Term
|
Definition
| nosocomial pneumonia, septicemia, soft tissue infection |
|
|
Term
Anaplasma phagocytophilum biology
(type, stain) |
|
Definition
|
|
Term
| Anaplasma phagocytophilum disease |
|
Definition
Human anaplasmosis = human granulocytic ehrlichiosis
incubation 1wk
flu-like, leukopenia, thrombocytopenia with severe complication, 10% get rash, co-infection with lyme disease, fatality 1% |
|
|
Term
| Anaplasma phagocytophilum pathogenesis |
|
Definition
elementary bodies, lives in host cell vacuoles (morula)
infects neutrophils |
|
|
Term
| Anaplasma phagocytophilum transmission and treatment |
|
Definition
transmission: deer tick
tx: doxycycline, 50% hospitalization |
|
|
Term
Borrelia burgdorferi biology
(type, stain, shape, O2 req., motility) |
|
Definition
extracelluar pathogen, spirochete
G- like, no LPS
helical
microaerophiles
endoflagella in periplasm, coiled, labile |
|
|
Term
| Borrelia burgdorferi culture, epidemiology, transmission, host response |
|
Definition
culture: yes
epidemiology: rising in E coast and upper midweest
trans: tick bites (hard ticks, slow feeders), mice are reservoir, deer important for life cycle, nymph tick most dangerous
host response: IMR, esp for arthritis |
|
|
Term
| Borrelia burgdorferi disease |
|
Definition
Lyme disease:
Stage1: 3-30d incubation, papule spread to EM, "bulls eye rash," grows and fades 3-4wks, flu-like, lymphadenopathy
Stage2: disease 1-4mo, symp 1-9mo; disseminated disease, neurological, facial/Bell's palsy, chronic fatigue, pain radiates
Stage3: lyme arthritis; long-term persistence of borreliae and lipoproteins in joints cause immune complex disease |
|
|
Term
| Borrelia burgdorferi dx and tx |
|
Definition
dx: clincal (endemic area, EM lesions)
tx: doxycyline or amoxicillin |
|
|
Term
| Borrelia burgdorferi viurlence factors |
|
Definition
highly invasive, not extremely toxic, long-term infection
potent proinflammatory genome
OspA - unfed ticks, essential for tick colonization
OspC - only expressed during feeding, essential for mammalian phase infection |
|
|
Term
Borrelia hermsii biology
(type, stain, shape, motility) |
|
Definition
extracellular obligate pathogen, spriochete
G- like, dual membrane, no LPS, helical, dark-field detection, endoflagella |
|
|
Term
|
Definition
Tick-borne relapsing fever
30-70% mortality
common in Africa |
|
|
Term
| Borrelia hermsii virulence factors |
|
Definition
Vector: Orinthodores (soft, slow feed tick)
Antigenic variance with each relapse |
|
|
Term
Borrelia recurrentis biology
(type, stain, shape, motility) |
|
Definition
extracellular obligate pathogen, spirochete
G- like, dual membrane, no LPS, helical, dark-field detection, endoflagella |
|
|
Term
| Borrelia recurrentis disease |
|
Definition
louse-borne relapsing fever
common in western-mountainous US |
|
|
Term
| Borrelia recurrentis virulence factors |
|
Definition
Vector: human louse
Antigenic variance with each relapse |
|
|
Term
|
Definition
RT infections (CF/chronic granulmomatous disease)
IV catheter-associated septicemia 2nd most important infection |
|
|
Term
| Chlamydia trachomatis NGU presentation |
|
Definition
men - groin pain, swelling, burning urination
women - 50% symp, mucopurulent cytitis, vaginal discharge, lower abdominal pain; 30% of women progress to PID (infertility, prematurity, chronic pain, death) |
|
|
Term
Chlamydia trachomatis biology
(type, stain, O2 req., motility) |
|
Definition
obligate intracellular
G-, stains poorly
aerobic
non-motile |
|
|
Term
| Chlamydia trachomatis disease |
|
Definition
1) nongonococcal urethreitis - usually co-inf with N. gonorrhea; men symptomatic, women 50% symptomatic
2) trachoma - disease of poverty, inital infection 2-3 months, repeated inf, cause of extensive scarring and blindness, tichiasis and corneal opacity
3) inclusion conjunctivitis - infected birth canal, mucopurulent discharge 2-25 dyas with inflamed edematous conjuctiva
4) neontal pneumonia - 20% progress to pneumona from conjunctivitis, 4-16wks after birth
5) lymphogranuloma venerum - most invasive; endemic in africa, asia and south america; lympho-proliferative reaction due to spread inguinal lymph node |
|
|
Term
| Chlamydia trachomatis dx and tx |
|
Definition
dx: mucosal scrapings (look for inclusions), identify antibody in sera or tears
tx: doxycycline/erythromycin |
|
|
Term
| Chlamydia trachomatis reservoir, transmssion, host response, at risk pop |
|
Definition
reservoir: human, asymptomatic carriers
transmission: STD, birth canal, fleas/flies feet, contact w/ eye
host response: CMI
risk pop: sexually active, endemic areas |
|
|
Term
| Chlamydia trachomatis virulence factors |
|
Definition
no detectable PG
dual membranes with LPS |
|
|
Term
Clamydophila pneumoniae biology
(type, stain, O2 req., motility) |
|
Definition
obligate intracellular
G-, stains poorly
aerobic
non-motile |
|
|
Term
| Clamydophila pneumoniae virulence factors, transmission, at risk |
|
Definition
no detectable PG
dual membranes with LPS
transmission: resp. droplets
risk: elderly (>60), 70% develop pneumonia |
|
|
Term
| Clamydophila psittaci virulence factors and reservoir |
|
