lets diagnose! Flashcards
pimples, furuncles, carbuncles, sty, pus formation
established in hair follicle leading to tissue necrosis
occur as a result of wounds
no vaccine, treated with topical ointment
folliculitis
staphylococcus areus
mainly in warm summer months
children
flattened red patches that develop into oozing pus filled vesicles that break open (honey colored & pus filled)
very contagious, person-to-person, via fomites, through cuts
can be fatal with out treatment
impetigo
staphylococcus areus (mainly) streptococcus pyogenes
toxin based diagnosis
staph in 1 location despite systemic affect
menstrating women (tampon) wound infection
fatigue, confusion, red rash, aches & pain, low BP
some fatal without treatment
S areus in elevated O2 levels and neutral BP
toxic shock syndrome
staph areus + toxic shock syndrome toxin
infants and children < 5, immunocompromised
normal flora or direct contact
red wrinkling skin near mouth, large blisters filled with fluid, skin sloughs off after 2 days
NO scarring
IV antibiotics, resolve after 7-10 days, low mortality but possible with secondary infection
Scalded Skin Syndrome (SSSS)
Staphylococcus aureus + exfoliative toxin
through normal flora
thrive on sebum
which triggers inflammation & pus formation
potential scarring
blackheads, cystic acne
Acne
Propionibacterium acnes
lack of / incomplete vaccination history
mainly children
maculopapular rash, koplik spots, fever, runny nose, cough, conjunctivitis
Measles (rubeola)
measles virus (paramyxovirus)
children < 10
respiratory secretions or direct contact
vaccination = varivax
exanthematous rash, vesicular rash that progresses ti scabbed lesions, intense itchiness, fever, chills, headache
chicken pox
varicella-zoster virus
adults > 45
respiratory secretions or direct contact
vesicular skin eruption along dermatome, pain, itchiness, numb / buring
shingles
varicella-zoster virus
pustular rash disease - zoonosis (sheep, goat, cattle)
most common, rarely fatal
causes necrotic ulcer (eschar)
develops 1-12 days after exposure
contact with endospores (cannot get person-to-person)
cutaneous anthrax
bacillus anthracis
staphylococcus aureus
streptococcus pyogenes
caused by fast spreading infection in the dermis and subcutaneous tissue
pain, tenderness, swelling, fever, lypph node inflammation
oral antibiotics
cellulitis
anaerobic and aerobic bacteria (mixed infection)
gram positive cocci & gram negative rods
common after surgery in patients with comorbities / wounds
rare, rapid spreading soft tissue infection, destroys the fascia and surrounding tissues
Necrotizing fasciitis type 1
e. coli
staph aureus
clostridium
monomicrobial infection
infect healthy patients
route of entry follows trauma, surgery, IV drug use
destroys the fascia and surrounding tissues
Necrotizing fasciitis type 2
streptococcus pyogenes
gram negative
endospore forming
Obligate anaerobe
Transmission = ubiquitous (through soil)
Abrupt onset following trauma in young men after injection of drug use or in elderly patients with diabetes- transmission via soil
Wound pain (watery) marked swelling, mental confusion, tachycardia, fever, skin legions (brown) Bullae filled with blue fluid- anaerobe
Crepitus - gas within the tissue (late stages)
Gas gangrene (clostridial myonecrosis)
Clostridium perfringens
mainly children
direct contact, extremely contagious
organisms get into conjunctiva, induces inflammation
otitis media?
