sketchy

• Widened mediastinum on chest x-ray if pulmonary infection
• B.cereus classically causes vomiting after eating reheated rice
• Large gram positive rods in chains
• Flouroquinolone treatment
• Tetracycline treatment
• Spore forming
• "Wool sorters disease"- classically causes pulmonary infection in those who work with wool.
• Protein capsule composed of poly-D-glutamic acid
• Edema factor
• Edema factor acts by causing elevation in cAMP
• Lethal factor
• Lethal factor responsible for tissue necrosis
• Most common manifestation of infection is cutaneous black eschar
• Pulmonary infection may lead to pulmonary hemorrhage
• Spore forming
• Spores found in soil
• Obligate anaerobe
• Lock jaw and facial spasms (risus sardonicus)
• Vaccine consists of deactivated toxin (same color orange)
• Tetanus toxin: cleaves SNARE
• Tetanus toxin: cleaves SNARE preventing release of inhibitory neurotransmitters GABA and Glycine
• Tetanus toxin inhibits inhibitory neurotransmitter release from Renshaw cells in spinal cord (wrench and saw)
• Muscle spasms cause arched back
• Tetanus toxin migrates to CNS via retrograde axonal transport
• Endospores transmitted via puncture wound from rusty nail
• Endospores transmitted via puncture wound from barbed wire
• Spore forming
• Transmitted by home canned food
• Obligate anaerobe
• Descending flaccid paralysis
• Ptosis
• Endospores found in honey
• Botulism toxin prevents acetylcholine release at neuromuscular junction
• "Floppy baby"
• Obligate anaerobe
• Toxin detected in stool
• Spore forming
• Clindamycin: C. Diff infection after antibiotic use
• Exotoxin A
• Exotoxin A attaches to brush border
• Exotoxin
• Exotoxin B disrupts cytoskeleton by depolymerizing actin
• Pseudomembranous colitis
• Watery diarrhea
• Oral vancomycin for treatment
• IV metronidazole for treatment
• Obligate anaerobe
• Spores found in soil
• May cause slow onset diarrhea
• Infection associated with motorcycle accidents and other major trauma
• Double zone of hemolysis when plated
• Penicillin treatment
• Causes "gas gangrene"
• Alpha-toxin disrupts cell membrane function
• Alpha-toxin also has hemolytic activity
• Infection associated with deep penetrating military wounds
• Metachromatic granules (red and blue)
• ADP ribosylation of elongation factor 2
• Pseudomembrane on throat and tonsils
• Bull neck
• Transmitted by respiratory droplets
• Cardiotoxic effects: myocarditis, arrhythimia, heart block
• Demyelination causes nerve deficits starting in posterior oropharynx
• b"Plated on Loeffler's medium"
• b"Elek's test"
• Inactivated pertussis toxoid vaccine
• Club shaped rods in V or Y formation
• Plated on Tellurite agar
• Common cause of neonatal meningitis
• Catalase positive
• Tumbling motility
• Beta hemolytic
• Facultative anaerobic bacterium
• Motile with flagella at 30 \xc2\xb0C and below
• May be acquired transvaginally- pregnant women may be advised not to eat soft cheese
• Treatment with ampicillin
• At body temperature, motile by actin polymerization, or "actin rockets"
• Transmitted from dairy products
• Transmitted by consumption of certain of cheeses

• Infection also prevalent in elderly population

• Obligate anaerobe
• Formation of sinus tracts
• Treat with penicillin
• Gram positive filamentous rod

• Infection associated with jaw trauma

• Yellow sulfur granules
• Urease positive
• Gram-positive branching filamentous rod. - Similar to actinomyces
• Obligate aerobe
• Found in soil
• Mycolic acids
• Catalase positive
• Immunocompromised especially affected
• Pneumonia like symptoms
• Associated with cavitary lesions in lung
• Brain abscess formation
• Cutaneous symptoms- indurated lesions and inflammatory reaction
• Treat with sulfonamides
• Partially acid fast
• Oxidase positive
• Growth on VPN agar
• Growth on VPN agar
• Growth on VPN agar
• Gram negative diplococci
• Growth on chocolate agar
• Alternate name for VPN agar
• Patients with C5-C9 deficiency are unable to form MAC complex, leading to increased infections
• C5-C9 deficiency
• Pili demonstrate antigenic variation
• IgA protease - cleaves IgA at hinge region
• Easily spread in close quarters like college dorms
• Ferments maltose in addition to glucose
• Colonizes nasopharynx first. Transmitted by respiratory secretions.
