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109 Cards in this Set
- Front
- Back
Teichoic acid
|
part of cell wall of gram +
induces TNF and IL-1 |
|
Lipopolysaccharide
|
Part of outer membrane of gram -
= ENDOTOXIN *major surface antigen LIpid A is part of it; induces TNF and IL-1 |
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Periplasm
|
only in gram-
space between cytoplasmic membrane and peptidoglycan wall *location of many beta-lactamases |
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Petidoglycan
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gives rigid support, protects against osmotic pressure
-sugar backbone with cross-linked peptide side chains |
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Capsule
|
protects against phagocytosis
polysaccharide; except Bacillus anthracis, which contains D-glutamate Strep pneumo Neisseria meningitidis H. flu type B Klebsiella Salmonella GBS |
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Spore-forming
|
Resistance to dehydration, heat, chemical
-keratin-like coat; dipicolinic acid -kill with 121C for 15min Gram + rods Bacillus Clostridium Coxiella burnetii (Q fever) |
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Plasmid
|
contains a variety of genes for antibiotic resistance, enzymes, toxins
made of DNA |
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Glycocalyx
|
mediates adherence to surfaces, esp foreign surfaces (catheters)
*polysaccharide |
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Gram + rods/branching
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ABCD LNM
Actinomyces (branching filamentous) Bacillus Clostridium Diphtheria Listeria Mycobacterium (acid fast) Nocardia (weakly acid fast; branching filamentous) |
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Don't gram stain well
|
These Rascals May Microscopically Lack Color:
Treponema (too thin) --> darkfield, fluorescent a.b.staining Rickettsia (intracell) Mycobacteria (high lipid content) Mycoplasma (no cell wall) Legionella (intracell) --> silver stain Chlamydia (intracell; lacks muramic acid in cell wall) |
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Giemsa
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Borrelia
Chlamydia Plasmodium Trypanosomes |
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PAS
|
Glycogen
Mucopolysaccharides Whipple's disease (Tropheryma whippelii) --> glycoproteins |
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Ziehl-Neelsen
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acid fast organisms
|
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India ink
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Crypt. neoformans (mucicarmine also can be used to stain polysach capsule red)
|
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Silver stain
|
Legionella
Fungi: PCP |
|
H. flu culture
|
chocolate agar with
Factors V (NAD+) and X (hematin) |
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N. gonorrhoeae culture
|
Thayer-Martin or
VPN: Vanc, Polymyxin, Nystatin |
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B. pertussis culture
|
Bordet-Gengou (potato) agar
Bordetella!! |
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C. diphtheriae
|
Tellurite plate
Loeffler's media |
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TB
|
Lowenstein-Jensen agar
|
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Mycoplasma
|
Eaton's agar
|
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MacConkey's agar
|
lactose-fermenting enterics:
bile salts, crystal violet, lactose, neutral red *fermentation produces acid --> turns pink macConKEES: Citrobacter Klebsiella E.coli Enterobacter Serratia |
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E. coli culture
|
MacConkey's
Eosin-methylene blue agar (blue-black colonies with metallic sheetn) |
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Legionella culture
|
Charcoal yeast extract agar buffered with Cysteine & Fe
|
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Fungal culture
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Sabouraud's agar
|
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Obligate aerobes
|
Nagging Pests Must Breathe
Nocardia Pseudomonas Mycobacterium tuberculosis Bacillus Use O2-dependent system to generate ATP |
