Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
NeisseriaMeningitidis
AcuteBacterialMeningitis
Non-Neonatal
GramNegativeDiplococci
GramStain.LatexAgglutination.
UtilizationofGlucose&Maltose.
ChocolatewithCO2.OxidasePositive.
Meningism:Headache,NuchalRigidity,PhotophobiaPetechialRashSepticShock
WaterhouseFriderichsenSyndrome(AdrenalFailure)
PolysaccharideCapsuleLOS,Pili
IgAProtease5Serotypes
ChildrenEldery
ImmunocompromisedAsplenic
C5-8Deficiency
RespiratoryDropletsHuman
RespiratoryTract3rdGenerationCephalosporins
Vaccines(Conjugate,Polysaccharide,and
Capsular)Prophylactic
AntibioticstoBreakCarriage(Rifampin)
Brudzinski'sSign:Neckstiffnesscausespatienttoflexknees/hips
whenneckisflexed.Kernig's:Cannotstraightenleg.JOLTTest:Movingheadsideto
sidehorizontallycausesworseningofheadache
StreptococcusPneumonia
AcuteBacterialMeningitis
Non-Neonatal#1Cause
GramPositiveDiplococci
LancetShaped
GramStain.AlphaHemolysisNeufeld/QuellungBileSolubility
OptochinSensitive
Meningism:Headache,NuchalRigidity,Photophobia
PolysaccharideCapsuleIgAProtease
Pneumolysin,NeuraminidaseAutolysin
PhaseVariationofSurfaceAntigens
80-90Seroytypes
Anyoneolderthan1year
RespiratoryDropletsHuman
RespiratoryTract
Vancomycin3rdGenerationCephalosporins
Vaccines:PPSV23(2-65)
andPCV13(<5and>65)
CannotBreakCarriage
Brudzinski'sSign:Neckstiffnesscausespatienttoflexknees/hips
whenneckisflexed.Kernig's:Cannotstraightenleg.JOLTTest:Movingheadsideto
sidehorizontallycausesworseningofheadache
HemophilusInfluenza
AcuteBacterialMeningitis
Non-Neonatal
GramNegativeRodwithPRP(TypeB)
GramStain.ChocolateAgar(XandVFactors)
RapidPRPAntigenTest
Meningism:Headache,NuchalRigidity,Photophobia
PolyribitolPhosphate(PRP)Capsule
IgAProtease
ChildhoodMeningitis(>1yearsold)Unvaccinated
RespiratoryDropletsHuman
RespiratoryTract3rdGenerationCephalosporins
Vaccines:(HibandMenhibrix)Prophylactic
AntibioticstoBreakCarriage(Rifampin)
Brudzinski'sSign:Neckstiffnesscausespatienttoflexknees/hips
whenneckisflexed.Kernig's:Cannotstraightenleg.JOLTTest:Movingheadsideto
sidehorizontallycausesworseningofheadache
ListeriaMonocytogenes
AcuteBacterialMeningitisNeonatal
GramPositiveRodFacultativeIntracellularNon-SporeForming
ColdEnrichmentCatalasePositiveCAMPPositive
LikesSaltandAcid
Meningism:Headache,NuchalRigidity,Photophobia
Internalins(Phagocytosis)Listeriolysin(Lysis)
ActA(HostActinFormation)Neonates
Transplacental(GranulomatosisInfantiseptica)
Parturition(Meningitis)
AnimalGITract Antibiotics Avoidance
Brudzinski'sSign:Neckstiffnesscausespatienttoflexknees/hips
whenneckisflexed.Kernig's:Cannotstraightenleg.JOLTTest:Movingheadsideto
sidehorizontallycausesworseningofheadache
UropathogenicE.Coli
AcuteBacterialMeningitisNeonatal
GramNegativeRodGramStain.
LactoseFermentation.IndolePositive.
Meningism:Headache,NuchalRigidity,Photophobia
K1PolysaccharideCapsule Neonates Parturition HumanGITract AntibioticsHygeineduring
delivery
Brudzinski'sSign:Neckstiffnesscausespatienttoflexknees/hips
whenneckisflexed.Kernig's:Cannotstraightenleg.JOLTTest:Movingheadsideto
sidehorizontallycausesworseningofheadache
StreptococcusAgalactiae
(GBS)
AcuteBacterialMeningitisNeonatal#1Cause
GramPositiveCocci
GramStain.CatalaseNegative.BetaHemolytic.
LancefieldGroupB.CAMPPositive.
HydrolyzesHippurate.CHROMRapidTest.
PneumoniaMeningism:Headache,
NuchalRigidity,Photophobia
TypeIIICapsuleWeakHemolysin(ClyE)
CAMPFactorNeonates
ParturitionEarlyRuptureofMembranes
Caretakers(DirectContact)
HumanUrogenitaland
GITractAntibiotics
ScreenallPregnantWomen(35-37Weeks)
IntrapartumAntibiotics
Brudzinski'sSign:Neckstiffnesscausespatienttoflexknees/hips
whenneckisflexed.Kernig's:Cannotstraightenleg.JOLTTest:Movingheadsideto
sidehorizontallycausesworseningofheadache
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
CryptococcusNeoformans
ChronicMeningitis
MonomorphicEncapsulatedYeast
IndiaInk(Capsule)AntigenDetectionLatexAgglutination
SlowOnset:IntermittentFever,Headaches,Altered
PesonalityWeekstoMonths
PolysaccharideCapsularAntigen
Galactomannan(GXM)Immunocompromised AerosolizedSpores
EnvironmentBirdsadjustsoil
pH.Antifungals Education -
CryptococcusGatti
ChronicMeningitis
MonomorphicEncapsulatedYeast
IndiaInk(Capsule)AntigenDetectionLatexAgglutination
SlowOnset:IntermittentFever,Headaches,Altered
PesonalityWeekstoMonths
PolysaccharideCapsularAntigen
Galactomannan(GXM)
UnknownHealthyPeople
AerosolizedSporesEnvironment
BirdsadjustsoilpH.
