Part 2- Microbio Diagnosing - Sheet1 Flashcards
UTI presentation
Dysuria, frequency, urgency, suprapubic pain, WBCs (but no wbc casts)
Pyelonephritic presentation
WBC casts*, fever, chills, flank pain, CVA tenderness, hematuria
Predisposing factors for UTI
- Women (short urethras, colonized by fecal flora)
- obstruction
- kidney surgery
- catheterization
- GU malformations (vesicoureteral reflux)
- Diabetes
- pregnancy
Diagnosing UTI
- Positive leukocyte esterase test = Bacterial UTI
- Positive Nitrite test = Gram-neg bacterial UTI
Leading cause of UTI
E. coli
2nd leading cause of community-acquired UTI in sexually active women
Staph Saprophyticus
suck it, saprophyticus!
3rd leading cause of UTI
Large mucoid capsule, viscous colonies, positive urease
Klebsiella
Nosocomial and drug-resistant UTI
- Serratia Marcescens (produce cherry red pigment)
- Enterobacter cloacae
- Pseudomonas (blue-green pigment, fruit odor)
UTI: assoc w struvite stones. Motility causes “swarming” on agar, produces urease
Proteus mirabilis
Childhood rash: rash begins on face and moves down –> fine truncal rash, Postauricular lymphadenopathy
Rubella!
Childhood rash: beginning at head and moving down, rash is preceded by cough, coryza, conjunctivitis and blue-white/Koplik spots on buccal mucosa
Measles! (a paramyxovirus)
Childhood rash: Vesicular rash begins on trunk, spreads to face and extremities w lesions of different age**
Chickenpox (VZV)
Childhood rash: Macular rash over body appears after several days of high fever. can present w febrile seizures**. Affects infants
Roseola (HHV-6)
Childhood rash: “Slapped cheek” rash on face (can cause hydrops fetalis in pregnant woman)
Parvovirus B19
“Erythema infectiosum”
Childhood rash: Erythematous, sandpaper-like rash w fever and sore throat
Scarlet fever (Step pyogenes)
Childhood rash: Vesicular rash on palms and soles, ulcers* in oral mucosa
Hand-foot-mouth ds (Coxsackievirus type A)
STD: Urethritis, cervicitis, PID, prostatitis, epididymis, arthritis*, creamy PURULENT discharge
Gonorrhea (N. gonorrhoeae)
STD: Painless chancre
Primary syphillis (Treponema pallidum)
STD: Fever, lymphadenopathy, skin rashes, condyloma lata
2ndary syphillis (Treponema pallidum)
STD: Gummas, tabes dorsalis, general paresis, aortitis, Argyll Robertson pupil
Tertiary syphillis (Treponema pallidum)
STD: Painful genital ulcer, inguinal adenopathy
Chancroid (Haemophilus ducreyi - “it’s so painful, you DO CRY”)
STD: Painful penile, vulvar, or cervical vesicles and ulcers. Can cause systemic sxs such as fever, headache, myalgia
Genital herpes: HSV-2, less commonly HSV-1
STD: Urethritis, cervicitis, conjunctivitis, Reiter’s syndrome, PID
Chlamydia (Chlamydia trachomatis D-K)
STD: Infxn of lymphatics; genital ulcers (heal quickly, painless), lymphadenopathy, RECTAL STRICTURES**
Lymphogranulmoa venereum (C. trachomatis L1-L3)
STD: Vaginitis, strawberry-colored mucosa, motile on wet prep
Trichomoniasis (Trichomonas vaginalis)
STD: Opportunistic infxns, kaposi’s sarcoma, lymphoma
AIDS/HIV
STD: Genital warts, Koilocytes
Condyloma Accuminata* (HPV6 and 11)
STD: Jaundice
Hepatitis B
STD: Noninflammatory, malodorous discharge (fishy smell), positive whiff test, clue cells, not exclusively an STD
BV: Gardenella vaginalis
PID top bugs:
Chlamydia tachomatis (subacute, often undiagnosed) Neisseria gonorrhoeae (acute) -Sxs: Cervical motion tenderness/Chandelier sign, purulent cervical discharge
Nosocomial: Newborn nursery
RSV, CMV
Nosocomial: Urinary catheterization
E. coli
Proteus mirabilis
Nosocomial: wound infection
Staph aureus
Nosocomial: Respiratory therapy equipment
Pseudomonas (assume when air or burns are involved)
Nosocomial: work in renal dialysis unit
HBV (needle stick)
Nosocomial: Hyperalimentation (over eating, too much protein/urea –> osmotic diuresis)
Assoc w Candida
Nosocomial; water aerosols
Legionella!
HY: pus, empyema, abscess
Staph aureus
HY: Pediatric infection
Haemophilus influenzae (including epiglottis for those not vaccinated)
HY: Pneumonia in CF, burn infection
Pseudomonas aeruginosa
HY: Branching rods in oral infxn, sulfur granules
Actinomyces Israelii
HY: Traumatic open wound
Clostridium perfingens
HY: Surigcal wound
Staph aureus
HY: Dog or cat bite
Pasteurella multocida
HY: “currant jelly” sputum
Klebsiella
HY: positive PAS stain
Tropheryma whipplei (Whipple’s ds)
HY: sepsis/meningitis in newborn
Group B strep (aglactaie)
HY: Health care provider
HBV (needle stick)
HY: Fungal infxn in diabetic or immunocompromized
Mucor or Rhizopus spp
HY: Asplenic pt
Encapsulated, esp: Strep pneumo, H. flu type B, N. meningitidies
HY: Chronic granulomatous ds
Catalase positive microbes, esp S. aureus
HY: Neutropenic pts
Candida albicans (systemic), Aspergillus
HY: Facial nerve palsy
Borrelia burgdorferi (Lyme ds)