Definition
no detectable PG, dual membranes with LPS
reservoir: psittacine birds, turkeys, ducts |
|
|
Term
Clamydophila psittaci biology
(type, stain, O2 req., motility) |
|
Definition
obligate intracelluar
G-, stains poorly
aerobic
non-motile |
|
|
Term
| Clamydophila psittaci disease |
|
Definition
Parrot fever, psittacosis or ornithosis
severe - high fever, mental confusion, interstitial pneumonitis, vomiting, cyanosis, encephalitis, coma (5-20% die) |
|
|
Term
| Clamydophila psittaci treatment |
|
Definition
tetracylcines or macrolides
quarantine to prevent spread |
|
|
Term
Coxiella burnetii biology
(type, stain) |
|
Definition
|
|
Term
| Coxiella burnetii disease |
|
Definition
majority are asymptomatic
1) Acute Q Fever - sudden high fever, severe headache, abdom/chest pain, 30-50% develop pneumonia, most recovery in few months w/o tx
2) Chronic Q fever - rare, lasts 1-20yrs, often occurs in heart value disease or IMS, subacute endocarditis, mortality of 65% w/o tx |
|
|
Term
| Coxiella burnetii dx and tx |
|
Definition
dx: test for Ab, culture, or PCR
tx: 1) acute - none or doxycycline, quarantine; 2) doxycycline + fluoroquinolones for long time |
|
|
Term
| Coxiella burnetii reservoir, transmission, risk population |
|
Definition
reservoir: farm animals, placenta of animals
transmission: associated with ticks, aerosols, unpasteurized milk
risk: people that work with farm animals, esp. pregnant sheep and cats |
|
|
Term
Ehlickia chaffeensis biology
(type, stain) |
|
Definition
|
|
Term
| Ehlickia chaffeensis disease |
|
Definition
Human Monocytic Ehrlichiosis (HME)
3-4 week incubation
rashless Rocky Mountain Spotted fever
flu-like illness, leukopenia, thrombocytopenia, abnormal liver function tests
2-3% mortality |
|
|
Term
| Ehlickia chaffeensis epidemiology, transmission, host response |
|
Definition
epidemiology: southern states
transmission: Lone Star tick, dog tick
host response: CMI |
|
|
Term
| Ehlickia chaffeensis pathogenesis |
|
Definition
elementary bodies and reticular bodies, lives in host cell vacuoles (morula)
infects blood monocytes and tissue mononuclear phagocytes |
|
|
Term
| Ehlickia chaffeensis treatment |
|
Definition
doxycycline
hospitlization (50%), long recovery |
|
|
Term
Enterococcus faecalis/faecium biology
(type, stain, shape, hemolysis) |
|
Definition
extracellular pathogen
G+ cocci, short chain or diplococcic, cata(-), gamma- or alpha-hemolytic, BILE ACID TOLERANT |
|
|
Term
| Enterococcus faecalis/faecium disease |
|
Definition
HA: bacteremia, UTI, or sepsis; associated with catheter and debilitated pts (lots of Abx)
CA: subacute endocarditis (fever, wt. loss, anemia, new heart murmur, vegetation on valve) |
|
|
Term
| Enterococcus faecalis/faecium tx |
|
Definition
Suscept and not-endocard -> penicillin or perpercillin or vanco;
Suscept and endocard -> ampicillin or vanco w/ aminoglyco or ampi + ceftriax;
VRE -> linezolid or daptomycin |
|
|
Term
| Enterococcus faecalis/faecium virulence factors |
|
Definition
| Abx-resistance from alternative PG synthesis pathway (changes 5th aa) |
|
|
Term
Haemophilus ducreyi biology
(type, stain, shape, O2 req., growth) |
|
Definition
extracellular pathogen, non obligate
G- coccobacilli, facultative anaerobe, requires NAD+ and Fe-hemin for growth, chocolate agar growth |
|
|
Term
| Haemophilus ducreyi disease |
|
Definition
STD in underdeveloped countries
Tender papule progresses to ulcerative, painful lesion
can be accompanied by painful inguinal bulbos |
|
|
Term
| Haemophilus ducreyi virulence factors |
|
Definition
| chanchroid increases risk of HIV transmission and virus shedding |
|
|
Term
Haemophilus influenza biology
(type, stain, shape, nutrient req., O2 req.) |
|
Definition
faculatative, extracelluar
G- rod
needs V (NAD+) and X (Fe-containing hemin)
anaerobe |
|
|
Term
| Haemophilus influenza culture, epidemiology, transmission |
|
Definition
culture: chocolate agar
epidemiology: peak Hib meningitis btwn 6-9mo; epiglottitis in 2-4y/o, 5% carriers or 60% at daycares
transmission: aerosols |
|
|
Term
| Haemophilus influenza diagnosis |
|
Definition
spinal tap - CSF for microscopy and culture (pleomorphic G- rods, detect PRP capsular Ag of Hib)
latex hemagglutinin test |
|
|
Term
| Haemophilus influenza disease nontypeable |
|
Definition
nonencapsulated strains
otitis media, sinusitis, tracheobronchitis, pneumonia (COPD and cancer patients) |
|
|
Term
| Haemophilus influenza disease type B |
|
Definition
1) meningitis - consequence of bacteremia, starts 1-3d after mild URD, rare before 2mo b/c of maternal IgG
2) epiglottitis - "beefy red and swollen" throat, leans forward to breath, drools profusely, croup-like barking cough
3) arthritis/cellulitis - was common in <2y/o before vaccine |
|
|
Term
| Haemophilus influenza prevention |
|
Definition
vaccine for Hib (PRP conjugate protein, 3 kinds)
used to be leading cause of meningitis and pneumonia before, 90% reduction since 1990s |
|
|
Term
| Haemophilus influenza treatment |
|
Definition
less severe - amoxicillin
more severe(Hib) - cephalosporins and dexamethsone (steroid) |
|
|
Term
| Haemophilus influenza virulence factors |
