06 Gm negative zoonotic bacilli

• red pillow: gm negative
• starry night and silver color: Warthin-Starry stain, a silver stain

• cat scratch fever
• bacillary angiomatosis

• princess: Cat scratch fever occurs in immunocompetent patients (healthy young princess)
• scratched arm: Cat scratch fever transmitted by cat scratches
• balls around arm: Axillary lymphadenitis. Noncaseating granuloma

• cane: Bacillary angiomatosis affects immunocompromised patients (HIV)
• scratched arm: Bacillary angiomatosis also transmitted by cat scratches.
• red dots: Raised red vascular lesions in bacillary angiomatosis
• mistaken for Kaposi but has neutrophils. Kaposi has lymphocytic infiltrate

• bicycle: Doxycycline treatment for bacillary angiomatosis
• crows: Macrolides can be used to treat either disease

Brucella

• red farm house: Gram negative
• Survive in macrophages, travel to different reticuloendothelial systems and causes enlargement
• open gate: Facultative intracellular organisms

• cow and pig: Direct contact reservoirs: cow, pig
• milk bucket on ground: Ingestion of unpasteurized dairy products

• farmer: Fever and anorexia, primary symptoms
• undulating hills: Undulant fever
• liver/spleen spots: Liver and splenic involvement/enlargement
• fish bone: chronic symptoms, Osteomyelitis

• rifle: Rifampin used for adjunctive therapy, not for contact
• bicycle wheel: Doxycycline

Francisella Tularensis

• red raddish: Gram negative, coccobacilli
• open cage: Facultative intracellular organism, recovery depends on cell mediated immunity
• Rabbits are main reservoir
• ticks from rabbit: Transmitted by dermacentor tick
• can also be aerosolized, as biological weapon

• enters at site of ulcer, gets inside macrophages, travels through lymph nodes, to reticuloendothelial organs
• rabbit hole ulcerating: Painful ulcer at the site of infection
• rotting radish: Granulomas with caseating necrosis in reticuloendothelial organs (i.e. lymph nodes)
• mud pushing up: Regional lymphadenopathy

• sai: Aminoglycosides for treatment

Pasteurella Multocida

• cat: Catalase positive, spread by cat bites as well
• blue ring: Oxidase positive
• capsule: Capsule is important virulence factor
• sheep blood: Grows on 5% sheep agar
• safety pin: Demonstrates double staining, described as a "safety pin"

• cat: cat bite
• dog bit: Transmitted by dog bites

• red bite location: Cellulitis may occur within the first 24 hours
• fish bone: Infection may spread to bone and cause osteomyelitis

• pencil: Empiric treatment is penicillin