SST Part II Flashcards by Jimleo Badilla

caused by an infection with Corynebacterium diphtheria or Corynebacterium ulcerans

Cutaneous Diphtheria Infection

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transmitted by direct contact with infected skin or getting a tattoo (very contagious)

C. diphtheria

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transmitted from infected animals/animal products

C ulcerans

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only species that have acquired the ____ _____ from a bacteriophage can cause respiratory form of Diphtheria

tox gene

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both toxigenic and non-toxigenic strains can cause ______ _______

cutaneous form

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C .diphtheriae
gram:
Catalase:
Urea

small gnb in club forms
positive
neg

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C ulcerans
gram:
Catalase
Urea:

small gpb in club forms
positive
pos

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infection of lymphatics by C trachomatis Serovars L1, L2, L2a orL3;
through sexual transmission, travels to lymphatic system-replicates in mononuclear cells

Lymphogranuloma venereum (LGV)

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LGV stage that begins as a genital ulcer that is painless-heals quickly

Primary stage

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spreads to lymph nodes near genital area
lymph node swells into painful buboes, becomes pus filled-begin to leak out pus or burst
2-4 weeks after primary stage

Secondary stage

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strictures/obstruction of lymph vessels
-possible necrosis of genital tissue

tertiary stage

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stage of Syphilis infection that causes a painless ulcer called chancres

primary stage skin manifestations

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stage of syphilis infection with reddish brown rash

Secondary stage skin manifestation

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stage of Syphilis infection with gumma formation on skin, bones, and organs with tissue destruction

Tertiary Stage skin manifestations

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an organism that is sexually transmitted
-causes Chancroid, a painful lesion with a soft edge
-if untreated, ulceration can cause lymph node buboes

Haemophilus ducreyi

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colonial appearance of H ducreyi
_____-_____ dry colonies that can be pushed intact across agar surface
gram:
oxidase
which factor does it need to grow

tan-yellow
gncb in school of fish formation
pos
only X factor

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branching beaded gnb, aerobic, white,chalky, smooth, dry crumbly colonies that can look like molar tooth

Nocardia

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Lyme disease
tick

Borrelia burgdorferi

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Rocky Mountain spotted fever
ticks, mites, lice, and flease

Rickettsiae (small gnb)

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Leptospirosis
rodents and other mammals

Leptospira interrogans (spirochete)

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Bartonellosis (Cat scratch fever)
sandflies, lice, fleas, animal scratches or bites

Bartonella henselae and Bartonella quintana (gncb)

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Rat Bite fever, Streptobacillosis, Spirillosis
rodent bites, scratches, or contact with feces

Streptobacillus moniliformis (gnb)
Spirillum minus (GNB spiral shape)

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Tularemia
rabbits, rodents or other wild animals
bite form infected tick, flea, deerfly or mosquitoes

Francisella tularensis (gncb)

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Erysipeloid
animals, animal meat or hides and saltwater fish

Erysipelothrix rhusiopathiae

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Anthrax cutaneous form coming into contact with animal or animal products with bacillus spores

Bacillus anthracis

zoonotic skin disease organisms are BSL-__ organisms that must only be tested in Containment Level __ labs

3 3

Common viral skin manifestations

Rashes lesions Warts Vesicles

Fifth Disease; "slapped cheek rash"

Parvovirus B19

Oral herpres; cold sores

HSV-1

Papillomas; warts

HPV

Roseola; initial cold-like symptoms with high fever, followed by a macular or papular rash 3-5 days later

HHV-6 HHV-7

Varicella; chicken pox

VZV

Rubeola; measles

Paramyxovirus

Rubella; German measles

rubella virus

Monkeypox

Orthopoxvirus

zoonotic viruses that cause severe bleeding under skin

Ebola, Marburg, Dengue

Virus shed early in the infection- must be taken within __ days of infection; -should be taken from where the virus causes infection

lesions secretions are best but swabs are easier to take- must use _______ or _______ swabs- plastic or wire shaft

Dacron Rayon

Virus specimen testing: must process for culture immediately- if not possible or there is a delay, store at __ C if delay is significant (> 72 hrs)- freeze at ____ C Never freeze at -20C because ice crystals form which are detrimental to virus Never freeze and thaw numerous times because may kill virus