|
Definition
PRP capsule - polyribital phosphate types a-f, prevents C3b deposition, antiphagocytic, antigenic
LOS - endotoxin
IgA peptidase
Pili - adherence |
|
|
Term
| Legionella pneumophilia (reservoir, transmission, and culture) |
|
Definition
reservoir: amoebas, humans are accidental host (cooling towers, water systems, shower heads)
transmission: aerosols
culture: charcoal yeast agar only |
|
|
Term
Legionella pneumophilia biology
(type, stain, O2 req., motility, virulence factors) |
|
Definition
intracellular pathogen
G-, weak staining
aerobe
non-motile
nutritionally fastidious (Fe and Cys) |
|
|
Term
| Legionella pneumophilia disease |
|
Definition
1) Pontiac fever - 95% of infections, acute, self-limiting, febrile disease w/o pneumonia, fever, headache, chills, flu-like, incubate 12hrs, persist 2-5days
2) Legionnaires disease - low rate, incubate 2-10 days, abrupt onset fever, chills, headache, chest pain, dry cough, bronchopneumonia, diarrhea, liver, CNS and kidneys; fatality 15% from resp. failure |
|
|
Term
| Legionella pneumophilia dx and tx |
|
Definition
dx: urinary antigen test (serotypes 1-6), sputum with legionella with immunofluorescent probes
tx: macrolide or fluroquinolone |
|
|
Term
| Legionella pneumophilia pathogenesis |
|
Definition
replicates in macrophages
prevents phagolysosome fusion |
|
|
Term
Leptospira interrogans biology
(type, stain, shape, O2 req., motility) |
|
Definition
extracellular
G- like
helical, hooked shape on one or both ends
aerobe
endoflagella in periplasm, coild, labile |
|
|
Term
| Leptospira interrogans disease |
|
Definition
Yellow fever, leptospirosis, hemorrhatic jaundice, rice-field fever
1st phase - disseminate spread including CNS, flu-like illness
2nd phase - endothelium damage in vessels, conjuctivitis, sudden headache, pain
3rd phase - 10% develop Weil's disease; meningitis, hepatic dysfunction with jaundice; renal failure, 10% mortality |
|
|
Term
| Leptospira interrogans dx, tx, and prevention |
|
Definition
dx: serology
tx: penicillin G or tetra/macrolides
prevention: vaccine for pets and livestock |
|
|
Term
| Leptospira interrogans pathogenesis |
|
Definition
spread through CNS
endothelium damage |
|
|
Term
| Leptospira interrogans virulence factors, reservoir, epidemiology, transmission |
|
Definition
virulence: LPS
reservoir: rodent renal tubules
epidemiology: widespread in world, Brazil in rainy season
transmission: contact with urine of infected animals, contaminated water |
|
|
Term
| Listeria monocytogenes (reservoir, tranmission, risk populations, prevention) |
|
Definition
reservoir: soil, decaying veggie matter, feces of mammals, birds
transmission: food-borne (milk, cheese, meat, raw veggies); transplacental
risk: neonates, elderly, pregnant, IMC
prevention: avoid processed meats in high risk groups |
|
|
Term
Listeria monocytogenes biology
(type, stain, shape, O2 req., motility) |
|
Definition
faculatative intracelluar parasite
G+, small rod
anaerobe
motile |
|
|
Term
| Listeria monocytogenes disease |
|
Definition
symptoms: neonatal sepsis/meningitis, IMC or elderly meningitis, pregnancy 3rd tri fever
1) healthy adult - influenza-like, +/- gastro
2) IMC or pregnant - meningitis + primary bacteremia
3) transplacental - granulomatosis infantiseptica, disemminated abscesses and granulomas withing few hours after birth
4) neonates - meningitis during birth/environment withing 2 weeks |
|
|
Term
| Listeria monocytogenes dx and tx |
|
Definition
dx: culture at 4*C
tx: ampicillin |
|
|
Term
| Listeria monocytogenes pathogenesis |
|
Definition
infects GI, penetrates enterocyte epithelium or M cells
engulfed by macrophages and can disseminate (LLO and ActA) |
|
|
Term
| Listeria monocytogenes virulence factors |
|
Definition
Can grow from 4-46*C and in high salt
LLO - exotoxin listeriolysin
PLC - with LLO, escapes phagolysosome
ActA - induces actin polymerization to spread btwn cells |
|
|
Term
Moraxella catarrhalis biology
(type, stain, shape, O2 req., oxidase reactivity) |
|
Definition
opportunistic, extracellular
G-, diplococci
strict aerobe
oxidase+ |
|
|
Term
| Moraxella catarrhalis disease |
|
Definition
sinusitis, otitis media in healthy pts
bronchitis and bronchopneumonia in elderly with chronic pulm disease |
|
|
Term
| Moraxella catarrhalis virulence factors, risk pop |
|
Definition
normal resident of URT esp. children and elderly
risk: smokers |
|
|
Term
| Mycobacterium avium complex or M. intrcelluare (reservoir, transmission) |
|
Definition
reservoir: soil, water, undercooked poultry
transmission: ingestion or inhalation |
|
|
Term
| Mycobacterium avium complex or M. intrcelluare biology (type, stain, shape, O2 req., motility) |
|
Definition
atypical MOTT, intracellular filamentous, opportunistic with AIDS
G+ rod, acid-fast, Ziehl-Neelson stain
aerobic
non motile |
|
|
Term
| Mycobacterium avium complex or M. intrcelluare diagnosis |
|
Definition
| isolation of organism in culture of blood or lymph |
|
|
Term
| Mycobacterium avium complex or M. intrcelluare disease |
|
Definition
non-specific symptoms: fever, night sweats, abdominal pain, diarrhea, weight loss preceding fever
