Reverse Comprehensive Microbial List Flashcards
1
Q
Eddman
- inheirited, rare disorder
- progressive degree of insomnia to sleeplesness
- autonomic instability, motor system degeneration, spongiform changes (like CJD)
A
Fatal familial insomnia
2
Q
Eddman
- similar to smallpox, milder.
- fever, headache, lymphadenopathy, malaise, myalgia, back ache.
A
Monkeypox
3
Q
Eddman
- HSV1: oral secretions
- HSV2: genital secretions
- painful ulcerating lesions on skin or mucous membranes
- Herpes encephalitis and hepatitis (rare HSV1)
- neonatal Herpes–serious complication of maternal genital herpes (high mortality)
- acyclovir effective
A
Herpes Simplex Virus 1 and 2
4
Q
Eddman
- a.k.a Tropical Foot, fusospirochetal infection
- Follows trauma (lesions) in the tropics, malnutrition is a factor.
- Painful leg legion with necrosis, sloughing of skin, and gray putrid exudate -May be complicated by tibial osteomyelitis and squamous cell carcinoma
- Deep wounds that persist for years, often need reconstructive surgery to fix
A
Tropical Phagedenic Ulcer (Bacillus fusiformis and Treponema vincentii)
5
Q
Eddman
- ingestion of food contaminated with eggs
- most common helminthic infection in humans
- usually ASYMPTOMATIC
- penetrate small intestine and travel to lungs
- can cause obstruction of pancreatic or biliary ducts-pancreatitis, suppurative cholangitis, and liver abscesses.
- Ascaris pneumonia (rare): larvae fill alveolar airspaces
A
Ascariasis (Ascaris lumbricoides)
6
Q
Eddman
- Epidemiology: ancient disease. named after latin “varius” meaning “pimple/spot”. Common in Europe. Arrived in the new world by explorers and decimated native populations. Edward Jenner (1796) performed first vaccination by innoculating child with lymph from hand of milkmaid infected with cowpox. WHO began eradication campaign in 1967 leading to eradication in 1978 (Somalia last endemic cases). CDC and Russia still have virus stockpiled.
- Etiology: Spread between infected and susceptible hosts via droplets or aerosol of infected saliva. Virus highly stable and remains infective for long periods outside human host. Variola major (Asia and parts of Africa–prototypical) and Variola minor (Africa, South America, and Europe–minor systemic toxicity and lesions).
- Pathology: Skin vesicles of variola show reticular degeneration and areas of ballooning degeneration. Guarnieri bodies (eosinophilic, intracytoplasmic inclusion bodies) are seen, but not specific to smallpox (most poxviral infections). Vesicles also occur in palate, pharynx, trachea, and esophagus. Severe cases produce gastric and intestinal involvement, hepatitis, and interstitial nephritis.
- Clinical Features: Incubatin period: 12 days (7-17 days). Spreads to regional lymph nodes to produce viremia. Abrupt malaise, fever, vomiting, and headache manifest. Characteristic rash (face and forearms) follows in 2-3 days. After eruptions on lower extremities, rash spreads central during next week to trunk. Lesions: macules–>papules–>pustular vesicles–>scabs–>scars. Fatality rate is 30% in unvaccinated.
A
Smallpox (Variola virus)
7
Q
Eddman
- Gram(-), highly motile. -granulomatous–taken up by macrophages
- Pyogenic STD with 3 characteristic stages
- Primary: Chancre (firm, painless) with luetic vasculitis, occasionally multiple lesions in immunecompromised.
- Secondary: (involves systemic spread) Maculopapular rash on palms and soles of the feet, follicular and numular syphilids, condylomata lata (white plaques on perineum region), obliterative endarteritis.
- Latent stage: Asymptomatic
- Tertiary (3-15 yrs after infection): Gumma: soft, tumor-like balls of inflammation which may vary considerably in size. NeuroSyphilis - meningitis, seizure, dementia + tabes doralis (peripheral nerve demyelination) Cardiovascular syphilis- aortitis => aneurism.
