INTRODUCTION STAINING > Gram stoining DIFFERENTIAL 7 Aad fast Staining CZN Stoining] } STRINING > Bipolor Staining ORAM STAINING SEQUENCE > Memy! Methyl violet CCrystel violet! Gentian violet] Grom's Jodi = > = Mordant C éixer] Ratone > pecoloriger Sofranin > countr stain Grom = Positive ae Purple / violet Grom Negative + Pink > cell wall Thickness Crepidoglycan lays thickness J > most Important fartor governing gram Staining + Thick peptdogiycan Layer > Gram Positive feature > Thin pephdoeglycan faye 7 Gram Negative Feabure GRAM POSITIVE cocet Ail Cocti are Grom +ve — Except Meningocoeet Gonococci Veitonelia Moraxella Pll Gadi ore Grom —ive Except > Mywbocterio > Anthrace badilus 7 clostridium Species 3 Nocardia Ackinomytetes Listeria Dipheroid Porxrz00r ag@Acto Past siAINING > Based ACID FATNESS CA”bility fo restr decolorisat™ I + dun to mycolic AcLp content) > Mycobacterium Tuberculosis > av. Acid fast a Mycobacterium — Lepros. > 52 Rad Fost eoawnne) Nocardia > 47. Acid fost Q@breoraR smINENG 7% Poles are Stained, remaining spared > Examples Yersinia pestis Hosmophylus ducreyi Burkholderia mollei Burkholderia pseudo mallel Calymatobatker granulo matis Vibrio porvhemoly tions ¥+ydur (CAPSULATED ORGANISMS P — Preamococcur , Pseudomonas Anihrads Bacillus Klebsiella species TnFluanzae Hasmophiluk Yersinia species Bordutelia Speces Meningococci Clostridium perfringes [C. wuldhiJ » Cryptococcus neoformans Vibrio parahemolytions eozzeKxuxs capsule > Viralnce factor > Antiphaqouytic > mainly modi of polysaccharide Exapt? > pacilue onfirocig capsul, [madi of Polypeptide) + bemonstaked by QUELLUNG REACTION > copsulor swelling dit seroleqical reack® Mc FADYEAN’S REACTION > ebserved tn Becillus anrrads> SiamyY LAYER /BIOF TIM FORMATION 7 omer forme of coprule 7 Helps fo adherence > BIOFILM > Pnbibiotic resiglance can alto happen MOTILITY > dit flagella C Hagelin) + Antigenic 7% pemontrar® oF Flagelia ——_—— > Monotrichous = > Vibrio cholera —_—___>——__ > Amphitrichous «=F Blealigenes farcolis << et > Lophotrichous 7 Spirillom minos Spee > Peritrichoos «= E.coli Proteus , Ligkria > MoTILITY NAMES T > Tumbling > Usteria’ DF darting Fv. cholerae, S > Swarming > Proteus > Falling ba Like Giardia Lamblia (4 poirs oF flagella) > Spirochetes have ENROFLAGELLA > Prige From periplasmic Spoce > Treponema pallidum > cork sere motility Borrelia Loghing motility METHODS TO DEMONSTRATE MOTILITY | Hanging Drop memod 2 Semi Solid agar memod + Mannitol motility aqor if ured CULTURE MEDIA > SIMPLE compLex SIMPLE MEOTA > Nubrient agar gor solidifying agent Cav) No nultition provided 4d Nugiek = Peptone Meok extract 7 Nukrient Broth > Liquid culture mediaCOMPLEX MmeDTA @ ENRICHED meDtA + Solid culture media > Blood Agar 57, sheep blood agar used checololi Agar > RAC Lysis + - = Home | Released * > NAD © eNRtcHmMENT MEDIA > Liquid culture media > Selenite - F - Brom @ seiecrrve cuLTuRe mentA > mostly Solid > Lrmeoth for MTB (Malachif qretn is Seletkive agent] LSS mEnIE Fr Corynebacterium diphiieria [LSS - LoFFLER SERUM SLOPE) TCBS MEDIA For Vibrio cholerar Critosovpttare. CITRATE GILE SALT SucRDSE] @ INDICATOR » DIFFERENTIAL & SELECTIVE meEDIA, 7 Mpc - CoNKEY — AGAR > Color change LPink] indicalid > DifferenHolts = biw Lactose fermenting Non lackoge fermenting > Selective dit — Peptone Lackai Aqor Neutral red Taurochola sodium CL Selective Agent © TRANSPORT MECTA > mointaing the viability of organtem but 9p body i ollowed to multiply 7 VENKATRAMAN RAMAKRISHNAN meDrB CYR MEDIBI } For Vv. cholera. CARY BLATR STUART'S & AMIE'S = For Gomececcs & Meningececci PLKE’S MEOTA > for Streploceceus pysqenes SACHS BUFFERED GIYEROL SANE + For Shigella Bnosrobic medio =F ~—- ROBERTSON COOKED MEAT MEDIA THIO GLYCOLATE BROTH SUGAR MEDIA + imdicator — RNDRADE’SCLASSIFICATION BASED ON Oy REQUIREMENT © oeiigATe AERDBEC > need desperot 02 + re, Pseudomonas @ oettgare ANAcROBES > woes not need 0, of alt FB > Petinomycetes & + 8 asteroide © > Clostridiun @ PacuLratrve ANREROBES > changed anaurobe 7 ferobe + Anatrobe > Most oF the medically important bacteria @ MrcroMEROPHILES > need 5% Og only 7 compylobocker Helicobacter © crpnopustes + cog loving 7 Brucella abortus Preumococcos BASED ON TEMPERATURE REQUIREMENT P oF P£yhcrophile * — acc to +actc M > Mesophile = asc to 4°c [medically important bocteria) T > Thermophile > Sse, > y lode > Thermos aquakeur L Typical example] > osed in PR > Fother of RR + KARRY B MULLIS‘SYSTEMIC BACTERIOLOGY GRAM POSITIVE COCCI CATALASE TEST] & Negative, Positive STREPTOCOCUS STAPHY LOCOCCUS [_rosteive | Stoph. aureus Staph. epidermidiz Stoph. faprophyticus NOVOBIOCIN TEST | + eS Novobiocin Staph epidumidia Staph. Saprophyticuk + 3% Hyd + Staph. Colonies — Bubbles [catrinse Posinvel Ast Cantibiotic Sensitivity Tecting] + Eq Novobiocin sensitivity test 7 pene on MHA (muler Hinton Agow] NA Cautriene Agar] % KIRBY BAUER DISC DIFFUSION TESTING done ~ interpretation BONE OF TNATBITLON > Sensitive No BONE OF TNHTBITION > Resistant‘COagulase Negative Staph(CONS) Staph epidermidis > @ commensal of gtin epidirenidiz > ayes INTERVENTIONS - I canula, CSE Shunts, proshetic valve surgery — causes Early prosthetic valve endocarditie ( BIOFILM FORMATION Sen > helps in Adherence 7 Novobiocin Sensitive Bone of inhibit™ is tnt Staph saprophyticus > Young female develops UTIL. Me GPC involved —> S.Saprophyticus Young f&malk develops UT. Mc cause overcl => E.Coli > Novobietin resistance 7 No 20Me OF Inhibit? PATHOGENIC STAPH Staph aureus Gram positive cocci catolage tive Coagulase tive Gram Staining > VIOLET GRAPE UKE CLUSTERS CoLTURE MEDTA © NA LNubrent Agar] > GOLDEN YELLOW pigmantal” © BA CBlood Agor 7 - canter p hermolysis a — pin head sine colonies seen f eves @ monnitToL gtr AGAR [Best selective media] @ woiam's meoth © SALT mILK AGAR > VIRULENCE FACTORS ee eee © ickness oF peptidoglycan toyer @ Teichoic acid @ clumping foctor ® Protein a > is present in CoWAN-! Strain meee > plays a role in coAgglukination ® Hemolysing 7 Bd> a hemolysins > Shows PARADOXICAL ACTEON — tnatkivakes at p%c — reatkivotes ak lov'e > p hemolysins > ShowsK HOT & COLD phinomenon, = B hemolysis better seen ak 34% = th S.aurens better geen af ae © Leveocipin LC PANTON