HAEMOPHILUS INFLUENZAE - if they go to respiratory tract can cause BRONCHITIS

- round and linear shape (inflammation of bronchi) or PNEUMONIA (infla of lungs)

- pink bcs of sefranin
- thin peptidoglycan H.I colonizes nasopharyx:
- non motile 1. encap - 3-5% of children aged 2-5 y.o
- facultayive anaerobic 2. unencap - 40-80% of child and adult
- catalyse +
- oxidase + RISK FACTOR OF H.I TYPE B
- TRANSMISSION: respiratory droplets and secretions 1. children
- can be cultivated on CHOCOLATE AGAR bcs it has nutrients 2. spleen issues
to grow like FACTOR X(HEMIN) and FACTOR V - splenectomy
(NICOTINAMIDE ADENINE NUCLEOTIDE) - sickle cell disease
- can also grow in BLOOD AGAR W/ STAPHYLO AUREUS with - functional asplenia
FACTOR V via RBC HEMOLYSIS 3. malignancies
- convex 4. congenital deficiency of compelemt components
- smooth 5. acute viral infection
- gray or transparet colonies - influenza cirus: fatal bactetrial superinfecion even
- respiratory
- encapsulated strains: 6 stereotypes (A B C D E F) RISK FACTORS OF H.I NONTYPEABLE
- unencapsulated strains: also called as NON TYPE-ABLE bcs 1. children
they lack polysaccharide capsule and capsular antigen 2. immunocompromising condition
- diabetes
haemophilus influenzae type b or hib - most causes disease in - malignancies
human - HIV infection
- viral infection that can cause POSTVIRAL PNEUMONIA
encapsulated strain vf: 3. underlying lung condition
1. capsule against phagocytosis - COPD causes BRONCHOPNEUMONIA
2. pili - adherance - cystic fibrosis

