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Case: An infant born in a rural area is brought to the ER with severe bouts of coughing throughout the day. During the visit, the baby appears cyanotic and suffers an attack of many coughs on a single expiration followed by an inspiratory whoop. The coughs produce a copious greenish phlegm. History reveals that the mother of the child is against the practice of vaccination.
Organism: Treatment: Prevention:
Bordetella Pertussis Supportive, Antibiotics to prevent spread (Erythromycin + Clarithromycin) PT toxoid + FHA Vaccine (DTaP)
filamentous hemagglutinin (FHA). Pili.Bordetella Pertussis Structure: Disease: Gram (-) Coccobacillus 3 stages: Catarrhal (wks 1-2): profuse mucoid rhinorrhea (most communicable stage). Tracheal cytotoxin (TCT). Pertactin Isolation via nasal swab (Charcoal agar) Supportive Therapy Transmission: Virulence Factors: Diagnosis: Treatment: . Adenylate cyclase (ACT). Paroxysmal (wks 2-4): Persistent Cough + inspiratory whoop. lymphocytosis (up to 40.000/mm3). . Convalescent (4 wks+): gradual fade of cough Airborne droplet nuclei (80-100% infectivity) Pertussis toxin (PT).
When asked about his sexual history he admits that he recently had intercourse with a local sex worker during which the condom that they were using broke. Organism: Treatment: Hemophilus Ducreyi Azythromycin/Erythromycin. Physical exam reveals chancroid ulcers and enlarged inguinal lymph nodes (Bubos). Ceftriaxone. Culture of the ulcer material comes back overgrown with normal flora microbes. Ciprofloxacin .Case: A 23 year old male comes into the clinic because he is concerned about appearance of painful lesions on his penis.
Bubos. Ceftriaxone. Ciprofloxacin Transmission: Virulence Factors: Diagnosis: Treatment: . Clinical. Chocolate Agar w/ antibiotics to normal flora Azythromycin/Erythromycin.Hemophilus Ducreyi (Chancroid) Structure: Disease: Gram (-) Bacillus Erythematous Papules on the Penis which progress to chancroid ulcers (soft and painful). . Chancroid Toxin Hard to diagnose. Increased chance of HIV infection (CD4 attraction) Microabrasions during sexual intercourse with infected person Antiphagocytic Proteins (2).
tetracycline. An LP is preformed and culture of the CSF reveals an organism which only grows on chocolate agar media (hemin + NAD). Organism: Treatment: Prevention: Haemophilus Influenzae (90% type B) 3rd Gen Cephalosporin (ceftriaxone). Apicillin amoxacilin.Case: A 1 year old infant develops a fever. and sulfonamides Hib Vaccine (capsular polysaccharide) . The parents decide to bring her to the hospital when notice that she seems unusually drowsy. Physical exam reveals neck rigidity and occasional seizures. aminogycocides.
LPR. Gram Smear Aminopenicillins. Arthritis. sore throat. Otitis media. . Antiphagocytic capsule Blood Culture (chocolate agar). Transmission: Virulence Factors: Diagnosis: Treatment: . 3rd Gen cephalosporins. aminoglycosides. Acute epiglotitis (fever. and often a muffled cough). and sulfonamides.Haemophilus Influenzae Structure: Disease: Gram (-) coccobacilli Meningitis. and Chronic bronchitis Inhalation of aerosol Pili + Adhesins (attachment to respiratory epithelium). hoarseness. Conjunctivitis. Acute chronic sinusitis. tetracycline. reddish-blue swelling in cheek or periorbital areas). Cellulitis (Tender. OMP. IgA protease.
Case: A traveler returning from New Mexico presents to the ER with fever. Organism: Treatment: Yersinia Pestis Tetracycline + Streptomycin . Upon physical exam the patient was found to have several flea bites on his torso. and enlarged painful lymph nodes in his groin (Bubos). He maintains an awkward pose with extremities extended which he says lessens his pain. dark black skin patches.