Antifungals Education -
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
NaegleriaFowleri
Meningo-encelphalitis
(PAM)Amoeba
MicroscopyAntigenDetectionLesionsonMRI
75%DiagnosedPost-Mortem
Meningism:Headache,NuchalRigidity,PhotophobiaFocalDeficits
Olfactory/GustatoryHallucinations
CystsTrophozoites
Children/AdolescentsCribiformPlateisnot
fullyformed.
DirectInoculation(NassalCavities)
NOTFROMDRINKING
EnvironmentWarmWater
Miltefosine-AKTInhibitor
LargelyIneffectiveAvoidance
CSF:Clear,HighWBCs,HighProteinLevels.
ViralPCR,EEG,MRI,CATScan
FlaviviridaeWestNileSt.LouisJapanese
Encephalitis
ArbovirusssRNA,EnvelopedPositiveSense
MRI/CTPairedSeraSerology
ELISA
Meningism:Headache,NuchalRigidity,PhotophobiaFocalDeficits
-
ElderyAfricanAmericans
MalesHypertension
MosquitoBite Birds Antiviral VectorControlCSF:Clear,HighWBCs,High
ProteinLevels.ViralPCR,EEG,MRI,CATScan
BunyaviridaeCaliforniaLaCrosse
Encephalitis
ArbovirusssRNA,EnvelopedNegativeSenseSegmented
MRI/CTPairedSeraSerology
ELISA
Meningism:Headache,NuchalRigidity,PhotophobiaFocalDeficits
- Children MosquitoBite SmallMammals Antiviral VectorControlCSF:Clear,HighWBCs,High
ProteinLevels.ViralPCR,EEG,MRI,CATScan
HerpesSimplexVirus
Meningo-encephalitis
dsDNA,EnvelopedTzanckSmear(Syncytia)
Serology,PCR
Meningism:Headache,NuchalRigidity,PhotophobiaFocalDeficits
Seizures,MemoryLoss,AlteredConsciousnessErythemaMulfiforme
HSV-1:FocallesionsonTemporal/FrontalLobes+
PerivascularCuffingHSV-2:Parturition-generalizedbraininvolvedment.
ImmunocompromisedNeonates(Parturition)
DirectContactHumans(LifelongInfection)
Acyclovir,Valacyclovir,Famciclovir
AvoidanceCSF:Clear,HighWBCs,High
ProteinLevels.ViralPCR,EEG,MRI,CATScan
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
Rhabdoviridae:RabiesVirus
RabiesEncephalo-myelitis
ssRNA,EnvelopedNegativeSense
Ante-Mortem:RabiesAntigeninSkin/Hair
Post-Mortem:PresenceofNegriBodies(DFA)
MultipleTestsarerequiredforconfirmation
Asymptomaticfor30-90Days.Varioussymptoms
includingfever,nausea,painatsiteofbite,phyaryngeal
spasms,paralysis,confusion,coma,etc.
NeurotoxinAnimalHandlerVeterinarians
AnimalBitesBodyFluids(AnimalLickingWound)Inhalation(Rare)
WildAnimalsGroundhogs,
Bats,UnvaccinatedDomesticPets
1.Rig(Passive)aroundthewound.
2.ActiveVaccination:1,3,
7,14days
AnimalVaccinationviaBait.
HumanVaccinationforHighRiskPopulations
ClinicallyConfusingwithoutHistoryofExposure
Picornaviridae:PolioVirus
PolioPoliomyelitis
ssRNA,NOEnvelopePositiveSense
SerologyAffectstheAnteriorHorn
Cells
Asymmetric,FlaccidParalysis
GI,RespiratorySigns,Meningitis,Encephalitis70%
Asymptomatic
3SerotypesNucleocapsids(Tropism)
Unvaccinated.Travel(Afghanistan,Pakistan,Nigeria)
Fecal-OralRespiratoryDroplets
Humans Supportive
Vaccines:Sabin:Live,Attenuated
Salk:Inactivated(USA)+Boosters
Post-PolioSyndrome:NewWeaknessorMusclePainyears
afterrecovery.
ClostridiumTetani
TetanusGramPositiveRodSpore-FormingAnaerobe
ClinicalPresentation:1stSign:TrismusorRisusSardonicus(LockJaw)
Progression:Opisthotonus:Backspasms.
Musclespasmswhichleadtotetanicparalysisrangingfromlocaltosystemic.
Tetanospasmin-Plasmid-EncodedNeurotoxin--ABToxinthatblocksreleaseof
GABAandGlycinebydegradingSynaptobrevin.
EntersCNSviaNeuromuscularJunctions.
Unvaccinated.
Sporesreleasedintopoorlyvascularizedwounds(puncture
wounds)
Soil
SurgicalDebridement.Delayclosuretoincreaseoxygen
perfusion.Passive
Immunizationifunvaccinated.
Vaccination+Boosters(maintainhighIgG)
-
ClostridiumBotulinum
BotulismGramPositiveRodSpore-FormingAnaerobe
ToxinAssaysofPatientandFoodSpecimen
Symmetrical,Descending,FlaccidParalysisConstipation
7ABToxinsonLysogenizedPhagesthatblocksreleaseofAcetylcholinebydegrading
Synaptobrevin.