VALENTINE TOXIN] > kills Leucouyres > ToxLN MEDIATED LLINESSES © Foop PoLtsoNING 7? IP > \-6 brs ~ resembles Bacillus cerus emetic Strain — S.aurevs Contaminated meat & milk producks — B.emeic > contaminated chinese fost Food > dit Preformed toxin > Enterotexin A Hear stable Vaqomimutic act? / vagal Stimulot” @ ssssS [stppHyLococesL SkIN ScALDED SYNDROME] > dit Exfollokive Toxins A&B > aka TEN > Toxin EpidirmolyHe Neerlysis in adults RITTER'S Disease in Children @ tes Lroxte sHock SYNDROME > dit 188 Toxin CENTEROTOXIN FJ > tt 18 a SUPER ANTIGEN aurivates —>R07. Iymphooytes t masgive lymphokine release | shock 7 dit wtage oF cortominated vagina! tampons during menses+ MRSA, 4 OTHER DISEASES CELLULITIS IMPETIGO CARBUNCLES FURUNCLES BorRYOMMCOSES > mycetoma Like lesion TROPICAL PYOMYO SITS Post oP. PAROTETIS ACUTE OSTEOMYELITIS Roure MASTITES BANE veive EnpocARDLTIS Loriginal valve] IVDRUG ABUSER > RE SIDED VALVE ENDOCARDITIS ©89e96 60800 [ Memicillin Resistant stoph. Aurens 1 pec vancomycin = jw RED MAN SYNoROME MECHANESM OF RESTSTANCE © pep ——— PBPaa bmain mechanism] Crap - Penicillin Binding Protein), dic =MACA gene aquisttion ® produck™ oF p lathommasez SCREENING TESTS © ceroxtrin OXACLLLEN L + RESISTANT Resistant L 1 marsh Doubt (needs furmer testing] > con add 47, Noc! > Keep temperature oF incubokion +> <37% [30° -35°J ® PcR For Mec A Gene TRANSDUCTION — me meifod oF resistance trangfer in S- aureus — Bacteriophage medioted — PHAGE TYPING can be done — a3 types oF phages are ausilable — 80/810 + ome phageCLASSIFICATION ef_hemoly sis. B hemolysis Themolysis > claesified into A-V > based upon corbohydrali @in the cel wall Cuan@eeren ctascrerentrond = S$. pneumonior 8. viridang 4 > PF t€ divided into 80 types boned on M Prottin [qriefiTH TYPING] + Group A [s. pyogenes] B Is. agolackias] D [Enterococcus] Enterococcus GROUP A STREPTOCOCCT GROvP 8 STREPTOCOCCI Longest chain > S. salivorivs CULTURE meDtA ' eva Carystel violet Blood Agor] CV does mot allow Staph. produce p hemolysis PINPOENT SIZE COLONIES 2 PIKE’s MEDIA Tronsport media BACITRACIN TesT | > Sensitive > Resistant camp Test > Neqakive > Positive HHT > Neqakive > Positive comp Test > Christe AtKinS munch Peterson Test HHT > Hippurati Hydrolysic Test GROUP A STREPTOCOCCUS Streptococcus pyogenes > Gram positive cocci > cobalase -tve > arranged in chaint in Gram stoining Cviolet2 GRAM SHINING PENPOLNT STZE COLONIES7 pisenses ACUTE PHARYNGLIILS [ Sore throat] CELLULTES Impeti@o ERYISEPLAS —[ Lymphakice Involved) NECROTISING FASCITIS —> FLESH EATING BACTERIA PUEPERAL SEPSIS SCARLET FEVER Scarter Ruer toxin/Erymrogenic toxin —> Super antigen NON SUPPURATLVE ComPLLCATIONS o 8 e @ ic} © @ ® [ ACUTE RHEUMATIC FEVER |_Beute GLomERULONEPHRITIS H/o Sore throat HIo pyodermic Infeck? Immune responce — morked mild to moderali tenrnune response Complemuue levels are Normal complement —> tse, then Normal Lifelong prophylaxis of Penicillin Spontaneous b> Come § required Spontaneous to go Aso Titres — Y 200 t+ odd unig Anti ONASe B + 7 300-350 uu bead Saureos GROUP B STREPTOCOCCUS Hspehiee Streptococcus agalectiae een Z_Morenal conantal oF seth conab atte ate Leads to eorky or tai neonatal meningitis e-ourens Camp TEST tive Lenhontd|Buterely 20r0] wags: > HHT is tve ENIANCED /QUITER FLY ZONE OF hemdyés ENTEROCOCCUS + &. Faecolig . forctum > Resist 7 ©-57,Nocl ~ PH = qQ ~ 407 Bile ~ Ternperakure of 755°C for minus, > CULTURE MEDIA — BIE RESCULTN AGAR F Black coloured colonies > on GRAM STAINING, Speckade like appearane is Sean+ poc + Penidilin + aminoglycoside Vancomytin Cand line drug] Normal commengol of gut + cruses = Surgical wound Infections = th IV preg abusers, tk. sided valve endocarditis VANCOMYSIN RESISTANT ENTEROCOCCE + T van qew aquisition [van A - vont] - van ® ‘8 most resistant > pec > LINezoLTD ALPHA HEMOLYTICS > Gtviridens > Leads €0 SABE, Loh onset prostmebic valve endocarditis > St. mukons > leads to dentol cares > Early onset prosthetic valve endocarditis > Nokive valve endocorditis > In Iv png abusers — Rt. cided valve endocarditis — lt. sided valve endocortitis > SABE [sub peut Batterial Endocarditis] Woh onset prostnetic valve endocarditis Stop. epidermidis C Gram positive cocci > Lonceslate [Flame shoped] > DRAUGHTS MAN / CARROM COIN LIKE COLONTES on various Gultuse madia 7 copsulalid — mada of Polysacthorids — wemongtrottd by QuELLUNG REACTION — copsutar cuoelling — Serological reaction — Copsulor Antigen + Antibody — — sweurng | DELINEATON also seen in Homo philus influema - Diplo cocci Bile soluble Anolin fermenter Optochin Sensitive atochn Sensitivite, ono — om the basis oF capsular polysaccharide, dividid Into So types SSS Typing LC Specific Soluble Substana. boned Typing]> DISEASES CONJUNCTIVITTS: OTETES meotA MENINGITIS [mccanse oF meningitis in adults] Preumonta —[ Typical / Lobar Pneumonia s Type 3 7 Type 1] SINOSLTIS ovz00 bisve > VACCTNES 1 23 valent Polysaccharide voccin, - oged For Splenectomiaed individuals 2 + valent conjugal Vaccine — for Non copswloiid — Some ore capsulated > tens shaped Kidney shaped > ReuriRapid carbohydra. utilizet” test] | > — ReuriRapid carbohydrahs otilizak” test] — fermantz Glucose & maltose — ferments only Glucose > Plasmid recruit obsent[forresictancs)| > Plasmid recruit present 7 Extra /Intrescellulor 7 mainly, introuiviar e 28 f oe & i. MENINGOCOCC! > capsutATED - onthe basis oF capsular polysaccharides — 13 Seroqroupr - BBC, YALE most important seroqroups - pee > most infeckive Serogroups > VERULENCE FACTORS capsular poly Sacchoride @ IgA, protease ® Lipo oligo saccharide @® ome Louker mumbran. Proteins] © Pili 2 5-15% personf are normal nasophorynqeol carriers 7 Spreads by Droplet infections + Lungt involved 4 Houmatogenous cpread 4 Meninges [Meningitis] — Fever = vomiting headache neck sigidity> LAB orAGNosts © CSF ExAmINATEON Microscopy, + Ssomples taken ry Pathology For cytology ns for Biochemistry for proteins & Soqoss @ cours > on MHA THAYER MARTIN MEDIA > Gram staining shows Pink colored cocci arranged extra] intra cellular bot * most dreadful complication ~* IWATER HOUSE FRIDERICHSEN SYNOROME, — Adrenal Hormorrhagic necrosis F In C5-g complerunt defidency + Reuurent Neiggariol infections > vaccines