All Bacteria

ALL BACTERIA
BACTERIA
Moraxella
Catarrhalis
CHARACTERISTICS
gram (-) aerobic

diplococcus.
Oxidase (+)
DISEASE
otitis media,
sinusitis in
children
RESERVOIR / TRANSMISSION
normal flora
RESPIRATORY
gram (+) coccus in Strep throat

Streptococcal
rheumatic fever, normal flora,
chains or pairs.
pyogenes (group
infected
acute postcatalase (-), lactose
A antigen)
persons
streptococcal
(+)
glomerulonephritis
Corynebacterium
diphtheriae
gram (+) clubshaped rods,

aerobe
Bordetella
pertussis
gram (-) coccobacillus, strict

aerobe, mucosal
surface pathogen
Mycobacterium
tuberculosis
ACID-FAST, rod
shaped, obligate
aerobe, very slow
growth, facultative
intracellular
tuberculosis
gram (-)
pleomorphic rod,
small, facultative
anaerobe. requires
growth factor X
(hemin) and V
(NAD, NADP)
otitis media,
sinusitis,
bronchitis
epiglottitis,
pneumonia,
meningitis,
septic arthritis,
cellulitis
Haemophilus
influenzae (nonencapsulated)
Haemophilus
influenzae (Hib)
diphtheria
normal flora,
humans only
whooping cough humans only

pertussis
reservoir infected
humans
Chlamydophila
species
Chlamydophila
psittaci
smallest free-living
bacteria, NO CELL
"walking
WALL,
pneumonia",
pleomorphic, no
tracheobronchitis
gram stain
small obligate
INTRACELLULAR
pathogen, gram (-),
not seen on gram
stain, cell wall lacks
peptidoglycan layer,
unable ot make ATP energy parasites
pneumonia or
bronchitis
parrot fever,
psittacosis,
ornithosis,
pneumonia
-lactamase
CLINICAL
DIAGNOSIS
respiratory
droplets
acute inflammation of pharynx and tonsils,

LTA, surface proteins F and M,
-hemolysis on blood
sore throat, fever, exudative tonsillitis, anterior
hyaluronic acid capsule, streptolysin,
agar, bacitracin
cervical lymphadenopathy, scarlatiniform rash
exo-enzymes, pyrogenic exotoxins
sensitive
or fever
respiratory
droplets
Heat-labile A-B
exotoxin, ADP
ribosyl
transferase
(blocks protein
syn), diphtheria
toxin is invasive
respiratory
droplets
attachment, immobilization,
destruction (murein) of cilia, Fha,
Ptx (AB toxin - cAMP), pertactin,
pili
Catarrhal stage: 1-2 wk, highly

communicable, paroxysmal stage: 2-4 wk,
paroxysmal cough, whoop. Convalescent
stage: wks to mn
Inhalation of
infectious
aerosols
Mycolic acid, sulfolipids, cord

factor, tuberculin + mycolic acid DAMAGE DONE BY HOST IMMUNE
SYSTEM
primary TB: Ghon complex, progressive

primary (active) TB, latent dormant TB,
secondary (reactivation) TB: apex.
Productive cough - bloody sputum, fever,
weight low, night sweats
exotoxin cell
death, necrosis
lipopolysaccharides, IgA protease,

polysaccharide capsule
asymptomatic carriers
infants: passive maternal protection, poor

response first 2 years, > 5 - disease
uncommon
respiratory
droplets
rusty sputum, typical lobar pneumonia
human
respiratory
tract
aerosol
droplets
p1 adhesin, toxic metabolic

products: hydrogen peroxide and
superoxide radicals
hacking cough, dry productive, slow

resolution
infected
humans
respiratory
droplets
inhalation of
zoonotic
dried
pathogen,
secretions from
mainly birds
birds
Page 1 of 15
treat to prevent
acute rheumatic
fever: penicillin
Loeffler medium,
pseudomembrane obstruction and
antitoxin serum
selective tellurite
suffocation, sore throat and pharyngitis, low
therapy + antibiotics
medium (- extra flora)
grade fever, regional lymph nodes swollen (penicillin or
--> black colonies
bull neck. Toxin: myocarditis & cardiac
macrolides:
with dark halo. Toxin
dysfunction, laryngeal nerve palsy, lower limb
erythromycin) DTaP
detection: Eleck
polyneuritis
vaccine
immunodiffusion test
polysaccharide capsule, autolysin,

pneumolysin O, peptidoglycan/
teichoic acids, adhesins, GOOD AT
PICKING UP DNA
2 stages: elementary body (EB):

infectious, survive outside, non
reproductive. Reticulate body (RB):
noninfectious, intracytoplasmic,
reproductive form
TREATMENT
penicillin +
lactamase inhibitor
(amoxicillinbronchitis or pneumonia in pts with underlying mostly skipped, blood
clavulanic acid), 2nd,
chronic lung disease
or chocolate agar
3rd gen
cephalosporin, TMPSMX, macrolide
normal flora
lancet-shaped,
gram (+)
communityStreptococcus
diplococcus or in
acquired
normal flora,
pneumoniae
chains,
pneumonia, OM, humans only
(pneumococcus)
fermentation
adult meningitis
metabolism
Mycoplasma
pneumoniae
respiratory
droplets
VIRULENCE / PATHOGENESIS
asymptomatic to pneumonia or bronchitis,

complications: atherosclerotic vascular
diseases
charcoal-blood agar
(Bordet-gengou potato
agar) , pearl-like
erythromycin DTaP
colonies, direct
vaccine
fluorescence antibody
test
CXR, PPD: >5mm =
isoniazid, rifampin
(+) in HIV, >10mm =
(4m), pyrazinamide
(+) in high-risk.
(2m), ethambutol
>15mm = (+) in lowBCG Vaccine,
risk, ziehl-Neelson
isoniazid
stain, Lowensteinprophylaxis
Jensen medium
amoxicillin +
chocolate agar (X and clavulanic acid
V factors), satellite
phenomenon, latex
3rd gen
agglutination test cephalosporin Hib
PRP
conjugate vaccine
OM: amoxicillin +
-hemolytic on blood
clavulanic acid.
agar, not typeable Pneumonia/meningiti
(A/B), Optochins: 3rd gen
sensitive, bile soluble,
cephalosporin +
surface capsule
vancomycin PPV,
PCV7 vaccine
Eaton's media
(sterols), serological
tests
tetracycline or
macrolide
serological tests,
isolation is difficult
macrolides
(azithromycin) or
tetracyclines
(doxycycline)
serodiagnosis by
complement fixation
test
tetracycline or
erythromycin
URINARY TRACT INFECTIONS
Enterobacteriaceae gram (-) rods, facultative anaerobes,

catalase (+), oxidase (-), nitrite (+)
RESPIRATORY
ALL BACTERIA
BACTERIA
CHARACTERISTICS
Legionella
pneumophila
weakly gram (-)

rods, water
organisms (45C),
complex nutritional
requirements,
aerobic, motile
Klebsiella
pneumoniae
enterobacteriaceae
family, gram(-) rod,
lactose (+)
Pseudomonas
aeruginosa
gram(-) rod,
aerobic, motile,
minimal nutritional
requirements
Burkholderia
pseudomallei
Burkholderia
cepacia
gram (-), aerobic

rod
Acinetobacter
spp
gram (-) coccobacilli
Bacillus anthracis
aerobic gram (+),

spore forming,
nonmotile
Escherichia coli
Klebsiella
pneumoniae
DISEASE
opportunistic
pathogen
Serratia
(marcescens)
lactose (+)
Staphylococcus
Saprophyticus
gram (+) cocci,

clusters, catalase
(+), coagulase (-)
Enterococcus
faecalis (80%)
respiratory
ubiquitous in secretions,
environment direct contact,
fomites
melioidosis, acute
pneumonia
soil, ponds,
opportunistic
pathogen - same rice paddies,
zoonotic
as P. aeruginosa,
causes serious
infections
inhalation,
inoculation
anthrax
DIAGNOSIS
TREATMENT
fever, chills, non-productive cough, chest

pain, HA, mental confusion, diarrhea
BYCE (buffered
charcoal yeast
extract), requires Lcys, Fe, pH 6-9, slow
growth 2-5 days,
SILVER STAIN
macrolides
(erythromycin),
Pontiac fever - selflimiting
hacking cough, dry productive, slow

resolution. DM at high risk
mucoid colonies
3rd gen
cephalosporins
unknown
resembles TB - abscesses and granulomas
-lactams or
tetracyclines, high
mortality if untreated
pneumonia, wound infections, UTI, sepsis
case-by-case
fluoroquinolones
box car chains, large (ciprofloxacin) cellnonhemolytic colonies free vaccine - used
in high-risk
ubiquitous, zoonotic
polypeptide capsule, spore,

exotoxin: EF, LF, PA (adenyl
cyclase)
normal flora
FimH (cystitis) - FIMBRIAL

ANTIGEN, P-pilus (nephritis),
capsule, hemolysin, aerobactin, LPS
MacConkey agar:
lactose (+) - pink, EMB
agar - LACTOSE (+):
blue-black colonies
catheters
capsule, pili, endotoxin
MacConkey agar,
mucoid
normal flora
peritrichous flagella - swarming,

