Microbiology (medbullet all)

- Clostridium anerobic ( think grows in cans for botulisim)

Most Common
MOPS strep pneumonia :
1. Meningitis adult
2. Otitis media
3. Lobar pneumonia community acquired
4. Sinusitis
Colon cancer endocarditis : Strep Bovis / gallolyticus
GI or genital urinary surgery and then endocarditis : Enterococcus
feacalis

Meningitis neonate:
1. Strep agalactiae
2. E.coli
3. Listeria Monocytogenes ( why preg should avoid deli)
- can lead to spontaneous abortions
- granulomatosis infantiseptica

Hot tube folliculitis : Pseudomonas aeruginosa

Abdominal abscess : Bacteroides fragilis

Osteomyelitis
Assume Staph aureus is nothing else given #1
Sickle cell : salmonella enteridis ,
Puncture foot (diabetic drug) : pseudomonas
TB : vertebral osteomyelitis ( Potts disease)

Infectious arthritis
Neiserria gonorrhea: sexually active
Staph aureus: not sexually active or kids
UTI
1. E.coli
2. Staph saprophyticus (especially for newly sexually active
females)
3. Klebsiella

Information
UTI
Leukocyte esterase test = Bacterial UTI
 NitRITE TEST = Gram negative (convert nitrate to nitrite)

ToRCHeS
Toxoplasmosis
Others (Coxsackie B, Polio, Parvovirus B19, Listeria)
Rubella
CMV
HIV, Herpes simplex (HSV-2)
Syphilis

Rashes

HHV-6 lace like rash

Coxsackie A : palms and soles only + mouth ulcers
Chicken pox : asynchronous : means not at the same stages
some are vesicles, some are scabs
Smallpox: was synchronous vesicles
Palm and soles : CARS : Coxsackie A, Rickettsia, Syphilis
* Rickettsia is pettichial rash, SO IS NISSERIA MENINGITIS
Special Properties
Special cultures :
1. Chocolate ( have V (NAD+) and X (hemin) : haemophilus
influcenza , Neisseria
2. Thayer-Martin ( Chocolate + VPN) : for N.gonorrhea select
-Vancomycin: inhibit Gram (+)
-Polymyxin: inhibit Gram (-)
-Nystatin: fungal
3. Cholesterol: mycoplasma
- Eatons agar: mycoplasma pneumonia
4. Salt : Staph aureus , Vibrio, Enterococci ( differentiate from strep
Bovis)
5. Lowenstein-Jensen: TB slow growth
6. Bordatella Pertussis:
-Regan-Lowe
-Bordet- Gengou
7. Lofflers media : Corynebacteria .diptheria ( and tellurite)
8. Thioglycolate : anerobes
9. Charcoal ( cysteine and Iron) : Legionella
10. Cysteine : Francisella, brucella, legionella, pasteurella

Tick Vectors:
Ixodes tick
-Borrelia burgdorferi
-Babesia
-Ehrlichia
Dermacentor tick (dog tick)
-Rickettsia
-Francisella tularensis
Toxins carried by Phages COBEDS
1. Cholera
2. Botulinum
3. DIptheria
4. Erythrogenic toxin strep pyogenes
5. Shiga toxin

Definitions
Viral
1. Recombination: exchange genes 2 chromosomes in homologous
2. Reassortment: segmented genomes exchanged (Influenza
Pandemic)
-two virsuses music infect one cell
3. Complementation: 2 viruses infect cell but one is mutated and
depends on the other to replicate and survive ( Hep D depend
 Hep B)
4. Phenotyping mixing: two virsues infect same cells but change
the coat phenotype

Weird facts
- Salmonella typhi reservoir : humans ( the gall bladder)
-Salmonella enteridis : chicken and reptiles (turtles)
Gardnerella vaginalis : Vaginosis , clue cell ( with bacteria around
epithelial cell)
Ehrlichia : similar to Rocky mountain spotted fever except here
theres no rash
Norcardia mimics TB but creating lung cavity too ( also acid fast
stain weak, but these are BRANCHING)
EHEC : shiga like toxin, no invasion BLOODY
o EIEC: shiga like with invasion , BLOODY
Shigella: invasion and shiga toxin to 60S ribosome :
bloody
Pork + unpasteurized milk : Yersinia
Beef undercooked, petting zoo : EHEC
Chicken, unpasteurized milk : Campylobacter
Chicken, reptiles (turtle) : Salmonella
Unpasteuzied dairy : Brucella

Meningitis:
HSV-1 classic for encephalitis (temporal perivenular)
HSV-2 classic for meningitis
 Aspectic meningitis is one cause by NOT BACTERIA (without
stupor and meningeal irritation)
STD
Chlamydia trachomatis
- Have elementary body and reticular bodies (replicating)
1. Chlamydia : D-K serotypes DKNY
2. Lymphogranuloma Venerum : L1-L3
Hepititis B
Gardnerella vaginalis, trichomonas vaginallis

HIV
Brain abscess : ring enhanced lesions = TOXOPLASMA Gondii
Diarrhea : cryptosporiDium
Eye retinitis: CMV cotton wool spots

