MICROBIOLOGY- BACTERIA Flashcards
What is unusual about Mycoplasma bacteria?
Does NOT contain a cell wall i.e. does NOT Gram stain
- Contains cholesterol
What is unusual about Mycobacteria?
Contains MYCOLIC ACID
What culture media is used for the isolation of H. influenza?
Chocolate agar with factors V and X
What culture media is used for the isolation of N. gonorrhea and N. meningititis?
Thayer-Martin
What culture media is used for the isolation of B. pertussis?
Bordet-Gengou
What culture media is used for the isolation of C. diptheria?
Tellurite agar
What culture media is used for the isolation of M. tuberculosis?
Lowenstein-Jensen agar
What culture media is used for the isolation of M. pneumonia?
Eaton agar
What culture media is used for the isolation of Lactose-fermentering enterics?
MacConkey= pink colonies
How does E. coli appear when grown of eosin-methylene blue agar (EMB)?
Green metallic
What culture media is used for the isolation of Legionella?
Charcoal yeast extract buffered w/ cysteine and iron
What bacteria expressed Protein A? What is the function?
S. aureus
- Prevent opsonization and phagocytosis
What bacteria secrete IgA protease? What is the function?
SHiN= S. pneumonia, H. influenza, Neisseria
- Cleaves IgA to colonize respiratory mucosa
What bacteria contains M protein? What is the function?
Group A Streptococci (S. pyogenes)
- Prevent phagocytosis
What is “Endotoxin?” What bacteria is this virulence factor associated with?
LPS –associated with the Gram negatives
What is Exotoxin?
This is a polypeptide toxin that is SECRETED from various Gram positive and negative bacteria
What bacteria contain an exotoxin that inhibits protein synthesis?
1) Corynebacterium diptheria
2) Pseudomonas aeruginosa
3) Shigella
4) EHEC (O157:H7)
What is the MOA of the Corynebacterium diptheria toxin?
Inactivation of EF-2
What is the manifestation of the Diptheria toxin?
- Pharyngitis with pseudomembranes
- “Bull neck” lymphadenopathy
What exotoxin is associated with Pseudomonas aeruginosa?
Exotoxin A
What is the MOA of Exotoxin A?
Inactivation of EF-2
What is the manifestation of Exotoxin A?
Host cell death
What toxin is associated with Shigella?
Shiga Toxin (ST)
What is the MOA of the Shigella Toxin?
Inactivation of 60S ribosome by removing adenine from rRNA
What is the manifestation of the Shiga Toxin?
- GI mucosal damage–> dysentery (bloody diarrhea)
- HUS
What toxin is associated with E. coli O157:H7?
Shiga-like Toxin (SLT)
What is the MOA of the STL toxin in E. coli O157:H7?
Inactivation of the 60S ribosome by removing adenine from rRNA
How does EHEC differ from Shigella?
Does NOT invade host cells but does cause HUS
What kind of diarrhea is seen with E. coli O157:H7?
Bloody
What bacterial exotoxins will increase fluid secretion?
1) ETEC
2) Bacillus anthracis
3) Vibrio cholerae
What toxins are associated with ETEC?
Enterotoxigenic E. Coli=
1) Heat-labile toxin (LT)
2) Heat-stable toxin (ST)
What is the MOA of ETEC’s LT?
Heat-Labile Toxin:
- Activates cAMP
- cAMP increases Cl- secretion
- H20 efflux
Think watery diarrhea is Labile in the Air (cAMP), and Stable on the Group (cGMP)
What is the MOA of ETEC’s ST?
Heat-Stabile Toxin:
- Activates cGMP
- cGMP decreases resorption of NaCl
- Increased H20 in gut
Think watery diarrhea is Labile in the Air (cAMP), and Stable on the Group (cGMP)
What toxin is associated with Bacillus anthracis that will increased fluid secretion? What clinical manifestation does this toxin cause?
Edema factor
Causes the edematous borders of black eschars in Anthrax
What is the MOA of edema factor (Bacillus anthracis)?
Mimics adenylate cyclase to increase cAMP
What toxin is associated with Vibrio cholerae?
Cholera Toxin
What is the MOA of the Cholera Toxin?