• Polysaccharide capsule inhibits phagocytosis
• Polysaccharide capsule inhibits phagocytosis
• Vaccine contains polysaccharide capsule
• Type B capsule not included in vaccine
• Sickle cell and asplenic patients at higher risk of infection
• LOS envelope proteins cause inflammatory response
• Inflammation leads to leaky capillaries
• Inflammation leads to leaky capillaries
• Characteristic petechial rash indicates thrombocytopenia
• Petechial rash from thrombocytopenia. Risk of DIC
• Petechial rash from thrombocytopenia. Risk of DIC
• Petechial rash from thrombocytopenia. Risk of DIC
• Petechial rash from thrombocytopenia. Risk of DIC
• Capillary leakage can lead to hypovolemia and shock
• Waterhouse-Friderichsen syndrome, characterized by hemorrhage of adrenals
• Ceftriaxone treatment
• Rifampin prophylaxis in close contacts
• IgA protease - cleaves IgA at hinge region
• Asymmetric arthritis, commonly in knee
• Gram negative diplococci, facultative intracellular in PMNs
• not encapsulated
• Causes Pelvic Inflammatory Disease in females
• Characteristic white purulent discharge
• Violin string adhesions form to capsule of liver
• Fitz Hugh Curtis Syndrome: spread of PID into peritoneum
• Early onset conjunctivitis in newborns
• Ceftriaxone treatment
• Chlamydia coinfection
• Chlamydia coinfection
• Sexually Transmitted Infection (the sexual tension is palpable)
• Ceftriaxone treatment
• Gram negative diplococci, facultative intracellular in PMNs
• Ceftriaxone treatment
• Urease positive
• Lactose fermenter
• Pink on MacConkey Agar
• Capsule
• Alcoholics
• Abscesses
• Aspiration
• "Currant" jelly sputum
• Immotile
• Klebsiella
• Enterobacter
• Motile
• Motile
• Serratia
• Produces red pigment
• Pneumonia
• Cavitary lesion
• Urinary tract infection
• Multidrug resistant
• Acid-labile
• Salmonella is motile
• H2S positive, black colonies on Hektoen Agar plate
• Capsule
• Salmonella enteritidis
• Salmonella typhi
• The reservoir for Salmonella enteritidis is the chicken
• Salmonella typhi in the gallbladder of chronic carriers
• Typhoid Mary
• Rose colored macules
• Osteomyelitis
• In Sickle Cell disease
• "Pea soup" diarrhea
• Fluoroquinolones treatment (ie Cipro)
• Live attenuated vaccine
• Inflammatory diarrhea
• Type III secretion system
• Facultative intracellular within macrophages
• Facultative intracellular within macrophages
• Acid stable
• Green colonies on Hektoen agar
• Immotile
• Use of actin filaments
• Invasion of M cells
• Blood in stool
• Inflammatory diarrhea
• Glomerular damage
• Drop in platelet counts
• Red blood cell hemolysis
• HUS common in young children
• Toxin binds to 60S subunit of ribosomes
• Type III Secretion System
• Shiga-like toxin can cause HUS
• Most common cause of UTI
• Catalase positive
• Lactose fermenter
• Pink on MacConkey Agar
• Encapsulated
• K Antigen
• Green on EMB agar
• Fimbriae
• Sepsis
• Neonatal meningitis
• Only if it has K antigen
• Transmitted by eating undercooked meat
• Bloody diarrhea
• Does NOT ferment sorbitol
• Damages endothelial cells in the glomerulus
• Platelet aggregation and decrease in platelet count
• Red blood cell hemolysis
• O157:H7 antigen is associated with outbreaks
• b"Traveler's diarrhea"
• Transmitted via water
• L = Labile A = cAMP
• S= Stable G = cGMP
• Watery diarrhea
• Bipolar staining, sometimes described as having a safety pin appearance
• Killed vaccine can be used to prevent transmission
• Streptomycin (with tetracycline) for treatment
• Resistant to cold temperatures
• Y. enterocolitica transmitted through puppy feces
• Infection can mimic appendicitis symptoms
• May be transmitted through contaminated milk products
• Toddlers are commonly affected by Y. enterocolitica
• Transmitted by flea bites
• Gram negative organism
• Characteristic buboes form on skin
• Uncontrolled spread can cause organ abscess, cutaneous hemorrhage, and tissue necrosis.
