Peptidoglycan

(Function and Chemical Composition)

Function = Rigid support; protects against osmotic pressure

Composition = Sugar backbone with peptide side chains cross-linked by transpeptidase

Cell Wall/Cell Membrane (Gram +)

(Function and Chemical Composition)

Function = Major surface antigen

Composition = Peptidoglycan for support; Lipotechoic acid induces inflammation

Outer Membrane (Grame -)

(Function and Chemical Composition)

Function = Site of endotoxin (LPS); major surface antigen

Composition = Lipid A (induces inflammation); O polysaccharide (antigen)

Plasma Membrane

(Function and Chemical Composition)

Function = site of oxidative and transport enzymes

Composition = Phospholipid bilayer

Ribosome

(Function and Chemical Composition)

Function = protein synthesis

Composition = 50S and 30S subunits

Periplasm

(Function and Chemical Composition)

Function = Space between cytoplasmic membrane and outer membrane in G-neg bacteria

Composition = Contains many hydrolytic enzymes (including B-lactamases)

Capsule

(Function and Chemical Composition)

Function = protects against phagocytosis

Composition = Polysaccharide (except Bacillus anthracis - D-glutamate)

Pilus/Fimbria

(Function and Chemical Composition)

Function = Mediate adherence to cell surface; sex pilus forms attachments between bacteria during conjugation

Composition = Glycoprotein

Flagellum

(Function and Chemical Composition)

Function = motility

Composition = protein

Spore

(Function and Chemical Composition)

Function = Resistant to dehydration, heat, and chemicals

Composition = Keratin-like coat; dipicolinic acid; peptidoglycan

Plasmid

(Function and Chemical Composition)

Function = Contains genes for antibiotic resistance, enzymes, and toxins

Composition = DNA

Glycocalyx

(Function and Chemical Composition)

Function = adherence to surfaces, especially foreign surfaces (indwelling catheters)

Composition = Polysaccharide

Endotoxin (LPS)

Periplasm

Staphylococcus

Streptococcus

Clostridium

Corynebacterium

Bacillus

Listeria

Mycobacterium (acid fast)

Gardnerella (gram variable)

Gram (-) Bacilli

(Enterics)

Vibrio

Yersinia

Klebsiella

E. coli

Enterobacter

Proteus

Salmonella

Helicobacter

Psuedomonas

Shigella

Bacteroides

Campylobacter

Serratia

Gram (-) Bacilli

(Respiratory)

Haemophilus (pleomorphic)

Legionella (silver)

Bordetella

Gram (-) Bacilli

(Zoonotic)

Pasteurella

Brucella

Francisella

Bartonella

Actinomyces

Nocardia (weakly acid fast)

Rickettsiae (Giemsa)

Chlamydiae (Giemsa)

Borrelia (Giemsa)

Treponema

Leptospira

(These Microbes May Lack Real Color)

Treponema (dark-field microscopy and fluorescent antibody staining)

Mycobacteria (high lipid content detected by acid-fast stain)

Mycoplasma (no cell wall)

Legionella pneumophila (primarily intracellular)

Rickettsia (intracellular parasite)

Chlamydia (intracellular parasite; lacks muramic acid in cell wall)

(Certain Bugs Really Try my Patience)

Chlamydia

Borrelia

Rickettsia

Trypanosomes

Plasmodium

Anaplasma spp.

(Disease and Transmission)

Anaplasmosis

Ixodes ticks

(live on deer and mice)

Bartonella spp.

(Disease and Transmission)

Cat Scratch Disease

Bacillary Angiomatosis

Transmission = Cat scratch

Borrelia Burgdorferi

(Disease and Transmission)

Lyme Disease

Ixodes ticks

(live on deer and mice)

Borrelia recurrentis

(Disease and Transmission)

Relapsing Fever

Louse

(recurrent due to variable surface antigens)

Brucella spp.