Anyone
Consumptionofcontaminatedfoods.
PreformedToxin(>1yr)andSpores(<1yr)
Environment Supportive
Propercleaningandstorageofcanned
foods,rootvegetables,herb-oils,fruits,and
vegetables.
1.Botulism(ingestedtoxin)2.InfantBotulism(FloppyBaby)
3.WoundBotulism(drugusers)
BorreliaBurgdorferi
LymeDisease-Neuritis
(2-3Stage)Spirocete
HardtoGramStainSerology,
ELISA(Screen)WesternBlot(Confirm)
Primary:ErythemaMigransSecondary:Carditis,
Meningitis,BellsPalsy,Polyarthralgias
Tertiary:ArthritisandNeurologicalDecline
EndoflagellaCampers,Hikers
NEUSATickBite
(takes18-48hours)WildAnimals Anti-Microbials
ProtectiveClothing,InsectRepellent
HLADR-2.DR-3,DR-4
Polyomaviridae:JVVirus
ProgressiveMultifocalLeuko-
encephalo-pathy(PML)
dsDNA,NOEnvelope
CT/MRI-WhiteMatterLesions.
JCVirusinCSFNon-EnhancingLesionson
BrainBiopsy
DemyelinatingDisease.Hemiparesis,Ataxia,Dysphasia,Seizures.
AffectsOligodendrocytesandAtrocytesinCNS.
70-90%ofpeopleareSeropositive
VirionslatentinKidneyandGITract
ImmunocompromisedReactivation
RespiratoryDropletsContaminatedWater
HumansImmune
ReconstitutionNone -
MycobacteriumLeprae
Leprosy/Hansen'sDisease
AcidFastRodObligateIntracellular
LikesLowerBodyTemps(Skin,NasalMucosa)
ThickenedPeripheralNerves
1.Tuberculoid(Paucibacillary)-Poorly
pigmentedskinlesionswitherythematousbordersand
sensoryloss.2.Lepromatous
(Multibacillary)-Nodules,SensoryLoss,Respiratory
CongestionAffectsSchwannCellsand
Histiocytes
-
EndemicAreas,LivingwithUntreated
CasesImmunocompromisedcausesLepromatous
Type
ProlongedContactRespiratoryDroplets
Humans
Tuberculoid:Self-LimitedLepromatous:Antibiotics
VaccinationwithBCG(againstTB)
-
GIDISEASES
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
CandidaAlbicans EsophagitisYeastw/
Pseudohyphae
KOHPrep:BuddingyeastswithPseudohyphaeCultureonSDA/MYC
Dysphagia,Odynophagia,Off-White,firmlyadherentplaqueswithulcerations
underneath.Curd-LikeLesions
- Immunocompromised EndogenousNormalFlora:SkinandMucusMembranes
Azoles AvoidOvergrowthEndoscopy,Biopsy,BariumX-
Ray,Culture,Serology
HerpesSimplexVirusAlpha
EsophagitisdsDNA,Enveloped
LatentinDorsalRootGanglia
Serology-SyncytiaonTzanckSmear
Dysphagia,Odynophagia,Multiple,confluentulcerswithraisededges(ruptured
vesicles)
- Immunocompromised ReactivationHumans
LifelongInfection
CiclovirsReconstitutionofImmuneSystem
PreventReactivationEndoscopy,Biopsy,BariumX-
Ray,Culture,Serology
CytomegalovirusHSVBeta
EsophagitisdsDNA,EnvelopedLatentinMonocytes
Owl'sEyeInclusions(Enlargedcellw/Basophilic
Inclusions),CondensedChromatin
Dysphagia,Odynophagia,AcidRegurgitation,
Ulcermarginsaresmooth,punchedout,and
interveningmucosaappearsnormal.
- Immunocompromised ReactivationHumans
LifelongInfection
CiclovirsReconstitutionofImmuneSystem
PreventReactivationEndoscopy,Biopsy,BariumX-
Ray,Culture,Serology
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
StaphylococcusAureus
Intoxication GramPositiveCocci
ClinicalDiagnosis-ShortIncubationPeriod-BetaHemolysis
CatalasePositive-MSA
Vomiting+/-Diarrhea
EmeticExo-EnteroToxin:StimulatesVagusNerve
Improperlycookedfoods:"RichorSalty"i.e.
Mayo
Consumptionoffoodscontainingpre-formed
toxinHumans
Self-Limiting24-48Hours
ProperFoodCooking
EmeticExotoxincanbepresentevenwhenbacteriaaregone.Pre-formedtoxinsalwayscause
vomiting
BacillusCereus IntoxicationInfection
GramPositiveRodSpore-FormingAerobe
Intoxication(Rapid:1-6hours)
Infection(Delayed:6-16hours)
Vomiting+/-+/-Diarrhea
1.EmeticExotoxin2.DiarrhealExotoxin
Inadequatelycleaned,cooked,storedrootvegetables,grains
1.Foodscontainingpre-formedtoxin.(rice)
2.Foodscontaminatedwithmicoorganism
(stews)
EnvironmentSelf-Limiting24-48Hours
ProperFoodCooking
Pre-formedtoxinsalwayscausevomiting.Iftheactual
organismispresent,itwillcausediarrhea.
