BACTERIA Identification - family Gram (+) Cocci Staphloccoccus faculative anaerobic, but grow best aerobic "grape-like clusters"

hemolysis (-) Species Murray p 221 S. aureus Identification - species Transmission Virulence factors Diseases Keynote Sx Pathology

gold colonies

physical contact fomites aspiration

Capsule

coagulase (+)

Significant PG Protein A, Teichoic acid Hyaluronidase

Skin infection (Scalded Skin Syndrome) Impetigo Toxic Shock Syndrome Pneumonia

bullous exfoliative dermatitis w no scarring honey crusted lesion sudden F, multi-organ involve., diffuse exfoilative Rash yellow-green sputum, sudden F w prolonged chills acute D/V

Toxin-mediated

TSST-1

catalase (+)

PV leukocidin

growth on blood agar, 10% NaCl

Fibrolysin

Enteritis

thick peptoglycan coat --> stains violet NO flagella, non-mobile, non-spore forming S. epidermidis white colonies coagulase (-) white colonies coagulase (-) "

Penicillinase Exotoxins (poreforming) Enterotoxins (super Ag)

Osteomyelitis

Wound infections 1o cause in artifical HT Prosthetic, surgical, wound valves: 50% of catheter infx, hip replacement infection Urinary Tract infection dysuria, pyuria

intense back pain w F, Brodies Abscess red, pain, pus

heat stable enterotoxin on improperly refrigerated food 2o to trauma, blood spread foreign body in wound PG SLIME layer sticks to devices

S. saprophyticus

"

Streptococcus found in pairs growth w CO2 faculative anaerobic

Murray p 237 S. pyogenes (Group A)

susceptable to bacitracin B-hemolytic (+)

Respiratory break in skin fomites

Capsule M-Protein Streptolysin O (higly immunogenic)

Pharyngitis Impetigo (Pyoderma) Scarlet Fever

sore throat vesicles --> pustules, then rupture and crust over strawberry red tongue, maculopapular rash (NOT around mouth, hands/feet), F septicemia following childbirth red streaks, NO clear borders, peau d'orange, Systemic S/Sx shiny red lesion w well defined borders, marked lymphangitis HTN, edema, hematuria, RBC cast (+), anti-DNAse (+)

rapid strep test (+), high anti-ASO titr

rapid strep test (+), high anti-ASO titre

hemolysis (+)

arthropod vector

Streptolysin S (cz Bhemolysis) Streptokinase (lyse blood clots) Strep Pyrogenic Exotoxin (SPET) DNAase (group A)

catalase (-)

Puerperal fever = "Childbed Fever" Cellulitis

Erysipelas

Glomeroloneph ritis

Toxic shock syndrome Rheumatic fever

S. agalatiae (Group B)

(+) CAMP make long chains Bacitracin, ABC resistant B-hemolytic (+)

birth

CAMP factor (enhances hemolysis)

Rheumatic heart disease Neonatal meningitis Urinary Tract infection

sudden F, hypotension, multi-organ involvement, NO exfoliative rash damage to HT, joints, subQ tissue; (CHANCE = chorea, arthritis, nodules, carditis, d/t mitral valve damage from RF, CHF fetal distress, foul smelling amniotic fluid, apnea, cyanosis, DIC, F, etc

Type III hypersensitivity rxn; Ab-Ag deposit in glomerulus, cz inflamm damage no single virulence factor, SPET X-reacting Ab to strep proteins & similar proteins in HT

if mom doesn't have IgG or suffc complement

S. enterococcus (Group D)

pairs or short chains

selfinnoculation, some pt-pt spread endogenous spread mostly winter 85 Ag capsular polysacch no major toxins changes penicillin binding protein Techioc acid (reacts w C-reactive protein) large sticky dextran capsules

Upper respiratory infection Needle stick Upper respiratory infection meningitis Otitis media sepsis "rust" blood-tinged sputum, starts w sudden shaking chill, high F

S. pneumonia

ABC resistant "lancet shaped"

a-hemolytic (+) ABC resistant inhibited by optochin

S. viridans

must have B6 to grow a-hemolytic (+)

Endocarditis Bacteremia Abscess formation Wound/trauma tic injury

Gram (-) diplococci Nesseiria Facultative anaerobic

Murray p. 311 N. gonorrheoea

Needs CO2

Human sole carriers

Pili

Urethritis

Fastidious growth in culture

Can only ferment glucose

STD (#2 m/c)