(Disease and Transmission)

Brucellosis

Undulant fever

Transmission = Unpasteurized dairy

Campylobacter

(Disease and Transmission)

Bloody diarrhea

Transmission = Puppies, Livestock

(fecal-oral, ingestion of undercooked meat)

Chlamydophila psittaci

(Disease and Transmission)

Psittacosis

Transmission = Parrots/birds

Coxiella burnetii

(Disease and Transmission)

Q Fever

Transmission = Aerosols of cattle/sheep amniotic fluid

Ehrlichia chaffeensis

(Disease and Transmission)

Ehrlichiosis

Transmission = Lone Star ticks

Francisella tularensis

(Disease and Transmission)

Tularemia

Transmission = Ticks, rabbits, deer fly

Leptospira spp.

(Disease and Transmission)

Leptospirosis

Transmission = Animal urine

Mycobacterium leprae

(Disease and Transmission)

Leprosy

Transmission = Humans with lepromatous leprosy; Armadillos (rare)

Pasteurella multocida

(Disease and Transmission)

Cellulitis
Osteomyelitis

Transmission = Animal bite (cats/dogs) 

Rickettsia prowazekii

(Disease and Transmission)

Epidemic Typhus

Transmission = Louse

Rickettsia rickettsii

(Disease and Transmission)

Rocky Mountain Spotted Fever

Transmission = Dermacentor ticks

Rickettsia typhi

(Disease and Transmission)

Endemic Typhus

Transmission = Fleas

Yersinia pestis

(Disease and Transmission)

Plague

Transmission = Fleas

Reservoir = Rats/Prairie dogs

Flu-like syndrome after antibiotics are started

Cause = killed bacteria release pyrogens

Constricts with accommodation, but non-reactive to light

Association = Tertiary Syphilis

(Prostitute Pupil - accomodates, but does not react)

Lyme Disease

(Cause, Transmission, Reservoir)

Borrelia Burgdorferi

Transmission = Ixodes tick

Reservoir = Mouse

Lyme Disease

(location)

Lyme Disease

(Treatment)

Doxycycline

Ceftriaxone

Lyme Disease

(Symptoms)

• Initial:
• Erythema chronicum migrans
• Flu-like symptoms
• +/- facial nerve palsy
• Late:
• Monoarthritis (large joints)
• Migratory polyarthritis
• Cardiac (AV node block)
• Neurologic (Encephalopathy, Facial nerve palsy, Polyneuropathy)

• FAKE a Key Lyme pie:
• Facial nerve palsy
• Arthritis
• Kardiac block
• Erythema migrans

Syphilis

(Cause)

Syphilis

(Treatment)

Syphilis

(Symptoms)

• Primary:
• Painless genital chancre
• Secondary = Systemic
• Constitutional symptoms
• Maculopapular rash (palms and soles)
• Condylomata lata (confirmable with dark-field microscopy)
• Latency
• Tertiary:
• Gummas (chronic granulomas)
• Aortitis (vasa vasorum destruction)
• Neurosyphilis (Tabes Dorsalis, "general paresis")
• Argyll Robertson pupil
• Broad-based ataxia
• + Romberg
• Charcot joint
• Stroke without HTN
• Congenital:
• Saber shins
• Saddle nose
• CN VIII deafness
• Hutchinson teeth
• Mulberry molars

Syphilis

(Testing)

• Primary:
• VDRL/RPR (non-specific)
• Confirmation = FTA-ABS
• Secondary:
• VDRL/RPR (non-specific)
• Confirmation = FTA-ABS
• Latent:
• Positive serology without symptoms
• Tertiary:
• Test spinal fluid with VDRL/RPR

Congenital Syphilis

(Symptoms and Treatment)

Symptoms:

- Saber Shins

- Saddle nose

- CN VIII deafness

- Hutchinson teeth

- Mulberry molars

Treatment:

Treat in early pregnancy, since placental transmission happens after first trimester

Detects nonspecific antibody that binds beef cardiolipin

Inexpensive, widely available, quantitative, sensitive but not specific

Many False positives

(Viral infection [Mono, Hepatitis], Drugs, SLE)

VDRL:

Viruses (mono, hepatitis)

Drugs

Rheumatic fever

Lupus and Leprosy

Gardnerella vaginalis

(Appearance)

Gardnerella vaginalis

(Disease)

Gardnerella vaginalis

(Presentation)

Gray vaginal discharge with fishy smell

Nonpainful (vs. vaginitis)

Overgrowth of anaerobic bacteria in vagina

Clue cells

(vaginal epithelium covered with Gardnerella bacteria)

I don't have a clue why I smell fish in my vagina garden!