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Obligate anaerobes
|
Can't Breathe Air
Clostridium Bacteroides Actinomyces lack catalase and/or superoxide dismutase; susceptible to oxidative damage *foul smelling (short-chain FA), difficult to culture, produce gas in tissue (CO2, H2) Tx: clinda or metronidazole aminoglycosides ineffective (req O2) |
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Obligate intracellular
|
Really Cold
Rickettsia Chlamydia *can't make own ATP |
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Facultative intracellular
|
Some Nasty Bugs May Live FacultativeLY
Salmonella Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersinia |
|
Quellung reaction
|
if encapsulated bug is present, capsule swells when specific anticapsular antisera are added
|
|
Vaccines
|
if contains polysaccharide capsule antigens, a protein is conjugated to promote T cell activation and class switching:
Pneumovax Hflu type B Meningococcus |
|
Urease +
|
PHUK Urease
Proteus H. pylori Ureaplasma Klebsiella |
|
PIgment-producing
|
Actinomyces israelii: yellow "sulfar" granules (composed of filaments and formed in pus)
S. aureus: yellow Pseudomonas: blue-green Serratia marcescens: red |
|
Protein A
|
S. aureus
binds Fc region of Ig; prevents opsonization and phagocytosis (prevents complement fixation) |
|
IgA protease
|
enzyme that cleaves IgA:
S. pneumo H flu type B Neisseria *colonize/penetrate mucosa |
|
M protein
|
G.A.S
prevents phagocytosis |
|
Intracellular survival
|
inhibit phagosome-lysosome fusion or resistance to lysosomal enzymes:
Mycobacterium: TB, Leprae Legionella Ehrlichia |
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Growth curve
|
Lag: metabolic acitvity without division
Log: rapid cell division Stationary: nutrient depletion slows growth; SPORE formation Death: prolonged nutrient depletion & build up of waste --> death |
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Transformation
|
take up DNA from environment (aka "competence")
esp used in SHiN bugs |
|
Conjugation
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F+ x F-
F+ plasmid contains genes required for conjugation; Plasmid is replicated and transferred through pilus from F+ cell to F-(without plasmid) *no transfer of chr genes HFr x F-: F+ plasmid can become incorporated into bacterial chr DNA (Hfr cell) *transfer of plasmid AND chr genes |
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Transposition
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Segment of DNA that can "jump" (excision and reincorporation) from one location to another
-can transfer genes from plasmid to chr and vice versa |
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Transduction: generalized
|
A "packing" event: LYTIC phage infects bacterium and destroys it immediately after replicatoin
-cleavage of bacterial DNA and synthesis of viral proteins -parts of bacterial chr DNA may become packaged in viral capsid -phage infects another bacterium, transferring these genes |
|
Transduction: specialized
|
"excision" events
LYSOGENIC phage infects bacterium --> viral DNA incorporated into bacterial chr -when phage DNA is excised, flanking bacterial genes may be excised with it -DNA is packaged into phage viral capsid and can infect another bacterium *can replicate in host without killing it until later |
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Toxins encoded in lysogenic phage
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ABCDE
shigA-like toxin Botulinum Cholera Diphtheria Erythrogenic toxin of G.A.S. |
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Beta-Hemolytic
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1. GAS
2. GBS 3. Staph aureus 4. Listeria |
|
Staph aureus
|
Catalase +
Coagulase + (converts fibrinogen to fibrin; can hide out in clots) Hemolysin Protein A: binds Fc-IgG inhibition complement/phagocytosis *causes skin/soft tissue TSST-1 Exfoliative toxin: scalded skin syndrome Enterotoxin: food poisoning MRSA Endocarditis, osteo |
|
Staph Epi
|
blood culture contaminant
Prosthetic devices and catheters **produces bilfilms endocarditis in IVDU (tx. with vanc) |
|
Strep pneumo
|
MOPS:
meningitis otitis pna sinusitis lancet shaped encapsulated IgA protease *rusty sputum, sepsis in SCA & splenectomy Vaccine: for >65, asplenic, HIV, chronic lung dz |
|
Viridans
|
dental caries: mutans, sanguis