Por protein - prevent phagocytocis

Pelvic inflammatory dz Conjunctivitis

grows best at 35-37C in humidity coffee bean Transparent, nonpigmented colonies on chocolate blood agar oxidase (+) catalase (+) N. meningitidis

require cysteine for growth cannot live in dry conditions or w FA diplococci can be inside PMN cells (+) ELIZA or LCR for Ag Can ferment glucose & maltose close contact respiratory droplets

LOS (an endotoxin w no strain specific O Ag)

Men: Purulent urethral discharge, Women: Cervicitis, vaginal discharge Migratory arthralgias, tender papillary lesions on extremities, F, maculopapular rash Purulent conjunctivitis, sticky discharge, edema, inflamm

Arthritis IgA protease neutralizes IgA

Pili

Septic meningitis

Small petechial rash on trunk WaterhouseFriderichsen syn: high F, DIC, shock, bilat destruction of adrenals, can lead to acute meningitis

bug attaches to non-ciliated epithelium, passes to submucosa where can enter bloodstream and CSF

Capsule LPS = endotoxin that cz shock LOS = lipooligosaccharide

Gram (+) endo-spore forming rods Clostridium strict anaerobic

Murray p. 401 C. Botulinum

sausage shaped

contaminated food (esp alkaline foods), honey

Spore formation

Botulism

No GI distress, No F, Dilated fixed pupils, furry tongue, bilat descending weakness & flaccid paralysis, Respiratory paralysis

toxin prevent release of Ach in autonomic & motor N

large

B-hemolytic on sheep blood agar Grows best > 4.5 pH Spores can survive temp extremes & irradiation C. perfringens Plump rectangular rod

food tastes 7 Ag diff Botulinum looks/tastes ok, toxins - Strain A,B,E m/b bubbling m/c cz of dz cooking food destroys toxin very very tiny infective dose

spores in wounds, eating contaminated food (esp meat and gravies) need large infective dose

Spore formation

Myonecrosis (gas gangerene)

Rapid onset of intense pain, extensive muscle necrosis toxic delerium

Non-motile Rapidly spreading growth in sheep blood agar Needs devitalized tissue to grow best Favours O2 & pH (ie ischemic tissue) "double zone" of hemolysis indicates lecithinase heat destroys enterotoxin

Enterotoxin --> super Ag Alpha toxin (Lecithinase = phospholipase C) --> necotizing activity Beta toxin

Food poisoning

Abd cramps, watery diarrhea, NO F, N/V

Damage d/t alpha toxin that kills any cell in path, enzymes ferment sugars and produce bubbles enterotoxin type A

C. Tetani

tennis raquet shape

punture wounds

Spores

Tetanus (General, Localized, Cephalic, Neonatal)

General: Exaggerated DTRs, trismus, risus sardonicus, drooling, opisthotonus

Tetanospasmin binds irreversibly to ganglioside R & blocks release of inhibitory mediators (GABA); results in unhibited excitation of motor N & spastic paralysis;

Gram (+) in fresh culture Very difficult to grow Hates O2 motile spores can survive adverse conditions difficult to culture

Tetanospasmin

Localized: pain/stiffness to local area, no systemic Cephalic: tetanus localized to head (bad!) Neonatal: difficult sucking

C. difficile

endogenous, takeover d/t ABC

Toxin A cholera-like Enterotoxin

Pseudomembra nous colitis

Prolonged hemorrhagic diarrhea; Multiple raised white/yellow exudative plaques on colonic mucosa

Toxin A cz diarrhea & mucosal damage (destroys tight jxns); Toxin B is cytotoxic (destroys cytoskeleton)

Hates O2

Toxin B diptheria-like Cytotoxin Hyaluronidase Spore formation Adhesion factor

Antibiotic assoc self-limited diarrhea while taking ABC diarrhea

Bacillacea Facultative anaerobes

Murray p. 256 B. Anthracis

Single/paired jointed bamboo rod clinical

inhalation, close contact, ingestion

anti-phagocytic Capsule

Cutaneous anthrax

Long serpent chains medusa head in culture

Biological warfare

3 part toxin protective Ag, lethal factor, edema factor

Inhalation anthrax "Woolsorters dz" Ingestion anthrax

Non-hemolyic, sticky

Painless, necrotic black eschars w gelatinous edema "malignant pustule"; Internal hemorrhage 1st: flu-like sx; 2nd: worsening F, diaphoresis, massive enlargement of mediastinal LN; 3rd: hemorrhagic meningitis sx Upper GI: oral ulcers, edema, sepsis, LN; Lower GI: bloody diarrhea, N/V, systemic sx

skin inoculation open skin in contact w infected animals & spores Breathing in of spores