complications: focal lymphadenitis |
|
|
Term
| Mycobacterium avium complex or M. intrcelluare treatment |
|
Definition
| HIV medications with clarithromycin and azithromycin |
|
|
Term
| Mycobacterium avium complex or M. intrcelluare virulence factors |
|
Definition
filamentous with complex, lipid-rich cell wall
mycolic acid - INH drug target
cord factor - prevents lysosome fusion, necessary for survival in macrophages, triggers Th1 response
LAM - LPS-like trigger, PMN attractant, granulomas formation agent |
|
|
Term
| Mycobacterium leprae (reservoir, culture, transmission, host response) |
|
Definition
15% of armadillos in TX/LA and humans
no culture possible
aerosols or broken skin transmission
CMIR host response |
|
|
Term
| Mycobacterium leprae at risk population |
|
Definition
| most common in asia (india) and africa |
|
|
Term
Mycobacterium leprae biology
(type, stain, shape, O2 req., motility) |
|
Definition
intracellular filamentous pathogen
G+ rod, acid-fast, Ziehl-Neelson stain
Aerobic
non-motile |
|
|
Term
| Mycobacterium leprae disease |
|
Definition
Leprosy - chronic disease skin, peripheral nerves, URT mucosa
1) Tuberculoid/paucibacillary Hansen's disease - elicits CMIR, hypopigmented skin macules, damage to nerves
2) lepromatous/multibacillary Hansen's disease - no CMIR, disfiguring skin lesions, nodeules, extensive tissue destruction |
|
|
Term
| Mycobacterium leprae pathogenesis |
|
Definition
| infects dermal macrophages and Schwann cells |
|
|
Term
| Mycobacterium leprae treatment |
|
Definition
combo: reverses effects, except nerve damage
1) paucibacillary - RIF + dapsone for 6 months
2) multibacillary - RIF + clofazimine |
|
|
Term
| Mycobacterium leprae virulence factors |
|
Definition
filamentous with complex, lipid-rich cell wall
Mycolic acid - INH drug target
Cord factor - prevent lysosome fusion, necessary for survival in macrophages, triggers Th1 response
LAM - LPS-like trigger, PMN attractant, granulotomas formation |
|
|
Term
| Mycobacterium tuberculosis (reservoir, culture, transmission, host response and incubation) |
|
Definition
humans only reservoir
cutlure Lowesnstein-Jensen
transtmit by aerosols
host response is CMI, contains within 2-6weeks
slow growth, 3-8weeks to detect |
|
|
Term
| Mycobacterium tuberculosis at risk population and prevention |
|
Definition
Risk: HIV, homeless, prisoners, health care workers
Prevention: screen with mantoux, BCG vaccine (attenuated) |
|
|
Term
Mycobacterium tuberculosis biology
(type, stain, shape, O2 req., motility) |
|
Definition
intracellular filamentous pathogen
G+ rod, acid-fast, Ziehl-Neelson stain
aerobic
non-motile |
|
|
Term
| Mycobacterium tuberculosis diagnosis and treatment |
|
Definition
chest X-ray (necrosis, ghon complex, granulomas)
sputum sample (acid-fast bacilli, AFB)
Mantoux test - inject PPD intradermally, check few days for size, can be false positive (with past inf or vaccine) |
|
|
Term
| Mycobacterium tuberculosis disease |
|
Definition
1) with strong CMI, immediate clearance
2) chronic/latent infection
3) primary/miliary TB - rapid progrression, 80% fatal, spreads to liver and spleen, recovery or chronic
4) progressive 2* TB - reactivation many years later, most severe, 10% AIDS pts get and faster after 1*
5) can have MDR |
|
|
Term
| Mycobacterium tuberculosis pathgoenesis |
|
Definition
infect alveoli and proliferate in macrophages
graulomas in chronic infection by LAM
lymphadenopathy if not controlled, primary TB
Ghon complex - lesion by tubercle in lung and lymph
CMI - progressive destructive lung, causeation of necrosis |
|
|
Term
| Mycobacterium tuberculosis treatment |
|
Definition
multi-drugs: INH, EMB, RIF, PZA for 2 months
INH and RIF for 4 months
prophylaxis = INH for 3 months |
|
|
Term
| Mycobacterium tuberculosis virulence factors |
|
Definition
filamentous w/ complex lipid-rich cell wall
mycolic acid - INH drug target
Cord factor - prevent lysosome fusion, triggers Th1 response, key to survival in macrophages
LAM - LPS-like trigger, PMN attractant, can lead to granulomatous tubercles chronic |
|
|
Term
Mycoplasma genitalium biology
(type, shape, stain) |
|
Definition
extracellular obligate pathogen
no cell wall, cholesterol in membrane, extremely tiny
Giemsa stain, ball |
|
|
Term
| Mycoplasma genitalium disease |
|
Definition
| non-gonococcal urethritis |
|
|
Term
Mycoplasma hominis biology
(type, stain) |
|
Definition
obligate extracellular pathogen
no cell wall, cholesterol membrane, extremely tiny
Giemsa stain??? |
|
|
Term
| Mycoplasma hominis disease |
|
Definition
| vaginitis, cervicitis, polynephritis, pelvic inflammatory disease, postpartum fever (prevented by hand-washing of physicians) |
|
|
Term
| Mycoplasma pneumonia culture, epidemiology, transmision, host response |
|
Definition
culture: difficult, grows slowly, requires sterols
epidemiology: summer, fall
trans: aerosols
host response: Ab immune-mediated symptoms |
|
|
Term
| Mycoplasma pneumonia virulence factors |
|
Definition
P1 - attachment protein, gliding motility
H2O2 - production, damages cilia causing cioliostasis and non-productive cough