Gardnerella vaginalis

(Treatment)

Metronidazole

Clindamycin

(treats anaerobic bacteria)

• Rash Common:
• RMSF (R. rickettsii)
• Typhus (R. typhi)
• Rash Rare:
• Ehrlichiosis (Ehrlichia)
• Anaplasmosis (Anaplasma)
• Q fever (Coxiella burnetii)

RMSF

(Cause, Vector)

Rickettsia rickettsii

Vector = tick

RMSF

(Location)

South Atlantic states

(North Carolina)

RMSF

(Presentation)

Rash at wrists/ankles > trunk, palms, soles

(Vasculitis)

Headache

Fever

You drive CARS with your palms and soles

Coxsackievirus A

RMSF

Syphilis (2)

RMSF

(Organism Characteristics)

Intracellular

(require CoA and NAD+ because they can't synthesize ATP)

Typhus

(Cause)

Endemic (fleas) = R. typhi

Epidemic (human body louse) = R. prowazekii

Typhus

(Presentation)

Ehrlichiosis

(Cause, Vector)

Ehrlichia

Vector = tick

Ehrlichiosis

(Presentation)

Anapalsmosis

(Cause, Vector)

Anaplasma

Vector = tick

Anaplasmosis

(Presentation)

Q Fever

(Cause, Transmission)

Coxiella burnetii

No vector

Transmission = Tick feces and cattle placenta > spores > inhaled

Q Fever is Queer because it has no rash/vector and causative organisms survives outside in endospore form

Q Fever

(Presentation)

Chlamydiae

(Organism Characteristics)

Obligate Intracellular

(cannot make their own ATP)

Cell wall lacks muramic acid

Chlamydiae

(Forms)

• Elementary body (small, dense)
• Enfectious
• Enters cell via Endocytosis
• Transforms into Reticulate
• Reticulate body
• Replicates by fission
• Reorganizes into Elementary bodies

Chlamydiae

(Types and Presentations)

• C. Trachomatis
• Reactive arthritis
• Follicular conjunctivitis
• Nongonococcal urethritis
• PID
• C. Pneumoniae and C. Psittaci
• Atypical pneumonia (aerosol transmission)

Chlamydiae

(Diagnosis)

Chlamydiae

(Treatment)

Azithromycin

(one-time treatment)

or

Doxycycline

Types A, B, C

Types D-K

Types L1, L2, L3

Chlamydiae Trachomatis

(Types A, B, C presentations)

Chronic infection > blindness (Follicular conjunctivitis) in Africa

ABC = Africa/Blindness/Chronic infection

Chlamydiae Trachomatis

(Types D-K presentation)

Urethritis/PID

Ectopic Pregnancy

Neonatal pneumonia

(Staccato cough)

Neonatal conjunctivitis

Chlamydiae Trachomatis

(Types L1, L2, L3 presentation)

Lymphogranuloma Venereum

(Cause, Presentation, Treatment)

Cause = Chlamydiae Trachomatis (types L1-L3)

Small, painless ulcers on genital > swollen, painful inguinal lymph nodes that ulcerate (buboes)

Treatment = Doxycycline

Mycoplasma Pneumoniae

(Presentation)

Atypical pneumonia

(insidious onset, headache, nonproductive cough, patchy/diffuse interstitial infiltrate)

Mycoplasma Pneumoniae

(Labs)

X-ray looks worse than patient

High titer of cold agglutinins (IgM) > agglutinate/lyse RBCs

Grown on Eaton agar

Mycoplasma Pneumoniae

(Treatment)

Macrolide, Doxycycline, or Fluoroquinolone

(No cell wall = Penicillin not effective)

Mycoplasma Pneumoniae

(Characteristics)

No cell wall

Not seen on gram stain

Membrane has sterols (stability)

