Micro Flashcards
Transmitted by the Ixodes tick (live on deer and mice)
Anaplasma spp. and Borrelia burgdorferi (Lyme disease)
What bug is associated with cat scratch disease?
Bartonella spp.
What bug is associated with lice?
Borrelia recurrentis - relapsing fever
What bug is associated with unpasteurized dairy and cows?
brucella spp. - undulant fever (granulomatous dz)
What bug is associated with bloody diarrhea + birds(chicken)/pigs as pets or food?
Campylobacter
What bug is associated with parrots and other birds?
Chlamydophila psittaci - psittacosis (fever and dry cough)
What bug is associated with sheep/cattle amniotic fluid?
Coxiella burnetii - Q fever (flu-like sx and fever for weeks), culture negative endocarditis
What endocarditis bug is associated with colon cancer?
Strep bovis
What bug is associated with the Lone Star Tick (amblyomma)?
Ehrlichia chaffeensis (HA, myalgia, fever)
What bug is associated with rabbits?
Francisella tularensis (tularemia - concern for bioterrorism)
What bug is associated with animal urine?
Leptospira spp.
What bug is associated with lepromatous leprosy and transmitted by armadillos?
mycobacterium leprae
What bug is associated with dog and cat bites?
Pasteurella multocida - causes cellulitis, osteomyelitis
What bug is associated with epidemic typhus and transmitted by lice?
Rickettsia prowazekii
What bug is associated with Dermacentor (dog tick)?
Rickettsia ricketsii - RMSF
What bug is associated with endemic typhus and transmitted by fleas?
Rickettsia typhi
What bug is associated with GI disease + reptiles/poultry?
Salmonella spp. (esp. Salmonella typhi)
What bug is associated with fleas and pet prairie dogs?
Yersinia pestis (inflammed/painful LNs)
Four obligate aerobic bacteria
Nocardia, Bacillus, Pseudomonas, Mycobacterium tuberculosis
Encapsulated bugs
“Even Some Pretty Nasty Killers Have Shiny Bodies” - E.coli, Streptococcus pneumoniae, Pseudomonas aeruginosa, Niesseria meningiditis, Klebsiella pneumoniae, Haemophilus influenzae, Salmonella typhi, Group B strep
Obligate intracellular bacteria
Rickettsia, Chlamydia, Coxiella
Chemotactic factors for leukocytes (not necessarily micro)
C5a, kallikrein, Leukotriene B4, IL-8
Common cause of pneumonia in immunocompromised patients
Pneumocystis jirovecii
Most common cause of atypical/walking pneumonia
Mycoplasma pneumoniae
Common causative agent for pneumonia in alcoholics
Klebsiella pneumoniae
Cause of interstitial pneumonia in bird handlers
Chlamydophila psittaci
Cause of pneumonia in a patient with a history of exposure to bats and bat dropping
Histoplasma
Cause of pneumonia in a patient who has recently visited South California, New Mexico, or West Texas
Coccidiodes
Pneumonia associated with currant jelly sputum
Klebsiella
Q fever
Coxiella burnetti
Pneumonia associated with air conditioners
Legionella pneumonia
Most common cause of pneumonia in children 1 year old or younger
RSV
Most common cause of pneumonia in children and young adults (college, military)
Mycoplasma pneumoniae
Most common cause of pneumonia in neonates (birth to 28 days)
Group B strep, E. coli
Most common cause of viral pneumonia
RSV
Causes wool-sorter’s disease (life-threatening pneumonia)
Bacillus anthracis
Common cause of pneumonia in ventilator patients and those with cystic fibrosis
Pseudomonas, MRSA
Pontiac fever
Legionella
Bugs causing infective endocarditis
Staph aureus, Viridans Strep, strep bovis, staph epidermidis, enterococcus, HACEK (hib, actinomycetes, cardiobacterium, eikinella, kingella), Bartonella, Brucella, Coxiella
Pneumonia in an alcoholic
Klebsiella
Pneumonia in a patient with decreased level of consciousness
