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Microbiology > Infections - Skin, Ocular, Respiratory, Sterile Body Sites > Flashcards

Infections - Skin, Ocular, Respiratory, Sterile Body Sites Flashcards

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1
Q

Normal flora of skin

A
  • Diphtheroids
  • S. epidermidis
  • Other coag neg staph
  • Propionibacterium (Cutibacterium) acnes
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2
Q

Folliculitis

A

Minor hair follicle infection

Papules or pustules pierced by a hair with redness

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3
Q

Furuncle (boil)

A

Abscess that started off as a red nodule with a hair follicle

Painful, full of pus

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4
Q

Carbuncle

A

Furuncle that spreads into deep dermis and subcutaneous tissue

Usually have multiple sites

Drain to skin surface (sinuses)

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5
Q

Macule

A

Flat, discoloration of skin

Dermatophytes, T. pallidum, Enteroviruses

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6
Q

Papule

A

Elevated, solid lesion (<5 mm diameter)

HPV, pox virus, scabies, S. aureus, P. aeruginosa

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7
Q

Nodule

A

Raised, solid lesion (>5 mm diameter)

Corynebacterium diphtheriae, Sporothrix schenckii (Rose Gardener’s Disease), fungi, Mycobacterium marinum (fish), Nocardia sp.

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8
Q

Rose Gardener’s Disease

A

Sporothrix schenckii

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9
Q

Pustule

A

Raised, pus filled lesion with leukocytes and fluid

Candida sp., dermatophytes, HSV, N. gonorrhoeae, S. aureus, GAS, varicella-zoster virus

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10
Q

Vesicle

A

Raised, fluid filled (blister-like) lesions (<5 mm diameter)

Varicella-zoster virus

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11
Q

Bulla

A

Raised, fluid filled lesions (>5 mm diameter)

Clostridium (gas gangrene), HSV, G(-) rods, S. aureus, vibrios

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12
Q

Scales

A

Dry, horny, platelike lesions

Dermatophytes

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13
Q

Ulcer

A

Lesion with loss of epidermis and dermis

B. anthracis, bowel flora, Haemophilus ducreyi, T. pallidum

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14
Q

ErySIPELAS

A

Painful, red, swollen lesions

Fever

Regional lymphadenopathy

GAS, Group B, C, G strep sometimes

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15
Q

Cellulitis

A

Infection spreading to deep layers of the dermis

GAS, S. aureus

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16
Q

Impetigo

A

Erythematous lesions

GAS (nonbullous)
S. aureus (bullous)

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17
Q

Dermatophytosis

A

Fungal infection

Ringworm

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18
Q

EryTHRASMA

A

Chronic infection of keratinized layer of epidermis

Corynebacterium minutissimum

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19
Q

ErySIPELOID

A

Purplish lesion with irregular, raised border

Erysipelothrix rhusiopathiae

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20
Q

Necrotizing fasciitis caused by

A

GAS
S. aureus

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21
Q

Bacterial synergistic gangrene caused by

A

Microaerophilic strep
S. aureus

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22
Q

Myositis

A

Inflammation of muscle

S. aureus - hematogenous spread (gets into blood)

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23
Q

Most common postoperative infection agent

A

S. aureus

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24
Q

Animal bite agents

A

Pasteurella
Fusobacterium

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25
Q

Burn agents & why are burns bad?

A

S. aureus
P. aeruginosa
Enterococci
Enterobacter
E. coli

Skin is unable to protect

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26
Q

Diabetes patients

A

Foot infection

Agents: S. aureus, GAS, Enteric/E. coli, anaerobes

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27
Q

Collection for:
- Erysipelas & cellulitis
- Vesicles
- Bullous lesions
- Wound infections

A
  • Erysipelas & cellulitis - clinical observation mainly but can culture swab of lesions
  • Vesicles - swab and culture
  • Bullous lesions - blood culture
  • Wound infections - anaerobic conditions
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28
Q

