HAEMOPHILUS , ACTINOBACILLUS, AGGREGATIBACTER, PASTEURELLA

SONYA ESTI KHOLIFA

What is the species of Haemophilus that cause acute purulent conjunctivitis ?

1. H. influenzae
2. H. aegyptius
3. H. haemolyticus
4. H. parahaemolyticus
5. H. ducreyi
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2. Haemophilus aegyptius

What is the etiologic agent of the sexually transmitted disease soft chancre or
chancroid ?
1. H. influenzae
2. H. aegyptius
3. H. haemolyticus
4. H. parahaemolyticus
5. H. ducreyi
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5. Haemophilus ducreyi

Mention two growth-stimulating factors in media supplementation for most species of

Haemophilus ?

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(1) hemin (also called X factor for “unknown factor”)
(2) nicotinamide adenine dinucleotide (NAD; also called V factor for “vitamin”)

How many antigenic serotypes of of H. influenzae have been identified ?

2
4
6
8
10
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3. Six antigenic serotypes (a through f)

How many biotypes of

H. influenzae based on the serologic differentiation ?
2
4
6
8
10
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4. eight biotypes (I through VIII)

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Where is the particularly
H. parainfluenzae and nonencapsulated H. Influenzae colonize ?

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the upper respiratory tract

What is the etiologic agent of disease in unvaccinated children (meningitis,

epiglottitis, cellulitis) ?
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encapsulated H. influenzae (particularly serotype b [biotype I])

Mention the structure for mediate colonization of the oropharynx with

H. Influenzae.

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Pili and nonpilus adhesins

What are the cell wall components of H. influenzae impair ciliary function, leading
to damage of the respiratory epithelium ?
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lipopolysaccharide and a low-molecular-weight glycopeptide

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What is the major virulence factor in type b H. Influenzae ?

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the antiphagocytic polysaccharide capsule, which contains ribose, ribitol, and
phosphate (commonly referred to as polyribitol phosphate [PRP])

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What is the component of H. Influenzae that induces meningeal inflammation in an

animal model and may be responsible for initiating this response in humans ?
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The lipopolysaccharide lipid A component.

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What enzyme that produced by H. influenzae and may facilitate colonization of the
organisms on mucosal surfaces by interfering with humoral immunity ?
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Immunoglobulin IgA1 proteases

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What is the most common cause of pediatric meningitis ?

1. H. influenzae type a
2. H. influenzae type b
3. H. influenzae type c
4. H. influenzae type d
5. H. influenzae type e
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2. H. influenzae type b

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What is the other name of H. aegyptius ?

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Koch-Weeks bacillus

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What examination should be used for the microbiological diagnosis of sinusitis or

otitis ?

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Direct needle aspiration

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What specimen is used for the diagnosis of pneumonia caused by Haemophilus ?

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sputum produced from the lower airways

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What specimen should be collected from patients with the diagnosis of meningitis ?
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Both blood and cerebrospinal fluid (CSF)

18

What is the rapid and sensitive way to diagnose H. influenzae type b disease?
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The immunologic detection of H. influenzae antigen, specifically the PRP capsular
antigen

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What is the media that used in most laboratories to isolate H. Influenzae ?

1. Blood agar
2. Chocolate agar
3. Nutrient agar
4. Haemophilus Test Medium Agar
5. Mueller-Hinton Agar
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2. Chocolate agar

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What is the treatment for serious infections Of H. influenzae ?

1. amoxicillin
2. cephalosporin
3. Azithromycin
4. Gentamycin
5. doxycycline
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2. broad-spectrum cephalosporins

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Less severe infections, such as sinusitis and otitis caused by Haemophilus can be
treated with, except ?
1. amoxicillin
2. cephalosporin
3. Azithromycin
4. Gentamycin
5. doxycycline
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4. Gentamycin

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What is the drug recommended for treatment for H. ducreyi infection ?