Anaerobes
Pneumonia in a patient with cystic fibrosis
Pseudomonas aeruginosa
Pneumonia in HIV pt
Pneumocystis jirovecii
Pneumonia post-influenza
Staph aureus
Pneumonia from patio-cooling water mister
Legionella
Pneumonia after traveling to southwest US
Coccidiodes
Pneumonia associated with exposure to bird/bat dropping in Ohio/Mississippi River valleys
Histoplasma
Pneumonia associated with pet parrot
Clamydophila psittaci
Meningitis in unvaccinated child
Hib
Meningitis in a dorm
Niesseria meningitidis
Meningitis with petechial rash
Niesseria meningitidis
Meningitis with pt who has HIV
Cryptococcus neoformans
RBCs in CSF + temporal lobe involvement
HSV encephalitis
CSF findings in bacterial meningitis
increased opening pressure, increased WBC, neutrophils, increased protein, decreased glucose
CSF findings in viral meningitis
normal or slightly increased opening pressure, increased WBC count, lymphocytes, increased protein, normal glucose
CSF findings in TB/fungal meningitis
increased opening pressure, increased WBC, lymphs, increased proteins, decreased glucose, NEGATIVE gram stain
Thin, gray-white discharge, fishy odor, increased pH, clue cells, + whiff test
Gardnerella vaginalis
tx = metronidazole, clindamycin
Frothy, yellow-green discharge, fishy odor, increased pH, motile, pear-shaped organism, strawberry cervix
Trichomonas vaginalis
Tx = metronidazole
Vomiting 1-6 hours after eating potato salad at a picnic
Staph aureus
Vomiting 1-6 hours after eating reheated rice
bacillus cereus
Vomiting and watery diarrhea on cruise
Norovirus
Watery diarrhea 12 hours after eating meat or poultry from cafeteria
C. perfringens
Inflammatory diarrhea after eating undercooked hamburger meat, followed by acute kidney injury
E. coli (can cause HUS - kidney injury)
Inflammatory diarrhea followed by ascending paralysis
Campylobacter
Descending paralysis after ingestion of homemade canned goods
C. botulinum
Osteomyelitis in sickle cell disease pt
Salmonella
Osteomyelitis in pt with prosthetic valve
Staph epidermidis
Osteomyelitis in pt following cat bite
Pasturella
Osteomyelitis with involvement of the vertebrae
TB
Osteomyelitis following puncture wound to foot thru sneaker
Pseudomonas
Congenital infection causing chorioretinitis + hydrocephalus + intracranial calcifications
Toxoplasma gondii
Congenital infection leading to Hydrops fetalis
Parvovirus B19
Congenital infection leading to PDA + cataracts + deafness
Rubella
Congenital infection leading to saddle nose, snuffles, Hutchinson teeth, saber shins
Syphilis
Live attenuated vaccines
Smallpox, yellow fever, rotavirus, chickenpox (VZV), Sabin polio (oral), MMR, Influenza intranasal
-no boosters needed, cellular and hemoral response
Live attenuated vaccines that shouldn’t be given to HIV pts (even if CD4 count >200)
influenza, varicella
-still give MMR
What vaccines are killed vaccines
Rabies, injected Influenza, Salk polio, HAV
-only cause hemoral response, need boosters
Subunit Vaccines
HPV and HBV
Vaccines made from eggs
MMR - not contraindicated in allergy
Yellow fever - desensitize first
Influenza - only contraindicated with anaphylactic rxn
Dark purple lesions in an HIV patient
Kaposi sarcoma (HHV-8)
Temporal lobe encephalitis
HSV-1
Intranuclear esoinophilic inclusions
Type A Cowdry bodies - HSV (also VZV, CMV)
Owl’s eyes inclusions in organ tissue
CMV
Locations of dormant state for HHV infections
HSV-1 = trigeminal ganglia HSV-2 = sacral ganglia VZV = dorsal root or trigeminal ganglia (reactivation can cause blindness) EBV = B cells (increased risk of lymphoma) CMV = Mononuclear cells
What are downey cells?
