Gram Negative Infections Flashcards
pseudomonas greenish-blue, yellow-green, and black pigment causes
greenish-blue: pyocyanin
yellow-green: fluorescein
brown-black: pyomelanin
recurrent infections with n. meningitidis caused by?
late complement deficiency (C5-C9)
glanders: 1. bug, 2. vector, 3. presentation, 4. txt
burkholderia mallei
contact with horses
ulcerated nodule at inoculation site, LAD, farcy buds
sulfonaminde
Tularemia: 1. aka, 2. bug, 3. vector, 4. presentation, 5. txt
- francisella tularensis
- rabbits (ticks, deer flies) - hunters
- hands- HSM, violaceous papulonodular eruption
- doxy w/ rifampin
vibrio infection 1. bug, 2. vector, 3. presentation, 4. txt
- vibrio vulnificus
- raw seafood, wound in seawater
- fever, chills, abd pain, red-violaceous macules –> painful hemorrhagic bullae with cellulitis
TCN PO
plague 1. bug, 2. vector, 3. presentation, 4. txt
- yersinia pestis
- flea
- fever, small papule/pustule at site of flea bite w/ swollen painful fluctuant lymph nodes (buboes)
- streptomycin IM
malakoplakia 1. bug, 2. presentation, 3. histo, 4. txt
- e. coli (also pseudomonas, proteus, klebsiella)
- uti, weeping perianal plaque or polypoid mass
- michaelis-gutmann bodies
- cipro, surgery
rhinoscleroma 1. bug, 2. transmission, 3. presentation, 4. histo, 5. txt
- klebsiella rhinoscleromatis
- inhalation droplets, fomites
- infectious granulomas in nasal mucosa, resp tract, epistaxis, Hebra nose (destruction cartilage)
- mikulicz cell, russell bodies
- cipro
rat-bite fever: 1. aka, 2. bug, 3. vector, 4. presentation, 5. txt
- haverhill fever
- streptobacillus moniliformis
- rodents, contaminated food
- fever, arthritis, ulceration at site of bite, generalized morbilliform eruption with acral invoment
- PCN
cat bite: 1. bug, 2. txt
pasteurella multocida
augmentin +/- tetanus ppx
dog bite bug/txt
pasturella canis and multocida, capnocytophaga canimorsus
augmentin +/- tetanus
human bite bug/txt
eikenella corrodens
augmenting +/- tetanus
bartonella bug, vector, pathogenesis
gram neg intracelluar
ticks, fleas, sand flies, mosquitos
bacilliformis adheres to and invades RBCs
all 3 types produce endothelial-stimulating factor –> proliferation endothelial cells and blood vessels
oroya fever aka, bug, vector, 2 stages, txt
- carrion’s ds, verruga peruana, Peruvian wart
- bartonella bacilliformis
- sanfly lutzomyia verrucarum
- acute stage (oroya) = fever + hemolytic anemia
- chronic stage (verruga) = erythematous papules/nodules for years
- acute txt chloramphenicol (covers salmonella coinfection)
- chronic txt TCN or PCN
cat-scratch disease bug, vector, presentation, txt
- bartonella henselae
- cat flea ctenocephalides felis (comb)
- u/l tender LAD 2-4 wks after scratch in axilla/epitrochlear node
- spontaneous resolution, doxy/erythro
parinaud oculoglandular syndrome: 1. bug, 2. presentation
bartonella henselae (cat-scratch ds) u/l conjunctivitis and regional LAD
trench fever aka, bug, vector, presentation, txt
- shinbone fever
- bartonella quintana
- body louse pediculus humanus corporis
- relapsing fever, tender shins, back pain, transient macular eruption
- doxy/erythro
pediculus humanus corporis carries causes what 3 diseases
trench fever (bartonella quintana) epidemic typhus (rickettsiae prowazekii) louse-born relapsing fever (borrelia recurrentis)
rocky mountain spotted fever bug, vector, presentation, txt
- rickettsiae rickettsii
- dermacentor andersoni, dermacentor variabilis
- fever, HA, myalgias –>purpuric or hemorrhagic macules & papules on wrists & ankles –> trunk, hands, feet
- doxy (15-25% mortality w/o txt)
mediterranean spotted fever aka, bug, vector, 2 forms, txt
- boutonneuse fever
- rickettsiae conorii
- brown dog tick rhipicephalus sanguineus
- tache noir = indurated papule at site of tick bite –> necrotic ulcer
- exanthem = erythematous papules over lower limbs
- doxy or chloramphenicol
rickettsialpox bug, vector, presentation, txt
- rickettsiae akari
- mouse mite liponyssoides sanguineus
- papule or vesicle at site of bit –> eschar & LAD –> fever, chills, HA, diffuse vesicular rash
- doxy, chloramphenicol
epidemic typhus bug, vector, reservoir, presentation, txt
- rickettsiae prowazekii
- body louse pediculosis humanus corporis
- flying squirrel
- fever, chills, HA –> pale red macules on trunk –> diffuse petechial papules (spares face, palms, soles)
- vascular inflammation of skin, CNS, heart, kidneys, muscle