Normal eye flora

A

S. epi
S. aureus
Lactobacillus
Propionibacterium (Cutibacterium) acnes
H. influenzae

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29
Q

Blepharitis

A

Inflammation of eyelids/glands near eyelids
- Stye/cyst
- Bacteria: S. aureus
- Parasite: Phthirus pubis (louse on eyelashes)
- Viruses: HSV

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30
Q

Conjunctivitis

A

Inflammation of conjunctiva
- Pink eye
- Allergies/infection
- S. pneumo, S. pyogenes (GAS), S. aureus, Haemophilus, Chlamydia trachomatis, N. gonorrhoeae, Moraxella sp
- Viruses: Adenoviruses, HSV, VZV

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31
Q

Keratitis

A

Inflammation of cornea (can cause ulcers and lead to blindness)
- Reduced vision, sudden pain, sensitivity to light, excessive tearing/discharge
- Non-infectious: from contact lenses
- Infectious: from bacteria, viruses, fungi, parasites
- Bacteria: S. aureus, S. pneumo, P. aeruginosa (cause green in eye), Moraxella, Bacillus
- Viruses: Adenoviruses, HSV, VZV

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32
Q

Chorioretinitis & uveitis

A

Inflammation of retina and choroid/uvea
- Blurred vision, pink eye, light sensitivity, continuous tearing
- Candida, Toxoplasma, Toxocara (roundworm), M. tuberculosis, T. pallidum, B. burgdoriferi
- Viruses: Cytomegalovirus (CMV), HSV

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33
Q

Endophthalmitis

A

Infection of aqueous or vitreous humor (liquid in the eye)
- usually after surgery or trauma, can lead to blindness
- Bacterial or fungal

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34
Q

Lacrimal infections and canaliculitis

A

Inflammation of lacrimal canals
- Actinomyces, Propionibacterium

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35
Q

Dacryocystitis

A

Inflammation of lacrimal sac (near tear duct)
- S. pneumo, S. aureus, S. pyogenes, H. influenzae
- Fungi: Candida albicans, Aspergillus sp

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36
Q

DacryoADENITIS

A

Inflammation of lacrimal gland (outer eyelid, near brow)
- Viruses (most common): mumps, EBV, VZV
- Bacteria: S. pneumo, S. aureus, S. pyogenes, T. pallidum, C. trachomatis

37
Q

Tzanck smear

A

HSV
- multinucleated epithelial cells

For eye gram stain

38
Q

Normal ear flora

A

Normal flora of external ear canal is sparse

Pneumococci
Propionibacterium (Cutibacterium) acnes
S. aureus
Enterobacteriaceae
P. aeruginosa
Candida sp

39
Q

Otitis Externa

A

Acute:
S. aureus
S. pyogenes
P. aeruginosa
Other G(-) rods

Chronic:
P. aeruginosa
Anaerobes

40
Q

Otitis media

A

Middle ear infection

Mastoiditis - infection of bone
- Acute: S. pneumo, H. influenzae, Moraxella catarrhalis, S. pyogenes, influenza virus
- Chronic: anaerobes

41
Q

Laryngitis

A

Inflammation of larynx (vocal cords)
- Symptoms: hoarseness/weak/loss of voice, tickling sensation, rawness
- Cause: overuse or irritation (yelling, smoking, viral or bacterial infection)
- Treatment: supportive care (biopsy in chronic case)

42
Q

Epiglottis

A

Above vocal cords
Cause swelling/blockage of trachea —> can be life threatening
- Symptoms: fever, severe sore throat, difficulty swallowing and breathing
- H. influenzae, pneumococcus, Group A, B, C strep
- Culture is not recommended

43
Q

Parotitis

A

Inflammation of salivary glands under cheeks
- Symptoms: swelling of tissues, dry mouth, strange taste, mouth or facial pain, fever, chills
- Sjogren’s syndrome (autoimmune)
- Bacteria: S. aureus, strep, Haemophilus
- Viruses: Mumps, parainfluenza, influenza, CMV, EBV, HIV

44
Q

Rhinitis (common cold)

A

Viral infection of URT
- Symptoms: sore throat, cough, watery eyes, sneezing, congestion, low grade fever, mild fatigue
- Associated with rhinovirus
- Higher risk in preschool children
- No treatment necessary unless fever, etc.