• Yops secreted via type III secretion systems
• Tetracyclines (with streptomycin) for treatment
• Prairie dogs main reservoir in United States
• Encapsulated
• Causes bloody diarrhea
• Grows at 42 degrees C
• Poultry reservoir
• Curved gram negative rod
• Oxidase positive
• Invasive
• Reactive arthritis
• Guillain-Barre syndrome - Ascending paralysis
• Oxidase positive
• Comma shaped mustache
• Rice water stools
• Watery diarrhea
• Fecal-oral transmission
• Gram negative
• Fimbrae attachment
• Increases cAMP
• Activates Gs pathway
• Oral rehydration therapy
• Grows on alkaline media
• Acid labile
• Urease positive
• Motile
• Curved gram negative rod
• Oxidase positive
• Duodenal ulcers
• Increased risk of gastric adenocarcinoma
• Mucosa associated lymphoid tissues (MALT)
• Proton Pump Inhibitor (PPI)
• Amoxicillin
• Clarithomycin
• Duodenual ulcers
• Catalase positive
• Gram negative rod
• Thrives in aquatic environment
• Oxidase positive
• Produces blue-green pigment (pyocyanin and pyoverdin)
• Produces fruity grape odor
• Obligate aerobe
• Nosocomial pneumonia and respiratory failure in cystic fibrosis patients
• Osteomyelitis in diabetics and IV drug users
• Encapsulated
• Infection associated with burn patients
• Nosocomial urinary tract infections
• Ecthyma gangrenosum - black necrotic lesions on skin
• Otitis externa
• Toxin inactivates EF-2 by ribosylation (Same mechanism as Diphtheria toxin)
• Piperacillin for treatment
• Fluoroquinolones
• Aminoglycosides
• Urease positive
• Swarming motility when plated
• Forms staghorn calculi
• Alkaline environment can cause struvite stone production
• May cause UTI
• Fishy odor
• Treat with sulfonamides
• Filamentous hemagglutinin
• Adenylate cyclase toxin: acts like Anthracis EF toxin
• Pertussis toxin increases cAMP
• Tracheal toxin
• 100 day cough: convalescent stage can last for months
• DTaP vaccine has acellular Pertussis antigens
• Lymphocytosis
• Paroxysmal stage: Whooping cough
• Gi disabled by Pertussis toxin
• Pertussis toxin rirosylates Gi
• Macrolide treatment
• Transmitted by respiratory droplets
• Coccobacillary shape
• factor V (nicotinamide) added to chocolate agar
• Rifampin prophylaxis for close contacts
• Ceftriaxone for meningitis or systemic disease
• Epiglottitis
• Vaccine is polysaccharide conjugated to Diphtheria toxoid
• Vaccine for ages 2-18 months
• Factor X (hematin) added to chocolate agar
• Strains with type B vaccine cause meningitis
• Aerosol transmission
• Grown on chocolate agar
• Cherry red epiglottis
• Increased risk of infection in sickle cell or asplenic patients
• Otitis media
• Meningitis in children
• Vaccine for H. flu type B
• Gram negative but needs silver stain to be visualized
• High fever
• May present with headache and confusion
• b"Pneumonia with diarrhea suggestive of Legionnaires' disease "
• Grown on charcoal yeast extract
• Fluoroquinolone may also be used for treatment
• Oxidase positive
• Growth requires presence of iron and cysteine
• Urine antigen test for rapid diagnosis
• Hyponatremia
• b"Legionnaires' disease more common in smokers "
• X-ray shows patchy infiltrate with consolidation of one lobe
• Pontiac fever: self limited fever and malaise
• Macrolides for fever
• Axillary lymphadenitis
• Cat scratch fever occurs in immunocompetent patients (healthy young princess)
• Cat scratch fever transmitted by cat scratches
• Warthin-Starry stain
• Macrolides can be used to treat either disease
• Bacillary angiomatosis also transmitted by cat scratches.