MENINQOCOCCAL CONTUGATE VACCINE. — ockive againse AC, Y, Wd — No good vaccine is available Fer group & — Group B ig poorly immunogenic > TREATMENT — poc For carriers > — CIPROFLOXACLN, and line > RIFAMPICIN — pee For cates > 3rd genurak” CEPHALOSPORINS GONOCOCCI > TYPING — Pit based typing done — RuKo typing [Nutrient boned] done > Ip + 2-7 days VIRULENCE FACTOR © capsular poly saccharide @ 3qf, proteose ® Lipo oligosaccharide @ omp Coute membran. Proteins] @ pin Transferrin / LackoFerrin> DISEASES ® gonorrhea Moles > urenritis Femoles > cervicitis Newborn + Ophmalmia neonatorum > WE DIAGNOSTS (sure > mates vetted Swab > Females Endo Cervica! Swab High vaginal swab not tatn > Neonates Eye swab CULTURE MEDIAL THAYER MARTEN MEDIA Modified Newyork Agat GRAM STAENING Pink Coloured cocci arranged mostly fetraailulor COMPLICATLONS © WATER CAN PERINEUM — oceure in moter Curetiritis) @ FITZ HUGH GURTIS SYNDROME — perthepatitis alco ajo Chlamydia @ poty artHRtTs, SUPPURRATIVE ARTHRITIS > TREATMENT — pec + 3rd gen CEPHALOSPORINS Plasmid reruit + T Resistance against 3rd gen CEPHPLOSPORINS > OPHTHALMER NEONATORUM 1S MORE QW CHLAMYDIA THAN GonocaccuSGRAM POSITIVE BACILLI ‘CORYNEBACTERIUM DIPHTHERIA (Klebloffler’s bacillus) > geAnuLes mekachromokic qranwles Polqmetaphosphah qranules volukin granules Babes ernest granules ®e@o > There ore Energy deposite > Stained by P > Ponderg Stain 8 7 Alberts Stain No Neeser Stoin + cuneiform aurangemint | chinese letter patiern ae % > couture meota mie taue > ss [ toreler SERUM sioPE] chinege letter pales: > potassium tellurite Agar 7H Hoyle’s medio 7M macleo de media >t Tindale media 7 USS Is vsed For early Dx C 6-hred > Best Selective media > Potassium tellurite Agar > BTOTYPES colonies on PTA @© gravis > patsy ’S DAISY HERD APPEARANCE. @ antermentus 7 FROGEGGS ore FROG EGG APPEARANCE. ® mts > PoacheD POACHED EGG APPEARANCE > DIPTHERIR TOXIN > mode of A+B [Bipartite toxin] > Strong exotoxin > needa Optimum ron for tHe act” > 3 helps in Binding 4 A > ADP Ribosylakion oF Elongak” Factor a hibition OF Protein GynFesis oF celh cell Deak> every Corynebacterium diphtheriae ig not pathogenic, but made pathogenic by B phage tox gene LYSOGENIC CONVERSION Ligsogenic Phase Lytic Phose Port oF Transduct? 5 Ceaureriophage mectabid J moet dangerous location ~ 7 Neck edima tne = > BULLS Meck > CHRONTC COMPLICATIONS 1 myo carctitis 2 Poly neuropathies NON CORYNEBACTERIUM DIPHTHERIAE © c. parvum > immuno modulator ® ©. jeikum > MmpR fsolali @ C. minutigsimum > causes Erythrosma coral red fluorescence ic Senn @ c. pseudo th He Causes animal diseases aka PRETSZ NOCARD BACLUL > TOKEN DEMONSTRATION © LEK GEL PRECIPITATION TEST ® Pcr for tox gene ® ELISA for toxin production SCHICK TesT determines Susceptibility oF on individual to diphtherios te positive > needs immunize: tr neqabive + already immunized neukrabizak™ test > diphijeria ig ToxEMTA not Backeraumia, > PRESENTATION > PseUDOMEMBRANE’S me lecation > faucial Cronsilior] Laryngeo! C retp. obstruct)BACILLUS ANTHRACIS > aps [Gram Positive Bocilli] > Non motile 7 capsuloted 7 Spore bearing — Certain size spores used in Category A Bioterrorism > CAPSULE made of Poly peptids Mc FADYEAN'S REACTION - demonstrates capsule — Culture qrowlh + LOFFLER'S METHYLE BLUE —> CAPSULAR STAINING > BPPERRANCES GRAM STAINING > BamBoo STICK APPEARANCE [purple EO Violet] PENICILLIN AGAR > STRING OF PEARL REACTION GELATIN STAB CULTURE => INVERTED FIR TREE / INVERTED CHRISTMAS TREE, NORMAL AGAR MECROSON > MEDUSA HEAD] MATTED WOOL LIKE | MATTED HAIR TRE Hand lens) — observed on edge oF colony — also cen t Blood Agar > CULTURE mEDTA a So ¥ PLET mEOEA [Best Selective media) Bee f BO. i Sees | olymyxin Oy x de LF Lysoayme get ae — 7 €or oH T > Thallovs acetal porcelains nag > RNTHRAX ToxIN 7 mods OF TRIPARTITE TOXIN E Edema factor P Protective factor Lo Leal Factor > otks synergitically > 4% came > pIseasec CUTANEOUS ANTHRAX PULMONARY ANTHRAX (HIDE PORTER'S DISEASE] Coot SORTER’S DISEASE] > eschor > occupational Horord F causes mediastinal hemorrhagic necrosis! > Pustule non pitting edema > Prevented by DUCKERING - makignant Pustule Pre treat the wool by formaldihyds cSporocides > INTESTINAL ANTHRAX = __ Spread trough contaminoted wild animal meat ingestion> LAB DIAGNOSTS © Ascolrrs THERMO PRECIPITATION TesT — (ASColi > Anthrax antigen] ® FcR for Bodillus anthracis BACILLUS CEREUS EMETIC STRALN 3 TP > 10 Ghee > causes Food poisoning DIARRHOEAL STRAIN Ip > @-léhre dit chinese food resembles Heak stable toxin of | > E.coli in ackion > T camP resembles Heak labile toxin of E.coli in action % tcAmP > curr mest > MYPA [Mannitol Yotksac Polymeyxin Phenol Red Agar] MeDrA CLOSTRIDIUM ctens| > es + Mon copsulaked > motile + StaTELy [Slo Form oF Stoarming) Excepth > 1. perfringes (copsulaked , Non motile )d porfringrs COLTURE MEDTA ReDearsoricoener ROBERTSDN COOKED MEAT MeEDLA Meat meotum 7 fe meot pieces turn PINK > Sacchrolytic perfringens > If meok pieces turn BLACK > Proteolytic > dl. tetoni SPORE ARRANGEMENT 7 Terminal & round + DRUMSTICK APPEARANCE > Cl. tebani > Sue terminal spore > most clostridia > Cena! spore > cl bifermuntane Clost > ium perfringens/welch 12 major & minor toning are present 2B» epsilon, theta, iota Type PB - & most infection are caused by Type A/a toxin Bol clostriciiurn perfringensDISEASES © GAS GANGRENE | CLOSTRIDIAL mYONECROSIS > 1p > 1-a doy > UF + Pain crepitus L@an in the deep compas mentI > TREATMENT > For tnitial lesion > Gurgical debridmant | Antibiotics > for Advanced case > Penpukakion oF the limb + antibiotics > Gas Gangrene cavsen BY Pp od. perfringens No a. novytf S > d. Septicum ® Foon Poisoning > dit contorninaked meat products > 1p > 6-auhre > Involves Heat Labile enterotoxin > bur spores are Heak Resistent ® piqper > dit uncooked pork consumption > couses necroticing enteritis > dit B toxin TYPE REACTIONS @ NAGLER’S REACTION ® sTORMmY FERMENTATION IN LITMUS MILK @ taR@eT HEMOLYSIS [ Double ZONe OF hemolysis] @® Reverse camp TEST ® NagLeR’S REACTION > dit -Ledtibinase > this a neukralizar” Reaction 7 done on €qq Yolk Aor @ STORMY FERMMENTATEON IN LITMUS MILK @® Target Hemocysts CoouBle 20NE HEmoLysis] + anner zone > dit © toxin outer zone > _dit_ a toxin Frkitonin NO Anéitoxin + tmmense Famenkation of colored milk TARGET 2ONE STORMY FERM- Hemonyers — ENTATEON. 