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57 Cards in this Set
- Front
- Back
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Moraxella catarrhalis stained smear
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gram -ve diplococci
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Moraxella catarrhalis diseases
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sinusitis , otitis media, bronchitis, pneumonia, espicially in immunocompromised patients "opportunistic infection"
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Moraxella catarrhalis biochemical tests
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oxidase +ve
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Niesseria meningitidis classification
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the capsule is antigenic
allow identification of at least 13 capsular polysaccharide types called serogroups A,B,C,W-135,Y about 90% of cases are caused by serogroups A&C epidemics ,B sporadic |
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Niesseria meningitidis virulence factors
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polysaccharide capsule
lipopolysaccharide endotoxin pilli IgAI proteases |
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polysaccharide capsule
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most important virulence factors
anti-phagocytic , anti-complementry antigenic |
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lipopolysaccharide endotoxin
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endotoxin can cause
fulminant meningococcemia septic shock |
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pilli
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mediate attachment to mucosa
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diseases of Niesseria meningitidis
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Epidemic cerprospinal meningitis
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Epidemic cerprospinal meningitis
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mode of infection: droplet
source of infection: case or carrier in nasopharynix,10% in normal population , 20-90% in epidemics infection may end in asymptomatic carrier, mild pharyngitis, meningitis, fulminant meningeoccocemia meningitis: the bacteria reach the subarachinoid space either heamatogenous or direct through the sheath of olfactor nerve meningitis symptoms: fever , sore throat, severe headache, photophobia, projectile vomiting, nuchal rigidity, coma, death fluminant meningiaococcemia : "septicemia" intravascular coagulation, circulatory collapse, fatal shock without meningitis |
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lab diagnosis of Niesseria meningitidis
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1-case:
specimen ; CSF or blood gram stained film rapid test : PCR isolation identification serology:serogroping by slide agglutination with specific antid sera fluorescent antibody staining 2- carrier |
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CSF specimen of Niesseria meningitidis case
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obtained by lumber puncture
turbid and under tension centrifuged to get supernatant and deposit |
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supernatant of CSF of Niesseria meningitidis case
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cytological examination to detect type and count of inflamatory cells , elevated , mostly neutrophils
glucose is decreased and total peotein is increased capsular meningiococcal antigen by Ring pericepitation, latex agglutination ,Staphylococcal agglutination test |
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deposit of CSF of Niesseria meningitidis case
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microscopic examination of gram stained film
isolation and identification on chocolate agar or THyer Martin media in 5-10% CO2 24-48hs colonies are transparent or gray ,shiny, 1-2mm, |
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blood specimen of Niesseria meningitidis case
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microscopic examination of gram stained film
isolation and identification on chocolate agar or THyer Martin media in 5-10% CO2 24-48hs colonies are transparent or gray ,shiny, 1-2mm, |
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gram stained film of Niesseria meningitidis
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capsulated gram -ve diplococci, kideny shaped, non motile, non spore forming
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isolation of Niesseria meningitidis
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on chocolate agar or thayer martin
in 5-10% CO2 24-48hs colonies are transparent or gray ,shiny, 1-2mm, |
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identification of Niesseria meningitidis
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gram stained film:capsulated gram -ve diplococci, kideny shaped, non motile, non spore forming
colonies are transparent or gray ,shiny, 1-2mm, biochemical tests: oxidase +ve , fermints glucose and maltose with acid production only |
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diagnosis of Niesseria meningitidis carrier
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nasopharyngeal swap
immediate culture on modified thayer martin " contain vancomycin , colistin and amphotricin antibiotics" or transport media Staurt's transport media culture in 37C, 5% CO2 for 24hs the colonies are transparent or gray ,shiny, 1-2mm differs from commensal Nisseria which can grow on ordinary media at room tempraturewith no need for CO2 enriched atmosphere sugar utilization is variable cann't agglutinate with group spicific antisera may be pigmented |
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treatment of Niesseria meningitidis
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IV cephlosporins 3rd generation such Cefotaxime OR Ceftriaxone
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prophylaxis of Niesseria meningitidis
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chemoprophylaxis
vaccination |
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chemoprophylaxis of Niesseria meningitidis
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given to contacts of the case to prevent infection in epidemics
Rifambicin perefered as it's secreted in saliva and eradicate carriers Cephofloxacin single oral dose, widely used |
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vaccination of Niesseria meningitidis
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4 available vaccins prevent 4 types
A, C, Y, W-135 group B doesn't elicit an effective immune response prevent meningitis in epidemics and reducing carrier rates |
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Niesseria gonorrhoeae virulence factors
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lipopolysaccharide endotoxin
pilli outer membrane proteins "OMP" IgAI proteases B-lactamases |
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lipopolysaccharide endotoxin of Niesseria gonorrhoeae
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endotoxin
cause fever & inflammation increase vascular permiability may cause endotoxic shock |
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pilli of Niesseria gonorrhoeae
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allow adhesion
undergo marked antigenic variation |
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outer membrane proteins "OMP" of Niesseria gonorrhoeae
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play role in attachment
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B-lactamasis of Niesseria gonorrhoeae
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resistance to pinicillins due to plasmid mediated B-lactamase production
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diseases of Niesseria gonorrhoeae
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Gonorrhea