- Congenital syphilis can cause snuffles, saddle nose, saber shins, and Hutchinson teeth in newborn
A
Syphilis (Treponema pallidum)
8
Q
Eddman
- Rare, granulomatous disease.
- Zoonotic; associated with horses.
- Burkholderia mallei aka pseudomonas mallei
- Transmission via cuts in the skin, via musoca, or inspiration.
- Nodular lesions in the lungs and ulceration of the mucous membranes in the upper respiratory tract
- Acute bacteremia => Almost always fatal. Generally a 50% mortality rate and very small minimum infectious dose.
A
Glanders
9
Q
Eddman
- Spread via respiratory tract and secretions (person-person) -Necrosis of respiratory epithelium, with predominate lymphocytic infiltrate.
- Warthin-Finkeldey giant cells (up to 100 nuclei).
- fever, rhinorrhea, cough, and conjunctivitis. -Progresses to characteristic mucosal and skin lesions (Koplik spots) develope -Subacute sclerosing panencephalitis (SSPE) -more deadly in immunocompromised
A
Rubeola (Measels)
10
Q
Eddman
- Coxiella burnetii
- From animals–inhalation of aerosolized dropletts
-phagocytosed and proliferation inside macrophages.
- Typically a self-limited systemic infection, particularly lungs and liver.
- Granulomatous hepatomegaly.
A
Q Fever
11
Q
Eddman
- mosquito vector (South America + Africa) flavivirus -coagulative necrosis of hepatocytes
- Presence of apoptotic (Councilman) bodies in liver biopsies.
- abrupt onset of fever, chills, headache, myalgias, nausea, and vomiting.
- 3-5 days, hepatic failure with jaundice, clotting factor deficiencies, and diffuse hemorrhages.
- “Black vomit” is classic feature of severe cases.
- High mortality rate
A
Yellow Fever
12
Q
Eddman
- Mango fly bite transmites loa loa (round worm), which travels to the conjunctiva, where it can be readily seen in patient.
- Does not cause blindness
- rarely lethal (sudden + diffuse cerebral ischemia)
- usually self limited with mild CNS involvement
A
Loiasis “African Eye Worm”
13
Q
Eddman
- Epidemeology: 10-40 million annual cases for 35,000 deaths. Highly contagious and epidemics spread world wide. Hemagluttinin (H) and Neuraminidase (N) designate serotype.
- Pathology: Necrosis and desquamination of ciliated respiratory tract epithelium–lymphocytic infiltrate. infection of lungs leads to necrosis and sloughing of alveolar lining cells.
- Clinical Features: Rapid onset of fever, chills, myalgia, headaches, weakness and nonproductive cough. Upper respiratory infection Deaths from both influenza and its complications. Vaccine 75% effective in preventing influenza.
A
Influenza Type A, B, C
14
Q
Eddman
- small, aerobic bacillus, gram(-)
- respiratory spread: aerosols of infected sources, NOT CONTAGIOUS
- pneumoina: Legionaire’s Disease (life-threatening) and Pontiac fever (milder, self-limiting)
- proliferate inside resident macrophages (granulomatous)–macrophages show eccentric nuclei pushed aside by vacuoles containing L. pneumophila
- alveolar necrosis, fever, nonproductive cough followed by hypoxia leading to death.
- Silver grain stain, Urine antigen test for diagnosis
A
Legionella pneumophilia
15
Q
Eddman
- sporadic, familial, iatrogenic (from pituitary of cadaveric victims)
- neurodegenerative -myoclonus, behavioral changes, dementia
- New Variant (vCJD): associated with mad cow
- genetic susceptibility (met-met at codon 129 of gene PRNP -fatal (no cure)
A
Creutzfeldt-Jakob Disease
16
Q
Eddman
- Light or non-productive cough.
- Non-lobar, very small localizations. “Patchy consolidation” often in lower lung.