adhesins, endotoxin
MacConkey agar: clear
common cause
normal flora and environment
of nosocomial
infections
nosocomial
normal flora and environment
infections
UTIs sexually
active young
endogenous
women
nosocomial
gram (+)
infections, UTI,
diplococci or short endocarditis (pt
chains, catalase
with damaged
(-), Lancefield's
heart valves),
group D antigen wound infections,
bacteremia
CLINICAL
blue-green colonies,
pili, capsule, endotoxin:
fever, productive cough, weight loss, breathing
pyocyanin,
antipseudomonal
lipopolysaccharide, tissue damage:
difficulties and cyanosis, complications:
polyverdin, or
PNC (carbenicillin) +
exotoxin A (AB - protein syn),
malignant otitis externa (DM), colonization fluorescein (green),
aminoglycoside
exoenzyme S, elastase, alkaline
of cystic fibrosis patients
fruity aroma, mucoid,
(tobramycin)
protease, cytotoxin, hemolysin
UV light
nosocomial
soil, water, sewage, animals,
infections in
normal skin, GI tract of pts or
immunodeficient pt
health care workers
community/hospita
highly motile,
l UTIs, pneumonia,
Proteus mirabilis lactose (-), urease
septicemia, wound
(+)
infections
lactose (+), motile
inhalation of
pneumonia,
contaminated
biofilms in
low virulence, biofilms, prevents
Legionnaire's
aerosols, no
water
phagosome-lysosome fusion, lung
disease and
person-tosources
damage and inflammatory response
Pontiac fever
person
transmissions
capsule, endotoxin - necrotic
pneumonia, UTI, human colon and URT, from
destruction of alveolar spaces,
septicemia
own flora
abscesses, resistance plasmids
UTI, diarrheas/
dysentery,
motile, lactose (+)
Neonatal
meningitis,
septicemia
UTIs, Lower
non-motile, lactose respiratory tract
(+)
infection (lobar
pneumonia)
Enterobacter
adhesins, capsule, endotoxin

adhesins, capsule, endotoxin
adhesin, inflammation response
normal flora
adhesins, toxins, enzymes
Page 2 of 15
dermal, respiratory, GI anthrax, possible

sepsis
TMP/SMX - UTIs in
hospital and
acute uncomplicated UTI, acute
community,
uncomplicated pyelonephritis, complicated
Fluoroquinolone brick-red colonies
UTIs, asymptomatic bacteriuria, renal abscess
complicated UTI,
Cephalosporin -hemolysis,
pregnancy
novobiocin resistant
or hemolytic,
resistant to 40% bile
salts, 6.5% to NaCl,
bacitracin and
Optochin.
Enterococcus
faecium (20%)
Pseudomonas
aeruginosa
aerobic gram (-)

rod, motile,
oxidase (+),
lactose (-)
opportunistic
infections
ALL BACTERIA
adhesins, toxins, enzymes
CLINICAL
normal flora
ubiquitous in environment
polysaccharide capsule, endotoxin,

adhesin, exotoxins
infective
endocarditis,
etc
normal flora
Protein A - (-) phagocytosis.

Fibrinogen-binding protein clumping factor. Coagulase - fibrin
clot. Cytotoxic toxins - pore-forming
toxins. Enterotoxins A-E:
gastroenteritis, TSST-1, Exfoliations skin infections
OTHER GRAM (-)

ORGANISMS: HACEK
DIOVASCULAR INFECTIONS
CARDIOVASCULAR INFECTIONS
Staphylococcus
epidermidis
gram (+) cocci,

clusters, catalase
(+), coagulase (-)
catheter and
prosthetic device
infections, IE in
IV drug users
and prosthetic
valve IE
normal flora
biofilm
normal flora, dental caries
low virulence, dextran-mediated

adherence - biofilm damaged
heart valve surfaces, FimA surface
adhesin, lack capsule
most common
gram (+) cocci,
cause of
Viridans
chains, catalase
subacute IE in
Streptococci
(-), lack capsule and
pts with
(many, do not
lancefield antigens,
abnormal or
need to identify)
no serologic group damaged heart
valves
Enterococcus
faecalis (was
classified as
streptococcus)
gram (+) cocci,

single cells,
diplococci or short
chains, catalase
(-), lancefield
antigen: group D
nosocomial
infections, UTIs,
wound infections,
bacteremia,
endocarditis in
pts with damaged
heart valves
normal intestinal flora
Streptococcus
Bovis
gram (+) cocci,

chain, catalase (-),
lancefield antigen:
group D, also
named non
enterococcal group
D organisms
subacute
infective
endocarditis
normal intestinal flora
Pseudomonas
aeruginosa
IE in IV drug users
aerobic gram (-)
and patients with
motile rod, oxidase
prosthetic heart
(+)
valves.
Haemophilus
aphrophilus
Actinobacillus
actinomycetemco
fastidious organisms; requires 5-10%
mitans
carbon dioxide for growth + 3 wks
Cardiobacterium
incubation
hominis
complications: embolization from infective

endocarditis to parietal lobe, to lung
Subacute IE: w/n 2 weeks of dental or other

procedure, low grade fever and chills, fatigue,
anorexia weight loss, new or changing heart
murmurs, skin lesions. Acute IE: acute onset
of high-grade fever and chills, rapid onset of
CHF, murmurs can be absent
associated with colon cancer
ubiquitous in environment
subacute IE (5%), complications may include massive arterial emboli and congestive heart failure
Page 3 of 15
TREATMENT
pyocyanin,
polyverdin, or
fluorescein (green),
UV light
CARDIOVASCUL
AR INFECTIONS
gram (+) cocci,
clusters, catalase
Staphylococcus
(+), coagulase (+),
aureus
salt tolerant,
mannitol (+)
or hemolytic,
resistant
to 40% bile
DIAGNOSIS
salts, 6.5% to NaCl,
bacitracin and
Optochin.
mannitol-salt
agar: yellow
colonies, hemolysis
no hemolysis,
NOVOBIOCIN
sensitive
-hemolytic,
Optochin
resistant, not bile
soluble
not bile soluble,

growth in 6.5%
NaCl, or hemolysis
not bile soluble,

no growth in
6.5% NaCl, or
-hemolysis
no fermentation,
produces
pigments BLUE-GREEN
methicillin
resistant, some
vancomycin
emerging
Native valve IE: PNC + gentamycin. IV drug use: nafcillin + gentamicin. Prosthetic valve IE: vancomycin + gentamicin
BACTERIA
nosocomial
gram (+)
infections, UTI,
diplococci
or short endocarditis
CHARACTERISTICS
DISEASE (pt
chains, catalase
with damaged
(-), Lancefield's
heart valves),
group D antigen wound infections,
bacteremia
Multiple (+) blood cultures (3-5 sets taken), if (+) for same organism - sensitivity testing. Culture (-): recent
antibiotic use, fastidious organisms, fungi. Echocardiography - vegetations
pregnancy
vancomycin
major resistant
problems for
antibiotic
problems
sensitive to
penicillin
Eikenella
corrodens
Kingella kingae
Bartonella
species
Polymicrobial IE
Fungal
endocarditis
SKIN
INFECTIONS
CHARACTERISTICS
DISEASE
B. quintana most commonly involved
BACTERIAmay include massive arterial emboli and congestive heart failure

subacute IE (5%),ALL
complications
CLINICAL
DIAGNOSIS
Native valve IE: PN
OTHER GRAM (-)

ORGANISMS: HAC
CARDIOVASCULAR INFECTION
BACTERIA
fastidious organisms; requires 5-10%

carbon dioxide for growth + 3 wks
incubation
TREATMENT
homeless males with poor hygiene, must be considered in cases of culture-negative endocarditis among individuals whoa re homeless
most common combo: Pseudomonas

observed in cases of IV drug users IE, the cardiac surgery mortality rate is twice that associated with single-agent IE.
+ enterococci
Generally found in IV drug users and intensive care unit patients who receive broad spectrum antibiotics, blood cultures often negative, causes subacute IE. Most common
organisms of both fungal valve IE and fungal prosthetic valve IE are: Candida spp, and Aspergillus spp.
fibronectin-binding proteins, collagen

