Systems Microbiology EC Flashcards
Normal dominant flora in Skin
Staph. epidermidis
Normal dominant flora in Nose
Staph epidermidis
Staph. aureus (colonized)
Normal dominant flora in Oropharynx
Viridans group strep.
Normal dominant flora in Dental plaque
Strep. mutans
Normal dominant flora in Colon
Bacteriodes fragilis > E. coli
Normal dominant flora in Vagina
Lactobacillus
colonized by E. coli and group B strep
Food poisoning from contaminated seafood
Vibrio parahaemolyticus Vibrio vulnificus (also wound infections w/ water/shellfish)
Food poisoning from Reheated rice
Bacillus cereus
Food poisoning from Meats, Mayonnaise, Custard
S. aureus (preformed toxin)
Food poisoning from Reheated meat dishes
Clostridium perfringens
Food poisoning from Improperly canned foods (bulging cans)
Clostridium botulinum
Food poisoning caused by Undercooked meat
E. coli O157:H7
Food poisoning caused by Poultry, Meat, and Eggs
Salmonella
Bugs that can mimic appendicitis
Yersinia enterocolitica
Salmonella
Campylobacter jejuni
Bloody diarrhea: Comma/S-shaped, grow at 42 degrees C
Campylobacter jejuni
Bloody diarrhea: Lactose negative, flagellar motility, fish/turtle/poultry/egg reservoir
Salmonella
Bloody diarrhea: Lactose negative, very low ID50, produces toxin
Shigella (shiga toxin)
Bloody diarrhea: Can cause HUS, Shiga-like toxin
EHEC O157:H7
Bloody diarrhea: Invades colonic mucosa
EIEC
Bloody diarrhea: Day-care outbreaks, pseudoappendicitis
Yersinia enterocolitica
Bloody diarrhea: Protozoan
Entamoeba histolytica
Watery diarrhea: Traveler’s diarrhea, ST and LT toxins
ETEC
Watery diarrhea: Comma-shaped, rice-water diarrhea
Vibrio cholerae
Watery diarrhea: Pseudomembranous
C. dif (can sometimes be bloody)
Watery diarrhea: Also causes gas gangrene
C. perfringens
Watery diarrhea: by Protozoa
Giardia
Cryptosporidium (immunocompromised)
Watery diarrhea: Viruses
Rotavirus
Norovirus
Causes of pneumonia in Neonates
Group B strep
E. coli
Causes of pneumonia in Children
“Runts May Cough Chunky Sputum”
RSV Mycoplasma Chlamydia C. pneumoniae Strep. pneumo
Causes of pneumonia in Adults 18-40
Mycoplasma (walking pneumonia)
C. pneumoniae
Strep. pneumo
Causes of pneumonia in Adults 40-65
S. pneumo H. influenzae Anaerobes Viruses Mycoplasma
Causes of pneumonia in Elderly (65+)
S. pneumo Influenza virus Anaerobes H. influenzae Gram negative rods
Causes of nosocomial pneumonia
Staph.
Enteric gram - rods
Causes of pneumonia in immunocompromised
Staph. Enteric gram - rods Fungi Viruses Pneumocystis jirovecii in HIV (CD4<200)
Causes of aspiration pneumonia
Anaerobes
Causes of pneumonia in Alcoholic/IV drug user
S. pneumo
Klebsiella
Staph
Causes of pneumonia in CF
Pseudomonas
S. aureus
S. pneumo
Post-viral causes of pneumonia
Staph
H. influenzae
S. pneumo
Causes of atypical pneumonia
Mycoplasma
Legionella
Chlamydia
Causes of meningitis in Newborn
Group B strep
E. coli
Listeria
Causes of meningitis in Children (6mo-6yrs)
Strep. pneumo
Neisseria meningitidis (w/ purpura)
H. influenzae (in unvaccinated)
Enterovirus
Causes of meningitis 6-60yrs
S. pneumo
N. meningitidis (esp. in teens)
Enterovirus
HSV
Causes of meningitis 60+
S. pneumo
Gram - rods
Listeria
How do you treat meningitis
Ceftriaxone + Vancomycin (add Ampicillin for Listeria)
CSF findings in bacterial meningitis
Opening pressure: Increased
Cell type: Increase PMNs
Protein: Increased
Sugar: Decreased
CSF findings in Fungal/TB meningitis
Opening pressure: Increased
Cell type: Increased lymphocytes
Protein: Increased
Sugar: Decreased
CSF findings in Viral meningitis
Opening pressure: Increased/normal
Cell type: Increased lymphocytes
Protein: Increased/Normal
Sugar: Normal
Osteomyelitis with no other information available
S. aureus
Osteomyelitis and sexually active
N. gonorrhoeae (rare-septic arthritis more common)
Osteomyelitis in Diabetic or IV drug user
Pseudomonas aeruginosa
Serratia
Osteomyelitis in Sickle cell
Salmonella
Osteomyelitis in Prosthetic replacement
S. aureus
S. epidermidis
Osteomyelitis in Vertebrae
TB (Pott’s disease)
Osteomyelitis due to cat/dog bites or scratches
Pasteurella multocida
What does a positive leukocyte esterase test mean?
Bacterial UTI
What does a positive nitrite test mean?
Gram negative bacterial UTI
What is the leading cause of UTI?
