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Bacteria II
Disease
70
Microbiology
Graduate
09/30/2009
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Term
Bordetella (Catarral)
 Definition
Nasal drainage, sneezing, low-grade fever, occasional coughing; 1-2 weeks; most communicable
Term
Bordetella (paroxysmal stage)
 Definition
2-4 weeks, up to 50 paroxysms a day; 10-20 abrupt rapid coughs with inability to breath between = whooping sound upon inhalation; may lead to exhaustion and vomiting
Term
Bordetella (convalescent)
 Definition
3-4 weeks, frequency and severity fade
Term
Neisseria pathogenesis
 Definition
 adhesion
• NG: urethra, rectum, cervix, pharynx, conjunctiva
• NM: nasopharnyx
 Endocytosis
 Transcytosis: basal membrane to submucosa
Term
NG
 Definition
 GU tract infections: symptoms may be mild to absent, esp. in women
 acute and easier to ID in males: urethritis (purulence)
 Endocervical, urethra, and vagina: discharge, dysuria, adb. pain, intermenstrual bleedingmay progress to cause salpingitis and pelvic inflammatory disease (PID)
 Disseminated gonococcal infection (DGI): fever, purulent arthritis, small pustules on skin with erythematous base
 ophthalmia neonatoreum: conjunctivitistreated with silver nitrate, tetracycline or erythromycin
 rectal infections: constipation, painful defecation, purulent discharge
 pharyngitis: oral-genital contact; purulent exudates-may mimic mild viral or streptococcal sore throat
Term
NM
 Definition
 meningitis: sore throat, headache, fever, stiff neck;100% mortality if not treated and 10% with; sequelae
 septicemia: thrombosis, skin lesions on trunk and lower extremities
 pneumonia
 arthritis
 urethritis
Term
Escherichia general
 Definition
• Extraintestinal disease
o opportunistic of normal flora
o UTIs
o Neonatal meningitis: w/in first month
o septicemia: intestinal perforation
Term
Enterotoxigenic E. coli (ETEC)
 Definition
watery diarrhea
Term
Enteropathogenic E. coli (EPEC)
 Definition
infant diarrhea; watery diarrhea, fever, vomiting
Term
Enteroaggregative E. coli (EAEC)
 Definition
infant diarrhea
Term
Enterohemorrhagic E. coli (EHEC)
 Definition
o starts with water diarrhea (~4 days)bloody diarrhea (hemorrhagic colitis) 1 to 2 days later
 recovery w/in 10 days
 ~10% children <5 y/o develops into Hemolytic-Uremic Syndrome (HUS): toxin causes direct kidney damage – life threatening
Term
Enteroinvasive E. coli (EIEC)
 Definition
o starts with water diarrhea
o dysentery-like illness (bloody stools with leukocytes, severe abdominal cramps, fever)
Term
Salmonella general
 Definition
• Salmonellosis
• Gastroenteritis
o onset: 24-48 hrs (nausea, vomiting, nonbloody diarrhea)
o May have abdominal cramps, low-grade fever, myalgias, and headache
o resolves in 2 to 7 days
• Bacteremia: higher in young, old, and immunocompromised
Term
S. typhi
 Definition
• Enteric/Typhoid fever (strictly human)
o transmission: food or beverage handler
o pass through cells or intestine, phagocytosed by macrophages, replicate (used catalase, superoxide dismutase)
o Liver, spleen, bone marrow, lymph nodes, gall bladder, into blood
o Endotoxin release (10-14 after infection): fever, malaise, lethargy, headache, aches and pains, faint rash on abdomen and chest, diarrhea or constipation
Term
S. paratyphi
 Definition
milder enteric/typhoid fever
Term
Shigella
 Definition
 Early symptoms (1-3 after ingestion)
• abdominal cramps, fever, diarrhea, bloody stools
 Later symptoms
• lower abdominal cramps, straining to defecate, pus, blood, neutrophils, RBCs and mucus in stool
 Self-limiting
Term
Y. pestis
 Definition
 Y. pestis
• Bubonic plague
o fleas ingest blood from infected animal; bites human
o incubation: 2-8 days
o high fever, chills, headache, myalgia and weakness
o painful bubo develops = pronounced swelling of infected lymph nodes: groin (most common), axilla, neck
o untreated can lead to bacteremia and death
• Pneumonic plague
o 2-3 days incubation
o Fever, malaise, pulmonary signs
o person-to-person spread
o untreated = high mortality
Term
Y. enterolotica and pseudotuberculosis
