What are the bacteria with capsules?
Even Some Pretty Nasty Killers Have Shiny Bodies"
E.coli (some)
Strep pneumo
Pseudomonas
Neisseria gonnorrheae
Hib (type B)
Salmonella typhi
GBS (strep agalactiae)
For an asplenic patient, what vaccines MUST you give?
Think capsulated bacteria:
SHiN
Step. pneumo
Hib
Neisseria gonorrheae
What fungi causes meningitis in AIDS patients?
it is CAPSULATED:
CRYPTOCOCCUS NEOFORMANS
Bacterial transformation takes place in what organisms?
SHiN (yes, again)
Strep pneumo
Hib
Neisseria
Phage infecting bacterium and injecting a gene is known as:
Transduction
Stain for Leigonella:
silver stain
India ink stain used for:
Think yeast... mostly
CRYPTOCOCCUS NEOFORMAS
Silver stain is used for:
Fungi (pneumocystis)
Legionella
H. pylori
The Zeihl-Neelsen (carbol fuschin) stain is used for:
Acid fast bacteria
(nocardia, mycobacteria)
Some protozoa
(cryptosporidium Oocysts)
PAS (periodic Acid Schiff) stain is used for what?
Stains glycogen
(Whipple disease caused by Tropheryma whipplei)
What bugs stain with Giemsa stain?
Certain Bugs Really Try my Patience"
Chlamydia
Borrelia
Rickettsia
Trypanosomes
Plasmodium
Where are beta lactamases produced in gram - bacteria?
Periplasmic space
How do superantigens work?
Bring together MHC II and TCR to stimulate MASSIVE cytokine release
Endotoxin stimulate 3 things. What are they?
Macrophages
Complement
Tissue Factor
Endotoxin stimulation of Macrophages results in what?
IL-1, IL-6 >>>>>> fever
TNF-a >>>>>>>> Cell death, Cachexia
Nitric Oxide >>>>>> Hypotension, developmental of septic shock
Endotoxin stimulation of Complement results in what?
C3a >>>>>>> hypotension and edema (mediated by histamine)
C5a >>>>>>> Neutrophil chemotaxis
Endotoxin stimulation of tissue factor results in what?
Coagulation cascade activated and >>>> DIC!!!
Mediator of hypotension and septic shock in endotoxin poisoning:
Nitric Oxide (stimulated release by Macrophages)
What are the toxins of Staph aureus?
alpha hemolysin (B-hemolysis of RBCs)
PVL (forms pores in WBC)
Exfoliative toxin (serine protease that ruins stratum granulosum) ---SSSS
Enterotoxin
TSST (superantigen) ---- TSS
What are the toxins for Strep. pyogenes?
Streptolysin O (destroys rbcs - Beta hemolysis)
Streptolysin S (destroys rbcs - Beta hemolysis)
Exotoxin B (degrades immune proteins) (SpeB)
Exotoxin from strep pyogenes responsible for causing scarlet fever:
Exotoxins A, B, C
aka: erythrogenic toxins
Exotoxin and action of Corynebacterium diptheriae:
Diptheria toxin
inactivates E2F ----- Pharyngitis with pseudomembranes in throat and severe lymphadenopathy
Exotoxin and action of Pseudomonas aureginosa:
Exotoxin A
inactivates E2F --- host cell death
Exotoxin and action of Shigella:
Shiga toxin (ST)
inactivates 60S ribosome by removing adenine from rRNA ---- GI mucosal damage
also enhances cytokine release causing HUS
Exotoxin and action of EHEC:
O157:H7
shiga like toxin
inactivates 60S ribosome by removing adenine from rRNA
enhances cytokine release causing HUS
****doesn't invade host cell
Exotoxin and action of ETEC
traveler's diarrhea"
Heat labile toxin - overactivates adenylate cyclase (increase cAMP) >>>>> increased Cl- secretion into gut lumen (with water)
Heat stabile toxin - overactivates guanylate cyclase (increase cGMP) >>>>> decreased resorption of NaCl and
Exotoxin and action of Bacillus anthracis:
Edema toxin
Increases cAMP >>>>>> edematous borders of black eschar in cutaneous anthrax
