 If an organism gives a positive reaction

with the anti-Group A latex test, you would also expect the bacterium to be:
Optochin sensitive  Bacitracin sensitive  Coagulase positive  Citrate positive  Alpha hemolytic

 The major reason for failure of standard

penicillin treatment of streptococcal pharyngitis to prevent rheumatic fever is:

Non-compliance of patients in taking antibiotics  Plasmid-encoded beta-lactamase  Chromosomal mutation in the gene encoding the target  Antigenic variety of bacterial antigens  Lysogenic conversion

 A 1-year-old child is brought to the hospital in

respiratory distress. Her father reported that following a period of increased nasal discharge and a slight pyrexia which lasted for 5 days, she began breathing fast and developed a paroxysmal cough.
   

What other information should be elicited from the parents? What investigations should be carried out? What is the etiology of paroxysmal cough? What is the antibiotic of choice to treat this child?


Dr. Noura AL-Sweih

Definition Bacteria which lack cell wall
 Can

grow in rich artificial media

Three species associated with infection in man
 Mycoplasma

pneumoniae  Mycoplasma hominis  Ureaplasma urealyticum

Fried egg Chinese hat

Mycoplasma pneumoniae
Clinical Infections Respiratory Infections
 Atypical


Children are more affected  More during summer  Prominent X-ray findings  Disease course > 2 weeks  Hemolytic anemia

Mycoplasma pneumoniae
Extrapulmonary manifestation Hemolytic anemia Myocarditis

Erythromycin ? Why not penicillin  Tetracycline

Mycoplasma Hominis & Ureaplasma urealyticum

Clinical Infections (same range)
Genital infections
 Male
 Non-gonococcal


 Female
 Pelvic

inflammatory disease PID  Abortion & Preterm labor  Stillbirth

Mycoplasma Hominis & Ureaplasma urealyticum
 Urinary tract infections
 Pyelonephritis

 M.hominis  Renal stone  U.urealyticum
 Respiratory infections
 Newborn

respiratory disease

 Treatment
 Erythromycin  Tetracycline

Clinical Case
 A 14 year old male presents with a low-grade fever,

general malaise and cough. He was prescribed ampicillin. One week later he returned with a persistent low-grade fever , non- productive cough and cold agglutinins were detected in his blood. A chest X-ray showed a patchy bronchopneumonia with diffuse interstitial infiltrates.
   

What was the organism causing this patient infection? Were this patients clinical course and chest X-ray consistent with his infection? How this organism can be detected in the lab? Why this patient did not improve on Ampicillin?

 Name other organisms known to cause      

community acquired pneumonia? Streptococcus pneumoniae Haemophilus influenzae Mycoplasma pneumoniae Chlamydia pneumoniae Chlamydia psittaci Rarely Klebsiella pneumoniae

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