B. cereus

Stain blue non-motile spores are durable motile

consuption of contaminated rice/grains punture wounds

Heat stabile enterotoxin

Food poisoning - emetic form

VOMITTING; NO fever, NO diarrhea

B-hemolytic on sheep blood agar

Heat labile enterotoxin

Food poisoning - Diarrheal form

Bloody diarrhea; NO fever

d/t heat-stabile, proteolysis resistant enterotoxin d/t heat-labile enterotoxin; stimulates adenylate cyclase in epith C of intestine (like V. Cholera)

IV

Phospholipase C

Gram (+) NON-endospore forming rods Corynebacterium faculative anaerobe

Murray p. 279 C. diptheriae

catalase (+)

"club shaped Chinese letters", irregular orientation, dark gray colonies cell wall mycotic acids ferments CHO stains metachromatically (cell blue, granules of polymerized phosphate red) grow side-by-side, "regular" orientation black colonies

aerosolized droplets

diptheria toxin (A-B exotoxin) - inhibits protein synthesis

Diphtheria

pharngitis w grey pseudomembrane that bleeds if removed, low F

bug takes over throat, produces toxin that kills surrounding cells

opportunistic

Dipheroids C. xerosis; C. hofmanii Listeria anaerobic Murray p. 273 L. monocytogenes

nonpathogenic

Acne

may contribute

small, "chinese letter" clumping

weakly B-hemolytic motile @ room temp grows at wide temp range (0-45C), high NaCl, acidity resists pasteurization

consumption of contaminated meat/dairy, raw veg transplacental opportunistic

intracellular pathogen (grows in macrophages)

Neonatal morbidity

meningitis, encephalitis, disseminated abscesses & granulomas in mult organs

listeriolysin O hemolysis Phospholipase C

Gram (-) rods Escherichia Facultative anaerobes

Murray p. 326 Enterotoxic E. coli

endogenous

Adhesins

Travellers diarrhea

WATERY DIARRHEA, cramps, N/V, low F

SMALL INTESTINE: enterotoxins stimulate hypersecretion of fluids & electrolytes

Outer envelope catalaxe (+) cytochrome oxidase (-) all ferment glucose susceptable to drying O-Ag (common Ag) ferments LACTOSE Enteroinvasive E. coli

Opportunistic

LPS endotoxin outer membrane Adhesins Exotoxins: STa & STb Invasive capabilities P-fibriae Bloody diarrhea Watery diarrhea -> Scant, bloody stool, FEVER, Colonic ulceration WATERY DIARRHEA, vomitting, cramps COLON: plasmidmediated invasion & destruction of epith C of colon SMALL INTESTINE: microvilli destroyed, malabsorption COLON: Shiga toxins disrupt protein synthesis; destroyed microvilli

Enteropathogenic E. coli

Infantile diarrhea

Enterohemorrhagic O157 strains do NOT ferment sorbitol E. coli O157:H7

Bloody diarrhea & Hemolytic Uremia Syndrome endogenous aspiration of resp droplets blood borne Pneumonia UTI

initial watery diarrhea --> grossly BLOODY diarrhea w NO FEVER, hemolytic uremic syndrome

Klebsiella facultative aerobes

Murray p. 335 K. pneumonia

very large capsule colonies look "mucoid"

THICK CURRENT JELLY SPUTUM

Enterobacter Facultative anaerobes ferment glucose oxidase (-) Citrobacter Salmonella Facultative anaerobes

E. aerogenes

reduce nitrates for energy fast growing shiny colonies

(catheters, IV, intube)

UTI

found in mixed infx

C. freundii Murray p. 330 S. typhi

hospital acq human-human fecal oral Surface Ag: O Ag, V1 Ag, fibria

UTI Typhoid Fever Increasing remittent fever, Rose-coloured spots on abd (red, blanch w press) bug enters Peyer's patches, then spreads to reticuloendothelial C of SP, LV, GB;

oxidase (-) Ferments Outer membrane susceptible to drying Catalaze (+) S. enteritidis /paratyphi