 Definition
• enterocolitis: Characterized by fever, abdominal pain, diarrhea; resolution 1-3 weeks
o when accompanied by LRQ pain/tenderness—clinically indistinguishable from appendicitis
Term
V. cholera
 Definition
• ingestionadherence and colonization of intestinal mucosaproliferation and exotoxin production
• Symptoms
o vomiting
o watery diarrhea: “rice water stools” – colorless, odorless, flecks of mucous, epithelial cells and lots of bacteria
o extreme fluid loss, muscle cramps, sever thirst, sunken eyes, apathy
o hypotension, shock, renal failure and death

contaminated food and water
Term
V. parahaemolyticus and V. cholera (non-01 serotypes)
 Definition
 Gastroenteritis: headache, low grade fever, water diarrhea, nausea, vomiting, abdominal cramps; self-limiting
Term
V. parahaemolyticus and vunificus
 Definition
 Cutaneous infection: trauma to body site (wound or burn); swelling around wound, localized tissue involvement, fever, chills
Term
V. vulnificus
 Definition
 Septicemia: fever, chills, vomiting, diarrhea, and abdominal pain; skin lesions
Term
Aeromonas
 Definition
 ingestion or exposure to contaminated food or water
 gastroenteritis
• diarrhea, vomiting, abdominal cramps
• no fever or blood in stool
• acute is self-limiting, chronic requires treatment
 Wound infection
 Opportunistic systemic disease in immunocompromised
Term
o Campylobacter
 Definition
 Gastroenteritis
• infection of intestines
• ulcerative, inflammatory lesions in jejunum, ileum or colon
• Symptoms
o fever
o abdominal pain, painful abdominal cramping
o watery or bloody diarrhea
o may mimic acute appendicitis
• Self-limiting in uncompromised patient (3 days to 2 weeks)
Term
o Helicobacter
 Definition
 initially as acute gastritis with nausea and upper abdominal pain (1-2 weeks)gastric and duodenal ulcers (years later; asymptomatic to nausea, vomiting, epigastric pain)
• complications: infection = risk factor for gastric carcinoma and gastric B-cell lymphoma (MALT lymphoma)
Term
Pseudomonas
 Definition
o respiratory tract: pneumonia in patients with chronic lung diseases or cystic fibrosis
 ventilator or broad spectrum antibiotic
o skin: burn wound or folliculitis due to immersion in contaminated water (whirlpools, hot tubs, swimming pools
o urinary tract: catheterization
o eye: corneal ulcers following trauma
o ear: external otitis – swimmer’s ear
 also malignant external otitis and chronic otitis media
o bacteremia: immunocompromised pts.
o endocarditis: IV drug users
Term
Haemophilus influenzae
 Definition
o H. influenza type b (Hib)
o Meningitis: bacteremic spread from nasopharnyx: 1-3 days of mild upper respiratory disease
o Epiglottis: children 2-4 y/o
o cellulitis: proximal to oral mucosa
o arthritis: children younger than 2
o unencapsulated H. influenzae: otitis, sinusitis, lower respiratory tract
Term
o H. ducreyi
 Definition
chanchroid (genital ulcers): mostly seen in men
 small papule on genitalia (5-7 days after exposure)
 ~2 days later, pustule ruptures and forms an ulcer similar to chancre in syphilis
 ulcer is painful and often accompanied by swollen regional lymph nodes
Term
o H. aegyptius
 Definition
 conjunctivitis
 transmission: contaminated fingers
 Risk group: children
Term
o Francisella tularensis
 Definition
 fevers, chills and malaise
 ulceroglandular: cutaneous ulcer and swollen lymph nodes, papule at site of inoculation becomes necrotic and ulcerative
 oculoglandular: eye involvement and swollen lymph nodes, direct contamination of eye = painful conjunctivitis
 pneumonic tularemia
Term
o Brucella melitensis
 Definition
 acute (1-3 weeks after infection): malaise, chills, fatigue, fever, weakness, myalgias, weight loss, arthralgias, sweats and nonproductive cough; recovery after few weeks or months
 mild disease
 chronic: can survive in phagocytic cells
Term
Leginonella
 Definition
o Legionnaire’s disease
 2-10 day incubation
 Early signs: fever, myalgia, and headache
 Dry cough develops, may become productive
 nausea, vomiting, chills, chest pain (confusion and delirium may also occur)