Mycoplasma Pneumoniae

(Epidemiology)

More common in patients < 30 years old

Frequent outberaks in military recruits and prisons

Systemic Mycoses

(Organisms, Characteristics, Presentation, Treatment)

• Organisms:
• Histoplasmosis
• Blastomycosis
• Coccidiomycosis
• Paracoccidiomycosis
• Characteristics:
• Dimorphic fungi (Cold = Mold, Heat = Yeast)
• Exception = Coccidiodomycosis (spherule in tissue)
  
• Presentation:
• Pneumoniae (can disseminate)
• Mimic TB (granuloma formation) but no person-person transmission
• Treatment:
• Local = Fuconazole or Itrazonazole
• Systemic = Amphotericin B

Histoplasmosis

(Location)

Histoplasmosis

(Presentation)

Pneumoniae

Macrophages filled with Histoplasma

(Histo Hides)

Histoplasmosis

(Source)

Blastomycosis

(Location)

Blastomycosis

(Presentation)

Inflammatory lung disease

Can disseminate > Skin/Bone

Granulomatous nodules

Broad-base budding

(Blasto buds broadly)

Coccidiomycosis

(Location)

Coccidiomycosis

(Presentation)

Pneumonia

Meningitis

Disseminate > Bone/Skin

(Desert Bumps = erythema nodosum

Desert Rheumatism = arthralgias)

Spherule filled with endosphores

(Coccidio crowds)

Paracoccidiomycosis

(Location)

Paracoccidiomycosis

(Presentation)

Budding yeast with "captain's wheel" formation

(Paracoccidio parasails with the captain's wheel all the way to Latin America)

Tinea Versicolor

(Cause)

Tinea Versicolor

(Pathophysiology/Presentation)

Degradation of lipids > acid > damage melanocytes > Hypo/Hyperpigmented patches

Occurs in hot, humid weather

Tinea Versicolor

(Microscopy)

Tinea Versicolor

(Treatment)

Topical miconazole

+

Selenium sulfide

(Selsun)

Tinea appearance

(not Versicolor)

Tinea microscopy

(not Versicolor)

Mold hyphae in KOH prep

Not dimorphic

Tinea cause

(not Versicolor)

Dermatophytes

(Microsporum, Trichophyton, Epidermophyton)

Candida albicans

(Presentation)

Systemic or superficial infection

Oral/Esophageal thrush in immunocompromised

(neonates, steroids, diabetes, AIDS)

Vulvovaginitis

(diabetes, antibiotic use)

Diaper rash

Endocarditis in IV drug users

Disseminated

(to any organ)

Chronic mucocutaneous candidiasis

Candida albicans

(Treatment)

Vaginal = Topical azole

Oral/Esophageal = Fluconazole or Caspofungin

Systemic = Fluconazole, Amphotericin B, or Caspofungin

Candida albicans

(Microscopy)

Dimorphic yeast

Pseudohyphae and budding yeasts at 20 C

Germ tubes at 37 C

Aspergillus fumigatus

(Presentation)

Invasive aspergillosis, especially in immunocompromised and CGD

Allergic Bronchopulmonary aspergillosis

Aspergillomas in lung cavities

(especially at TB infection)

Hepatocellular carcinoma

(aflatoxins)

Allergic Bronchopulmonary Aspergillosis

(ABPA)

Associated with asthma and cystic fibrosis

Can cause bronchiectasis and eosinophilia

Aspergillus fumigatus

(Microscopy)

Not dimorphic

Septate hyphae that branch at 45 degree angle

(Acute Angles in Aspergillus)

Conidophore with radiating chains of spores

Cryptococcus neoformans

(Presentation)

Meningitis

(hematogenous dissemination)

Cryptococcosis

Cryptococcus neoformans

(Source, Transmission)

Cryptococcus neoformans

(Transmission)

Cryptococcus neoformans

(Labs)

Culture on Sabouraud agar

Stains with India ink and mucicarmine

Latex agglutination test detects polysaccharide capsular antigen

(more specific)

"Soap bubble" lesions in brain imaging

Cryptococcus neoformans

(Microscopy)

Heavily encapsulated yeast; not dimorphic

5-10 um yeasts with wide capsular halos and unequal budding in India ink stain

Mucor and Rhizopus spp.

