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