disseminated gonococcal infection "DGI" vulvovaginitis Gonococcal conjuctivitis: auto infection in adults Ophthalmia neonatorum |
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sexually transmitted diseases of Niesseria gonorrhoeae
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Gonorrhea
disseminated gonococcal infection "DGI" |
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non-sexually transmitted diseases of Niesseria gonorrhoeae
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vulvovaginitis
Gonococcal conjuctivitis: auto infection in adults Ophthalmia neonatorum |
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Gonorrhea
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mode of infection: sexually
incubation period: short site of infection: superficial mucosall surfaces lined with columner epithelium males: acute: urethiritis: dysurea and purulent urethral discharge ascending: prostatitis and epidymitis females: acute: asymptomatic common, vaginal discharge, urethirtis : dysurea ascending: to fallopian tubes causing salpingits, pelvic infalmmatory disease and infertility prognosis: easy to diagnose and treat but acute infections can be chronic and progress to fibrosis |
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disseminated gonococcal infection "DGI"
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more in females
bacteriemia skin lesions on extermities artheritis shock |
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vulvovaginitis
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in young girls
columnar vaginal epithelium before puberty stratified squamous after puberty to resist infection |
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Ophthalmia neonatorum
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newborn is infected from birth canal
prevented by topical erythromycin |
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lab diagnosis of Niesseria gonorrhoeae
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specimen ; blood, joint aspirate, conjuctival swap , skin swap
gram stained film rapid test : PCR isolation identification serology: |
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specimen of Niesseria gonorrhoeae
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conjunctival swap
joint aspirate, blood, swab from skin in dissementaed infection male urethral discharge, morning drops in chronic cases female endocervical and urethral swap "high vaginal swap isnot suitable |
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direct gram stained film of Niesseria gonorrhoeae
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gram -ve kideny shaped diplococci, intra and exctra cellular in pus cells
non motile, non spore forming , non capsulated it's diagnostic in acute infection of male but need culture in females and chronic infectio |
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rapid tests for detection of Niesseria gonorrhoeae
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PCR detect gonococcal DNA
direct immunofluorescence detect gonococcal OMP |
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isolation of Niesseria gonorrhoeae
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Fastidious : rapid culture
selective media "Modified Thayer Martin" due to contamination of samples sterile samples "joint aspirate" on chocolate agar immediate incubation in moist 5-10% CO2 , 37C, 24-48hs |
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identification of Niesseria gonorrhoeae
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colonial morphology: colourless, raised, 1-2mm in diameter
gram stained smear: gram -ve diplococci , kideny shaped biochemical reactions: oxidase +ve , ferment glucose with production of acid only |
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serological diagnosis of Niesseria gonorrhoeae
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no available test sensitive and spacific due to high variablity of gonococcal antigens
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treatment of Niesseria gonorrhoeae infections
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3rd generation ceohalosporins eg. Cefixime, Cefotaxime,or Spectinomycin in allergy single IM dose
tetracyclins to eredicate Chalamydia Trachomatis |
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mode of infection of
Epidemic cerprospinal meningitis |
droplet
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source of infection in Epidemic cerprospinal meningitis
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case or carrier in nasopharynix,10% in normal population , 20-90% in epidemics
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out come of infection with Nisseria meningitidis
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infection may end in asymptomatic carrier, mild pharyngitis, meningitis, fulminant meningeoccocemia
meningitis: the bacteria reach the subarachinoid space either heamatogenous or direct through the sheath of olfactor nerve meningitis symptoms: fever , sore throat, severe headache, photophobia, projectile vomiting, nuchal rigidity, coma, death fluminant meningiaococcemia : "septicemia" intravascular coagulation, circulatory collapse, fatal shock without meningitis |
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Epidemic cerprospinal meningitis symptoms
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fever , sore throat, severe headache, photophobia, projectile vomiting, nuchal rigidity, coma, death
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how Nisseria meningitidisreach the subarachinoid space?
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either heamatogenous or direct through the sheath of olfactory nerve
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fluminant meningiaococcemia :
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"septicemia" intravascular coagulation, circulatory collapse, fatal shock without meningitis
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commensal Nisseria
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can grow on ordinary media at room tempraturewith no need for CO2 enriched atmosphere
sugar utilization is variable cann't agglutinate with group spicific antisera may be pigmented |
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mode of infection of Gonorrhea
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sexually
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incubation period of Gonorrhea
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short
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site of infection of Gonorrhea
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superficial mucosall surfaces lined with columner epithelium
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symptoms of Gonorrhea in males
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acute: urethiritis: dysurea and purulent urethral discharge
ascending: prostatitis and epidymitis |
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symptoms of Gonorrhea in females
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acute: asymptomatic common, vaginal discharge, urethirtis : dysurea
ascending: to fallopian tubes causing salpingits, pelvic infalmmatory disease and infertility |
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symptoms of Gonorrhea
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males:
acute: urethiritis: dysurea and purulent urethral discharge ascending: prostatitis and epidymitis females: acute: asymptomatic common, vaginal discharge, urethirtis : dysurea ascending: to fallopian tubes causing salpingits, pelvic infalmmatory disease and infertility |
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prognosis of Gonorrhea
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easy to diagnose and treat but acute infections can be chronic and progress to fibrosis
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