extremely resistent - Aggressive treatment required - Use multiple antibiotics together: - Antipseudomonal B-lactams - Ceftazidime - Tobramycin - Ciprofloxacin |
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Pseudomonas aeruginosa Mechanisms
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Mechanisms
- Slime Layer/glycocaylx - Elastase, phopholiases, proteases Toxins - Exotoxin A (same as C. dip) - Pili/flagella allow adherence to tissue |
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Brucella Lab ID
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Lab ID
- Gram-negative - Small coccobacilli arranged singly or in pairs - no capsule - aerobic - intracelluslar parasite - culture on blood agar |
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Brucella Symptoms
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Symptoms
- Flu-like (malaise, fever, sweats, anorexia, GI symptoms, headache and back pains) - May also include depression - Undulating fever |
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Brucella Treatment
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Treatment
- Combination of doxcycline and gentamicin (or streptomycin) |
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Brucella Mechanisms
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Mechanisms
- Enters the body through cuts/abrasions in the skin or the GI tract or via aerosols - Localized in large numbers in milk, urine and placenta of cows, pigs and goats |
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Francisella tularensis Lab ID
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Lab ID
- Gram-negative - small, pleomorphic coccobacillus - lipid-rich capsule - faculative intracellular parasite - strict aerobe - hard to culture |
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Francisella tularensis Symptoms
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Symptoms
- Flulike (chills, fever,headache, etc) Ulceroglandular tularemia (punched out ulcers) - Ulcers on hands/forearms or near bites - Lymphadenopathy Other forms of tularemia - Lymphadenopathy w/o ulceration - Many different points of entry Systemic w/o lymphadenopathy - Typhoid tularemia |
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Francisella tularensis Treatment
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Treatment
- Streptomycin - Vaccine exists - Prevention: care when handling animals |
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Francisella tularensis Mechanisms
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Mechanisms
- Very infectious (10 organisms is enough) - Spreads via a wide range of mammals, birds and blood sucking arthropods - Classic vector: Rabbit w/ deerfly - Summer: mostly from bites - Winter: mostly hunters from dead animals - Localized in Arkansas, Missouri and Oklahoma |
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Yersinia pestis Lab ID
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Lab ID
- Gram-negative - Small rod that stains bipolarly (clothes pin stain) - Encapsulated - Culture on blood or CIN agar |
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Yersinia pestis Symptoms
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Symptoms
- High fever, chills, headache, myalgia - Painful buboes (swelling comprised of one or more nodes and edema, typically in the groin) - Low blood pressure - Septic shock - Purpura and necrosis - Pneumonic plague: organisms in the lungs - Plague meningitis: organisms in the CSF |
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Yersinia pestis Treatment
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Treatment
- Streptomycin + tetracycline - Avoid dead animals |
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Yersinia pestis Mechanisms
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Mechanisms
TONS of Virulence factors - YOPs, antiphagocytic F1 envelope, protease, coagulase, exotoxin, LPS Yersinia Outer Proteins (YOPs) - inhibit TNF production, induce apoptosis, degrades c3b/c5a - Primarily transmitted in rodents and fleas |
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Bartonella quintana
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- Causes trench fever
- 5 day relapse - Maculopapular rash - Vector: human louse - Treatment: Broad-spectrum antibiotics - Doxycycline, Azithromycin, Rifampin |
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Bartonella henselae
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- Associated with catscratch disease
- Small abscesses at the site of cat scratch or bite - Fever, localized lymphadenopathy - Bacillary angiomatosis - Treated with rifampin and doxycycline |
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Pasteurella
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- Colonize mammals and birds
- Wound infectsions from cat/dog bites - Virulence factors: capsules and LPS - non-intracellular parasite - Soft tissue infection - Acute cellulitis, lymphadenitis - Fastidious organism, biochemical ID - Sutures increase infection probability - Treatment: Penicillin or tetracycline |
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Treponema pallidum Lab ID
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Lab ID
- Spirochete - Undulating appearence - Can not be cultured in vitro - Extremely sensitive to drying, disinfectants and heat - Can not be viewed by light microscopy due to its thinness - Need IF or darkfield microscopy - Serological testing for antibody is best-> treponemal antigen |
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Treponema pallidum Symptoms
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Symptoms
- Non-painful lesions - Primary syphilis: genital lesions - Secondary symphilis: Rash elsewhere, multi-system: hepatitis, meningitis etc. - Latent syphilis: no symptoms - Tertiary syphilis: Gumma of skin, nervous system and cardiovascular problems - Congenital syphilis: transmitted via placenta to fetus causing defects or abortion |
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Treponema pallidum Treatment
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Treatment
- Penicillin |
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Treponema pallidum Mechanisms
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Mechanisms
- Spreads via blood/lymph - Sexually transmitted - Does NOT produce toxins - Secretes hyaluronidase that distrupts ground substance - Because of its motility it diseeminates extremely quickly |
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Borrelia burgdorferi Lab ID
