OTITIS, SINUSITIS, DIPHTHERIA, & PERTUSSIS Flashcards by S C

most common bacterial cause of otitis externa

p. aeruginosa, staph aureus

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most common bacterial cause of otitis media and sinusitis

strep pnemo (50%), moraxella catarrhalis, haemophilus flu

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most common bacterial cause of diphtheria

corynebacterium diphtheriae

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most common bacterial cause of pertussis

bordetella pertussis

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predisposing factors of OE

MOISTURE, foreign objects, trauma, chronic skin dz

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signs and symptoms of OE

otalgia and otorrhea

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p. aeruginosa

G- bacilli, encapsulated, pigment producer

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types of pigments in p. aeruginosa

Pyocyanin (non-fluorescent blue) 2. Pyoverdin (fluorescent green)

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pyocyanin

generates ROS

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pyoverdin

sequestrate iron a siderophore

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staph aureus

G+ cocci in clusters, encapsulated, Coagulase positive, beta hemolytic

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beta hemolytic

staph aureus

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coagulase positive

staph aureus

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dx of OE

examination and gram stain

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tx of OE

removal of debris, topicals ( acidifying agents, corticosteroids, abx), oral if fever, systemic analgesics

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acute OM

inflammation of the middle ear a/w fluid

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sinusitis

inflammation w/in paranasal sinuses

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strep pneumo

G+, lancet shaped diplococci, virulent strains are encapsulated, alpha hemolysis on blood agar, sensitive to optochin

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? is sensitive to optochin

strep coccus pnemo

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alpha hemolysis on blood sugar a/w

streptococus pneumo

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H. flu

G- cocobacilli, nontypeable strains

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M. Catarrhalis

G- diplococci, oxidase positive, beta lactamase producer

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oxidase positive a/w

m. catarrhalis

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OM dx

clinical presentation, culture and gram stain of fluid

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OM tx

amoxicillin, tympanostomy tubes

sinusitis dx

nasal biopsy (cytology), CT scan, allergy testing

tx of sinusitis

varies: irrigation, analgesics, decongestant, abx, steroids, surgery

corynebacterium

G + pleomorphic bacilli shaped

chinese letters appearance a/w

corynebacterium diphtheriae

metachromatic (volutin) granules

corynebacterium diphtheriae

grows aerobically on blood agar

corynebacterium diphtheriae

cultured on selective media isolation/identification

corynebacterium diphtheriae

toxigenic strains of corynebacterium diphtheria have

phage-exotoxin = diphtheria toxin

diphtheria toxin

A-B exotoxin

what does the A subunit of diphtheria toxin do?

inactivated EF-2 via ADP-ribosylation=>halting protein synthesis

cutaneous diphtheria is due to

nontoxigenic strains

respiratory diphtheria

formation of pseudomembrane

ball neck a/w

serious dz of respiratory diphtheria

diphtheria spread via

person-person via droplets/skin

diphtheria Dx :culture

Loeffler's medium & Cysteine-tellurite agar

Loefflers medium

supports growth & enhances formation of volutin granules

cysteine-tellurite agar

distinctive black to tellurite reduction-> isolates tested for toxin

Loefflers medium

diphtheria

cysteine-tellurite agar

diphtheria

diphtheria Dx: staining

Gram: club shaped G+ bacilli Volutin: Metachromatic (volutin) granules

club shaped G+ bacilli

diphtheria

toxin tests for diphtheria on isolates

Elek test, PCR, ELISA, Immunochromatographic strip assay

Elek test

immunodiffusion assay to secretion of exotoxin

PCR

detect presence of tox gene

ELISA

detect diphtheria exotoxin

Immunochromatographic strip assay

detect diphtheria exotoxin -very sensitive

diphtheria tx

1. Neutralize w/antitoxin 2. erythromycin 3. isolation 4. vaccine when recovered

diphtheria prevention

vaccine toxoid (formalin-inactivated toxin)

bordetella pertussis

small G- coccobacilli, aerobic on agar

virulence factors in bordetella pertussis

endotoxin, exotoxin, adhesins

pertussis adhesins

attachment to integrins =>colonization of the cilliated respiratory epithelium

pertussis toxins

1. A-B exotoxins 2. dermonecrotic toxin 3. tracheal cytotoxin 4. adenylate cyclase toxin

three stages of pertussis

1. catarrhal 2. paroxysmal 3. convalescent

catarrhal stage

nosspecific URI

pertussis highly contagious

catarrhal stage

paroxysmal stage

paroxysmal cough w/ vomiting for weeks

complication during paroxysmal stage due to

vomiting and increased pressure

convalescent stage

recovery, less paroxysms for weeks

complication of convalescent stage

PNEUMONIA, encephalopathy, seizures, death

pertussis epidemiology

human dz, more in <1yo, endemic dz, epidemics

presumptive dx of pertussis

serology ELISA to detect Igs

definitive Dx of pertussis

1. culture sample on enriched medium 2. PCR (highly sensitive)

Cultures for pertussis

1. Bordet-gengou agar 2. Regan-lowe agar

pertussis tx

erythromycin, caccine

pertussis vaccine

inactivated toxin and 1+adhesins/ other components