Bacterial Infections Flashcards by tinay alcantara

Microbiologic characteristics of corynebacterium diphtheriae

Gram+ rods
Non sporeforming
Aerobic
Non motile
Curved
Chinese character

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3 biotypes of corynebacterium diphtheriae

Mitis
Gravis
Intermedius

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Gray- brown adherent pseudomembrane

Diphtheria

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Bull neck appearance

Diphtheria

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Difference of diphtheria and strep throat

Relative lack of fever

Nonexudative throat

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Diagnosis of diphtheria

Culture from nose and throat

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Treatment for diphtheria

Pen G 100,000-150,000 units/kg/day q6H x 14 d

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Eradicates nasopharyngeal carriage in diphtheria

Erythromycin 40-50 mkD PO or IV x 14 days

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Most infectious stage of pertussis

Catarrhal stage

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Cough in pertussis

Explosive outbursts in series of 5-10 rapid coughs in 1 expiration and ending in a high pitched whoop (forceful inspiratory gasp)

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Medium culture for pertussis

Bordet gengou agar plate

-swab from posterior nasopharynx for 15-30 sec

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Presumptive diagnosis for pertussis

Leukemoid reaction (very high wbc ct)

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Complications of pertussis

HSOAP

Hemorrhage (subconjunctival or intracranial)
Seizures
Otitis media
Atelectasis, apnea, activation of latent TB
Pneumonia

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Treatment for pertussis

Erythromycin 40-50 mkD PO q6 x 14 days

Isolate px for at least 5 days after initiation of erythromycin therapy

Erythromycin x14 days for close contacts

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Cause of meningococcemia

Neisseria meningitidis

gram neg diplococci
maltose and glucose fermenter

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Risk factors for meningococcemia

with viral infx (esp influenza)
smoking and smoking exposure
crowded living conditions (military, dormitories)
with underlying chronic diseases
low socioecomomic status

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Mode of transmission of meningococcemia

Person to person thru infected droplets

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Waterhouse-Friderichsen syndrome

Diffuse adrenal hge
DIC
coma
Death

(In meningococcemia)

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Important features of meningococcemia

abrupt fever, chills, headache, vomiting
rapid worsening of sx (within hrs)
mobilliform rash becoming petechial then purpuric within hrs

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Difference of meningococcemia from other bacterial meningitis

Less frequent seizures and focal neurologic signs

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Poorer prognostic factors of meningococcemia

Absence of petechiae < 12 hrs before admission
Absence of meningitis
Low or normal ESR

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DOC for meningococcemia

Penicillin G 250,000-400,000 U/kg/day IV in 4-6 divided doses for at least 5-7 days

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Complications of enteric fever

Intestinal hemorrhage (<1%)
Perforation (0.5-1%)

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Mainstay of diagnosis of enteric fever

Blood culture - positive in 40-60% of px

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Treatment for uncomplicated fully sensitive enteric fever

Chloramphenicol | Amoxicillin

Treatment for uncomplicated but multidrug resistance typhoid fever

Fluoroquinolone Or Cefixime

Treatment for uncomplicated but quinolone resistant typhoid

Azithromycin Or Ceftriaxone

Treatment for chronic carriers of Salmonella typhi

Ampicillin

4 species of shigella

Dysenteriae Flexneri Boydii Sonnei

Shigellosis: pathologic changes occur in what part of GIT

Colon, distal ileum

Watery voluminous diarrhea evolving into frequent small-volume bloody mucoid stools, severe abdominal pain, high fever, abdominal tenderness, rectal tendernes

Shigellosis

Most common cause of bacillary dysentery

Shigella sonnei

Most severe form that causes epidemic dysentery

Shigella dysenteriae type 1

Definitive diagnosis for shigellosis

Culture of stool and rectal swab specimen

Culture medium for shigella

MacConkey agar XLD SS agar

Treatment for shigellosis

Oral ampicillin

Microbiologic characteristic of shigella

Gram neg rods Non lactose fermenter Non HS Non motile

Basic virulence trait for shigella

Ability to invade epithelial cells * Requires VERY LOW INOCULA to cause illness

E.coli : group that causes infantile explosive diarrhea with dhn

ETEC

Traveller's diarrhea | montezuma's revenge

ETEC

E.coli : group that causes colonic lesions like dysentery

EIEC

E.coli group that causes nonbloody diarrhea with mucus, prolonged

EPEC

E.coli group that produces shiga-toxin, bloody diarrhea

EHEC

Pathogenesis of E. Coli

Adherence of organisms to a glycoprotein or a glycolipid receptor *Requires a LARGE INOCULUM of organisms to induce disease

Confirmatory test for cholera

Stool culture

Transport medium of cholera

Cary-blair

Culture medium of choice for cholera

Thiosulfate citrate bile sucrose (TCBS) media

Diarrhea is profuse, watery, painless, rice watery consistency and fishy odor without abdominal cramps or fever

Cholera

"Darting" organisms in darkfield microscopy (rapid test)

Vibrio cholerae

Antibiotics for cholera

Tetracycline | Doxycycline

In cholera, dehydration will lead to what complication

Acute tubular necrosis

In cholera, complication of hypoglycemia?

Coma--> death

In cholera, what is the complication of hypokalemia?

Arrythmia

Muscle affected in trismus

Masseter

Muscle affected in risis sardonicus

Facial and buccal

Progressive difficulty feeding, hunger and crying, paralysis or diminished movt, stiffness to touch, spasms with or without opisthotonus

Neonatal tetanus

Antibiotic of choice for tetanus

Penicillin G

Clean painless ulcers with raised borders that heal spontaneously are called?

Chancre *Found in PRIMARY syphilis

Syphilis: gummatous lesions

Tertiary syphilis

Syphilis: non pruritic maculopapular rash involving palms and soles

Secondary syphilis

Unilateral or bilateral thickening of steenoclavicular portion of the clavicle--what sign?

Higoumenakis sign *a late manifestion of congenital syphilis

Barrel-shaped upper central incisors

Hutchinson teeth *a late manifestion of congenital syphilis

Abnormal first lower molar

Mulberry molars *a late manifestion of congenital syphilis

Anterior bowing of the midportion of the tibia

Saber shin *a late manifestion of congenital syphilis

Painless knee joint swelling with sterile synovial fluid in px with congenital syphilis

Clutton joint *a late manifestion of congenital syphilis

Treatment for CONGENITAL syphilis

Aqueous penicillin G

Treatment for primary, secondary and early latent syphilis

Bemzathine Penicillin G

Jarisch-herxheimer reaction

Acute systemic febrile reaction with exacerbation of lesions occuring in 15-20% of px with acquired or congenital syphilis who are treated with penicillin

Primary lesion in leptospirosis

Damage to the endothelial lining of small blood vessels

Triad of Weil's syndrome

Jaundice Uremia Bleeding

Most useful screening test of leptospirosis

Microscopic slide-agglutination test

Treatment for leptospirosis

Penicillin | Tetracycline