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Lab ID
- Large spirochete - Flagella - Highly motile - Can be cultured, but takes a long time - PCR is standard for ID |
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Borrelia burgdorferi Symptoms
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Symptoms
First - Bulls eye rash - Flu-like symptoms Second - Multisystem disease: arthritis, cardiac complications, neuroligical conditions Third - Chronic arthritis - CNS disease |
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Borrelia burgdorferi Treatment
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Treatment
- Doxycycline (amoxicillin for children) - Ceftriaxone - Avoid tick bites |
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Borrelia burgdorferi Mechanisms
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Mechanisms
- No toxins - Transmitted via tick from Deer/Rodent - Can not be transmitted human to human |
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Leptospira interrogans Lab ID
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Lab ID
- Spirochete - 'Hooked ends' - Hard to culture, best is serological testing |
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Leptospira interrogans Symptoms
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Symptoms
First - Fever Second - Liver (Jauntice), kidney and CNS infections |
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Leptospira interrogans Treatment
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Treatment
- Doxycycline |
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Leptospira interrogans Mechanisms
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Mechanisms
- Utilize hooked ends |
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Other treponemal (Bejel, Yaws, Pinta)
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Symptoms
- Similar to Treponema pallidum, but spreads via skin contact, not just sexually |
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Borrelia recurrentis Lab ID
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Lab ID
- Gram-negative - Spirochete - Highly motile - Difficult to culture |
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Borrelia recurrentis Symptoms
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Symptoms
- Recurrent fever, lessing seriousness - High fever, headache, myalgia, malaise - Up to 10 recurences - Can invade multiple body organs |
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Mycoplasma pneumoniae Lab ID
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Lab ID
- Not rod or cocci (free of cell wall) - Does NOT stain with gram because lacks peptidoglycan - Grow slowly in culture (look like sunny side up eggs) - Serodiagnosis or Ab - Cold agglutinins can be detected |
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Mycoplasma pneumoniae Symptoms
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Symptoms
- Gradual onset - Productive cough - Atypical pneumonia->cause of RTI - Occurs in crowded areas - mild, walking pneumonia - rarely complications-> CNS disturbances, rash, mild hemolytic anemia |
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Mycoplasma pneumoniae Treatment
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Treatment
- doxcycline or azithromysin |
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Mycoplasma pneumoniae Mechanisms
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Mechanisms
- Grab onto tracheal epithelium - Transmitted via respiratory droplets - Get into LOWER respiratory tract - P1 adhesins - Adhesion inhibits ciliary movements - Produces H2O2-> cytotoxic |
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Mycoplasma hominis, incognitus, urealyticum
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- Genital mycoplasmas
- GU infections - Endometritis - Pelvic Inflammatory Disease - Produces Urease Treatment - Doxycycline |
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Chlamydia pneumoniae Lab ID
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Lab ID
- Resembles gram structure, but no peptidoglycan - Different dyes can locate intracellular bodies - Does NOT grow on cell free culture - Serodiagnosis is hard: most are exposed |
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Chlamydia pneumoniae Symptoms
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Symptoms
- Upper respiratory problems - Atypical pneumonia - Associated with plaques in atherosclerosis and Alzheimer's - Pharyngitis - Laryngitis, bronchitis |
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Chlamydia pneumoniae Treatment
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Treatment
- doxycycline - erythromycin |
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Chlamydia psittaci Lab ID
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Lab ID
- Four-fold rise in antibody titer with complement fixation or indirect IF tests - Can't be grown in culture - Highly contagious |
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Chlamydia psittaci Symptoms
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Symptoms
- Lower respiratory problems - Atypical pneumonia - Very contagious in the lab - flu-like symptoms, bilateral patchy pulmonary infiltration - Enlargement of liver and spleen |
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Chlamydia psittaci Treatment
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Treatment
- Doxycycline or erythromycin |
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Chlamydia psittaci Mechanisms
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Mechanisms
- Transmitted to humans by inhalation of dust contaminated by infected birds - Look for contact with birds |
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Chlamydia trachomatis Lab ID
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Lab ID
- Use Iodine dye to ID intracellular - Grab epithelial cells to try to find intracellular organisms - small, round to ovid cells - resembles gram-negative envelope without peptidoglycan - can be cultured when added to human cell lines |
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Chlamydia trachomatis Symptoms
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Symptoms (by serotype)
- A, B, C: Trachoma: A chronic keratoconjunctivitis, transmitted by personal contact, can lead to blindness - D-K: Nongonococcal urethritis, cervicitis, endometritis, inclusion conjunctitis in newborn (ICN) - L1, L2, L3: Lymphogranuloma venereum: transient papules on genitalia (painful) - Often co-infection with other STDs |