- Activation of cAMP via Gs activation
- Cl- secretion into the gut
- H20 follows
What is the manifestation of the Cholera Toxin?
Rice-water stool associated with Vibrio Cholera or Cholera
What bacteria has an exotoxin that inhibits phagocytosis?
Bordetella pertussis
What is the MOA of the pertussis toxin?
- Overactivation of adenylate cyclase via disabling Gi
- Increased cAMP
What is the clinical manifestation of the pertussis toxin?
Whooping cough
What bacterial have exotoxins that inhibit neurotransmitter release?
Clostridium tetani
Clostridium botulinum
What toxin is associated with C. tetnai?
Tetanospasmin
What is the MOA of Tetanospasmin?
- Tetanospasmin is a protease that cleaves SNARE proteins
- Prevents the release of inhibitory NT (GABA and Glycine)
Specifically, this action occurs in RENSHAW cells of the spinal cord
What is the clinical manifestation of the Tetanospasmin toxin?
- Spasticity
- Risus sardonicus
- Lock-jaw
What is the MOA of Botulinum toxin?
Protease that cleaves SNARE proteins
- Prevents the release of ACh
What are the clinical manifestations of the Botulinum toxin?
- Flaccid paralysis
- Floppy baby
What bacteria contain toxins that lyse cell membranes?
1) Clostridium perfringens
2) Streptococcus pyogens
What toxin is associated with Clostridium perfringens?
Alpha toxin
What is the MOA of Alpha Toxin?
This is a phospholipase or “lecithinase” that degrades the cell membrane
What are the clinical manifestations of the Alpha Toxin?
- Myonecrosis b/c of phospholipid degradation that causes “gas gangrene”
- Hemolysis
What toxin is associated with Streptococcus pyogenes?
Streptolysin O
What is the MOA of Streptolysin O?
This is a protein that degrades cell membranes
What is the clinical manifestation of Streptolysin O?
RBC lysis
How are antibodies to Streptolysin O measured?
ASO (Streptolysin O antibody) titer
What is the clinical utility of an ASO titer?
Diagnosis of Rheumatic Fever (S. pyogenes)
What superantigens cause shock?
1) S. aureus – TSST-1
2) S. pyogenes – Exotoxin A
What is the MOA of superantigens causing shock?
TSST-1 and Exotoxin A
- Bring MHC II and TCR in proximity–>antigen binding
- IFN-gamma and IL-2 are released
Shock ensues
Draw the Gram-positive lab algorithm.
p. 129
How do alpha-hemolytic bacteria appear on blood agar?
Green rings
How do beta-hemolytic bacteria appear on blood agar?
Clear rings
What inflammatory diseases are caused by S. aureus?
1) Skin infections
2) Organ abscesses
3) Pneumonia
4) Endocarditis
5) Osteomyelitis
What toxin mediated diseases are caused by S. aureus? What toxin are these diseases associated with?
1) Toxic Shock Syndrome–> TSST-1
2) Scalded Skin Syndrome–> “Exfoliative toxin”
3) Food poisoning–> “Enterotoxin”
What causes MRSA?
Resistance to Methicillin (Beta-Lactam) b/c of ALTERED PBP
What behavior is associated with S. aureus mediated Toxic Shock Syndrome?
Retained tampon
Where is S. epidermidis normally found?
- Normal flora of the skin
- Frequently contaminates blood cultures
What infections are associated with S. epidermidis?
- Prosthetic devices
- IV catheters
What is S. saprophyticus infection associated with?
This is the 2nd most common cause of UTI (E. coli is first)
What is the mnemonic to remember the infections caused by S. pneumonia?
MOPS
M= Meningitis O= Otitis media P= Pneumonia S= Sinusitis
What color sputum is pathognomonic for S. pneumonia induced pneumonia?
Rust colored
Describe the shape of S. pneumonia.
Lancet-shaped diplococci
Where are viridans streptococci normally found in the body?
Part of the normal flora of the mouth
What species of viridans streptococci is associated with dental carries?
Streptococcus mutans
What species of viridans streptococci is associated with subacute bacterial endocarditis?
Streptococcus sanguinis
What are the three categories of disease caused by Streptococcus pyogenes?