encap and unencap virulence factor: SYMPTOMS OF H.I TYPE B

1. outer membrane - compose of lipo-oligi that helps in 1. epiglotis
MUCOCILIARY CLEARANCE or SELF-CLEANING MECHANISM - fever
OF BRONCHI - sore throat
2. make IgA protease - creates IgA that opsonizes invading - difficulty speaking
bacteria - dyspnea
iga proteaseb- nuetrilizes first line of mucosal defense 2. Meningitis
- fever
unencap virulence factor: - lethargy
1. oligoaaccharides - phase variation - sore neck
phase variation - nakakalimytan nya yunb infection so - altered mental stat
mahirap alalahanin ng immune ng host cell in the future 3. cellulitis
2. biofilms - made of EPS where H. Influenzae live and - fevee
reproduce - warm and tender area of: ERYTHMEA ON CHEEKS and
parang strawberry jam PERIOEBITAL AREA
4. bacterimia
encapsulated: - fever
- higher invasive disease - chillla
- causes EPIGLOTTITIS - hypotension
- spread to nasopharynx to epig or soft palate causing - tachy
CELLULITIS 5. septic athritis
- can also enter epithelium ng nasopharynx then mapupunta - fever
sa blood capillaries causing BACTERIMIA - pain
- the through blood it can also spread sa: - swelling
1. meninges causing MENINGITIS - tendernews od joints
2. bones causing OSTEOMYELITIS 6. osteomyelitis
3. joints causing SEPTIC ATHRITIS - fever
- bone pain
nonencapsulated: - weakness
- less invasive
- mostly cause MUCOSAL INFECTIONS by DIREXT EXTENSIOS SYMPTOMS OF H.I NONTYPEABLE
- middle ear causing OTITIS MEDIA 1. otitis media
- causes CONJUNCTIVITIS - ear pain
- spreads to paranasal sinus causing SINUSITIS - otorrhea (discharge in ear)
2. sinusitis - other symptoms: headache, muscle pain, GI disturbances
- tenderneas in sinus - DISSEMINATION: endobronchial, hematogenous, lymphatic
- purulent nasal discharge 1. LEGIONNAIRE'S DISEASE
3. bronchopneumonia - sym: fever, dyspnea, non productive coughing
- chills - if untreated it can cause ATYPICAL PNUEMONIA
- chest pain - diarrhea and encephalophaty are common
- shortness of breath - MORTALITY: bcs of PROGRESSIVE RESPIRATORY DISEASE and
4. conjunctivitis SHOCK
- eye redness - more cases in ELDERLY
- pain and burning eye 2. PONTIAC FEVER
- mild, non-fatal, influenza like illlness w/ fever, chills, myalgoa
DIAGNOSIS and headache
1. bio sample
- blood LAB DIAG:
- csf 1. sputum
- synovial fluid 2. bronchial aspirate
- pleural fluid 3. lung biopsy
- lung aspiration or TRACHEAL by DFA TESTING
2. sero method
- latex auggulation identification of legionella antigen: IN URINE - latex agglutination
- enzyme immunoasaay and elisa
- coaggulitination
TREATMENT
TREATMENT: 1. newer macrolides
1. H.I TYPE B 2. ciproflaxin
- meningitis: ceftriaxone 3. rifampicin - used in severe cases lang
- vaccine: L VACCINE w/ diptheria toxoid
2. H.I NONTYPEABLE BORDETELLA PERTUSIS
- mucosal infections: amoxicillin - "whooping cough disease"
- "100 day cough"
LEOGINELLA PNEUMOPHILA - acute respiratory infection by severe/spasmodic coughing
- causative of LEGIONNAIRES DISEASE episodes
- causative of PONTIAC FEVER - LEUKOCYTOSIS and LYMPHOCYTOSIS is commom during this
- causing LEGIONELLOSIS (acute pneumonia) illness
- other rare disease: PERICARDITIS and ENDO - COMPLICATIONS: bronchopneumonia and encephalophaty
- BACTERIMIA also occurs - bacterimia DOES NOT OCCUR
- TRANSMISSION: inhaling infected aerosols produced by - coccobacillus shape
cooling towers, acs, etc - red color
- facultative intercellular parasites - aerobic
- non capsulated - catalyse +
- thin - encapsulated
- motile: polar/subpolar flagella - pertactin, fimbria, and filamentous (vf)
- nonsporeforming - TRANSMISSION: droplets like from coughing or sneezing
- pleomorphic rods (mostly rounded or rod)
- cannot be seen easily in gram stain SPECIMENS:
- use SILVER STAIN 1. from nasopharyngeal swavs
- visualized by: DIRECT FLUORESCENT ANTIBODY (DFA) 2. from nasopharyngeal secretions (RLM agar)
STAINING
- oxidase + MEDIA TO GROW B. PERTUSIS
- fast growth - BCYE media (buffered charcoal yeast extract) 1. bordet-gengou agar
- obligate aerobe - w/ potato xtract
- no animal reservoir 2. regan-low medium
- NO HUMAN TO HUMAN TRANSMISSION - w/ blood
- found in natural water resourced (hot tubs, aircon, - w/ charcoal
factories, hot baths) - w/ antibiotic
3. PCR (polymerase chain reaction)
RISK FACTORS: - detects bacterial dna
1. w/ chronic heart disease 4. serology
2. w/ lung disease 5. DFA testing

legionellosis (acute pneumonia): TOXINS:

