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  • 8/2/2019 Bugs Table1

    1/13

    Bug Name Manifestations Identifying Properties Culture / Tests Virulence Vaccine / Rx

    Staphylococcus

    Aureus

    Food Poisoning

    Scalded Skin Syndrome TSS Syndrome Furuncle, Carbuncle Bacteremia, Osteo-myelitis, Endocarditis

    GRAM(+) COCCI in clusters

    Catalase(+) -HEMOLYTIC Onlyat 4C COAGULASE(+)

    MANNITOL fermenting

    Hot-Cold Hemolysin Test:

    -Hemolysin lyses at 4C Mannitol-Salt Agar forfecal specimens

    Coagulase

    Exfoliatin TSS-Toxin Protein-A (Type-IV Hyper-sensitivity) Ribitol Phosphate Peptido-glycan (Type-IHypersensitivity)

    -Lactamase Penicil-

    lin Resistance

    Staphylococcus

    Saprophyticus

    Symptomatic UTIs.Selectively adheres totransitional epithelium.

    GRAM(+) COCCI in clusters Catalase(+) Coagulase (-)

    Non- Mannitol Ferment-ing

    Urease(+)

    StaphylococcusEpidermidis

    Catheter infections leadingto local infection or

    bacteremia

    GRAM(+) COCCI in clusters Catalase(+) Coagulase (-) Non- Mannitol Ferment-

    ing Urease(-)

    Surface Glycocalyx No Protein A

    Bacillus

    Anthracis

    ANTHRAX: Zoonotic,cattle Cutaneous eschar(malignant pustule) Pulmonary Anthrax GI Anthrax (othercountries) Septicemia

    GRAM(+) ROD, large withsquare end Zoonotic Penicillin-Susceptible string of pearls formation -Phage susceptible

    Methylene blue stain showsthin capsule Medusa-Head Colonies

    Poly-D-Glutamic Acid Pro-tein Capsule Anthrax Toxin: ProtectiveAntigen, Edema Factor, LethalFactor.

    Cattle Vaccine: At-tenuated strainHuman Vaccine: at-risk people get mul-tiple shots of toxoidalone.

    Bacillus Cereus Food Poisoning: Re-fried beans and rice Opportunistic noso-comial bacteremia

    GRAM(+) ROD Penicillin-Resistant chains of rods -Phage resistant

    Emetic Toxin (early vomiting) Diarrheal Toxin (late diarrhea,heat resistant)

    -Lactamase Cephalosporinase

    BacillusSubtilis

    Heroin users at risk cutaneous lesions

    GRAM(+) ROD Penicillin-Resistant

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    Bug Name Manifestations Identifying Properties Culture / Tests Virulence Vaccine / Rx

    Francisella

    Tularensis

    TULAREMIA:

    Zoonotic, rabbits Ulceroglandular, oculo-glandular, typhoidal,

    pneumonic Painful suppuration oflymph nodes

    GRAM(-) ROD: Cocco-

    bacillus Facultative IntracellularParasite

    Cystine Agar Required

    notify lab 3 days to culture. Longerthan usual High antibody titer. Cross-rxn with Yersinia

    Intracellular parasite of macro-

    phages Capsule

    Vaccine: Live atten-

    uated organism forat risk individuals

    Yersinia Pestis PLAGUE: Sylvatic, Bu-bonic, Pneumonic, Septi-cemic

    GRAM(-) ROD Facultative IntracellularParasite (due to V & Wantigens)

    Special transport medium toprotect handlers.

    Fibrinolysin to dissolve theclot. YOPs V & W antigens allow repli-cation inside macrophages.

    Streptococcus

    Pyogenes(Group A)

    Scarlet Fever

    Pyoderma (Impetigo,Erysipela) Pharyngitis Bacteremia Non-Suppurative:Rheumatic Fever,Glomerulonephritis

    GRAM(+) COCCI in chains

    of 8 to 4 BACITRACIN-SENSITIVE

    CATALASE (-): Does notbubble H2O2 in water. -HEMOLYSIS: Largerzones.

