Systems Flashcards
Normal flora skin
Staphylococcus epidermidis
Normal flora nose
S. epidermidis, colonized by S. aureus
Normal flora oropharynx
Viridans group streptococci
Normal flora dental plaque
Streptococcus mutans
Normal flora colon
Bacteroides fragilis > E. coli
Normal flora vagina
Lactobacillus, colonized by E. coli and group B strep
Food poisoning from seafood
Vibrio parahaemolyticus and V. vulnificus
Food poisoning from reheated rice
Bacillus cereus
Food poisoning from meats, mayo, custard
S. aureus (preformed toxin)
Food poisoning from reheated meat dishes
Clostridium perfringes
Food poisoning from improperly canned foods
C. botulinum
Food poisoning from undercooked meat
E. coli O157:H7
Food poisoning from poultry, meat, eggs
Salmonella
Mimics appendicitis
Yersinia entercolitica is MCC of mesenteric adenitis
Nontyphoidal Salmonella
Camplyobacter jejuni
Bugs that cause bloody diarrhea
Campylobacter - comma/s-shpaed, 42 C
Salmonella - lactose (-), flagellar motility, animal reservoir, poultry/eggs
Shigella - lactose (-), low ID50, Shiga toxin
EHEC - O157:H7, HUS, Shiga-like toxin
EIEC - invades colonic mucosa
Yersinia enterocolitica - daycare outbreaks, pseudoappendicitis
Entamoeba histolytica - protozoan
Bugs that cause watery diarrhea
ETEC - traveler’s diarrhea, ST/LT toxin
Vibrio cholerae - comma shaped, rice water
C. difficile - bloody too, pseudomembranous
C. perfringens - gas gangrene
Protozoa - giardia, cryptosporidium (IC)
Viruses - rotavirus, norovirus
Bugs that cause pneumonia in neonates
Group B streptococci
E. coli
Bugs that cause pneumonia in children
Viruses - RSV Mycoplasma Chlamydia trachomatis C.pneumoniae Streptococcus penumoniae (Runts May Cough Chunky Sputum)
Bugs that cause pneumonia in adults
Mycoplasma
C. pneumoniae
S. pneumoniae
Bugs that cause pneumonia in older adults
S. pneumoniae H. influenzae Anaerobes Viruses Mycoplasma
Bugs that cause pneumonia in elderly
S. pneumoniae Influenza Anaerobes H. influenzae Gram-negative rods
Nosocomial bugs pneumonia
Staphylococcus, enteric gram negative rods
IC bugs pneumonia
Staphylococcus, enteric gram negative rods, fungi, viruses, Pneumocystis
Aspiration pneumonia
Anaerobes
Alcoholic/IVDA pneumonia
S. pneumoniae
Klebsiella
Staphylococcus
Cystic fibrosis pneumonia
Pseudomonas
S.aureus
S. pneumoniae
Postviral pneumonia
Staphylococcus
H. influenzae
S. pneumoniae
Atypical pneumonia
Mycoplasma
Legionella
Chlamydia
Meningitis of newborns
Group B streptococci
E. coli
Listeria
Meningitis of children
Streptococcus pneumoniae
Neisseria meningitidis
Haemophilus influenzae type B
Enteroviruses
Meningitis of 6 to 60 yoa
S. pneumoniae
N. meningitidis (#1 in teens)
Enteroviruses
HSV
Meningitis of 60 + yoa
S. pneumoniae
Gram-negative rods
Listeria
Tx for meningitis
ceftriaxone and vancomycin empirically and add ampicillin if Listeria is suspected
Viral causes of meningitis
Enteroviruses (coxsackievirus) HSV2 HIV West Nile VZV
Meningitis for HIV +
Cryptococcus, CMV, toxoplasmosis (brain abscess), JC virus
Bacterial CSF findings
increase opening pressure
increased PMN
increased protein
decreased glucose
Fungal/TB CSF findings
increased opening pressure
increased lymphocytes
increased protein
decreased glucose
Viral CSF findings
Normal to increased opening pressure
increased lymphocytes
normal to increase protein
normal glucose
osteomyelitis typical bug
children or adults?