Exotoxin and action of Vibrio cholerae:
Cholera toxin
overactivates adenylate cyclase (increased cAMP) by permanently activating Gs >>>>> Cl- secretion in gut and H20 efflux
Exotoxin and action of Bordetella pertussis:
Pertussis toxin
increase cAMP by inhibiting Gi (g-inhibition)
which impairs microbe phagocytosis
Whooping cough
Exotoxin and action of Clostridium tetani:
Tetanospasmin
Cleaves SNARE so no release of INHIBITORY neutrotransmitters (GABA, Glycine)
spastic paralysis
Exotoxin and action of Clostridium botulinum:
Botulinum toxin
Cleaves SNARE so no release of STIMULATORY neurotransmitters at NMJ
flaccid paralysis
Exotoxin and action of Clostridium Perfinges:
Alpha Toxin
phospholipase (lecithinase) that degrades tissue and cell membranes
(gas gangrene, myonecrosis) + (hemolysis - double zone)
Exotoxin and action of strep pyogenes:
Streptolysin O
hemolysis of rbc
What exotoxin (strep pyogenes) can the host develop antibodies against?
what is this test called?
Streptolysin O
ASO test
What is the number 1 cause of Balanitis (inflammation of the glans penis:
Candida albicans
What bacteria causes large, golden colonies?
Staph Aureus
What bacteria causes yellow sulfur granules?
Actinomyces israelii
What bacteria causes Blue/green pigment?
Pseudomonas aureginosa
What bacteria causes red pigment?
Serratia Marcensces
Hemolysis of GAS and GBS:
Beta hemolysis
Strep species with alpha hemolysis:
S. pneumoniae (capsule)
S. viridians (no capsule)
Y-hemolytic streptococci:
Enterococcus (GDS)
CoNS that is novobiocin resistant:
S. saprophyticus
Toxin in mayonnaise, eggs:
Exotoxin from staph aureus
Function of protein A in S. aureus:
Binds to Fc receptors on IgG preventing opsonization
What are the gram + rods:
ENDOSPORE FORMERS
Clostridium
Bacillus
NON-ENDOSPORE FORMERS
Cornyebacterium dipthiriae
Listeria
Staph organism that causes infections of indwelling catheters:
Strep epidermidis
TX: vancomycin
Staph organism that causes UTIs
S. saprophyticus
TX: penicillin
MRSA resistance genes are carried by mobile genetic elements in...
SCCmec
TX for S. aureus:
Clindamycin
trim/sulfa
vancomycin/daptomycin
linezolid
Gram + filaments:
Actinomyces
Nocardia
GBS is a cause of ______ in newborns (<3 months):
Meningitis
pneumonia
sepsis
When GBS (strep agalactiae) is grown along with S. aureus, there is an enlarged zone of hemolysis. This is due to:
CAMP factor that s. aureus provides
Gram + diplococci
(what is it):
Strep Pneumoniae
(alpha hemolysis)
What bugs are considered y-hemolytic GDS?
Enterococcus (e. faecalis; e.faecium)
Strep. Bovis
What does GDS, srep bovis cause?
Bacteremia
subacute endocarditis
and
COLON CANCER!!!
What are the 2 species of enterococcus (GDS):
E. faecalis
E. faecium
In enterococcus become resistant to vancomycin, what is the alternative treatment?
Daptomycin
Linezolid
(dalfopristine for faecium)
Pyogenic diseases caused by Strep pyogenes (GAS):
Pharyngitis
Cellulitis
Impetigo
Erysepilas
Toxigenic diseases caused by Strep pyogenes (GAS)
Scarlet fever
Necrotizing fasciitis
TSS
Red rash that spares face. Caused by GAS:
Scarlet fever
Immunologic diseases caused by Strep pyogenes (GAS):
Rheumatic fever
Acute glomerulonephritis
What are the criteria for Rheumatic fever (GAS)
JONES criteria
Joints
Myocarditis (endo/peri) (mitral valve damave)
Nodules (subQ)
Erythema Marginatum
Syndenham Chorea
Where do antibody-antigen complexes deposit in post-streptococcal glomerulonephritis?
