07 Mycobacterium
- Mycobacterium cowboy: acid-fast gunslinger
- Fuschin color: Carbol fuchin stain
- tassels: Mycolic acids
- lowenstein general store: TB grows on Lowenstein-Jenses medium
- air bellow: Obligate aerobe
- latent
- miliary and systemic, multiorgan failure
- reactivation
- Primary TB: infects middle or lower lobe of lung
- Primary TB: Hilar lymph node calcification
- cactus with holes in middle lobe and hilar involvement, gun complex: Ghon complex: Hilar lymphadenopathy + peripheral granulomatous lesion in middle or lower lung lobe
- Proliferates in macrophages
- cord: cord factor (serpentine shaped) secreting TNF-a to activate macrophages and walled off in granuloma
- spur and clouds: Sulfatides (spurs), phagosome and lysosome unable to fuse
- broken down carts: Necrotic macrophages, caseating granulomas
- sleeping kid: Latent infection common after primary infection kids
- sleeping kid with sac: Fibrosis
- shovel: Positive PPD test
- BCG vaccine can cause a false positive skin test
- Millet seeds everywhere: Miliary TB
- cow skull: Miliary TB can be lethal
- TNF guy bound: neurtralized TNF > reactivation
- Reactivation with TNF alpha inhibitors
- guy coughing blood and sweating at night: Symptoms of reactivation: cough, hemoptysis, night sweats
- wasting from TNF alpha
- 2nd cactus: Reactivated TB: affects upper lung lobes
- bullet in hat: CNS involvement with cavitary lesion or tuberculoma
- pots damaged: Pott's disease, multiple vertebrae affected, demineralization of bone, soft tissue swelling
- RIPE: Rifampin, isoniozid, pyrazinamide, ethambutol
- Rifampin and isoniazid for prophylaxis
Mycobacterium Leprosy
aka Hansen's disease.
- tassles: Mycolic acids
- Mycobacterium cowboy: Acid-fast gunslinger
- gun: Carbol fuchsin stain
- armadillo jail and armadillo: Armadillo is main reservoir in United States
- Winter scene: Thrives in cool temperatures: predilection for extremities
- tuberculoid
- lepromatous
- Jail cell 1: Tuberculoid leprosy: Th1 response with cell mediated immunity
- Jail: Tuberculoid leprosy: able to contain bacteria within macrophages
- bald head: Tuberculoid leprosy: well-demarcated, hairless, hypoesthetic skin lesion
- rifle and deputy: Treatment: Rifampin/dapsone
- shovel in dirt: Tuberculoid leprosy: positive Lepromin skin test, good cell mediated response
- Jail 2: Lepromatous leprosy: bacteria unable to be contained by macrophages
- prisoner laughing: Lepromatous leprosy: Th2 mediated humoral response
- touching hands: lepromatous human to human transmission
- lion's face mask: Lepromatous leprosy: leonine facies
- gloves: Lepromatous leprosy: symmetric glove and stocking neuropathy
- skin lesions on arm/legs: Lepromatous leprosy: poorly demarcated raised lesions on extensor surfaces of extremities
- clothe: Treatment: Clofazimine along with rifampin/dapsone