what other tests?
s. aureus
children
elevated CRP and ESP
osteomyelitis bug if sexually active
N. gonorrhoeae, septic arthritis more common
osteomyelitis bug if diabetics/IVDA
Pseudomonas aeruginosa, Serratia
osteomyelitis bug if sickle cell
Salmonella
osteomyelitis bug if prosthetic replacement
S. aureus, S. epidermidis
osteomyelitis bug if vertebral disease
mycobacterium tuberculosis (pott’s disease)
osteomyelitis bug if cat and dog bites or scratches
Pasteurella multocida
UTI
Cause:
Clinical:
Males vs females:
UTI
Cause: ascension of microbes from urethra to bladder and can result in pyelonephritis - fevers, chills, flank pain, CVA tenderness, hematuria, WBC casts
Clinical: dysuria, frequency, urgency, suprapubic pain, WBCs in urine
Males: infants w/ congenital defects, vesicoureteral reflux, enlarged prostate
Females: 10x more common
Predisposing factors: obstruction, kidney surgery, catheterization, GU malformation, diabetes, pregnancy
Dx: positive leukocyte esterase test for bacterial and positive nitrate test for gram neg bacterial and urease test (proteus, klebsiella)
Leading cause of UTI
Escherichia coli
Green metallic sheen on EMB agar
(-) urease test
2nd leading cause of community acquired UTI in sexually active women
Staphylococcus saprophyticus
3rd leading cause of UTI
Klebsiella pneumoniae - large mucoid capsule and viscous colonies
(+) urease test
Red pigment producing, nosocomial and drug resistant UTI bug
Serratia marcescens
Nosocomial and drug resistant UTI
Enterobacter cloacae
Motility causes swarming on agar; produces urease; associated with struvite stones; UTI bug
Proteus mirabilis
Blue-green pigment and fruity odor; usually nosocomial and drug resistant UTI bug
Pseudomonas aeruginosa
ToRCHeS infections
Microbes that may pass from mother to fetus; transmission is transplacental; signs - hepatosplenomegaly, jaundice, thrombocytopenia, growth retardation. Toxoplasma gondii Rubella CMV HIV Herpes simplex virus 2 Syphilis Others: s. agalactiae, e. coli, listeria monocytogenes, meningitis of neonates
Toxoplasma gondii as a TORCH
Cat feces or ingestion of undercooked meat
Usually asymptomatic lymphadenopathy
Triad: chorioretinitis, hydrocephalus, intracranial calcifications
Rubella as a TORCH
Respiratory droplets
Rash, lymphadenopathy, arthritis
Triad: PDA, cataracts, deafness and blueberry muffin rash
CMV as a TORCH
Sexual contact/organ transplant
Usually asymptomatic - mono like illness
Hearing loss, seizures, petechial rash, blueberry muffin rash
HIV as a TORCH
Sexual contact, needlestick
Variable depending on CD4+ count
Recurrent infections, chronic diarrhea
HSV2 as a TORCH
Skin or mucous membrane contact
Usually asymptomatic, herpetic lesions
Encephalitis, herpetic lesions
Syphilis as a TORCH
Sexual contact
Chancre and disseminated rash are the two stages likely to result in fetal infxn
Stillbirth, hydrops fetalis, if child survives presents with facial abnormalities (notched teeth, saddle nose, short maxilla), saber shins, CN VIII, deafness
Rubella virus rash
Rash begins at head and moves down –> fine truncal rash, postauricular lymphadenopathy
Measles rash
A paramyxovirus begins at head and movign down
rash preceded by cough, coryza, conjunctivitis and blue-white Koplik’s spots on buccal mucosa
VZV rash
chickenpox
begins on trunk –> spreads to face and extremities with lesions of different age
HHV-6 rash
Roseola