Basement membrane
Bugs causes neonatal sepsis:
E.coli
GBS
Listeria monocytogenes
When to screen women for GBS (strep agalactiae):
37-39 weeks gestation
How to treat strep pyogenes infections:
Penicillin
for erysepilas, impetigo, cellulitis (risk of S.aureus too) = Dicloxacillin (penicilliase resistant)
Strep pneumoniae causes what dieases:
COMPS"
Conjunctivitis
Otitis Media
Meningitis (adults)
Pneumoniae ---------RUST COLORED SPUTUM
Sickle cell septicemia/sinusitis
Cause of pneumonia with rust colored sputum:
S. Pneumoniae (a-hemolysis)
S. pneumoniae virulence factors:
Capsule
IgA1 protease
Pneumolysin (O2 labile)
A vaccine for S. pneumonia against the capsule is conjugated to a carrier protein eliciting what antibody production?
IgG
A vaccine for S. pneumonia against the capsule is conjugated to a polysaccharide eliciting what antibody?
IgM
S. viridians has many sub species. Which causes dental problems?
S. mutans
S. viridians has many sub species. Which causes subacute endocarditis?
S. sanguis
subacute = slower than acute endocarditis by s. aureus
S. pneumoniae and S. viridians are both alpha hemolytic streptococcus
how can you differentiate?
S. pneumoniae - diplococci; CAPSULE
How do you kill spores?
Autoclave at 250 degrees F (121 C) for 15 min
What antibiotics are typically used for obligate anaerobes?
Clindamycin
Metronidazole
For a patient who was immunized for Tetanus but last booster was > 10 years ago, what shall we do?
Give patient booster
For a patient who was NEVER immunized for Tetanus, what shall we do?
Give booster + preformed antibodies
In Clostridium dificile causing pseudomembranous enterocolitis, what are the symptoms?
Diffuse watery diarrhea
Toxic Megacolon
Colon perforation
In Clostridium dificile causing pseudomembranous enterocolitis, what are the toxins?
Toxin A: enterotoxin (binds to brush border of gut)
Toxin B: Cytotoxin (causes destruction of actin filaments in colonic epithelial cells)
What is the treatment for C.diff?
MOFF"
Metronidazole
Oral Vancomycin
Fidaxomicin
Fecal transplant
What are some of the diseases caused by Clostridium Perfinges?
Cellulitis/wound infection
gas gangrene (myonecrosis)
Watery diarrhea
In Clostridium Perfinges, what damages the tissue (toxin)
Alpha toxin
What are the diseases that are caused by Bacillus anthracis?
Cutaneous anthrax
Pulmonary anthrax
GI anthrax (just a necrotic lesion + diarrhea + pain)
What are some sx of cutaneous Anthrax
(b. anthracis):
large painless ulcer with central necrosis
What are some of sx of Woolsorters disease (pulmonary anthrax)
Mediastinal widening on CXR
some hemorrhage too!
What does Bacillus cereus cause?
Gastroenteritis
What are the virulence factors for bacillus cereus (gastroenteritis):
Heat labile toxin
Heat stabile toxin
Cornyebacterium Diptheriae causes Pseudomembranous pharyngitis. What other organs can it affect?
CNS
Heart
What are 2 virulence factors for Cornyebacterium Diptheria?
Toxin A: enters cell and blocks protein synthesis by inactivating EF2
Toxin B: binds to target cells
How do you diagnose Cornyebacterium Diptheriae causing Pseudomembranous pharyngitis?
Loeffler's serum or K+ tellurite culture
must also prove toxin production by either:
PCR
Elek test
What disease does actinomyces cause?
Cervicofacial lesions
What disease does Nocardia cause?