subacute endocarditis: sanguis *can produce extracell polysacc (dextrins) using sucrose, which facilitates adherence to fibrin (deposited at sites of endothelial trauma -->damaged valves) |
|
Strep pyogenes
|
Pyogenic: pharyngitis, cellulitis, impetigo
Toxigenic: scarlet fever, toxic shock-like syndrome Immune: rheumatic fever, acute GN (after impetigo OR strep throat) M protein = major virulence factor; inhibits phagocytosis and complement activation; mediates adherence a.b. to M protein enhance host defenses against s. pyogenes but can give rise to rheumatic fever Streptolysin O: O2-labile protein; lyses RBCs and pmns ASO titer: detects recent S. pyogenes infxn *DNase: degrades DNA in pus to facilitate spread |
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Strep agalactiae
|
colonizes vagina
BABIES; pna, meningitis, sepsis produces CAMP factor, which enlarges the area of hemolysis formed by S. aureus *screen pregnant at 35-37weeks; give intrapartum penicillin or amp |
|
Enterococci
|
normal colonic flora; PCN G resistant
cause UTI and subacute endocarditis VRE **can grow in 6.5% NaCl and bile (vs. nonenterococcal group D strep) |
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Lancefield grouping
|
based on differences in C carbohydrate on cell wall
|
|
Strep bovis
|
Group D strep
colonizes gut; can cause bacteremia and subacute endocarditis; in colon cancer patients |
|
Diphtheria
|
exotoxin encoded by beta-prophage (lysogenic)
ADP ribosylation of EF-2 pseudomembranous pharyngitis LAD Lab: metachromatic blue & red granules on gram stain (+) grows on tellurite agar, Loeffler's media Toxoid vaccine Tx: antitoxin, PCN, vaccine |
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Clostridium tetani
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tetanospasmin
blocks glycine and GABA release from RENSHAW CELLS in spinal cord |
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C. botulinum
|
heat-labile toxin that inhibits ACh release at neuromuscular junction
*canned food, honey |
|
C. perfringens
|
alpha toxin: licithinase, a phospholipase
can cause myonecrosis (gas gangrene) and hemolysis |
|
C. difficile
|
AB toxin is DIFFerent (A binds, B destroys)
Toxin A: enterotoxin binds to brush border of gut; pmn chemoattractant, inflammation Toxin B: cytotoxin, destroys cytoskeletal structure of enterocytes (actin depolymerization), causing pseudomembranous colitis Tx: flagyl or vanc |
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Anthrax
|
Virulence factors:
1. exotoxin (EF, LF, protective antigen) 2. Anti-phag capsule: only bacterium with a polypeptide capsule: D-glutamate Cutaneous: due to contact; black eschar (painless ulcer) surrounded by edematous ring --> bacteremia, death *caused by lethal factor and edema factor (adenylyl cyclase); suppresses pmns and accumulates fluid Pulm: inhalation of spores --> fluelike --> fever, hemorrhage, mediastinitis, shock Woolsorters' disease: inhalation of spores from contaminated wool |
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Listeria
|
Only gram + to produce LPS endotoxin
ingestion of unpasteurized milk/cheese/deli meats; vaginal transmission during birth *form actin rockets to move from cell to cell; tumbling @22C; can culture at 4C (narrow zone of beta-hemolysis on sheep blood) granulomatosis infantiseptica neonatal meningitis amnionitis, spontaneous abortion *dz in compromised CMI |
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Actinomyces
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gram + branching filamentous rod
anaerobe oral/facial abscesses that may drain through sinus tracts in skin yellow sulfur granules normal oral flora SNAP: Sulfa for Nocardia Actinomyces use PCN |
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Nocardia asteroides
|
gram + branching filamentous rod
aerobic, weakly acid-fast pulm infection in immunocompromised SNAP: Sulfa for Nocardia Actinomyces use PCN |
|
Catalase +
|
ppl with CGD are susceptible
SNAPS: Staph aureus Nocardia Aspergillus Pseudomonas cepacia Serratia Also catalase + (but CGD not at increased risk: Mycobacteria Diphtheria Crypt. neoformans |
|
Ghon complex
|
TB granulomas: Ghon focus + lobar and perihilar node involvement
*reflects primary infection |
|
Mycobacteria
|
kansasii: pulm TB-like sxs; water contaminant
