Diseases Flashcards
- Bacterial meningitis and diagnosis
- Neonatal (bacterial) meningitis
- Health-care associated, following trauma/surgery
(new)
- ‘PIMALL’:
s.pneumoniae (no1) - capsule (vaccine)
h.influenza - capsule (vaccine)
n.meningititis - capsule (vaccine
s.aureus
Listeria (serous meningitis)
Leptospira (serous, not purulent) - ‘ALE’
s.agalactiae - capsule
listeriosis - can go through placenta
e.coli (k1) - Staphylococcus aureus
- E.coli
- Klebsiella pneumoniae
- Pseudomonas aerguniosa
Diagnosis:
- CSF: elevated WBC, elevated protein, low sugar
- from CSF: microscopy, latex agglutinaton, PCR, cultivation
- Blood cultures
Treatment:
- Empiric: 3rd gen cephalosporin - Ceftriaxone
- prevention with vaccines
Community acquires pneumoniae
- typical
- atypical and diagnosis
- haemorrhagic
- aspiration
Therapy?
- Typical pneumoniae
s.pneumoniae (no1)
H.influenza
s.aureus
Morexella catharralis
Klebsiella
Nocardia - lobar pneumoniae (?)
Symtoms:
- fever, dyspnea, chest pain, coughing, sputum
Diagnosis:
- Sample: sputum, blood culture
- Method: microscopy, cultivation
2. atypical legionella pneumoniae chlamydophilia pneumoniae chlamydia psittaci mycobacterium pneumoniae coxiella burnetti
Symtoms:
- low grade fever, or subfebrility
- dry cough
Diagnosis:
- serology: specific IgM
- PCR from urine, blood and broncho-alveolar lavage
- for legionella: detection from urine, culturing on BCYE.
- hemorrhagic
- yersinia pestis
- b. anthracis
- f.tularencis - aspiration
anaerobes:
- bacteriodaceae
- actinomyces
Other:
- bordetella pertussis
- mycobacterium tuberculosis
- Atypical mycobacterium
- Nocardia
- Actinomyces
Therapy:
- amoxicillin/clavulanic acid +/- macrolide or fluoroquinolones
Hospital acquires pneumoniae/ventilator associated pneumoniae
therapy?
- Pseudomonas aergunisa
- acinetobacter baumanii
- stenotrophomonas maltophilia
- Klebsiella
- e.coli (?)
- s. aureus
Therapy: - for empiric treatment: combination of antibiotics (e.g. piperacillin + tazobactam) vancomycin aminoglycosides etc.
- Nosocomial MDR pathogens
2. other nosocomial pathogens (not MDR)
EsCkAPEe 1. Enterococcus S. aureus C.difficule (k) klebsiella Acinetobacter baumanii Pseudomonas Enterobacter e.coli
2. aeromonas plesimonas proteus stenotrophomonas maltophila
- UTI
2. specimen
E.coli (other pathogenic enterobacteria) - Klebsiella - Serratia - enterobacter - proteus
P.aerginosa
Coagulase - cocci: - s.saphrophyticus - s.haemolyticus - enterococcus acinetobacter baumanii corynebacterium urealyticum
burkholdeira capacia
- specimen:
- clean catch midstream urine or dip-slide techique (uricult).
- culturing
- native microscopic test
- pyuria must be seen
- antibiogram
Storage of specimen: sterile urine: 24h at 4C, or max 2h at room temperature
- STIs
- diagnosis
(new)
1.STDs:
• Ulcer
◦ Haemophilia ducreyi - ‘ulcus molle’ - chancroid
◦ T.pallidum ssp palidum - ‘ulcus durum’ - syphilic Chancroid
◦ Chlamydia trachomatis L1-L3 serotypes (LGV)
◦ Granuloma inguinale/donovaniosis - Klebsiella granulomatis
• Discharge:
- Gonorrhea (N.gonorrhea)
- Non-gonorrheal urethitis: often asymtomatic
- Mycoplasma hominis, M. genitalium
- Ureaplasma urealyticum
- Chlamydia serotype D-K
- diagnosis:
- clinical specimen: genital discharge or cells (for IC pathogens)
- women: collection with cytobrush
- men: first catch urine
- PCR: chlamydia, mycoplasma, ureaplasma
- Gonorrhea: gram stained smear + PCR + culturing + AB testing (inoculation ASAP)
- syphilis:- dark field microscopy from discharge, ulcer
- serology (specific and nonspecific tests)
Serology not used:
- gonorrhea
- mycoplasma
- ureaplasma
- chlamydia
Diarrhea and diagnosis
food poisening: normal diarrhea: by eating toxin-contamonated food and not the bacteria
s. aureus
c. perferinges
b. cereus
Watery diarrhea: v.cholera ETEC EPEC EAEC Bacillus cereus (diarrheal type) Clostidium perferingens and difficile Protozoa: - Cryptosporodium spp - Giardia
Diagnosis:
Stool is tested: culturing and other specific tests (see topics)
When food poisening: usually based on the symtoms and food is tested for pathogen.
c.botulinum: inoculation of mice with patients serum.
