Gram-Indeterminate Bacteria

Question 1

Chlamydiae:
trachomatis
pneumoniae
psittaci

Answer 1

-OB INTRA, lack of stain, lack muramic acid
-ES: enter, RS: replicate
-NAAT to confirm (PCR)
-Giemsa stain

TRICH:
-AC- blindness(ABC)/DK- STI/L1-L3- LGV
(Watery discharge, PID, IF, AP)
-Can spread to baby (conj/pneum)
-Can’t see can’t pee can’t climb a tree (rieter’s syndrome)

PNEUM:
-Atypical / walking pneumonia , more common in ELDERLY

PSITTACI:
-Pneumonia via birds (parrots)

TX: MACROLIDES (AZITHRO) oral and TETRA (DOXY)
-co inf of gonorrhea (tx includes CEFTRIAXONE)

Question 2

Mycoplasma pneumoniae

Answer 2

-WALKING pneumonia, no severe SX (X-ray appears worse then pt shows, PIXR)
-No cell wall = no gram stain
-CHOLESTEROL in cell membrane

At risk: young adults (close contact), military recruit

Confirm DIA: Cold agglutination, clump RBC in cold temps also IgM.

TX: Macrolides (azithromycin)

Question 3

Ricketts species

Answer 3

-OB INTRA (can’t produce NAD+/COA)
-Poor gram stain (but weakly gram -)
-Coccobacillary shape
-Weil Felix test: DIAGNOSIS

SX: HA/Fever/VASCULITIS(rash)

TX: DOXYCYCLINE (TETRAS)

Question 4

Rickettsia prowazekii

Answer 4

-Rash: starts in middle of body then moves outward (spares hand/feet/head)

Risk: military camp recruits, prisoners

-SPREAD VIA LICE (LOUSE): scratching

SX: myalgia, arthralgia, pneumonia, dizzy, confusion, coma (CNS)

Question 5

Rickettsiae rickettsia

Answer 5

Rocky Mountain Spotted Fever
-Rash not immediate
-Starts on ankles/joints, then central
-Also HA/fever/muscle pain

-SPREAD VIA TICKS (derma), direct contact