- Caused by unexpected organisms (Not: Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis)
- Caused by atypical bacteria, viruses, fungi,
- smallest free-living prokaryotes
A
Atypical pneumonia (Mycoplasmal pneumoniae) = Walking pneumonia
17
Q
Eddman
- Asia, Vietnam, Korea
- spread by ingesting inadequately cooked freshwater fish
- flat and transparent adult
- lethal due to complications: biliary obstruction, bacterial cholangitis, pancreatitis, cholangiocarcinoma
A
Clonorchiasis / Liver fluke (Clonorchis sinensis)
18
Q
Eddman
- spread through ingestion of uncooked crab
- Korea, Philippines, Taiwan, China
- peripheral eosinophilia-distinguishing factor against TB + eggs in sputum or stools
- frequently misdiagnoses as tuberculosis
A
Paragonimiasis / Lung fluke (Paragonimus westermani)
19
Q
Eddman
- extracellular enteric infection
- diarrheal infection
- self-limiting, unless immunocompromised
- AIDS patients, etc, develop chronic infection with persistent chronic diarrhea that can lead to death
A
Cryptosporidiosis (Cryptosporidium parvum)
20
Q
Eddman
-
A
Pinworm Infection (Enterobius vermicularis)
21
Q
Eddman
- Histoplasma capsulatum.
- Primarily effects lung, typically SELF_LIMITED in HEALTHY.
- Intracellular, macrophages = > granulomatous, may resemble TB. => caseous necrosis + calcifications.
- Can dissemminate bone, spleen, liver, adrenal glands, mucocutaneous membranes–AIDS, immunocompromised–fatal,
A
Histoplasmosis
22
Q
Eddman
- Mosquito-born, hemolytic, febrile illness.
- obligate intracellular parasite-replicate, kill human cells
- Equitorial regions (tropics)
- P. falciparum tends to be worst.
- Human reservoire; gametocytes are in human blood and taken up by mosquito
- Reproduce sexually in mosquito = > sporozoites
- Trasmitting to human via bite; go to the liver and form merozoite, perform asexual division.
- Merozoites can invade/multiply within/destroy RBCs. => hemosiderin-laiden Macrophages seen.
- Hepatosplenomegaly
- clumped, infected erythrocytes block blood vessels–hemorrhages, obstruction–acute renal failure with renal blood vessels, intravsascular hemolysis leads to hemoglobinuric nephrosis (blackwater fever)
A
Malaria (Plasmodium sp: P. falciparum, P. vivax, P. ovale, P. malariae)
23
Q
Eddman
- CSF with leukocytosis,CSF is clear with mild pleocytosis and elevated protein in CNS infection.
- meningoencephalitis (Medulla).
- Fever, Rash, lymphadenopathy, and polyarthropathy.
- not very infectious, but severe disease has moderate mortality
- most dangeous in elderly and immunocompromised
A
West Nile Virus (Flaviviridae)
24
Q
Eddman
- antigenically diverse, aerobic (facultatively anaerobic), gram(-) rod, most commensal and opportunistic
- synthesize vitamin K2, virulence after plasmid transfer
- 90% of all urinary tract infections -bladder mucosa infection–dysuria, pyuria (leukocytes in urine)
- Immunocompromised: Pneumonai, sepsis
- neonatal meningitis: colonizes vaginal canal
- Four strains:
- ENTEROTOXIGENIC: traveler’s diarrhea from contaminated water and food, self-limited (Africa, Latin America)–produce 3 enterotoxins–secretory dysfunction of small bowel (one similar to cholera-adenylyl cyclase, other acts on guanylyl cyclase)
- ENTEROPATHOGENIC: diarrheal illness in tropical regions among infants and children, spread from contaminated food and water, deforms microvilli of intestinal epithelial cells, fever + malaise
- ENTEROHEMORRHAGIC: bloody diarrhea, fever, cramping abdominal pain, hemolytic-uremic syndrome (anemia, acute kidney failure, thrombocytopenia), contaminated meat/milk, enterotoxin similar to Shigatoxin
- ENTEROINVASIVE: food-borne DYSENTERY, indistinguishable from shigella (similar toxin to shiga toxin)-self-limited, invades and destroys mucosal cells of ileum and colon. abdominal pain, fever, tenesmus (feeling of incomplete defecation), bloody diarrhea. week long illness
A
Escherichia coli
25
Q
Eddman
- penetrate human epidermis on contact-enter venous circulation
- Duodenale = Asia / Mid East / Africa
- Americanus = Americas, Southeast Asia, Subsaharran africa.