(Disease)

Mucor and Rhizopus spp.

(Presentation)

Rhinocerebral, frontal lobe abscesses

Headache, facial pain

Black necrotic eschar on face

Possible CN involvement

Mucor and Rhizopus spp.

(Epidemiology)

Mucor and Rhizopus spp.

(Pathophysiology)

Mucor and Rhizopus spp.

(Treatment)

Mucor and Rhizopus spp.

(Microscopy)

Pneumocystic jirovecii

(Disease)

Pneumocystic pneumonia (PCP) in immunocompromised patients

Usually asymptomatic

Pneumocystic jirovecii

(Transmission)

Pneumocystic jirovecii

(Labs)

Methenamine silver stain

Diffuse, bilateral CXR appearance

Pneumocystic jirovecii

(Diagnosis)

Pneumocystic jirovecii

(Microscopy)

Pneumocystic jirovecii

(Treatment)

Treatment:

TMP-SMX

Pentamidine

Prophylaxis:

Dapsone

Atovaquone

Start prophylaxis when CD4 count drops < 200 in HIV patients

Sporothrix schenckii

(Disease)

Sporotrichosis

("Rose Gardner's Disease")

Sporothrix schenckii

(Microscopy)

Sporothrix schenckii

(Source, Transmission)

Spores traumatically introduced into skin by a thorn

(rose gardener's disease)

Sporothrix schenckii

(Presentation)

Local pustule or ulcer with nodules along draining lymphatics

(Ascending lymphangitis)

Little systemic illness

Sporothrix schenckii

(Treatment)

Itraconazole or Potassium Iodid

(Plant a rose in the pot)

Giardia lamblie

(Disease)

Giardia lamblia

(Presentation)

Bloating, flatulence

Foal-smelling, fatty diarrhea

Often seen in campers/hikers

(Fat-rich Ghiradelli chocolates for fatty stools of Giardia)

Giardia lamblia

(Transmission)

Giardia lamblia

(Diagnosis)

Giardia lamblia

(Treatment)

Entamoeba histolytica

(Disease)

Entamoeba histolytica

(Presentation)

Bloody diarrhea (dysentery)

Liver abscess (anchovy paste exudate)

RUQ pain (flask-shaped ulcer if submucosal abscess of colon ruptures)

Entamoeba histolytica

(Transmission)

Entamoeba histolytica

(Diagnosis)

Serology

and/or

Trophozoites (with RBC's in the cytoplasm) or Cysts (with up to 4 nuclei) in stool

Entamoeba histolytica

(Treatment)

Metronidazole

Iodoquinol for asymptomatic cyst passers

Cryptosporidium

(Presentation)

Severe diarrhea in AIDS

Mild disease (watery diarrhea) in nonimmunocompromised

Cryptosporidium

(Transmission)

Cryptosporidium

(Diagnosis)

Cryptosporidium

(Treatment)

Prevention

(filtering city water supplies)

Nitazoxanide

(immunocompetent hosts)

Giardia lamblia

Entamoeba histolytica

Cryptosporidium

Toxoplasma gondii

Naegleria fowleri

Trypanosoma brucei

Toxoplasma gondii

(Presentation)

Brain abscess in HIV

(ring-enhancing brain lesions on CT/MRI)

Congenital triad

(Chorioretinitis, hydrocephalus, intracranial calcifications)

Toxoplasma gondii

(Transmission)

Cysts in meat

Oocysts in cat feces

Crosses placenta

(pregnant women should avoid cats)

Toxoplasma gondii

(Diagnosis)

Serology

Biopsy

(tachyzoite)

Toxoplasma gondii

(Treatment)

Naegleria fowleri

(Presentation)

Naegleria fowleri

(Transmission)

Swimming in freshwater lakes > enters cribriform plate

(Nalgene bottle filled with fresh water and Naegleria)

Naegleria fowleri

(Diagnosis)

Naegleria fowleri

(Treatment)