    Todd-Hewitt Broth shows

    diffuse turbidity down side oftube Colonies go from Mucoid(capsule) > Smooth(capsule breaks down) > Rough (protein) ASO-Test identifies Strepto-lysin-O

    Superantigen Erythrogenic

    Toxin A (SEA) causes TSS-Like Syndrome Erythrogenic Toxin causesScarlet Fever. Streptolysin O M-Protein: Immunogenic,

    protective antibodies. 85 types. DNAse Type-B: Diagnosticfor non-suppurative sequelae

    Penicillin-G is treat-

    ment of choice.

    StreptococcusAgalactiae

    (Group B)

    Leading cause ofNeona-tal Meningitis (up to 3months)

    GRAM(+) DIPLOCOCCI BACITRACIN-RESISTANT

    -HEMOLYSIS: Smallzones CATALASE (-)

    CAMP Test: Mix withStaph and it augments the zoneof -Hemolysis

    5 serotypes. Type III associ-ated with meningitis.

    Type-III capsular antigen isassociated with meningitis.

    StreptococcusEqui(GroupC)

    Major pathogen of horses Cellulitis from skin

    breaks

    GRAM(+) COCCI CATALASE (-)

    ASO-Test identifies Strepto-lysin-O Agglutination with Group-Cantigens

    Streptolysin O Streptokinase: Antigenicallydistinct from Strep A.

    Streptococcus

    Bovis(Group D)

    Respiratory Peritoneal infections

    GRAM(+) COCCI CATALASE (-) -HEMOLYTIC: Green,

    Penicillin

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    Bug Name Manifestations Identifying Properties Culture / Tests Virulence Vaccine / Rx

    partial hemolysis Penicillin-Sensitive

    EnterococcusFaecalis

    (Strep Group

    D)

    Complication of chole-cystitis. Gi obstruction >

    bacteremia, endocarditis.

    GRAM-VARIABLE COCCI CATALASE (-) Penicillin-Resistant

    Grows in the presence of bile. Blood agar with bile and6.5% NaCl Variable hemolysis in culture

    Lipoteichoic Acid: Lots oflipid leads to gram-variable ap-

    pearance.

    Penicillin-BindingProteins: StrongPenicillin-resistance

    StreptococciGroup G

    Cellulitis Synovitis Bacteremia, Endo-carditis

    GRAM(+) COCCI CATALASE (-)

    ASO-Test identifies Strepto-lysin-O

    Streptolysin O Streptokinase DNAse

    Viridians

    Streptococci

    Periodontal Disease

    opportunistic pathogen Bacteremia will lead toendocarditis

    GRAM(+) COCCI CATALASE (-) -HEMOLYTIC OPTOCHIN-RESISTANT

    Optochin Disk Test: Grows inthe presence of optochin.

    Penicillin resistant

    Streptococcus

    Pneumoniae(Pneumo-

    coccus)

    PNEUMONIA Rusty Sputum Sudden onset, with res-olution by crisis Pericarditis, Empyema,Pleurisy Bacteremia Otitis Media in infants

    GRAM(+) DIPLOCOCCI,Lancet-Shaped OPTOCHIN-SENSITIVE

    Very large capsule = colonieswith halo. Autolysis = middle of colonysunken in. Serology: CIE

    Thick Capsule. 85 types;some are bacteremic. Amidase causes autolysis Pneumolysin-O released uponautolysis: cytotoxin and anti-PMN Forssman Antigen: Inhibitsamidase and autolysis.