Inflammation
Redness
Mucopurulent discharge
Possible keratitis - inflammation of the cornea
Bacterial Conjunctivitis (Pink Eye)
Streptococcus species
children, leading cause of traumatic blindness in humans
contact with fomites or fingers; during birth
pathogen triggers purulent discharge that scars conjuctiva
Eyelashes turn inward
Eyelashes abrade
irritate, & scar cornea = blindness
trachoma
chlamydia trachomatis
Anyone (school aged children)
Sore throat; more painful & longer to resolve (than viral)
White patches on the back of the throat and tonsils (pus exudate)
Little/no cough
Headache
Fever
normal flora/ respiratory droplets
M Proteins
Rapid Antigen Test (possibly B-hemolytic gram positive cocci in chains)
Antibiotics (penicillin)
bacterial pharyngitis
streptococcus pyogenes group A
Follows local Streptococcus pyogenes infection (bacterial pharyngitis)
Rash on trunk after 24 hrs., spread to extremities (focal infection)
Death can occur because of high fever
Usually resolves in 1-2 weeks
Scarlet Fever (toxemia)
Streptococcus pyogenes
Follows local Streptococcus pyogenes infection (bacterial pharyngitis)
Most serious
Fever Malaise Joint pain Evidence if inflammation of all parts of the heart Development of scar tissue May lead to heart failure
Rheumatic Fever
Streptococcus pyogenes
commonly affects children
Spreads from normal flora in the oropharynx to the sinus or middle ear
Inflammation, pain, pressure in ear
Treat with broad spectrum antibiotics
otitis media
streptococcus pneumoniae
Moraxella catarrhalis
virus replicates killing cells, infected cells loss of ciliary activity and fall off, triggering inflammation and stimulating mucus production
Common in fall and spring
spread by respiratory droplets or contact with fomites
Sneezing, and congestion
prevent with hand antisepsis and disinfection
common cold
rhinoviruses
Diphtheria toxin secreted
Mainly in unvaccinated children
Transmission → droplet contact
Sore throat, localized pain, fever, PSEUDOMEMBRANE in back of throat
pseudomembrane can occulate respiratory passages = death
diphtheria
corynebacterium diphtheriae
Pertussis toxin
Found primarily in children
High contagious and spread through the air via respiratory droplets
Fever, sneezing, violent coughing “whooping” upon inhalation, rib fractures, Mild dry persistent cough, cyanosis
vaccine
whooping cough
bordetella pertussis
Contact with rodents / rodent feces
Muscle ache
Hemorrhaging
Renal failure
High fever, headache, myalgia, pulmonary edema leading to severe respiratory compromise
Hantavirus pulmonary syndrome
hanta virus
Fever, chills, sore throat, nausea/vomiting
Body aches
Extreme fatigue
Mention of vaccine history (of lack of)
Seasonal
“Outbreak”
Anyone, elderly & very young
influenza
Influenza A Virus (orthomyxovirus)
Smokers, elderly, patients with chronic respiratory disease, immunocompromised
summer, early fall
Found in freshwater protozoa, humans inhale mist- water gone bad
2-10 day incubation period followed by systemic signs of acute pneumonia
outbreak-environmental source
Pontiac fever
Legionnaires’ disease
Legionella pneumophila
Mycolic acid (waxy lipid)
Chest X-ray → granuloma / tubercle, dense localized consolidation
Weight loss Extreme fatigue Shortness of breath Extreme cough Bloody sputum Acid fast bacilli (sputum test) ****
Immunocompromised
Tuberculosis
Mycobacterium tuberculosis
fever chills congestion cough chest pain rust-colored sputum community acquired
Lobar Pneumonia
streptococcus pneumoniae
coughing fever chest pain thick bloody sputum recurrent chills
Nosocomial Pneumonia
streptococcus pneumoniae
world wide, Mainly in CA, UT, AZ, NV, NM, CO
flea bite
(most common) travel to lymph nodes; break into blood
stream
Bubose (tense, tender swollen lymph node)
Fever, chills, malaise
Muscle pain
Severe headache
Treatment → antibiotics
Untreated = 50% mortality
Bubonic plague
yersinia pestis
world wide, Mainly in CA, UT, AZ, NV, NM, CO
untreated bubonic or via respiratory droplets (aerosols)
Fever, malaise
Severe cough with blody frothy sputum
Chest pain
Hard to breathe
Treatment → antibiotics
Untreated = fatal
pneumonic plague
yersinia pestis
world wide, Mainly in CA, UT, AZ, NV, NM, CO
flea bite
spread from lungs to persist in blood, disseminated
