164 terms


Virulent stage @ 37C
Yeast, Histoplasma capsulatum
Saprophytic stage has thick spherical macroconidia and small oval microconida
Histoplasma capsulatum
Not transmitted from person to person, grows from bird and bat ****, Ohio/Mississippi Valley
Histoplasma capsulatum
Inhaled and lives in alveolar macrophages, suppresses oxidative response, modulate phagolysosome pH
Histoplasma capsulatum
Causes acute, mediastinitis, pericarditis, chronic pulmonary, and disseminated infections
Histoplasma capsulatum
Immunosuppressed, infants, reticuloendothelial system
Acute disseminated Histoplasma capsulatum
More focal, mucous membrane lesions
Chronic disseminated Histoplasma capsulatum
Microconidia bind CD11/CD18 receptors of alveolar macorphages
Histoplasma capsulatum
Thick walled chlamydospores
Blastomyces Dermatitidis
On blood agar, wrinkled and folded glabrous and yeast-like
Blastomyces Dermatitidis
Broad based budding yeasts
Blastomyces Dermatitidis
Warm humid temperatures, rotting wood, decaying organic material
Blastomyces Dermatitidis
South central states and boarders of great lakes
Blastomyces Dermatitidis
Histopathology reflects mized granulomatous and pyogenic response, BAD-1 or WI-1 glycoproteins
Blastomyces Dermatitidis
Causes pulmonary dry cough/nodes, disseminated causes lesions all over skin
Blastomyces Dermatitidis
Life threatening fungal infections are treated with
Amphotericin B
Mild or moderate fungal infections are treated with
Southwestern regions of united states
Coccidio immitis
Grows as a saprobe in alkaline desert soil
Coccidio immitis
At 37C, in tissue develops into spherules
Coccidio immitis
Has this life cycle Hyphae → Arthrospore → Spherule → Endospores
Coccidio immitis
Growth evident in 3-5 days
Coccidio immitis
Bird ****, polysaccharide capsule, AIDS, meningitis, lumbar puncture, encapsulated budding yeast
Cryptococcus Neoformans
Neutropenic, angioinvasive, 45 degree branching, fluffy green colonies
Aspergillus fumigates
Nonseptate hyphae, branch at 90 degrees, diabetes with ketoacidosis
Protozoan, inhaled from environment, T cell deficiency, foamy proteinacious material, hypoxemis
Toronto Canada and Hong Kong
FEVER, myalgia, headache, mild diarrhea, DRY COUGH, atypical pneumonia, novel corona virus
Fever, lower respiratory tract infection, 10 days of travel or contact
Suspect case of SARS
Fever, lower respiratory tract infection, 10 days of travel or contact + CXR of pneumonia or ARDS
Probable case of SARS
Best test for SARS diagnosis
Acute and convalescent serum Ab titiers, PCR
Gene mutation on chromosome 7, common lethal genetic disorder whites
Cystic fibrosis
Defective CFTR protein production
Class 1
Defective CFTR protein processing
Class 2, delta F508
Defective regulation of CFTR
Class 3
Defective conduction of CFTR
Class 4
Chronic sinusitis, nasal polyps, chronic bronchial suppuration, pancreatitis, DM, reduced fertility
Cystic fibrosis
Diagnostic for CF
>60 mMol/L
Newborn screening marker for CF
Immunoreactive trypsinogen (IRT)
Common CF respiratory pathogens
pseudomonas, S. aureus, H. influenza
CF, gram positive, coagulase positive
Staph Aureus
CF, aerobic, non-spore-forming, gram negative rods, non-fermenter, mucoid, ↓ FEV1
Pseudomonas Aeruginosa
Helps CFTR fold right way so channel works
Helps the channel open
Potentiator, VX-770
Dew drop on rose pedal, itchy, vesiculopustular rash, bilateral infiltrates
