Sf: Small Gram Negative Bacilli

Front 1

Enumerate the 6 types of small gram negative bacilli

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1. Bordetella
2. Haemophilus
3. Brucella
4. Yersinia pestis
5. Calymatobacterium
6. Gardnerella

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Bordetella pertussis
. Gm - small bacilli or coccobacilli
. non motile, non__ forming
. have bipolar metachromatic staining best seen by __ blue staining
. capsulated
. strict aerobes
. pathogenicity is mainly due to the release of pertussis __ which is responsible for the s/s of pertussis
. the organisms do not invade the blood stream; they are mainly found in the epithelial cells of the __ and __

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spore

toluidine

exotoxin

trachea and bronchi

Front 3

Clinical Infection: pertussis or __ cough

. transmission is through inhalation of droplet spray
. IP 5-21 days
. highly __ disease primarily affecting children

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whooping

communicable

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Stages of Pertussis:

1. __ or prodromal stage - mild upper RR tract infection lasting for 1-2 weeks

2. __ stage - paroxysmal cough is characterized by __-__ forcible hacking coughs occuring in __-__ seconds often terminating in a d deep insipatory whoop
. last for 1-6 weeks
. children usu end up vomiting, convulsion (due to brain anoxia), rupture of conjunctival blood vessels, rectal prolapse

3. __ stage - manifestation gradually subside and mild coughing may last for several weeks

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1. catarrhal

2. paroxysmal
. 5-20
. 15-20

3. convalescent

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Laboratory Dx: best clinical specimen is nasopharyngeal swab

1. culture - __-__ medium (potato-glycerol-blood) --> pinpoint, smooth, convex glistening, almost transparent and pearl-like in apperance - "__ droplets"

__ plate method - place plate in front of the mouth of patient, about 4-5 inches from mouth, then let the patient cough 2-3 times directly into plate
. but nasopharyngeal swab has higher yield of organism

2. __ count - leukemoid reaction with lymphocytosis
. 12,000 - 200,000 cells/cu mm blood with 60% lymphocytes

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1. Bordet-Gengou, mercury

cough, mercury

2. WBC

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immunity - permanent

prevention and control:
active immunization = __ vaccine

Schedule: 3 doses starting 2 months at 4-8 weeks interval, booster 1 year after last dose, another booster at 4-5 years old then DT at 10 years old, then every 10 years thereafter

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DPT

Front 7

Haemophilus species:

H. __
H. __
H. __

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influenzae

ducreyi

aegyptius

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___ loving organism because they require accessory growth factors present in the blood

1. heat stable __ factor - hemin
2. heat labile __ factor: nicotinamide adenine dinucleotide (NAD)

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blood

X

V

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Haemophilus influenzae (influenza bacillus of __)
. __ known pathogenic bacilli
. gm - coccobacilli
. non motile, non spore forming
. 2 groups:
.. capsulated - polysaccharirde capsule
.. - serotypes a, b, c, d, e, f
.. - serotype B is the most __ and asso. with severe infection

.. non capsulated

. aerobic or facltatively anaerobic
. X and Y factors are required for growth
. pathogenecity is due to polysaccharide capsule and protease enzyme

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. smallest

.. invasive

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clinical infection:
. transmission through inhalation of droplet spray
. mainly cause infection in children:

1. __ - most common cause of meningitis in children between 3 months to 3 yrs old

2. __ - same age group as above; also occur in adults in those individuals with chronic lung disease and alcoholism

3. __ epiglottitis

4. cellulitis

5. bacteremia

6. sinusitis and __ media

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1. meningitis

2. pneumonia

3. acute

6. otitis

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Laboratory Dx:
sputum, middle ear secretions, blood, CSF