    Pneumo-Vac Vac-

    cine: Only the mostvirulent (bacteremic)

    blood groups. Givento old, Diabetic, HIV,splenectomy, COPD. Penicillin is stilleffective

    HaemophilusInfluenzae INFANTILE MENIN-GITIS #1 cause inkids 6-24 months Epiglottitis Cellulitis Bacteremia Otitis Media and Pneu-monia in non-typablestrains

    GRAM (-) ROD, Short Pleo-morphic. Types a-f: Type-B is mostvirulent. There are also non-typable strains

    Chocolate Agar Absolute Growth Require-ments: Hemin Precursor and

    NAD Fildes Agar: enzymaticallylysed RBCs. Satellite Growth aroundStaph Aureus Quellung Reaction againsttype-B

    LOS Coat: High molecularweight is more serum-resistant. Capsule: Polyribitol phos-phate. Antibodies are protec-tive; infants susceptible oncematernal antibodies are gone. IgA Protease

    -Lactamase Peni-cillin Resistance DPT Vaccine con-taining Hib-conjugate Diph-theria toxoid plus

    poly-ribitol phos-phate. Vaccine given at 2,4, and 6 months.

    WHOOPING COUGH: GRAM (-) ROD, Collect with nasopharyngeal Filamentous Hemagglutinin DPT Vaccine at 2,

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    Bug Name Manifestations Identifying Properties Culture / Tests Virulence Vaccine / Rx

    Bordetella

    PertussisBugs infect cilia of upperairway Bugs should be col-lected during CatarrhalStage of infection Lymphocytosis foundduring Paroxysmal Stage

    Pleomorphic.OBLIGATE AEROBE

    swab that contains no cotton.Specimen inoculated at bed-side Bordeau-Gangeau Platerequired for culture mustnotify lab Toluidine-blue on gram-stain Direct-FA can be done onculture only.

    (FHA): Sticks to cilia Capsule Pertactin Pertussis Toxin: Blocks Gi toyield increased cAMP. Causeshistamine sensitization,lymphocytosis, and hypo-glycemia.

    4, and 6 months. Initial shots aremethiolate-killedwhole organisms Boosters at 15months and 6 years:Pertussin toxoid +FHA

    Corynebacteri

    um Diph-theriae

    DIPHTHERIA : Bull neck Pseudomembranous

    Necrosis of throat

    Systemic Toxemia: goesto heart, nerves, kidney

    GRAM (+) RODS, Slender

    Ernst-Babes Bodies foundon methylene blue stain

    Blood-Tellurite Agar spe-cific for Diphtheria and Staph Coagulated Serum Agar

    used to test for presence of

    toxin, which will show creamycolonies Precipitin Test: Test for

    presence of toxin. Comparebefore and after administrationof antitoxin.

    Tox-gene is phage-mediatedand regulated by genome. Onlyactivated by absence of iron. Diphtheria Toxin binds to

    EL-2 to stop protein synthesis.Deadly once inside the cell. Cornymycolic Acid

    DPT Vaccine

    Formalin-inacti-vated toxoid, withalum added

    Shick Test used todetermine whichvaccine to give. Hypersensitive folksget the ammoniumvaccine.

    KlebsiellaPneumoniae

    Alcoholic, Malnour-ished PNEUMONIA.Focal lung abscesses Bacteremia Wound infections UTI

    GRAM(-) RODLACTOSE (+)

    Selective Medium Thick Capsule = extremelymucinous Enterotoxin Endotoxin

    -Lactamase

    LegionellaPneumophila LEGIONNAIRES DIS-EASE non-communicable Dry, non-productivecough Pulmonary fibrinousexudate. Multifocal le-sions Toxemia Pontiac Fever is milderform

    GRAM(-) ROD Facultative IntracellularParasite of PMNs 14 Serotypes. Group 1 ismost common Catalase (+)

    Dieterle Silver Stain. Doesnot stain otherwise. Direct-FA for Group 1 CYSTEINE absolutely re-quired for culture notifylab! Culture takes 3-5 days.