 multilobar consolidation, inflammation, and microabscesses
 may lead to shock, respiratory failure or both
 mortality ~15% in healthy people, over 50% in hospital outbreaks
o Pontiac Fever
 Mild influenza –like illness: fever, chills, myalgia, malaise and headache but no pneumonia
 Self-limiting: develops after ~12 hours, resolves in 2-5 days
 characteristically infects otherwise healthy individuals
 mortality rate <1%
Term
Bartonella quintana
 Definition
Trench fever (mild to severe, chills headache, recurrent fever, and maculopapular rash on trunk and abdomen, lasts 14-30 days)
Bacteremia (homeless or immunocompro): recurrent fever, malaise, body aches, fatigue, weight loss, headaches
Bacilliary angiomatosis (immunocompro): skin lesions
Term
Bartonella bacilliformis
 Definition
Carrion disease
Oroya fever (Acute febrile illness with severe anemia)
Verruga peruana (chronic cutaneous disease): 1 to 2 cm cutaneous nodules engorged with blood
Term
Bartonella henselae
 Definition
Cat scratch fever:
Febrile lymphadenitis,
Skin rashes, conjunctivitis, encephalitis, persists for weeks or months
Term
C. perfringens (Clostridial myonecrosis - gas gangrene)
 Definition
• spore introduction into host via traumatic injury surgery with muscle damage
• Symptoms: 1-7 days
o pain in infected tissue
o local edema due to alpha toxin
o gas production due to fermentation
o change of skin color due to lack of O2
o bleeding
o hypotension, renal failure, and death within 2 days
Term
C. perfringens (clostridial cellulitis)
 Definition
• localize infection of necrotic muscle only (symptoms similar to myonecrosis but of a lesser severity)mode of infection: ingestion of viable cells on meat products (spores vegetate)
• enterotoxin producedsymptoms (8-24 hrs): watery diarrhea, abdominal cramps, nausea, no fever or vomiting (self-limiting)
Term
C. perfringens (Necrotizing enteritis)
 Definition
• acute, necrotizing destruction of the jejunum
• abdominal pain, vomiting, bloody diarrhea
• undercooked pork and sweet potatoes
Term
C. difficile
 Definition
 one to ten days after beginning antibiotics: abdominal pain, diarrhea ( mild and watery or bloody), fevercan progress to pseudomembranous colitis (can be lethal): white plagues of fibrin, mucous and inflammatory cells
Term
o C. tetani
 Definition
 Conditions of infection (favor spore germination)
• small puncture wounds
• necrotic tissues at wound site
 Incubation: few days to weeks
 Generalized tetanus
• initial involvement of neck, jaw and back muscles
• drooling, sweating, irritability
• respiratory muscles, violent contraction of back
• can lead to death from respiratory failure
 Localized tetanus: confined to muscles at site of infection
 Cephalic tetanus: primary site of infection is head
 Neonatal tetanus: rare, except in developing countries
• initial infection of umbilical stump, progression to generalized tetanus
Term
 Food borne botulism
 Definition
• ingestion of poorly preserved food containing toxin: spores not killed sufficiently
• improper food preservation: anaerobic environment, room temperature, alkaline or low acid food (canned beans), spores vegetate and produce toxin
• Symptoms
o Early symptoms (1-3 days): nausea, dry mouth, abdominal pain, possibly diarrhea; no fever
o Neuromuscular: blurred or double vision, pupil dilation, REM, difficulty speaking or slurred speech, difficulty swallowing
o critical: descending paralysis with involvement of respiratory muscles (death due to respiratory paralysis
Term
 Infant botulism (3 weeks to 8 months)
 Definition
• ingestion of spores (honey)
• spores vegetate and multiply in colon (no normal flora)
• Symptoms: constipation, poor muscle tone, lethargy, flaccid paralysis, and respiratory arrest (may be cause of some deaths attributed to SIDS)
Term
 wound botulism (rare neuroparalytic disease)
 Definition
• Incubation: more than 4 days (spores enter puncture wound and in vitro toxin produced)
• Symptoms : similar to food borne botulism (abdominal pain and diarrhea less prominent)
• Risk group: IV drug users
Term
Actinomyces israeli
 Definition
o granulomatous lesions