reactive T cells trying to fight off EBV infection in mono
What abs are present in EBV mono and how are they tested?
heterophile abs - Monospot test
-abs that cause agglutination of sheep or horse RBCs
- Monospot mononucleosis in immunocompromised pt
CMV
-can cause retinitis leading to blindness in HIV
Most common TORCH infection
CMV - petechial rahs, jaundice, intracranial calcifications
High fever in kid followed by rash
Roseola - HHV 6
Lab test for HSV infection
Tzanck smear - see giant multinucleated cells
Only DNA virus that isn’t ds
Parvovirus
Virus type of Hep B
hepadnavirus - partially ds, circular
Infections caused by Parvovirus B19
aplastic crisis in sickle cell pt, slapped cheek in kids, hydrops fetalis in fetus
Hand, foot, and mouth dz
Coxsackievirus
Common cold
Rhinovirus, Coronavirus
Most common cause of fatal gastroenteritis
Rotavirus - reovirus family, ds linear RNA (weird)
Can infect the anterior horn motor neurons
West nile virus, Poliovirus
Aspetic meningitis in the summer
Echovirus
Most common cause of viral myocarditis
Coxsackievirus
Musculoskeletal pain, retro-orbit HA, hemorrhagic fever
Dengue
High fever, black vomit, jaundice, increased liver enzymes
Yellow fever virus
Fever, lymphadenopathy, arthralgias, fine confluent rash that starts on face and spreads to trunk and extremities
Rubella
Congenital rubella infection sx
cataracts, heart defects (PDA, pulmonic stenosis), deafness
Aseptic meningitis (think about viruses)
Enteroviruses (polio, coxsackievirus, echovirus) + Mumps
Virus spread thru mouse urine
Hantavirus - can lead to hemorrhagic fever, pneumonia
Seal-barking cough, steeple sign on X-ray in kid
Croup - parainfluenza virus
Bronchiolitis, pneumonia in young kids, winter months, associated with F fusion protein, prevent with palivizumab in premies
RSV
Cough, Coryza (running nose), Conjunctivitis + fever + red spots with blue-white center on buccal mucosa + rash that spreads head to toe
Measles (paramyxovirus)
Consequences of Measles
encephalitis, giant cell pneumonia in immunosuppressed, Subacute sclerosing panencephalitis years later
Parotitis, Orchitis, aseptic Meningitis, Pancreatitis
Mumps
Bullet shaped virus, symptoms appear weeks to months after animal bit, fever/malaise –> agitation, photophobia, hydrophobia (FEAR OF WATER), –> coma –> death
Rabies
How does rabies infect CNS?
retrograde transport from bite along nerve axons to CNS
When do you start prophylaxis and with what for AIDS?
CD4
What are the receptors for HIV and what viral protein binds to these?
gp120 binds to CD4 and uses CCR5 or CXCR4 as coreceptors
Multiple ring enhancing lesions on MRI of AIDS pt
toxoplasma gondii
What does CMV cause in AIDS pts?