*it is partially acid fast
skin or pulmonary infections in IMMUNOCOMPROMISED
Nocardia and Actinomyces are both filamentous branching Gram + organisms. How do you differentiate?
Actinomyces is obligate anaerobe
Nocardia is an aerobe
What is in the Diptheriae vaccine (DPT)?
Formalin inactivated diptheriae toxin
Which bacteria are spore formers?
Clostridium spp.
Bacillus spp.
Coxiella Brunetii
What disease does Coxiella brunetii cause?
Q fever
transmitted from aerosols of cattle/sheep amniotic fluid
What are the gram - cocci, oxidase +?
N. meningitidis
N. Gonorrheae
what is the difference between N. meningitidis and
N. Gonorrheae?
NM: capsule, maltose + glucose oxidizer
NG: no capsule, glucose oxidizer
What are some of the virulence factors for N. meningitidis?
Endotoxin (LPS): causes blood vessel destruction and sepsis w/ hemorrhage >>>>> PETECHIAE
IgA1 protease
Extract iron
Pili with antigenic variation
Whare are the diseases caused by N. meningitidis?
Meningitis
Sepsis
Waterhouse Friedrichson syndrome
What is Waterhouse Friedrichson syndrome?
Septic shock
Bilateral adrenal hemorrhage (adrenal insufficiency)
Abrupt onset of hypotension, tachycardia, petechial lesions
What is the transmission of N. meningitidis?
Respiratory secretion (think close quarters)
What is the EMPIRIC treatment for N. meningitidis?
Cefotaxime
Ceftriaxone
there is a vaccine for N. meningitidis
Just know that there is
In N. gonorrheae, what are the infections?
Men: Urethritis
Women: Urethritis/cervicitis
Neonates: Opthalmia neonatorum (in vaginal birth canal)
What are complications of PID caused by N. gonorrheae?
Endometritis
salpingtitis
Oophoritis
Fitz-Hugh-Curtis syndrome (infection of liver capsule with violin string adhesions to peritoneum of liver) --
What are the nerves carrying pain from Fitz-hugh-Curtis syndrome?
Lower intercostal nerves
What groups are at risk for N. gonorrheae and N. Meningitis infections?
Complement deficiencies (C5-9) because they can't mount a Membrane attack complex
There are 2 types of H. influenzae, how are they differentiated?
Capsule (typeable)
No capsule (non-typeable)
What are the virulence factors (most) of H. influenzae?
Pili
LOS
IgA1 protease
What are diagnostic techniques to identify H. influenzae?
Gram stain - requires X factor (NAD) and V factor (hematin)
Quellung rxn (typeable)
Transmission of H. influenzae:
Inhalation
Treatment for H. influenzae:
3rd generation cephalosporin (ceftriaxone or cefotaxime) -- serious infections
Amplicillin or amoxicillin +/- clavulanate
The HiB (typeable) vaccine is conjugated to what?
Diptheria toxoid
What does Haemophilus ducreyi cause?
Chancroid
PAINFUL genital ulcer
(unilateral painful swollen inguinal L.N. that can rupture releasing pus)
Treatment for Chancroid caused by Haemophilus ducreyi?
Azithromycin
IM ceftriaxone
Diseases caused by Legionella pneumophila:
Pontiac fever
Legionnaires disease
What is Pontiac fever?
(caused by legionella)
HA
Fever
Muscle aches
Fatigue
Self limiting
What is Legionnaire's disease?
Pneumonia + HYPONATREMIA + diarrhea
How do you culture Legionella pneumophila?
Charcoal Yeast requiring:
L.cysteine + Iron
Silver stain too!
What is the treatment for Legionella pneumophila diseases (pontiac + pneumophila)?
Macrolide (erythromycin, azithromycin)
Fluoroquinolone
What is the mode of transmission for Legionella pneumophila?