Typhoid Mary - Asx carriers very small inoculum reqd

Endotoxin (LPS) Invasive proteins Enterotoxins: LT/STlike, verotoxin-like

ingestion of contaminated meat, chicken, eggs Does NOT ferment glucose Outer membrane susceptible to drying resistant to ST acid fecal-oral "fingers, food, feces, flies" small inoculum Shiga exotoxin (S. dysenteria)

Food poisoning

Non-bloody diarrhea, N/V, FEVER

bug infiltrates SI mucusal cells & BM,

Shigella Facultative anaerobes

Murry p. 332 S. dysenteriae

Shigellosis (Bacillary dysentery)

bloody mucoid diarrhea d/t ulcerations of colon;

unable to attach to mucoid cells release endotoxin

Significant outer membrane oxidase (-) Ferments S. sonnei

Bloody diarrhea

mild watery diarrhea to bloody/mucoid

Proteus Facultative anaerobes

Murray p. 336 P. mirabilis

urease (+)

fecal oral

urease

UTI

urine pH >6, "coffin lid" cyrstals, urine has marked odour

lots of flagella "swarming" pattern on agar urease (+) Yersinia Facultative anaerobes P. vulgaris Murray p. 334 Y. pestis

indole (-)

nocrosomial infx catheters UTI flea bite (sylvaic cycle) capsule makes it antiphagocytic Bubonic plague high F, chills, hot large painful buboes in groin, axilla, neck followed by bubonic purerea (bleeding into skin) once spreads to LU cz hemorhagic pneumonia; toxins cz DIC, shock

indole (+) protein capsule

oxidase (-)

"safety pin" appearance

Outer membrane susceptible to drying Catalaze (+)

Y. enterocolitica

grows at cold temp

larger than Y. pestis

person-person inhalation of droplets (urban cycle) direct skin contact only req 1-10 bugs for infx!!! Most virulent contaminated REFRIGERAT ED food products (esp pork) need large inoculum

Type III secretion system

Yop proteins - induce cell death

Enterotoxin

Food poisoning

watery/bloody diarrhea, F, rt side abd pain

Pseudomonas obligate aerobes

Murray p. 357 P. aeruginosa

minimal nutritional req'd - will grow in distilled water!!!!

endogenous

capsule, pili, LPS

Opportunistic infection

oxidase (+) non-fermenter

optimal at 37C but can grow 4-42C flat colonies w GREEN "metallic" pigment sweet grape-like "fruity" odour SINGLE flagella PYOCYANIN - turns pus blue PYOVERDIN flouresce yellow-green under UV light Murray p. 391 L. pneumophilia pleomorphic

opportunistic

exotoxins A - blocks protein synthesis Phospholipase C Elastase - cz LU damage

Swimmers ear Folliculitis

mild bronchitis to severe necrotizing pneumonia w micro abscess & tissue necrosis; can also colonize burns, bacteremia, endocarditis (esp tricuspid) mild to severe (malignant EO)

Legionella obligate aerobes

inhale aerosolized

Pneumonia

multi-lobar w NONPRODUCTIVE cough, multi organ involvement (GI, LV, KI, CNS)

Catalaze (+) non-fermenter

SINGLE flagella picky eater, hard to grow, needs Fe req special silver stain Chlorine, ABC resistant can survive temps up to 50C

NO personperson spread

Gram (-) CURVED rods Helicobacteriacea Microaerophilic

Murray p. 351 H. pylori

Spiral shape

fecal oral

Acid inhibitory protein Urease

Peptic Ulcer disease (PUD) Gastric adenocarcinom a

Burning, gnawing upper GI pain,

Duodenal ulcers (90%), gastric ulcers (75%)

corkscrew motion w flagella

Urease (+) Narrow temp range (30-37C) Campylobacteriacea Microaerophilic Murray p. 347 C. jejuni S shape Single polar flagella Thermophilic Slow growing able to filter like CO2 Grow better @ 42C "comma shaped" contact w infected animal raw milk, water

Heat shock protein Flagella

Fatigue, wt loss, low F, night pain,N/V, belching, indigestion, epigastric mass Type B gastritis Abd pain, N, bloating Foul-smelling breath,

neutralizes gastric acid w urease,

enterotoxin

Food poisoning

Foul smelling, watery diarrhea progressing to profuse bloody diarrhea, NO vomiting, F, abd pain

Vibrioacae Facultative anaerobes

Murray p. 339 V. cholera

ingestion of contaminated food, water

Cholera toxin complex Cholera A-B

Abrupt onset, Watery diarrhea & V, Rice water stools, Severe fluid, electrolyte loss, NO cramps, NO fever

A toxin permanantly turns on G protein thus activates cAMP, cz electrolyte shift

Cytochrome oxidase (+)

Wide temp range (1837C) Most tolerate salt, except V. cholera!