    Facultative Intracellular Para-site Catalase Metalloprotease

    -Lactamase

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    Bug Name Manifestations Identifying Properties Culture / Tests Virulence Vaccine / Rx

    Mycobacteriu

    m Tuberculosis

    TUBERCULOSIS

    Very small numberneeded to infect Hilar lymphadenopathy Granulomas in lung Miliary Tuberculosis Reactivation Tuber-culosis

    ACID-FAST ROD

    Obligate IntracellularParasite Strict Aerobe Produces Niacin

    N-Acetylcysteine will free

    bugs from macrophages Culture takes 3 to 8 weeks! Lowenstein-JensenMedium: inhibit normal flora,

    plus penicillin Liquid Bactec is fastermethod Luciferase Gene used forsusceptibility testing

    Catalase, Peroxidase

    Cord Factor = virulence Wax-D is an adjuvant Siderophore: Exochelin +Mycobactin Tuberculin: antigenic Arabinogalactan: hypersens-itivity

    Multi-Drug Re-

    sistance (MDR) is aproblem PPD Skin Test: >10 mm is positive; GI-Tract> Bacteremia Prevalent with HIV

    Obligate Intracellular Para-site Group 3 MAC: Non-

    chromogenic

    Can be used to distinguish withTuberculosis. It cross reacts,

    but look for the test that has abigger diameter.

    Mycobacterium Fortuitum

    ATYPICAL MACCutaneous abscess

    ACID-FAST ROD Obligate Intracellular Para-site Group 4 MAC: Rapid

    Grower

    Mycobacterium Ulcerans

    ATYPICAL MAC ACID-FAST ROD Obligate Intracellular Para-site MAC: Non-Runyon slowgrower

    Mycobacterium Leprae

    LEPROSY Tuberculoid Leprosy Lepromatous Leprosy(Anergic)

    ACID-FAST ROD Obligate Intracellular Para-site

    Has never been grown inculture

    Can be harvested in arma-dillos or mouse footpads. Skin-test available (antigenderived from armadillos) toindicate prognosis

    Phenolic glycolipid is keyantigen CD8-Suppressor cells in-volved in Lepromatous re-sponse.

    YersiniaEnterocolitica

    (Enterobact-

    eriaceae)

    Watery Diarrhea Mesenteric Adenitis (5-15 yrs old)

    Terminal Ileitis (15-20yrs old) Diarrhea HLA-B27 arthritis

    GRAM(-) ROD Enrichment broth usedbefore collecting, due to lownumber of collecting organ-

    isms. Cold Incubation Tempera-ture: 28C

    Invasin Gene YOP-1, including Mannose-resistant hemagglutinin

    Yad-A adherence protein Arithrotigenic Factor: for HLAB27 arthritis Enterotoxin simulates cGMP

    CampylobacterJejuni

    (Enterobact-eriaceae)

    Invasive Gastro-enteritis

    Crypt abscesses hemor-rhagic necrosis.

    GRAM(-) ROD, WavyMICROAEROPHILIC

    MOTILE NON-LACTOSE

    FERMENTING

    High IncubationTemperature: 42C mustnotify lab Campy Agar

    Antigenic Diversity Enterotoxin: Heat-labile, stim-ulates cAMP. Cytotoxin

    Campylobacter

    Fetus

    Bacteremia, going tomeninges, lungs, and

    GRAM(-) ROD, WavyMICROAEROPHILIC

    Campy Agar

    Low Incubation Facultative Intracellular Para-site of vascular endothelial cells.

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    Bug Name Manifestations Identifying Properties Culture / Tests Virulence Vaccine / Rx

    (Enterobact-

    eriaceae)joints Suppurative (early) andRheumatoid (late) arthritis No GI Manifestations

    MOTILE NON-LACTOSEFERMENTING

    Temperature: 25C mustnotify lab

    Antigenic Diversity Protein Capsule

    Helicobacter

    Pylori(Enterobact-

    eriaceae)

    PEPTIC ULCER

    DISEASE Type-B(inflammatory) Gastritis

    GRAM(-) ROD, WavyMICROAEROPHILICMOTILE NON-LACTOSEFERMENTING

    CATALASE (+) UREASE (+)

    Normal Incubation Temper-ature: 28C Campy Agar

    Urea Breath Test: Breatheout radiolabeled C.