retinitis - retina looks like cheese pizza
esophagitis - linear ulcers on endoscopy
Most common cause of meningitis in AIDS pt and presents with soap bubble appearance in encephalitis
Cryptococcus neoformans - stain with India ink
Irregular, broad nonseptate hyphae that branch at wide angles and cause disease in ketoacidotic diabetics and neutropenic (leukemia) pts
Mucor, Rhizopus
Presents with headache, facial pain, black eschar on the face, Infect blood vessels, enter brain, cause frontal lobe abscess and cavernous sinus thrombosis, can lead to blindness and cranial nerve involvement
Mucormycosis - mucor and rhizopus
cause disease in ketoacidotic diabetics and neutropenic (leukemia) pts
pseudohyphae and budding yeast, can form germ tubes in blood cultures (small projections from side of cell)
Candida albicans
Diseases associated with candida albicans
thrush (immunocompromised and neonates), vaginitis, diaper rash (look for satellite lesions), endocarditis in IV drug users, systemic infection in IV drug users or central line pts
Septate hyphae that branch at 45 degree acute angles
Aspergillis fumigatus
Infections caused by aspergillis
invasive aspergillosis in immunocompromised, aspergillomas in pre-existing TB lung cavities, aflatoxins to cause hepatocellular cancer
Three species of dermatophytes
microsporum, trichophyton, epidermophyton
-see branching hyphae on KOH prep
Appearance of malassezia on microscopy from tinea versicolor
spaghetti and meatballs
-degrade lipids that make acid and damage melanocytes –> hypopigmentation
Ground glass opacities on CXR/CT
Pneumocystis jirovecii pneumonia in an AIDS pt
Dimorphic yeast associated with vegetation and roses, spores introduced thru injury into skin, causes ascending painless nodules along lymphatics
Sporothrix schenckii
Mississippi and Ohio river valleys, found in bird and bat droppings, found within macrophages, dimorphic, can cause pneumonia
Histoplasmosis
Found in Eastern US and Central America, causes pneumonia and can spread to bones and skin, forms granulomatous nodules, BROAD-BASE BUDDING
Blastomycosis
Southwestern US, causes pneumonia and meningitis, can disseminate to skin and bone, spherule form in body fills with endospores that are eventually released, mold form has barrel-shaped anthroconidia
Coccidiomycosis
Budding yeast from Latin America, captain’s wheel formation, can cause severe progressive disease including pneumonia and granulomatous skin changes
Paracoccidioidomycosis
Biliary tract dz –> pigmented gallstones, cholangiocarcinoma
Clonorchis sinensis
Brain cysts, seizures, undercooked pork
Tanea solium
Hematuria, squamous cell bladder cancer
Schistosoma haematobium
Myalgias, periorbital edema
Trichinella spiralis
Perianal pruritis
Enterobius (pinworm)
Portal hypertension with parasite
Schistosoma mansoni, Schistosoma japonicum
Vitamin B12 def. with parasite
Diphyllobothrium latum
Cause of elephantiasis
Wuchereria bancrofti
Microcytic anemia from a parasite
Ancylostoma, Necator
Nematodes transmitted orally
Enterobius, Ascaris, Trichinella (EAT)
Nematodes transmitted thru skin penetration
SANd - Strongyloides, Ancylostoma, Necator
Giant roundworm that could cause intestinal obstruction
Ascaris lumbricoides
Foul-smelling vaginal discharge, motile protozoa with flagella, strawberry cervix
Trichomonas vaginalis
What transmits leishmania donovani?
Sandfly
Visceral leishmaniasis - fever, hepatosplenomegaly, pancytopenia
Cutaneous - skin ulcers slow to heal
Dilated cardiomyopathy, megacolon, megaesophagus, South America
Chagas disease - trypanosoma cruzi
-transmitted by kissing bud leaving feces on skin
Congenital toxoplasmosis
Chorioretinitis, hydrocephalus, intracranial calcifications
- reactivation seen in AIDS pts
- transmitted thru cat feces
Enlarged lymph nodes, recurring fever, somnolence, coma, death
African sleeping sickness - Trypanosoma brucei
Fatty, foul-smelling diarrhea, flatulence in campers/hikers
Giardiasis - giardia lamblia
Pear shaped protozoa with four flagella, double nuclei (owl’s eyes)
Giardia
Bloody diarrhea (dysentery), liver abscess, RUQ pain, histology of colon shows flask-shaped ulcer
Entamoeba histolytica
Protozoa with multiple RBCs inside of it, or cysts that are multinucleated
Entamoeba histolytica
Severe diarrhea in AIDS pt
Cryptosporidium, transmitted thru oocysts in water
Oocysts from stool stain bright pink on acid-fast stain
Cryptosporidium