Hypotension
Shock
Necrotic skin plaques - cause gangrene (black of black death)
Treatment → antibiotics
Untreated = fatal
Septicemic plague
yersinia pestis
Arises from normal flora
Dark stains on teeth - plaque → brush teeth
Sensitivity in teeth - caries → filling teeth with amalgam or resin
Dental bacterial diseases
Streptococcus mutans
Aries from normal flora
Endotoxins and acid trigger inflammation breaking down epithelial cells
gum inflammation bleeding at touch tooth loss gingivitis acute necrotizing ulcerative gingivitis (severe)
Periodontal disease
poryphoromonas gingivalis
Protein inhibits acid production, urease
Risk factors → 50% of ppl globally Overuse of anti-inflammatory meds (aspirin) Alcohol consumption Smoking
likey fecal-oral (unclear)
Attach to gastric epithelial cells
Mucus thins epithelia exposed to acid destroying it and underlying tissue
Abdominal pain Nausea Vomiting Weight loss Bloody stool
detection of urease in stomach biopsy
antimicrobial drugs & acid production inhibitors
gastric ulcers
Helicobacter pylori
preformed toxins
Heat stable enterotoxins → inflame tissue stimulate vomit center of brain
Food improperly prepared or stored, causing contamination and toxin production
Creamy food, high in salt and sugar
INTOXICATION
More common in warm months
Start 1-6 hours after eating
Recover in about 8 hours
bacterial food poisoning
Staphylococcus aureus
preformed toxins
spore-forming
Enterotoxins released during germination under anaerobic conditions
Food improperly prepared or stored, causing contamination and toxin production
Meat dishes, gravy, cooked and cooled slowly with no refrigeration
Watery diarrhea, severe cramping
Begins 12-24 hours after ingestion
Lasts over than 24 hours
bacterial food poisoning
Clostridium perfringens
> or equal to 3 loose stools in a 24-hour period
Ingestion of contaminated food
Self limiting; no treatment required
acute diarrhea
Salmonella
inflammation of the intestine
INFECTION (not intoxication)
Bacterial enteritis
E. coli
Colonize intestinal epithelium produce Cholera toxin
Found globally (Africa and South America) Drinking fecally contaminated water
Severe fluid & electrolyte loss
Massive diarrhea
Rice water stool (shred intestinal mucosa)
Cholera: bacterial enteritis
vibrio cholera
Form protective cyst (stable for months)
Attach via ventral adhesive disk
Interfere with food absorption by host (maximizing available nutrients)
Found in every stream in the rocky mountains
greasy, frothy, fatty diarrhea. foul smelling stool (rotten eggs), low grade fever, nausea, loss of appetite
Most common water born GI disease
giardiasis (beaver fever)
giardia spp
fecally-contaminated food
@ small intestine → diarrhea
@ large intestine (week later) → fever, cramping, diarrhea, dysentery (bloody)
Shigellosis- bacillary dysentery
shigella spp
Enterotoxin A and B
Most common in patients that have been given broad-spectrum antibiotics
Pseudomembranous colitis
Severe diarrhea
avoid contact with spores and broad spectrum antibiotic
Antibiotic-associated colitis
Clostridium difficile
Anyone, normal flora of poultry and other birds and reptiles
Colonize intestine disrupting microvilli
Acid tolerance protein
Consuming contaminated food, ingestion of raw eggs
Diarrhea
Vomiting
Fever (can be severe)
Traces of blood
Self-limiting, supportive care
Salmonellosis
Salmonella enterica serovars
Bacteria phagocytized (not degraded) go to liver slpeen bone marrow and gallbladder
Consuming contaminated water
Fever Headache Muscle pains Malaise Loss of appetite Diarrhea Perforated intestine (if repeated gastroenteritis), can leading peritonitis and death
typhoid fever
Salmonella enterica serovars
self limiting
acute infection of liver
most common
fecal-oral via contaminated food and water
Person-to-person transmission is possible
jaundice followed by fatigue and malaise → result of host response
clay-colored stool
particularly in children
Viral Hepatitis A
Hepatitis A
self limiting
acute infection of liver
via blood or blood products (sharing IV needle/ sexual)
jaundice, dark urine, anorexia, fatigue, nausea, body aches
Viral Hepatitis B
Hepatitis B
chronic infection of liver
leading cause of liver transplantation