CULTURE
a. __ agar - the most common culture media used to isolate H. influenzae - colonies are very small and characteristically described as __ DROP colonies

b. __ medium - a transparent, colorless medium which is useful in differentiating capsulated and non capsulated strains of H. influenzae. The capsulated strains produce colonies showing iridescence (gleaming like a rainbow) when colonies are viewed under oblique light

c. __ agar - permit grown of H. influenzae, if cross inoculated by V factor releasing organisms like Staphylococcus, Pneumococcus, Neisseria, and Pseudomonas. More luxuriant growth of H. influenzae in the vicinity of colonies of V factor releasing organism --> __ PHENOMENON

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a. chocolate, DEW

b. levimhal

c. blood, SATELLITE

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Haemophilus ducreyi
. requires only X factor for grwoth
. transmitted through sexual contact
. clinical infection: __ and soft __
1. single or multiple painful ulcers found in the genitalia and perianal areas
2. organism spread to __ lymph nodes --> supurative inguinal buboes

Laboratory Dx:
1. gm staining swabs from base of ulcer or from bubo aspirate ---> characteristic school of RED __ appearance (red bacilli in long strands)
2. culture with CA

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chancre, chancre

FISH

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Haemophilus aegyptius (__ weeks bacillus)
. requires x and v factors for growth
. transmission thru contaminated hands, handkerchiefs, towels
. clinical infection --> PINK __ disease ( highly contagious purulent conjunctivitis with brilliant pink color of the eye and intense itching)

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Koch

EYE

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Brucella species:
. small gm - bacilli or coccobacilli
. non motile non spore forming
. some are capsulated
. strict aerboes
. quickly destroyed by __

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pasteurization

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3 important species:
1. B. meletenensis --> undulant fever or __ fever - affects goats and sheep

2. b. abortus --> contagious __ or Bang's disease

3. B. suis - contagious __ in hogs

. primarily attack animals (zoonotic) but can be transmitted to man
. in animals --> abortion of fetus
. human infection: most invasive human infection is caused by B. melitenensis
. humans acquire the infection by:

1. contact with infected excreta and fetus and organism enters the body through skin abrasions or wounds
2. ingestion of contaminated __ and milk products

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malta

abortion

abortion

milk

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occupational hazards for veterinarian, farmers, and butchers

clinical manifestation in man:
1. __ is a major complaint
2. fever and chills
3. generalized mm aches
4. mental depression and __ nervousness

* not cause abortion in pregnant women

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1. weakness
4. increase

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Yersinia pestis
. gm - coccobacilli, non motile, non spore forming with marked bipolar staining "SAFETY __ appearance"
. fresh isolates are capsulated
. grow best at temp. 28 degress C

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PIN

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clinical infection: plague or __ death
. infectious disease of __, esp rats (zoonotic) that can be transmitted to man
. rat to rat transmission : bite of infected rat __

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black

rodents

fleas

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human infection: transmission is through:
1. inhalation of droplet spray from patients with __plague
2. bite of infected human flea
3. accidentally through the bite of infected rat __

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pneumonic

flea

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3 clinical types:
1. __ plague - most frequent
2. __ plague - common in all severe forms of plague and often cause of death
3. __ type - mortality rate is very high

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1. bubonic
2. pulmonary
3. septicemic

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Lab Dx:
1. culture of clinical specimens - organisms can grow on ordinary media like NA
2. __ test

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serologic

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Prevention and control:
1. __ of patient
2. rat and __ control
3. __ vaccine

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1. isolation
2. flea
3. plague

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Calymatobacterium granulomatis
. pleomorphic gm - rods
. responsible for STD called granuloma __, a chronic disease characterized by ulcerating lesions of skin and mucous memberane of genitalia and inguinal areas --> bubo formation possible
. diagnosis is based on direct examination of biopsy material stain with Giemsa or _- stain --> demonstrate __ bodies within cytoplasm of macrophage

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inguinale

Wright

Donovan

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Gardnerella vaginalis
. old name is Corynebacterium vaginalis
. pleomorphic gm - rods
. responsible for non specific urethritis (non gonococcal urethritis) and vaginitis - STD; sexual transmission
. diagnosis is based on direct smear of genital secretions or urine --> gm staining --> characterized microscopic apperance: __ CELLS which are epithelial cells covered by masses of bacteria

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CLUE