L9 Otitis, sinusitis, diptheria, pertussis Flashcards
causes of otitis externa
pseudomonas aeruginosa
staphylococcus aureus
causes of otitis media/sinusitis
streptococcus pneumoniae (50%)
moraxella catarrhalis
haemophilus influenzae
cause of diphtheria
corynebacterium diptheriae
cause of whooping cough/pertussis
bordetella pertussis
signs/symptoms of otitis externa
otalgia
otorrhea
fever
predisposing factors to otitis externa
moisture, insertion of foreign objects, trauma, chronic skin diseases
pseudomonas aeruginosa
G-
encapsulated
pigment producer
pseudomonas aeruginosa produces pigments
pyocyanin: non-fluorescent blue
pyoverdin: fluorescent green
pyocyanin
produced by many pseudomonas stains
generates reactive oxygen species
pyoverdin
produced by all pseudomonas strains
sequesters iron
something that sequesters iron
a siderophore
staphylococcus aureus
G+
Cocci in clusters
Coagulase positive
B hemolytic
bulging tympanic membrane due to pus in middle ear
acute otitis media
streptococcus pneumoniae
G+ lancet shaped diplococci virulent strains are encapsulated alpha-hemolytic sensitive to optochin
beta hemolytic
staphylococcus aureus
alpha hemolytic
streptococcus pneumoniae
pseudomonas cause
otitis externa
staph aureus causes
otitis externa
strep pneumo causes
otitis media/sinusitis
moraxella catarrhalis causes
otitis media/sinusitis
haemophilus influenzae causes
otitis media/sinusitis
haemophilus influenzae
G-
coccobacilli
some nontypeable strains
moraxella catarrhalis
G-
diplococci
oxidase positive
Beta lactamase producer
resistant to beta lactams due to beta lactamase
moraxella catarrhalis
the only diplococci
moraxella catarrhalis
who gets a typmanocentesis to culture/gram stain
restricted pt populations
2 diseases that are diphtheria
cutaneous
diptheria/respiratory
corynebacterium diptheriae
G+
pleomorphic bacilli with palisade shape
metachromatic (volutin) granules
grow aerobically on blood agar
palisades
diptheriae have a V appearance
diptheria toxin is a
phage encoded A-B exotoxin
diptheria toxin binds to
heparin-binding EGF receptor
The A subunit of diptheria toxin, once acidified and released within the vesicle and moving to the cytoplasm
inactivates EF-2 via ADP ribosylation, halting protein synthesis
chronic nonhealing sores or ulcers
cutaneous diphtheria due to nontoxigenic strain
bull neck
severe respiratory diphtheria
pseudomembrane
respiratory diphtheria
respiratory diphtheria colonizes
pharynx
ssudden onset of malaise, exudative pharyngitis, low grade fever, LAD
respiratory diphtheria
pseudomembranes are composed of
fibrin
bacteria
WBCs
necrotic eptihelial cells
systemic toxicity of respiratory diphtheria
myocarditis
demyelination
diphtheria spread
asymptomatic carriers
person-to-person via respiratory droplets or skin contact
developing countries
what can you culture diphtheria on
loeffler’s medium
cystein-tellurite agar
loeffler’s medium
enhances formation of volutin granules in diptheria
cystein-tellurite agar
diptheria grows a distinctive black color due to tellurite reduction, isolates are tested for toxin production
volutin staining of diptheria
metachromatic (volutin) granules
Tests for toxin production in diphtheria
Elek test
PCR
ELISA
Immunochromatographic strip assay
Elek test for diptheria toxin production
immunodiffusion assay to secretion of exotoxin
PCR test for diptheria toxin production
detect tox gene
ELISA test diptheria toxin production
detects the exotoxin
Immunochromatographic strip assay test for diptheria toxin production
detects the exotoxin and is very sensitive
Bordetella pertussis
G- small coccobacilli grows aerobically on enriched agar virulence factors adhesions, exotoxins endotoxin
4 pertuiss exotoxins
Pertussis toxin
Dermonecrotic toxin
Tracheal cytotoxin
Adenylate cyclase toxin
Pertussis toxin
A-B exotoxin that inactivate Giz, causing increased cAMP and respiratory secretions.
inhibits phagocytic killing and monocyte migration
causes lymphocytosis
Dermonecrotic toxin
pertussis: vasoconstriction causes ischemic necrosis
Filamentous hemagglutin
pertussis: facilitates attachment, highly immunogenic
Tracheal cytotoxin
Pertussis:
kills cilated epithelia cells
stimulates IL-1 release
cause of lymphocytosis in pertussis
pertussis toxin
pertussis effects
compromises small airways
pertussis predisposes patients to
cough
atelectasis
cyanosis
pneumonia
catarrhal stage of pertussis
inflammation of mucous membranes, nonspecific URI, 1-2 weeks
when are patients with pertussis highly contagious
catarrhal stage
paroxysmal stage of pertussis
attacks/spasms, up to 50/day
coughing followed by vomiting, “whoop”
lasts for weeks
during the paroxysmal stage of pertussis
GI complications can occur due to vomiting and increased pressure
serious complications of pertussis
pneumonia
encephalopathy
seizures
death
pertussis occurs in
humans only
how to presumptively diagnose pertussis
Serology: ELISA detects Igs to pertussis toxins or adhesions
4x increase
how to definitively diagnose pertussis
culture sample on enriched medium
PCR
enriched mediums for pertussis
Bordet Gengou agar
Regan Lowe agar
pertussis labs
lymphocytosis
Adenylate cyclase toxin
pertussis: similar to pertussis toxin, decreases chemotoxis
encapsulated
staph aureus pseudomonas strep pneumo (virulent strains)
optochin sensitive
strep pneumo
coagulase positive
s aureus
oxidase
morexella
lancet shaped
strep pneumo