binding proteins, clumping factors (A,
MSSA: nafcillin,
B), teichoic acids, capsule, protein A Furuncles, carbuncles - neck, face, axillae,
MRSA:
person-to- binds Fc, prevents complement,
buttocks. NTSS associated with tampons, -hemolysis, mannitol
vancomycin, VRSA:
person
enzymes, exotoxins, inflammatory
scalded skin syndrome in neonates, bullous salt agar, 7.5% NaCl
linezolid, Synercid,
response, superantigen: TSST-1,
impetigo is localized form.
daptomycin
enterotoxins, ETA, ETB, exfolatins
produce bullae
impetigo,
M-protein, F-protein and lipoteichoic
HONEY CRUSTED LESIONS - involves
erysipelas,
acid, hyaluronic acid capsule,
gram (+), chain
normal flora,
dermal lymphatics, pain and systemic
Streptococcus
respiratory
cellulitis,
streptococcal pyrogenic exotoxins,
forming cocci and
infected
manifestation, necrotizing fascitis "flesh-hemolysis
penicillin, macrolide
pyogenes
necrotoxic fasciitis
droplets
superantigens, streptolysin S + O,
diplococci
persons
eating bacteria", scarlet fever: strawberry
- gangrene, scarlet
exoenzymes, peptidoglycan + teichoic
tongue, diffuse erythematous rash, TSS
fever
acids
antipseudomonal
pyocyanin,
aerobic gram (-)
"Hot tub:
capsule, biofilm, lipopolysaccharide
blue-green pus, grape-like odor, inflamed
penicillin
Pseudomonas
polyverdin, or
motile rod, oxidase folliculitis, burn
ubiquitous
and lipid A, A-B toxin, exoenzymes, follicles from neck down, shallow puncture
(carbenicillin) +
aeruginosa
fluorescein (green),
(+)
wounds
pili
wound through tennis shoe sole
aminoglycoside
(tobramycin)
UV light
paucibacillary/tuberc
uloid: Dapsone +
Paucibacillary (tuberculoid) leprosy: central
obligate intracellular parasite of
rifampin ~6 months.
Mycobacterium
healing, low infectivity, few rods, DTH to
no growth on medium
acid fast bacillus
Leprosy
reservoir: humans
macrophages and Schwann cells.
Multibacillary/leprom
Leprae
lepromin. Multibacillary (lepromatous)
or tissue culture
DAMAGE FROM HOST RESPONSE
atous: Dapsone +
leprosy: infectious, many rods, (-) lepromin
rifampin +
clofazimine ~2 years
"box car chains"
culture: large
ubiquitous, zoonotic, lives in
vegetative form, dormant spore,
cutaneous anthrax: erythematous papule,
colonies; NONfluoroquinolones
Bacillus anthracis gram (+) rod, spore
anthrax
soil, causes anthrax in
polypeptide capsule, PA, EF, LF
black eschar surrounded by edema
HEMOLYTIC,
(ciprofloxacin)
animals and humans
M'Fadyean methylene
blue stain or DFA
WOUND
INFECTIONS
culture under
anaerobic conditions,
necrotizing and hemolytic toxins:
large gram (+)
Iron Milk Medium @
myonecrosis "GAS
LECITHINASE ~ PHOSPHOLIPASE marked gas formation, "crepitance in tissue",
surgery, amputation,
Clostridium
rods, spore, strict
45C stormy
GANGRENE",
ubiquitous in soil, flora
C ~ ALPHA TOXIN - splits
systemic signs: fever, hemolysis, hypotension,
penicillin, hyperbaric
perfringens
anaerobes, lactose
fermentation, blood
cellulitis
phospholipid molecles.,
renal failure, shock, death
O2 chamber
(+) only
agar - characteristic
enterotoxins, DNase, hyaluronidase
double zone of
hemolysis
ANAEROBIC GRAM (+)
WOUND INFECTIONS
SKIN INFECTIONS
folliculitis,
gram (+) cocci,
furuncles,
clusters, catalase
carbuncles,
Staphylococcus
human skin
(+), coagulase (+), impetigo, scalded
aureus
and mucosa
salt tolerant,
skin syndrome,
mannitol (+)
toxi shock
syndrome
Actinomyces
(israelii)
gram (+) rods,

facultative or strict
anaerobes
actinomycosis
part of oral, intestinal and

vaginal human flora
low
Page 4 of 15
sulfur granules. long
granulomatous lesions, suppurative,
branching filaments,
abscesses, sulfur granules: YELLOW PUS,
slow growth ~2 weeks,
dental extraction or trauma
white colonies: molar
tooth appearance
surgical drainage,
penicillin or
amoxicillin
ANAEROBIC
BACTERIA
Peptostreptococcus
ANAEROBIC
GRAM (-)
WOUND INFECTIONS
ALL BACTERIA
CHARACTERISTICS
gram (+) cocci,

anaerobic
Bacteroides
fragilis,
pleomorphic
Fusobacterium
anaerobic gram (-)
nucleatum,
rods
Prevotella
melaninogenica
Pasteurella
multocida
Bartonella
henselae
DISEASE
CLINICAL
Rickettsial Diseases/Rickettsiosis
SYSTEMIC INFECTIONS
Rickettsia akari
(Spotted fever
group)
Rickettsia
prowazekii
(Typhus group)
small gram(-) rods;

take gram staining
weakly; obligate
INTRACELLULAR
pathogens; zoonotic
Rickettsia typhi
pathogens
(Typhus group)
Orientia
tsutsugamushi
(Scrub typhus
group)
TREATMENT
mixed, skin and

soft-tissue
infections
normal
human flora
endogenous
flora of
animals
animal bites
systemic infection in immunocompromised pts
reservoir:
animals
cat scratches,
bites, contact
with fleas
cutaneous papules or pustules at inoculation

site painful regional lymphadenopathy,
Bacillary angiomatosis in IC - pts
rods in lymph nodes,

culture usually
negative, definitive dx
by serologic tests
antibiotics not
indicated
wound infections after exposure to

contaminated seawater - necrotic cellulitis,
gastroenteritis and septicemia after
consumption of raw oysters
culture: requires salt

for growth media:
Thiosulfate citrate
bile salts sucrose
agar (TCBS), ID biochemical tests
tetracycline
(doxycycline)
5-10 days incubation. EARLY: Flu-like

symptoms; LATER: petechial-hemorrhagic
rash (first on extremities spread to entire
body); various organs failures (2nd & 3rd
febrile day). Fever + Rash + Previous tick
bite
Clinical presentation
+ Serologic tests
(indirect immunofluorescence assay)
(high Ig titers by the 7th
day of illness); PCR
(most rapid and
specific); Immunostaining (70%)
Tetracycline
(doxycycline)
cat-scratch
disease
found in salt water, oysters
capsule, fimbriae, succinic acid,

extracellular enzymes
polar flagella, polysaccharide capsule
illness when native host defenses and

anatomical barriers are altered, progress to
myonecrosis
SYSTEMIC
INFECTIONS
Rickettsia
rickettsii (Spotted
fever group)
DIAGNOSIS
gram (+) in pairs or
brain abscesses, sinusitis, endocarditis,
chains, rich media for
osteomyelitis, intraabdominal infections, pelvic
culture, long
infections, skin and soft tissue infections
incubation time 5-7
days
part of normal human flora;

oral, GI, GU, skin
gram (-) rods,

curved, facultative
Vibrio vulnificus
necrotic cellulitis
anaerobe, oxidase
(+)
WOUND
infection at
normally sterile
sites
gram (-)
coccobacilli,
localized cellulitis
small, facultative and lymphadenitis
anaerobes
gram (-) rods,
short, aerobes
Tick
(Dermacentor), Infect vascular
Wild rodents,
Mortality: 5-7%
Rocky mountain
American dog endothelial cells
domestic
delayed therapy to
(1) induced
spotted fever
tick (eastern
animals
2nd week, ~25% if
(April Sept)
US), Rocky Mt endocytosis (2)
(dogs), ticks
untreated.
lysis
of
wood tick
phagosome
(western US)
membrane phospholipase A
(3) replication in
host cell
Wild rodents, Mouse mite cytoplasm (4) lysis benign, self-limited
Rickettsialpox
of host cell
rodent mites (transovarian)
disease, not fatal
vascular damage
(hemorrhage,
edema), LPS weak endotoxin
Epidemic typhus,
activity, vasculitis exit: cell lysis
Brill-Zinsser
Humans;
Human body and thrombosis
disease
flying
(around all the Mortality: 10-60%
louse
(Recrudescent
squirrels
body).
if untreated
typhus)
IMMUNITY: both
humoral and cell
mortality rate mediated
Endemic typhus
Rats
Rat flea
rare even with
important - after
(Murine typhus)
untreated
recovery - solid
and lasting
Mite larva
immunity
Rodents,
mortality ~30% in
Scrub typhus
(chigger)
rodent mites
untreated
(transovarian)
Page 5 of 15
Phase1: (~1 wk) local proliferation eschar

at bite site; Phase2: (~3-7d) dissemination
flu-like symptoms + fever + generalized rash
(randomly distributed, papulovesicular
eschar, exanthem ~ chicken pox)
anaerobic culture, foul

odor
penicillin + broad
spectrum
metronidazole,
surgery
amoxicillin + lactam inhibitor
Tetracycline
(doxycycline) +
chloramphenicol can
speed recovery
(benign)
(~8d) Flu-like symptoms; maculopapular