Disseminated water sources
Gram - ROB
Oxidase +
Urease +
H. pylori
Gram -, spiral shaped bacteria
oxidase +
H. pylori
Treatment for H. pylori:
Omeprazole
Amoxicillin
Clarithromycin
Gram - ROB
Oxidase +
Catalase +
Think Pseudomonas aureginosa
Diseases caused by Pseudomonas:
Pneumonia
Sepsis
otitis Externa
UTIs
Drug use
Diabetes
Osteomyelitis
Keratitis
Hot tub folliculitis
Erythema gangrenosum (in immunocompromised)
what is Erythema gangrenosum (in immunocompromised)?
Pseudomonas aureginosa
Rapidly progressive necrotic cutaneous lesion
Treatments for Pseudomonas aureginosa
Pipercillin, ticarcillin, cefepime
carbapanems
monobactams (aztreonam)
Fluoroquinolones (ciprofloxacin)
Aminoglycosides (gentamicin)
multidrug resistant --- Colistin, polymixin B
Gram -
Oxidase +
diplococci
in sputum of a COPD patient:
Moraxella Catarrhalis
Gram - Rod
Oxidase -
Lactose nonfermenter
Urease ++++
Proteus Mirabilis
Disease caused by Proteus Mirabilis:
UTI --- staghorn calculi
Treatment for UTI caused by proteus mirabilis:
Sulfonamides
Gram - Rod
Oxidase -
Lactose nonfermenter
motile
causing pseudoappendicitis:
Yersinia Enterolytics
Diarrhea caused by salmonella typhi is likely from what foods?
Chicken
eggs
NOT FOOD - HANDLING REPTILES
Osteomyelitis is sickle cell patients:
Salmonella typhi
Carrier state of salmonella typhi is harbored in what organ?
Gallbladder (typhoid mary)
Gram - Rod
Oxidase -
Lactose nonfermenter
causing reactive arthritis:
Shigella Flexneri
How does shigella spread?
uses actin to spread from epithelial cell to epithelial cell
What diseases are caused by shigella?
Bloody, inflammatory, diarrhea
Dysenteriae HUS
ETEC causes:
Watery diarrhea
EHEC causes:
bloody diarrhea (hemorrhagic colitis)
shiga like toxin
EIEC causes:
Bloody diarrhea
shiga-like toxin
EPEC causes:
Diarrhea
ASCENDING paralysis caused by Campylobacter:
GBS
Pseudoappendicitis:
Yersinia enterolytics
Why does proteus cause Staghorn calculi?
Urease causes increase ammonia increasing the pH of the urine so struvite stones can precipitate
What is the mechanism of action of the Cholera toxin?
Activates G-protein,
increases Adenylate cyclase
Increases cAMP
active secretion of NaCl; loss of bicarb
What is the mechanism of action of shigella toxin?
Invades intestinal epithelial wall
produces shiga toxin that inactivates 60S ribosomes causing cell death
What is the mechanism of pathology for EHEC's shiga-like-toxin?
NOT invasive but causes bloody diarrhea by causing vascular damage
(inhibition of 60S ribosome resulting in epithelial death)
Used in Bordet-Gengou media:
Bordetella
Rust colored sputum in pneumonia:
Step pneumo
Currant jelly sputum in pneumonia:
Klebsiella
Pathogens associated with animal urine:
Leptospira
Hantavirus
What are bugs that cause a rash on the palms and soles?
Kawasaki CARS"
Kawasaki disease
Cocksackie A
Rocky Mountain spotted fever
Syphilis
What causes Cat scratch disease
Bartonella species
Bacillary angiomatosis caused by bartonella spp is seen in what patients?
Immunocompromised
(they are lesions of blood vessel proliferations)
What transmits Lyme disease
Ixodes tick
What are the spirochetes?
Borriella
Leptospira
Treponema
What is leptospirosis?
Flu-like symptoms, myalgias, Jaundice, photphobia with conjunctival suffusion
What causes leptospirosis?
Leptospira interrogans
What is Weils disease and what causes it?