Single flagella V. parahemolyticus requires salt for growth

rare personperson spread need large inoculum (killed by ST acid) can have Asx human carriers shellfish, seawater

Adhesins Mucinase

Soderphores thermostable direct hemolysin Food poisoning painful and cramping, explosive watery diarrhea, HA,

Gram (-) coccobacilli Haemophilus Obligate parasite Pleomorphic Small Gram variable anaerobic

Murray p. 367 H. influenza

Fastidious growth req (X factor = hematin, V factor = NAD)

endogenous

type b (encapsulated strain w polyribitiol phosphate) is most virulent PRP Capsule Pili LPS damages resp epithelium IgA protease -helps colonize mucosa & avoid IS

Meningitis

Same sx as other meningitis but more insidious onset

Encapsulated strain can have systemic sx

Grows on chocolate agar No Spores Non-MOTILE Ferments glucose and xylose Catalase (+)

Otitis media

rupture of TM w pus/blood, Unexplained F, NV

Non-encapsulated strain colonize URT & LRT, cause OM, sinusitis

Epiglottitis

Joint infection

Medical emergency, Dysphagia, drooling, muffled voice, minimal cough, sever dyspnea, hot potato voice Monarticular, large joint

H. duceryi

H. vaginalis

Slow growth in rich media, narrow temp range Non-encapsulated Catalase (-) Does NOT FERMENT sugars grows in blood agar in moist CO2 rich

Sexually transmitted

Pili Cell bound hemolysin LPS

Chancroid

Soft, purulent, painful ulcer (soft chancroids) on genitalia painful buboes, phimosis, urethral stricture

STD, endogenous

Bacterial vaginosis

excessive thin, white, adherent malodourous discharge, prupitis, dyspaerunia

presence of clue cells, (+) whiff test

(f. Gardnerella vaginalis)

Bordetella Strict aerobes

Murray p. 377 B. pertussis

Fastidious growth

respiratory droplets

Pertussis toxin - cAMP secretions, kills IS cells

Whooping Cough

bug sticks to epith C w pili; secretes pertussis toxin that stimulates G protein and cAMP;

Oxidase (+)

Very small

Grows in humid, specialized media (charcoal, blood, NAD enriched) "glistening pearl" cultures PCR for rapid ddx

Most infectious in catarrhal stage highly contagious

Adenylate cyclase toxin

Tracheal cytotoxin

Dermonecrotic toxin Filamentous hemagglutin - allows attachment to ciliated epith C & PMN LPS "mild" Whooping Cough

B. parapertussis

Acid-fast rods (weakly gram (+)) Mycobacterium Obligate aerobe

Murray p. 297 M. tuberculosis

Fastidious, SLOW growth (8wks!); forms "snake" pattern (cord factor) on egg yolk agar

Person-person transmission

Intracellular growth

Tuberculosis

Insidious onset, malaise, low F, wt loss, fatigue; sputum w blood; master impersonator

Acid fast (cannot de-colour stained rods)

(+) Manoux test

Via infectious aerosolized particles

Damage d/t host response form tubercles that develop into necrotic, caseous grnulomas

cell walls rich in lipids mycolic acid Resist drying, detergents, acid/bases M. leprae CANNOT be cultured

Very small dose req

respiratory droplets

Intracellular survival (in histiocytes, endothelial, Schwann cells)

Tuberculoid leprosy

<5 cutaneous macular lesions w hypopigmented centres; peripheral N damage w complete sensory loss Most destructive extensive disfiguring skin/bone, cartilage lesions, >5 skin lesions, less nerve Pulmonary dz almost indistuiguishable from TB; usually also GI tract involvement

Grow in Globi bundles

contact thru break in skin

Special glycolipids Prefers lower temp Capsule

Lepromatous leprosy

strong cellular response but weak humural response; Lanhans cells present, no rods present; NOT infectious HIGHLY infectious