• Bacillary angiomatosis affects immunocompromised patients
• Raised red vascular lesions in bacillary angiomatosis
• Doxycycline treatment for bacillary angiomatosis
• Axillary lymphadenitis
• Direct contact: cow
• Liver involvement
• Gram negative
• Splenic involvement
• Ingestion of unpasteurized dairy products
• Rifampin used for adjunctive therapy
• Facultative intracellular organisms
• Undulant fever
• Doxycycline
• Fever and anorexia
• Osteomyelitis
• Direct contact: pig
• Painful ulcer at the site of infection
• Transmitted by dermacentor tick
• Regional lymphadenopathy
• Rabbits are main reservoir
• Facultative intracellular organism
• Regional lymphadenopathy
• Aminoglycosides for treatment
• Granulomas with caseating necrosis in reticuloendothelial organs (i.e. lymph nodes)
• Gram negative, coccobacilli
• Catalase positive
• Oxidase positive
• Infection may spread to bone and cause osteomyelitis
• Capsule is important virulence factor
• Demonstrates double staining, described as a "safety pin"
• Empiric treatment is penicillin
• Cellulitis may occur within the first 24 hours
• Transmitted by dog bites
• Grows on 5% sheep agar
• Primary TB: infects middle or lower lobe of lung
• Primary TB: Hilar lymph node calcification
• Mycobacterium cowboy: acid-fast gunslinger
• cord factor
• TB grows on Lowenstein-Jenses medium
• Proliferates in macrophages
• Symptoms of reactivation: cough, hemoptysis, night sweats
• Obligate aerobe
• Reactivated TB: affects upper lung lobes
• CNS involvement with cavitary lesion or tuberculoma
• b"Pott's disease "
• RIPE: Rifampin, isoniozid, pyrazinamide, ethambutol
• Reactivation with TNF alpha inhibitors
• BCG vaccine can cause a false positive skin test
• Latent infection
• Positive PPD test
• Fibrosis
• Miliary TB can be lethal
• Necrotic macrophages
• Phagosome and lysosome unable to fuse
• Sulfatides (spurs)
• Mycolic acids
• Carbol fuchin stain
• Rifampin and isoniazid for prophylaxis
• Ghon complex: Hilar lymphadenopathy + peripheral granulomatous lesion in middle or lower lung lobe
• Miliary T
• Tuberculoid leprosy: Th1 response with cell mediated immunity
• Treatment: Dapsone
• Tuberculoid leprosy: well-demarcated, hairless, hypoesthetic skin lesion
• Tuberculoid leprosy: able to contain bacteria within macrophages
• Tuberculoid leprosy: positive Lepromin skin test
• Armadillo is main reservoir in United States
• Treatment: Rifampin
• Thrives in cool temperatures: predilection for extremities
• Treatment: Clofazimine
• Lepromatous leprosy: bacteria unable to be contained by macrophages
• Lepromatous leprosy: Th2 mediated humoral response
• Carbol fuchsin stain
• Lepromatous leprosy: leonine facies
• Lepromatous leprosy: symmetric glove and stocking neuropathy
• Lepromatous leprosy: poorly demarcated raised lesions on extensor surfaces of extremities
• Human to human transmission
• Humoral response (laughing)
• Mycolic acids
• Mycobacterium cowboy: Acid-fast gunslinger
• Transmitted by bite of tick living in wooded areas
• Primarily Northeastern United States
• b"Visualized by Wright's stain"
• Flu-like symptoms
• "Bull\'s eye" rash
• Spirochete
• b"Bilateral Bell's palsy "
• b"Bilateral Bell's palsy "
• White-footed mouse main reservoir (host of tick larvae)
• Doxycycline treatment if caught in early stage
• Ixodes Scapularis species of tick
• Tick is the vector
• Ceftriaxone treatment if more severe or later presentation
• Heart block caused by Myocarditis
• White-tailed deer obligatory host (host of adult tick)
• Encephalopathy
• Migratory polyarthritis
• Visualized by Giemsa stain
• Conjunctival suffusion
• Leptospira found in water contaminated with animal urine
• b"Weil's disease can cause liver dysfunction and jaundice "
• Described as spiral shaped or question mark shaped
• b"Weil's disease "
• Leptospira affects multiple different organs by hematogenous spread
• Leptospira can cause kidney dysfunction
• Fever
• Spirochete: may be described as spiral shaped
• Darkfield microscopy needed for direct visualization
• Possible false positive antigens
• FTA-ABS is specific test to confirm a positive screening result
• Primarily syphilis characterized by painless genital chancre
• Jarisch-Herxheimer reaction characterized by fever and chills
• Congential- Saber shins, an anterior bowing of tibia
• Congenital- saddle nose
• Tertiary- aneurysm of ascending aorta with "tree-barking" appearance
• Formation of gummas: soft growths with firm necrotic center
