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
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
Bird ****, polysaccharide capsule, AIDS, meningitis, lumbar puncture, encapsulated budding yeast
Cryptococcus Neoformans
Protozoan, inhaled from environment, T cell deficiency, foamy proteinacious material, hypoxemis
Pneumocystosis
Fever, lower respiratory tract infection, 10 days of travel or contact + CXR of pneumonia or ARDS
Probable case of SARS
Chronic sinusitis, nasal polyps, chronic bronchial suppuration, pancreatitis, DM, reduced fertility
Cystic fibrosis
CF, aerobic, non-spore-forming, gram negative rods, non-fermenter, mucoid, ↓ FEV1
Pseudomonas Aeruginosa
DS DNA herpes virus, latency shingles, positive TSANCK smear, treat with acyclovir
Varicella Zoster Virus
Nasal flaring, fever, nose crusting, hyperinflation, bilateral patchy infiltrates, paramyxovirus, winter or spring, humans only
RSV
Paramyxovirus, contagious 1-2 days before onset of symptoms, treat with vitamin A and supportive care, 2 vaccinations
Measles
Cold symptoms for 3 weeks, cobble stoning posterior pharynx, dark circles under eyes, clinical diagnosis
Acute sinusitis
Begins with URI, infective during this stage, if treated you stop the progression
Catarrhal phase of pertussis
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
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
Cysticercosis/Neurocysticercosis
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
Painful urination, hematuria, swam in river, penetration of skin by free living cercariae, bladder biopsy
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
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
Swollen nodes on back of neck (winterbottom's sign), tetse fly, trypomastigote, can get in CNS
Trypanosoma Brucei
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
Large RBC's, fever, chills, ↓ Hb, spleenomegaly, big red dots in cells, funny shapes
Plasmodium Viviax
Transmission of malaria
bite of female anopheles, bite from dusk to dawn, sharing needles, transfusion, mother → infant
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
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
Gram negative curved rod, motile, facultative anaerobe, non-lactose fermenter, grows in SALT and FRESH water
Vibrio Cholerae
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
Acid induced oxidative stress, CPD capsule, iron acquisition, RtxA1 toxin
Virulence Factors of Vibrio Vulnificus
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
Salmonella
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
SHIGELLA
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
Pet
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
E.coli
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
CAMPYLOBACTER JEJUNI
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)
YERSINIA ENTERCOLITICA
3 type III secretion systems (Ysc, Ysa, flagellar), rearrange actin and mess up cell signaling
YERSINIA ENTERCOLITICA
Mild disease diarrhea, fever, vomiting, cramping, HA, misdiagnosed as UC/CD, campy agar, uncooked poultry, guilian barre syndrome, miller fisher syndrome, HLA B27
CAMPYLOBACTER JEJUNI
Severe enterocolitis, dysentery, fever, vomiting, pain, misdiagnosed as appendicitis/Chron's disease, growth at 4C, undercooked PORK, erythema nodosum, reactive arthritis, HLA B27
YERSINIA ENTERCOLITICA
Sec-dependent, major secretory pathway G+/-, 2 step, most common, shoot out into environment
Type 2 secretion