Listeria, H ifluenzae, P aeruginosa, M tuberculosis, M pneumoniae Flashcards
Clinical history: A 33-year-old female dairy farmer develops a severe headache and neck stiffness. On physical examination, her temperature is 38.2°C. She has no papilledema. A lumbar puncture is performed, and a Gram stain of the CSF obtained shows many short, gram-positive rods.
What is the most likely causative agent in the case above?
Listeria moncytogenes
Listeria appears in animals, skin, food (T/F)
True
Epidemics of Listeria are linked to contaminated food (T/F)
True
Complications
Meningitis
Persons at risk
Pregnant women, infants, elderly
L moncytogenes resembles S pneumoniae (gram +ve diplococci)
True
CAMP results for L moncytogenes
-Strep B produces CAMP factor (protein) that interacts with S aureus to enhance lysis of RBCs.
Group B strep streaked perpendicular to S aureus streak on blood agar
+ve result: –Arrowhead zone of hemolysis
Important diagnostic factor to distinguish S pneumoniae and L moncytogenes
L moncytogenes is catalase positive and all streptococci are catalase negative
Motility pattern
Umbrella motions
Treatment
Ceftriaxone
Vancomycin
Listeria treatment - add in ampicillin and gentamicin
Why is it important to identify if L moncytogenes is the pathogen?
Since Listeria doesn’t respond to usual antibiotic treatment for strep, it is important to identify which it is.
Num 1 cause of community acquired meningitis is L moncytogenes, why?
Neurotropism - An ability to invade and live in neural tissue.
Virulence factors: L moncytogenes
Facultative anaerobe - because it can survive in cells
Survives digestion
Adheres to host cells
Can replicate in macocrophages so can carry bacteria anywhere and cross placenta.
Life cycle: L moncytogenes
Adheres to host cells -> internalize into phagolysosome
Low pH actives O and C = break out of Listeria
Bacteria replicates in cytosol
Creates actin rockets = propelling around cell into cell wall
Neonatal effect: L moncytogenes
- Early onset
- -miscarriage, stillbirth, in utero transmission
Late onset in babies- Listeriosis
- At/shortly after birth
- Meningitis/ meningoencephalitis
A 10-month-old child of a family from Mexico living in Durham was noted by his mother to have a grand mal seizure with shaking of arms and legs by the description given to the EMT. The EMTs found the child limp and unresponsive. In the emergency room the child’s fever was 39.5°C (103.1°F). Blood cultures and lumbar puncture were performed. CSF findings were as follows:
cell count of 4000
95% PMNs
glucose 20mg/dl
protein 125mg/dl.
Gram stain showed PMNs and occasional Gram-negative coccobacillary organisms. The organism grew on chocolate agar but not on sheep blood agar or MacConkey’s agar. What is the most likely organism in this case?
Haemophilus influenzae
Hemophilus influenzae is located where?
Nasopharynx of healthy persons
Cell morphology - H influenzae
Short, gram negative rods/coccobacillus
Non motile
No flagella/pilli
Fastidious