Clinical presentation +
rash (first on trunk spread to extremities);
Tetracycline
Serologic tests,
complications: myocarditis, CNS
(doxycycline) or
typhus (indirect
dysfunction; Recrudescent typhus = (10-40 fluorescent antibody chloramphenicol,
yrs later) endogenous secondary infection by
vaccine for high-risk
test, latex
R. prowazekii persisting in
pop
agglutination tests).
reticuloendothelial cells
NO STAIN Tetracycline
(1-2 wk) Same as Epidemic typhus but milder; INTRACELLULAR
(doxycycline) and
rash not always present
chloramphenicol
(1-3 wks) Necrotizing eschar at bite site; flulike symptoms; maculopapular rash (first on
trunk spread to extremities) + generalized
lymphadenopathy
Tetracycline
(doxycycline) or
chloramphenicol
SYSTEMIC INFECTI
ALL BACTERIA
BACTERIA
CHARACTERISTICS
Human
Monocytic
Ehrlichiosis
Ehrlichia
chaffeensis
Ehrlichiosis
DISEASE
Anaplasma
phagocytophila
Human
Granulocytic
Ehrlichiosis
Ehrlichia ewingii
Deer, dogs
Sheep,
cattle,
rodents,
bisons,
deer
Dogs, ticks
CLINICAL
mononuclear
leukocytes
(monocytes,
macrophages)
Infect leukocytes
(1)
phagocytosis (2)
Similar to RMSF but generally without rash,
Inhibition of
granulocytes
5-10 days, leukopenia, thrombocytopenia,
phagosome(neutrophils >
elevated liver enzymes. Severe: prolonged
Black legged
lysosome fusion +
eosinophils)
fever, renal failure, disseminated intravascular
tick (Ixodes)
multiplication in (higher morality ~
coagulopathy, meningoencephalitis, adult
cytoplasmic
10%)
respiratory distress syndrome, seizures, coma.
vacuoles - Morula
Mortality ~2-3%
same - pts with
(3) Host cell +
underlying
Lone star tick phagosome lyses
immunosuppression
Lone star tick
Enterobacteriaceae
Infect
macrophages=>
(1) phagocytosis
Sheep,
Small gram(-)
(2) phagosomegoats, cattle
resistant to heat
pleomorphic rod;
lysosome fusion;
(excreted in
and drying,
intracellular
Q. fever; Chronic
Inhalation of
but bacteria
Flu-like symptoms, rarely rash; pneumonia;
milk, urine,
Proliferation in
Coxiella burnetii
pathogen with
Q fever
dust containing
survive and
hepatitis; endocarditis (Chronic form - 1-20
feces,
respiratory tract
extracellular
(Endocarditis)
pathogen
multiply inside
y, high mortality ~65%)
amniotic
then dissemination
"spore-like" form;
acidic
fluids and
to other organs
zoonotic pathogen
phagolysosome
placenta
(3) Host cell +
phagolysosome
lyses
Yersinia pestis
EMIC INFECTIONS
Francisella
tularensis
Gram(-) rod,
lactose (-), oxidase
(-), catalase (+),
coagulase (+),
nonmotile, bipolar
staining; facultative
intracellular
pathogen; zoonotic
pathogen
DIAGNOSIS
TREATMENT
Clinical presentation +
Microscopy: Giemsa
stain. (Morulae) +
Serologic tests: IFA
(high IgM or IgG titers
by the 2nd wk of
illness), PCR
Tetracycline
(doxycycline)
Acute: tetracycline
Serologic tests (doxycycline);
antigenic variation =>
Chronic:
acute disease: high
(doxycycline +
titer of phase II
quinolones for 4 yrs
antigen; chronic
or doxycycline +
disease: high titers of
hydroxyphase I and II
chloroquine 1.5 to 3
antigens; PCR
yrs), vaccine for high
risk pop
Virulence plasmids; Changes in

genes expression in response to
environmental changes (1) Changes
in flea behavior: yersinia murine
Bubonic plague: flu-like symptoms;
toxin (survival), low T - fibrinolysin & Multiplication of bacteria in regional lymph
Serologic tests: direct
phospholipase (agglutination); (2)
node => suppurative lymphadenitis = "Bubo"
immunofluorescence
Wild
Flea bite; Survival in human body: Capsule (F1 (~70% M untreated); Pneumonic plague: flutest (rapid, presence of
Streptomycin,
Plague: Bubonic,
rodents
direct contact; protein), plasminogen activator:
like symptoms + cough, bloody sputum,
F1); microscopy: gram tetracycline, and
Pneumonic &
(Sylvanic
respiratory
prevents opsonization, important for dyspnea and cyanosis (2-3rd day death due to
stain or Giemsa chloramphenicol,
Septicemic
cycle); Urban droplets (only dissemination (3) Damage: Type III septic shock); Septicemic plague: bacteremia
bipolar staining,
isolation for 72 hours
rats (Urban
pneumonic
secretion system (Yop proteins:
without buboes => flu-like symptoms+
culture: highly
cycle)
plague)
Lcr, Ysc) suppress cytokine
bleeding into skin and other organs => dark
infectious
production, cytotoxic effect;
discoloration (40% M in treated, 100% in
endotoxin (septic shock);
untreated)
yersiniabactin (obtain iron from
host); intracellular grow in
reticuloendothelial cells
Small gram(-) rod,

aerobe, require
cysteine, facultative
intracellular
Wild animals,
Tularemia (rabbit
pathogen; zoonotic
ticks, deer
or deer fly fever)
pathogen, oxidase
fly
(-), urease (-),
nonmotile, thin lipid
capsule
Infects reticuloendothelial organs:

Serologic tests; PCR,
Tick or fly bite,
Ulceroglandular form: 75% painful ulcerating
multiplication in macrophages,
gram stain
direct contact,
lesion at site of infection; Oculoglandular
hepatocytes and endothelial cells =>
unsuccessful, requires
inhalation,
form: 1% purulent conjunctivitis +
necrosis and granuloma production in
cysteine-glucose
ingestion of
lymphadenopathy; also Pneumonic,
areas of multiplication; Survival:
blood agar - tiny
contaminated
Gastrointestinal & Septicemic forms (10inhibition of phagosome-lysosome
transparent colonies,
food or water
15%, more severe). Untreated ~5-30% M
fusion; antiphagocytic lipid capsule
culture is hazardous
Page 6 of 15
Streptomycin
ALL BACTERIA
CHARACTERISTICS
SYSTEMIC INFECTIONS
Small gram(-) rods,

strict aerobes,
Brucella spp.
facultative
(abortus,
intracellular
melitensis, suis) pathogens, zoonotic
pathogens, no
capsule, no spore
Bartonella
quintana
Spirochetes infections
Borrelia
burgdorferi
Borrelia
recurrentis
other Borrelia
spp.
ease - No invasion, no inflammation
Leptospira
interrogans
Small gram(-) rod;

aerobe, zoonotic
pathogen
DISEASE
Brucellosis
Trench fever,
bacillary
angiomatosis,
subacute
endocarditis
Domestic
livestock
Humans, lice
CLINICAL
DIAGNOSIS
TREATMENT
Serologic tests,
microscopy:
Multiply in
Inhibit
insensitive, culture:
Direct contact,
Flu-like symptoms; night sweats (undulant
macrophages in
phagosomedifficult and hazardous.
inhalation,
fever); Chronic illness: body aches, headache,
reticuloendothelial lysosome fusion;
B abortus - needs
ingestion of
anorexia, depression few physical findings
system =>
impair cytokine
CO2, antigen A, (-) by
unpasteurized
unless enlargement of reticuloendothelial
granulomas =>
production;
dye thionine, B.
dairy products
organs. (M is low <25)
septicemia
endotoxin
Melitensis - antigen M,
B. Suis - (-) by
fuchsine
Doxycycline +
rifampin (for 6
weeks)
Serologic tests; PCR,

fastidious growth
requirements, difficult
culture, blood of
chocolate agar, 5%
CO2 with high humidity
for 4 weeks
Erythromycin
Contaminated
louse feces
(scratching)
Prolonged bacteremia, WWI, now

amongst homeless, little is known,
biopsy of skin does not reveal
organisms
4 fever patterns: (1) asymptomatic with 1

episode; (2) 3-5 days single febrile episode;
(3) multiple recurrent febrile episodes "5-day
fever"; (4) persistent fever for 2-6 weeks.
OspA (in tick),

OspC (in
Stage1 (localized infect.): erythema migrans
mammals); toxic
CDC:ELISA or IFA
Tetracycline
(bull's eye appearance) + flu-like symptoms;
LPS;
then Western blot,
(doxycycline),
Spiral morphology,
Antigenic
Black
Stage2 (disseminated infect.): cardiac and
Lyme disease
Tick bite
serologic - later stages,
amoxicillin, or
large; motile; slow
variation - escape downregulation of
legged tick
neurologic (nerve palsies) abnormalities;
immune functions;
culture - not rec, OCT - cefuroxime, Vaccine
growth; gram(-),
immune
(Ixodes)
Stage3 (persistent infection): fluctuating
possible
not standardized
no longer available
zoonotic pathogens,
clearance,
arthritis.
autoimmune
hard to isolate in
modulation of host
response
culture, complex
immune system nutritional needs,
inhibition of
flexible
mononuclear and Endotoxin (febrile
Crushing
peptidoglycan cell
natural kill cell illness); Recurrent
Epidemic
Human body
Microscopy (during
infected louse
wall around which Relapsing Fever
function, antilouse
episodes of fever
febrile period)
+ scratching
several axial
OspA has
+ septicemia
High fever, headache, muscle pain, weakness. Giemsa or Wright
Tetracycline
endoflagella are
autoimmune
separated by
2-4 days between relapses; 2-3 relapse
staining; Serologic
(doxycycline) or
wound
activities
afebrile periods;
cycles; possible myocarditis.
tests unhelpful
erythromycin
new set of
(because of antigenic
Endemic
Tick
Tick bite
surface antigens
variation)
Relapsing Fever
at each relapse
Spiral morphology;
motile; slow growth;
gram(-) but not
seen on gram stain;
zoonotic pathogen,
tight terminal
hooks
ETEC
EnteroToxigenic
E. coli
Leptospirosis
Traveler's
Diarrhea
Enterobacteriacea
e; Motile;
lactose(+)
Direct contact
with urine,
blood or
Shed in urine
tissues of
Multiply in blood and tissues; damage
of infected
infected
endothelium of small blood vessels;
animals
animals;
no virulent factors known
Contact with
contaminated
water
Human's
intestine
Fecal-oral
Cfa (colonization factor antigen) adherence; ST (heat stable toxin) guanylate cyclase activation
[cGMP]; LT (heat labile toxin, AB
toxin) - ADP ribosylates G protein
activation of adenylate cyclase
[cAMP]; High cGMP or cAMP
hypersecretion of H2O and Cl; in Na
reabsorption
Page 7 of 15
both febrile: Septicemic phase: flu-like

symptoms; Immune phase: anicteric form
(possible meningitis), icteric form or Weil's
disease (jaundice, renal + pulmonary
dysfunctions, subconjunctival hemorrhage)
Culture: from blood,