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
E.ColiETEC
Non-InflammatoryDiarrhea-Afebrile
GramNegativeRodLactoseFermenterSorbitolFermenterIndolePositive
Traveler'sDiarrhea2Toxins
Heat-LabileEnterotoxin(LT):ExcesscAMP(↑Cl-)
HeatStableEnterotoxin(ST):ExcesscGMP(↓Na+)
Anyone Fecal-OralGITractofAniimals
Self-LimitingOralRehydration
FoodSafety
E.ColiEAEC
Non-InflammatoryDiarrhea-Afebrile
GramNegativeRodLactoseFermenterSorbitolFermenterIndolePositive
Enterotoxin
AggregativeAdherenceFimbriae(AAF):adherenceStackedBrickAppearance
ShorteningofMicrovilliaEAST1Toxin:ST-likeEnterotoxin:
ExcesscGMP(↓Na+)
AnyoneInfantsinDeveloping
WorldFecal-Oral
GITractofAniimals
Self-LimitingOralRehydration
FoodSafety
E.ColiEPEC
Non-InflammatoryDiarrhea-Afebrile
GramNegativeRodLactoseFermenterSorbitolFermenterIndolePositive
NoToxins
1.Bundle-FormingPili(InitialBinding)
2.Intimin(Intimatebinding)3.TirProtein(Rearrangement
ofActin)4.Membrane-EffacingInfection:Pedestal-Like
Structure
Anyone2ndMostCommonCauseofInfantile
Diarrhea
Fecal-OralGITractofAniimals
Self-LimitingOralRehydration
FoodSafety
E.ColiEHEC/STEC
Non-InflammatoryDiarrhea-Afebrile
GramNegativeRod
LactoseFermenterNON-SorbitolFermenter
SMACPlateIndolePositive
HemolyticUremicSyndrome(HUS)
HemorrhagicColitisBloodyDiarrhea
NotanEnterotoxin
1.Bundle-FormingPili(InitialBinding)
2.Intimin(Intimatebinding)3.TirProtein(Rearrangement
ofActin)4.Membrane-EffacingInfection:Pedestal-Like
Structure5.ShigaToxin
(STX/Verotoxin):disruptsproteinsynthesis
Anyone Fecal-OralGITractofAniimals
Self-LimitingOralRehydration
FoodSafety
VibrioCholeraNon-
InflammatoryDiarrhea-Afebrile
Comma-ShapedGramNegativeRod
HalophileCulture:ThiosulfateCitrateBileSaltsSucroseAgar
(TCBS)Colonies:Flat,YellowLactoseFermenterOxidasePositive
LifeThreatningDiarrheaWateryDiarrhea(14-20L/day)resultingin"Rice
Water"Stoolswithclumpsofmucus.
1.CholeraEnterotoxin:LT-Like:IncreasesCellularcAMP
(↑Cl-)2.HemagglutinationProtease(HA/P):Degradationofcell-
celladherence(TightJunction).3.Toxin-RegulatedPili(TcpA):
forattachment
AnyoneContaminatedWaterImproperlyCooked
Seafood
Fecal-OralHumans
(Transient)andFish,Shellfish
ORTTherapyforDehydration.
Vaccination+Boosters
TurgorTest:Largeamountsofwaterloss.
VibrioParahemolyticusVibrioVulnificus:Non-InflammatoryDiarrheainHealthyIndividuals,but
patientswithliverdiseasehavesevereeffects.(4thBlock)
ClostridiumPerfringens
Non-InflammatoryDiarrhea-Afebrile
GramPositiveRodSpore-FormerAnaerobe
Culture:EggYolkAgar(Lecithinase-Lipase
production),NaglerReaction:
DoubleZonesofHemolysis(AlphaandBeta)
LeadingcauseofFoodPoisoningintheUS
1.CPEToxinisheldintheSporeCoat(Pre-FormedToxin):DisruptsTight
Junctions2.Lecithinase(AlphaToxin):breaksdownphospholipids
ConsumptionofHighProteinFoods(reheated)
Consumption
EnvironmentAnimals
Heatingtriggersgermiantionofbacteriawhichthensporulatein
theGITract
Self-LimitingOralRehydration
ProperFoodCooking -
ListeriaMonocytogenes
Non-InflammatoryDiarrhea-Afebrile
GramPositiveRodFacultativeIntracellularNon-SporeForming
ColdEnrichmentCatalasePositiveCAMPPositive
LikesSaltandAcid
DiarrheaMayseeinvasivedisease
withSepticemiainPregnantWomenandElderly(Fever+
Chills)
Internalins(Phagocytosis)Listeriolysin(Lysis)
ActA(HostActinFormation)
Healthy:AymptomaticImmunocompromisedandPregnanyPeople:
SevereDisease
ConsumptionofContaminatedFoods
AnimalGITract Antibiotics Avoidance -
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
GiardiaLambliaProtozoanNon-InflammatoryDiarrhea
ExtracellularFlagellatedProtozoan
Minimumof3stoolspecimensduetoSucking
DisksFecalAntigenTests(EIA)Biopsycanshowmicrovilli
damagedbymicrobe
Giardiasis:Foul-SmellingGreasy/Oilydueto
Malabsorption:SuckingDisk(DigestionEnzymes)
SuckingDisk-MechanicalandChemicalInjurytoGITract
Consumptionofuntreatedriver/lake
water
Fecal-OralIngestionofCysts
HumansAnimals
Anti-Parasitic WaterTreatmentChronic
Lawn-MowerDestruction
CryptosporidiumParvum
ProtozoanNon-InflammatoryDiarrhea
Tiny,IntracellularProtozoan
SphericalOocystsinStool(MultipleStoolSamples
Required)EIAforAntigen
NotAutofluorescent
Cryptosporidiosis:Malabsorption:
Intracellular,butrupturesanddestroysmicrovilli.