It is severe form of leptospirosis with jaundice and azotemia from liver and kidney dysfunction
caused by leptospira interrogans
What is the transmission of leptospira interrogans causing leptosirosis and Weil's disease?
Animan urine
even in water!
What is the treatment for Leptospirosis?
Penicillin
Ceftriaxone
Doxycycline
What is the treatment for lyme disease for children < 8y/o?
amoxicillin
In lyme disease there are 3 stages.
what are they?
early: bulls eye rash - erythema migrans; flu-like sx
Early disseminated: (weeks to months)
bilateral CN palsies, AV heart blocks
Late: (months-years)
Chronic arthritis, encephalopathy
Syphilis has 3 stages.
what is the first?
Primary PAINLESS skin ulcer that resolves on its own
Syphilis has 3 stages.
what is the 2nd?
diffuse maculopapular rash on palms and soles
condyloma latum (painless wart-y lesion)
alopecia (moth eaten)
Syphilis has 3 stages.
What is the 3rd?
Gummas of skin and bone (granulomatous lesions)
Cardiovascular (aotitis - dilation of aorta and insufficiency)
Neurosyphilis: argyll-Robertson pupil; tabes dorsalis (posterior column for vibration and proprioception; dorsal roots)
Syphilis can be spread congenitally.
What are some of the early findings?
Children can have snuffles (blood tinged nasal discharge)
Facial abnormalities (saddle nose, notched incisors - hutchinson's teeth, mulberry molars, short maxilla)
Saber shins
CN VIII problems (hearing loss)
What is a Jarisch-Herxheimer reaction?
Flu-like symptom (fever, chills, HA, myalgia) after antibiotics are started
this is due to killed bacteria (spirochetes) releasing endotoxins
How to diagnose syphilis:
nonspecific (VDRL, RPR)
Specific (FTA-AB) this tests for antibody directly to treponema
What can give you a false + nonspecific Syphilis test?
VDRL?
VDRL"
Viruses (EBV)
Drugs
Rheumatic fever
Lupus (and other autoimmune dz)
Leprosy
What is the treatment for syphilis?
Penicillin G
can give Erythromycin
Doxycycline
What is Psittacosis:
Fever and dry cough
caused by Chlamydophila psittaci
What transmits Chlamydophila psittaci causing Psittacosis?
Parrots and other birts
What is Q fever?
and what causes it?
Flu sx
followed by abrupt fever lasting weeks
caused by Coxiella burnetii
Pathogen that causes infection of monocytes.
Transmitted by lone start tick:
Infection: Erlichiosis
Transmission: Erlichia Chafeensis
What cell type is responsible for lepromatous leprosy?
think immune response
TH2
because CMI is defective (TH1 cells)
What is the treatment for leprosy?
Rifampin
Dapsone
Clofazime
What causes Rocky mountain spotted fever?
Rickettsiae rickettsi
(wood tick/dog tick)
What causes Epidemic typhus?
Rickettsiae prowazekii
(louse) (lice)
What causes Endemic typhus?
Rickettsiae typhii
(fleas)
What is Brill-Zinser disease?
Reactivation of Rickettsiae prowazekii causing mild sx, but no rash!!!
Anaplasmosis causes granulocyte infection... what is the vector?
Ixodes tick
Drugs causing hemolysis in G6PD deficiency
that are used to treat mycobacterial infections:
Isoniazid
Rifampin
What is the difference between primary and secondary TB?
Primary:
Can be asymptomatic or overt disease of lungs --- caseous necrosis
Ghon focus (area of necrosis)
Ghon complex (focus + hilar LN)
Secondary TB:
can be pulmonary (with constitutional sx)
Kidney
LN infection - scrofula
Potts disease
Miliary TB (all
What is the pathophysiology of reactivation TB... what cell types involved and where it is often seen??
Due to down regulation of TNF
affects upper lobes!! (apical posterior segments)
How do you detect active TB?
Acid fast stain --- weakly gram +
Lowenstein Jensen agar (fluorescent apple green w/ auramine staining)
How do you detect latent TB?
