Bacteria Flash Cards

Case: An infant born in a rural area is brought to the ER with severe bouts of coughing throughout the day. During the visit, the baby appears cyanotic and suffers an attack of many coughs on a single expiration followed by an inspiratory whoop. The coughs produce a copious greenish phlegm. History reveals that the mother of the child is against the practice of vaccination.

Organism: Treatment: Prevention:

Bordetella Pertussis Supportive, Antibiotics to prevent spread (Erythromycin + Clarithromycin) PT toxoid + FHA Vaccine (DTaP)

Bordetella Pertussis
Structure: Disease: Gram (-) Coccobacillus 3 stages: Catarrhal (wks 1-2): profuse mucoid rhinorrhea (most communicable stage); Paroxysmal (wks 2-4): Persistent Cough + inspiratory whoop, lymphocytosis (up to 40,000/mm3), Convalescent (4 wks+): gradual fade of cough Airborne droplet nuclei (80-100% infectivity) Pertussis toxin (PT), Adenylate cyclase (ACT), Tracheal cytotoxin (TCT), filamentous hemagglutinin (FHA), Pili, Pertactin Isolation via nasal swab (Charcoal agar) Supportive Therapy

Transmission: Virulence Factors:

Diagnosis: Treatment:

Case: A 23 year old male comes into the clinic because he is concerned about appearance of painful lesions on his penis. Physical exam reveals chancroid ulcers and enlarged inguinal lymph nodes (Bubos). When asked about his sexual history he admits that he recently had intercourse with a local sex worker during which the condom that they were using broke. Culture of the ulcer material comes back overgrown with normal flora microbes.

Organism: Treatment:

Hemophilus Ducreyi Azythromycin/Erythromycin, Ceftriaxone, Ciprofloxacin

Hemophilus Ducreyi (Chancroid)

Structure: Disease: Gram (-) Bacillus Erythematous Papules on the Penis which progress to chancroid ulcers (soft and painful), Bubos, Increased chance of HIV infection (CD4 attraction) Microabrasions during sexual intercourse with infected person Antiphagocytic Proteins (2), Chancroid Toxin Hard to diagnose, Clinical, Chocolate Agar w/ antibiotics to normal flora Azythromycin/Erythromycin, Ceftriaxone, Ciprofloxacin

Transmission:
Virulence Factors: Diagnosis: Treatment: .

Case: A 1 year old infant develops a fever. The parents decide to bring her to the hospital when notice that she seems unusually drowsy. Physical exam reveals neck rigidity and occasional seizures. An LP is preformed and culture of the CSF reveals an organism which only grows on chocolate agar media (hemin + NAD).

Organism: Treatment:

Prevention:

Haemophilus Influenzae (90% type B) 3rd Gen Cephalosporin (ceftriaxone), Apicillin amoxacilin, tetracycline, aminogycocides, and sulfonamides Hib Vaccine (capsular polysaccharide)

Haemophilus Influenzae
Structure: Disease: Gram (-) coccobacilli Meningitis, Acute epiglotitis (fever, sore throat, hoarseness, and often a muffled cough), Cellulitis (Tender, reddish-blue swelling in cheek or periorbital areas), Arthritis, Conjunctivitis, Otitis media, Acute chronic sinusitis, and Chronic bronchitis Inhalation of aerosol Pili + Adhesins (attachment to respiratory epithelium), IgA protease, LPR, OMP, Antiphagocytic capsule Blood Culture (chocolate agar), Gram Smear Aminopenicillins, 3rd Gen cephalosporins, tetracycline, aminoglycosides, and sulfonamides.

Transmission: Virulence Factors:

Diagnosis: Treatment:

Case: A traveler returning from New Mexico presents to the ER with fever, dark black skin patches, and enlarged painful lymph nodes in his groin (Bubos). He maintains an awkward pose with extremities extended which he says lessens his pain. Upon physical exam the patient was found to have several flea bites on his torso.

