Micropara Diseases/cause Flashcards
Bartonella sp stain
Whartin starry silver impregnation stain
Bartonella bacilliformis
Oroya fever - initial
Verruga peruana - eruptive stage
Bartonella henslae
Cat scratch disease
Bartonella quintana
Trench fever / quintan fever
Streptobacillus moniliformis
Rat bite fever
Haverhill fever
Trophyryma whipplei
Whipplei disease
Unusual bacteria pathogens
Bartonella
Streptobacillus moniliformis
Trophyryma whipplei
Obligate intracellular arthropod-borne bacteria
Ricketsiaceae
Anaplasmataceae
Coxiellaceae
Rickettsia prowazekii
Louse borne typhus
Brill zinsser disease
Rickettsia typhi
Murine typus
Fleaborne
Rickettsia tsutsugamushi
Scrub typhus
Mite borne
Rickettsia rickettsii
Rocky mountain spotted fever
Tick
Rickettsia conorii
Fiever boutonneuse
Tick
Tache noire
Black spot
Rickettsia sibirica
Siberian tick typhus
Rickettsia akari
Rickettsial pox
Mite
Rickettsia australis
Queensland tick typhus
Ehrlichia and anaplasma
Resemble chlamydia
Ehrlichia chaffeensis
Human monocyte ehrlichiosis
Tick
Ehrlichia ewingii
Ewingii Ehrlichiosis
Tick
Anaplasma phagocytophylium
Human granulocyte anaplasmosis
Tick
Coxiella burnetti
Q fever
Gram negative- but cannot be stained
Airborne, fomite, ticks
Mycobacteria
Rod shape, obligate aerobe
Cannot be classified as gram - or +
Acid fast
Resist discoloration by acid or alcohol
Mycobacteria members
Mycobacterium tuberculosis
“ leprae
“ Avium complex (M avium intracellulare)
“ bovis
Mycobacterium tubrculosis
Koch’s disease
Pulmonary TB
Spinal TB / Pott’s disease
Miliary TB
Mycobacterium tubrculosis culture medium
Inscipitated egg
Loweinstein - Jensen
Mycobacterium tubrculosis
Responsible for acid fastness
Lipids
Mycobacterium tuberculosis
spread in host (3 ways)
Direct extension
Lymphatic spread - regional lymphnodes
Hematogenous spread- to all organs
Mycobacterium tubrculosis
Diagnosis
TST- tuberkulin skin test (mantoux test)
Acid Fast Smear - Ziehl Nielsen method
CXR
Gene Xpert MTB/RIF
Mycobacterium tubrculosis
1st Line Agents
H- isoniazid
R- rifampicin
Z- pyrazinamide
E- ethambutol
Mycobacterium leprae
Leprosy
Hansen’s disease
Hansen’s disease
Leprosy
Lepromatous- progressive & malignant
Tuberculoid- benign & nonprogressive
Mycobacterium leprae
Leprosy / Hansen’s Disease
treatment
Dapsone (doc)
Lepromatous - dapsone+rifampicin+clofazimine
Tuberculoid- dapsone+rifampicin
Mycobacterium avium complex
M Avium Intracellulare
One of the mosst common oppurtunistic infection in parients with AIDS & cystic fibrosis
Chest CT: tree in bud pattern
Mycobacterium bovis
Causes TB like disease
Source of BCG (bacillus calmette-guerin)
Beta Lactams antibiotics
Inhibitors of bacterial cell wall synthesis
Penicillin
Cephalosporins
Carbapenems
Fluoroquinolones
Kill bacteria and fight infections
Ciprofloxacin
Levofloxacin
Ofloxacin
Typical pneumonia
Limited to lungs
Respond to beta lactams
S. Pneumoniae
H. Influenzae
Atypical pneumonia
Systemic findings
Does not respond to beta lactams
More severe
Mycoplasma Pneumoniae
Legionella pneumophila
Chlamydophila pneumoniae
Legionella pneumophila
Legionnaires disease- atypical pneumonia
Pontiac fever- self limiting
Pneumonia outbreak in american legion convention
Fastidious aerobic gram -
BCYE - buffered charcoal yeast extract agar with a-ketoglutarate, L-cysteine & iron
Mycoplasma sp
Smallest organisms
Requires sterol
Horse Serum and Yeast Extract (fried egg appearance)
Mycoplasma pneumaniae
Walking pneumonia
There may be blood streaked sputum
Mycoplasma hominis