Varicella Zoster Virus
DS DNA herpes virus, latency shingles, positive TSANCK smear, treat with acyclovir
Varicella Zoster Virus
Secondary infection associated with Varicella Zoster Virus
Nasal flaring, fever, nose crusting, hyperinflation, bilateral patchy infiltrates, paramyxovirus, winter or spring, humans only
Blue white dots in mouth
Koplick spots, Measles
Barking, photosensitive, cough → coryza → conjunctivitis → kopliks → rash, desquamation
Paramyxovirus, contagious 1-2 days before onset of symptoms, treat with vitamin A and supportive care, 2 vaccinations
Clear nasal drainage, bulging TM's, fever, cough
Otitis media
3 pathogens for otitis media and acute sinusitis
S. Pneumo, H. Influ, M. Catarralis
Bulging, bacteria, antibiotic treatment
Acute Otitis Media
Retracted, prominent short process, no antibiotics
Middle Ear Effusion
Collection of squamous epithelium and keratin in ear
Cold symptoms for 3 weeks, cobble stoning posterior pharynx, dark circles under eyes, clinical diagnosis
Acute sinusitis
Water's view X-ray, fluid line, treat with antimicrobials for 20-21 days
Acute sinusitis
Gram negative, aerobic bacillus, acid-fast, highly communicable, URI
Bordetella pertussis
Begins with URI, infective during this stage, if treated you stop the progression
Catarrhal phase of pertussis
Progresses to severe coughing with whoop followed by vomiting
Paroxysmal stage of pertussis
Why petussis cases are increasing
acellular pertussis vaccine, wears out in 7-10 years
Tropics/subtropics, streaks down leg, swollen feet/scrotum, diagnose at night, TX- DEC or ivermectin
Wuchereria Bancrofti Lymphatic Filariasis
Asia/South Pacific, streaks down leg, swollen feet/scrotum, diagnose at night, TX- DEC or ivermectin
Brugia Malayi Lymphatic Filariasis
Spaces between tail tips
Brugia Malayi
Running water, lose vision, nematode
Onchocerca Volvulus
Simulium fly transmits larvae, adult worm nodules, microfilaraie in skin, worm in eye, skin snip test
Onchocerca Volvulus
Numerous lesions in CT scan of brain, consume taneia solium eggs (pork tapeworm), TX-praziquantel, albendazole & corticosteroids
Hyatid cyst, tapeworm in dogs, ship liver, TX- albendazole and cyst removal
Fever, malaise, rash, ↑ LIVER ENZYMES, separate male and female, adult in veins of large intestine and liver
Schistosoma Mansoni
Transmitted by free-living cercarie, rash at entry sight, typhoid fever like symptoms, hypatospleenomegaly
Schistosoma Mansoni
Lateral spine
Schistosoma Mansoni
Painful urination, hematuria, swam in river, penetration of skin by free living cercariae, bladder biopsy
Schistosoma Haematobium
Terminal spine
Schistosoma Haematobium
Spleenectomy, sporozoan, infects RBC's, deer tick, northeast, tiny rings with cross formation, TX- clindamycin and quinine
Babesia Microfti
Large cervical lymph nodes, cats, oocyst, tachyzoite in tissue, tissue and brain damage, ↑ IgM titer, TX- pyrimethamine
Toxoplasma Gondi
Iraq, flagellate, phebotomus sand fly, amastigote in tissue/macrophages, TX- antimony-containing compounds
Leishmania species
Middle east, dry long lasting lesions, Tropica, Major, Mexicana, Bazillensis
Cutaneous Leishmania
India, Brazil, spiking fevers, sweat, diarrhea, weight loss, organomegaly, anemia, Donovani, Tropica
Visceral Leishmania
Megacolon, megaesophagus, reduvid bug, tryptomastigote, South and Central America, CHAGA's, ROMANIA SIGN
