Term
| Pseudomonas Aeruginosa (TM and RV) |
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Definition
TM: inhalation and direct contact
RV: ubiquitous, more common in wet environments (wet sneakers), occasional pt of normal GI tract, inanimate objects |
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Term
| Pseudomonas Aeruginosa (DZ) |
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Definition
| DZ: pulmonary infections -> nosocomial infections, pts with indwelling devices-high risk, common CF pts, form biofilms, slimy capsule; ecthyma gangrenosum-necrotizing skin lesion in neutropenic pts; folliculitis; osteomyelitis; external otitis (swimmer's ear); skin -> localized tissue necrosis and vesicular damage, eye, UTI infections; otitis media, bacteremia, endocarditis |
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Term
| Pseudomonas Aeruginosa (EPI) |
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Definition
| EPI: debilitated, pts w/ lots of previous Ab exposure, pts w/ indwelling devices, neutropenic pts; contaminated hot tubs, whirlpools; ear-swimmers, diabetics; skin-burn pts, contact lens wearers, pts with indwelling devices; IV drug abusers |
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Term
| Pseudomonas Aeruginosa (VF) |
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Definition
| VF: capsule (anti-phagocytic, suppress neutrophil, inhibit Ab penetration); exotoxin A (blocks protein synthesis); extracellular proteases; motile due to flagella; overall virulence is low; elastase (degrades ECM and impede neutrophil production -> sepsis) |
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Term
| Pseudomonas Aeruginosa (DX) |
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Definition
| DX: easy to culture and ID; fluorescent pigments can help; blue green with fruity odor; oxidase positive |
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Term
| Pseudomonas Aeruginosa (TX) |
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Definition
| TX: plasmids are common, many multiply resistant strains; sensitivity test is a must; beta-lactam (piperacillin, ticaricillin, cefepime, ceftazimide) w/ aminoglycoside (gentamicin or tobramycin) |
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Term
| Nocardia (N. Asteroides and N. brasiliensis) (TM and RV) |
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Definition
TM: inhalation, direct contact with abrasions
RV: common soil bugs |
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Term
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Definition
| DZ: Nocardiosis-pneumonia that resembles TB with dyspnea, fever, productive cough, abscess, extensive nectrosis and cavity formation -> can spread to other sites; cutaneous infections-various abscesses, ulcerative lesions, cellulitis, painless mycetomas; often form and break surface |
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Term
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Definition
| EPI: opportunistic infections usually infect immunocompromised; tropical areas of skin |
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Term
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Definition
| VF: can survive inside macrophage |
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Term
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Definition
| DX: weakly acid fast along with branching filaments=very suggestive |
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Term
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Definition
| TX: long term TMX/SX; surgical drainage of abscess |
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Term
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Definition
TM: animal bite
RV: normal oral flora cats and dogs
DZ: pasteurella multocida-most common in cat bites, involve pain, erythema, edema -> progress to rapid cellulites with tenosynovitis, abscess, septic arthritis, osteomyelitis
EPI: hands and feet esp. of debilitated or immunocompromised
VF: capsule
DX: clinical signs/HX/culture
TX: amoxicillin-clavulanate |
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Term
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Definition
TM: animal bite
RV: normal flora in cats and dogs
DZ: capnocytophaga canimorus-most common in dogs, causes bacteremia and sepsis
EPI: immunocompromised or asplenics
TX: penicillin or cephalosporin empiric |
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Term
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Definition
TM: human bite
RV: opportunistic in bite
DZ: eikanella corrodens-infections usually polymicrobial (subacute endocarditis)
EPI: especially clenched fist wounds
TX: empiric tx same as for other bite wounds |
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Term
| Bartonella henselae (TM and RV) |
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Definition
TM: cat scratch, cat flea bite, close cat contact
RV: domestic cat pathogen, not part of normal flora |
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Term
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Definition
DZ: cat scratch disease-2 weeks post scratch -> verracous, nonerythemous, nontender papule appears on scratch line -> 2 weeks after nearby lymph node enlargement that takes 4-8 weeks to resolve
hepatosplenic CSD-high fever, malaise, anorexia, lesions usually resolve over time (consider in cases of fever of unknown origin)
bacillary angiomatosis-red raised mucocutaneous lesions that resemble lesions of kaposi sarcoma, accompanied by hepatosplenomegaly, fever, chills |
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Term
| Bartonella henselae (EPI) |
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Definition
| EPI: CSD -> 2-14 yrs of age; hepatosplenic CSD -> children; bacillary angiomatosis -> AIDS and other immunocomp |
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Term
| Bartonella henselae (DX and TX) |
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Definition
DX: serology using immunofluorescent Ab, PCR also available, H-CSD -> ultrasound or CTs can show liver and spleen changes, culture is slow and uncertain
TX: azithromycin |
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Term
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Definition
TM: bite of body louse
RV: infected humans only known resevoir
DZ: bacillary angiomatosis-same as B. henselae
trench fever-2 to 3 weeks post bite, recurrent fever, myalgia, headaches, bone pain with lasting bacteremia, may cause endocarditis
EPI: mainly poor population US and Europe, used to be epidemic in trenches in WWI
DX: culture from blood definitive, but slow and uncertain; serology for Ab to the bug
TX: macrolides 1st choice but controversial |
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Term
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Definition
-brackish or salt water environments
-causes either diarrhea or skin infections
-diarrhea due to eating undercooked or raw shellfish from salt waters, non-inflammatory and mild version of cholera, tx of diarrhea is fluid and salt replacement, more severe infections tx with doxycycline or fluoroquinolones
-wound infections due to cuts or trauma in contaminated ocean water (snorkeling or scuba diving) -> can lead to bullae and tissue necrosis
-severe infections can lead to bacteremia and septicemia
-pts with liver problems are more likely to get sever infections
-tx with doxycycline/ceftriaxone or fluoroquinolones |
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