Questions

Leigonella: diagnosed by urine antigen test , culture on charcoal

agar ( with cysteine and iron)
- suspect if high fever + WATERY DIAHREA +
neutropenia
Haemophilus influenza
- epiglottitis
- PRP capsule : polyribosyl-ribitol-phosphate
Bacillus anthracis; malignant pustule (painless ulcer with
black center and local edema)
-capsule made of PROTEIN instead of polysaccharide ( D-
glutamate)
Give vaccine strep pneumonia to
1. HIV
2. Asplenic
3. COPD
4. Immunosuppressed
Hepatitis B vaccine : RECOMBINANT surface protein
 Inactivated toxin vaccine : DTP : diphtheria, tetanus, Pertussis
Aspergillus Fumigatus : cause allergic bronchopulmoary
aspergilliosis : high IgE and eosinophils
1. Colonizing aspergillosis: old lung cavities, form fungal
balls in people with TB, emphysema sarcoidosis
2. Hypersensitivity: allergic bronchopulomary
aspergillosis in people with asthma
3. Invasive Aspergillosis: immunosuppressed and
neutropenic patients

EBV:
-Heterophil antibiodies SPECIFIC (monospot test)
-EBV encode oncogenes cause high proliferation B cells
(still secrete Ig)
Tzank Smear : HSV-1 and 2, and 3( varicella)
Staph makes yellow pigment

Most common source E.coli bacteremia is catheter

Receptors bind to
1. CMV : Integrins
2. EBV : CD21
3. HIV CD4 + CCR5 and CXCR4
4. Rabies: nicotinic acetylcholine
5. Rhinovirus : ICAM1 (CD54)
Toxoplasmosis:
Hydrocephalus, calcifications intracranial, chorioretinits
Part of Torches therefore go across placenta ( in-utero
infection)
Intrapartum (during birth)
-HSV
-chlamydia and gonorrhea: neonatal conjunctivitis
-strep agalactiae
Neisseria are facultative intracellular therefore can be seen in
PMN
Arthritis
Septic: asymmetric polyarthralgia ( N.gonorrhea)
Rheumatic fever : migratory polyarthritis
Cryptococcus neoformans
Acquired via inhalation
Yeast form only : narrow based buds
Pigeon dropping
Diagnose: , latex agglutination CSF
CNS lymphoma are B cell origin
Lyme disease : bells palsy bilateral
 Haemophilus without capsule , vaccine wont work
Rubella : POSTAURICULAR AND OCCIPITAL LYMPHADENOPATHY
Exanthem subitum/ roseola infantum
Clostridium perfringens : causes
1) gas damage tissue
2) food poisoning watery
Candida normal part of flora in the mouth and GI.
Mycoplasma causes the immune system to also attack own RBC
causing anemia . these cross react with RBC : leading to cold
agglutinin
Intracellular : chlamydia, rickettsia, gonorrhea, Salmonella
Transduction
1) Generalized: during LYTIC, random bacterial genes
accidentally packaged
2) Specialized: during LYSOGENIC , select bacterial genes
The (+) ss RNA does the polycistronic to monocystronic
by POLYPROTEIN CLEAVED BY PROTEASE
Campylobacter cant survive in alkaline whereas vibrio can
GI infection NO WBC IF DONT INVADE MUCOSA
Phospholipase C/ lecithinase is degraded by clostridium
perfrigens
No 3-5 proof reading in viruses
Cold agglutinin: mycoplasma, EBV, and blood malignancy
Catalase (+) : serratia, nocardia, aspergillus
o PLACESS
o Pseudomonas
o Listeria
o Aspergillus
o Candida
o Enterobacteriacea
o Staph aureus
o Serratia
EHEC DOESNT FERMENT SORBITOL (ONLY ONE)
PYR ( pyrrolidonyl arylamidase) + is strep pyogenes
Rotavirus has 10-11 segments therefore can undergo genetic
reassortment like influenza
Clostridium difficle does damage by CYTOSKELETON DAMAGE
Mucormycosis: mucor, Rhizopus, Absidia
Serpetile growth of TB is due to CORD FACTOR which
correlated with virulence by inhibiting PMN , mitochondria
destruction and release TNF
Neonatal rubella:
1. Cataract
 2. Microcephally mental retardation
3. Deafness
4. PDA or pulmonary stenosis
Fungi
1.Immune low: candida, aspergillosis, mucormycosis
2.Antibiotic use: Candida oral and vagina
3.Animal: microsporum canis= tinea capitis
4.Bats or pigeon near Ohio and Mississippi: Histoplamosis
capsulatum
5. Thorn prick: sporothix schenckii
Necrotizing Fasciitis :
1. Strep pyogenes
2. Staph aureus
3. Clostridium perfringens

E.coli
Virulence factor Mechanisim Presentation
LPS IL-1, 6 and TNF-alpha Bacteremia and shock
release from
macrophage
K1 capsular Prevent phago and Neonatal meningitis
polysaccharide complement
Verotoxin/ shiga like Inactivate 60S Gastroenteritis bloody
Head stable/liable Fluid and electrolyte Gastroenteritis watery
enterotoxin sectetion
P fimbriae Allow adhesion to UTI
urothelium