superantigen |
|
|
Term
Mycoplasma pneumonia biology
(type, stain, shape, O2 req.) |
|
Definition
atypical, extracellular, obligate human pathogen
no cell wall for staining
very tiny
aerobic |
|
|
Term
| Mycoplasma pneumonia disease |
|
Definition
1) mild URT - may see tracheobronchitits 2-3wks after exposure, nonproductive cough, fever, chills, malaise, sore throat
2) walking pneumonia (PAP) - productive cough, mucoid/mucopurulent sputum, can have nonpleurotic chest pain, no consolidation |
|
|
Term
| Mycoplasma pneumonia dx, tx, and risk pop |
|
Definition
dx: bed-side test for cold agglutinins, PCR throat swab, serology, ELISA
tx: empiric therapy, macrolides
risk: ages 5-25 b/c humoral mediated |
|
|
Term
| Mycoplasma pneumonia pathogenesis |
|
Definition
| selective affinity for respiratory epithelium, due to P1 |
|
|
Term
| Nocardia at risk populations |
|
Definition
| chronic pulm disease, IMC pts |
|
|
Term
Nocardia biology
(type, stain, shape, O2 req.) |
|
Definition
filamentous-like
G+, weakly acid-fast
aerobic |
|
|
Term
| Nocardia diagnosis and treatment |
|
Definition
Dx: gram stain, acid-fast stain, culture; pulm and CNS symptoms together
Tx: sulfanomide |
|
|
Term
|
Definition
symptoms: no pathogonomic signs/symptoms, look for pulm and CNS
Nocardiosis - 1* bronchopulmonary disease, can disseminate to CNS in 40% and cause brain abscesses |
|
|
Term
Rickettsia prowazekii & typhi biology
(type, stain, shape, O2 req., motility) |
|
Definition
obligate intracellular
G- rod, poor stain
aerobic
cell-cell spread via ActA |
|
|
Term
| Rickettsia prowazekii & typhi culture, transmission, incubation |
|
Definition
culture: cell culture, lice eggs
transmission: direct contact or arthropod vector
incubation: 8-12 days with generalized flu symptoms |
|
|
Term
| Rickettsia prowazekii & typhi disease with reservoirs |
|
Definition
Prowazekii - epidemic plague, remains endemic in africa, human lice and flying squirrels, untreated 20-70% fatality
Typhi - endemic in SW states, milder form of thyphus, rat lice or flea, untreated 2% fatality |
|
|
Term
| Rickettsia prowazekii & typhi dx and tx |
|
Definition
dx: MIF
tx: tetracycline, vaccine for high risk populations |
|
|
Term
| Rickettsia prowazekii & typhi pathogenesis |
|
Definition
grows in cytoplasm of endothelial cells
using host ATP, cytolysis
increased vascular permeability, thrombogenesis, peripheral vascular collapse, noncardiogenic shock (death) |
|
|
Term
| Rickettsia prowazekii & typhi symptoms |
|
Definition
acute phase - very high fever, frontal headache, intense mm pain; rash from trunk to extremity growth
rash can become hemorrhagic
tissue anoxia can occur from vascular collapse
death from ischemia, stroke, MI or intractable shock |
|
|
Term
| Rickettsia prowazekii & typhi virulence factors |
|
Definition
phospholipase to degrade phagosome
ActA |
|
|
Term
Rickettsia rickettsii biology
(type, stain, shape, O2 req., motility) |
|
Definition
obligate intracellular
G- rod, poor stain, low amount LPS and PG
aerobic
can cell-cell spread via ActA |
|
|
Term
| Rickettsia rickettsii disease |
|
Definition
Rocky Moutntain Spotted Fever (RMSF)
incubate 2-12 days (fever, severe headache)
2-4 days after that maculopapular rash starts on extremeties and moves to trunk
cough, bleeding, edema, confusion, focal neurologic signs, seizures
extensive thrombosis can lead to amputation (5-90% fatality) |
|
|
Term
| Rickettsia rickettsii dx and tx |
|
Definition
dx: antibody test (MIF, cross-reactive with proteus, Weil-Felix test)
tx: tetracycline or chloraphenicol |
|
|
Term
| Rickettsia rickettsii pathogenesis |
|
Definition
grows in cytoplasm endothelial cells
using host ATP, cytolysis
increases vascular permeability, thromogenesis, peripheral vascular collapse, noncardiogenic shock (death) |
|
|
Term
| Rickettsia rickettsii reservoir, transmission, culture |
|
Definition
reservoir: ticks (wood and dog)
transmission: tick bites
culture: cell culture, eggs |
|
|
Term
| Rickettsia rickettsii virulence factors |
|
Definition
phospholipase to degrade phagosome
ActA |
|
|
Term
Staphylococcus aureus biology
(type, stain, shape, hemolysis, reactivity) |
|
Definition
extracellular pathogen
G+ cocci, clusters, B-hemolytic, coag(+), yellow colonies, ferments mannitol |
|
|
Term
| Staphylococcus aureus disseminated disease |
|
Definition
Dissem: septic arthritis (RA and DM associated), osteomyelitis (growth plates children, spine adults), pyomyositis, represent infected blood stream and are manifestations of endocarditis; presence in urine ->bacteremia unless catheter present
CA-Bacteremia: MSSA or MRSA; endocarditis and osteomyelitis; risk with IV drug use; Tricuspid valve ->pulm emoboli or Left-sided endo (rapidly progressive)
HA-Bacteremia: MRSA>>MSSA; assoc. w/ IV device, remove promptly; 25% have valve vegetation; ID consult |
|
|
Term
| Staphylococcus aureus other diseases |
|
Definition
Pneumonia: suprative; <5% of CA-pneu (<1y/o or >75y/o); 25% of HA-pneu (pts on vents, 45%MSSA, 55%MRSA); follows flu in nursing home; necrotizing, empyema, 50% are MRSA; 60% mort if CA
