L45

Question 1

Are all anaerobes pathogenic?

Answer 1

No for endogenous strains - normal flora
- @ mouth & colon
Ex: probiotics

Question 2

Which anaerobic bacteria is exogenous and most likely to cause disease in humans?

Answer 2

Clostridium:

• tetani
• botulinum
• perfringens
• difficile

Question 3

Why don’t you see strict anaerobic infections in healthy tissue?

Answer 3

Healthy tissue has O2 requirement too high for strict anaerobic growth
1st injury tissue –> obligate anaerobic infection

Question 4

Which are important clinical symptoms of anaerobic infection?

Answer 4

Smell bad!!
Sulfur granules in discharge
Must ask for anaerobic culture to see morphology

Question 5

Diagnose anaerobic infections.

Answer 5

Slow growing

Sterile collection - NO normal flora in specimens

Question 6

What are the 4 big anaerobic GP rods non-spore forming bacteria?

Answer 6

Actinomyces
Lactobacillus
Propionibacterium
Mobiluncus

Question 7

Where do you find actinomyces?

Answer 7

Mouth
GI
Female GU

Question 8

What is the disease caused by actinomyces? Symptoms & signs.

Answer 8

Actinomycosis
- Disruption of mucosal barrier (normal flora)
- Multiple possible sites
Chronic & relapsing infections
Do through planes - abscess and draining sinuses
Sulfur granules
Mistaken for tumor

Question 9

What disease may result from lactobacillus infection?

Answer 9

Nothing in healthy people!
Sepsis - immune compromised pts
Endocarditis - underlying disease (prior Rheumatic disease)

Question 10

Where do you normally find mobiluncus? How does this clue you into its disease association?

Answer 10

Vaginal tract –> bacterial vaginosis

Question 11

Which cells are unique to mobiluncus pathology?

Answer 11

Clue cells = epithelial cells that’s borders are obscured by bacteria
“Blurred edges”

Question 12

How do you treat actinomyces?

Answer 12

Penicillin

Question 13

How do you treat lactobacilli?

Answer 13

Penicillin +/- genta

Resistant to vanco

Question 14

How do you treat mobiluncus?

Answer 14

Metronidazole

Weird b/c technically resistant but YOLO

Question 15

Which anaerobic GN rod should you be aware of? Where is it a normal colonizer?

Answer 15

Bacteroides fragillis

Normal @ colon

Question 16

Virulence factors B.fragilis?

Answer 16

Capsule

LPS

Question 17

Disease caused by B.fragilis

Answer 17

Abscess!!!

• Intra-ab
• Surg wounds

Question 18

Drugs for B.fragilis

Answer 18

Metronidazole + combo

Resistant to penicillin

Question 19

What is a clinical sign of an anaerobic infection?

Answer 19

Subq emphysema = air under skin

Question 20

Fusobacterium - gram stain, shape, normal colonization

Answer 20

GN
Rod
Normal @ mouth, GI, GU

Question 21

4 iInfections caused by fusobacterium

Answer 21

Abscesses
Mouth infections:
- Trench mouth = necrotizing ulcerative gingivitis
- Pharyngitis
- Tonsillitis
- Lemierre’s syndrome = jugular venous thrombophleitis

Question 22

Describe Lemierre’s syndrome.

Answer 22

Pharyngitis
Peritonsillar abscess
Bacteria through pharyngeal spaces 
Thrombophlebitis of IJ 
R heart
Clot embolize to lungs