45
Q

Pharyngitis - Tonsillitis

A

Infection of pharynx —> sore throat
- Symptoms: tonsil abscesses, upper airway obstruction, can become systemic (rheumatic fever, acute glomerulonephritis)
- Can be caused by viruses in colder months
- Bacteria: S. pyogenes (primary), Group C and G strep, Arcanobacterium haemolyticum (in adolescents)

46
Q

Diphtheriae

A
  • Symptoms: febrile/fever, sore throat, malaise
  • Pseudomembranous membrane - main sign of diphtheria, exudate or gray-white membrane forms on tonsils
  • Corynebacterium diphtheriae
  • Throat swab. SBA, CTBA, TIN, Loeffler slant, Elek test. Incubate 35°C in O2 or 5-10% CO2 for 48 hrs
47
Q

Whooping cough

A
  • Bordetella pertussis
  • Symptoms: dry cough, fever, runny nose, paroxysmal (violent) cough
  • Nasopharyngeal swab (incubate directly at patient’s bedside), culture must contain charcoal because fastidious. Incubate 35°C O2
48
Q

Vincent’s angina

A
  • Fusobacterium
  • Trench mouth: acute necrotizing ulcerative gingivitis
49
Q

Sinusitis

A

Acute: postnasal discharge, pressure over sinus area. H. influenzae, S. pneumo, S. pyogenes, Moraxella cat

Chronic: inadequate drainage, impaired mucociliary clearance, mucosal damage

50
Q

Stomatitis

A

Inflammation of oral cavity mucous membranes
Canker sores (non contagious) and cold sores (HSV)

51
Q

Thrush

A

White patches on exudate on cheek, mucosa, tongue, or oropharynx

Candida sp.

52
Q

Periodontal infections

A

Root canal and orofacial odontogenic: anaerobes, streptococci

Perimandibular space: staph, Eikenella corrodens

53
Q

Neck Infections

A

Caused by oral flora - anaerobes, Viridans strep

54
Q

How to collect for URT infections

A

Calcium alginate swab is best for cultures
- Do not use cotton swabs for Neisseria or Bordetella
- Dacron or rayon are best for PCR
- Keep swabs moist for 4 hours, except GAS can stay dry

55
Q

Throat swabs (URT)

A

GAS
Corynebacterium diphtheriae
Mycoplasma
Chlamydia
Candida

56
Q

Nasopharyngeal swabs (URT)

A

Bordetella, Neisseria

57
Q

Bronchitis (LRT)

A

Inflammation of tracheobronchial tree

58
Q

Bronchiolitis (LRT)

A

Inflammation of smaller diameter bronchiolar surfaces (causes obstruction from swelling)

59
Q

Pleural Infection (LRT)

A

Organisms infect lungs and go into pleural spaces (covering of lungs)

Empyema - pus in body cavity

Pleurisy - inflammation of pleura

60
Q

Typical/acute pnuemonia & community-acquired pneumonia in adults

A

S. pneumoniae

Think “S” for senior

61
Q

Atypical pneumonia & community-acquired pneumonia in young adults (under 30 yo)

A

Mycoplasma pneumoniae

Think “M” as in me

62
Q

Community acquired pneumonia in children under 5

A

Viruses: RSV, parainfluenza, influenza
Bacteria: S. aureus, S. pneumoniae, M. pneumoniae, C. pneumoniae, H. influenzae

63
Q

Hospital-Acquired Pneumonia

A

Increased risk in intubated patients

P. aeruginosa, Enterobacter, Klebsiella, S. aureus (MRSA emerging), Acinetobacter, S. pneumo, anaerobes, Legionella, H. influenzae

64
Q

Most likely cause of chronic LRT infections

A

M. tuberculosis

65
Q

Patients with AIDS have a high risk for

A

Pneumocystis jirovecii

66
Q

Specimen collection of LRT

A

Bronchial brush
Other invasive techniques

67
Q

What defines a good gram stain for LRT?