parenterally, predominantly by injection drug use
acquire in utero and via sexual transmission
Fatigue Malaise Anorexia RUQ pain low grade fever lasting 2-10 days jaundice ensues and may last several weeks
Viral Hepatitis C
Hepatitis C
Form cysts
Carried in 10% of world population, kills 100,000 ppl per year
Ingestion of cysts released from feces → trophozoites released in the small intestine and migrate to large intestine
Avoid contaminated food (undercooked)
dysentery Invasive severe diarrhea Colitis Appendicitis ulceration of intestinal mucosa bloody mucus-containing stools pain)
Invasive extraintestinal
necrotic lesions in liver, lungs, spleen, kidneys, and brain
Amoebic dysentery
Entamoeba histolytica
gram negative rod
Occur primarily in women
Inflammation of urethra
spreads to either…bladder (cystitis), Prostate (prostatitis), Kidneys (pyelonephritis)
Slight fever
Frequent, urgent, painful urination = dysuria
UTI
e. coli
(diplococci, fimbriae)
Second most common STI
Sexually transmitted or can be a neonatal infection
Men Urethritis Painful urination Yellowish discharge Can spread causing infertility Diagnosis = Gram negative diplococci in pus
Women
50% asymptomatic
Both urinary & genital tracts infected
Mucopurbulent discharge
Painful urination
Can lead to PID (scar tissue in fallopian tube, ectopic pregnancies, infertility)
Treatment → resistance is common, antibiotics, no vaccine
Gonorrhea
Neisseria gonorrhoeae
sex workers, homosexual men, illegal drug users, poses a world-wide problem
Spirochete
No vaccine
Transmitted person-to-person by chancre sore
Primary = chancre
Secondary = disseminated persistent rash
Tertiary = dementia, blindness, paralysis, gummas, heart failure, neurosyphilis
Syphillis
Treponema pallidum
Most common STI in US
Humans only, women younger than 20 more likely
Intracellular growth, provoking intense inflammation
Gram Negative
sexual or through infected mothers
Most asymptomatic
Men Urethritis Dysuria Pus discharge Epididymitis Orchitis
Women Cervicitis Discharge Salpingitis (inflamed fallopian tubes) PID (painful or asymptomatic)
Diagnosis → PCR or ELISA (serology not reliable)
antibiotics (reinfection frequent all partners need to be tested), no vaccine
Chlamydia
Chlamydia trachomastis
Sore around the mouth (cold sore)
Reoccurrence
Itchiness prior to lesion eruption
Oral Herpes
Herpes Simplex Virus 1
vesicles/sores/lesions in genital area Painful itchy NOT open Multiple sexual partners Unprotected sex Never cured; no direct treatment May mention latency
Genital Herpes
Herpes Simplex Virus 2
Aquired by 50% of sexually active people
High previlance world wide
Enters body through small cuts in the skin or mucosalmembranes
Anogenital warts → primarilly sexually transmitted
Infection benign in most cases, present as warts (verruca)
verrucous, cauliflower-like excrescences of anogenital skin
may be numerous and become confluent -immunocompromised
those with cervical carcinoma may present with pain or bleeding during intercourse
ONLY ONE WITH A VACCINE
Genital warts
Human papillomaviruses (HPV)
gram negative diplococci
massive amounts of endotoxin; capsule (a, b, c, y)
Colonizes nasopharynx, spread to blood, then meneges → inflammatory swelling occurs
Fever Shock Cyanosis Petechial rash Purpura fulinans
CSF culture following spinal tap
Antibiotics
High number of neutrophils Protein levels in CSF are high Low glucose rigidity viral- normal glucose and wbc count inflammation of the meninges, high fever, increased WBC in the CSF
poor unless caught early, death in 24-48 hours following onset of symptoms
bacterial meningitis
Neisseria meningitidis
Form endospores, obligate anaerobe
Gram positive rod- botulinum toxin
Anyone, infants most common younger than 1 year
Severity depends on the amount of toxin in the blood
Foodborne
eating improperly canned non-acidic food contaminated with preformed toxin
Intoxication
Weak and dizzy 1-2 days after eating Blurred vision fixed dilated pupils Dry mouth Constipation Abdominal pain NO FEVER
Infant = eating honey
Nonspecific (constipation, weak cry)
Progress to flaccid paralysis and respiratory arrest
Floppy baby syndrome
Botulism
clostridium botulinum
Deep wound / through umbilical cord