Food poisoning: contaminated protein after cooked, 1-6hr inc, 6-12hr duration; staph enterotoxins (SEB, SEA, SEC) act as SUPERANTIGENS; nausea, vomit, diarrhea, MAST cells; [MOST COMMON CAUSE IN US]
TSS: non-supprative, really rare; TSST in only 20% of strains; was assoc. with tampons in '80s; toxins are SUPERANTIGENS; wounds, shock, fever, vascular leak, hypotensive |
|
|
Term
| Staphylococcus aureus skin diseases |
|
Definition
Folliculitis-suprative, pustule in hair follicle
Furnuncles-suprative, boils where pustule spreads into subcutaneous, hot and tender; may have fever
Carbuncles-furnuncles interconnect
Impetigo-suprative, superficial epidermis only, mostly children, highly contagious 20% co-inf w/GAS
Burn infection-suprative, HA-MRSA
Scalded Skin: non-supprative, rare, exofoliative toxins (ETA and ETB), mucosal colonies in infants; disrupt desmosomes, INTRAepidermal separation; positive Nikolsky sign; heals w/o scar; Ab to toxin can neutralize somewhat |
|
|
Term
| Staphylococcus aureus treatments |
|
Definition
Folliculitis/Impetigo: local antiseptics
Furn/carbuncles: incision, drain; CA-MRSA-TMP/SMX or doxy; MSSA-same or B-lactam
Carriers: decolonize with mupirocin
CA-Bacteremia: 4-6wks IV Abx
HA-Bacteremia: IV Abx only, 2-4wks
MSSA: nafcillin, cefazolin
HA-MRSA: vanco
CA-MRSA: vanco, clinda, TMP/SMX, or doxy
Food poison: supportive
TSS: incision, drain; vanco + circulatory support |
|
|
Term
| Staphylococcus aureus virulence factors |
|
Definition
MRSA and MSSA strains
NF of nares and axilla/perineal skin
Protein A (binds IgG and inactivates)
Secreted toxins, ahesins (attach to PG and bind ECM), Techoic acid (targets epi cells), LTA and PH (trigger cytokines), lipases, nucleases, cytotoxins, hyaluronidase, fibrinolysin, Panten-Valentine Toxin (MRSA, recruits PMNs, causes granulomas), enterotoxins |
|
|
Term
Staphylococcus epidermidis biology
(type, shape, stain, hemolysis, etc.) |
|
Definition
extracellular pathogen
G+ cocci, clusters, B-hemolytic, coag(-) |
|
|
Term
| Staphylococcus epidermidis disease |
|
Definition
50% of sepsis cases in NICU
Other disseminated diseases are association with devices |
|
|
Term
| Staphylococcus epidermidis dx and tx |
|
Definition
Dx: erythema around device helps
Tx: remove any assoc. device; if IMC/neonate Vanco 1-6wks; normal = vanco for a few days; |
|
|
Term
| Staphylococcus epidermidis virulence factors |
|
Definition
NF of skin
forms biofilms on invasive devices |
|
|
Term
Staphylococcus saparophyticus biology
(type, stain, shape, hemolysis, etc.) |
|
Definition
extracellular pathogen
G+ cocci, clusters, coag(-) |
|
|
Term
| Staphylococcus saparophyticus disease |
|
Definition
| UTI in sexually active young women (2nd most common cause) and in elderly men (uncommon cause) |
|
|
Term
| Staphylococcus saparophyticus dx and tx |
|
Definition
Dx: culture coag(-) staph
Tx: TMP/SMX |
|
|
Term
| Staphylococcus saparophyticus virulence factors |
|
Definition
| transient flora of rectum and UG (5-10% of females) |
|
|
Term
| Stenotrophomonas maltophilia |
|
Definition
emergence of steno "superbug" MDR
pneumonia, bacteremia
contaminates disinfectants, resp. equipment, ice machines |
|
|
Term
Streptococcus alagacitiae (Group B) biology
(type, stain, shape, hemolysis |
|
Definition
extracellular pathogen
G+ cocci, chains, B-hemolytic, Group B Lancefield, cAMP test -> arrowhead, citrate(+), cata(-) |
|
|
Term
| Streptococcus alagacitiae diagnosis |
|
Definition
G+ cocci in chains
B-hemolytic
cAMP test --> arrowhead |
|
|
Term
| Streptococcus alagacitiae disease |
|
Definition
Neonatal: transmission at delivery, early onset -> aspiration of amniotic fluids, pneumonia; late onset -> meningitis due to colonization of gut;
Elderly: pneumonia, UTI, cellulitis, bacteremia |
|
|
Term
| Streptococcus alagacitiae epidemiology |
|
Definition
Infants -> pneumonia and meningitis
Elderly
DM -> cellulitis
#1 cause of meningitis in neonates |
|
|
Term
| Streptococcus alagacitiae treatment and prevention |
|
Definition
Adult: cellulitis or pneumonia, ceftriaxone or Aminoglyc+amp
Infants: amp+aminoglycoside
Prevent: screen preggers at 35-37 week, treat intrapartum if (+) |
|
|
Term
| Streptococcus alagacitiae virulence factors |
|
Definition
polysaccharide capsule (Type III = 60% sialic acid, which mimics host)
NF in GI and GU tracts |
|
|
Term
Streptococcus pneumoniae biology
(type, stain, shape, hemolysis) |
|
Definition
extracellular pathogen
G+ diplococcic, lancet-shaped, alpha-hemolytic, cata(-), dimple colony, optchin sensitive, bile acid senstive |
|
|
Term
| Streptococcus pneumoniae diagnosis |
|
Definition
Clinical
a-hemolytic
optchin sensitive, G+ diplococci |
|
|
Term
| Streptococcus pneumoniae disease |
|
Definition
Pneumococcal Pneumonia - follows viral inf; abrupt onset, pleurotic/chest pain, yellow/rusty sputum, diarrhea, DULL precussions, crackles, lobar consolidation, elevated WBC (if low->poor prognosis), blood culture can be positive
Acute otitis media - #1 bacterial cause in US, follows viral URI, daycares, formula-fed = higher risk
Sinusitis - follows viral URI
Bacteremia - usually from pneumonia, 25% mort w/tx if debilitated pt