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Chlamydia trachomatis Treatment
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Treatment
- Broad spectrum antibiotics |
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Rickettsia rickettsii Lab ID
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Lab ID
- Gram-negative, but stain poorly - small, rod-like or coccobacillary - grow inside living host cells - hard to grow in vitro - serological methods best for diagnosis |
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Rickettsia rickettsii Symptoms
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Symptoms
- Acute onset High fever, malaise, heache - Rocky Mountain Spotted Fever - Rash: macular to petechial and hemorrhagic begins on palms/soles and then spreads to rest of body |
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Rickettsia rickettsii Treatment
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Treatment
- Doxycycline |
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Rickettsia rickettsii Mechanisms
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Mechanisms
- Transmitted by arthropods - Reservoirs can be animals, arthropods or humans - Utilizes Phospholypase A (PLA) to get through cellular membranes - Grows inside cells and then uses PLA to lyse the cell and allow spreading - Invades vascular endothelium |
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Ehrlichia chaffeensis and Anaplasma phagocytophilum
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- Obligate intracellular parasite of leukocytes and replicate in cytoplasmic vaculoes (morulae in monocytes or granulocytes)
- Tick vector - Acute fever, myalgia, leucopenia and thrombocytopenia Treatment - Doxycycline |
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Coxiella burnetii
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- Q fever
- spore-like structure, resistant to heat/drying - No arthropod vector - Infected dust from dried animal products - Reproduces in the respiratory tract - Causes atypical interstitial pneumonia - Culture negative endocarditis - Grows at low pH Treatment - Doxycycline |
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Rickettsia akari
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- rickettsialpox
- Mite vector in mouse/rodent reservoir - Eschar (thick crust) at site of bite and papulovesicular rash |
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Rickettsia prowazekii and typhi
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prowazekii
- Body louse vector - Reservoir is humans - fever, chills, severe headaches, rash - Rash starts on trunk and moves outward - Brill Zinsser disease typhi - Similar, but milder disease - Rodent fleas/lice |
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Mycobacterium tuberculosis Lab ID
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Lab ID
- Clinical Symptoms - Long, slender, non-motile rods - Acid-fast bacilli - Lipid-rich cell walls - Lowenstein-Jensen agar - PCR is best (fast, and accurate) |
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Mycobacterium tuberculosis Symptoms
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Symptoms
- Lesion in the respiratory tract (visible on chest X-ray) - Chronic cough, red-tinged sputum, fever - Most damage is caused by host immune system becoming very activated with out being able to remove the pathogens (because they hide in macrophages) - chronic pneumonitis, TB osteomyelitis, TB meningitis, miliary (disseminated) TB |
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Mycobacterium tuberculosis Treatment
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Treatment
- Use multiple drugs together - Isoniazid, rifampin, ethambutol, streptomycin, and pyrazinamide - Treatment lasts 12-18 months - BCG vaccine exists and is used outside of United States |
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Mycobacterium tuberculosis Mechanisms
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Mechanisms
- Initial infection -> 10% start showing symptoms (Progressive primary (active) infection), 90% become latent-dormant - 90% of the latent-dormant will stay that way, 10% will get secondary (reactivation) TB |
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Mycobacterium leprae Lab ID
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Lab ID
- lipid rich cell wall - acid-fast bacillus - can NOT culture - clinical diagnosis (histology) |
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Mycobacterium leprae Symptoms
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Symptoms
Tuberculoid leprosy (1st) - Lesions on cooler body tissues like skin (nose, outer ears) - Cell-mediated immune response - Low infectivity Lepromatous leprosy (2nd) - Extensive erythematous macules, papules or nodules; extensive destruction of skin - Immunity is severely depressed - High infectivity |
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Mycobacterium leprae Treatment
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Treatment
- Dapsone, rifampin and clofazamine |
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Actinomyces israelii and Arachnia propionica Lab ID
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Lab ID
- gram-positive - anaerobic - filamentous, branching - 'sulfur granules' (yellowish granules) - grow on blood agar |
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Actinomyces israelii and Arachnia propionica Symptoms
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Symptoms
- Chronic suppurative abscess that leads to scarring and disfigurement - Lesions can be almost anywhere (often cervicofacial) |
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Actinomyces israelii and Arachnia propionica Treatment
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Treatment
- Penicillin G |
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Nocardia asteroides and Nocardia brasiliensis Lab ID
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Lab ID
- Gram-positive - branched filaments - do NOT form 'sulphur granules - aerobic - grow on blood agar |
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Nocardia asteroides and Nocardia brasiliensis Symptoms
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Symptoms
- Pneumonia - abscesses, extensive necrosis and cavity formation - Brain and Kidney are most common secondary locations - N. asteroides is more common in US |
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Nocardia asteroides and Nocardia brasiliensis Treatment
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Treatment
- Sulfamethoxazole |