Amphotericin B

(effective for few survivors)

Trypanosoma brucei

(Disease)

Trypanosoma brucei

(Presentation)

Enlarged lymph nodes

Recurring fever

(antigenic variation)

Somnolence

Coma

Trypanosoma brucei

(Species)

Trypanosoma brucei rhodesiense

Trypanosoma brucei gambiense

Trypanosoma brucei

(Transmission)

Tetse fly

(painful bite)

Trypanosoma brucei

(Diagnosis)

Trypanosoma brucei

(Treatment)

Blood-borne disease = Suramin 

CNS penetration = Melarsoprol

(it sure is nice to go sleep; melatonin helps with sleep)

Plasmodium (Vivax, Ovale, Falciparum, Malariae)

Babesia

Plasmodium

(Disease)

Plasmodium

(Presentation)

• General:
• Headache
• Fever
• Anemia
• Splenomegaly
• P. vivax/ovale:
• 48 hr cycle (Tertian; 1st day and 3rd day)
• Dormant form in liver (Hypnozoite)
• P. falciparum:
• Severe
• Irregular fever patterns
• Parasitized RBC's occlude capillaries in brain (cerebral malaria), kidneys, and lungs
• P. malariae
• 72 hr cycle (Quartan)

Plasmodium

(Transmission)

Mosquito

(Anopheles)

Plasmodium

(Diagnosis)

Blood smear

(Trophozoite ring form within RBC;

Schizont containing merocoites)

Plasmodium

(Treatment)

Begin = Chloroquine

(blocks Plasmodium heme polymerase)

Resistant = Mefloquine or Atovaquone/Proguanil

Life-threatening = IV Quinidine

(test for G6PD deficiency)

Vivax/Ovale = add Primaquine for hypnozoite

(test for G6PD deficiency)

Babesia

(Disease)

Babesia

(Presentation)

Fever

Hemolytic anemia

Severe disease = Asplenia

Babesia

(Location)

Babesia

(Transmission)

Ixodes tick

(same as Lyme disease; can coinfect!)

Babesia

(Diagnosis)

Blood smear

(Ring form; Maltese cross)

PCR

Babesia

(Treatment)

Trypanosoma cruzi

(Disease)

Trypanosoma cruzi

(Presentation)

Dilated cardiomyopathy

Megacolon

Megaesophagus

Trypanosoma cruzi

(Location)

Trypanosoma cruzi

(Transmission)

Reduviid bug feces, deposited in painless bite

(kissing bug)

Trypanosoma cruzi

(Diagnosis)

Trypanosoma cruzi

(Treatment)

Benznidazole

or

Nifurtimox

Leishmania donovani

(Disease)

Visceral Leishmaniasis

(Kala-azar)

Trypanosoma cruzi

(Presentation)

Spiking fevers

Hepatosplenomegaly

Pancytopenia

Trypanosoma cruzi

(Transmission)

Trypanosoma cruzi

(Diagnosis)

Trypanosoma cruzi

(Treatment)

Amphotericin B

Sodium Stibogluconate

Trichomonas vaginalis

(Disease)

Trichomonas vaginalis

(Presentation)

Foul-smelling, greenish discharge

Itching and burning

DON'T CONFUSE WITH GARDNERELLA!

(Gram-variable bacteria associated with bacterial vaginosis)

Trichomonas vaginalis

(Transmission)

Sexual

(cannot exist outside human because it cannot form cysts)

Trichomonas vaginalis

(Diagnosis)

Trophozoites on wet mount

(motile)

Strawberry cervix

Trichomonas vaginalis

(Treatment)

Enterobius vermicularis

(Disease)

Enterobius vermicularis

(Transmission)

Enterobius vermicularis

(Presentation)

Enterobius vermicularis

(Diagnosis)

Enterobius vermicularis

(Treatment)

Ascaris lumbricoides

(Disease)

Ascaris lumbricoides

(Transmission)

Fecal-oral

(eggs visible in feces under microscope)

Ascaris lumbricoides

(Presentation)

Ascaris lumbricoides

(Treatment)

Strongyloides stercoralis

(Transmission)