Trypanosoma Cruzi
Chaga's disease, Chagoma (chancre) at site of bite
Trypanosoma Cruzi
Unilateral swelling of face where bitten
Trypanosoma Cruzi, ROMANIA SIGN
Swollen nodes on back of neck (winterbottom's sign), tetse fly, trypomastigote, can get in CNS
Trypanosoma Brucei
β hemoplitic, G+ cocci in pairs and chains
Group A Streptococcal Pyogenes
Rheumatic fever and acute glomerulonephritis
acute non-suppurative sequealae of GAS
Palatal petichiae
GAS pharyngitis
Strawberry tongue, circumoral pallor, sandpaper rash, pastia lines on arms, desquamation
Scarlet Fever
Holosystolic murmur, hepatomegaly, mitrial > aortic > tricuspid, carditis, polyarteritis, erythema, chorea, subcutaneous nodules, blanching rash
Rheumatic Fever due to GAS
Can see ring and gametocyte stages, rings and dots, 2/3 of RBC's size
Plasmodium Falciparium
Large RBC's, fever, chills, ↓ Hb, spleenomegaly, big red dots in cells, funny shapes
Plasmodium Viviax
More common in non-immune mothers, placenta gets full of parasites
Congenital malaria
Transmission of malaria
bite of female anopheles, bite from dusk to dawn, sharing needles, transfusion, mother → infant
Half malaria cases, 95% of deaths
Plasmodium Falciparum
Prefers reticulocytes but can invade RBC's of all ages
Plasmodium Falciparium
Invades reticulocytes
Plasmodium falciparum, vivax, and ovale
Preferentially invades senescent erythrocytes
Plasmodium Malariae
Types of plasmodium that persist in the liver
Ovale and Vivax
How do you treat plasmodium that is stuck in liver
PRIMAQUIN (ovale and vivax)
What causes malaria fevers
cyclical RBC lysis, release of TNFα and other inflammatory cytokines, cyclical
Some pathogenesis of malaria
hemolytic anemia, thrombocytopenia, adherence to chondrotin sulfate → low birth weight
Two properties that make falciparum dangerous
high degree of parasitemias, CO-ADHERENCE (stick RBC's together by making proteinaceous knobs → clog up blood vessels), also hit all RBC's
Treat plasmodium falciparum (assume resistance)
malarone, quinine, clindamycin, tetracycline
Treat plasmodium vivax
Pathogenic bacteria of the small intestine
Vibrio Cholerae, Vibrio Vulnificus
Pathogenic bacteria of large intestine
Vibrio Parahaemolyticus
Small intestine, enterotoxin or adherence, N/V fever, fluid loss, 1-3 days, self-limiting
non-inflammatory watery disease
Colon, small intestine, invasion or cytotoxin, fever, abdominal pain, cramps, vomiting, blood in stool, 2-7 days
inflammatory diarrhea
Vibrio Parahaemolyticus
Vibrio Cholerae
Gram negative curved rod, motile, facultative anaerobe, non-lactose fermenter, grows in SALT and FRESH water
Vibrio Cholerae
Grows in salt and fresh water
Vibrio Cholerae
Serotype of cholera that causes more epidimcs
Serotype O1
Serotype of cholera that emerged from India
Serotype O139
Ongoing cholera pandemic
EI Tor
Severe watery diarrhea, rice water stool, isolate organism in stool:
Vibrio Cholerae
Virulence factors of Vibrio Cholera
flagellum, Tcp (pili), AB enterotoxin
Filamentous phage
Tcp pili virulence factor of vibrio cholera
CTX phage
AB cholera enterotoxin
ADP ribosylates Gs protein, causes Gs activation, ↑ cAMP
cholera AB toxin
Contract from contaminated shelfish
Vibrio Parahaemolyticus
Found only in salt water
Vibrio Parahaemolyticus
Gram negative, halophilic small rods, swimming flagella, survives in marine sediment