2: perringens opacitySpeen @ REVERSE cAMP REACTTON + Bow TLE HEMOLYELS % St. oqalackiat 49s (st.aqalation) Bow TIE HEmowvsts| REVERSE CAMP REACTION Clostridium tetani TOXINS © TETANOLYSIN @ TETANDSPASMIN > more donqerous > couser presynaptic inhibition of Glycine GABA Linhibitory neuro - transmitters) > constant Stimulation 4 Lock yow [ TRrIsmos] t DRIMETECK APRERRA- OPISTHOTONUS PocTURE NCE OF ct. Cetani + % Deep Tendon Rerlexes Ip + 8-10 nays > ie ww > clean practices > antenatal immunization > Hospital deliveries Clostridium botulinum TORLNS © Nenrotoxing Cmainj > most potent toxin On earth ® q Centerotorin > aj canned food poitoning CANNED FOOD POTSONING CLINECAL FERTORES 7 pysphagia 7 diplopic > diarythria > Conertparion [ dit Ach] > JorINFANT BOTULTSM > ako Sporulared honey ingestion > CLINICAL FEATURES > Floccid paralysic => FLOPPY INFANT SYNDROME NEOROTOXIN USES © Botox treakmunt + Eo remove corinkles @ Eye Surgeries > Blephayo spar, > Strabigrus, DIAGNOSIS © PR for cl. botulinum @ caltwe for cl. botulinum direkt to teolot CLOSTRIDTUM DIFFICLE ASSOGATED OrARRHOEA [cDAD] > TF mot Ry in tim, tadx fo Pseudomembranous calitiz > @ commensal: of quer L el. difricle] 7% T iwokional broad spectrum antibiotic Usage « Normal Flora destroys cl. difficleg attaches to qut 4 Diarrhoea LAB preqnosts © TOXIN DEmoNsTRATION [Enterp toxin [A] + Cyto toxin Lo] J Dumonetraked on Hep Q cell nes Ceemmonly used for viral isoloth PCR for tox gent ELisp for toxin production StamorposcoPY bo vigualige any ulcer CULTURE For Cl. difficeMycobacterium tuberculosis > ActD Fast F obidity t resict decoloviaakion > depende on = Mycolic Acid content F VIRULENCE PACTORS © cord foctor @ Lipo arabinomannan F ip children, lower Lobes are involved > GHON's Focus + Hilor Lyrmphadnopoihy =F GHON'S CompPLEX 7 calcified tHlor Lym phodino palny > RANKE’S COMPLEX > PosT PRIMARY TB y Upper Lobes are involved > Subpleuro) focus > Stmon’s Focus > BIL tnfrocloviutar Lions > ASCMAN"S Focus > skin TS Me primary lesion — LUPUL YUL@ARIS C Apple Jelly nodulec] and me lesion > ScROFULODERMA > qe me sig + Leo caecal yuntkton + Bone ta > Por’s spine Le oragneccs @® sputum ExAMENATION > sputum samples taken © onspot sample ® Early morning Sample > conuntrazh mimod > PETROFF’S METHOD > Thick sputum + NaoH | Hel > Liquified sputum © 2N smENTNG Spukum smear 4 casbol fuschin Enferrnitient heating QO HaS04 [ Decolouriser 7 1 Meliglent Blue Btve backqround 5 Pinkingh to red coloured Badllli© 15 mente [ LoweN SEIN JENSEN mented > baqx are ured for Solidifrcation > &leckive media agent + Malachite qresn 7 Green colored medio > Rough , Tough, BUFF Colonice > Rough % wrinkled opparance aeee > Tough = diFFuME to remove > Rore > Yeliowith grown MTB PCR METHODS Gene xpert wit [ vif - debection of Rifarmpicin resistance] conept [cartridge RBared Nuckic Acid Amplification test] Line Probe Pssays MTB PCR+ MuLH Drug Resistance detection 7 con give Me results tin abre > Drewwback OF PCR + pees not differtiaked blo Active and Loknt TS ©@00@ @ QuANTIFERON TB Goto ASSAY LIGRA — Inkrferon Gamma Releose Assay] Mycobackerfal Antigens Stimulate BLOOD sensitized T byrnphoayies mensure Interferon T activity Cactvity OF Sensiticed T Lymphocytes] Priov expoture will be Eneton > Drowsback > pees not differtiaked blo Adkive and Latent TS ® puRAmINe - RHODEMINE STRAINING + Flupreecent staining > Bene in cages of move Lood > Prowback 5 Falke positive Robe are high @ sueERcuLiN Ter | monroUX TEST > ot ml PPD CPurifred Prolein Derivative] > into Flexor aspect of fore arm > after Sdays,meagure Indurakion [ Hardness Diameter] <5mm ad Neqokive 5 -1omm > Equivoce) 7 tormm 7 tive> False Positive reant Beg vacdnak” typical mytobaereria. infection > Falte neqabive Hiv +ve Crdvanced staged Mi jury T3 malignancy Immunosupression Delayed hypersensitivity reaction Beg [Bacillus calmette Guerin] vacctNe > dertved from Banith 1331 Strain oF Mycobacterium bovis > Anta demo > biluane > Normal soline 7 RFFCOy > 0- 807% > 12 1 a@ Nokifichle bieoxe + Serological reste[mTa cord testa , MTB EusA] are boned in Sndlia Atypical Mycobacteria RUNYON'S CLASSTFLCATION PHOTO cHROMOGENS Mask SCOTO CHROMOGENG ss4 NON CHROMOGENS MAC 4M. xenopi » M. Ulcrrans RAPED GROWERS mM, datoni »M, fortuitum PHOTO CHROMOGENS 7 Grow in Light 7 M — Mgcobatkerium — marinum Mycobatkerium, Mgcobatkeriam — gimiok Mycobatterium — Konsa sit xo GCOTD cHROMOGENS > @rovwe in dartness > SS Mycobatkerium — ®aulgal S mygeobatkerium — SCrofulacaunm G — Mycobatkerium — gordanazNON CHROMOGENS > neither Light nor darkness required > mpc > Mycobacterium awium Complex / Myvobaderium intracellulare aka +: BATIEY’S BaCELLUS 7M. xenopi > wm. ulovons RAPID GROWERS >, chalont 7m. fortuitum > mM Pbiei > MM. Smeqmatis. DrsEnseS © SWImmING Pool SRANULOMA / FESH TANK GRANULOMA, > qt M. martnum @ BurRvit vice > dit ™.vlerans @ post invecrton Aascess > dit RePrD GROWERS ® most Ptypicad backeria covsez + CuTANEDUS INFECTIONS LYmPHADENOPATHY Peypical Mycobacteria which mimict M.7TB in Lung involve > M.kangassi Mycobacterium leprae 7 causes HANSEN'S DiseRse + Not cutured in pure culture media Cdoes rit folloco Koch uncle's Postulates) Grows fn Foot PAD of ARMADILLO CNine Bandid] Groor Ip FooT PAP oF MICE LEPROMmIN TEST cio > Type iv HSA nine banded Armadillo > Lepremin Test ig a PROGNOSTEC TEST, nok aq diagnostic tect EARLY LEPROMEN REACTLON/ LATE LEPROMLN REACTLON/ FERNANDEZ REACTION MITSUDA REACTION > rend oer 3 days > rende ofte 8 wre measures Indurat pianucer > _mensures Nodular diameter LEPRA_REACTIONS TYPE 1 LEPRA REACTION TYPE 2 LEPRA REACITON = pasen grading reaction > Erythema Nodosum Leprozum > Type W hypersensitivity > Type M1 hypersensitivity reaction > me Feature > edema =| + immune complex Mectiaked Teattion!