Post partum fever
Ureaplasma urealyticum
Non gonococcal, non chlamydial urethritis in men
Mycoplasma genetalium
Chronic non gonococcal urethritis, cervicitis, endometritis, salpingitis, infertility
Spirochetes
Endoflagella (axial filaments)
Reproduce by tranverse fission (strobilization) asexual
Spirochetes members
Spirochaetaceae- treponema, borreilia
Leptospiraceae- leptospira
Treponema pallidum
Venereal - Syphilis (std)
Non Venereal - Bejel & Yaws
Syphilis acquired STD
Primary: hard chancre
Secondary: Condyloma lata
Latent: up to 10y
Tertiary: Gummas
Neurosyphilis
Aortic aneurism
Syphilis congenital
Hutchinsons triad: hutchinsons teeth, interstitial keratitis, sensorineural hearing loss
Saddle nose
Saber shin
Schapoid scapula
Treponema pallidum diagnosis
Non Treponemal test: screening, measure antibodies to cardiopilin (released by damaged cells)
RPR- rpaid plasma reagin TRUST- toluidine red unheated serum test
Treponemal test: confirmatory
TP-PA- T. pallidum particle agglutination
FTA ABS- fluorescent treponemal antibody absorbed
Treponema pallidum diagnosis
Non Treponemal test: screening, measure antibodies to cardiopilin (released by damaged cells)
RPR- rpaid plasma reagin TRUST- toluidine red unheated serum test
Treponemal test: confirmatory
TP-PA- T. pallidum particle agglutination
FTA ABS- fluorescent treponemal antibody absorbed
Treponema pallidum treatment
Pen. G
Treponema pallidum treatment
Pen. G
Jarisch Herxheimer reaction
Response to lipoproteins released by dying T. Pallidum organisms
Self limiting
Paul Ehrlich
Cure for syphilis
Arsphenamine / Salvarsan
Bejel
Caused by T. Pallidum ssp: endemicum
aka endemic syphilis
Oral lesions
Shared utensils
Yaws
Caused by T. Pallidum ssp: pertenuae
Direct contact
Borreilia recurentis
Relapsing fever
3-10 recurrences
Bacteria is in the blood during febrile stage but not during afebrile stage
Borreilia burgdorferi
Lyme disease
“Dart Target”
Ixodes tick
Lyptospira interrogans
Worldwide zoonosis
Sheds bacteria in the urine
Anecteric leptospirosis
Biphasic
Leptospiremia: 3-7days, acute phase
Leptospiruria: up to 1mo, immune phase
Self limiting
Icteric leptospirosis
Weil Symdrome
Triad of hemorrhage, jaundice & acute kidney injury
Leptospirosis treatment
Doxycycline
Ampicillin
Amoxicillin
Aerobic Non spore forming gram positive bacilli members
Corynebacterium diptheriae
Listeria monocytogenes
Erysipelothrix rhusiopathiae
Actinomycetes:
Nocardia
Actinomycetoma
Corynebacterium diptheriae
Clubbed shaped, resemble chinese letters or palisades
Transmission: droplet or contact
Corynebacterium diptheriae toxins
Fragment A: inhibits polypeptide chain elongation (arrest protein synthesis)
Fragment B: binds to host cell for receptor mediated endocytosis
Corynebacterium diptheriae diagnosis
Dacron swab
Culture: tellurite medium, Loffler serum
Identification: babes/ernst/volutin/metachromic granules
Red when stained with methylene blue
Beaded appearance
Elek test: to determine wether the organism is able to produce Diptheria Toxin
Corynebacterium diptheriae findings
Respiratory diptheria: bull neck
Cutaneous diptheria: membrane may form on an infected wound that fails to heal
Corynebacterium diptheriae
treatment & prevention
Penicillin, macrolides
Antitoxin
Diphtheria toxoid in DPT
Listeria monocytogenes
Can survive red temp 4•C, low pH, high salt
Foodborne
Tumble end over end motility
Umbrella growth pattern
Listeria monocytogenes
Findings
Perinatal listeriosis:
Granulomatosis infantiseptica- early onset