Organism: Treatment:

Yersinia Pestis Tetracycline + Streptomycin

Yersinia Pestis (Plague)

Structure: Disease: Gram (-) Bacillus
Ulcerative necrotic skin lesions, Enlarged painful lymph nodes (Bubos), Bacteremia (DIC, septic shock), necrotizing hemorrhagic pneumonia (Pneumonic Plague; no bubos) Rodents to humans via flea vector, human-to-human via aerosoles F1, V and W antigens (antiphagocytic), YOPs; all expressed at 37C

Transmission: Virulence Factors: Diagnosis: Treatment: .

Culture of bubo fluid Streptomycin + Tetracylcine

Case: An elderly diabetic woman, who recentlyl began swimming to control her weight, complains of painful discharge from her left ear. Physical exam shows extreme tenderness of the the left tragu. A swab culture of the ear reveals oxidase (+) gram negative bacilli producing a blue/green pigment.

Organism: Treatment:

Pseudomonas Aeruginosa Newer Aminoglycosides (Gentamicin), 3rd Gen Cephalosporins (ceftazidime), Carbapenems, Monobactams

Pseudomonas Aeruginosa
Structure: Disease: Gram (-) Bacillus Pneumonia, UTI, Endocarditis, osteomyelitis, External Otitis, Folliculitis (hot tub infection); Most commonly in patients with weakened immunity and CF patients Opportunistic infection from environment (soil, water, vegetation), normal flora (GI) Mucoid exopolysaccharide/Alginate capsule, Exotoxin A, Exoenzyme S, Elastase, Phospholipase C Culture (Oxidase (+)), pyocyanin (pigment) Newer Aminoglycosides (Gentamicin), 3rd Gen Cephalosporins (ceftazidime), Carbapenems, Monobactams

Transmission:

Virulence Factors:

Diagnosis: Treatment:

Case: A teenager complains of pain during sexual intercourse and irregular intermenstrual bleeding. She has also begun to experience lower abdominal pain. A pelvic exam reveals a yellow mucopurulent discharge; during the exam, the cervix begins to bleed. Gram stain of discharge reveals gram (-) intracellular diplococci. The teenager reports that she has been sexually active with several partners over the last year. One of her partners, a male, comes to the same clinic complaining of dysuria and profuse yellow urethral discharge.

Organism: Treatment:

Neisseria Gonorrhoeae 3rd Generation Cephalosporin (Ceftriaxone)

Neisseria Gonorrhoeae
Structure: Disease: Gram (-) Diplococci Women: Urethritis, cervicitis (vaginal discharge, urinary frequency, dysuria, abdominal pain, and menstural abnormalities), PID, Sterility, septic arthritis Men: purulent urethral discharge and dysuria: can lead to epididymitis and protatitis Sexual Intercourse w/ infected person LOS, Pili, Opas Proteins, Sialic Acid Capsule Culture in glucose but not maltose on Thayer-Martin media 3rd gen Cephalosporin

Transmission: Virulence Factors: Diagnosis: Treatment:

Case: Early one evening, a young soldier in an army base enters the emergency room with a petechial rash, fever, and headache. Physical exam reveals (+) Kernigs sign (pain and resistance upon extension of the leg at the knee during thigh flexion), Nochal Rigidity, and impaired mental status. An LP is performed showing increased PMNs and protein, decreased glucose, and gram negative diplococci.

Organism: Treatment:

Neisseria Meningitidis Penicillin, 3rd generation Cephalosporin (Ceftriaxone)

Neisseria Meningitidis
Structure: Disease: Gram (-) diplococci Meningitis (Neck stiffness (nuchal rigidity) and headache), Petechial rash, may progress to shock Droplette inhalation, present in the normal flora of 10% of health people Lipooligosaccharide (LOS), Polysaccharide Capsule, Endotoxin Culture in maltose + glucose (ThayerMartin media) Penicillin G, Ceftriaxone

Transmission:

Virulence Factors: Diagnosis: Treatment: .