    Flagellum Mucinase Catalase Oxidase Urease

    Three antibiotics plusBisthmus as astomach coating.

    Clostridium

    Difficile

    Pseudomembranous Co-

    litis Endogenous infection:antibiotics Exogenous infection:nosocomial

    GRAM(+) RODOBLIGATE ANAEROBE

    Toxin Assay done on fecalfiltrate. Not all specimenscontain toxin.

    Exotoxin-A: Damages intest-inal mucosa Exotoxin-B: AB-toxin disruptscytoskeleton.

    High relapse rate totreatment

    EscherichiaColi

    (Enterobact-eriaceae)

    EPEC: Travelers Di-arrhea

    ETEC: Watery Diarrhea EIEC: Dysentery EHEC: Hemolytic Ure-mic Syndrome (HUS) Neonatal Meningitis(less than 3 months) #2 cause

    GRAM(-) ROD LACTOSE-FERMENT-

    ING MOTILE MANNOSE-SENSITIVEHEMAGGLUTININ (F1)

    F2-F10: Pili antigens areMannose-Resistant

    B Flagellar subtype reported

    with meningitis

    Selective Medium: InhibitsGram (+) strains and containslactose

    Labile Toxin (LT): Kicks outthe water (cAMP). In smallintestine. Stable Toxin (ST): Preventsthe water from coming back in(cGMP). In small intestine. Verotoxin: (EIEC) Shiga-Like toxin is cytotoxic andworks in the colon.

    Invasin Hemolysin is an EHEC strand.

    Shigella(Enterobact-

    eriaceae)

    DYSENTERY ulcer-ative colitis.Communicable and verylow infective dose.

    GRAM(-) ROD NON-MOTILE

    NON-LACTOSEFERMENTING

    Special transport mediumrequired. Shigella is killed bythe organic acid byproducts ofnormal flora.

    Hemolysin Actin-polymerization mechan-ism to get into other cells. Shiga Toxin (S. Dysenteriaeonly): Removes adenine fromthe 28s rRNA and irreversiblyinactivates protein synthesis at60s ribosomal subunit.

    Must treat with anti-biotics

    Salmonella Enterocolitis: Non- GRAM(- ) ROD Selective Medium including Flagellum (H antigen)

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    Bug Name Manifestations Identifying Properties Culture / Tests Virulence Vaccine / Rx

    Enterocolitica

    (Enterobact-eriaceae)

    bloody diarrhea Large infective dose No bacteremia

    MOTILE

    NON-LACTOSEFERMENTING

    MANNOSE-SENSITIVEHEMAGGLUTININ

    High antigenic diversity. Biphasic expression of theflagellar antigen.

    bile and lactose.Bugs like bile.

    Polysaccharide (O Antigen) Capsule (K Antigen) Pili: Mannose-sensitivehemagglutinins LPS Endotoxin Enterotoxin similar toE. Coli Cytotoxin in colon

    Salmonella

    Typhi(Enterobact-

    eriaceae)

    TYPHOID FEVER

    Constipation Then bacteremia, sus-tained fever Rose-spot rashes Diarrhea Carrier state for up to ayear after resolution Organisms go fromsmall intestine > RES

    > liver > bile ducts> back to small intes-tine.

    GRAM(-) ROD MOTILE NON-LACTOSE

    FERMENTING Facultative IntracellularParasite of monocytes

    Selective medium containinglactose and bile.

    Vi Capsular Antigen : Anti-phagocytic, serum-resistant.Enhances survival inside mono-cytes. Endotoxin Flagellar Antigen: Biphasicexpression Outer Membrane Proteins:enhances resistance to chlorin-ating agents inside monocytes.