Strongyloides stercoralis

(Presentation)

Strongyloides stercoralis

(Treatment)

Ancylostoma duodenale

Necator americanus

Hookworm

(Transmission)

Hookworm

(Presentation)

Hookworm

(Treatment)

Onchocerca volvulus

Loa loa

Wuchereria bancrofti

Toxocara canis

Enterobius vermicularis

Ascaris lumbricoides

Strongyloides stercoralis

Ancylostoma duodenale

Necator americanus

Onchocerca volvulus

(Transmission)

Onchocerca volvulus

(Presentation)

Hyperpigmented skin and River blindness

(black flies, black skin nodules, black sight)

Allergic reaction to microfilaria

Onchocerca volvulus

(Treatment)

Ivermectin

(Ivermectin for river blindness)

Loa loa

(Transmission)

Loa loa

(Presentation)

Swelling in skin

Worm in conjunctiva

Loa loa

(Treatment)

Wuchereria bancrofti

(Transmission)

Wuchereria bancrofti

(Presentation)

Blocks lymphatic vessels

(Elephantiasis)

Takes 9 months to become symptomatic

Wuchereria bancrofti

(Treatment)

Toxocara canis

(Transmission)

Toxocara canis

(Presentation)

Toxocara canis

(Treatment)

Ingested = Enterobius, Ascaris, Toxocara

(You'll get sick if you EAT these!)

Cutaneous = Strongyloides, Ancylostoma, Necator

(These get into you feet from the SANd)

Bites = Loa loa, Onchocerca, Wuchereria

(Lay LOW to avoid getting bit)

Cestodes

(Tapeworms)

Taenia solium

Diphyllobothrium

Echinococcus granulosus

Taenia solium

(Disease)

Taenia solium

(Transmission)

Ingestin of larvae encysted in undercooked pork

Ingestion of eggs

Taenia solium

(Presentation)

Intestinal infection

Seizures (neuro)

Taenia solium

(Treatment)

Praziquantel

Neuro = Praziquantel or Albendazole

Diphyllobothrium latum

(Transmission)

Diphyllobothrium latum

(Presentation)

Diphyllobothrium latum

(Treatment)

Echinococcus granulosus

(Transmission)

Echinococcus granulosus

(Presentation)

Hydatid cysts in liver > anaphylaxis if antigens released

(surgeons preinject with ethanol > kills cysts before removal)

Echinococcus granulosus

(Treatment)

Trematodes

(Flukes)

Schistosoma

Clonorchis sinensis

Schistosoma

(Transmission)

Host = snails

Cerceriae penetrate skin of humans

Schistosoma

(Presentation)

Liver and spleen granulomas, fibrosis, and inflammation

Chronic infection with S. haematobium > Squamous Cell Carcinoma of bladder

(Painless hematuria)

Schistosoma

(Treatment)

Clonorchis sinensis

(Transmission)

Clonorchis sinensis

(Presentation)

Biliary tract inflammation > pigmented gallstones

Associated with cholangiocarcinoma

Clonorchis sinensis

(Treatment)

Biliary tract disease, Cholagiocarcinoma

(Parasite Hints)

Brain cysts, Seizures

(Parasite Hints)

Taenia solium

(cysticercosis)

Hematuria, Bladder cancer

(Parasite Hints)

Liver (hydatid) cysts

(Parasite Hints)

Microcytic anemia

(Parasite Hints)

Perianal pruritus

(Parasite Hints)

Portal HTN

(Parasite Hints)

Schistosoma mansoni

Schistosoma japonicum

Vitamin B12 deficiency

(Parasite Hints)

PAS stain

(Periodic Acid-Schiff)

Stains glycogen, mucopolysaccharides

(PASs the sugar)

Used to diagnose Whipple disease

(Tropheryma whipplei)

Ziehl-Neelson stain

(Carbol Fuchsin)

Acid-fast organisms

(Nocardia, Mycobacterium)

Cryptococcus neoformans

(mucicarmine can also be used to stain thick polysaccharide capsule red)

Fungi (Pneumocystis)