E. coli
2nd leading cause of community acquired UTI in sexually active women
Staph. saprophyticus
3rd leading cause of UTI w/ large mucoid capsule and viscous colonies
Klebsiella pneumo
Nosocomial UTI that are drug resistant
Serratia marcescens (produce red pigment) Enterobacter cloacae
UTI: motility/swarming on agar, urease +, associated with struvite stones
Proteus mirabilis
Nosocomial UTI w/ blue/green pigment and fruity odor, drug resistant
Pseudomonas aeruginosa
Hemorrhagic cystitis
Adenovirus
Acute urethral syndrome in women associated with intercoarse
Chlamydia trachomatis
Mother to fetus infections
ToRCHHS
Toxoplasma gondii Rubella CMV HIV HSV-2 Syphilis
Toxoplasma gonii (Transmission, Maternal, Neonatal)
Cat feces or ingestion of undercooked meat
Mother asymptomatic
Neonate:
Chorioretinitis
Hydrocephalus
Intracranial calcifications
Rubella (Transmission, Maternal, Neonatal)
Respiratory droplets
Mother: Rash, Lymphadenopathy, Arthritis
Neonate: PDA Cataracts Deafness "Blueberry muffin" rash
CMV (Transmission, Maternal, Neonatal)
Sexual contact, organ transplants
Mother asymptomatic (or mononucleosis like)
Neonate:
Hearing loss
Seizures
Petechial rash “blueberry muffin”
HIV (Transmission, Maternal, Neonatal)
Sexual, needlestick
Mother variable depending on CD4 count
Neonate:
Recurring infections
Chronic diarrhea
HSV-2 (Transmission, Maternal, Neonatal)
Skin or mucous membrane contact
Mother asymptomatic (other than lesions)
Neonate:
Encephalitis
Vesicular lesions
Syphilis (Transmission, Maternal, Neonatal)
Sexual
Mother: Chancre (primary), Disseminated rash (secondary)
Neonate: Stillbirth Hydrops fetalis Notched teeth Saddle nose Short maxilla Saber shins (curved) CN VIII deafness
Child with fine truncal rash that begins at head and descends; postauricular lymphadenopathy
Rubella virus
Child with cough, coryza, conjunctivitis, and blue white (Koplik) spots on buccal mucosa. Rash begins at head and descends.
Measles virus
Child with vesicular rash beginning on trunk. Spreads to face and extremities with lesions of different age.
VZV (chickenpox)
Infant with several days of high fever develops macular rash. Febrile seizures.
HHV-6 (roseola)
Child with “slapped cheek” rash on face (can cause hydrops fetalis in utero)
Parvovirus B19 (erythema infectiosum)
Child with erythematous, sandpaper-like rash with fever and sore throat and strawberry tongue.
Step. pyogenes (scarlet fever)
Child with vesicular rash on palms and soles. Ulcers in oral mucosa.
Coxsackievirus A (Hand-Foot-Mouth disease)
Urethritis, Cervicitis, PID, Prostatitis, Epididymitis, Arthritis, Creamy purulent discharge
Gonorrhea
Painless chancre
Primary syphilis (T. pallidum)
Fever, Lymphadenopathy, Skin rash, Condylomata lata
Secondary syphilis (T. pallidum)
Gummas, Tabes dorsalis, General paresis, Aortitis, Argyll Robertson pupil (accommodates but not react)
Tertiary syphilis (T. pallidum)
Painful genital ulcer, inguinal adenopathy
Chancroid (H. ducreyi “it’s so painful, you DO CRY”
Painful penile vulvar or cervical vesicles and ulcers. Fever, headache, myalgia.
Genital herpes (HSV-2)
Urethritis, Cervicitis, Conjunctivitis, Reiter’s syndrome (reactive arthritis), PID
Chlamydia (D-K)
Infection of lymphatics, genital ulcers, lymphadenopathy, rectal strictures
Lymphogranuloma venereum (C. trachomatis L1-L3)
Vaginitis, Strawberry-colored mucosa, motile in wet prep
Trichomonas. vaginalis
Opportunistic infections, Kaposi’s sarcoma (caused by HHV-8), Lymphoma
AIDS (HIV)
Genital warts, koilocytes
Condylomata acuminata (HPV-6 and 11)
STD w/ jaundice
HBV
Noninflammatory, malodorous discharge “fishy”, Positive whiff test, clue cells, not exclusively and STD
Bacterial vaginosis (Gardnerella vaginalis)
Cervical motion tenderness, Purulent cervical discharge. (Diagnosis, Causes, and Complications)
PID
Chlamydia and Gonorrhea
Salpingitis (ectopic pregnancy, infertility, chronic pelvic pain, adhesions), Endometritis, Hydrosalpinx, Tubo-ovarian abscess
Fitz-Hugh-Curtis syndrome- Liver capsule infection with “violin string” adhesion to parietal peritoneum.
Nosocomial infections from newborn nursery
CMV
RSV
Nosocomial infections from urinary catheterization
E. coli
Proteus mirabilis
Nosocomial infection from respiratory equipment
Pseudomonas aeruginosa
“think AIRuginosa for air or burns”
Nosocomial infection from dialysis
HBV
Nosocomial infection from Hyperalimentation (overeating, TPN)
Candida albicans
Nosocomial infection due to water aerosols
Legionella
Unimmunized child with rash beginning at head and descending with postauricular lymphadenopathy
Rubella
Unimmunized child with rash beginning at head and descending. Rash preceded by cough, coryza (respiratory inflammation), conjunctivitis, blue-white (Koplik) spots on buccal mucosa.
Measles
Unimmunized child with Meningitis. Microbe colonizing nasopharynx.
H. influenzae
Unimmunized child with Meningitis. Can lead to myalgia and paralysis.
Poliovirus
Unimmunized child with pharyngitis with grayish oropharyngeal exudate (“pseudomembranes” may obstruct airway). Painful throat.
C. diphtheriae (toxin causes necrosis in pharynx, head, and CNS)
Unimmunized child with Epiglottitis, fever with dysphagia, drooling. Difficulty breathing due to edematous “cherry red” epiglottis
H. influenzae (sometimes occurs in immunized children)