- GI inflammation, iron deficiency anemia
- Most common cause of chronic anemia worldwide.
A
Hookworms (Necator americanus, Ancylostoma duodenale)
26
Q
Eddman
- infects lymphocytes and monocytes–Infectious Mononucleosis
- symptomatic in immune suppressed patients (as is EBV)
- encephalitis, pneumonitis, GI hemmorhage
A
Cytomegalovirus
27
Q
Eddman
- Inadequatly cooked or encysted meat; PORK.
- Survives in human skeletal muscle, myositis (diaphragm, ocular muscles, tongue, intercostals, deltoids, gastrocnemius), calcifications
- Classic sign: periorbital edema, swelling around the eyes, which may be caused by vasculitis.
- Extreme eosinophilia (>50% of leukocytes)
- May have CNS or cardiac involvement
A
Trichinosis (Trichinella spiralis)
28
Q
Eddman
- Orientia tsutsugamushi, a Gram-negative α-proteobacterium of Rickettsia family.
- Transmitted by Chigger (mites) bite, leaving a black eschar that helps with diagnosis.
- Endemic to parts of Russia, Korea and Japan.
- Can be fatal without treatment.
- Similar effects to those above.–obligate intracellular pathogen–infects endothelial cells
A
Scrub Typhus
29
Q
Eddman
- spread by eating contaminated vegetation (watercress) with cysts from sheep
- cysts liberate metacecariae that pass into peritoneal cavity–live in intrahepatic and extrahepatic bile ducts
- hepatic abscesses and granulomas
- induce hyperplasia of bile duct epithelium, portal and periductal fibrosis, and biliary obstruction
- Symptoms: eosinophilia, vomiting, acute gastric pain
- Fatal if untreated
- diagnosis: recovering eggs from stool or biliary tract
A
Fascioliasis
30
Q
Eddman
-Spreads person to person through intimate contact - respiratory tract or open wounds
-Proliferates in areas of lower body temperature (hands and face)
-Infection occurs in 5% of exposed people and is either tuberculoid or lepromatous
Tuberculoid = Moderate: few lesions, dermal granulomas with sensory loss (not caseous). Reflects appropriate TH1 activation
Lepromatous = Severe: foamy macrophages act as incubators and form globi. Form diffuse, tumor like lesions of skin, eyes, testes, nerves, lymph nodes and spleen. Results from deficient TH1 activation.
A
Leprosy (Mycobacterium leprae)
31
Q
Eddman
Epidemiology: Spreads by respiratory route. World wide locus. Not highly contagious (only 10-15% unvaccinated women remain susceptible into reproductive years). live attenuated viral vaccine prevents rubella.
Pathology: Infects repiratory epithelium and spreads to bloodstream and lymphatics. Rash results from immunologic response to virus and resolves in 3 days. Fetal infection occurs through placenta during viremic phase of maternal illness. Fetus remains persistently infected. Heart, brain, eyes most frequently affected in fetus.
Clinical Features: Febrile illness, rhinorrhea, conjunctivitis, postauricular lymphadenopathy. 30% infections asymptomatic. Fetus: pulmonary valvular stenosis, pulmonary artery hypoplasia, ventricular septal defects, and patent ductus arteriosus. Cataracts, glaucoma, and retinal defects. Microcephally and mental retardation
A
Rubella (German Measels)
32
Q
Eddman
- infection of connective and subcutaneous tissues
- transmitted by drinking water contaminated with intermediate host, crustacean of genus Cyclops
- year incubation: symptoms: systemic allergic reaction, blisters that burst upon contact with water with female worm partially emerging
- dead worms provoke intense inflammatory response
A
Dracunculiasis / Guinea worm (Dracunculus medinensis)
33
Q
Eddman
- gummas in skin, airways, bone
- transmission is mouth-to-mouth, breast-to-mouth, or utensil-to-mouth
- usually begins in childhood as a small mucous patch, often on the interior of the mouth, followed by the appearance of raised, eroding, Pyogenic lesions on the limbs and trunk. Periostitis (inflammation) of the leg bones is commonly seen, and gummas of the nose and soft palate develop in later stages.