4 -70

Mycobacteria skin manifestations -due to Mycobacteria in MTB complex

Cutaneous manifestations

caused by Mycobacterium ulcerans and other ulcers caused by slow growing NTM

Buruli ulcer

caused by Mycobacterium leprae or Mycobacterium lepromatosis

Lerposy

caused by rapidly growing NTM

Cutaneous infections

Mycobacteria classification

causes Buruli ulcer (Africa) or Bairnsdale ulcer (Australia) -found in environment- transmission through trauma in skin -causes nodular skin lesions with or without ulceration -produces necrotizing immunosuppressive toxin- MYCOLACTONE -can also infect underlying bone to cause osteomyelitis

M ulcerans

causes leprosy -strictly a human pathogen- can only also infect armadillo -spread by respiratory droplet -Only 5% of people can develop leprosy-rest are genetically immune- but can still be carriers

M leprae (Hansen's Bacilli)

a form of leprosy with less number of organism with small number of infected skin patches

Paucibacillary

a form of leprosy with higher number of organisms with a larger number of infected skin patches

Multibacillary

Specimens for Mycobacterial skin infection investigation:

Swabs of the lesion, vesicle or ulcer Aspirate of fluid tissue samples blood

a Superficial mycoses caused by an often NF on skin; causes Tinea versicolor pathcy lesions, scaling or varied pigments on skin- most often face, chest trunk and abdomen -needs fat/oil to grow- found in areas with sebaceous glands -lab diagnosis includes microscopic exam of skin specimens on 10%KOH -"spaghetti and meatballs"= budding yeast & hyphae -will not grow on culture media unless covered with oil

Malassezia furfur

caused most often by Dermatophytes -involve keratinized area on host- skin, hair, and nails -causes a ring like lesion (ringworm) now named Tinea followed by the site where lesion is found

Cutaneous mycoses

Tinea pedis

feet

Tinea capitis

hair

Tinea corporis

body skin

3 genera of dermatophytes:

Microsporum Epidermophyton Trichophyton

infects skin and hair (not nails)

Microsporum

infects skin and nails (not hair)

Epidermophyton

infects hair, skin, and nails

Trichophyton

Dermatophytes are BSL ___ and can be worked up at a CL __ lab but must use proper PPE and a class __ BSC

2 2 2

Specimens for Dermatophytes:

Skin- scraped from the margin of the lesion Hair- PLUCKED, not cut, from the edge of the lesion Nails- scrapings are obtained form the nail bed

yeast infection of the skin caused by Candida spp most often C albicans; -affects warm, moist areas of skin especially where it creases -seen as red, itchy rash, where skin may crack or blister -can also infect nails or the corners of the mouth -seen most often in infant diaper rash

Cutaneous candidiasis

chronic infection of deep skin layers that may spread to muscle and bone but not usually blood or organs fungus found in soil in tropical areas and enters through sites of skin trauma causes progressive non-healing ulcers, may also see draining sinus tracts and tissue destruction

Subcutaneous mycoses

a mycetoma caused by a fungus

Eumycotic Mycetoma

if mycetoma caused by bacteria from group of Actinomycetes, like Nocardia

Actinomycetoma

a fungal infection that spreads throughout the body; can affect multiple organs, blood, CSF -can be fatal especially in immunocompromised individuals -usually caused by dimorphic fungus, Aspergillus or a yeast

Systemic Mycoses

Lab Diagnosis of Dimorphic Fungus BSL_ organisms should only be worked on in a CL_ Lab must use proper PPE and a class __ biological safety cabinet

3 3 II

a helminth that burrows along a tract, leaving a winding, threadlike, raised, reddish brown itchy rash -small bumps and blisters may also occur

Nematode (round worms) like Hookworm

causes irritation of skin where the larval form enters through the persons skin

Trematode like Schistosoma (flat worm)

insects from the genus Cimex, fed on blood, usually at night

Bed bugs

sarcoptes scabiei mite; burrows superficially in skin, causes intense itching and a generalized rash

Scabies

head Louse pedicures groin louse phthirus pubis head, body, pubic region spread by close contact itching and sores from itching

Lice