 sulfur granules in pus
 sinus tracts which eventually discharge to surface
 cervicofacial actinomycosis most common: swelling of face, draining sinuses at jawline
• due to poor oral hygiene, dental procedure, oral trauma
o Others difficult to diagnose due to nonspecific symptoms
 abdominal: gastrointestinal surgery or trauma to bowel
 thoracic: abscesses in lung tissue
 pelvic: extension from other sites due to intrauterine device
Term
T. pallidum (primary)
 Definition
• ulcerative lesions: chancre (shallow, hard ulcer with firm base develops at inoculation site)
o usually painless, appears 3 to 90 days after exposure (median 3 weeks), regional lymphadenopathy ~1 week after ulcer
o primary lesion heals after 4 to 6 weeks
Term
Secondary syphilis
 Definition
• red, maculopapular rash: trunk, extremities, palms, soles, face
• fever, sore throat, malaise, headache, myalgias, lymphadenopathy
• condylomata lata: moist, warty erosion in anogenital
• resolves spontaneously after a few weeks
• possibilities following this stage:
o complete resolution with no further manifestation of disease
o progression to latent or clinically inactive stage
Term
Tertiary syphilis
 Definition
• chronic inflammation
• gramulomatous lesions (gummas) in the liver, skin and bones
• organ system defines late syphilis
o neurosyphilis: degeneration of the nervous system (CNS): dementia
o cardiovascular: arteritis leads to aneurysm
Term
Congenital syphilis
 Definition
• in utero, transmitted through placenta to fetus
• can cause spontaneous abortion
• if fetus survives, development of condition like secondary syphilis
• CNS and structural abnormalities
Term
B. burgdorferi (early, 3-32 days)
 Definition
• Erythema migrans: red, circular lesion with clear center appears at site of bite
• lasts from 2-4 weeks, often expands in circular fashion out from the site of infection, giving appearance of a Bull’s Eye
• assoc. with flu-like symptoms: swollen lymph nodes, chills, fever, headache, stiff neck, myalgias, fatigue (organism spread via blood)
Term
B. burgdorferi (late, weeks to months)
 Definition
• assoc. with cardiac complications (irregular heartbeat, atrioventricular block) and neurological complication such as meningitis, paralysis and visual disturbances
• months to years later: chronic arthritis
• rarely fatal, but can result in poor quality of life if untreated (diagnosis is difficult)
Term
B. recurrentis
 Definition
 first symptoms within 3-10 after exposure: sudden onset of high fever with severe headache, chills, muscle pain, general malaise, and possible rash
 febrile period (3-7 days): many spirochetes in blood
 fever decreases due to number of spirochetes
 afebrile period and apparent recovery lasts up to 10 days, then patient relapse
• one to many relapses with decreased severity
• antigenic variants are cause of relapses
 Fatality: spirochete invasion of bodily organs (cardiac failure, hepatic necrosis, or cerebral hemorrhage)
Term
Leptospira interrogans
 Definition
 flu-like symptoms 1-2 weeks post infection
• fever, myalgia, chills, headache (spirochetes in blood)
• signs decrease after ~1 week
 biphasic: spirochetes reappear with invasion of liver, kidneys and CNS (aseptic meningitis)
 systemic disease (Weil’s disease
• renal/hepatic involvement
• cardiac inflammation
• death
Term
Mycoplasma pneumoniae
 Definition
Tracheobronchitis
– Onset is gradual (2-3 weeks after exposure)
– Starts with non-specific signs – headache with fever
and malaise
– After 2-4 days, dry nonproductive cough develops
– Primary atypical pneumonia or “walking pneumonia”
– Chest X-ray reveals patchy, diffuse
bronchopneumonia involving one of more lobes
– Patients often remain ambulatory throughout the
illness
– Pharyngitis and/or otitis media is fairly common
Term
M. hominis
 Definition
pyelonephritis, pelvic inflammatory and
postpartum fever
Term
M. genitalium
 Definition
pelvic inflammatory disease and
nongonococcal urethritis
Term
Ureaplasma urealyticum
 Definition
nongonococcal urethritis
Term
Rickettsia rickettsii
 Definition