- Mediterrenian/West Africa
A
Bejel (endemic syphilis) (Treponema pallidum endemicum).
34
Q
Eddman
- aerobic, gram(+) rod, pleomorphic
- P2P spread: respiratory droplets + oral secretions
- diphteria exotoxin
- thick, gray, leathery membranous lesions from respiratory epithelium (necrotic debris, fibrin, neutrophils,
- fever, sore throat, malaise -treated with antitoxin and antibiotics
- most in western world immunized
- peripheral nerve demyelination w/ neural involvement
A
Corynebacterium diphtheriae
35
Q
Eddman
- aerobic, pleomorphic, gram(-) coccobacillus, nonencapsulated, capsulated(Type B): most virulent
- P2P spread: respiratory droplets and secretions
- Normal flora of oropharynx -pyogenic infection, MENINGITIS (#1 cause in
- broncopneumonia, epiglottitis (obstruct airway), septic arthritis (bacteremic), facial cellulitis (bacteremic)
- vaccine: nearly eliminated infantile meningitis
A
Haemophilus influenzae
36
Q
Eddman
- aerobic, curved, gram(-) rod
- spread from ingesting contaminated food/water; shellfish are natural reservoir–sporadic outbreaks
- epidemics in areas where human feces pollute water supply -cholera exotoxin: binds GM1 ganglioside in enterocyte cell membrane to enter cell and activated adenylyl cylase- increase cAMP and increase Na+/H20 secretion into intestinal lumen. -severe watery diarrhea with flecked mucus (rice water stools)–leads to fluid and electrolyte loss that leads to shock
- 50% mortality rate in untreated patients (lacking electrolyte and oral rehydration therapy +antibiotis)
- vaccine available (50% effectiveness)
A
Cholera (Vibrio cholerae)
37
Q
Eddman
- respiration or cutaneous inoculation
- gram(+) aerobic filamentous
- May affect lungs, brain, skin or systemic dissemination
- Disease of immunocompromised.
- Pyogenic: Pulmonary abcesses w/ central necrosis.
- Fatal if untreated, long term antibiotics.
A
Nocardia (Nocardiosis)
38
Q
Eddman
- ingestion of fecal contaminated food (from dogs/cats)
- hypereosinophilia, pneumonitis, hypergammaglobulinemia
- cheif symptom: loss of vision in one eye.
- usually Self-limited
A
Visceral Larva Migrans / Toxocariasis (Toxocara canis & T. catis)
39
Q
Eddman
- Gram-negative, aerobic, coccobacillus bacterium
- highly antibiotic-resistant
- nosocomial pneumonia, wound infections, UTI, and sepsis
- proteoglycan coat protects against ciliary action, complement, and phagocytes
- elastase, alkaline protease, cytotoxin (exotoxin A)– ADP-ribosylate/inhibit EF-2 (like diptheria toxin) facilitate tissue invasion
- ECTHYMA GANGRENOSUM: disseminated infections causes these skin lesions
- AGRESSIVE: rapid sepsis progression (exotoxin + endotoxin production)–hemorrhagic necrosis + thrombosis
A
Pseudomonas aeruginosa
40
Q
Eddman
- spread through skin on contact (dogs and cats major source of of disease)
- severe, itching, inflammation
A
Cutaneous Larva Migrans (“Creeping eruption”)
41
Q
Eddman
- rare transmissable spongiform encepalopathy
- dementia common feature
- some rare sporadic cases, usually familial
A
Gerstmann-Straussler-Scheinker Syndrome
42
Q
Eddman
- gram(-) bacillus, histology looks like school of fish
- P2P: sexually
- Chancroid: leading cause of genital ulcers in 3rd world countries (facilitate spread of HIV)
- opportunistic: enters through breaks in skin
- painful, unilateral, suppurative, inguinal lymphadenitis (bubo)
- erythromycin: effective treatment
A
Chancroid (Haemophilus ducreyi)
43
Q
Eddman
- Epidemiology: Present worldwide–disease of childhood. Highly contagious–infects 90% of exposed with 60-70% showing symptoms. Live attenuated viral vaccine prevents mumps.