MechanicalDamageAIDS-Associated
Diarrhea(Immunocompromised)
IngestionofContaminatedFoods
(Water,Fruits,Vegetables)
AnimalsReptiles
FishHumans
Self-LimitinginHealthy
ORF/ORTforDehydration
ReconstitutionofImmuneSystem
WaterTreatmentChronic
SpottyDestruction
CyclosporaCayetanesis
ProtozoanNon-InflammatoryDiarrhea
SmallIntracellularProtozoan
SphericalOocystsinStool(MultipleStoolSamples
Required)EIAforAntigenAutofluorescent
Malabsorption:Intracellular,butrupturesanddestroys
microvilli.MechanicalDamage
AnyoneImportedFruitsandVegetableshave
beenlinkedtooutbreaksinUS.
Fecal-OralRequirestimetomatureintheenvironment
Humans Anti-Parasitic FoodSafetyChronic
SpottyDestruction
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
NorwalkVirusesViralNon-
InflammatoryDiarrhea
ssRNA,Non-EnvelopedPositiveSenseCaliciviridae
PCRforGiVirusesinGeneral(NotSpecific)
NegativeStoolsWateryDiarrhea+Emesis -
AllAgesConsumptionof
contaminatedfoods(includingShellfish)and
water.
Fecal-OralSmallinfectiousdose
requiredHumans
Self-LimitingOralRehydration
SanitationRe-infectionsPossible
MostCommoncauseofDiarrheainAdults
CruiseShips
AdenovirusesViralNon-
InflammatoryDiarrhea
dsDNA,Non-EnvelopedSpikes
Adenoviridae
EIAforAntigenPCR
NegativeStoolsWateryDiarrhea+Emesis - Children Fecal-Oral Humans
Self-LimitingOralRehydration
Re-InfectionsPossibleinNon-Immunized
Primarycauseofdiarrheainchildren
RotavirusesViralNon-
InflammatoryDiarrhea
dsRNA,Non-EnvelopedSegmentedReoviridae
EIAforAntigenPCR
NegativeStoolsWateryDiarrhea+Emesis
PRODUCESENTEROTOXINNSP4
InfantsAdults:AsymptomaticChildren:SymptomaticInfants:SevereDisease
Fecal-Oral HumansSelf-Limiting
OralRehydration
VaccinationRe-InfectionsPossibleinNon-Immunized
Leadingcauseofdeathfromdehydrationininfants.
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
Shigella(S.Dysenteriae)
BacterialInflammatoryDiarrhea
GramNegativeRodFacultativeIntracellular
HektoenAgarLactoseNon-FermenterDoesNOTproduceH2S
WateryDiarrhea+Pus+/-Blood+FEVER(Febrile)Dysentary+TenesmusShigellosis/BasicallyDysentery:BIPHASICSmallIntestineAffectedFirst,thenmovestoLarge
IntestineSequela:
1.HUSinyoungchildren.(Triad:Thrombocytopenia,HemolyticAnemia,Acute
RenalFailure)2.ReactiveArthritis
Enterotoxin:ShET1/ShET2-blockNaUptake
CytolethalDistendingToxin(CDT):apoptosisofhostcells.ShigaToxin(Verotoxin):ABTypeToxin:InhibitsProtein
SynthesisRearrangeshostcellactinforintracellularmovementand
celltocellinfection.
PediatricDisease(upto10years)
EpidemicsinDaycareCenters
Fecal-OralContaminatedFomites,
Water,Food
Humans(NOANIMALRESERVOIR)
Self-LimitingOralRehydration
CiprofloxacinNOVACCINESanitationFoodSafety
BIPHASIC:StartsasNon-InflammatoryDiarrheaandprogressestoInflammatoryFrankBlood(VisibleinStool)OccultBlood(useGuaiacAcid
Test)PositiveLactoferrinTest
LowerHematocritandLowPlateletCount=HUS
EnteroinvasiveE.Coli
BacterialInflammatoryDiarrhea
GramNegativeRodFacultativeIntracellular
CultureLactoseFermenterIndolePositive
WateryDiarrhea+Pus+/-Blood+FEVER(FEBRILE)
Dysentary+TenesmusSequela:ReactiveArthritis
SimilartoShigellaCytolethalDistendingToxin(CDT):apoptosisofhostcells.
NoEnterotoxin
AnyoneConsumingGroundBeef
Children<5inDevelopingCountries
Fecal-Oral AnimalsSelf-Limiting
OralRehydration
CiprofloxacinSanitationFoodSafety
PositiveLactoferrinTest
CampylobacterJejuni
BacterialInflammatoryDiarrhea
GramNegativeComma/SpiralShaped
RodExtracellular
AgDetectionCulturebestat42Degrees(ChickenBodyTemperature)Campy/SkirrowSelective
Media
WateryDiarrhea+Pus+/-Blood+FEVER(FEBRILE)
Dysentary+TenesmusSequela:Bacteremia,
Guillain-BarreSyndrome(AscendingMuscle
Weakness/Paralysis),andReactiveArthritis
CytolethalDistendingToxin(CDT):apoptosisofhostcells.
SevereDiseaseinYoungChildren
ImmunocompromisedFecal-Oral
AnimalsPoultry,Pets,Unpasteurized
Milk
Self-LimitingOralRehydration
Ciprofloxacin PositiveLactoferrinTest
EntamoebaHistolytica
InflammatoryDiarrhea
AmoeboidProtozoan
Cysts(4Nuclei)MotileTrophozoites
(MultipleStoolsRequired)ELISA/AgglutinationAssay
WateryDiarrhea+Pus+/-Blood+FEVER(FEBRILE)
Dysentary+TenesmusChronic
RightUpperQuadrantPain(LiverAbscesses)
UlcerationofLargeIntestineSequela:Flask-Shaped
Ulcers
ProteolyticEnzymesCysteineProteinases(tissue
damage)Amebapore:Lysisofhostcells
viachannelformation
WaterBoyScouts
Fecal-Oral
HumanCarriersAnimalCarriersCystssurviveinsoilandwater
MetronidiazoleORTTherapyforDehydration.