- doxy or chloramphenicol
endemic typhus aka, bug, vector, presentation, txt
- murine typhus
- rickettsiae typhi
- rat flea xenopsylla cheopis (no comb)
- fever, HA, myalgias, transient truncal maculopapular exanthem
- doxy, chloramphenicol
scrub typhus bug, vector, presentation, txt
- rickettsiae tsutsugamushi
- chigger mites (trombiculid - larval stage)
- HA, chills, eschar at inoculation w/ LAD –> maculopapular rash on trunk +/- cardiac and pulm ds
- doxy, chloramphenicol
ehrlichiosis, 2 bugs and types, 2 vectors and types, txt
ehrlichiosis chaffeenis - ambyloma americanum = monocytic
e. phagocytophilia - ixodes scapularis & pacificus = granulocytic
tetra or doxy
Q fever bug, presentation, txt
- coxiella burnetii
- no skin findings, limited febrile illness +/- organ involvement
- doxy
lyme disease bug, vector, 3 presentations, dx, txt
- borrelia burgdorferi
- eastern US: ixodes dammini/scapularis; western: ixodes pacificus; europe: ixodes ricinus
- early localized: flu + erythema migrans 1-2 wks post bite, disappears in 4 wks w/o txt
- early disseminate: satellite erythema migrans, bell’s palsy, arthralgias, carditis
- chronic: acrodermatitis chronic atrophicans (loss of subcu fat w/atrophic skin)
- PCR, tissue cx
- doxy or amox x 14-21 days
borrelial lymphocytoma aka, 2 bugs, presentation, txt
- lymphocytoma cutis
- borrelia afzellia, borrelia garinii
- firm bluish-red tumor or plaque on ear lobes of children or areolae of adults
- doxy
louse-borne relapsing fever: 1. bug, 2. vector, 3. presentation, 4. txt
- borrelia recurrentis
- body louse pediculus humanus corporis
- paroxysmal fevers, myalgias, no specific cutaneous findings
- doxy
tick-born relapsing fever: 1. bugs, 2. vector, 3. presentation, 4. txt
- borrelia parkeri & hermsii
- soft ticks ornithodoros
- paroxysmal fevers, no specific cutaneous findings; risk of Jarisch-Herxheimer rxn
- doxy
leptospirosis: 1. aka’s, 2. bug, 3. transmission, 4. presenation, 5. txt
- fort bragg fever, pretibial fever, weil ds
- leptospira interrogans
- direct skin contact w/ animal urine in water
- fever, HA, painful pretibial plaques, conjunctivitis, jaundice, diffuse exanthem
- PCN or macrolide or doxy
yaws: 1. aka, 2. bug, 3. transmission, 4. primary, secondary, tertiary presentation
- frambesia
- treponema pallidum (pertenue)
- direct contact
- primary: erythematous papules at inoculation (“mother yaw) –> enlarges, ulcerates, disappears with scar
secondary: daughter yaws symmetrically over body - tertiary: gummata, keratoderma, midfacial destruction, bony inflammation/damage
pinta: bug, transmission, primary, secondary tertiary presentation
treponema carateum
direct contact
primary: smooth papule at inoculation
secondary: psoriaform yellowish-brown papules & plaques (pintids)
tertiary: depigmented vitiligo-like lesions over face, wrists, trochanteric areas
endemic syphilis: 1. aka, 2. bug, 3. transmission, 4. primary, secondary presentation
- bejel
- treponema pallidum endemicum
- direct skin contact
- primary: skin lesions rare
secondary: mucosal patches, condylomata lata, LAD +/- osteitis, periostitis, bony damage, gummata
chancroid 1. bug, 2. presentation, 3. gram stain findings, 4. txt
- haemophilus ducreyi
- soft painful ulcer w/purulent base & ragged borders, buboes w/ suppuration. no healing w/o txt.
- school of fish pattern
- azithro 1g x 1 or ceftriaxone IM x1 or cipro 500 mg bid x3d
granuloma inguinale: 1. aka, 2. bug, 3. presentation, 4. histo finding, 5. txt
- donovanosis
- klebsiella (calymmatobacterium) granulomatis
- painless subcu nodule –> ulcerates to painful beefy red granulation tissue. does not heal w/o txt
- donovan bodies
- 3 wks with: azithro 1g qwk or bactrim ds bid or cipro 750 mg bid or doxy 100 my bid
lymphogranuloma venereum 1. aka, 2. bug, 3. presentation, 4. txt
- tropical buob
- chlamydia trachomatis L1-L3 serotypes
- stage I w/ papule –> painless ulcer w/ gray base. stage II w/ u/l suppurative bubo & groove sign
- gamma-favre bodies
- 3 wks with: azithro 1g qwk or erythro qid or levo 500mg qd, or doxy 100mg bid
gonorrhea: 1. bug, 2. presentations (4), 3. txt
- neisseria gonorrhoeae
- men: urethritis w/ dysuria and pus
women: urethritis & purulent cervicitis
ascending: salpingitis or PID
disseminated: fever, arthralgias, pustualr hemorrhagic lesions - azithro 1g x1 or ceftriaxone IM x1 or doxy 100 mg bid x 1wk