- legionella enters respiratory then sa alveoli magmumultiply 1. Pertusis toxin - inactivates Gi leading to increase cAMP
- high fever and cough that do not produce much sputum formation and helps evading phagocytosis
- impair CHEMOKINE RECEPTORS that are responsible for TRANSMISSION:
locating infection in human 1. consumption of meats
2. adenylate cyclase 2. consumption of unpasturized milk
3. tracheal 3. direct contact w/ infected animals
4. filamentous hemagglutinin: capacity to agglutinate red note for ENDEMIC AREAS and consumption of animal products
cells from geese, chickens, etc
PORTAL OF ENTRY:
3 PHASE OF PERTUSIS STAGE 1. mouth
1. CATARRHAL 2. conjunctivae
- 1-2 weeks 3. resp tract
- fever 4. abraded skin
- runny nose
- mild cough DISEASE:
- rhinorrhea 1. Brucellosis
2. PAROXYSMAL - "malta fever"
- 2-3 weeks - "undulant fever"
- cough - " mediterranean fever"
- post tussive vomiting - 4 weeks incubation
- blood leukocytes resembles LEUKEMIA
3. CONVALESCENT symptoms:
- recovery 1. undulant fever (cyclical) - temp goes up and down frequently
2. headache
TREATMENT: 3. arthralgia (joint pain)
1. macrolide 4. anorexia
2. TMP-SMX if allergic sa macrolide 5. night sweats (foul smelling)
6. fatigue
VACCINE: 7. hepatomegaly
1. acellular vaccine: DTap or Tdap 8. anemia is often a feature
*D - diptheria
*T - tetanus COMPLICATIONS:
*aP - acellular pertusis 1. athritis
2. orchitia (testes)
BRUCELLA SPECIES 3. spondylitis (vertebrae)
- causes BRUCELLOSIS (zoonotic infection) 4. oesteomyelitis (bone)
- aerobic 5. neurobrucellosis (n.s)
- non motile 6. endocarditis (endocardium)
- non capsulated 7. affects fetus
- facultative intracellular 8. low birth rate
- urease + 9. hepatosplenomegaly or resp difficulties
- oxidase + 10. DEATH
- catalyse +
- survive in high temp TREATMENT:
- survive in extreme pH 1. doxycycline + rifampin or streptomycin
- stays alive inside macrophages
- slow growing organisms PREVENTION
- W/ ANIMAL RESERVOIR 1. milk pasteurization
- NO HUMAN TO HUMAN 2. iwas sa maraming may brucellosis
- ABORTION is often a sign of disorder
FRANSICELLA TULARENSIS
CAN BE GROWN BY: - causing TULAREMIA
1. charcoal yeast extract agar - spread by tick bites
- needs to contain cysteine and iron - zoonotic pathogen (from animal like rabbit)
- non motile
DIAGNOSIS: - very small
1. blood - faintly staining
2. bone mardow - thin lipud capsule
slow glowing organisms and need prolonged incubation up to - aerobic/facultative anaerobic
6 weeks - requires BYCE
3. serological test - requires CHOCOLATE AGAR
- SAT (serum agglutination test) - slow growing
- ELISA - intracellular pathogen: macrophages, neutrophils
- inhibits phagolysosome formation
TRANSMISSION:
-all spead by ticks VF:
1. TYPE A: west 1. polysaccharide capsule - for phagocytosis/ anti phagocytic
- rocky montains 2. opsonins - “marking antigen”
- exposure to rabbits
- exposure to cats DISEASE:
2. TYPE A: EAST 1. CELLULITIS
- hairs, cats, rabbits - developed in 1-2 days
3. TYPE B: MISSISSIPPI RIVER VALLEY 2. LYMPHADENITIS
- small rodents and cats 3. EXACERBATION OF CHRONIC RESPIRATORY DISEASE:
Pneumonia
TULEREMIA - cough fever
- ulcer or glandular disease - shortness of breath
1. Ulceroglandular - mga may ulcer na pabilog and common - chest pain
symptoms like fever, mylargia, etc 3. SYSTEMIC INFECTION
2. Oculoglandular - less common - mga immunosuppress peeps like nag undergo ng transplant, etc.
- direct contamination to eyes
- PAINFUL CONJUNCTIVITIS SPECIMEN:
3. pneumonic - galing sa blood 1. cultivation of soft tissue infection
ulceroglandular can progress to pneumonic
DIAGNOSIS:
LAB DIAG: 1. BLOOD AGAR
1. detect orgs form aspirate, node, ulcer 2. CHOCOLATE AGAR
2. CULTURE IS GOLD STANDARD (bcs of BYCE/CHOCOLATE) do not grow on MAC
3. serology
- 4 fold or greater increase in the titer of antibodies during TREATMENT:
illness para madetect yung tulerimia 1. penicillin
- or [1:160] 2. antibiotic theraphy: prophylaxis

TREATMENT: YERSINIA PESTIS

1. gentamicin - ZOONOTIC disease
2. doxycyline - transmitted by RAT FLEAS
- short, plump, ovoid
PASTEURELLA MULTOCIDA - rounded cells and convex side
- zoonotic (bites, licks, and scratches) - causative agent of PLAGUE
- SKIN/SOFT TISSUE INFECTIONS - can survive in proliferate and phagocytic cells
- infection typically develops within 24 hours - rats, ground squirrels, prairie dogs
- caused SWELLING AROUND AREA, ERYTHMIA, TENDERNESS, - infects HUMAÑS AND ANIMALS
PURULENT DRAINAIGE - used as BIOLOGICAL WEAPON
- can also cause NECROTIZING FASCIITIS - SAFETY PIN APPEARANCE
- possible sequale: SEPTIC ATHRITIS and OSTEOMYELITIS - HIMALAYAS: orig home of plague
- associated w/dogs and cats
- small coccobacilli VF:
- spheroid or spehircal (more on pleomorphic) 1. fraction I
- fermentative - inhibits phagocytosis
- catalyse + - heat liable antigen
- oxidase + 2. V ANS W ANTIGEN
- normal commensal bacterial of healthy animals - produced together
- non motile 3. BACTERIOCIN
- penicillin sensitive 4. PLAGUE TOXIN: ENDOTOXIN
- MUSTY ODOR - murine toxin (active in rats)
- human infections are cuased by sergroups A and D 5. ABILITY TO SYNTHSIZE PUREASE