Meningitis - follows bacteremia, most common causes except in neonates
Conjunctivitis - unencapsulated strains, younger population, outbreak associated |
|
|
Term
| Streptococcus pneumoniae prevention |
|
Definition
>65y/o - 23-valent-polysacc vaccine
<2y/o - PCV-7 and PCV-13 pneumococcal conjugate vaccines
>19y/o w/ risk - PVC-13 conjugate vaccine |
|
|
Term
| Streptococcus pneumoniae transmission and pathogenesis |
|
Definition
Trans: NF of URT, defect in resp. tract
Path: gain access to lung through defect, and defect in immunity allow for dissemination |
|
|
Term
| Streptococcus pneumoniae treatment |
|
Definition
Otitis/sinusitis - amoxicillin or clavulanic acid
CA-pneumonia - ceftriax+macro or resp. Quinolone
Meningitis - vanco+ceftrix; then sensitivity testing |
|
|
Term
| Streptococcus pneumoniae virulence factors |
|
Definition
Polysaccharide capsule
Pneumolysin - cytotoxin, creates pore in ciliated epi cells and WBCs, activates complement
IgA protease
PG, LTA, C-polysaccharide
Phosphocholine-containing proteins - adherence to endo, WBCs, lung and meninges |
|
|
Term
Streptococcus pyogenes biology
(type, shape, stain, O2 req., motility) |
|
Definition
extracellular,
G+ cocci, chains, cata-, B-hemolytic, Group A Lancefield, Bacitracin senstive |
|
|
Term
| Streptococcus pyogenes complications |
|
Definition
Acute rheumatic fever - Ab to cardiac antigen, 1wk to 1mo post-infection, follows pharyngitis
Acute glomerulonephritis - abs to kidney ag, onset 1wk to 1mo post-inf, follows pharyngitis, pyoderma or impetigo |
|
|
Term
| Streptococcus pyogenes diagnosis |
|
Definition
pharyngitis: cluture, rapid Ag detection
general: Abs to GAS
Necrotizing ForM: surgical explore, gram stain, culture, positive blood culture
Scarlet fever: clinical
TSS: GAS isolated, BP<90, >1organs, systemic dysfunction
ARF: anti-ASO, anti-hyluronidase,anti-DNAse Abs
AGN: anti-hyaluronidase and anti-DNAse ABs |
|
|
Term
| Streptococcus pyogenes pyogenic infections |
|
Definition
strep throat - crowding assoc.
cellulitis - subdermal, no pus
impetigo - pyoderma, superficial inf.
erysipelas - sharp borders on areas
sepsis - endometritis, at birth process
bacterial endocarditis
necrotizing fasciitis - minor trauma, rare
necrotizing myositis - minor trauma, rare
pneumonia - epidemics in barracks |
|
|
Term
| Streptococcus pyogenes toxic mediated disease |
|
Definition
TSS - M1 or M# serotypes, rapid progression
Scarlet fever - pharyngitis, erythrogenic+ strain, diffuse rash, sandpaper feel, spares palms/soles/face, strawberry tongue |
|
|
Term
| Streptococcus pyogenes treatment |
|
Definition
Pen, cephalosporin, clinda or macro
Pharyngitis: prevent spread, tx
Necrotizing: pen+clinda+surgery
TSS: source, ICU care, IVIG
ARF: prophylatic, low dose, anti-inflam
AGN: supportive |
|
|
Term
| Streptococcus pyogenes virulence factors |
|
Definition
PG, LTA, capsule, protein F, fibrillae
M protein - serotypes, anti-phaytocytic, binds factor H and fibrinogen
streptolysins, C5a peptidase, hyaluronidase, sterptokinase, DNAse, pyrogenic exotoxins |
|
|
Term
Streptococcus viridians biology
(type, stain, shape, hemolysis) |
|
Definition
extracellular pathogen
G+ cocci, chains, cata(-), A-hemolytic, >30 species |
|
|
Term
| Streptococcus viridians diagnosis and treatment |
|
Definition
Dx: G+ cocci in chains, alpha-hemo
Tx: PenS = penicillin; PenR = pen + aminoglyc or vanco; 4-6wk duration |
|
|
Term
| Streptococcus viridians disease |
|
Definition
Subacute Endocarditis - bacteria in vegetation on valve; fever, weight loss, embolie, NEW HEART MURMUR, anemia; lasts wks-months; increased risk w/ prior valve damage
Abscesses - agionosis/milleri species
Bacteremia - associated with colon cancer, bovis species |
|
|
Term
| Streptococcus viridians prevention |
|
Definition
| prophylactics for high risk pts before procedures (i.e. dental extractions) |
|
|
Term
| Streptococcus viridians virulence factors |
|
Definition
ahesins that attach to heart valves
Transmission into blood via tooth brush/floss/procedure |
|
|
Term
| Treponema pallidum pathogenesis |
|
Definition
enter mucus membranes
multiply locally
spread to lymph/blood |
|
|
Term
Treponema pallidum biology
(type, stain, shape, O2 req., motility) |
|
Definition
extracelluar pathogen
G- like, helical, no LPS
microaerophiles
endoflagella in periplasm, coiled, labile |
|
|
Term
| Treponema pallidum culture, transmission, host reponse |
|
Definition
do not culture, cultivate in rabbit testes
trans: STD, transplacentally
host response: tissue destruction due to immune response |
|
|
Term
| Treponema pallidum disease |
|
Definition
1) Syphillus (primary) - localized lesion with 10-120d incubation, sphilitic chancre is painless, hard shallow ulcer, heals in 3-6wks, filled with treponemes
2) syphillus (secondary) - disseminated lesions, 6-8wks after primary, flu-like syndrome, few days later rash develops, filled with treponemes, heals 2-6wks
3) syphillus (early latent) - aysmptomatic, detic only in serologic tests, 1st year
4) symphillus (late latent) - not infections, but can spread transplacentally, 25% revert back to secondary during first 4 yrs of latency, trepnemes in endothelium cause chronic inflamation