CSF during septicemic
phase; from urine
during immune phase;
slow growth, special
media, PCR - not
widely available.
Serologic tests:
agglutination test
Watery diarrhea, abdominal cramps
Immunoassays
Penicillin or
Doxycycline
Fluoroquinolon
es
(ciprofloxacin),
TMP/SMX
te replacement
BACTERIA
DISEASE
Watery diarrhea
Human's
intestine
Chronic diarrhea
Human's
intestine
Yersinia
Enterobacteriacea
enterocolitica (Y. e; Bipolar staining; Watery diarrhea,
pseudotuberculosi
lactose (-),
gastroenteritis
s - uncommon)
zoonotic
Animal's
intestine
EAEC
EnteroAggregativ
e E. coli
Vibrio Cholerae
(serogroups O1
and O139)
Curved gram(-)
rods; facultative
anaerobes,
oxidase(+), motile
(polar flagella)
Cholera and
gastroenteritis
Watery diarrhea
Dysentery
Enterobacteriaceae;
Shigella spp. (S.
Non-motile;
sonnei)
lactose(-)
Dysentery,
shigellosis
(gastroenteritis)
Bfp (Bundle-forming pilus) Fecal-oral,

adherence; Type III secretion system
LOW in infants
cytoskeleton proteins modification
(person-toin host cell; Attaching and effacing
person); high in
lesions changes in microvilli
adults
malabsorption
CLINICAL
DIAGNOSIS
Watery diarrhea, abdominal cramps

(INFANTS)
Immunoassays
Fecal-oral
Bfp (Bundle-forming pili)

autoagglutination "stacked-brick"
arrangement + biofilm
malabsorption
Chronic watery diarrhea (in AIDS patients),

abdominal cramps, dehydration in infants and
children ~ growth retardation
Immunoassays
Fecal-oral
Invade M cells: Yops and Type III

secretion system; gene expression
under Ca and T control, virulence
genes, spread microabscesses in
lymph nodes
Watery diarrhea, abdominal cramps, fever;

mesenteric lymphadenitis (mimics acute
appendicitis) other: arthritis, intra-abdominal
abscess, septicemia, osteomyelitis
Stool culture at 25C
Warm costal Ingestion of

water
contaminated
(marine life)
seafood
Human's
intestine
Human's
intestine
Fecal-oral,
LOW
person-toperson
transmission
Fecal-oral
Enterotoxin - chloride secretion
Watery diarrhea, abdominal cramps, nausea
Bloody diarrhea with pus, fever, abdominal

cramps, nausea
Immunoassays,
sorbitol (-),
glucuronidase (-)

cramps, nausea (first watery then blood
mucoid stools)
Hektoen enteric agar:

lac(-), H2S(-) green
colonies
Ruffles, invasion, inflammation

cramps, nausea
Hektoen enteric agar:

lac(-), H2S(+) blue
colonies with dark
center
Invasion of intestinal mucosa;

virulence factors poorly defined

pain; Complications: Guillain-Barre
syndrome, Reactive arthritis
Culture
(microaerophilic
conditions - T - 42C,
blood or charcoal
media)
Invasion of colonic mucosa through M

Fecal-oral,
cells; Invade basal surface of
LOW
enterocytes cell death +
person-toinflammation, focal ulcer; shiga-toxin,
person
cleaves rRNA - HUS (see above),
transmission
acid resistant, endotoxin
ingestion of
Intestinal
Dysentery-like
contaminated
Enterobacteriaceae;
tracts of
food (eggs,
diarrhea; possible
Motile; lactose(-)
animals and poultry) or water;
bacteremia
humans
direct contact
Fluoroquinolon
es
(ciprofloxacin),
TMP/SMX
Fluoroquinolon
es or
doxycycline +
gentamycin
Self-limiting
Attaching & Effacing lesions (no

invasion); Shiga toxin (AB toxin) Culture on MacConkey
cleaves rRNA blocks protein
Bloody diarrhea (no leucocytes), abdominal
agar (sorbitol(-));
synthesis cell death; circulating cramps, vomiting; oliguria+renal failure (HUS)
Immunoassays
shiga toxin can bind to renal tissue
renal failure (HUS)
Invasion and destruction of colonic
epithelium, virulent plnv genes,
INACTIVATE RIBOSOMAL
SUBUNITS
Fluoroquinolon
es
(ciprofloxacin),
TMP/SMX
Ciprofloxacin or
doxycycline
TCBS - blue-green
colonies; Halophilic
Fecal-oral;
Salmonella
enterica
(enteritidis &
typhimurium)
TREATMENT
Tcp (toxin coregulated pilus) adherence; Ctx (cholera toxin, ABWarm costal Ingestion of
TCBS (Thiosulfate
toxin, on lysogenic CTX phage) water,
contaminated
Profuse watery diarrhea; "rice-water" stools;
citrate bile salts
ADP ribosylates G protein constant
asymptomati
water or
severe dehydration hypovolemic shock sucrose agar) - yellow
activation of adenylate cyclase
c carriers
shellfish
colonies
cAMP hypersecretion of H2O and
Cl; decrease in Na reabsorption
EHEC
Enterobacteriaceae;
Hemorrhagic
EnteroHemorrhag Motile; lactose(+), Colitis; Hemolytic Intestine of
ic E. coli
sorbitol(-) Uremic Syndrome
cattle
(O157:H7)
"spinach outbreak"
(HUS)
EIEC
Enterobacteriaceae;
EnteroInvasive E.
Motile; lactose(+)
coli
Fluid+electrolyte replacement
EPEC
EnteroPathogenic
E. coli
CHARACTERISTICS
Enterobacteriacea
e; Motile;
lactose(+)
Antibiotic
therapy not
recommended;
dialysis in HUS
cases
Fluid + electrolyte replacement
Watery Diarrhea - Small intestine disease - No invasion, no inflammatio
BACTERIA
Vibrio
parahaemolyticus
Watery to Bloody Diarrhea - Large Intestine
GI INFECTIONS
ALL BACTERIA
Fluoroquinolon
es
(ciprofloxacin),
TMP/SMX
Fluoroquinolon
es
(ciprofloxacin),
TMP/SMX
Fluoroquinolon
es
(ciprofloxacin),
TMP/SMX
with reptiles
Campylobacter
jejuni
Thin gram(-) rods;

spiral shape;
microaerophile;
oxydase(+),
Dysentery-like
diarrhea
Animal's
intestine
Fecal-oral;
ingestion of
contaminated
food (poultry),
milk or water;
direct contact
with pets, LOW
Page 8 of 15
Fluoroquinolon
es
(ciprofloxacin)
or erythromycin
ALL BACTERIA
BACTERIA
Salmonella typhi
Helicobacter
pylori
Enterobacteriaceae;
Non-motile;
lactose(-)
DISEASE
Typhoid fever
Gram(+) rods,
motile; spore
forming
Emetic
gastroenteritis
Ubiquitous
CLINICAL
DIAGNOSIS
Invasion of M cells; Multiply in

Fecal-oral;
macrophages; bacteremia and
Sustained fever and headache; possible rash Culture from blood or
Mod-low
invasion of RES (mesenteric lymph
and/or diarrhea; persistent bacteremia
feces, Hektoen enteric
(possible
node, liver, spleen); infection of
myocarditis, encephalopathyconstipation agar: blue colonies
person-togallbladder (carrier state); Capsule (Vi
more common, diarrhea = late in disease
with dark center
person trans)
polysaccharide); endotoxin
Fecal-oral;
oral-oral
Mucous layer invasion (Mucinase,

phospholipase, flagella) + Alteration
of gastric acid production (urease ->
ammonium production)
Inflammation of gastric mucosa
Tissue destruction
Ingestion of
preformed
toxin (rice)
Heat-stable enterotoxin (if spore