Vibrio Parahaemolyticus
TDH/TLH thermostable hemolysins, two type III secretion systems (T3S1, T3S2)
Vibrio Parahaemolyticus
Linked to handling/eating raw oysters
Vibrio Vulnificus
Sepsis, bullous skin lesions, hypotension ,fever, GI
Vibrio Vulnificus
Wound exposure to contaminated water, necrotizing wound lesion
Vibrio Vulnificus
Acid induced oxidative stress, CPD capsule, iron acquisition, RtxA1 toxin
Virulence Factors of Vibrio Vulnificus
Low temperature pasteurization, high-pressure processing, irridation of oysters
Invasive infection, gram negative rods, facultative anaerobes, non-lactose fermenter, motile, cause gastroenteritis/septicemia/enteric fever, improper food handing or processing, fluid and electrolyte replacement, no ABX
Contaminated food or water, human carriers, bacteria multiply in macrophages, fever, HA, lethargy, myalgia, rose rash on abdomen, re-infection of intestinal tract, invasive disease treated with antibiotics, produce SOD and catalase, resistant to complement, LPS, T3S, spreads to other organs
Enteric Typhoid Fever caused by Salmonella Typhi
Invasive and toxigenic, resistant to several Abx, gram negative facultative rods, non-motile, group based on O antigen, contaminated food/water, causes dysentery, bacteria directed endocytosis through M cell proteins
N-glycosidase, cleaves adenosine residue, stops cell protein synthesis, enetotoxin (fluid loss), neurotoxin (paralysis), cytotoxin (cell death), important role in Hemolytic Uremic Syndrome
Shiga Toxin (Stx)
Acute kidney failure, more common in children, hemolytic anemia, thrombocytopenia, caused by shigella
Hemolytic Uremic Syndrome (HUS)
Gram negative curved rod, motile, slow growing, lives in gastric mucosa, acute or chronic inflammation in gastic mucosa, gastritis, nausea, vomiting, epigastic pain, flagella, urease (creates alkaline stomach), LPS, VacA, cag, ↑ Gastrin, ↑ free radicals, ↑ proliferation, ↓ ulcers
Helicobacter Pylori
Gram-negative rod, motile, facultative anaerobe, ferment lactose, serotype O, H, K, virotype based on virulence factors, transmitted in food and water, fever, dehydration
E. Coli
Watery non-inflammatory diarrhea, non-toxigenic/non-invasive, T3S, LEE PAI, bundle-forming-pilus (EAF), infants, food, water, lactose fermenter, DNA probe detects bfp, tx-non-absorbable aminoglycosides
EPEC (pathogenic)
Watery non-inflammatory diarrhea, Heat Labile Toxin (LT), Heat Stable Toxin (ST), colonization factor antigen fimbrae, traveler's diarrhea, tx- Trimethoprim-sulfmethoxazole
ETEC (toxigenic)
Cholera like AB toxin, ADP ribosylates Gs, stimulates PG, LT, cytokines
Heat Labile Toxin (LT), ETEC
Non-inflammatory or inflammatory bloody diarrhea, biofilm, AIDS, aggregative adherence fimbrae (AAF), EAST1, Pet, tx- ciprofloxacin, rifaximin, phenotypic Hel-2-adhearance assay
EAEC (aggregative)
Virulence factor for EAEC, stacked brick aggregates, adherence to epithelial cells
Aggregative Adherence Fimbriae (AAF)
Virulence factor for EAEC, cytotoxic serine protease autotransporter, disrupts actin, induces exfoliation
Inflammation, necrosis, ulceration, dysentery, non-toxigenic, invasive, get into colon via M cells, use T3S, shigella like organism, food, water
EIEC (invasive)
Dysentery, progresses to HUS, Triad of symptoms (RBC destruction, thrombocytopenia, acute renal failure), Sxt (shigella like toxin), T3S LEE PAI, EAST1, contaminated beef, 0157:57 (most active serotype), delayed sorbitol fermentation, DNA fingerprinting, Tx- NO ABX, use transfusion/hemodialysis