CiprofloxacinSanitation
PositiveLactoferrinTest
YersiniaEnterocolitica
BacterialInflammatoryDiarrhea
GramNegativeRodExtracellular
BipolarStaining
Growsat4Degrees(Stoolsat25Degrees)
WateryDiarrhea+Pus+/-Blood+FEVER(FEBRILE)
Dysentary+TenesmusChronicSequela:
MesentericLymphadenitis:LowerRightQuadrantPain-
PsuedoappendicitisBacteremia
-
DairyProductsPorkPets
MeatProductsUnpasteurizedMilkBloodProducts
SeriousDiseaseinChildren
Fecal-OralTransfusions
AnimalsSelf-Limiting
OralRehydrationCiprofloxacinFoodSafety
PositiveLactoferrinTest
Non-TyphoidalSalmonellaEnterica
BacterialInflammatoryDiarrhea
GramNegativeRodFacultativeIntracellular
HektoenAgarLactoseNon-Fermenter
ProducesH2S
WateryDiarrhea+Pus+/-Blood
Dysentary+TenesmusSalmonellosis
Sequela:ReactiveArthritisandBacteremia
SopE:IncreasescAMP(LikeETECLT)
Sips(Ssps,SopB):TriggerActinRearrangement
AnyoneConsumingEggs/Chicken
Fecal-Oral ?Self-Limiting
OralRehydrationCiprofloxacinFoodSafety
PositiveLactoferrinTest
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
ClostridiumDifficile
AntibioticAssociatedDiarrhea/
PseudomembranousColitis
GramPositiveSpore-FormingRodAnaerobe
ToxinAssaysFecalAntigen
NAATS
AntibioticAsociatedDiarrhea(AAD)-AcuteNon-Inflammatoryto
InflammatoryPseudomembranousColitis
(PMC)-ChronicInflammatory+
Psuedomembrane(PlaqueFormation)
Enterotoxin(ToxinA):ChemotacticforNeutrophils,
HypersecretionofFluidCytotoxin(ToxinB):
DepolymerizationofActin,LossofCytoskeleton(Pro-Inflammatory)Targetfor
Zinplava
Colonization:HospitalizedPatientsImmunocompromised
Disease:AssociatedwithuseofBroadSpectrum
Antibiotics
EndogenousEnvironmentalvia
SporesHumans
MetronidazoleProbiotics
FecalTransplantsZinplava-MonoclonalAntibody
(Target:ToxinB)
Difficult
Associatedwithuseof:Clindamycin,Lincomycin,
Cephalosporins,Amoxicillin,Ampicillin
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
SalmonellaTyphi TyphoidFeverEntericFever
GramNegativeRodH2SProducing
BloodCulture(+at1week)StoolCulture(Week3)
BiopsyMarroworLiverifRoseColoredSpotsPresent
TyphoidNodules(aggregatesofmacrophages)
WidallTest:AntibioticsagainstOandHAntigens--
agglutinationreaction
Multi-SystemIllness:Fever(upanddown),Bacteremia,Constipation,Rose-Colored
Spots
OAntigenFlagellarAntigens(H)andSurfaceAntigens(Vi)
UnvaccinatedTravelers
EndemicAreasFecal-Oral
HUMANGITract(NOANIMALRESERVOIRS)
Antibiotics
LiveAttenuatedVaccine(7years)orCapsular/ConjugateVaccine(2years)
+Boosters
WidallTest
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
TaeniaSaginataHelminthicGIInfectionsWeightLoss
BeefTapewormDetectionof
worm/proglottids/ovainstool
TaeniasisAsymptomatic
Non-InflammatoryDiarrheaWeightLoss
UpsetStomachConstipation
- Anyone
Ingestionofundercookedmeatcontaininglarvae
(encysted)
Cattle Anti-ParasiticDrugs FoodSafety
Egg:Thickcapsule,striations
TaeniaSoliumHelminthicGIInfections
MassLesionsPorkTapeworm
Detectionofworm/proglottids/ovain
stoolNeurocysticerosis:
MigratingLarvae/CystsinNeuralTissue.