MAC: disseminated dz in AIDS; px with azithro Marinum: aquatic Scrofulacem **all are acid fast dx: early morning sputum acid fast stain x3d Culture in Lowenstein-Jensen agar (2-4wks) |
|
Leprosy
|
Hansen's disease
Acid-fast bacillus that likes cool temperatures; cannot be grown in vitro **armadillos Tx: long-term dapsone (tox: methemoglobinemia and hemolysis) Alternative: rifampin, clofazimine, dapsone Lepromatous: diffusely over skin and is communicable (patients with low CMI and a Th2 response) Tuberculoid: few hypoesthetic skin nodules; patients with high CMI and TH1 response |
|
Oxidase +
|
Campylobacter (42C)
Vibrio cholera (alkaline media) Pseudomonas (loves air!) Neisseria Moraxella |
|
H2S production
|
Salmonella
Proteus |
|
Non-lactose fermenting GNRs
|
Oxidase -:
Shigella Salmonella Proteus Oxidase +: Pseudomonas |
|
Coccoid rods
|
H flu
Pasteurella Brucella Bordetella |
|
Lactose fermenters
|
Fast: (KEE)
Klebsiella E coli Enterobacter Slow: Citrobacter Serratia |
|
PCN & GNRs
|
Resistant to PCN G and vanc bc outer membrane inhibits entry
*but may be susceptible to derivatives like amp |
|
Neisseria
|
Diplococci
Gonococci: ferment Glucose (not maltose) no polysaccharide capsule no vaccine (bc rapid antigenic variation of pilus proteins) Meningococci: ferments Maltose + Glucose Polysaccharide capsule Vaccine (except type B) Transmitted through resp and oral secretions Rifampin px of contacts **LPS = endotoxin, assoc with disease manifestations and severeity |
|
Route for meningitis
|
meningoCoccus:
nasopharynx --> blood --> CHOroid plexus HaemoPHilus: pharynx --> lymPHatics --> meninges |
|
Haemophilus
|
MOPE:
meningitis otitis pna epiglottitis coccobacillus aerosol transmission *produces IgA protease Culture on chocolate agar (with factors V(NAD) and X(hematin) **can be grown with S. aureus, which provides fasctor V tx: meningitis with ceftriaxone Rifampin px capsule is immunogenic: anti-polyribitol ribose phosphate a.b. vaccine: contains type B capsule conjugated to diphtheria toxoid 2-18months |
|
Legionella
|
Legionnaires: severe pna and high fever; diarrhea, HA, confusion, hypoNa
Pontiac fever: mild flulike Use silver stain grow on charcoal yeast extract with iron and cysteine dx: antigen in urine *aerosol transmission from water source Tx: erythromycin |
|
Pseudomonas
|
Pna (esp in CF)
Sepsis (black lesions on skin) External otitis (swimmer's) UTI Drug use & DM Osteo Hot tub folliculitis aerobic, non-lactose, oxidase+ -produces pyocyanin (blue-green) pigment; grapelike odor -water source endotoxin and exotoxin (inactivates EF-2) tx: AG + extended spectrum PCN (piper, ticar) |
|
E. coli
|
virulence factors:
fimbriae: cystitis, pyelo K capsule: pna, neonatal meningitis LPS: sepsis EIEC: invades mucosa; necrosis and inflammation; bloody diarrhea ETEC: labile/stable toxins; watery diarrhea EPEC: no toxin; adheres to apical surface, flattens villi, prevents absorption -Pediatrics EAEC: "stacked-brick" intestinal adhesion (infants in developing countries) EHEC: O157:H7; shiga-like toxin and HUS (anemia, tcp, ARF) -endothelium swells and narrows lumen --> mechanical hemolysis and reduced renal blood flow; damaged endothelium consumes PLTs ***does not ferment sorbitol (vs other E coli) |
|
Klebsiella
|
Asp pna
Abscess in lungs Alcoholics diAbetics *red currant jelly sputum -nosocomial UTIs |
|
Salmonella & Shigella
|
-both non-lactose fermenting GNRs
-both invade mucosa and cause bloody diarrhea Salmonella: flagella can disseminate hematogenously produce H2S monocyte response Typhoid fever: fever, diarrhea, HA, rose spots; can remain in gallbladder Shigella: more virulent fecal-oral no flagella but propel themselves within cells by actin polymerization only in humans, no animal reservoir |
|
Campylobacter
|
*major cause of bloody diarrhea, esp in children
fecal-oral; poultry, milk; can be transmitted from domestic animals Comma or S-shaped (corkscrew mobility) oxidase+, grows at 42C (likes the CAMPfire) Can cause Guillain-Barre |
|
Vibrio cholerae
|
rice-water diarrhea
**grows in alkaline media comma shaped, oxidase + activates Gs --> increase cAMP |
|
Yersinia enterocolitica
|
pet feces (puppies)
contaminated milk, pork day care center outbreaks of diarrhea **causes mesenteric adenitis that can mimic Crohn's or appendicitis |
|
H. pylori
|
causes gastritis and up to 90% duodenal ulcers