macular rash over body appears after several days of fever
febrile seizures
usually affects infants
Parvovirus B19 rash
erythema infectiosum
slapped cheek rash on face
can cause hydrops fetalis in pregnant women
Streptococcus pyogenes rash
scarlet fever
erythematous, sandpaper-like rash with fever and sore throat
Coxsackievirus type A rash
Hand-foot-mouth disease
Vesicular rash on palms and soles, ulcers in oral mucosa
Gonorrhea
Clinical
Organism
Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy purulent discharge
Neisseria gonorrhoeae
Primary syphilis
Clinical
Organism
Painless chancre
Treponema pallidum
Secondary syphilis
Clinical
Organism
Fever, lymphadenopathy, skin rashes, condylomata lata
Treponema pallidum
Tertiary syphilis
Clinical
Organism
Gummas, tabes dorsalis, general paresis, aortitis, Argyll Robertson pupil
Treponema pallidum
Chancroid
Clinical
Organism
Painful genital ulcer, inguinal adenopathy
Haemophilus ducreyi
Genital herpes
Clinical
Organism
Painful penile, vulvar or cervical vesicles and ulcers; cause cause systemic symptoms such as fever, HA, myalgia
HSV2, less commonly HSV1
Chlamydia
Clinical
Organism
Urethritis, cervicitis, conjunctivitis, Reiter's syndrome, PID Chlamydia trachomatis (D-K)
Lymphogranuloma venereum
Clinical
Organism
Infection of lymphatics; genital ulcers, lymphadenopathy, rectal strictures
C. trachomatis (L1-L3)
Trichomoniasis
Clinical
Organism
Vaginitis, strawberry colored mucosa, motile in wet prep
Trichomonas vaginalis
AIDS
Clinical
Organism
Opportunistic infections, Kaposi’s sarcoma, lymphoma
HIV
Condylomata acuminata
Clinical
Organism
Genital warts, koilocytes
HPV6 and 11
Hepatitis B
Clinical
Organism
Jaundice
HBV
Bacterial vaginosis
Clinical
Organism
Noninflammatory, malodorous discharge (fishy smell), positive whiff test, clue cells, non exclusively an STD
Gardnerella vaginalis
PID
Bugs:
Clinical:
Risk for:
PID
Bugs: Chlamydia trachomatis, Neisseria gonorrhoeae,
Clinical: cervical motion tenderness (chandelier sign), purulent cervical discharge; salpingitis, endometritis, hydrosalpinx, tubo-ovarian abscess
Risk for: Fitz-Hugh-Curtis syndrome (infxn of liver capsule and violin string adhesions or parietal peritoneum); ectopic pregnancy, infertility, chronic pelvic pain, adhesions
Nosocomial infections newborn nursery
CMV, RSV
Nosocomial infections urinary catheterization
E. coli, Proteus mirabilis
Nosocomial infections wound infection
S. aureus
Nosocomial infections respiratory therapy equipment
Pseudomonas aeruginosa or when burns are involved
Nosocomial infections in renal dialysis unit
HBV
Nosocomial infections hyperalimentation
Candida albicans
Nosocomial infections of water aerosols
Legionella - water source
Unimmunized children with a rash
Beginning at head and moving down with postauricular lymphadenopathy - Rubella
Beginning at head and moving down; rash preceded by cough, coryza, conjunctivitis, and blue-white spots on buccal mucosa - Measles virus
Unimmunized children with meningitis
Microbe colonizes nasopharynx - H. influenzae type B
Myalgia and paralysis - Poliovirus
Unimmunized children with pharyngitis
Grayish oropharyngeal exudate (pseudomembranes can obstruct) with painful throat –> Corynebacterium diphtheriae
Unimmunized children with epiglottitis
Fever with dysphagia, drooling, and difficulty breathing due to edematous “cherry red” epiglottis –> H. influenzae type B