    May need cholecyst-ectomy.TAB Vaccine: Fortravelers, short-term

    passive protectionagainst Vi antigen.

    Vibrio

    Cholerae(Enterobact-

    eriaceae)

    CHOLERA: Profusenon-invasive rice-waterdiarrhea dehydration

    GRAM(-) ROD, comma-shaped with long flagellum MOTILE

    NON-LACTOSEFERMENTING

    OXIDASE (+)

    HALOPHILIC Does not grow in 8%NaCl

    Transport medium containspH > 8 to supress other flora. Darkfield stain only. Serology test for O1 Serotypeto test forTox-gene Then test forCholera El Tor

    by hemolysis. It is a lessvirulent strain.

    Polar flagellum Mucinase Cholera Toxin: AB-toxin,

    binds to Gs-subunit, blocking iton, leading to high cAMP.

    Live attenuatedvaccine providesshort-term protection. Oral rehydrationtherapy.

    Vibrio Para-

    haemolyticus(Enterobact-

    eriaceae)

    Raw shellfish high infective dose Self-limiting diarrhea Wound-infections

    GRAM(-) ROD HALOPHILIC

    Grows in 8% NaCl

    Salty (3% NaCl) selectivemedium

    in-vivo hemolysin Not usually treated

    Escherichia

    Coli(Enterobact-

    eriaceae)

    UTIs: #1 cause GRAM(-) ROD LACTOSE-FERMENT-ING

    MOTILE

    Mid-stream clean catch P-Antigen: Correlates withlikelihood of Pyelonephritis (Piliantigen 2-10). K-Antigen (Capsule): Associ-

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    Bug Name Manifestations Identifying Properties Culture / Tests Virulence Vaccine / Rx

    MANNOSE-SENSITIVE

    HEMAGGLUTININ (F1)

    MANNOSE-RESISTANTP-ANTIGEN

    ated with adherence to transi-tional epithelium.

    Proteus

    Vulgaris(Proteaceae)

    10-15% of HospitalAcquired UTIs Wound infections

    GRAM(-) ROD UREASE (+) Metabolizes Tryptophan

    to Indole

    Swarming Growth in culture,forming rings of growth

    Urease: alkaline urine can leadto calculi and kidney stones Lots of peritrichous flagella Pili: Adhesin in renal pelvis

    Ampicillin-Resis-

    tant. Await sensi-tivity test results

    ProteusMirabilis

    (Proteaceae)

    Same asP. Vulgaris GRAM(-) ROD UREASE (+)

    Does not MetabolizeTryptophan to Indole

    Same asP. Vulgaris Same asP. Vulgaris Ampicillin-Sensitive

    Pseudomonas

    Aeruginosa(Pseudomon-

    aceae)

    UTIs 3rd most com-mon cause Burn infection Opportunistic pneumo-nia, especially in CF pa-tients. Micro-abscessesseen in lungs. Otitis Externa Eye infection

    GRAM(-) ROD STRICT AEROBE NON- FERMENTING of

    all sugars OXIDASE (+)

    Juicy-Fruit Smell Pyocins (against same spe-cies) used in hospital for typ-ing strains.

    Blood Agar: -Hemolyticblue-green colonies. Direct microscopy not helpful

    Pyocyanin: against StaphAureus Pyoverdin : Ciliastatic, acquireiron Flagella: Adhere to urinarytract Pili: Adhere to respiratory tract Exotoxin-A: Binds to EL-2,stop protein synthesis. Exotoxin-S -Hemolysin Alginate: In CF patients Elastase Alkaline Protease

    Highly drug resistant big problem.