1) Pyogenic= pus-producing
2) Toxigenic
3) Immunologic
What are the pyogenic diseases caused by S. pyogenes?
1) Pharyngitis
2) Cellulitis
3) Impetigo
What are the toxigenic diseases caused by S. pyogenes?
1) Scarlet fever
2) Toxic shock-like syndrome
3) Necrotizing fasciitis
What are the immunologic diseases caused by S. pyogenes?
1) Rheumatic fever
2) Acute glomerulonephritis
What is the mnemonic to remember the features of Rheumatic Fever?
JONES
J= Joints, polyarthritis O= Heart, carditis N= Nodules (subcutaneous) E= Erythema miarginatum (pink rings on the chest) S= Syndenham chorea (rapid purposeless movements of the face, feet, and hands)
What are the clinical features of scarlet fever?
1) Scarlet rash with sandpaper-like texture
2) Strawberry tongue
3) Circumolar pallor
What is an alternate name for Streptococcus agalacticae?
Group B Strep
What is the first thing that should come to mind when you hear Group B Strep (GBS)?
Group B is for babies
What diseases are caused by GBS?
1) Pneumonia
2) Meningitis
3) Sepsis
What is the screening protocol for GBS?
Screen pregnant women at 35-37 weeks
What is protocol for GBS positive pregnant women?
Intrapartum PCN prophylaxis
What is an alternate name for the Group D Strep?
Enterococci and Streptococcus bovis (both fall under the GDS heading)
What infections are caused by GDS or Enterococci?
1) UTI
2) Biliary tract infection
3) Subacute endocarditis following GI/GU procedures
What infections are caused by S. bovis?
1) Bacteremia
2) Subacute endocarditis in colon cancer patients
What organism causes Diptheria?
Corynebacterium diptheriae
What are the symptoms to diptheria?
- Pseudomembranous pharyngitis
- Lymphadenopathy
- Myocarditis
- Arrhythmia
How is Diptheria diagnosed?
1) Gram positive rods with metachromatic granules
2) Elek test for toxin
What lab test detects the presence of the diptheria toxin?
Elek
What type of vaccine is given to prevent diptheria?
Toxoid
What causes Botulinum in adults?
Ingestion of preformed toxin
What causes Botulinum in kids?
Ingestion of spores–often in honey
*Causes “Floppy Baby Syndrome”
What toxins are produced by Clostridium difficile?
Toxin A
Toxin B
What is the MOA of the C. diff toxins?
Toxin A= enterotoxin, binds the brush border of the gut
Toxin B= cytotoxin, causes cytoskeletal disruption via actin depolymerization
How is C. diff diagnosed?
Detection of either Toxin A or B in the stool
What is unique about the composition of Bacillus anthracis?
Only bacterium with a polypeptide capsule
*Specifically, D-glutamate capsule
Describe the presentation of cutaneous anthrax.
Boil-like lesion that progresses to a black eschar
Describe the presentation of pulmonary anthrax.
Flu-like symptoms that rapidly progress to:
- Fever
- PULMONARY HEMORRHAGE
- Mediastinitis (inflammation of mid-chest structures)
- Shock
What is a colloquial term for pulmonary anthrax?
“Woolsorter’s Disease” –historically caused by inhalation of spores from contaminated wool
What does Bacillus cereus cause?
“Reheated rice syndrome”
- Food poisoning associated with bacteria that grow in warm rice
What are the two timeframes of disease presentation with Bacillus cereus infection?
1) Emetic-type= 1-5 hours post ingestion
2) Diarrheal= 8-18 hours post ingestion
How is Listeria monocytogenes commonly acquired?
- Ingestion of unpasteurized dairy products and deli meats
- Transplacental
- Transvaginal
What is the unique mechanism of pathogenesis associated with L. monocytogenes?
Actin rockets that allow for transmission from cell to cell while avoiding antibodies
What is unique about the composition of L. monocytogenes?
Only gram positive bacteria with LPS
What type of infection is seen with L. monocytogenes in a healthy adult?
Mild gastroenteritis
What can L. monocytogenes infection cause in a pregnant woman?
1) Amnionitis
2) Sepsis
3) Spontaneous abortion
What can L. monocytogenes cause in neonates?