• b"Congenital- Hutchinson's teeth and Mulberry molars "
• Destroys vasa vasorum that supplies aorta with blood
• Jarisch-Herxheimer reaction may occur hours after treatment
• Congenital deafness
• Tertiary: Argyll Robertson pupils, reacts to accommodation but NO REACTION TO LIGHT
• Tertiary: damage to posterior column of spinal cord
• Treatment: Penicillin for all stages
• Test spot
• Systemic disease
• May see condyloma latum on mucous membranes
• Maculopapular rash occurs on palms and soles weeks to months after infection
• Spirochetes can be visualized within condyloma latum via darkfield microscopy
• VDRL is a screening test for trepenoma
• Add Ceftriaxone to treatment for gonorrhea coinfection
• Obligate intracellular organism
• Poor gram staining
• Cell wall lacks muramic acid
• 1st lifestyle stage: elementary body, infectious form, outside of organism and needs to enter
• 1st lifestyle stage: elementary body, infectious form, outside of organism and needs to enter
• 2nd stage: reticular body active form that can divide and replicate
• Final stage: release back out of cell into elementary body
• Inclusion bodies visible within cells under microscope
• May be visualized with Giemsa stain
• Commonly diagnosed by NAAT (nucleic-acid amplification test)
• D-K STI characterized by watery discharge
• D-K STI If left untreated, may lead to pelvic inflammatory disease (PID)
• D-K STI Newborns born to infected mothers can develop conjunctivitis and pneumonia
• L1-L3 LGV Lymphogranuloma venereum characterized by tender inguinal lymphadenopathy
• A-C blindness leading cause of blindness world wide
• A-C: blindness transmitted by hand to eye contact, or fomites
• Reactive arthritis
• b"Reiter's syndrome- uveitis"
• b"Reiter's syndrome- urethritis"
• b"Reiter's syndrome- arthritis"
• Chlamydophila pneumoniae causes atypical pneumonia
• Chlamydophila psittaci also causes pneumonia, transmitted by bird droppings
• May use macrolides for treatment, oral macrolides effective against trachoma
• Doxycycline is effective treatment
• Commonly coinfected with gonorrhea
• Chlamydia divided into three groups, Trachomatis also divided into three groups
• Headache
• Gram negative
• No rash caused
• Q-fever
• Obligate intracellular organism
• Contained in spore like structures in animal feces
• Transmitted to humans via aerosol transmission, farm animals are major reservoir
• Pneumonia
• Fever
• May cause hepatitis
• Metronidazole for treatment
• Gram variable staining
• Bacterial overgrowth that disrupts normal flora is method of infection
• Grayish-white malodorous "fishy" discharge
• Infection occurs when pH over 4.5
• KOH whiff test
• Clue cell = epithelial cells coated with bacteria visible under microscope
• Macrolide for treatment because no cell wall
• b"No cell wall, can't appear on gram stain"
• Cell membrane contains cholesterol
• X-ray shows reticulonodular or "patchy" infiltrate, appears much worse than patients seem clinically
• Walking pneumonia
• Common in military recruits living in close quarters
• Commonly occurs in young adults
• IgM cold agglutinins cause agglutination of red blood cells
• b"Eaton's agar"
• Poor gram staining
• Headache and fever in early Rickettsial infection
• Rash may be associated with vasculitis
• Doxycycline for treatment
• Weakly gram negative
• Coccobacillary shape
• Unable to produce CoA, gets it from eukaryotic cells
• Vasculitis
• Unable to produce NAD+, important for bacterial growth and reproduction
• Weil-Felix agglutination test for Rickettsial infections
• Obligate intracellular organism
• Encephalitis, with and confusion. can cause coma if very serious
• Obligate intracellular organism
• Require CoA and NAD+ for growth
• Doxycycline treatment
• Rash starts at trunk, and spreads outward towards extremities
• Rash spares hands, head, and feet
• Affects military camp recruits and prisoners of war
• Spread by louse, defecates near bite spread to blood by scratching.
• Spread by louse
• Spread by louse
• Illness is called epidemic typhus
• Causes myalgia and arthalgia
• Causes pneumonia
• Doxycycline for treatment
• Obligate intracellular organism
• Poor gram staining
• CoA and NAD+ necessary for growth, provided by host
• Transmitted by direct bite of Dermacentor ticks
• Transmitted by direct bite of Dermacentor ticks
• Rash not immediate, incubation period between 2-14 days
• Rash begins at extremities
• Rash spreads centrally from extremities
• Symptoms include headache, fever, myalgias