    NeisseriaGonorrhea

    (Gonococcus)

    GONORRHEA

    Bacteremia leading toseptic arthritis #1cause in young adults Neonatal conjunctivitis

    GRAM (-) DIPLOCOCCI,Kidney-shaped CATALASE (+) OXIDASE (+) GLUCOSE-FERMENT-ING

    NON-MALTOSEFERMENTING

    Facultative IntracellularParasite

    Stain is only useful on ure-thral exudate not swab. Thayer-Martin Medium:Contains Vancomycin,Colistin, Nystatin, iron.

    PI: Complexes with PIII toform Porin PII: Adhesin, autoagglut-ination PIII: Complexes with PI toform Porin LOS IgA Protease, two types. Catalase, SuperoxideDismutase, Peroxidase

    By law, prophylac-tic treatment for neo-natal conjunctivitis. Penicillin-Resis-tant, due to both -Lactamase and al-tered PBPs.

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    Bug Name Manifestations Identifying Properties Culture / Tests Virulence Vaccine / Rx

    Leptospira

    Interrogans

    LEPTOSPIROSIS

    Liver, kidneys, CNS

    Tropic for endothelialcells in the CSF Carried in animals urine

    SPIROCHETE -Hemolytic

    Dark Microscopy: Two axialfilaments per pole with hook at

    end.

    Cell Wall Lipids = 25% ofdry weight of cell. LPS-like

    symptoms Hemolysin Surface antigens

    Dog Vaccine

    BorreliaRecurrentis

    RELAPSING FEVER Spread by head lice.

    SPIROCHETEMICROAEROPHILIC

    Dark Field Microscopy: 15-20axial filaments per pole. Can be visible under lightmicroscope

    Antigenic Shift

    Borrelia

    Burgdorferi

    LYME DISEASE

    Spread by Dear Tick Erythema ChronicumMigrans Later: Neurological,cardiac, rheumatoid.Strong immunologicsequelae

    SPIROCHETEMICROAEROPHILIC

    Dark Field: 7-11 flagella ateach pole, but no axial fila-ments. Kellys Medium: Enrichedagar with fatty acids.

    Outer Membrane Proteins:Polyclonal activation of B-Cells, responsible for sequelae.

    Bugs probably killedby Ab + Complement(few PMNs). Rx = Penicillin

    BacteroidesFragilis

    (Enterobact-eriaceae)

    PID Peritonitis Sustained Bacteremia

    STRICT AERO-TOLERANT ANAEROBE

    CATALASE (+)

    Anaerobic Transport Mediumrequired Direct FA Gas-liquid chromatography

    Capsule LPS, not as bad as E. COLI

    Surgically drain ab-scesses

    ClostridiumPerfringens

    GAS GANGRENE:Type-A Necrotizing Enteritis:Type-C Food-Poisoning: Type-A

    GRAM (+) ROD, Spore-FormingSTRICT AERO-TOLERANT ANAEROBE

    Stain: Rods with square endsand a capsule. Egg-Yolk Agar: Lecithin is

    present to test for lecithinase. Double-Zone of hemolysis.

    Very fast replicating Alpha Toxin: Lecithinase,responsible for zone ofincomplete hemolysis Beta Toxin: Cytotoxin,responsible for necrotizingenteritis. Theta Toxin: Oxygen labilehemolysin, responsible forsmaller zone of hemolysis. Enterotoxin: Only releasedupon hemolysis.

    Antibiotics.Hyperbaric oxygentreatment.

    ClostridiumTetani

    TETANUS: SpasticParalysis and respiratoryfailure

    GRAM (+) ROD, Spore-formingSTRICT ANAEROBE

    Diagnosis is clinical not byculture

    Tetanospasmin: Blocks re-lease of GABA and Glycine at

    Alum-precipitatedToxoid given at 2, 4,6, 18 months

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    Bug Name Manifestations Identifying Properties Culture / Tests Virulence Vaccine / Rx

    Somatic Antigen O has onlyone serotype, so virus is easy.

    Swarming Growth in culture. post -synaptic terminal Boosters every 10years are ammonium-

    ppt Give both vaccineand antitoxin fortreatment.