Rocky mountain spotted fever-OmpA allows adherence to endothelial cells; 2-12 day incubation; abrupt onset fever, headache, and myalgia; Rash in 2-3 days in 90% of pts.: hands and feet->trunk (maculopapular to petechial); complications with widespread vasculitis (GI, respiratory, seizures, coma, renal failure; most common when rash does not appear); 25% mortality in untreated cases
Term
Rickettsia akari
 Definition
Rickettsialpox;Phase I (1 week): papule at bite site, eschar formation; Phase II (1-3 weeks): fever, chills, sweats, headache, myalgia, generalized rash (papulovascular, crusts); mild disease, fatalities rare, self limiting
Term
Rickettsia prowazeki
 Definition
Epidemic typhus;1 week incubation; fever, headache, myalgia; rash: maculopapular progressing to petechial or hemorrhagic, trunk to extremities; complications: myocarditis, stupor, delerium; mortality (60-70%); Brill-Zinsser Disease: milder epidemic typhus, common during WWII
Term
Rickettsia typhi
 Definition
Murine or endemic typhus; 1-2 week incubation; fever, chills, headache, nausea, myalgia; maculopapular rash: trunk to extremities; mild disease: 2-3 week resolution
Term
Ehrlichia chaffeensis and Anaplasma phagocytophilum
 Definition
Human monocytic ehrlichiosis (HME)and Human granulocytic anaplasmosis (HGA): fever, malaise, headache, myalgia (1-3 after tick bite; no rash in most patients (30-40% in HME, <10% in HGA); leukopenia, thrombocytopenia, and elevated serum transaminases; mortality low (<5%)
Term
Coxiella burnetti (Acute Q fever)
 Definition
Multiplication in lungs and dissemination to other organs; mild or asymptomatic; fever, chills, headache, myalgia (9-20 days after inhalation); atypical pneumonia, hacking cough; hepatomegaly, splenomegaly; histological granuloma in the liver; no rash
Term
Coxiella burnetti (Chronic Q fever)
 Definition
Years to months later; typically presents as endocarditis, difficult to diagnose
Term
C. trachomatis biovar: trachoma (eye)
 Definition
chronic or repeated infection: follicle formation on conjunctiva; eyelids turn in and abrade cornea: ulceration, scarring, blood vessel formation, potential blindness; flow of tears impeded (2nd infection); inclusion conjunctivitis: mucopurulent discharge, corneal infiltrates (vacularization and scarring), assoc. w/genital chlamydia, birth canal transmission (5-12 days after birth, ear infection and rhinitis copresent)
Term
C. trachomatis biovar: trachoma (lungs)
 Definition
Infant pneumonia; from contaminated birth canal (2-3 weeks after birth); wheezing cough, pneumonia, no fever; often preceded by conjunctivitis
Term
C. trachomatis biovar: trachoma (urogenital)
 Definition
Females: asymptomatic (80%); cervicitis, urethritis, salpingitis; increased rate of sterility or ectopic; Males: symptomatic (75%); urethritis, dysuria, pyuria; cause of nongonoccal urethritis (35-50%); common cause of postgonococcal urethritis
Term
C. trachomatis biovar: trachoma (polysite)
 Definition
Reiter's syndrome: conjuctivitis, polyarthritis, genital, gastrointestinal; 50-65% have C. trachomatis; 80% have antibodies to CT
Term
C. trachomatis, biovar: LGV
 Definition
Ocular lymphogranuloma venereum: assoc. w/ LGV serovars; conjuctivitis and assoc. lymphoadenopathy; Lymphogranuloma Venereum: First Stage (1-4 weeks): small, painless lesion at infection site (genitals, heals in a few days), fever, headache, myalgia; Second stage: fever, chills, headache, myalgia, inflammation of draining nodes, painful buboes
Term
Chlamydophila psittaci
 Definition
Orthinosis: Inhale bird dropping->spread to spleen and liver->hematogenous spread to lungs and other organs->lymphocytic inflammatory response (edema, infiltration of macrophages, necrosis, and hemorrhage; mucus plug in alveoli)->cyanosis and anoxia; fevers, chills, headache, nonproductive cough, mild pneumonitis (<5% mortality in complicated infection)
Term
Chlamydophila pneumoniae
 Definition
respiratory pathogen that causes pharyngitis, laryngitis, bronchitis, sinusitis, interstitial pneumonia (many are asymptomatic)
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