Urease + creates alklaline environment Tx: PPI, Clarithromycin, amoxicillin, Metronidazole |
|
Spirochetes
|
spiral-shaped bacteria with axial filaments
BLT Borrelia (big) Leptospira Treponema |
|
Leptospira
|
? -shaped
water contaminated with animal urine flulike, fever, HA, abd pain, jaundice, photophobia with conjunctivitis *surfers and in the tropics Weil''s disease: icterohemorrhagic leptospirosis -severe form with jaundice and azotemia from liver and kidney dysfunction; fever hemorrhage, anemia |
|
Lyme disease
|
Borrelia burgdorferi
Ixodes tick (mice and deer are reservoirs) BAKE and key LYME pie: Bell's palsy (bilateral) Arthritis Kardiac block Erythema chronicum migrans Stage 1: erythema migrans, flulike Stage 2: Bell's, cardiac (AV block), myopericarditis Stage 3: chronic arthritis Tx: early - doxy; late - ceftriaxone |
|
Syphilis
|
1. painless chancre (many treponemes present)
2. SYSTEMIC; maculopapular rash on palms & soles, alopecia arriata, condylomata lata (many treponemes present) 3. Gummas (chronic granulomas), aortitis (vasa vasorum destruction, tree-barking), neurosyphilis (tabes dorsalis), Argyll Robertson pupil Congenital: saber shins (bowing of tibia), saddle nose, CN8 deafness, Hutchinson's teeth, mulberry molars, frontal bossing, snuffles- blood-tinged nasal secretions signs: + romberg, charcot joint, stroke w/o HTN Screen: VDRL confirm: FTA-ABS |
|
VDRL false postives
|
Viruses (mono, hep)
Drugs Rheumatic fever Lupus & Leprosy |
|
Yaws
|
Treponema pertenue
-infection of skin, bone, joints; healing with keloids -limb deformities not STD; +VDRL |
|
Carteonella
|
cat scratch
can cause bacillary angiomatosis in immunocompromised (often confused with Kaposi's) |
|
Borrelia recurrentis
|
Recurrent fever (variable surface antigens)
Louse |
|
Brucella
|
UNdulant fever (from UNpasteurized)
dairy, contact with animals |
|
Francisella tularensis
|
Tick bite; rabbits, deer
|
|
Yersinia pestis
|
Plague
flea bit, rodents, prairie dogs |
|
Pasteurella multocida
|
cellultits, osteomyelitis
animal bite: cats, dogs |
|
Gardnerella vaginalis
|
pleomorphic
gram-variable rod **polymicrobial: involved Mobiluncus, anaerobe gray vaginal discharge, fishy smell; painless tx: Flagyl **CLUE CELLS: vaginal epithelial cells covered with bacteria |
|
Rickettsiae
|
obligate intracell
need CoA and NAD+!!!! (vit B3 and B5) triad: HA, fever, rash (vasculitis) *all have arthropod vectors except Coxiella (aerosol- pna) tx; doxy |
|
Bacteroides fragilis
|
MC organism in colon
peritoneal abscess when gut lining compromised |
|
Rocky Mountain spotted fever
|
rickettsia rickettsii
tick *rash starts on hands and feet; migrates to wrists, ankles, then trunk -HA, fever **EAST coast |
|
Typhus
|
Endemic: R. typhi; fleas
Epidemic: R. prowazekii; human body louse Typhus rash starts centrally and spreads outwards (no palms and soles) Typhus on the Trunk Ricketssia on the Rists |
|
Ehrlichiosis
|
tick
no rash granulocytes with berry cluster organisms |
|
Q fever
|
Coxiella burnetii
tick feces and cattle placenta release spores --> inhaled --> PNA no rash, no vector, neg Weil-Felix |
|
Weil-Felix
|
Test for Rickettsial infxn
Serum mixed with Proteus antigens: antirickettsial a.b. cross-react to Proteus O antigens and agglutinate **negative in Coxiella |
|
Rash on palms and soles
|
CARS
Coxsackie A (hand, foot, mouth) RMSF Syphilis |
|
Chlamydiae
|
cannot make their own ATP
obligate intracellular; mucosal infxns **cell wall LACKS MURAMIC ACID lab: cytoplasmic inclusions on Giemsa or fluorescent a.b-stained smear 1. Elementary body: small, dense; is Enfectious and Enters cell via Endocytosis 2. Reticulate body: Replicates in cell by fission; form seen on tissue culture Trachomatis: reactive arthritis, conjunctivitis, urethritis, PID Psittaci: atypical pna; avian reservoir Pneumoniae: atypical pna tx: azithro or doxy |
|
Chlamydia trachomatis
|
A,B,C: chronic infxn, blindness in AFrica
D-K: urethritis, PID, ectopic preg, neo pna, neo conjunctivitis L1-L3: lymphogranuloma venereum -primary ulcers, inguinal lymphadenitis, rectal dz (can look like IBD) |
|
Mycoplasma
|
walking pneumonia
CXR worse than patient **high titers of cold agglutinins (IgM), which can agglutinate or lyse RBCs -grown on Eaton's agar -no cell wall -only bacterial membrane containing cholesterol *outbreaks in military recruits, prisons tx: tetra, erythro (can't use abx that target cell wall!) |