1) Neonatal meningitis
2) Granulomatosis infantiseptica–pus-filled granuloma formation distributed throughout the whole body of the newborn
What infections are caused by Actinomyces?
Oral and facial abscess that drain through sinus tracts
How is the appearance of Actinomyces described?
Yellow sulfur granules
What infections are caused by Nocordia?
Immunocompromised= pulmonary infection
Immunocompetent= cutaneous infections post trauma
How are actinomycyes infections treated?
PCN
How are Nocordia infections treated?
Sulfonamides
What bacteria causes TB?
Mycobacterium tuberculosis
How is TB transmitted?
Inhalation of aerosolized TB
What is Primary TB?
This is the infection that a patient gets when they are FIRST exposed to TB
Describe the clinical manifestations of Primary TB.
- Focal caseating necrosis of the lower lung lobe
- AND focal caseating necrosis of the hilar lymph nodes
Hilar= mediastinal lymph nodes
What is a Ghon complex?
In Primary TB, necrotic areas in the lower lung lobe and hilar lymph nodes undergo:
- Fibrosis
- Calcification
These fibrotic and calcified nodules are called Ghon complexes
What symptoms are seen with Primary TB?
Primary TB is typically ASYMPTOMATIC, but it does lead to a POSITIVE PPD
What is Secondary TB?
This is when a Ghon complex is reactivated
What causes reactivation of TB?
1) AIDS
2) Aging
Where does reactivation of TB commonly occur?
Apex of the lung
- Oxygen tension is highest here
What are the manifestations of the reactivation of TB?
1) Formation of cavitary foci of caseous necrosis
2) May cause miliary TB
3) May cause tuberculous bronchopneumonia
What are the symptoms associated with Secondary TB?
- Fever
- Night sweats
- Cough with hemoptysis
- Weight loss
What will biopsy reveal in Secondary TB?
Caseating granuloma
*Note, AFB stain will show red acid-fast bacilli, differentiating this from ASPERGILLUS
When a patient has secondary TB, what will often happen?
Systemic spread
Where will TB commonly go to with systemic spread?
1) Meninges
2) Cervical lymph nodes
3) Kidney
4) Lumbar vertebrae
What is the tell-tale sign of TB meningitis?
Caseating granulomas involving the meningies at the base of the skull
What is the result of systemic spread of TB to the kidney?
“Sterile pyuria”
What is the disease called when TB spreads to the lumbar vertebrae?
Pott’s Disease
What is the presentation of M. kansaii infection?
Pulmonary TB-like symptoms
What kind of infection is seen with M. avium-intracellulare in AIDS patients?
Disseminated disease
How is M. avium intracellulare treated prophylactically?
Azithromycin
What is the reservoir for M. leprae in the US?
Armadillos
What are the two forms of Hansen Disease?
This is the disease caused by M. leprae:
1) Lepromatous
2) Tuberculoid
What are the distinguishing features of Lepromatous Hansen’s Disease?
- Leonine facies
- Low cell mediated immunity
- Th2 response
What are the distinguishing features of Tuberculoid Hansen’s Disease?
- Limited to hypopigmented and hairless skin plaques
- Robust cell mediated immunity
- Th1 response
What is the treatment for Lepromatous Disease?
1) Dapsone
2) Clofazimine
3) Rifampin
For 2-5 years
What is the treatment for Tuberculoid Disease?
1) Dapsone
2) Rifampin
For 6 months
Draw the gram negative lab algorithm.
p. 136
From a treatment perspective, what is unique about Gram negative bacteria?
Outer membrane inhibits the entry of:
- PCN G
- Vancomycin
What is the difference between N. meningitidis and N. gonorrhea in terms of fermented sugars?
- N. MeninGitidis ferments both maltose and glucose
- N. Gonorrheae only ferments glucose
What is the difference between N. meningitidis and N. gonorrhea in terms a capsule?
- N. meningitidis has a polysaccharide capsule
- N. gonorrheae does NOT have a capsule
What is the difference between N. meningitidis and N. gonorrhea in terms of vaccination?
- N. meningitidis= vaccine
- N. gonorrheae= no vaccine
What diseases are caused by N. meningitidis?
1) Meningitis
2) Waterhouse-Friderichsen Syndrome
What diseases are caused by N. gonorrheae?
