lung, brain, bone, GI bugs Flashcards
normal flora of skin
staph epidermidis
when in blood: can cause bacteremia, endocarditis
normal flora of nose
staph epidermidis
staph aureus
MRSA can colonize in nose!
normal flora of oral cavity
anaerobes
staph
viridans group strep: s. mutans in cavities and dental plaques →if abnormal heart valve + dental procedure →endocarditis
normal flora of colon
anaerobe: bacteroides fragilis (most abundant)
e. coli: can enter vagina/urethra → UTI
normal flora of vagina
lactobacillus: converts glycogen → lactic acid (↓ pH - 4.0-4.5)
e.coli
aneorobes
staph: GBS (s. agalactiae) → if vertical transmission: neonatal sepsis, meningitis, or pneumonia
strep
causes of pneumonia in neonates (
GBS E.coli less common: chlamydia trachomatis: long incubation (onset 4-12 wks later) HSV
causes of pneumonia in children (4 wk-18 yr)
RSV (most common viral cause) s. pneumoniae (most common bacterial cause) school-aged children = atypicals: mycoplasma pneumoniae chlamydophila pneumoniae
causes of pneumonia in adults (18-65 yr)
s. pneumoniae H. influenzae influenza virus (older adults >40 yo) atypicals: mycoplasma pneumoniae (younger adults
causes of pneumonia in elderly (>65 yo)
s. pneumoniae H. influenzae influenza virus s. aureus anaerobes G- rods: e.coli (fecal matter)
type of pneumonia in alcoholic patient
s. pneumoniae (most common)
klebsiella pnuemoniae: thick bloody sputum “currant jelly sputum”
aneoraboes: aspiration
type of pneumonia in patient with decreased level of consciousness (aspiration pneumoniae)
anaerobes
type of pneumonia in patient with CF
pseudomonas
type of pneumonia in patient with HIV and CD4
pneumocystis jirovecii
type of pneumonia in post-influenza
s. pneumoniae (most common)
s. aureus (know this one!, severe, fatal)
type of pneumonia acquired from patio-cooling water mister
legionella pneumophila (think with any water source)
type of pneumonia after travel to SW US
coccidioides immitis (fungus)
type of pneumonia after exposure to bird/bad droppings in Ohio/Mississippi River valleys
histoplasma capsulatum
type of pneumonia due to pet parrot
chlamydophila psittaci
causes of meningitis in neonates (
GBS
E.coli
listeria monocytogenes
causes of meningitis in infant + children (
S. pneumoniae (most common cause in all patient)
N. meningitidis
H. influenzae type B
enterovirus: coxsackie
causes of meningitis in 6-60 yo
S. pneumoniae
N. meningitidis (healthy, teenager-young adult)
enterovirus
causes of meningitis in elderly (60+ yo)
s. pneumoniae
listeria monocytogenes
G- rods
meningitis in unvaccinated child
H. influenzae type B
meningitis in outbreak in dorm
N. meningitidis
meningitis in patient with HIV
cryptococcus neoformans (stains with india ink)
RBC in CSF + temporal lobe involvement on MRI
HSV encephalitis
meningitis with petechial rash
N. meningitidis
fever severe headache nuchal rigidity photophobia AMS
meningitis
diagnosis of meningitis
lumbar puncture
G+ diplococci in CSF
s. pneumoniae
G- diplococci in CSF
N. meningitidis
G- coccobacili in CSF
H. influenzae
G+ rods in CSF
listeria monocytogenes
empiric treatment of meningitis
broad spectrum:
ceftriaxone + vancomycin +/- ampicillin (use if suspect listeria)
vomiting 1-6 hrs after eating reheated rice
food with B. cereus
ingest PREFORMED toxin = RAPID onset
VOMIT main sx
vomit + water diarrhea on cruise
norovirus
very contagious: person-to-person or food that someone with norovirus touched or put secretions on
VOMIT main sx
watery diarrhea 12 hrs after meat or poultry from cafeteria
food with clostridium perfringens
SPORES survive high temps
meat cooked but left out → spores germinate and grow → ingest
WATERY diarrhea
inflammatory diarrhea after eating undercooked hamburger meat, followed by acute renal failure
food with E. coli O157:H7
BLOODY diarrhea
can cause HUS esp children
inflammatory diarrhea 1-3 days after eating undercooked meat/poultry, eggs or produce
food with salmonella
vomit 1-6 hrs after eating potato salad at picnic unrefrigerated
food with s. aureus:
ingest PREFORMED toxin = RAPID onset
VOMIT (not diarrhea)
inflammatory diarrhea after eating raw seafood
food with vibrio
inflammatory diarrhea followed by ascending paralysis
food with camplyobacter jejuni
ASCENDING paralysis = gullian barre syndrome
leukocytes in stool
fever
ab pain
blood or mucus in diarrhea
inflammatory diarrhea: invasion into intestine
inflammatory diarrhea after eating undercooked poultry
food with camplyobacter jejuni
descending paralysis after ingestion of homemade canned goods
food with clostridium botulinum
spores germinate → produce toxin → inhibit release of Ach
babies with honey: ingest spore → grow and colonize GI and produce toxin →constipation, “floppy baby”
DESCENDING paralysis
ways of transmission for osteomyelitis
hematogenous spread
contiguous extension from nearby infection (started in soft tissue)
direct inoculation: trauma, surgery
systemic: fever, chills
pain, redness, swelling in region
leukocytosis
↑ESR and CRP
osteomyelitis
diagnosis of osteomyelitis
gold standard: bone biopsy + culture
(won’t show up on xray til wks later)
MRI
radionuclide bone scan
most common cause of osteomyelitis
s. aureus
osteomyelitis in patient with sickle cell disease
salmonella!!
osteomyelitis in patient with prosthetic device
s. epidermidis
osteomyelitis involving of vertebrae
myocbacterium tuberculosis (TB in spine = Pott’s disease: verebral collapse, spinal cord damage)
osteomyelitis following cat bite
pasteurella multocida
osteomyelitis in IVDU
s. aureus
pseudomonas
serratia
candida
osteomyelitis in diabetic with foot ulcer
polymicrobial: pseudomonas, anaerobes
osteomyelitis following puncture wound to foot through sneaker
pseudomonas
aspiration pneumonia (consider if delerius - in hospital)
polymicrobial
anaerobes