Neonatal meningitis- late onset
Adult listeriosis:
Erysipelothrix rhusiophatiae
H2S producing
Causes Erysipeloid in humans
Seal/whale finger
Raised, well circumscribed, violaceous
Causes Erysipelas in swine
Culture media: triple sugar iron - black colonies
Actinomycetes
Tends to form chains or filaments
With occasional branches
Truly acid fast
Mycobacterium
Weakly acid fast
Nocardia
Non acid fast
Streptomyces
Corynebacterium
Actinomadura
Nocardia
Filamentous with hyphae like branching
Contain mycolic acid that are shorter than those of mycobacteria
Nocardiosis: through inhalation
Oppurtunistic infection in corticosteroid treatment, organ transplantation, AIDS, & alcoholism
Nocardia
Nocardiosis treatment
Cotrimoxazole (doc)
Mycetoma (madura foot)
Causative agents
Actinomadura
Madurae
Streptomyces somaliensis
Actinomadura pelletieri
Nocardia asteroides
N. brasiliensis
madura foot treatment
Combination of:
Streptomycin
Trimethoprim
Sulfametoxazole
Dapsone
Amputation
Spore forming gram positive bacilli
Bacillus
Subtilis- bacitracin
Polymyxa- polymyxin
Anthracis
Cereus
Clostridium
Botulinum
Tetani
Perfeinges
Clostrioides defficile
Bacillus anthracis
Anthrax
Poly-y-d-gluthamic acid:
Bacillus anthracis toxins
Protective Antigen: PA
binds to specific receptors
mediates entry of EF & LF
Edema Factor:
w/ PA, forms edema toxin
Lethal Factor:
w/ PA, forms lethal toxin
major virulence factor
Bacillus anthracis findings
1- Cutaneous Anthrax
2- Inhalational Anthrax: woolsorter’s disease
3- Gastrointestinal Anthrax
4- Injection Anthrax
Bacillus anthracis
Anthrax treatment
Must be started early
Ciprofloxacin
Raxibacumab- treatment and prophylaxis against inhalational anthrax
Bacillus cereus
Food poisoning
Emetic type:
Due to emetic toxin
Diarrheal type:
Due to enterotoxin
Clostridium sp.
Large spore forming anaerobic gram positive motile (peritrichous) bacilli
With swollen sporangium
Many decompose proteins or form toxins or both
Saphrophytic
Clostridium sp. members
C. botulinum
C. tetani
C. perfringes
Clostridium botulinum transmission
Spiced, smoked, vacuum packed or canned alkaline foods that are eaten without cooking
Tissue contamination with spores (wound botulism)
Honey- for infant botulism)
Clostridium bitulinum
Snare proteins
Proteins that allow the fusion of vesicles and plasma membrane
Snare Proteins 2 types
V-snare:
In the vesicles
Synaptobrevin
T-snare:
In the target plasma membrane
Syntaxin
SNAP- 25
Clostridium botulinum findings
Flaccid paralysis
Floppy baby syndrome
Clostridium botulinum
treatment and prevention
Medical ventilator
Anti toxin
Cook canned goods before eating
Di not eat bulging canned goods
Clostridium tetani toxin
Found in soil dust, animal, manure
Spores through wounds
Tetanospasmin:
Larger peptide- binds to receptor
GABA
Smaller peptide- degrades synaptobrevin
VAMP2
Clostridium tetani findings
Spastic paralysis
Trismus / lockjaw
Risus sardonicus / sardonic smile
Opisthotonos / hyperarching of the back
Death from interference of respiration
Neonatal tetanus- cutting of umbelical cord with contaminated instruments
Clostridium tetani findings
Spastic paralysis
Trismus / lockjaw
Risus sardonicus / sardonic smile
Opisthotonos / hyperarching of the back
Death from interference of respiration
Neonatal tetanus- cutting of umbelical cord with contaminated instruments
Clostridium tetani
treatment
Prevention
Penicillin
Mescle relaxants
Sedation
Mechanical ventilator
Antitoxin
Active immunization with toxoids
Aggresive wound care