Normal flora of the skin (new)
- S. epidermidis
- Other coagulase negative staph.
- Propriobacterium acnes
- Apathogenic corynebacteria
Normal flora of oral cavity (new)
Oral cavity • Streptococci (dominant) viridans, mutans • Lactobacilli (dominant) - Actinomyces - Veillonella - Porphyromonas - Apathogenic Neisseria Apathogenic Corynebacteria • Anaerobes: ◦ Bacteroids ◦ Bifidobacterium
Normal flora of the respiratory tract
Normal flora of the respiratory tract • Nostrils ◦ S.aureus (20-30% of pop) ◦ Cornyebacterium ◦ S. epidermidis ◦ Streptococcus pneumoniae ◦ Neisseria sp ◦ Haemophilus sp
• Upper respiratory tract (nasopharynx) ◦ Streptococci: ‣ Alpha-hemolytic streptococi • Strep. Pneumoniae ‣ Beta-hemolytic: • Strep.pyogenes ‣ Non-hemolytic streptococci ◦ Gram neg cocci: ‣ Neisseria sp = pharyngococci ‣ Neisseria meningitidis ◦ Haemophilus influenza ◦ • Lower respiratiry tract: ◦ Usually sterile :) - by mucociliary elevator
Normal flora of urogenital tract (new)
Vagina:
- Lactobacillus
- Candida
- Gardnerella
- Streptococcus
Normal flora of GI and their role (new)
99% obligate anaerobes Bacteroides fragilis Porphyromonas Fusobacterium Enterococcus E. coli Klebsiella Enterobacter Serratia Proteus Streptococcus Bifidobacterium Lactobacillus Veillonella Prevotella Candida
Anti-tuberculotic drugs
- first phase: intensive replication
‘RIPE’
Rifapmin
Isoniazid (inhibits cell membrane function - blocks mycolic acid )
Pyrazinamide (inhibits cell membrane function - blocks mycolic acid)
Ethambutol (inhibits cell wall synthesis)
2nd line of defense:
- Ethionamide
- Capreomycin
- Cycoserine
- macrolides
- fluoroquinolones
Viral and fungal meningitis and encephalitis
Viral:
- Flavivirus: West nile virus (encephalitis and meningitis)
- Enterovirus (aseptic meningtis)
* Echovirus (aseptic meningitis)
* Poliovirus - HHV7
- LCV (arenavirus)
Fungal:
- Cryptococcous neoformans (meningitis)
- Coccoides immitis (meningitis in disseminated form)
- Histoplasma capsulatum
- Blastomyces dermatitis
Zoonotic infections and their prevention
Zoonotic pathogen: • pasteurella (cat-bite) • salmonella enteriditis (salmonellosis) • Brucella • Bacillus anthracis • Yersinia • Franciella tularensis • Pasteurella • Campylobacter jejuni • Coxellia burnetti • Bartonella • Burkholdeira mallei • Borrelia burgdorferi • Leptospira genus • Chlamydophilia psittaci • Erysipelothrix rhusiopathiae • Clostridium perferingens
Fungal and parasitic lung infections
Fungal:
- Coccoides immitis
- Paracoccoides braziliensis
- Blastyomyces dermatitis
- Histoplasma capsulatum
- Cryptococcus neoformans
- P. jiroveci
- Aspergillus
Protozoa:
- Entamoeba histologyica (lung abscess)
Helminths:
- Paragonius westermanii
Air-borne viral infections
Rhinovirus Paramyxovirus Orthomyxovirus VZV (Pox-virus?) both air-borne and contact Parvovirus Togavirus: rubella
Toxin-mediated
Toxin-mediated infections: • Toxic-shock syndrome ◦ S.aureus • Toxin-shock like infection ◦ S.pyogenes • Dystentery: ◦ Shigella • Gastroenteritis: ◦ S. Aureus ◦ B. Cereus ◦ Shigella ◦ Yersinia ◦ V. Parahemolyticus ◦ Pleisomonas shigellosides ◦ Campylobacter jejuni (most common cause) ◦ Salmonella enteridtis ◦ Listeria • HUS ◦ Shigella ◦ E.coli • Enteral fever ◦ Salmonella typhi • Necrotizing fasciitis ◦ s.pyogenes • Rheumatic fever ◦ S.pyogenes • Rheumatoid artheritis ◦ S.pyogenes • Glomerulonephritis ◦ S.pyogenes
Food-poisoning
- s.aureus
- b.cereus
- c. perferings
- salmonella enterititis
- Listeria
- yersinia enterocolitica
- vibrio parahemolyticus
Impetigo
s. aureus
s. pyogenes
follliculitis
s. aureus
pseudomonas aerginosa
furuncle, carbuncle
s. auerus
cellulitis
s. aureus
s. pyogenes
clostridium perferingens?
fasciitis necrotisans
s. pyogenes
c. perfringens