Onset <6h after ingestion - Vomiting, nausea,
survive cooking germination + toxin
abdominal cramps
production in non-refrigerated food)
Biopsy=> microscopy,
culture, urease test;
Stool antigen test;
Urea breath test; PCR
TREATMENT
Fluoroquinolones
(ciprofloxacin),
TMP/SMX
Proton pump
inhibitor +
clarithromycin +
amoxicillin or
metronidazole
Isolation of organism
Self-limiting; Fluid +
from implicated food,
electrolyte
-hemolysis on blood
replacement
agar
Ingestion of
Heat-labile enterotoxin (germination
food
Incubation time >6h - Watery diarrhea,
of spore + toxin production in
contaminated
nausea, abdominal cramps
intestinal tract)
with spore
Ingestion of
Gram(+) cocci in
preformed
Heat stable enterotoxin acute
Isolation of toxin
Self-limiting; Fluid +
Staphylococcus
Staphylococcal
Normal
Onset <6h after ingestion - Vomiting, nausea,
cluster, catalase(+);
toxin (potato inflammation of gastric mucosa, small
producing bacteria
electrolyte
aureus
food poisoning
human flora
abdominal cramps and watery diarrhea
coagulase(+)
salad,
intestine
(mannitol salt agar)
replacement
custard)
Exposure to antibiotics
AntibioticVegetative
overgrowth of C. difficile
associated
Watery diarrhea
form: human
(endogenous); Toxin A Immunoassays (toxins
diarrhea
carrier;
Discontinue
Endogenous Enterotoxin: disrupts tight junctions
detection);
difficile
Spore in
implicated antibiotic;
infection
between enterocytes + induces
colonoscopy
Antibioticenvironment
vancomycin
inflammation watery diarrhea;
(pseudomembrane)
associated
(hospital
Profuse diarrhea, abdominal cramps, fever
Toxin B - cytotoxin: modification of
pseudomembrano
rooms)
enterocyte cytoskeleton cell death
us colitis
Large gram(+)
Enterotoxin: alteration of membrane
Watery diarrhea
Watery diarrhea + abdominal cramps
Self-limiting
Ingestion of
rods; Spore
permeability in enterocytes
Clostridium
Soil and
Culture; Immunoassay
spore or
forming; Strict
perfringens
human colon
Necrotizing
Bloody diarrhea; abdominal pain; vomiting, (enterotoxin detection)
-toxin (lethal toxin): necrotizing
bacteria
anaerobes
Penicillin
enteritis
peritonitis
destruction of jejunum
Diarrheal
gastroenteritis
Ubiquitous
Botulism,
neuromuscular
paralysis
Spores in soil
and dust
lancet-shaped,
gram (+) cocci,
chain or diplo,
catalase (-)
pneumococcal
meningitis in
adults
Weakness, dizziness, then neurological

Botulinum toxin=AB neurotoxin
features: blurred vision, drooping eyelids
blocks release of acetylcholine from
Clinical
respiratory paralysis. THREE Ds: DIPLOPIA,
peripheral nerves flaccid paralysis
trivalent botulinum
DYSPHAGIA, DYSPHONIA
Antitoxin
Ingestion of
Germination of spores in colon
Spores in soil
Clinical + C. botulinum
spore (honey), multiplication of vegetative form
"floppy baby"
and dust
found in feces
LOW
neurotoxin production
throat &
nasopharynx
Ingestion of
preformed
toxin, LOW
person-toperson via
respiratory
droplets
nasopharynx infection of lung or

eustachian tube inflammation or
OM bacteremia, meningitis.
Polysaccharide capsule:
antiphagotic, pneumolysin:
transmembrane pore-forming toxin,
IgA protease, others: teichoic acid,
peptidoglycan fragment, hydrogen
peroxide
Page 9 of 15
acute onset, complications: mental

retardation, learning disabilities,
deafness
WBCs, proteins, glucose
Clostridium
botulinum
Streptococcus
pneumoniae
Bacterial Meningitis
Humans
only
Gram(-) rods;
bacillary or spiral
Gastritis, peptic
Stomach of
shape;
ulcer, gastric
humans and
microaerophile;
adenocarcinoma,
animals
oxydase(+); urease
lymphomas
(+)
Infant botulism
CNS INFECTIONS
Infants: slow-appearing, irritable, vomiting, or

poor feeding
Clostridium spp & GI infections
GI INFECTIONS
Bacillus cereus
CHARACTERISTICS
gram stain: WBCs

+ gram(+) cocci,
Culture: mucoid,
-hemolytic,
Optochin
sensitive,
bacitracin
resistant, bile
solubility (+),
capsule (+)
quellung
vancomycin + 3rd
gen cephalosporin
(ceftriaxone or
cefotaxime), Prompt
txt of OM and
respiratory
infections.
VACCINES: 7valent conjugated
vaccine, 23-valent
polysaccharide
vaccine.
aerobic gram (-)

diplococci,
polysaccharide
capsule (A, B, C, Y,
W135), flattened
adjacent sides
gram (+) cocci in

short chains, hemolytic or
Streptococcus
nonhemolytic,
agalactiae (Group
group B lancefield
B hemolytic
capsular antigen,
streptococcus)
bile resistant,
polysaccharide
capsule
E. coli
Listeria
monocytogenes
gram (+) rods,

catalase (+), hemolysis
Mycobacterium
tuberculosis
obligate aerobe,
rod shaped,
facultative
intracellular
pathogen, acid-fast
bacteria
initial infection of upper resp tract

attachment to non-ciliated cells of
nasopharynx: pili, IgA protease
(colonization), capsule invasion
into bloodstream brain. Diffuse
vascular damage: endotoxins (LPS,
LOS)
nasopharynx
Haemophilus
meningitis and
sepsis
direct contact
nasopharynx invasion
with respiratory
bacteremia CNS. Pili, IgA
human
droplets. Risk: protease, polysaccharide capsule:
nasopharynx
infants - young
type-b: poly-ribitol-phosphate,
children
endotoxin (LPS) - inflammation
meningitis in
neonates
GI tract,
vagina
respiratory
droplets
meningococcal
meningitis
capsule rich in sialic acid, peptidase

infection
- inactivates C5a, hydrolytic enzymes
during
delivery,
nosocomial
transmission
gram (-) rod, K1

polysaccharide
capsule
Other
CNS INFECTIONS
Bacterial Meningitis in
Neonates
gram (-)
Haemophilus
pleomorphic
influenzae type b
coccobacillus,
capsule serovar b
DISEASE
CLINICAL
hemorrhagic skin rash (petechiae).

Waterhouse-Friderichsen syndrome
(ADRENALS), complications: 11-19%
permanent hearing loss, mental
retardation, etc
nonspecific: fever, feeding difficulty,

vomiting, diarrhea, respiratory distress,
irritability alternating with lethargy
Bacteremia: occult, proliferate in placenta.

ingestion of
pathogenic serotypes have unique
Neonatal: early onset sepsis host-dependent:
contaminated teichoic acid, facultative intracellular "granulomatosis infantisepticum", late-onset
intestine of
listerosis, sepsis,
food,
pathogen: growth in cells, internalins: meningitis: via vaginal transmission. CNS:
animals and
meningitis, fetal
transplacental attachment and entry, listeriolysin O: meningitis, encephalitis, brain abscess in
humans
loss
, during
pore-forming exotoxin, ActA: actin
10%. Febrile gastroenteritis (IC+), (IC- and
delivery
polymerization: motile comet tails
old: sepsis and meningitis, pregnant: flu-like
illness, fetal loss.
tuberculous
meningitis
Inhalation of
infectious
aerosols
Mycolic acid, sulfolipids, cord factor,

tuberculin + mycolic acid
Page 10 of 15
gradual onset (weeks), malaise, apathy,

anorexia brain abscesses, spinal TB
DIAGNOSIS
TREATMENT
cefotaxime or
ceftriaxone (10-15%
gram stain of CSF,
fatal, 100% if
culture: Thayeruntreated),
Martin agar (mod
antimicrobial
chocolate agar) +
chemoprophylaxis:
5% CO2.
rifampin or
MALTOSE &
ciprofloxacin,
GLUCOSE (+)
VACCINES: MPSV4,
MCV4
culture: chocolate
agar, X and V
cefotaxime or
factors, gram (-)
ceftriaxone, Hib
coccobacilli or
conjugate vaccine.
rods. Antigen
Rifampin prophylaxis
detection, latex
test
initially: runny nose, low grade fever,

HA, complications: 20% - hearing
loss, delayed language development or
mental retardation
capsule (sialic acid, ~

meningococcus), pili
reservoir infected
humans.
CSF: WBCs, proteins, glucose
Neisseria
meningitidis
CHARACTERISTICS
CAMP test
BACTERIA
high fever, HA, stiff neck. Infants: slow-appearing, irritabl

poor feeding
Bacterial Meningitis
CNS INFECTIONS
ALL BACTERIA
PCR, latex
particle
agglutination test
of urine: rapid, antiviral (acyclovir)
CSF and blood
+ antibacterial
cultures, CSF:
(ampicillin +
difficult in
cefotaxime)
neonates.
Bacterial culture
from mother.
broad T range, motile

at 25C "TUMBLING", nonmotile at 37C,
microscopy - wet
mount, culture: blood
agar, -hemolytic,
CSF: pleocytosis,
protein, glucose
ampicillin +
gentamicin
CXR, PPD skin test,