1) Gonorrhea
2) Septic arthritis
3) Neonatal conjunctivitis
4) PID
5) Fitz Hugh Curtis Syndrome
What is the treatment for N. meningitidis?
Cetfriaxone or PCN G
What is the treatment for N. gonorrhaea?
Ceftriaxone + (azithromycin or doxycycline) for possible chlamydia infection
What is H. influenza transmitted?
Aerosol
What type of H. influenza causes the most invasive disease?
HiB i.e. H. influenza type B
What is the mnemonic to remember the diseases caused by H. influenza?
HaEMOPhilus
E= Epiglottitis M= Meningitis O= Otitis Media P= Pneumonia
How are mucosal H. influenza infections treated?
Amoxacillin +/- clavulanate i.e. augmentin
How is H. influenza meningitis treated?
Ceftriaxone
What medication is used as prophylaxis for close contacts of individuals with H. influenza meningitis?
Rifampin
What is contained in the H. influenza vaccine?
Type B capsular polysaccharide conjugated to diptheria toxin
Note that a child can still get an H. influenza disease s/p vaccination but it will be from a non-B strain
How is Legionella pneumophila detected clinically?
Detection of the antigen in urine
How is Legionella penumophila transmitted?
Aerosol transmission from aqueous habitat
What two diseases are cased by Legionella pneumophila?
1) Legionnaires Disease
2) Pontiac fever
What is the difference between Legionnaires Disease and Pontiac Fever?
Legionnnaires= Sever pneumonia with GI and CNS symptoms
Pontiac Fever= mild-flu
What type of odor is associated with Pseudomonas aeruginosa?
Grape-like
What is the mnemonic to remember the diseases caused by P. aeruginosa?
PSEUDOmonas
P= Pneumona (esp. in CF) S= Sepsis E= External otitis U= UTI DO= Drug use and DM osteomyelitis
What skin infection is caused by P. aeruginosa?
Hot-tub folliculitis
Also, think burn victims
What is Ecthyma Gangrenosum?
- Rapidly progressive necrotic ulcer
- Seen in immunocompromised
- Caused by P. aeruginosa
How is P. aeruginosa infection treated?
Aminoglycoside + extended spectrum PCN
What infections are associated with the fimbriae of E. coli?
Cystitis and pyelonephritis
What infections are associated with the K capulse of E. coli?
Pneumonia and neonatal meningitis
What is associated with LPS endotoxin of E. coli?
Sepsis
How does EIEC present?
EnteroInvasive= dysentery
How does ETEC present?
EnteroToxigenic= Traveler’s diarrhea
How does EPEC present?
Diarrhea usually in children i.e. Pediatrics
How does EHEC present?
Dysentery and HUS
How is EHEC differentiated from the other E.coli species?
Does NOT ferment sorbitol
Where is Klebsiella normally found?
Gut normal flora
How can you remember the diseases caused by Klebsiella?
Four A’s
- Aspiration pneumonia
- Abscess in the lungs or liver
*Associated with Alcoholics and Di-A-betics
What is the pathognomonic feature of Klebsiella pneumonia?
Currant jelly sputum
Salmonella vs. Shigella: which is flagellated?
Salmonella
Salmonella vs. Shigella: undergoes cell-to-cell transmission.
Shigella
Salmonella undergoes hematogenous spread
Salmonella vs. Shigella: only reservoir is humans and primates?
Shigella
Salmonella has many animal reservoirs
Salmonella vs. Shigella: produces H2S.
Salmonella
Salmonella vs. Shigella: antibiotics are recommended?
Shigella
Salmonella vs. Shigella: invades intestinal mucosa and causes a monocytic response?
Salmonella
Salmonella vs. Shigella: invades intestinal mucosa and causes a PMN response?
Shigella
Salmonella vs. Shigella: often causes bloody diarrhea.
Shigella
What disease is caused by Salmonella typhi?
Typhoid fever
What are the symptoms of Typhoid Fever?
- Fever
- Headache
- Rose-spots on the abdomen
- Diarrhea
Where in the body can Salmonella typhi remain to cause a carrier state?
Gallbladder
How is C. jejuni transmitted?