Skin test (PPD)
Why would a PPD test be negative?
false - anergy
or
never infected
Why would you get a PPD + test?
False + BCG vaccine
or
ACTIVE INFECTION
What is the MOA of Rifampin?
Rifamycin
Inhibits DdRp in mycobacterium
What are the 4 R's for Rifampin?
RNA polymerase inhibitor
Ramps up microsomal cytochrome P450
Red/Orange body fluids
Rapid resistance when used alone
What toxicities does Rifampin cause?
Hepatotoxicity
Drug interactions --- (increases cyp450)
Orange body fluids ("red pee")
In patients with HIV infection who need treatment for TB... what drug can you give instead of Rifampin?
and why?
Rifabutin
because it has less Cytochrome P450 stimulation
What is the MOA of Isoniazid?
Inhibits synthesis of Mycolic acids
specific for the bacteria because the bacterial catalase peroxidase converts it into an active metabolite
What is the only agent that can be used alone for TB prophylaxis?
Isoniazid
What are some AE for Isoniazid?
Neurotoxicity (so we give Vitamin B6)
Heptatotoxicity
"INH injures neurons and hepatocytes
What is the MOA for Pyrazinamide ?
"RIPE" for TB
unknown. but it is a prodruc that is converted to its active metabolite pryrizonic acid
What are some AE for Pyrazinamide
"RIPE" for TB
Hyperurivemia
Hepatotoxicity
What is the MOA for Ethambutol?
"RIPE" for TB
Decreases carbohydrate metabolization of mycobacterium cell wall by blocking
Arabinosyltransferase ---
so no arabinoglycan
What are the AE for Ethambutol?
"RIPE" for TB
Optic neuropathy
(blue/green color blindness)
What is the rule of treatment for Active TB?
6 months total
2 months (RIPE)
then....
4 months (Rifampin + isoniazid)
How do you treat latent TB?
Isoniazid for 9 months
Cause of Fishtank granulomas:
Mycobacterium marinarum
Cause non-TB disease in aids patients. (mycobacterium):
M. avium and intracellulare
How do you prevent MAI in AIDS patients?
M. avium and intracellulare infection
Azithromycin once weekly when CD4 <50cells/mm3
Hwo do you treat Gardnerella Vaginalis infections?
Metronidazole
or
Clindamycin
What are the 3 bugs for atypical pneumonia?
Mycoplasma pneumoniae
Legionella pneumoniae
mycoplasma pneumoniae
Most common cause of culture negative endocarditis:
Coxiella burnetii
(Q fever)
Clamydia Trachomatis:
serotypes A, B, C
causes:
Trachoma - scarring of eyelids resulting in corneal scarring/blindness
Clamydia Trachomatis:
serotypes D-K
causes:
Inclusion conjunctivitis in adults and neonates
Infant pneumonia
Urethritis, Cervicitis, PID, epididymitis, prostatitis
What is the most common cause of Cervicitis?
Chlamydia
Clamydia Trachomatis:
serotypes L1, L2, L3
causes:
Lymphogranuloma Venerum:
painless papule on benital causing unilateral LN enlargement with groove
What is opthalmia neonatorum:
Inclusion conjunctivitis of neonates
tx: topical erythromycin drops
Treatment for inclusion conjunctivitis in adults:
Oral azothromycin
or
doxycycline
What is Reiter's syndrome?
Triad of conjunctivitis, urethritis, arthritis caused by
Chlamydia trachomatis
Cause of atypical walking pneumonia with CXR that looks worse than patient
(diffuse patchy infiltrates)
Mycoplasma pneumoniae
You can use ______ to detect mycoplasma pneumoniae although this is highly non-specific:
Cold agglutinins
lysing of RBCs with IgM agglutination
What is the drug used to treat lepromatous leprosy that is closely related to sulfonamides in inhibiting folate synthesis.
also a cause of hemolysis in G6PD deficiency:
Dapsone
What can you use to treat mycoplasma pneumoniae?
Macrolides
doxycycline
fluoroquinolone