| 7 ome nerve involved > vlner > crops OF Mmocules & Modules aver the skin Cait INF a]> can occur spontoneoudly oY oFter the treatment * lepra Rent ig a case oF -emurgenuy > poe + Gluco corticoide \me DingNosis GLIT SKIN SMEAR EXAMINATEON > Token from > BIL ear dobes > forehead 7 hin > Buttocks > ® Natal mucosol seoabs ZN Stoining. > add carbo! Fuschin + do intermitient heating 3 a somos & > add Mettylene Blue F Blue Bodkground 7 cigar bundle Shape /Globl like amangemmnt oF Maproa seen TREATMENT © Pruct BACLLLARY > ptR > popsone Rifornpidn > For & monma @ Moitt BACTLLARY > ptcrR > DAPSONE CLOFRZIMINE RIFAMPICIN: > for tyeor > For Prognosis of kprosy 7 MoRPHOLDgECAL INDEK > Better — measures % OF Solid Stained botilli [ Live bacilli]Nocardia & Actinomycetes NOCAROLA, ACTINOMYCETES > _Obliqali Aerobe 7 Mt Arid Fost > _Anaurobe mostly non Add fast bur Some species are acid fost > causes PULMONARY NOCARDLOSTS . —% ABR santier Ike branch ing Cetlamentoor toronching) + PCTINOMYCETES ee es Solphor granule Mycezoma > causes ORAL ACTINOMYCOSIS 7 sinus Swoelting TREAD, Sul phus qranvles + me site 4 cervico fotial SULPHUR GRANULES crush & See under microscope 7 SUN RAY APPEARANCE R ae jonieme > ACTENOMYCES ESRAELIT > cause PID > Adid fast in nobure Bom Nocardia & Berinomycer > stecardia cawian > Nocardia axteroides > Ackino madwa > _Betino madurar + cuLTuRE oF NOcARDLA 7 PARAFFIN GAIT TECHNIQUE Combine to couse > ACTINDMYCETOMA, > CULTURE OF ACTINOMYCES + = morHy mem cultured > Buk come cam be cultured 7 boc > CoTRLMOKAZOLE > pot > _PENICLLULIN Listeria monocytogenes > gram positive cece? Badilus 7 Turbling motility CPeritrichour flagella] z= cuttuRE > Blood Agar 7 chocolokk Agar > prLcAm Agar L.monoaytogenes > COLD ENRICHMENT meTHOD Lak afc] > ANTON TEST Positive > camp TEST Positive > CATALASE TEST Positive BNTON TEST > Pulting the Ligkeria culture into eyes oF Rabbit > KerakoconguncivitisDISEASE S ® @ ® GRANULOMATOSIS TNFANTESEPTICA [ sn neonalzs J MENLNG tS C children Cmoiniy) » Adubrs] CHORTOAMNIONITES (Sh preqnangy 1 — PROM “— Preterm Bivihs — Abortions SEPste [in immunocompromized J Doc > PMPLCTLLIN Listeria Bhouk DOLFFERENTIAL Motility boned of temperobure — Be > Non motile ao ~ a5 7 MobileGRAM NEGATIVE BACTERIA ENTEROBACTERIACAE CRITERLA © grom Negakive Bacteria ‘i leerese 10, @ cakalare Positive Se ae @ oxidare Neqakive ® Nitroh to Nikviti Reduckion Tect Positive SS Sore © motite Klebsiella @© ferment sugar § Produce Acid wits qos Shigella. sonnei E.coli | I M Ni c | zweoue METHYL RED | VOgES PROSKNUER exrRATE Positive Positive Negative Negokive Megokive. Neqakive positive i ae tiv j vovae's reogat j + color change in citrate Test = Green to Blue L“ Gram Bacillus”) DISeRSES © urt ® orAarRRHEA @ NeonATAL MENINGITIS @ EmpHysemArovs PYELONEPHRITES @ PooRNTER'S GANGRENE © PRIMARY BACEREAL PERLTONITIS @ sScromeorp frst POLSONTNG [ E.coli » Morganella) ® —Histomine Production tnt UrL “P Fimbriat pokses sing E.coli obath Eo woepitheliol cells > 105 E.coli] ml OF Urine > SIGNIFICANT BACTERIURIA > Griteria For diagnosis of uTt © > 100 colonies x 10% + Y 108 / mi ® > to colonies x 10% + > 10%/rat @® Symptoms] siqne oF O13 Coysoria, burning micturition] @ even | batkeria|mi in Sopra pubic Aspirol (103 - pilubion actor)> > 2 bypes oF Colonies on a culture plo + CONTAMINATION + Gen repeat the sample > mid thea urine Somple taken DEARRHOEA CAUSING E. coh EPEC > Enterp Pathogenic ©. Coli Etec > Enter Invasive E.coli ETEC * Enlero Torigenic €.coli EHEC * Entero Hasmorrhagic E.coli EREC > Entero Aggreqative E.coli EPec 7% causes Pediatric age qroup Diarrhoea * atrath to Enteromtes §& Damage thim — cauzez altaching & effacing lesong erec 7 resembles sHIQeLLOSIS > dit vm Envasive ness] + SERENY TECT Positive erec ? causes Trovelers Dforrhoea > Toxtns Heat Stoble Toxin? ads by T Camp Heat Lobile toxin * ade by T cAMP EHEC > ott He ° > somatic antigen 4 > Flageliar antigen 7 Comzer Hemolytic Uremic Syndrorre ‘in children > Tortns Verotoxin 1 & & C VERO TOALGENTC E.coli] -* SHIGA LIKE TOXIN > cokure media + SMAC LC Sovbital Moc - conkey Agor] Does not frmunt Sorbitol EREC > cuter Persistent type oF Diarrhoea couses Travelers diarrhoea too Chuo cases] F STRACKED BRECK APPEARANCE on Hepa Cell linesNEONATAL MENINGLIES. + mce oF Neonatal Meningitis -* €.coli LZ ki antiqen] and mec 7 Klebsiella Brd mee > 4@es C St aqalactiar] SCROMBOID FISH POISONING > aw Histamine production * coused by E.coli > Morqanella - morgan — belongt to family PROTEA — Prokeuz if another member of the family KLEBSIELLA 2 2 MMO? - = + + > Gram Neqakive Gacillos > cupsulaked 7 pon - motile > Lacoste fermenter > Urenge Positive L Yellow — Pink] JOREASE POSITIVE ORGANISMS: Stoph > — Stoph . aureus klub > Klebsiella maln > Morganelia ‘Urenge > Lreaplagma oreolytiaun Programme > Prokbgs Hod > H. pylori Cmax, urease produar] Chaloe 2 __ Cryptococcus neoformans Klebsiella pneumoniae [ FRIED LANDER’S BACILLI] > comes Typical pneumonia > aye REO CURRENT JELLY SPuTom 7 gw BULGING FISSURE SIGN On CXR Klebsiella ozaenae apo ozaana Cotrophic thinitis] 7 Roomy nose % Unmmense foul smell > Re by Naked, douches MODIFIED YOUNG”S OPERATIONiella rhinoscleromatis > couses Rhinosderoma [woony nose] > oMrkuLI2 CELLS RUSSEL BODIES Klel Seen Klebsiella granulomatis > causes Granuloma tnquinale Or Donovanosis > DONOVAN BODIES ose Seen > BIPOLAR SRFETY PIN APPEARANCE New Delhi Metallobetalactamase - 1(NDM 1) > aka SUPER BUG 7K. pneumonia strain > resistant to all meet all te drugs + dit metallic eyme > Metallic Ackion + Teed virulence > now termed an MEeTALLO BETA LACTAMASE 1 PROTEUS > ane > swarms 7 EMhIbTE Swarming by Sarton - 4 % oF Agar Hom ay to eh ‘nstill Some chemicals C Boric acid & chloral Hydrol] 7 can be cultured on Mac - conkey Agar > produce Non Lacbose Rrmanking CNLF] Colonies Phenyl Pyrusic Acid Agar FISHY SMELL] SEMINAL SMELL produced Or both media > DIENELS PHENOMENON Proteus Profes Proteus Nolgarie mivabiis Volgaris Border not crossed crossed borders + PROTEUS ANTIGEN INTERACTIONS 72 OK1I9, 2 GK + cross reacts & Rickeltsiol Family members 7 Gives WELL - FELIX REACTION C Heterophile agqlukinokn test 3 F oxk if strongly positive For Suub typhus > Protexs aju chronic orl Leads to Struvite | Triple Phosphala stones / Straghorn coleulosSALMONELLA > ens > motile motty non motile -* S. gallinarum S. pullorom > KAUFMANN & WHITE SCHEME is used to Classify Salmonella Salmonella typhi > comges TYPHOD FEVER, > Enteric Fever caused by - S.typhi — G. porakyphi AB &C tranemitted by Faro ore! contominat” Stepladdar