    Clostridium

    Botulinum

    BOTULISM: Food, in-fantile, and wound botu-lism.

    GRAM (+) ROD, Spore-formingSTRICT ANAEROBE

    Blood Agar. Heat to boiling toinduce sporulation.

    Botulin Toxin: Most potenttoxin known to man. Acetyl-choline blocker. Heat-labile.

    Alum-ppt toxoidavailable for labworkers. Gastric lavage andantitoxin administeredas Rx

    Coxiella(Rickett-

    siaceae)

    Q FEVER: No rash,insect-vector

    STRICT INTRA-CELLULAR PARASITE ofendothelial cells.

    Tetracycline

    Ehrlichia(Rickett-

    siaceae)

    Arthropod-vectored, in-fects WBCs

    STRICT INTRA-CELLULAR PARASITE ofendothelial cells.

    Tetracycline

    RickettsiaRickettsiae

    (Rickett-siaceae)

    ROCKY MOUNTAINSPOTTED FEVER:Prominent Rash + Endo-toxin symptoms.

    STRICT INTRA-CELLULAR PARASITE ofendothelial cells.

    Egg or Tissue Culture Direct-FA on endothelialcells

    LPS Phospholipase: Helps bugs getinto endothelial cells. Actin-polymerization for cell-to-cell infection.

    Tetracycline.

    ChlamydiaTrachomatis

    (Chlamyd-iaceae)

    CHLAMYDIA

    LymphogranulomaVenereum

    Leading cause of prev-entable blindness in theworld.

    OBLIGATE INTRA-CELLULAR PARASITE

    Stains brown with Iodine No Peptidoglycan Layer

    A-C: KeratoconjunctivitisD-K: ChlamydiaL1-L3: LymphogranulomaVenereum

    Iodinetest for inclusionbodies containing glycogen stains brown Take scrapings and look forinclusion bodies in epithelia.

    ATPase ATP-ADP Translocase

    Cylindrical Projections toget nutrients. LPS: Just antigenic, not endo-toxic.

    Tetracycline By law Prophylaxisfor infantile

    blindness.

    ChlamydiaPneumonia

    (Chlamyd-iaceae)

    Walking Pneumonia: in-fects columnar epitheliumof upper airway

    OBLIGATE INTRA-CELLULAR PARASITE

    No Peptidoglycan Layer

    Tetracycline

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    Bug Name Manifestations Identifying Properties Culture / Tests Virulence Vaccine / Rx

    Chlamydia

    Psittaci

    (Chlamyd-iaceae)

    PSITTACOSIS : Dryhacking cough, severe

    CNS symptoms (head-ache).

    OBLIGATE INTRA-

    CELLULAR PARASITE

    No Peptidoglycan Layer Does not stain brown withIodine

    Iodine Test is negative. Indirect FA

    Tetracycline

    MycoplasmaPneumonia

    (Mycoplasm-aceae)

    WALKING PNEUMO-NIA: Monocyticresponse. Ciliastatic inupper airway like Whoop-ing Cough. Bullous Myringitis inadults

    OBLIGATE INTRACEL-LULAR PARASITE

    Needs Cholesterol, nu-cleotides for growth

    Biphasic Enriched Broth/A-gar

    Cholesterol required forGrowth Cold-Agglutination Anti-body Test: Agglutinates withType-O blood-group antigen inthe cold. Complement Fixation test

    P1 Protein: Adhesin for GI,UG, respiratory epithelia. Glid-ing motility.

    Tetracycline

    UreaplasmaUrealytica

    (Mycoplasm-aceae)

    Urethritis, maybe asymp-tomatic.

    OBLIGATE INTRACEL-LULAR PARASITE

    UREASE (+) Needs Cholesterol, nu-

    cleotides for growth

    Add a pH indicator to mediumto test for Urease degradation.

    Urease Tetracycline

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