Culture of bubo fluid Streptomycin + Tetracylcine . septic shock). V and W antigens (antiphagocytic). no bubos) Rodents to humans via flea vector. human-to-human via aerosoles F1. YOPs. necrotizing hemorrhagic pneumonia (Pneumonic Plague. all expressed at 37˚C Transmission: Virulence Factors: Diagnosis: Treatment: . Bacteremia (DIC.Yersinia Pestis (Plague) Structure: Disease: Gram (-) Bacillus Ulcerative necrotic skin lesions. Enlarged painful lymph nodes (Bubos).
Carbapenems. complains of painful discharge from her left ear. A swab culture of the ear reveals oxidase (+) gram negative bacilli producing a blue/green pigment. Monobactams . Physical exam shows extreme tenderness of the the left tragu.Case: An elderly diabetic woman. who recentlyl began swimming to control her weight. 3rd Gen Cephalosporins (ceftazidime). Organism: Treatment: Pseudomonas Aeruginosa Newer Aminoglycosides (Gentamicin).
Elastase. water. normal flora (GI) Mucoid exopolysaccharide/Alginate capsule. Most commonly in patients with weakened immunity and CF patients Opportunistic infection from environment (soil. Carbapenems. osteomyelitis. UTI. Monobactams Transmission: Virulence Factors: Diagnosis: Treatment: . vegetation). Folliculitis (hot tub infection). 3rd Gen Cephalosporins (ceftazidime). Exotoxin A. External Otitis. Endocarditis.Pseudomonas Aeruginosa Structure: Disease: Gram (-) Bacillus Pneumonia. Exoenzyme S. pyocyanin (pigment) Newer Aminoglycosides (Gentamicin). . Phospholipase C Culture (Oxidase (+)).
during the exam. Gram stain of discharge reveals gram (-) intracellular diplococci. comes to the same clinic complaining of dysuria and profuse yellow urethral discharge. Organism: Treatment: Neisseria Gonorrhoeae 3rd Generation Cephalosporin (Ceftriaxone) . a male. A pelvic exam reveals a yellow mucopurulent discharge. One of her partners. The teenager reports that she has been sexually active with several partners over the last year.Case: A teenager complains of pain during sexual intercourse and irregular intermenstrual bleeding. She has also begun to experience lower abdominal pain. the cervix begins to bleed.
urinary frequency. Pili. septic arthritis Men: purulent urethral discharge and dysuria: can lead to epididymitis and protatitis Sexual Intercourse w/ infected person LOS. Sterility. abdominal pain. PID. cervicitis (vaginal discharge. dysuria. and menstural abnormalities).Neisseria Gonorrhoeae Structure: Disease: Gram (-) Diplococci Women: Urethritis. Opas Proteins. Sialic Acid Capsule Culture in glucose but not maltose on Thayer-Martin media 3rd gen Cephalosporin Transmission: Virulence Factors: Diagnosis: Treatment: .
and gram negative diplococci. An LP is performed showing increased PMNs and protein. decreased glucose. and impaired mental status. Organism: Treatment: Neisseria Meningitidis Penicillin. and headache. 3rd generation Cephalosporin (Ceftriaxone) . Nochal Rigidity. a young soldier in an army base enters the emergency room with a petechial rash. Physical exam reveals (+) Kernig’s sign (pain and resistance upon extension of the leg at the knee during thigh flexion).Case: Early one evening. fever.
present in the normal flora of 10% of health people Lipooligosaccharide (LOS). Polysaccharide Capsule.Neisseria Meningitidis Structure: Disease: Gram (-) diplococci Meningitis (Neck stiffness (nuchal rigidity) and headache). Endotoxin Culture in maltose + glucose (ThayerMartin media) Penicillin G. Ceftriaxone Transmission: Virulence Factors: Diagnosis: Treatment: . Petechial rash. . may progress to shock Droplette inhalation.
Case: An alcoholic presents with a fever. Culture reveals a lactose fermenting encapsulated gram (-) bacillus Organism: Treatment: Klebsiella Pneumoniae 3rd Generation Cephalosporin (Ceftriaxone) . dyspnea. and cyanosis. His cough produces a bloody sputum. pleuritic chest pain. CXR shows inflammation involving the right upper lobe with possible cavities.