EHEC (hemorrhagic)
Gram positive rods associated with GI disease
Anaerobes (C.Diff, C. Perfringens), Obligate Aerobes (B.Cereus, B.Anthracis)
Obligate anaerobes, spore formers, no catalase/peroxidase/SOD, look like tennis rackets, AIDS, hemophilia, trimethoprom-sulfamethoxazole cause diarrhea, large intestine has pseudomembrane, yellow lesions on mucosa, toxins A/B/binary toxin CDT, immunological tests for B, can't culture, Tx- VANCOMYCIN
Inactivate Rho GTPases by glucosylation, causes cytoskeletal disruption
C.Diff toxins A and B
New virulent strain, produces a lot of toxins A and B (due to deletion of TcdC), new CDT cytotoxin
NAP-1/027 Virulent Strain
Anaerobic, Diarrhea, abdominal camps, vomiting, corned beef, germinate and multiply in fod at RT, ingested spores make enterotoxin, tight junction proteins CLAUDIN3 and CLAUDIN4
Clostridium Perfringes
Rice, quick onset of N/V/D, gram positive rod, spore former, aerobe, heat stable toxin (triangle), 2 heat labile enterotoxins, aerobe
Bacillus Cereus
Gram positive, spore former, aerobic, inhalation or ingestion, poly-D-glutamic acid capsule, 3 subunit toxin (PA-protective antigen, EF-edema factor, LF-lethal factor), ↑ cAMP, edema, macrophage apoptosis, ↓ immune response, vascular leakage, shock, spores can get in carcasses of dead animals, TX- ciprofloxacin or doxycycline
Bacillus Anthracis
3 types of disease, Woolsorters (septicemia, chills, tightness), Malignant pustule (skin infection, edema, dark eschar), GI (spores ingested cause ulcers)
Bacillus Anthracis
Gram negative, spiral rod, motile, polar flagella, small dynamic genome, fever, cramping, bloody/watery diarrhea, AIDS, flagella, chemotaxis, adherence, invasion, Cytolethal Distending Toxin (CDT), uses microtubules to enter, contaminated poutry/water/milk, cross reactivity with peripheral neural tissue, self-limiting
DNAse like causes G2/M cycle arrest, cell distention/death
cytolethal distending toxin (CDT), CAMPYLOBACTER JEJUNI
Small Gram negative rod, non-lactose fermenter, undercooked pork, isolate form feces/mesenteric nodes, severe enterocolitis, intestinal abscess mesenteric lymphadenitis, fever, abdominal pain, diarrhea, invasive organism, INVASIN, AIL, YADA, zipper mechanism into M cells and macrophages, T3S (Ysc, Ysa, Flagellar)
3 type III secretion systems (Ysc, Ysa, flagellar), rearrange actin and mess up cell signaling
Mild disease diarrhea, fever, vomiting, cramping, HA, misdiagnosed as UC/CD, campy agar, uncooked poultry, guilian barre syndrome, miller fisher syndrome, HLA B27
Severe enterocolitis, dysentery, fever, vomiting, pain, misdiagnosed as appendicitis/Chron's disease, growth at 4C, undercooked PORK, erythema nodosum, reactive arthritis, HLA B27
ABC, G+/-, simplest, one step, hemolysins, bacteriocins, metalloproteases
Type 1 Secretion
Sec-dependent, major secretory pathway G+/-, 2 step, most common, shoot out into environment
Type 2 secretion
Contact dependent (flagellum structure), G+, shoots into host, 1 step
Type 3 secretion
DNA protein complexes (pilus structure), G+/-
Type 4 secretion
Auto-transporter, β-pore, G+/-, 2 step process
Type 5 secretion
Homology with phage, G- 1 step
Type 6 secretion
Prototype mycobacterium secretion, G-
type 7 secretion