RISK FACTORS STAINING: BIPOLAR STAINING

1. Alcoholism 1. giemsa/ MBS A
2. chronic corticosteroid use
3. history of joint replacement
TRANSMISSION:
TRANSMISSION: 1. PLAGUE INFECTED FLEAS: eat off naturally rat reservoir then
- is transmitted to humans by contact with infected animals, they bite humans
usually following bites or scratches from cats or dogs. 2. skinning infected animals
Respiratory tract infections may occur through airborne 3. scratches and bites
transmission 4. domestic cat licks (rare)
 - encap: spleen
TYPES OF PLAGUE - unencap: bronchopneumonia and post viral infection
1. BUBONIC
- 2-10 days of incubation 2. LEOGINELLA PNEUMOPHILIA
- swollon lymph nodes (groin, arms, or neck) - legionellosis - direct fluorescent antibody staining
- most common - legionnaires disease - BCYE
- swollen, tender lymph glands or BUBOES - pontirac fever - water resources
- untreated: mortality 50-70% rate - pericarditis, endocarditis, bacterimia (rare)
- not transmitabble from person to person - no human to human and animal transmission
- small % in developonh pneumonic - respiration of infected aerosol
2. SEPTICEMIC - w/ chronic heart disease and lung disease
- secondary to bubonic
- blood causing SEPTIC SHOCK 3. BORDETELLA PERTUSSIS
- not person to person - woophing cough disease
- spreas via DROPLETS to other human - LEUKOCYTOSIS and LYMPHOCYTOSIS is commom during this
- NO SWOLLEN LYMPH NODES illness
- NECROSIS IN FINGERS, NOSE, TOES - COMPLICATIONS: bronchopneumonia and encephalophaty
- also causes DISSEMINATED INTRAVASCULAR COAGULATION - cattharal, paroxysmal, convalascent (stages)
3. PNEUMONIC - bordet-gengoue, regan-low, pcr, serology, dfa
- 2-4 days incubation - pertussis toxin (endo) - murine toxin, adenalate cyclase,
- produces WATERY/BLOODY sputum tracheal, filamentous hemmaglutinin
- can be transmitted from PERSON/ANIMAL to PERSON via
airborne droplets 4. BRUCELLA SPECIES
- patient must be treated within 12-15 hours after onset of - zoonotic
fever - brucellosis
- death occurs in 3 days - night sweat (foul smelling), hepatomegaly, anemia
- 100% mortality - charcoal yeast extract agar (cysteine and iron)
- undulant fever, athralgia, anorexia
DIAGNOSIS: - lots of complications
1. SPECIMEN
* bulbonic - buboes by micro 5. FRANSCIELLA TULARENSIS
* septicimic - blood - tulerimia - BYCE - gold culture bcs of choco agar
* pneumonic - sputum - ticks - chocolate agar
2. DIRECT DEMO - rabits - slow grpwing
* microscopy - smears from bubo stained - type a: west, type a: east, type be: mississippi
3. FLUORESCENT ANTIBODY TECHNIQUE - ulceroglobular, oculoglobular, pneumonic
4. IMVIC TEST - increase in antibodies para madetect tulerimia
*I:-
*M:+ 6. PASTEURELLA MULTOCIDA
*V:- - NECROTIZING FASCIITIS
* C:+ - CELLULITIS, LYMPHADENITIS, CHRONIC RESP, SYSTEMIC INFECT
* ESCULIN: + - penicillin sensitive
* OXIDASE: - - - serotype A and D - DO NOT GROW IN MAC
* UREASE: - - possible sequale: SEPTIC ATHRITIS and OSTEOMYELITIS
- musty odor - BLOOD AGAR
- bite, lick, scratch - CHOCO AGAR
TREATMENT: - alcoholism, chronic corticosteroid use, joint replacement
1. STREPTOMYOCIN
2. CHLORAMPHENICOL 7. YERSINIA PESTIS
- plague
- rats
SUMMARY: - bubonic, septecimic, pneumonic
1. HAEMOPHILUS INFLUENZAE - septic shock
- epiglolittis - chocolate agar - necrosis in finger, nose, arms
- cellulitis - blood agar w/ staphy aurues - bloody/watery diarrhea
- bacterima - gray/transparent colony - methyl blue staining agar
- meningitis - serotype A and D - IMViC
- osteomyletis - respiration of droplets/secretions - SAFETY PIN APPEARANCE
- spetic athritis - BIO WEAPON
- otitis media
- conjunctivitis
- bronchitis or pneumonia