M. avian

Similar to M. tuberculosis

ingestion of raw fish, cheese, water

Intracellular growth

Opportunistic lung infection

begins as mild pulmonary infx; spreads to LN, then massive infx of all organs

Inhalation 3

Spirochetes Treponema Strict Anaerobes Thin-walled, small, coiled

Murray p. 427 T. pallidum

Fastidious, slow growth Grow only in bunny cells corkscrew motility

#3 STD contagious only during 1o/2o stages vertical transmission

Outer membrane adheres to host cell Hyaluronidase

Syphilis Ag from bug will induce Ab that Xreact w cardiolipin

LPS Syphilis Congenital Born appearing well but later has snuffles, widespread desquamating maculopapular rash 1st: erythma migrans rash bulls eye lesion; 2nd: nerological signs, cardiac dysfxn; 3rd: migratory arthritis, encephalitis

Test: VDRL & RPR for cardiolipinAb Borrelia microaerophillic Murray p. 433

Very labile & Susceptible to drying

Larger than other spirochetes Internal flagella Cholesterol in cell wall

Vector: deer tick

Do NOT produce toxins Antigenic variation

Lyme disease

Leptospira Obligate aerobe

Murray p. 438 L. interrogenes

Minimum nutritional req (LCFA, vit B1, B12); slow growth in culture

contaminated water thru breaks in skin

Endotoxins

Leptospirosis

mild influenza like; F, myalgia

Weil's disease

Aseptic meningitis

severe systemic dz w KI/LV failure (jaundice, uremia); extensive vasculitis, myocarditis generally uncomplicated and mild

Wall-less bacteria Mycoplasma No cell wall (-)

Murray p. 443 Mycoplasma pneumonia

Fastidious nutritional growth

Nasal, aerosol, close contact

Adhesion P cause ciliostasis & mechanical irritation to airways

Walking pneumonia

Prolonged mild form of pneumonia, mild sx to start w severity; nonproductive cough, CXR shows lower lobar pneumonia

Highly developed outer membrane w sterols Highly pleomorphic

Produce H2O2, hemagluttin Culture: most diff to grow mulberry shaped colonies

Binds neuramic acid superAg - cz release of CK at site H2O2 production & inhibit host catalase

smallest known organism capable of autonomous growth Strict aerobes Ureaplasma Facultative anerobes Murray p. 443 Ureaplasma urealyticum

**cold agglutination

incomplete immunity!! vaginal birth STD, endogenous Non-gonococcal Urinary sx in males, aSx in F urethritis

Produce urease TINY colonies look like "fried eggs"

Obligate intracellular bacteria (gram (-)) Rickettsia Obligate aerobic parasite

Murray p. 449 R. rickettsia

VERY Small bacteria minimum PG layer, some LPS, susceptible to ABC, need O2 No flagella Weakly adherent slime capsule

Arthropod vector (ticks) very low inoculum reqd need prolonged (>24hr) contact w tick STD (m/c)

Weak endotoxin

Rocky mountain spotted fever

Abrupt onset, F, HA, N, Rash diffuse, maculopapular rash, spread from extr to truck or eschar formation

Tissue damage d/t multiplication of bug in vascular epithelium

Survive inside phagocytes

Chlamydia Obligate intracellular parasites Bacillus Very small

Murray p. 443 C. trachomatis

Filterable; enery parasites, intracellular growth (like virus) Inner/outer memebrane but no PG layer --> no gram stain Stain w iodine d/t high amount of glycogen in inclusion body

thru minute abrasions in mucous mem respiratory droplets, autoinoculation, eye makeup, flies, fecal-oral

Limited tropism (nonciliated epithelial of urethra, cervix, endometrium, RT, conjuctiva

conjunctivitis

Sx d/t host inflamm response

Trachoma Urethritis Pelvic inflammatory dz

ADULT: Genital infection 1st, then unilateral mucopurulent discharge in eye; NEONATE: intense papillary conjunctivitis w lid swelling, profuse mucopurulent discharge chronic follicular keratoconjunctivitis,

d/t serovars D-K

sterility, m/b pain

C. pneumonia

difficult to grow similar to C. trachomatis

respiratory droplets

same

Atypical pneumonia

Mild, persistant cough, malaise lobar pneumonia

can infect and grow in smooth mm C, endothelial C of coronary aa, macrophages

C. psittaci

Same

inhalation of dried bird feces

Same

Parrot fever

Non-productive cough, rales, consolidation, HA, high F, GI sx (N/V/D), carditis, enlarged SP, LV