Gram (-) bacillus Pneumonia.Klebsiella Pneumoniae Structure: Disease: Transmission: Diagnosis: Treatment: . UTI Fecal Oral Clinical + Culture 3rd Generation Cephalosporin .
Clarithromycin. Metronidazole. Tetracycline) .Case: An aged man comes to the hospital complaining of upper abdominal pains. which becomes worse after a meal. A biopsy of the stomach mucosa is found to be urease positive and labeled CO2 is observed on his breath after ingestion of labeled urea. Organism: Treatment: Helicobacter Pylori BMT (Bismuth Therapy) + 2 antibiotics (Amoxicillin .
Tetracycline. Urea Breath test. Clarithromycin.Helicobacter Pylori Structure: Disease: Transmission: Virulence Factors: Gram (-) Bacillus Gastritis. Metranidazole Diagnosis: Treatment: . Vacuolating Cytotoxin. IgG titer in serum Bismuth Salts + Amoxicillin. Cag Protein. . Biopsy of gastric mucosa (Urease (+)). gastric carcinoma Fecal Oral Urease (allows survival in acidic pH). Gastric/Duodenal Ulcer.
Imaging of the patient’s abdomen detects an abscess which has formed. Organism: Treatment: Bacteroides Fragilis Drain Abscess + Antibiotic (Metronidazole. The area near the abscess is also noted to have a reduced blood supply. imipenem. ceftriaxone).Case: A patient whose appendix was removed is put on gentamicin to suppress gram (-) aerobes causing the initial infection. Culture of the abscess reveals a gram (-) organism. only to spike some hours later. resistant to most beta lactams . The patient’s fever declines. Clindamycin.
Clindamycin. surgery. Ceftriaxone) Virulence Factors: Diagnosis: Treatment: . can spread causing septic shock Normal Gut flora which spills into the peritoneum via trauma. or perforation Polysaccharide Caspule (prevents phagocytosis. deep pain. Culture Drain abscess + antibiotics (Metronidazole. Imipenem. promotes abscess formation) Clinical. .Bacteroides Fragilis Structure: Disease: Transmission: Gram (-) Bacillus (Anaerobe) Abdominal abcess.
although she doesn’t ever remember seeing blood. Her diarrhea occurs in tremendous volumes. She has an unremarkable recent past medical history. Sigmoidoscopy of her colon reveals yellow-white plaques. Oral Vancomycin . Organism: Treatment: Clostridium Difficile Oral metronidazole.Case: An old woman comes to the doctor with a fever and loose bowels. except for an infection a few weeks earlier that was treated with clindamycin.
. leukocytosis. Toxin B Toxin detection in stool Oral metronidazole or oral vancomycin Transmission: Virulence Factors: Diagnosis: Treatment: . fever Small portion of intestinal flora which is allowed to overgrow during antibiotic treatment Toxin A.Clostridium Difficile Structure: Disease: Gram (+) Bacillus (Anaerobe) Diarrhea (watery or bloody). abdominal cramping/pain.
probably due to a stiff jaw. Diazepam. and clamped palms. a week ago. Her father is anxious about the fact that she has also experienced difficulty eating. she sustains a facial sneer. Penicillin Tetanus Toxoid (DTAP vaccine) . The father affirms that his daughter is usually quite active and boasts how. Throughout her examination. a stiff arched back.Case: A teenage girl enters the emergency room suffering painful muscle spasms. she continues a soccer game even after falling on a nail in the field Organism: Treatment: Prevention: Clostridium Tetani Human antitoxin. Metronidazole.
. masseter muscle most sensititve (lockjaw) Wound contamination with spores found in soil or foreign bodies Tetanospasmin Toxin (TeTx) Clinical.Clostridium Tetani Structure: Disease: Gram (+) Bacillus (Anaerobe) Spastic paralysis. sustained muscle contraction (tetus). culture Human Tetanus Immune Globulin (HTIG) Transmission: Virulence Factors: Diagnosis: Treatment: .
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