Case: An alcoholic presents with a fever, pleuritic chest pain, dyspnea, and cyanosis. His cough produces a bloody sputum. CXR shows inflammation involving the right upper lobe with possible cavities. Culture reveals a lactose fermenting encapsulated gram (-) bacillus

Organism: Treatment:

Klebsiella Pneumoniae 3rd Generation Cephalosporin (Ceftriaxone)

Klebsiella Pneumoniae
Structure: Disease: Transmission: Diagnosis: Treatment: . Gram (-) bacillus Pneumonia, UTI Fecal Oral Clinical + Culture 3rd Generation Cephalosporin

Case: An aged man comes to the hospital complaining of upper abdominal pains, which becomes worse after a meal. A biopsy of the stomach mucosa is found to be urease positive and labeled CO2 is observed on his breath after ingestion of labeled urea.

Organism: Treatment:

Helicobacter Pylori BMT (Bismuth Therapy) + 2 antibiotics (Amoxicillin , Clarithromycin, Metronidazole, Tetracycline)

Helicobacter Pylori
Structure: Disease: Transmission: Virulence Factors: Gram (-) Bacillus Gastritis, Gastric/Duodenal Ulcer, gastric carcinoma Fecal Oral Urease (allows survival in acidic pH), Vacuolating Cytotoxin, Cag Protein, Biopsy of gastric mucosa (Urease (+)), Urea Breath test, IgG titer in serum Bismuth Salts + Amoxicillin, Clarithromycin, Tetracycline, Metranidazole

Diagnosis:

Treatment: .

Case: A patient whose appendix was removed is put on gentamicin to suppress gram (-) aerobes causing the initial infection. The patients fever declines, only to spike some hours later. Imaging of the patients abdomen detects an abscess which has formed. The area near the abscess is also noted to have a reduced blood supply. Culture of the abscess reveals a gram (-) organism.

Organism: Treatment:

Bacteroides Fragilis Drain Abscess + Antibiotic (Metronidazole, Clindamycin, imipenem, ceftriaxone); resistant to most beta lactams

Bacteroides Fragilis
Structure: Disease: Transmission: Gram (-) Bacillus (Anaerobe) Abdominal abcess, deep pain, can spread causing septic shock Normal Gut flora which spills into the peritoneum via trauma, surgery, or perforation Polysaccharide Caspule (prevents phagocytosis, promotes abscess formation) Clinical, Culture Drain abscess + antibiotics (Metronidazole, Clindamycin, Imipenem, Ceftriaxone)

Virulence Factors:

Diagnosis: Treatment: .

Case: An old woman comes to the doctor with a fever and loose bowels. Her diarrhea occurs in tremendous volumes, although she doesnt ever remember seeing blood. She has an unremarkable recent past medical history, except for an infection a few weeks earlier that was treated with clindamycin. Sigmoidoscopy of her colon reveals yellow-white plaques.

Organism: Treatment:

Clostridium Difficile Oral metronidazole, Oral Vancomycin

Clostridium Difficile
Structure: Disease: Gram (+) Bacillus (Anaerobe) Diarrhea (watery or bloody), abdominal cramping/pain, leukocytosis, fever Small portion of intestinal flora which is allowed to overgrow during antibiotic treatment Toxin A, Toxin B Toxin detection in stool Oral metronidazole or oral vancomycin

Transmission:

Virulence Factors: Diagnosis: Treatment: .

Case: A teenage girl enters the emergency room suffering painful muscle spasms. Throughout her examination, she sustains a facial sneer, a stiff arched back, and clamped palms. Her father is anxious about the fact that she has also experienced difficulty eating, probably due to a stiff jaw. The father affirms that his daughter is usually quite active and boasts how, a week ago, she continues a soccer game even after falling on a nail in the field

Organism: Treatment: Prevention:

Clostridium Tetani Human antitoxin, Diazepam, Metronidazole, Penicillin Tetanus Toxoid (DTAP vaccine)

Clostridium Tetani
Structure: Disease: Gram (+) Bacillus (Anaerobe) Spastic paralysis, sustained muscle contraction (tetus), masseter muscle most sensititve (lockjaw) Wound contamination with spores found in soil or foreign bodies Tetanospasmin Toxin (TeTx) Clinical, culture Human Tetanus Immune Globulin (HTIG)

Transmission:

Virulence Factors: Diagnosis: Treatment: .