- Pathology: Viral infection of respiratory epithelium–necrosis. Disseminates through blood and lymphatic systems to salivary and parotid glands, CNS, pancreas, and testes. 50% cases involve CNS. Epididymoorchitis (unilateral; no sterility) present in 30% males (swollen to three times normal size)–causing local infarctions. Swollen glands and ducts lined by necrotic epithelium and interstitium infiltrated by lymphocytes.
- Clinical Features: Fever and malaise followed by painful swelling of salivary glands, one or both of parotids. Symptomatic meningeal involvement manifests as headache, stiff neck, and vomiting. Prior to vaccination, mumps was leading cause of viral meningitis. Patients exhibit elevated serum amylase levels though sever pacreatitis is rare.
A
Mumps
44
Q
Eddman
- Via sandfly bite.
- proliferate in macrophages–amastigotes
- Tropic/Subtropic, overcrowding.
- Skin soars, may progress to disseminated disease, splenomegaly.
- kala azar=visceral leishmaniasis “black sickness”-viscera overwhelmed by build up of infected macrophages–disrupts organ architecture with sheets of parasitized macrophages.
- kala azar is fatal: Requires treatment if disseminated.
A
Leishmaniasis (Leishmania spp.)
45
Q
Eddman
- Environmental fungi, cause severe necrotizing, invasive infections that begin in sinuses and lungs (spores are inhaled)
- Rhinocerebral: creates a black crust with friable/hemorrhagic underlying tissue - spreads to vessels and brain. Tx = surgery, amphotericin B, may be fatal
- Pulmonary: Usually fatal, looks like aspergillosis (sepsis and infarction)
- Subcutaneous zygomycosis: In the tropics, hard inflamm. mass on shoulder, trunk, buttock, thigh
A
Mucormycosis (Zygomycosis)
46
Q
Eddman
- short, encapsulated, facultative anaerobic, gram(-) rods
- necrotizing lobar pneumonia with cavitations
- 10% of nosocomial infections: P2P spread
- patients with COPD, endotracheal tubes, catheters, and immunosuppressed.
- complication from influenza or other viral infections
- characteristic THICK MUCOID SPUTIM
- can lead to fulminating, deadly septicemia–requires aggressive antibiotic treatment
A
Klebsiella (pneumoniae) + Enterobacter
47
Q
Eddman
- penetrate human epidermis
- most cases asymptomatic, lethal disseminated disease in immunocompromised persons.
- reproduce in human hosts-autoinfection (rhabditiform larvae become infective filariform within host’s intestine and repenetrate perianal skin–new parasitic cycle
- Immunocompromised: autoinfection greatly increased-penetrate intestinal walls and disseminate leading to ulceration, edema, and severe inflammation leading to sepsis from gram(-) bacteria-FATAL
A
Strongyloidiasis / Threadworm (Strongyloides stercoralis)
48
Q
Eddman
- infectious mononucleosis: fever, malaise, pharyngitis, splenomegaly
- lymphadenopathy–spleen and lymph nodes (cervical)
- atypical lymphocytes
- heterophilic antibody–distinguishing lab test
A
Epstein-Barr Virus
49
Q
Eddman
- Epidemiology: spreads person to person by respiratory route. Infection common and occurs in outbreaks, mostly among children.
- Pathology: gains entry to erythroid precursor cells via P erythrocyte antigen and produces certain cytopathic effects: enlarged nuclei with peripheral chromatin displacement and eosinophilic material nuclear inclusion bodies.
- Clinical Features: Mild exanthematous illness (rash) known as erythema infectiosum, accompanied by interruption of erythropoiesis (mostly asymptomatic). Potentially fatal anemia caused in hosts with chronic hemolytic anemia–transient aplastic crisis. Fetal infection leads to severe anemia, hydrops fetalis, and death in utero (10% of maternal infections).
A
Human Parvovirus B19