ACTIVE: combo:
Ziehl-Neelsen stain =
isoniazid, rifampin
acid fast stain. Culture
(4m), pyrazinamide
confirms dx.
(2m), ethambutol.
Lowenstein-Jensen
LATENT: isoniazid.
medium = lipid rich
CNS I
ALL BACTERIA
Clostridium Spp
BACTERIA
gram (+) rods,

strict anaerobes,
no capsule, motile,
Clostridium tetani
spore-forming drumstick
appearance
Clostridium
botulinum
Bacterial Conjunctivitis: purulent discharge, conjunctival hyperemia
Streptococcus
pneumoniae
EYE INFECTIONS
CHARACTERISTICS
gram (+) rods,

fastidious, spore
forming, strict
anaerobes
DISEASE
tetanus:
generalized,
localized,
cephalic,
neonatal
botulism:
foodborne,
infant, wound,
neuroparalytic
illness
spores survive spore, botulinum toxin: heat labile

sterilizing
AB-neurotoxins, blocks release of Ach
soil,
process and
from peripheral nerves flaccid
contaminate
improper
paralysis, type A most significant in
d foods
canning
US, highly toxic. Path: ingestion of
procedures
preformed toxin
gram (+)
diplococci or
chains, catalase (-)
Hemophilus
influenzae
gram (-)
pleomorphic rod
Staphylococcus
aureus
gram (+) cocci,

clusters, catalase
(+), coagulase (+)
polysaccharide capsule, autolysin,

pneumolysin O
Acute Bacterial
Conjunctivitis
CLINICAL
spore: survival in environment,

tetanolysin (not sig),
enter body via
tetanospasmin: heat labile AB
wound,
neurotoxin, blocks release of
developing
inhibitory NTs (GLYCINE)
severe painful spasms and rigidity of voluntary
countries: nonspores:
constant contraction (spasms),
muscles, early = lockjaw, exg reflexes,
sterile
ubiquitous
highly toxic. Anaerobic conditions
muscle rigidity apnea, fractures,
techniques,
germination of spores, local
dislocations, death from respiratory failure
umbilical stump
bacterial multiplication, toxin
neonatal
production enters nervous
tetanus
system peripherally carried to
CNS
Direct contact
pili, lipopolysaccharides, IgAspecific protease, polysaccharide

capsule
protein A (inhibits phagocytosis),
fibrinogen-binding protein
(clumping factor), coagulase,
cytotoxic toxins
weakness, dizziness, dryness of mouth (N and

V), neuro: B/L flaccid paralysis and motor
and autonomic nerves, blurred/double vision,
drooping eyelids, difficulty swallowing, speech,
descending weakness, respiratory paralysis
DIAGNOSIS
TREATMENT
clinical
neutralization of
unbound toxins
(toxin binding is
irreversible),
supportive,
metronidazole to
eliminate bacteria in
wound, Vaccine
mainly clinical,
mouse bioassay
trivalent botulinum
antitoxin (A, B, E),
respiratory
support,
elimination of
bacteria: gastric
lavage,
metronidazole or
PNC
-hemolytic on blood
agar - large mucoid
colonies, Optochin
sensitive, bacitracin
resistant, bile soluble
Empiric txt w/
burning, irritation, tearing, mucopurulent
topical antibiotics,
chocolate agar (X & V
discharge
Gati/levo/
factors)
moxifloxacin
-hemolysis, mannitolsalt agar, yellow
colones
Trachoma: leading cause of blindness in

world, mostly children, ~ poor hygiene.
Chronic, inflam granulomatous dz of eye
surface corneal ulceration, scarring, pannus
formation blindness
Direct contact/newborn via birth canal
from conjunctival fluid
tropism for epithelial cells of
or surface scrapings;
conjunctiva; intracellular pathogen
gram stain/culture;
(evades host defense, killing host
immunocell); LPS (inflammation) severe
fluorescence,
inflam response necrosis,
cytologic exam (I)
Adult: acute infections --> mucopurulent d/c,
fibrosis, scarring
infiltrates, corneal scarring in chronic form;
ocular-genital contact,
sexually active - preceded by genital infection.
acquired from infected mom
Newborn: swelling of eyelids, copious purulent
d/c
trachoma,
Direct contact; hand to eye,
urogenital
contaminated clothing,
infections (Sero Aflies
C)
Chlamydia
trachomatis
small obligate
INTRACELLULAR,
no PG layer;
elementary &
reticulate bodies
inclusion
conjunctivitis
(sero D-K)
lymphogranuloma venereum
(sero L1 - L3)
Page 11 of 15
azithromycin or
doxycycline,
erythromycin
(newborn).
BACTERIA
Other Eye Infections
Neisseria
gonorrhoeae
CHARACTERISTICS
Aerobic gram (-)

diplococci, beanshaped, no
capsule, facultative
intracellular
Pseudomonas
aeruginosa (gram
(-) rod)
Contact lens-related
Acanthamoeba
spp.
DISEASE
Gonococcal
ophthalmia
neonatorum
DIAGNOSIS
TREATMENT
ceftriaxone;
Neonatorum
prophylaxis: silver
nitrate or
erythromycin or
tetracycline
keratitis
immunocompromised
Ocular toxocariasis - retinal detachment
River blindness, sclerosing keratitis, chorioretinitis
African eye worm
Gonorrhea
Aerobic gram (-)

diplococci, beanshaped, no capsule,
facultative
intracellular
PID
Rectal &
Pharyngeal
ophthalmia
neonatorum
Transmissio
n
F: Cervix, ~50% asymptomatic, Untreated

PID, ectopic pregnancy, salpingitis. M:
Urethra, ~25% asymptomatic, purulent
strict human pathogen,
urethral discharge and dysuria, Untreated
pili: adhesion,
sexual or intimate contact
epididymitis, prostatitis, periurethral
inhibit
gram smear from
abscesses. Both untreated infertility,
phagocytosis.
genital site in
disseminated infection, anorectal infection,
OMPs (outer
Attachment and
cytoplasm of
membrane
invasion of non pharyngitis, conjunctivitis and dissemination
neutrophils, sensitivity third generation
proteins):
ciliated
epithelial
spread of organisms along
fever, lower abdominal pain,
and specificity: 95% in cephalosporins
fallopian tubes (salpingitis), serotyping, Opa cells survival
complications: infertility or ectopic
M, 50% in W, nucleic
(ceftriaxone),
proteins
in
submucosa
pelvic cavity (peritonitis,

pregnancy due to scarring of fallopian
acid amplification
resistance to first
adherence,
spread
and
abscesses)
tubes
tests, culture:
line drugs (also
antigenic variation, dissemination
Thayer-Martin agar
treat chlamydia)
both usually asymptomatic, tenesmus,
PorB
prevent
(inflammation
and
linked to sexual practice
(chocolate, antibiotics
discharge,
rectal
bleeding,
sore
throat
phagolysosome
local damage)
to normal flora, 35C +
fusion, IgA
CO2)
acute purulent conjunctivitis, lid edema,
protease, LPS
acquired at birth
erythema, parked purulent discharge
and LOS
disseminated
gonococcal
infections
Chlamydia
trachomatis (all
biovars but L)
CLINICAL
bacterial keratitis, scleral

abscess, endophthalmitis
Toxocara canis
Onchocerca
volvulus
Loaloa
Neisseria
gonorrhoeae
at birth from infected mom attach &

invade epithelial cells; Pili +
from conjunctival fluid
PorB/Opa (adhesion/protection); IgA
or surface scrapings;
protease (colonization); Antigenic acute purulent conjunctivitis acquired at birth:
gram stain/culture;
variations escape immune
lid edema, erythema, marked purulent d/c
Thayer-Martin agar,
surveillance; LPS & LOS
GLUCOSE (+)
(inflammation); no capsule severe
inflammatory response
Fungal infections
Urethritis and Cervicitis, PID
EY
Bacterial Conj
ALL BACTERIA
D-K: urogenital
infections
(noninvasive), AC: trachoma.
Other: inclusion
conjunctivitis,
small obligate
INTRACELLULAR, infant pneumonia
no PG layer;
elementary &
reticulate bodies
generally in women, leading cause of purulent

arthritis, large necrotic gray skin lesions
close personal contact
EB: infectious,
outside, nonreproductive, RB:
noninfectious,
intracytoplasmic,
reproductive form.
Intracellular
replication, no
phagolysosome
fusion, LPS
spread by direct
contact tropism
for epithelial cells
3.3 F (15-19) > M. F: 70% asymptomatic,
(F: endocervix,
cervicitis urethritis: mucopurulent
upper genital tract
discharge dysuria. Complications: PID
in; both: urethra,
(40% untreated), permanent damage
rectum,
chronic pelvic pain, infertility, and ectopic
conjunctiva)
pregnancy. M: 25% asymptomatic,
infection, severe urethritis: dysuria + thin urethral discharge,
inflammatory
complications: rare, spread to epididymis
response
pain, fever, and sterility
necrosis,
fibrosis, scarring
Page 12 of 15
collection of
epithelial cells, direct azithromycin or
immunofluorescence:
doxycycline.
Ebs are bright yellow Pregnant and young
green dots under UV,
children:
NAAT (urine), enzyme
erythromycin.
immunoassay,
Follow-up: repeat
culture: iodine staining testing (NAAT) 3
of glycogen inclusion
months
bodies - dark brown
BACTERIA
small obligate
INTRACELLULAR,
no PG layer;
elementary &
reticulate bodies
CHARACTERISTICS
Chlamydia
trachomatis (L
biovar)
DISEASE
L: Lymphogranuloma
venereum
small,
pleomorphic, gram
(-) rods
Chancroid
Syphilis
Treponema
pallidum
thin, tightly coiled

spirochetes, not
intracellular
STDs
Genital Ulcers
Haemophilus
ducreyi
ALL BACTERIA
Congenital
Syphilis
Klebsiella
granulomatis
Vaginal Discharge
Trichomas
vaginalis
intracellular
encapsulated gram
(-) bacillus
protozoa flagellate
round/oval
budding yeasts,
polymorphic: y,
Candida albicans
hyphae, and
pseudohyphae
Granuloma
inguinale or
Donovanosis
sexual
CLINICAL
L-serovar are invasive travels via