Spastic paralysis Lock jaw Pupils WON'T dilate Unclear vaccination history Fever Anaerobic environment (devitalized tissue) Endospores
Tetanus
Clostridium tetani
zoonotic disease, dog major reservoir wild animal bites or scratches, or mucosal exposure to infected tissue (CNS) or fluids (saliva)
Prodromal vomiting Diarrhea Fever Malaise Muscle pain Sore throat Possible paresthesia Pain Pruritus at infection site
Furious Hyperexcitability Agitation Delirium Periods of unconsciousness Bouts of phobias Inspiratory spasms Signs of autonomic dysfunction (hypersalivation) Death in 7 days
Paralytic Vague early symptoms Longer course Limb weakness Ascending paralysis Respiratory paralysis
rabies
rabies virus
Most common cause of encephalitis
Acquired by mosquito or tick bite
Summer & early fall
Birds and small mammals are intermediate hosts
Viruses reaches CNS through blood from site of inoculation
More serious in children, elderly, and immunocompromised
arboviral encephalitis (general)
arboviruses
Caused by arthropod-borne viruses
bite of tsete fly
cyclical wave of parasites ever 7-10 days due to antigenic variation
Inflammation at bite site Week long fever Shortness of breath Cardiac pain Distrubed vision Anemia Increasing weakness Headache Tremors Uncoordinated gate Pain, stiffness of neck Paralysis Patient cant eat becoming emaciated, convulses, constantly sleeping, goes into a coma, dies
Acute = death occurs rapidly Chronic = symptoms are drawn out
african sleeping sickness
Trypansomiasis brucei
blood infection
Septic shock Low blood pressure Decrease in body temperature No urine Rapid breathing Blood-clotting Increased heart-rate Anxiety Death Petechiae & osteomyelitis Lymphangitis (long red rash)
Diagnosis → confirmed by blood culture
Prognosis → depend on causative agent and how rapid treatment is
bacterial septicemia
Pseudomonas aeruginosa
Bacterial infection of endothelial surfaces of the inner lining (endocardium) of the heart chambers and valves leading to formation of vegetations (these make it hard for heart to work properly and has difficulty with pumping blood
Subacute Fever Malaise Bacteremia Regurgitating heart murmor
Acute Rapidly progressive Destroys heart valve Death in a few days Congestive heart failure (bc of fluid accumulation around the heart)
Diagnosis → echocardiogram, blood culutre
Treatment → antobiotics, long time usually hospitalized
bacterial endocarditis
coagulase negative Staph sp or strepto sp
Low helper T cell count (below 200 cells per microliter)
Antibodies to HIV
Rare and opportunistic infections (presence of these infections indicate that your immune system is so deficient that one now has AIDS)
spread by sexual contact
rapid weight loss
AIDS
Human immunodeficiency virus (HIV)
Travel to area where standing water is common
(Africa, South East, South America)
Aedes mosquito
Fever & chills in a repeating pattern
Jaundice
Anemia
lysis RBC
Malaria
Plasmodium falciparum
bite of a hard tick in the Ixodes genus
occurs in nymph stage of tick life cycle
Spirochete travels from site of tick bite and disseminates into most tissues
immune response triggers inflammation
phase 2 and phase 3 may be almost entirely immune-driven
Phase 1: Erythema migrans Malaise Headaches Dizziness stiff neck severe fatigue Fever Chills muscle & joint pain
Phase 2:
disseminated rash
neurological symptoms
cardiac dysfunction
Phase 3:
severe arthritis
lymes disease
Borrelia burgdorferi
Aedes mosquito usually during/ after rainy season
sudden onset of fever (2-7) days Severe headache Muscle and joint pain Deep bone pain (break bone fever) Nausea & vomiting Eye pain Rash may present as hemorrhagic fever/shock syndrome when there is increased vascular permeability with plasma leakage into interstitial spaces
Dengue Virus
denguevirus
Occurs as acute outbreaks in Africa
Fever, headache, sore throat, muscle pain, rash, diarrhea, shock and death, hemorrhaging, no mosquitos
No vaccine
transmission with direct contact with reservoir (bats); bodily fluids, aerosol transmission
ebola
ebola virus
occurs through contact with saliva of an infected person
general malaise, pharyngitis, tonsillitis, myalgia, symptoms for 1 month but fatigue lasts for several
“mono”
early teens and young adults
Infectious mononucleosis
epstein-barr virus