Prophylactic use of antitoxin
Administration of penicillin
Clostridium perfringes toxins
Alpha toxin:
Hydrolyzes lecithin to phosphorylcholine
Theta toxin:
A hemolysin- forms pores
Epsilon toxin:
Causes edema, hemorrhage
Clostridium perfringes enzymes
DNAse
Hyaluronidase
Collagenase
Clostridium perfringes findings
Gas gangrene / Clostridal myonecrosis
Clostridium perfringes
Clostridal Myonecrosis/Gas Gangrene treatment
Prompt & extensive surgical debridement
Excission of devitalized tissue
Penicillin
Hyperbaric oxygen
Amputation
Clostrioides defficile
Pseudomembranous colitis
Microabscesses in patients who have diarrhea & have been given antibiotics (ampicillin, clindamycin, fluoroquinolones) May be watery or bloody & frequently has abdominal cramps, leukocytosis and fever
Enterobacteriaceae
Enteric gram negative bacilli- coliforms
Facultative anaerobes or anaerobes
Catalase + & oxidase -
IMViC test
Indole test: detects ability to produce indole
Methyl Red: to produce acids
Voges-proskauer: to produce acetoin
Citrate: to utilize citrate
Ability to ferment lactose
Mediums
Eosin methylene blue
MacConkey
Deoxycholate
Rapid Lactose Feementers
Klebsiella
Escherichia
Enterobacter
Late Lactose Fermenters
Edwardsiella
Serratia
Citrobacter
Arizona
Providencia
Erwinia
Non Lactose Fermenters
Pathogenic pathogens
Salmonella arizonae
Shigella except sonnei
Yersinia enterocolitica
Oppurtunistic pathogens
Proteus
Morganella
Enterobacteriaceae members
Eacherichia
Klebsiella
Enterobacter
Serratia
Proteus
Morganella
Providencia
Citrobacter
Shigella
Salmonella
Yersinia
Enterobacteriaceae antigenic structure
O Antigen:
Most external part of cell wall
Resistant to heat & alcohol
K Antigen:
External to O antigen
Associated with virulence
H Antigen:
Located on flagella
Denatured bu heat & alcohol
Escherichia coli findings
Most common cause of UTI
Sepsis
Meningitis
Diarrheal diseases
Escherichia coli
5 types of diarrheal disease
EPEC- enteropathogenic - infants
ETEC- enterotoxigenic - traveller’s
STEC- shiga toxin
EIEC - enteroinvasive - same w/ shigellosis
EAEC - enteroaggreagative- 14days duration
Klebsiella pneumoniae
Friedlander’s bacillus
Capsule is made up of K antigens
Polysaccharide
Hospital Acquired Pneumonia
Klebsiella granulomatis
Formerly Calymmatobacterium granulomatis
Granuloma inguinale / Donovanosis
STD
Chronic genital ulcerative disease
Pseudobuboes
(subcutatneous granuloma)
Treatment: Azithromycin
Enterobacter cloacae
Enterobacter aerogenes
Cause hospital acquired infections
Pneumonia
UTI
Wound and device infections
Serratia marcescens
Common oppurtunistic pathogen in hospitalized patients
Causes:
Pneumonia
Bacteremia
Endocarditis
Proteus mirabilis
Proteus vulgaris
Causes infections in humans when the bacteria leave the intestinal tract
Causes:
UTI, bacteremia, focal lesions in debilitated patients or those receiving contaminated IV infusions
Produce urease
Hydrolyzes urea with liberation of ammonia
Urine becomes alkaline promoting stone formation and making acidification virtually impossible
Providencia
Members of the normal intestinal microbiota
Cause UTI
Citrobacter
Causes UTI & Sepsis pricipally among debilitated patients
Associated with meningitis in infants <2mos
Shigella
Transmission:
Food, fingers, feces and flies
Findings: Shigellosis
Bacillary dysentery/bloody diarrhea
Shigella toxin
Exotoxin
Heat labile
Antigenic
Enterotoxic: dysentery
Neurotoxic: meningitis, coma
Shigelliosis treatment
Self limited
For severe infections:
Ceftriaxone
Ciprofloxacin