5) syphillus (tertiary) - 1/3 of cases, disease after latency, immune-mediated, gumma (granulomous lesions), neurosyphillus, cardiovascular symphillus
6) congential syphillus - massive invasion of treponemes to fetus; 1* = 100% risk, 2* = 90%, latency = 30%; multiorgan malformations (blidness, deafness, CV, Hutchinson's incisors, saddle nose, saber shins) |
|
|
Term
| Treponema pallidum dx and tx |
|
Definition
dx: darkfield, serology nontreponemal (VDRL, RPR) for anti-phospholipid Abs, treponemal (FTA-ABS) for high specificity to confirm
tx: penicillin G or tetar/doxy if allergic |
|
|
Term
| Treponema pallidum virulence factors |
|
Definition
highly invasive, not extremely toxin, long term infection
few outer membrane proteins (evades IMS)
hyaluronidase - facilitates perivascular penetration
fibronectin - coat themselves to protect against phagocytosis |
|
|
Term
| Ureaplasma urealyticum biology and disease |
|
Definition
extracellular pathogen
NGU |
|
|
Term
| Mycobacterium scrofulceum biology, VF and disease |
|
Definition
Facultative intracellular, G+ rod, aerobe, acid-fast
VF: Wax-like wall (resist detergents and disinfectants, promotes inflammation); serpentine cord
Disease: Cervical lymphadenopathy in children, rare |
|
|
Term
| Mycobacterium kansasii biology, VF and disease |
|
Definition
Bio: facultative intracellular, G+ rod, acid-fast, aerobe
VF: wax-like wall (resist detergents and disinfectants, promotes inflammation); serpentine cord
Disease: TB-like, rare |
|
|
Term
| Mycobacterium marinum biology, VF and disease |
|
Definition
Bio: facultative intracellular, G+ rod, aerobe, acid-fast
VF: wax-like wall (resist detergents and disinfectants, promotes inflammation)
Disease: swimming pool granuloma, rare |
|
|
Term
Francisella tularensis biology
(type, shape, stain) |
|
Definition
faculatative intracellular, zoonotic pathogen
G+ cocci |
|
|
Term
| Francisella tularensis virulence factors and transmission |
|
Definition
zoonotic: rabbits, cats, ticks
Trans: aerosols (low ID50), ingestion (high ID50), tick bite (high ID50), eye contact (high ID50) |
|
|
Term
| Francisella tularensis disease |
|
Definition
Aerosols: pneumonia or sepsis
Ingest/tick/eye: ulcers, swollen localized lymph nodes, or conjunctivitis |
|
|
Term
| Francisella tularensis diagnosis and treatment |
|
Definition
Dx: serology, culture on cysteine-sumpplemented media
TX: gentamycin, FQ, or doxy |
|
|
Term
Brucella biology
(type, stain, shape) |
|
Definition
facultative intracellular, zoonotic pathogen
G+ cocci, very tiny
several species |
|
|
Term
| Brucella transmission and disease |
|
Definition
Trans: direct contact or ingestion, assoc. w/ bison in western US
Sepsis
Granulomas/abscesses - lymph nodes, bone marrow, liver or spleen |
|
|
Term
| Brucella diagnosis and treatment |
|
Definition
Dx: serology and culture
Tx: Doxy + RIF w/ or w/o aminoglycoside |
|
|
Term
Chlamydia pneumoniae biology
(type, stain, shape, etc.) |
|
Definition
obligate intracellular pathogen
G- like, coccobacilli, LPS is weak, Major Outer Membrane Protein (MOMP), smallest genome |
|
|
Term
| Chlamydia pneumoniae virulence factors |
|
Definition
energy parasite - relies on host ATP, aa, and lipids
Elementary bodies - metabolically inactive, infectious
Reticular bodies - metabolically active, non-infectious |
|
|
Term
| Chlamydia pneumoniae transmission and pathogenesis |
|
Definition
Trans: resp. droplets
Path: EB contact w/ host cell, induce phagocytosis, live in inclusion, differentiate to RB, proliferate, differentiate into EB, host cell lysis, release of EBs, cycles 48-72hrs |
|
|
Term
| Chlamydia pneumoniae disease |
|
Definition
Respiratory: sinusitis, pharyngitis, bronchitis, atypical (walking)pneumonia; most cases are mild
Athersclerosis: infects SMCs, artery epi cells and macrophages; assoc. w/ inflammatory plaques |
|
|
Term
| Chlamydia pneumoniae diagnosis and treatment |
|
Definition
Dx: NAAT, difficult
Tx: macro, doxy or levofloxacin |
|
|
Term
Chlamydia psittaci biology
(type, stain, shape, etc.) |
|
Definition
obligate intracellular pathogen
G- like, no PG, weak LPS, small, MOMP |
|
|
Term
| Chlamydia psittaci virulence factors |
|
Definition
energy parsite-relies on host ATP, lipids and aa
Elementary bodies - infectious, metabolically inactive
Reticular bodies - noninfectious, metabolically active |
|
|
Term
| Chlamydia psittaci transmission and pathogenesis |
|
Definition
Trans: aersol of bird feces, blood/tissue/feather contamination
Path: EB contact with host cell, induces phagocytosis, live in inclusion, differentiate into RB, proliferation, differentiate to EB, host cell lysis, release of EB (CYCLES 48-72hrs) |
|
|
Term
| Chlamydia psittaci disease |
|
Definition
Parrot Fever - aka psittaciosis or ornithosis; a resp. (alveolar and interstitial) infection; spreads from resp. to liver and spleen, causing focal necrosis, spreads via blood
Fever, chills, vomit, headache, pneumonitis, CYANOSIS, ENCEPHALITIS, COMA |
|
|
Term
| Chlamydia psittaci dx and tx |
|
Definition
Dx: serology
Tx: doxy or macro |
|
|
