Diphtheria, Listeria, & Bacillus Flashcards

1
Q

What organism are we thinking when we hear “leather throat” and “Bull neck?”

A

Diphtheria

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2
Q

What are the microbiological characteristics of Diphtheria?

A

-Club shaped -Gram positive (sometimes gram variable in resp sample) -Granules (polymetaphosphate) visible when stained with methylene

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3
Q

What media can we culture Diphtheria on?

A

-Loeffler coagulated serum -Cystine-tellurite blood agar (black colonies)

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4
Q

How does Diphtheria spread?

A

-human -> human -Droplets or direct contact with skin abrasions

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5
Q

Where does diphtheria colonize?

A

Mucous membranes -mostly tonsils and pharynx **no invasion

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6
Q

How does diphtheria cause disease?

A

-virulence factor = exotoxin = diphtheria toxin

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7
Q

How does diphtheria toxin work?

A

-kills cells via inhibition of protein synthesis -enters cells via receptor-mediated endocytosis -Mucosal necrosis -toxin can travel in blood

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8
Q

What are the symptoms of Diphtheria?

A

-Soar throat -fever (doesn’t exceed 102) -“pseudomembrane” of necrotic epithelium -death by suffocation or toxic myocarditis in heart (arrythmia & myocarditis) *paralysis in 10-20% of pts, also neuropathy

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9
Q

What is Bull Neck?

A

-caused by diphtheria -lymphadenopathy and edema

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10
Q

Is diphtheria catalase positive or negative?

A

-Positive

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11
Q

How do we treat diphtherai?

A

*Tx must be prompt! -Antitoxin (DAT) -Antibiotics (penicillin & erythomycin) *vaccination makes disease very rare

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12
Q

Where does Listeria like to live?

A

-food-borne pathogen -cheeses, cold cuts and hot dogs **think bluebell outbreak

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13
Q

What organisms do we worry about with soft unpasteurized cheeses?

A

-Listeria -Brucella

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14
Q

Who is susceptible to infection by Listeria?

A

-Immunocompromised: elderly & AIDS, transplant patients -pregnant women, can cross to fetus

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15
Q

What is the microbiology of Listeria?

A

-Gm + bacillus -Resistant to high salt and bile concentrations -covered in flagella -can multiply at 4 degrees celcius

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16
Q

Is listeria catalase positive or negative?

A

Positive

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17
Q

Why is listeria scary in the fridge?

A

It can multiply at 4 degrees celcius

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18
Q

How does listeria invade?

A

-enters M-cells and gets to bloodstream -Uses surface protein invasin/internalin to bind to macrophage and invade -listeriolysin O releases the bacterium from the phagosome -actin filaments allow bacteria to cross from one cell to another

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19
Q

What cells do you need to get rid of a listeria infection?

A

-T-cells, because it is a facultative intracellular pathogen **cell mediated immunity important! not there in neonates and immunocompromised/HIV

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20
Q

What does listeriolysin O of lysteria do?

A

-allows organism release from a phagosome

21
Q

Why is there no vaccine for Listeria?

A

-antibody immunity will not save us

22
Q

What diseases are caused by listeria?

A

-Maternal listeriosis (33%) -perinatal listerosis -focal infection (GI, Liver) -sepsis & meningitis in immunocompromised

23
Q

What is the difference between presentation of early onset and late onset perinatal listerosis?

A

-Early (6days) = meningitis

24
Q

How is listeria treated?

A

-sensitive to most Abx, not B-lactams -must be a drug that can penetrate eukaryotic cells

25
What are the microbiologic features of Bacillus?
-Gm + -encapsulated, spore-forming (white) -grow in long end-to-end chains (looks like fungus) -non-motile
26
What culture medium does bacillus grow on?
-simple carbon and nitrogen sources -grows pretty much everywhere
27
How is B. antrhacis distinguished from B. cereus?
-anthracis requires thiamin to grow -cereus = hemolysis on blood agar
28
How is bacillus anthracis inoculated in humans?
-cutaneous (black eschar) -intestinal -Pulmonary
29
What are the x-ray findings of inhalational anthrax?
-mediastinal widening
30
Why have anthrax infections decreased since the 60's?
Animal vaccination
31
How does B. anthracis cause disease?
-spores phagocytosed by macrophates and transported to lymphatics -releases 3 exotoxins: EF, LF, and PA -death is due to septicemia, toxemia, and shock
32
What are the virulence factors (& toxins) of B. anthracis?
-Antiphagocytic capsule (very protective) Tripartite toxin: -Lethal factor (LF) -Edema Factor (EF) -protective antigen (PA) binds to cell and activates toxin release
33
What is the treatment for anthrax?
-susceptible to penicillin (but usually too late) -anthrax vaccine
34
What disease does Bacillus cereus cause?
-food poisoning
35
What are the virulence factors produced by Bacillus cereus?
-Emetic toxin = vomiting 6hrs after -Gastrointestinal toxin = diarrhea
36
What invasive diseases are caused by Bacillus cereus?
-soft tissue disease = cellulitis in leukemics/immunocompromised -eye infection -pulmonary infection
37
Fried rice and diarrhea! what organism we thinkin?
Bacillus cereus
38
What are the two most common causes of meningitis in people over 50?
#1 Strep pneumoniae #2 Listeria
39
"mediastinal widening"
Bacillus anthracis
40
"large Gm+ rods in chains"
Bacillus anthracis
41
"re-heated fried rice"
Bacillus cereus
42
What are the toxins produced by Bacillus cereus?
-Heat labile -heat stable
43
What organisms cause pediatric meningitis at less than 3 months of age and greater than 3 months?
3 mo: -Neisseria meningitides -H. influenzae
44
"Loeffler coagulated serum & Cystine-tellurite blood agar"
-Diphtheria
45
"Bull neck"
-Diphtheria
46
"pseudomembrane in oropharynx"
-Diphtheria
47
"tumbling club-shaped bacillus"
Listeria monocytogenes
48
"soft cheese & cold cuts"
Listeria monocytogenes
49
"black eschar"
-cutaneous anthrax