lymphatics, multiply w/n
mononuclear phagocytes in
regional lymph nodes,
characteristic granuloma formation
necrotic lesions, inflammation
spread to surrounding tissues
small painless ulcer at site of infection,

spontaneously heals. Second stage:
inguinal adenopathy, painful buboes
draining fistulas.
tender papule with erythematous base

painful ulceration with associated inguinal
lymphadenopathy. F: often asymptomatic,
often diagnosed in men
sexual contact
Primary: 1+ chancres at infection site, lots

of spirochetes painless ulcer, heals
local primary
spontaneously w/n 2 months, pt highly
infection: skin or
infections. Secondary: dissemination: fluouter membrane mucosal slow
only host = humans,
like syndrome, lymphadenopathy,
proteins:
multiplication,
susceptible to heat, drying
generalized mucocutaneous
adherence,
endarteritis &
and disinfectants, requires hyaluronidase:
maculopapular rash, 1/3 condylomata
granulomas.
close contact
lata, highly infectious, resolve
perivascular
Dissemination
spontaneously latent stage (clinically
infiltration,
(lymph nodes and
inactive). Tertiary: diffuse, chronic
antigenically
blood), quiescent
unreactive.
for months to inflammation neurosyphilis, CV syphilis,
gummas
Tissue damage =
years, late
patient's immune syphilis: injury
response
due to prolonged
intrauterine death, congenital
hypersensitivity abnormalities, silent infections, most: born
transplacental
responses
with rhinitis followed by rash
granulomatous ulcers that bleed on

contact, inguinal lesions (10-15%)
sexual contact
F: frequently symptomatic vaginitis,

replicates by
axostyle:
purulent discharge, copious, foamy, foulbinary fission,
attachment,
smelling yellowish, vulvar and cervical
only trophozoite
sexual contact, humans only contact-dependent
lesions, dysuria, itching. Pregnant: premature
Trichomoniasis
form, no cyst,
host
damage to
rupture of membranes, preterm delivery,
does not survive
epithelium, not
low birthweight. M: rarely symptomatic,
in external
invasive
mild urethritis, mild discharge, slight burning
environment
after urination or ejaculation, ~ prostatitis
Vulvovaginal
Candidiasis
normal oropharyngeal, GI,

genital flora, endogenous or
direct contact
mannoproteins: adherence, resistance F: pruritus and erythema of vulvar area, thick

to phagocytosis, hyphae secrete
cheesy vaginal discharge, itching of vulva.
proteinases and phospholipases (kill
M: 10% - balanitis: inflammation of glans
epithelial cells, tissue penetration)
penis, itchy rash on penis, rare: urethritis
Page 13 of 15
immunofluorescence:
doxycycline.
Ebs are bright yellow Pregnant and young
green dots under UV,
children:
NAAT (urine), enzyme
erythromycin.
immunoassay,
Follow-up: repeat
DIAGNOSIS
TREATMENT
culture:
iodine staining testing
(NAAT) 3
of glycogen inclusion
months
bodies - dark brown
clinical, microscopy,
DNA probe, culture:
relatively insensitive,
require x factor for
growth
azithromycin,
ceftriaxone,
ciprofloxacin, or
erythromycin
culture: no growth on
artificial media,
microscopy: darkfield
microscopy (live
motile bacteria), direct
fluorescence
antibody test, silver
staining. Serology:
nonspecific
penicillin
(cardiolipin, VDRL,
RPR, measure IgG
and IgM from damaged
cells), specific
(confirmation, FTAABS test, MHA-TP),
enzyme
immunoassays
Wright or Giemsa
stained: clusters or
encapsulated
coccobacilli in
Doxycycline
cytoplasm of
mononuclear cells
"Donovan bodies"
vaginal, urethral,
prostatic secretions:
microscopy: wet
mounts (motile),
metronidazole or
Giemsa stained,
direct
tinidazole (txt
immunofluorescence partners, do not use
antibody staining, during 1st trimester)
Culture: most
sensitive, diamond's
medium, anaerobic,
pH 5.5-6 (3-7 days)
from discharge,
microscopy: KOH:
budding years and
oral fluconazole,
pseudohyphae,
topical azole or
culture: Sabouraud or
nystatin, not
blood agar, large
recommended to
smooth white colonies:
treat sex partners
rapid growth, "germtubes" formation after
2 hr
Vagi
ALL BACTERIA
BACTERIA
Gardnerella
vaginalis
CHARACTERISTICS
gram-variable
rods, facultative
anaerobes
DISEASE
Bacterial
vaginosis
CLINICAL
DIAGNOSIS
TREATMENT
shift in vaginal flora, lactobacillus

spp replaced, increase risk:
anything that can upset normal
balance of bacteria
"non-specific vaginitis" ,white or gray

vaginal discharge with unpleasant odor,
dysuria, itching, or asymptomatic.
Complications: PID, preterm delivery, low
birthweight, increased susceptibility to HIV,
STDs
white discharge,
microscopy: clue
cells, absence of
lactobacilli, vaginal pH
> 4.5, "whiff" test after
adding KOH
metronidazole
Mycoplasma
hominis
sexual contact
postabortal or postpartum fever, PID ~

fallopian tubes infection, self-limiting
Ureaplasma
ureolyticum
sexual contact
F: chorioamnionitis and postpartum fever, M:

non-gonococcal, non-chlamydial urethritis
urease production
(distinguish from
mycoplasma)
erythromycin or
tetracyclines
intense itching and redness, bumps,

blisters, and crusting
rash, burrows, isolation

of mites, ova or feces
in skin scrapings
topical permethrin
(5%), wash
everything, treat
everyone
Sarcoptes scabiei
Phthirus pubis
human itch mite arthropod
genital scabies
insect
pediculosis
pubis, lice or
"crabs"
close - sexual contact
sexual
adult mites
risk of 2nd
create burrow in
bacterial infection,
upper layer of
Norwegian
epidermis, female
scabies - more
lay eggs in skin
severe form
burrow
Nit - egg, hard to

see, attached to
feeds on human
hair, nymph itching in genital area, visible nits or crawling
blood and
baby louse, adult lice
multiplies rapidly
females lay nits,
larger than males
Page 14 of 15
special media - large tetracycline (resistant

fried-egg colonies
to erythromycin)
lice-killing shampoo
(pediculicide) 1%
permethrin or
pyrethrin
ALL BACTERIA
BACTERIEAL RESPIRATORY INFECTIONS
BACTERIA
Sinusitis & Otitis
Pharyngitis
Epiglottis
Media
Streptococcus
Streptococcus
Haemonphilus
pyogenes (strep
Pneumoniae
influenzae
throat)
Corynebacterium
Haemonphilus
diphtheriae
influenzae
(diphtheria)
Moraxella
catarrhalis
Pertussis
Bordetella pertussis
Bronchitis
Tuberculosis
Streptococcus
Pneumoniae
Haemonphilus
influenzae
Mycoplasma
pneumoniae
Mycobacterium
tuberculosis
Pneumonia
Streptococcus
Pneumoniae
Haemonphilus
influenzae
Staphylococcus
aureus
Klebsiella
pneumoniae
Chlamydophil
pneumoniae &
psittaci
Mycoplasma
pneumoniae
Legionella
pneumonia
Pseudomonas
aeruginosa
Pulmonary
Anthrax
Bacillus anthracis
Page 15 of 15

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ALL BACTERIA

gram (-) aerobic

gram (+) coccus in Strep throat

gram (+) clubshaped rods,

gram (-) coccobacillus, strict

whooping cough humans only

acute inflammation of pharynx and tonsils,

Catarrhal stage: 1-2 wk, highly

Mycolic acid, sulfolipids, cord

primary TB: Ghon complex, progressive

lipopolysaccharides, IgA protease,

infants: passive maternal protection, poor

rusty sputum, typical lobar pneumonia

p1 adhesin, toxic metabolic

hacking cough, dry productive, slow

polysaccharide capsule, autolysin,

2 stages: elementary body (EB):

asymptomatic to pneumonia or bronchitis,

URINARY TRACT INFECTIONS

URINARY TRACT INFECTIONS

Enterobacteriaceae gram (-) rods, facultative anaerobes,

weakly gram (-)

gram (-), aerobic

gram (-) coccobacilli

aerobic gram (+),

gram (+) cocci,

fever, chills, non-productive cough, chest

hacking cough, dry productive, slow

resembles TB - abscesses and granulomas

pneumonia, wound infections, UTI, sepsis

polypeptide capsule, spore,

FimH (cystitis) - FIMBRIAL

capsule, pili, endotoxin

peritrichous flagella - swarming,

MacConkey agar: clear

adhesins, capsule, endotoxin

dermal, respiratory, GI anthrax, possible

aerobic gram (-)

adhesins, toxins, enzymes

polysaccharide capsule, endotoxin,

Protein A - (-) phagocytosis.

OTHER GRAM (-)

gram (+) cocci,

normal flora, dental caries

low virulence, dextran-mediated

gram (+) cocci,

normal intestinal flora

gram (+) cocci,

normal intestinal flora

complications: embolization from infective

Subacute IE: w/n 2 weeks of dental or other

associated with colon cancer

not bile soluble,

not bile soluble,

URINARY TRACT INFECTIONS

B. quintana most commonly involved

BACTERIAmay include massive arterial emboli and congestive heart failure

Native valve IE: PN