RingEnhancing=ActiveNon-RingEnhancing=
Calcified
TaeniasisAsymptomaticWeightLoss
UpsetStomachConstipation
Sequela:MassLesions(EGGS)--Seizures,
Headaches,Vomiting
-
Consumptionofundercooked/infectedPork(EncystedLarvae)Neurocysticerosis:ConsumptionofEggs
Tapeworn:ingestionofinfectedpork(Encysted
Larvae)Neurocysticercosis:consumptionofeggs
Swine(Major)Humans(Minor)
Anti-HelminthicDrugsSurgery
HygeineFoodSafety
-
DiphyllobothriumLatum
HelminthicGIInfectionsAnemia
FishTapeworm
HypersegmentedNeutrophilsDetectionof
worm/proglottids/ovainstool
Diphyllobothriasis:B12Deficiency
(Megaloblastic/PerniciousAnemia)-LargeRBCsIntestinalObstruction
-
Consumptionofundercooked/infectedFishFishermenin
PacificNEUS
Fecal-OralFreshWaterFish-
FishEatingCarnivores
Anti-ParasiticDrugs FoodSafety
Egg:Oval,1End-Cap
TrichurisTrichiura
HelminthicGIInfectionsAnemia
WhipwormDetectionof
worm/proglottids/ovainstool
BloodyDiarrhea,AbdominalPain,Flatulence
Chronic/HeavyInfections-MicrocyticAnemia-Small,
HypochromicRBCRectalProlapse
- Anyone Fecal-Oral Humans Anti-ParasiticDrugs Sanitation
Egg:Oval,2End-Plugs
AncyclostomaDuodenale/Necator
Americanus
HelminthicGIInfectionsAnemia
Hookworm Eggs(Ova)inStool
AbdominalPain,LossofApetite
Severeproteindeficiencyorirondefieincyanemia
(MicrocyticAnemia-Small,HypochromicRBCs)Ulcer-LikeSymptomswithBlood
Loss
- -
DirectSkinPenetration-LarvaeDevelopinEnvironment-
ContaminatedSoil
Humans Anti-ParasiticDrugs SanitationandSHOES
Egg:Thinshellwitharolledupwormontheinside--noplugs,
nocaps.
SchistosomaHematobium
HelminthicGIInfections
TissueFibrosis
Trematode(BloodFluke)
EggsinStoolUrineinBloodTest
Schistosomiasis:BiliaryorUrinaryFibrosis
AbdominalPainHematuria
Target:VeinsofUrinaryBladder
CercardialDermatitis:Swimmer'sItch
PruritisandUrticaria
Swimmingincontaminatedwaters
Immigrants/TravelerstoEndemicAreas
DirectSkinPenetration(viaCercariaelifestage)
Snails(Intermediate
Host)Humans
Anti-ParasiticDrugsRemovalofSnailsSewageTreatment
Egg:VentralSpine
SchistosomaJaponicum
HelminthicGIInfections
TissueFibrosis
Trematode(BloodFluke)
EggsinStoolUrineinBloodTest
Schistosomiasis:BiliaryorUrinaryFibrosis
AbdominalPainGIBleeding,Diarrhea
LiverDamage,Hepatosplenomegably
ClayPipeFibrosisTarget:SmallBranchesofInferiorMesentericVein
andLiver
CercardialDermatitis:Swimmer'sItch
PruritisandUrticaria
Swimmingincontaminatedwaters
Immigrants/TravelerstoEndemicAreas
DirectSkinPenetration(viaCercariaelifestage)
Snails(Intermediate
Host)Humans
Anti-ParasiticDrugsRemovalofSnailsSewageTreatment
Egg:SmallerVentralSpine
SchistosomaMansoni
HelminthicGIInfections
TissueFibrosis
Trematode(BloodFluke)
EggsinStoolUrineinBloodTest
Schistosomiasis:BiliaryorUrinaryFibrosis
AbdominalPainGIBleeding,Diarrhea
LiverDamage,Hepatosplenomegably
ClayPipeFibrosisTarget:SmallBranchesofInferiorMesentericVein
andLiver
CercardialDermatitis:Swimmer'sItch
PruritisandUrticaria
Swimmingincontaminatedwaters
Immigrants/TravelerstoEndemicAreas
DirectSkinPenetration(viaCercariaelifestage)
Snails(Intermediate
Host)Humans
Anti-ParasiticDrugsRemovalofSnailsSewageTreatment
Egg:PolarSpine
EnterobiusVermicularis
HelminthicGIInfectionsCuteanousExcoriations
Pinworm(US)
ScotchTapeTestStrubeTubes
SampleEggs/LarvaeMicroscopicExamination
TypeIVImmuneResponseagainstFemale/Eggs
SevereItching/Excoriations-
PoorHygeineSmallChildrenCrowding
Fecal-Oral Humans Anti-ParasiticDrugs Hygeine
Eggs:LemonShaped
TrichinellaSpiralis
HelminthicGIInfections
Edema,MusclePain,Vasculitis
HelminthicRoundworm
BloodTestAntibodiesEosinophilia
Biopsy:EncystedWormsinMuscle
MuscleAches,Diarrhea,PeriorbitalEdema
(Vasculitis)Severe:CNSandHeart
Involvement(TissueDestruction)
- Anyone
ConsumptionofRaw/UndercookedMeatsofInfected
AnimalsLarvaeTravelfrom
BloodtoIntestinestoStriatedMuscles
ZOONOTICSwineWildAnimals
(Seal/Walrus)Humans:
AccidentalHost
Anti-ParasiticDrugs
FreezePork,CookThoroughly,CookMeatFedtoPigs,
Sanitation
Eggs:EncystedLarvae
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
HelicobacterPylori
PepticUlcersGramNegative
Curved/SpiralRodMicroaerophilic
BiofilmsPolarFlagella
Oxidase,Catalase,UreasePositive
FecalAntigenTestUreaseBreatheTest:IngestradioactiveUrea(C-13),MeasureLabeledCO2MicroscopyImaging:BariumSwallowCulture,Serology,
Antibiogram
Abdominal/EpigastricBurning"Heartburn"GastricUlcers:PainincreaseswithmealsDuodenalUlcers:Paindecreaseswith
mealsSevere:
Hematemesis:Vomitingblood"CoffeeGrounds"-
SeriousConditionMelena:Dark-Colored
Stools
1.Mucinase:degradesmucus,allowsforcolonizationatneutralpH2.Urease:neutralizesGastricAcid,
neutralpH3.HeatShockProtein:
EnhancesUreaseproduction4.AcidInhibitoryProtein:
Inhibitsgastricacidproduction
5.VacA(BiotypeIStrain):avacuolingcytotoxin:apoptosis
ofgastricepithelium6.CagAPAI:ChemotaticforImmuneCells(IL-8)and(PAF):PlateletAggregatingFactor:
HypersecretionofGastricAcid5.&6.causeUlceration
ManyUnknownSmokingAlcohol
ObesityHighStress
Fecal-OralOral-Oral
Humans
Triple/QuadrupleTherapy
2-3AntibioticsProtonPumpInhibitor
Cyto-ProtectiveAgent
(DecreaseAcidinStomach)
None
50-80%ofpeoplehaveH.Pylori,sodetectionofthe
organismisnotdiagnosticofthedisease.Youmusthavethehistoryofulcerstomakethe
diagnosis.
Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras
HepatitisA HepatitisPicornaviridae
ssRNANon-EnvelopedPositiveSense
IndistinguishablefromHepatitisE
HAV-IgM:AcuteHAVIgG:PastInfectionor
ImmunizedLyticCytopathology
Acute
AbdominalPainJaundice(Icterus)
LightStoolsDarkUrine
ElevatedAST/ALTLevelsNoSequelae
NoChronicInfections
- Unvaccinated
Fecal-Oral(LowInfectiousDose)
CloseContactContaminatedFood,Water,Shellfish,
ProduceBloodExposureIVDrugUseTransfusions
Humans SupportiveCare
ActiveImmunity:InactivatedHepatitisA
Virus(Institutions)
PassiveImmunity:Ig(CloseContacts)LifelongImmunity
IP:28DaysDuration:2-12Weeks
QuickImmuneResponseClinicalIllness+Jaundice:>5
yearsChronicInfection:<5years
HepatitsB HepatitisHepeviridae
dsDNAEnvelopedCircular
HBsAg:OverproducedbyVirus-Infected
HBsAb(Anti-HBs):DocumentsVaccinationor
ResolvedInfectionAnti-HBcIgM:AcuteInfectionMarker
Anti-HBcIgG:PastorChronicInfectionMarkerHBeAg:ActiveReplication-highlycontagiousAnti-
HBe:LatentInfectionHBV-DNA:MonitoringTherapyResponseBuddingReplication
AbdominalPainJaundice(Icterus)
LightStoolsDarkUrine
ElevatedAST/ALTLevelsChildren<5mayprogressto
ChronicHBVWindowPeriod:Asvirusis
producingHBsAg,theimmuneresponseisslow.TheHBsAbbindstheHBsAgandequalizesit,causingbothtobenegative.YouCANseetheAnti-HBc.
ReverseTranscriptaseInfected
CellsProduceHBsAgevenbeforeDNAReplication
UnvaccinatedIDUs
NeonatesofChronicMothers
ParenteralSexualPerinatal
Humans
80%SelfLimiting20%:
PegylatedInterferona+Entecavir+Tenofovir
(RTInhibitors)
RecombinantVaccinePost/Pre-Exposure:
HBVIgGActiveandPassiveImmunizationwithin12Hoursofbirth
IP:60-90DaysSlowImmuneResponse
ChronicInfectionsClinicalIllness+Jaundice:>5
yearsChronicInfection:<5years
HepatitisC Hepatitis
ssRNAEnveloped
PositiveSense6Genotypes
SerologyforTotalIgPCR
BuddingReplication
AbdominalPainJaundice(Icterus)
LightStoolsDarkUrine
ElevatedAST/ALTLevelsChronicInfectionin80-90%:LiverCirrhosisandHepatocellularCarcinoma
IDUsTattoos
HemodialysisBloodProducts
ParenteralSexualFetus
Humans
PegylatedInterferona/Ribavirin-
dosagebywtPLUSProteaseInhibitors
orSovaldi/Sofobuvir(RNAPolymerase
Inhibitors)
Screeningblood/organs.
HighRiskBehaviorModificationVaccine
inClinicalTrials
SlowImmuneResponseChronicInfections
HepatitisD Hepatitis
ssRNAEnveloped
NegativeSenseDefective
HBsAgInserted
Serology:HDVAntibodies
HBsAgBuddingReplication
AbdominalPainJaundice(Icterus)
LightStoolsDarkUrine
ElevatedAST/ALTLevelsRequiresCo-Infectionwith
HBVSuper-Infection:
Chronic/Fulminating-LiverFailure
- - ParenteralRoutes Humans TreatHBVInfection
Coinfection:Pre/PostExposureProphylaxistoPreventHBV-Low
riskofChronicInfection.
Superinfection:Educationtoreduceriskbehaviors-
ChronicHBV+HDV
SlowImmuneResponseChronicInfections
HepatitisE Hepatitis
ssRNANon-EnvelopedPositiveSense4Serotypes
IndistinguishablefromHepatitisASerology
HEV-IgM:AcuteHEVIgG:PastInfectionor
ImmunizedLyticCytopathology
Acute
AbdominalPainJaundice(Icterus)
LightStoolsDarkUrine
ElevatedAST/ALTLevelsNoChronicInfection
-
Consumptionofcontaminedmeat,water,shellfish
TraveltoEastern/SouthAsia
Recently:US
Fecal-OralContaminatedWaterMeatfromInfected
AnimalsShellfish
TransfusionofInfectedBlood
PregnantWomentoFetus(Vertical)
HumansAnimals
SupportiveCareAvoidExposure
VaccineAvailableinChina
IP:40DaysDuration4-6WeeksFulminatingDisease:
PregnantWomen(Eclampsia,Hemhorrhage,LiverFailure,
Stillbirth)QuickImmuneResponse