1. amoxicillin
2. cephalosporin
3. erythromycin
4. Gentamycin
5. doxycycline
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3. erythromycin
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What is the antibiotic chemoprophylaxis is used to eliminate the carriage of H.

influenzae type b in children at high risk for disease ?
1. amoxicillin
2. cephalosporin
3. erythromycin
4. rifampin
5. doxycycline
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4. Rifampin

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What is the species of Haemophilus that only require V factor for growth , except ?
1. H. parainfluenzae
2. H. parahaemolyticus
3. H. pittmaniae
4. H. paraphrophilus
5. H. haemolyticus
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5. H. haemolyticus

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What is the species of Haemophilus that require only X factor for growth ?
1. H. influenzae
2. H. aegyptius
3. H. haemolyticus
4. H. parahaemolyticus
5. H. ducreyi
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5. H. ducreyi
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What is the species of Haemophilus that require V and X factor for growth ?
1. H. parainfluenzae
2. H. parahaemolyticus
3. H. pittmaniae
4. H. paraphrophilus
5. H. haemolyticus

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5. H. haemolyticus

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What is the most important human pathogen species in the genus Actinobacillus ?

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Actinobacillus actinomycetemcomitans

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Mention two members of Aggregatibacter are important human pathogens.

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A. actinomycetemcomitans , A. aphrophilus

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What is the treatment of choice for endocarditis caused by Aggregatibacter ?

1. amoxicillin
2. cephalosporin
3. Azithromycin
4. Gentamycin
5. doxycycline
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2. cephalosporin such as ceftriaxone

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Mention two members of Pasteurella are important human pathogens .

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Pasteurella multocida (the most common isolate) and Pasteurella canis

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What is the important virulence factor in Pasteurella strains responsible for

animal diseases and likely to be important in human infections ?
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Production of a polysaccharide capsule composed of hyaluronic acid

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What is the medium for P. multocida grows well ?

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on blood and chocolate agars

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What is the antibiotic of choice for P. multocida infection ?

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Penicillin is the, and expanded-spectrum cephalosporins, macrolides, tetracyclines,
or fluoroquinolones are acceptable alternatives

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61-year-old woman had a long history of smoking, chronic obstructive lung disease,
diabetes mellitus, and congestive heart failure. She pre-sented with left upper
lobe pneumonia, producing purulent sputum with many gram-negative coccobacilli. The
organism was susceptible to ampicillin, to which the patient responded.

What is the etiologic agent (specific) ?

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chronic underlying pulmonary disease to infections with
non–serotype b strains of H. Influenzae ( Haemophilus influenzae serotype d)

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54-year-old woman who was admitted to their hospital with a history of fever, night
sweats, and fatigue. Physical examination revealed a tricuspid systolic murmur and
splenomegaly, and echocardiography revealed vegetation on the tricuspid valve. Her
clinical history was incomplete because it was not known how chronic her course
was; however, this case illustrates the slow growth of the organism in routine
culture.

What is the diagnosis and etiologic agent (species) ?

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Endocarditis Caused by Aggregatibacter actinomycetemcomitans

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The 58-year-old man had a history of chronic renal insufficiency, gouty arthritis,
and Cushing syndrome treated with steroids. Upon admission to the hospital, his
left hand was erythematous, warm, and tender with reddish to purplish macules over
the surface. Over a 2-day period, bullae developed and extended rapidly to the left
arm, left calf, and right foot, and the patient had systemic signs of shock and
gastrointestinal bleeding. Despite aggressive antibiotic and surgical treatment,
the lesions progressed rapidly and the patient eventually expired.
What is the etiologic agent (species) ?

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Fatal Pasteurella multocida Infection (bacteremia and necrotizing fasciitis)

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What is the name of bacteria ?

1. H. influenzae
2. H. aegyptius
3. H. haemolyticus
4. H. parahaemolyticus
5. H. ducreyi
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Haemophilus influenzae

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What is the name of this phenomenon ?
and
What bacterial species that excretes nicotinamide adenine dinucleotide (NAD, or V
factor) into the medium ?
Satellite phenomenon
Staphylococcus aureus

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What is the name of bacteria ?

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Pasteurella multocida
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What is the name of bacteria ?

1. H. influenzae
2. H. aegyptius
3. H. haemolyticus
4. H. parahaemolyticus
5. H. ducreyi
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Haemophilus ducreyi
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