A

<25 WBC
Little or no squamous cells

68
Q

Transudate vs Exudate Pleural Fluid Effusion

A

Transudate - without inflammation, fluid leaks out from tissue. High fluidity, low protein/solid material content

Exudate - with inflammation, fluid escapes from blood vessels and goes to tissues. High protein/cellular debris due to inflammation. Everything is increased in Exudate, may clot

69
Q

Pleural Fluid

A

Lines thoracic cavity, lubricates the pleura

70
Q

Peritoneal Fluid

A

Lines abdomen

71
Q

Ascites

A

Accumulation of fluid in peritoneal cavity

72
Q

Peritonitis

A

Inflammation of peritoneal membrane

Primary: Infection spread from blood and lymph nodes
Secondary: trauma, surgery, perforated organ, obstruction

73
Q

Peritoneal Dialysis Fluid

A

During end stage of renal disease

Fluid injected into peritoneal cavity to allow salt and water exchange and remove waste products (that is typically done by the kidneys)

74
Q

Pericardial Fluid

A

Around the heart, typically caused by viruses

75
Q

Myocarditis

A

Inflammation of heart muscle

  • Coxsackie virus, Echovirus, Adenovirus
76
Q

Joint (Synovial) Fluid

A

Arthritis - inflammation of joint space

Hematogenous spread, infection from bone, injection/insertion of material (like hip replacement)

77
Q

Septic arthritis caused by

A

S. aureus (most common)
N. gonorrhoeae (young adults)
H. influenzae (young children)
Strep
anaerobic bacteria (Bacteroides)

78
Q

Osteomyelitis

A

Infection of bone

Children: affects long bones (legs and arms)
Adults: spine

Result of hematogenous spread, invasion of bone, trauma/surgery, poor circulation (diabetes)

79
Q

Collection of Solid Tissue

A

Sterile container, mince specimen

80
Q

Meninges layers

A

Dura mater (outer)
Arachnoid
Pia mater (inner)

Meninges is the inner CNS covering

81
Q

CNS consists of

A

Brain and spinal cord

82
Q

What are the two coverings of CNS?

A

Meninges (inner)
Bone (outer)

83
Q

Cerebrospinal fluid

A

Surrounds brain and spinal cord (CNS)

In subarachnoid space

Cushions brain from injury, removes waste, carries metabolites

84
Q

Meningitis

A

Infection of subarachnoid space (between brain and skull)

2 categories: Purulent (many PMNs) vs Aseptic (viral, many lymphocytes)

S. pneumoniae, N. meningitidis, H. influenzae, Listeria monocytogenes, E. coli, GBS

85
Q

Most common bacterial meningitis in adults

A

S. pneumoniae

86
Q

Why can neonates get Acute Meningitis?

A
  • Immature immune system
  • Increased blood-brain barrier permeability
  • Bacteria in vaginal tract

Most common pathogens: GBS, E. coli, Listeria monocytogenes

87
Q

Encephalitis and Meningoencephalitis

A

Encephalitis - inflammation of brain parenchyma, accompanied with Meningoencephalitis

Viral (Enteroviruses, mumps, HSV, arboviruses)

88
Q

Glucose and cell count will be ___ in Acute Bacterial Meningitis

A

Glucose reduced
Cell count increased (lymphocytes increased)

89
Q

How can you tell if there is a contaminant vs pathogen in a blood culture?

A

Contaminant: multiple organisms, clinical presentation not consistent with sepsis, organisms from primary site are not the same as organisms in blood culture.
- Bacillus, Corynebacterium, Propionibacterium acnes, coagulase negative Staph grow

Pathogen: same organisms grown in repeated cultures, suspected pathogens grow, certain organisms like GAS grow, commensal flora is isolated from patients with suspected bacteremia

Microbiology (9 decks)

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