Fecal-oral through foods including:
- Poultry
- Meat
- Unpasteurized milk
How does C. jejuni present?
Bloody diarrhea, esp. in kids
What temperature does C. jejuni grow in?
42 C
What are unique sequelae of C. jejuni infection?
- Gullian-Barre Syndrome
- Reactive arthritis
What type of diarrhea is associated with Vibrio cholera?
Rice-water
How is Yersinia enterocoliticia transmitted?
- Pet feces
- Contaminated milk or pork
How can Y. enterocolitica present?
Mesenteric adenitis that mimics Crohn’s Disease or appendicitis
What is triple therapy for H. pylori?
1) PPI
2) Clarithromycin
3) Amoxicillin or metronidazole
What is the mnemonic to remember the three spirochetes?
BLT
B= Borrelia L= Leptospira T= Treponema
How is Treponema visualized in the lab?
Dark-field microscopy
Where is Leptospira interrrogans found?
Water contaminated with animal urine
What are the symptoms of Leptospirosis?
- Flu-like sx.
- Jaundice
- Photophobia
Where is Leptospirosis seen in the US?
Surfers in HI
What is Weil Disease?
Severe “incterohemorrhagic leptospirosis”
- Severe jaundice
- Azotemia (high level of nitrogen containing compounds)
- Hemorrhage
- Anemia
What is the vector for Borrelia burgdorferi?
Ixodes tick
Same vector for Babesia
What is the natural reservoir for Borrelia burgdorferi?
Mouse
What is the mnemonic to remember the symptoms of Lyme Disease?
FAKE a Key Lyme pie
F= Facial nerve palsy A= Arthritis K= Kardiac Block E= Erythema migrans--bull's eye rash
How is Lyme Disease treated?
1) Doxycycline
2) Cetfriaxone
What causes Syphilis?
Treponema Pallidum
How is Syphilis treated?
PCN G
How does primary syphilis present?
Painless chancre
How is primary Syphilis diagnosed?
Serologic testing:
- VDRL/RPR
What is secondary Syphilis?
Disseminated Syphilis
What are the sx. of secondary Syphilis?
1) Constitutional sx.
2) Maculopapular rash on palms and soles
3) Condylomata lata
What is tertiary Syphilis?
Spread of Syphilis to the heart and CNS causing:
1) Gummas
2) Aortitis
3) Neurosyphilis/ Argyll Robertson pupil
What are the signs of tertiary syphilis?
- Broad-based ataxia
- Positive Rhomberg
- Charcot joint
- Stroke without HTN
What are the signs of congenital syphilis?
- Saber shin
- Saddle nose
- CN VIII deafness
- Hutchinson teeth
- Mulberry molars
What is the mnemonic to remember what an Argyll Robertson pupil is?
Prostitute pupil i.e. accomodates but does not react
- Constricts with near-vision
- Does NOT react to light
What is the VRDL test used to detect Syphilis?
Detection of nonspecific antibody that reacts with cardiolipin
What is the mnemonic to remember the false positives seen with VDRL?
VDRL
V= viruses D= drugs R= rheumatic fever L= lupus and leprosy
What disease is caused by Anaplasma?
Anaplasmosis
What is the vector for Anaplasma?
Ixodes tick
What disease is caused by Bartonella?
- Cat Scratch Disease
- Bacillary angiomatosis
What disease is caused by Borrelia recurrentis?
Relapsing fever
What is the vector for Borelia recurrentis?
Louse
What disease is caused by Brucella?
Brucellosis/ undulant fever
What is Brucellosis associated with?
Unpasteurized dairy products
What disease is caused by Coxiella burnetii?
Q fever
What are the common sources for Coxiella burnetti?
- Aerosols of cattle
- Sheep amniotic fluid
What disease is caused by Ehrlichia chaffeensis?
Ehrlichiosis
What is the vector for Ehrlichia chaffeensis?
Lone star tick
What disease is caused by Francisella tularensis?
Tularemia
What disease is caused by Pasteurella multocida?
Cellulitis and osteomyelitis
How is Pasteurella multocida transmitted?
Cat and dog bites (found on their salvia)
What disease is caused by Rickettsia prowazekii?
Epidemic typhus
What is the vector for Rickettsia prowazekii?