pattern Fever ROSE SPOTS Senn Longitudinal olars seen PER SOUP DIARRHOEA Gan ROSE SPOTS Yee te {AB DIAGNOSES B o> Blood cukure > 1st Week B > Agglubination Test > and Week S > Stool culture + 3d week D> vrine Gulkure > 41 Week Blood CULTURE > overott Best > Bloed 2 culture Fiuid F rete Ceg. Smi:5oml] — Bile bron oF Glucose brofy can be ured > Bdd SPS C Sodium Polyaneiol Guifonal ] — Eo remove antibiotic effect WIDAL TEST > Highly Sensitive bus Poorly Specific. = alco Positive in BFP - Biological False Positive = AnFecbiout mono nudleosis © Oo O 7 Malaria ° * a © ERs mae Se) 068 ee ) titre agoinse 0 + > {i100 } restrive Hw > > 14200 Flagellar antigen is more immunogen 7 Paired testing should be done , oFter a weeks of Initial testing and test — 4 fold t in titre should be presenk + PositiveF Pntibody titre Values are not red, they changes according to loality > Types © stipe wrpAl Test @ Toe weoAt Tesr = Serial dilut? t Normal sadice PROZDNE PHENOMENON is avoided - Proaone phanomenon > Antibody excess STOOL & URINE CULTURE > Enrichment midio CSELENTTE Ff SROTHI is used + Selective medio pcA Coeony Chola Agar] XLD CL xylose Lysint Dedxycholati J SS CEalmonella shigello Agor 7 HE [Hektoen enteric agar] ABOVE MEDIAS ARE ALSD USED FOR SHIGELLA Except WILSON & BLALR MEDTA — Best media for S. typhi CESCea eat — Jet Black colonies are produced colonies in WB - medion Vi Antigen > vi mostly covering up 0” 7 Vi phage Eyping con be ured for epidemiological Studies NON SALMONELLA TYPHT > s, typhi muriom S. cholerarsuis > Ss. typhimusium | camses S. enceridig Gastro enieritic FS. typhimurium — aj cContorninated Poultry Products — con enter the Intact qq shell boc > Brd generat CEPHALOSPORINSSHIGELLA > 4ue + non - motile > Mannitol fermentot? Based classificak™ used — nen mannitol fermenter > Shigella dysentrian catolage ive + S. dysentriow type 2 vena C viruuunce Marker Antigen] > responsible invasiveness Secrets Endo & Exotoxins SHIGA TOXLN Exo boxin — by S. dysenteran yeud > mee of badillary dysentry in Ondiqa > S. plexneri mee of badilary dysentry in World > &. sonnei — S.Sonnei + Lali Lackose fermunter Cue] > cucTuRE mente — Same as Salmonella Transport madia + Sach’s Burfered Glyarol Saline Non fermenters — Doesnt fermunt Sugars © Psesadomonas @ Burkboldsria males @ Burkholderia pseudo male: @ pcinetobacker baumontt > 4@nB > catalase tive co > oxtorse tive a Oxidage veagent ee — Tetra muy! Pora Phenylent diamine di hydro chloride — comes as white Dise — change oF color from White to blue tin lose. > Positive > VIRULENCE FACTORS © Capsular Poly sacchoride ® Alginic Add @ Pigments a Pyoujanin = > Blue &. Pyorubrin 7 Red MULLER HELTON © Pyomelanin > Breton Black hana4 Pyoverdin > Green me mostly found in Pseudomas aerginosa [ verdigris] These piqmentx enhance mn KING'S media > Best Sdeckive media > cetrimida Agar DISEASES | SHBNGHAL FEVER MALLQNANT OTETES EXTERNA ECYTHMA SANGRENOSUM VENTILATOR ASSOCLATED PNEOMONIA BURN WOUND INFECTIONS MENINGITLS oTt Psaudomanas infec koupurn > ANTE PSEDDO MONAL DRUGS 1 PolymyAtN ~ 8 } bo resistance reported uptill 2 COLISTEN BURKHOLDERIA MALLE! > Couses GLANDER’S DISEASES — animal digeage CHorses] > Non - motile BURKHOLDERIA PSEUDO MALLE! > couges —mettorposrs > aka INHITMORE’S BACIULL VEITNAM BOMB > Bol Burkholderia are Bipolar Stolned ACINETOBACTER BAUMANII > ev iol > MpbR Cmulti Drug Resistant] igolott > Oxidate negativeVIBRIO CHOLERAE > on the bagig of “oT antigen, vibrio classified into [ classical [__Eltor Polymyxin 8 Sensitivity Sensitive Resistant Mukherjee Phage M Susceptibility Susceptible Resistont Mukherjee Phage Susceptibility Negative Positive ve Cvoges Pros kouer] Neqokive Positive camp Neqakive Pocitive Chick Erytrowte Agglubinat® test Negative Positive > sue vIvEstons > classical > ogava, inaba, Hikojima 7 eltor 7 ogava, Inaba, Hikojima 7 first 6 pondemics caused by > classical Fi pandemic caused by > Eltor > Eltor - Place In Saudi > Hay — Quarantine station > NON 02 + 62 ~ 013g NAG > non agglubinable vitvfos + CHOLERA TOXIN: > RF ADP vibosylakP oF GTP > 7 in adenylaki cyclone activity — > camp + B + Binds to Gm, qongifoside receptor > inboceiular waker Comes ED Lumun resulting in monsive diatrhoes 7 Massive Diarrhoea ‘ — Non Inflammatory diarrhoea +] — RICE WATERY stools " ~ Fesembles Arsenic metal poisoning > cWLruRE mEOTA Tronsport media C mointain viobillty , no multiplicakn I © VenkorRaman Ramakrighon Media @ cary Blair media Envichrunt Media > Alkaline Peptone waker Selective media © 1cBS Chiosulphali Citroll Bile Salk Sucrose] > G@reey 7 Yellow Cdlt sucrose lysis] > Best seleckive mediaHALOPHILIC ytBRIOS © v. porshemolyticus C 4-87 halophilic] @ v. vulnificus C 8% halophilicd @ v. alginolyticas C10 halophilic] Y. PARA HEmoLYTIcUs > causes Sep FOOD POISONING F al KANAGAWA PHENOMENON on WAGATSUMA AGAR Lenhonud Bhimoly sis] VERIO CHOLERA ci oZHO = pyude cakalate positive Oxidate positive Indole positive Nitrakes t0 Nitrites Reduckion Test positive Sueroce Lysis String Test positive on Hanging Drop 5 PARTING MOTILITY Seen > STRING TEST STRING Test POSITIVE Sodium de oxy cholo CBile salt] ig addad to Stool Sample Try fo UF T Loop =F String iz formedHAEMOPHILUS, HAEMOPHILUS DUCREYI > coulgez CHANCROID [SFE Sore] — painful qenite) olor 7% Grows on Chocolete agar coLTuRE meotA 4 ITssve BIOPSY + STATNING 7 TRAMTRACK APPEARANCE or ScHOOL OF FISH APPEARANCE, HAEMOPHILUS INFLUENZAE CAPSULATED NON CAPSULATED. > cages invasive diseases = Meningitis > Hon invative Diseates — Obitig mdio — Fpiglottiti — Sinusitic — LRTI 7 Shows SareLLeTtsm “eee tte + LEVINTHAL FLELO’S AGAR iz Used mae E) releates XV Sted ager SatelibisryH. AEGYPTI CUS > cones © Pink EYES © BRAZILIAN PURPURIC FEVER NORMAL MOUTH COMMENSALS HB. porainfluenzat 4 H. aprophilus . H. parma oprophilur a Aggreqabibacker [Actinobacillus myteticomitans] c 7 Cardiobatkerium hominis E * — Eikenella coordens Cajw human bites] kK 7 Kingella Kingoe They con caiute culture negative Endocarditis In immuno compromized BORDETELLA PERTUSSIS > causes PERTUSSIS | WHOOPING CougH / 100 DAY couGtt > cuLTURE MEDTA ' BORDET GENg@OU MEDIA 2 REGAN LOWE MEDIA > cough PLATE METHOD obSolel. now > SPR Csecondary Attack Rak > > 47. > stages © cerprahat > most infectious © Paroxy somal > whoops tnt @ convarescent Recovery phone erg > 1p + 1] Wks > mB oLAGNostS © Naso Phoryngeal soabs @ culture media > op Borde Gengou media > BISECTED PEARL APPEARANCE © Pca for ©. patussiz > RCELLULAR PERTUSSIS VACINE * vred now Cequal in erficacy t Cellular voctine] * made op of — Pertussig Toxid — Fimbrial Hosmaqqiutinin - Petockin — Agglutinogens 1, &3BRUCELLOSIS BRUCELLOSIS + -roonctic Diseate > causes Brucella abortus + infects cattles B. melitensi¢ > nfeckt Sheep, Soot, corne! B. Suis 7 infect Pige B. conis > infece voge + Mor + by eating @ drinting contaminated food g milk producke B, MELITENSIS > causes AWTE BRUCELIDSIS / MPLTA/ MEDITTERANEAN / UNDULENT FEVER — Typhoid Like Illness > imp oLAgnosis © Blood culture Tokio oF blood & clue fluid > 1810 Glucece Brof ig takin az culture Fluid Add ERYTHRITOL > Stimulai Brucla growth carried by CASTANEDA METHOD — Biphagic media C Solid & liquid culture media] — use — minimiaes contominst” in Sub cultures @ catalase positive Onidare positive Oreaze positive TBLESL PHAGE TYPING ig dene STANDARD AGGLUILNATLON Test CSAT] is done PCR for Bruclla species TesTS FOR CONTAMINATED MILK FOR BRUCELLA © @B8B sengar CARB Test © mick @EN@ test © WHEY AGGLUTINATEON TEST ©9080 7 poe > DOKYCYCLIN,PLAGUE > caused by Yersinia pestis + wees © B > Bubonic > IP > 2-F days @ Ss + Septicammic > IP > 2-4 poys @ P > Pnumonic > IP 1-3 pays mast Dongtrous] > wLTeRE meni GHEE BROTH = — STALACTIrE TYPE OF Growth Wi RakFlea index © cheopis index is used > LAB DIAGNOSIS © Buboes Smear @ Blood smear > poc > STREPTOMYCLN > Last major opidamic endia > Surat ; Gujarat LEGIONELLA LEGIONELLA PNEUMOPHILA > most commen > mor © herosel rouli From Centralized AC plants ® Drinking contaminald woker t Legionella + cisences © PonTRIC FEVER @ LEGGIONARE’S PNEUMONIA + Atypical pneumonia > complicates 7 Encepholitis & Diarrhoea > cyoLruRE menta > BuFrered charcoal Yeast Extract PCR For Legionella species > Legionella micadedi is Acid fast in nature 4 CULTURE. mE DTA > Legionella cultured on — RCYE T a - Ketogqlutarote , L-cysteine & iron of pH oF 6.9, temp. of 35°C & 957. humidity & Aptibiotes added for celecivity — charcoal acks at detoxifying agent colonies + round t an entre edge, qlisiering, Convex » gfeen oF pink indesent & speckled opalescence } + NAYSON STAIN -, GLPOLAR STAINED t PPERRANCE } LEGLONNARE’S DISEASES = ala mortality Cecved Beye cuLTURE MeDrA (& ground glass)‘SPIROCHETES + Spiral in. shape = > perk FIELD microscopy ig done — botkground is dark — teflected light if ured Bark Field SCO" > PONTANA & LEYROITE STAINING done ‘seoPy Sliver Impreqnakion murod makes thum thick TREPONEMA PALLIDUM. 7% causes SYPHILIS > IP > 4-40 bays > stpges @ PRIMARY > Hard, painless chaneres sein @ SeconoARY ~* Rasher over the polme & Soles are present Condylomna lata lsiong ore san ~ most Infectious lesion 1 © rent @ Terrmary + GomMAS CSkin Lesions) sein Complications Neuro Psyphilié — presente C GPr [ Genial Poolysis of Inson] Tobes dorsalis L Cardio vasuilar Psyphilis presente & Aneurysm oF Aorto > Upp orAGnosis © NON TREPONEMAL TESTS @ vort Cveneral Cteeare Research Lab] © rer [Rapid Platrna Reognt] DRL RPR | > needs a microscope > Better Test > Fluid i to be prepared € - cord test to be used in auhrs — no Fluid is prepared done L cSE Lneuro Syphilit] > th CSF sample » RPR fail Best test to assess prognosis© TREPONEMAL TESTS @ Pra - ABS [ Fluorescent Treponema! Antibody Assay J © vex [ Treponema pallidury Immobolizak® Acsay] © THA L Treponema pallidum Hoamaggiutinak? Assay] @ trea C Treponema pallidur Partial agglubinar® assay] MOST SENSITIVE > FTA — ABS MOST SPECLFIC > TPT - but roukinely not dont dit involverntnt of lve Tepons 7 PPR and most Specific Test MC DONE > _TPHA CONGENITAL SYPHILIS > IgM erp ABS ig done T. Pertunot > couse ‘YAUS NOT Tenderniaum > couzes BecerLendemic syphilis] STDs T._Corakessm > couges PINTR: BORRELIA > EPEDEMIC LOUSE BORN RELAPSING FEVER — coused by B. reuuTrentis > ENDEMIC TEck BORN RELAPSING FEVER > counted by 8. duttoni & B. herme sii > Relapses are dit ANTIGENIC vaRTATIONS B, BURGDORFERI > transmitted by Ticks > comses Lyme’S OTSERSE — chovackerictic Lesion = ERYTHEMA CHRONTCUM mI@RANS > WlTuRE mMEDTA + BARBOUR STRNNOUR KELLY MEDIA B, VINCENTI & FUSIFORMIS. causes VINCENT ANGINA | TRENCH MouTH LAB DEAGNOSIS O corrore @ pcr for Borrelia © bork Held micrescopyLEPTOSPIRA LEPTOSPIRA INTERROGENS + causes IWETLS DISEASE [IcTERO HAEMORRHAGIC FEVER] > culTuRE meprA ® emo @ FiercHer @ korrAoKorr > LAB OrAGNOSTS @ seRoLogicAt test => MAT > Microscopic Agqlubinak” Test C preferred] > Mauro scopic Pqqiukinak” Test @ Pca For Leptospira speciek J R > Rok urine Ro Rim CPaddy Feld workes] R 7 Raing Waker GI LEFTOSPrROSES Rat rine contaminates Rainy walir, Ojos Paddy freld workers > Nokional Referal Gntre for Leptospira. Jocoted ot > Poxt Bloir © ph 204yr old male Who works ag truck driver f a genital vicer, painless For last 10 dovyt. He hod Unprotected { contact with & Commercial sex worker abour a weeks ad Previourly oJ€ vleer was Creumscribed, induraked & partially healed. the inguinal lymph nodis entorged - couse 2 @ ww © Treponema pallidum ® upv @ Hsv-aRICKETTSIAE F Obliqolt intracellWar organisms 7 Prmropod borne trongmigsion > non culturable ARTHOPODS INVOLVED EprDEmEe TYPHUS | _R. prowaze ENDEMEC TYPHUS R. typhi RMSF R. rickettsi INDIAN TICK TYPHUS | _R. conort R. POX R. akort ScauB TYPHUS Dvientia, teutsugormushi Presents © fever, rash & lymphadsnopalhy Doc + DoxYeyCLIN, Oxk ig strongly positive in Strub typhus Epidemic YS Endamic Typhus TUNICA REACTION CNEIL moosER?s REACTION Suntal neserit q| Inflammation of qunie piq > Endemic typhus No Suth Reackion & inflammar™ In quines piq > Epidemic Eyphus (QUERY FEVER | Q FEVER couged by Coxiella burnett contaminates milk Killed by Flath method of pasteurigation Mor > Rerosol trantmizzion Co arthopod transmission] No Rach Occurs ako culture neqakive andocorditis BARTONELLA + can be cultured on normol culture media 7B. badiliformis couses OROYA FEVER B. bengelos causes CAT SCRATCH DISEASE causes — BACILLARY ANQIOMATOSIS [Common in HIV+] B. quintana cousges TRENCH FEVER causes BACILLARY ANGTOMATOSIS [rawer cones] EHRLICHIA CHAFFENENSIS > conser Human monouytic ehrlichiosis EHRLICHIA PHAGOCYTOPHILA > cautes Human qronulotic drrlichiosizCHLAMYDIA (ATP PARASITE) > Forms Extra cellular /Elemantory Body > Infectious Intro cellular / Retiowlo Body > Replicating C. TRACHOMATOSIS F Seroqreup? A,B, Ba,C > Causes TRACHOMA Mx strabeqy SF surgery A > Antibiotics FoF Face clean E 7 Environmental clean > Seroqroupt 0 -K > Caugeg INCLUSION CONSUCTEVETES INFANTILE PNEUMONTA GENITAL CHLAMYDIASIS serotypes Listyy by > couges WYMPHO GRANULOMA VENERUMLL7)| 'SITTACL > causes BIRD PNEUMONIS — mainly co Parrots — help in atroso] transmission . PNEUMONIAE > causes ADULT PNEUMONTA > alw Ammerosclerosis + aj Asthrna[to be confirmed] INCLUSION SOOLES Trachoma. > HP Bodies CHALBERDT PROWOAZEKI Molloscum contagiosum > HP Bodies [ HENOERSON PETERSON] Psittacosis 7 tevintHal core GEE wovtes > couTuRE on Meoy cell Lint Copntinwous cell ine] - on Yolk sac oF eggs C Hens] > toc +> NAAT C Nucleic Acid Amplification Test] > PCR LGV > painless vler > Painful Lymph noder = Para rectol LN involved > FRIES SkIN TEST ig done * Compli car” +> ESTHIOMENE > Recto! & vulval StrictureMYCOPLASMA 7 smallest bockerra > No cell walt > cell maumbron ig present + mads of Stern} : > con pare through backerial Alters 3 > cptture meotr » PPLD Agar = «FREED EGG COLonres : 2 Stoined by DIENE?S METHOD —-FRTED EA COlontes [DieNe*’S PHENOMENON Seen in PROTEUS] 'M. PNEUMONIAE / EATON'S AGENT > me buckeriol couse OF Atypical pneumonia 7 aka WALKING PNEUMONIA — LAB DIAGNOSIS 1 cAT Ceold Agglukinath Test] > type of Heterophile ogqutinat™ test A Streptococcus MG Agglutinak™ Teste +> type OF Hekerephile agglutinal” test 3 PCR For M. pneumonion M4. qenitolium Causes NON GoNococcAL vuRETHRETTS M. hominis NON GoNecoccat oRETHRITES CAUSES © chlamydia trochomatis © vresplogma vrealytiourn @ Mycopiagma qenitoliusy @ Mywoplasma hominis > Diagnosed bY PCR MISCELLANEOUS (CAMPYLOBACTER JEJUNI > Gna > mice asrophila [57-03 required] > motile > GULL WING SHAPED BACTERIA > aj Poultry berd contaminak® > causes Inflammakory Diarrhoea — Fecal Lurcowtes ore tnt + th children, Diarrhoeal episodes et, GvLLION BARRE SYNOROME> Le ptr@nosrs © stooL samPLe 7 Gram staining > Pink coloured Gull using shaped bacterfa 7 Fecal bucowtes + nt + culture done on charenal based mediag > charcoal bated medias 7 campy BrP > BurZteR > SRERROW 7 Tneubat ak gate @ pcr for campylobacker Jejuni HELICOBACTER PYLORI GNG micro aurophile motile tloeug Strongly Urease positive C yellow > Pink] Drsences. Pup C PEPTIC UKER DISEASE] MALTOmA cA STOMACH > Law DragNosts NON INVASIVE TESTS > Urea Brealh Test Z radiolabelled C), orc, ‘INVASIVE TEST > Endoscopic Biopsy — Stain T WARTHIN STARRY SILVER STAIN Pemonstrai H. pylori Bx tigsue + Orease media > Yellows > Pink > Rm > HelteacT/ PyLp KITS for eradicat? oF H. pylori > cag & vac > ses Virulence oF H- pylori BACTERIAL VAGINOSIS camred by > Gordanella vaginalis > Mobilunws > Provetella NUGEN'S CRITERIA > PMSEL’S CRITERTA > PH > kB > owntee test > iccharge + 107.KOH > Fighy odour > cwe ceus > Epithelial calle t backeria > > a for Bacterial vaginosis Grading oF replatument oF normed Flora, of Vaging by Poljogenic organismsMISCELLANEOUS IMP POINTS STREPTOBACLUUS MONTLIFORMIS > caugeg HAVERHILL FEVER > ajco Rodunts [Rak bite fuer] SPERILLUM MINUS + couses Rear BITE FEVER, BACTEROLDS spEesTes obliga onovobes 6NB ermal commensal of qué Produce mild potent endo toxins ylLue Homan BETES > ayo Elkanella cordens jw anatrobie Strepto cocci chr {Pog BITES % ayw Pasrurella multocida SCROMBOLD FICH POISONING + ajo £.coli > Morganelia [family Proteus)MYCOLOGY me MORPHOLOGICAL CLACSLPECATION Yeosts + ceyptococcus neoformans Yeast like + candida albicans Mold Ft Rhinopur, Acpergillus Dimorphic DEMORPHEC FUNGAL DISEASES at 3#% a é, Ho Histoplasmnests FC > yeast S + Sporotrichosis ar aatc- 25% -* mold B + Blagkomysosis © > coccididomycosis CLagstercaT® based on SEXUAL SPoRE PX > Para coccididormycosis > _ Penicittiosis ZygosPORE = aygomycetes > Rhiaopus ASCOSPORE > Ascomycetes F Asperqitios BAStprosPORE 7 Basidiomycetes ~ cryptocomas DEUTROMYCETES > No sexual phare = Fungi imperfesti CLASSEFICAT” based om LOCATION SUPERPECLAL Mrcosrs > superficial Layers Of Sin involved 29. Dermakophytes SUB CUTANEOUS MYCoSsTG 7 Skin & Sub cukaneous tizguet Involved Eg M > Mytetoma R > Rhinosporidiois CF chromo blarto mycosis S 7 Sporotrichosis Cdimorphic) DEEP mycoste > Visceral invelvernent tnt Eg. Dimorphic fungal diseases [ Except” + Sporotrichosis ] Candida Cryptococcus coLrure meora = spn C cABOURAUD'S DExTROSE AgAR] [pH + 5.4] FUNGAL STAINS. Lece > Lasko Phenol Cotton Blue ms. 7 Gomori? Methamine Silver PAS 7 Periodic Acid échiFF Hee 7% Hemotoxylin & Eosin Aldan Blue Modcarmine stain Indian Ink chain LNegakive stain] Calcoftuor white C Fluorescent croind ®®@®@O0O00TINEA VERSICOLOR > caused by Molaseaaia Furrur > presents ¢ Hypo/Hyper pigmented scales over the trunk + Ln dtAGNosts Scales + 10% KOH —> SPHAGETTE & MEATBALL APPEARANCE Scales + Wood lamp > GOLDEN YelLow FLUORESCENCE Scalec + SDA [olive oil overlay] + FRIED E44 COLONTES > TREPTED by — SELENIM SULPHIDE ack pedro PIEDRA CHair nodules? > types Black PLEPRA > caused by Piedras hortat WHITE PIEDRA = cautgzed by Trichogporon beiqelii DERMATOPHYTES ‘TYPES © TRICHOPHYTON > tevolves Skin » Hair, Nails @ mrerospoRum > twolves Skin y Hair TM don't involve NJ @ EPLDERMOPHYTON > fnvolves Skin , Nails DISEASES © Tinea copitis > wolves Scalp ® Tineo borbar > involves beard ® Tinea unquium 7 twolves Neil Folds @ Tinea mannum — involves hand AF ® Tinea crris > Wolves qrotn [ PHOBI / JOCK ITCH] Tse © Tinea pedis > twvolves Foot LATHLETE’S FooT] @ Tinen corporis 7 tnvolves_ non hairy regions of body, Trichophyton mentagrophytes Trichophyton Tubrom > Hair Perforation Test } Positive in Gute tae | magnate infecred hair + moist conditions —> Halr perforation +nt Skin scraping + Ureate media > Yellow > Pink Cslow> TINER CAPITIS TYPES Faws by —> FAVUS > Dense Gust format” on scolp ‘.sdhoenteinit wegtaceor KERION > painful boggy stoelling over the Salp Tqypreom Favus cated by Trichophyton Sschoenlenit Kerion caused by Trichophyton verrucogsum , T. mentagrophyres