Louse
What disease is caused by Rickettsia rickettsii?
Rocky Mountain Spotted Fever
What is the vector for Rickettsia rickettsii?
Dermacentor ticks
What disease is caused by Rickettsia typhi?
Endemic typhus
What is the vector for Rickettsia typhi?
Fleas
What disease is caused by Gardnerella vaginalis?
Bacterial vaginosis
What type of discharge is seen with bacterial vaginosis?
Gray discharge with a fishy smell
On microscopy, what is pathognomonic for bacterial vaginosis?
Clue cells i.e. vaginal epithelial cells with Gardnerella bacteria
What is the treatment for Gardnerella vaginalis infection?
Metronidazole or Clindamycin
How are all the Rickettsial disease treated?
Doxycycline
Where is Rocky Mountain Spotter Fever commonly seen?
NOT in the Rockies; rather, South Atlantic states i.e. North Caroline
How is the rash seen in Rocky Mountain Spotted Fever described?
“Centripetal” or center seeking
- Starts on wrist and ankles
- Spreads to trunk palms and soles
What organism is responsible for Rocky Mountain Spotted Fever?
Rickettsia rickettsii
What type of rash is seen in Typhus?
“Centrifugal”
- Rash starts centrally and spreads out
- Spares the palms and soles
What is the mnemonic to remember the difference between Typhus and Rocky Mountain Spotted Fever?
Rickettsii on the wRists, Typhus on the Trunk
What are the two types of Typhus?
Endemic and Epidemic
What is the difference between Endemic and Epidemic Typhus?
Endemic=
- Rickettsia typhi
- Fleas
Epidemic=
- Rickettsia prowazekii
What is Ehrlichiolsis?
Ehrlichiolsis is a vector borne disease that causes flu-like symptoms and a rare rash
What is the vector for Ehrlichiolsis?
Tick
How is Ehrlichiolsis diagnosed?
Monocytes with morula i.e. berry-like inclusions
How is Anaplasmosis diagnosed?
Granuylocytes with morulae in cytoplasm
What causes Q fever?
Coxiella brunetii
How is Q fever transmitted?
- Tick feces and cattle placenta that release spores
- Spores are inhaled as aerosols
How does Q fever present?
Pneumonia
What is the mnemonic for Q fever?
Q fever is Queer b/c:
1) No rash
2) No vector
What are the two forms of Chlamydiae?
Elementary body= Enfectious/ Enters the cell and then transforms into:
Reticulate body= Replicates
What infections are caused by Chlamydiae trachomatis?
1) Nongonococcal urethritis
2) PID
3) Follicular conjunctivitis
4) Reactive arthritis
What diseases is caused by Chlamydiae pneumoniae and pisttaci?
Atypical pneumonia
How are Chlamydiae infections treated?
Azithromycin or Doxycycline
What is unique about the structure of the Chlamydiae species?
Lack muramic acid in cell wall
How is Chlamydiae diagnosed?
Cytoplasmic inclusions seen on Giemsa stain or flourescent antibody staining
What infection is predominantly caused by Chlamydiae trachomatic Types A, B, and C?
Chronic follicular conjunctivitis
What is the mnemonic to remember the important clinical features associated with Chlamydiae trachomatis Types A, B, and C?
ABC=
- Africa
- Blindness
- Chronic infection
What infections are predominantly caused by Chlamydiae trachomatic Types D-K?
- Urethritis/ PID
- Ectopic pregnancy
- Neonatal pneumonia
- Neonatal conjunctivitis
What infection is predominantly caused by Chlamydiae trachomatic Types L1, L2, and L3?
Lymphogranuloma venereum=
1) Painless ulcers on genitals that swell
2) Transition to painful inguinal LN that ulcerate (buboes)
How is Lymphgranuloma venereum treated?
Doxycycline
What is caused by Mycoplasma pneumonia?
Atypical “walking” pneumonia
What is Mycoplasma pneumonia associated with?
Military recruits and prisons
How is Mycoplasma pneumonia treated?
Macrolide, doxycycline or fluoroquinolone
What antibiotics should NOT be used to treat Mycoplasma pneumonia? Why?
PCNs b/c Mycoplasma has NO cell wall