Legionella

Helicobacter Pylori

(The silver helicopter legion are fun guys)

H. influenzae

(Special Culture Requirements)

Chocolate agar with factors V (NAD+) and X (hematin)

(Blood and chocolate)

N. gonorrhoeae/meningitidis

(Special Culture Requirements)

Thayer-Martin (VPN) media

Vancomycin = inhibits G+

Polymyxin = inhibits G- except Neisseria

Nystatin = inhibits fungi

(To connect to Neisseria, please use your VPN client)

B. pertussis

(Special Culture Requirements)

Bordet-Gengou (potato) agar

Bordet for Bordetella

C. diphtheriae

(Special Culture Requirements)

M. tuberculosis

(Special Culture Requirements)

M. pneumoniae

(Special Culture Requirements)

Lactose-fermenting enterics

(Special Culture Requirements)

MacConkey agar > Pink colonies

(fermentation produces acid)

Mac for Lac

E. coli grown on EMB agar with green metallic colonies

E. coli is green on EMB

Legionella

(Special Culture Requirements)

Fungi

(Special Culture Requirements)

Sabouraud agar

(Sab's a fun guy)

Use O2-dependent system to generate ATP

(Nagging Pests Must Breathe) 

Nocardia

Psuedomonas aeruginosa

Mycobacterium tuberculosis

Bacillus

P. aeruginosa is an aerobe in burn wounds, diabetes complications, nosocomial pneumonia, cystic fibrosis pneumonia

TB reactivation > apices of lung (highest PO2)

Can't Breathe Air

Clostridium

Bacteroides

Actinomyces

Lack catalase and/or SOD > susceptible to oxidative damage

Foul smelling (short-chain FAs), hard to culture, produce gas in tissue (CO2 and H2)

Normal flora in GI tract, pathogenic elsewhere

AminO2glycosides don't work (need O2 to enter cell)

Stay inside cells when it's Really Cold

Rickettsia

Chlamydia

Can't make own ATP

Some Nasty Bugs May Live FacultativeLY

Salmonella

Neisseria

Brucella

Mycobacterium

Listeria

Francisella

Legionella

Yersinia

SHiNE SKiS

Strep. pneumo

H. influenzae type B

Neisseria

E. coli

Salmonella

Klebsiella

Group B Strep

Capsules are antiphagocytic virulence factor

Capsule + protein conjugate > vaccine antigens

(H. flu, N. meningitidis, S. pneumo)

Opsonized and cleared by spleen

Asplenia > more risk for inefction

Catalase degrades H2O2 before it can be used by MPO

CGD (NADPH oxidase deficiency) > recurrent infections

You need PLACESS for your cats

Pseudomonas

Listeria

Aspergillus

Candida

E. coli

Staph. aureus

Serratia

Encapsulated Bacteria Vaccines

(Mechanism, Vaccines)

Contain polysaccharide capsule antigens > conjugated to carrier protein > enhances immunogenicity (promotes T-cell activation > class-switching)

Polysaccharide alone can't be presented to T-cells

Vaccines:

PCV/Prevnar (pneumococcal conjugate)

PPSV/Pneumovax (pneomococcal polysaccharide)

H. flu (conjugate)

Meningococcal (conjugate)

CHuck Norris hates PUNKSS

Cryptococcus

H. pylori

Proteus

Ureaplasma

Nocardia

Klebsiella

S. epidermidis

S. saprophyticus

Actinomyces israelii

(Pigment)

Yellow sulfur granules composed of bacterial filaments

Israel has yellow sand

S. aureus

(Pigment)

Yellow pigment

Aureus = gold

Pseudomonas aeruginosa

(Pigment)

Blue-green pigment

Aerugula is green

Serratia marcescens

(Pigment)

Red pigment

Think red maraschino cherries

Binds Fc region of IgG > prevents opsonization and phagocytosis

S. aureus

Cleaves IgA > helps colonize respiratory mucosa

Secreted by SHiN

S. pneumoniae

H. influenzae type B

Neisseria

Helps prevent phagocytosis

Goup A Strep.

Exotoxin

(Source)

Exotoxin

(Secreted?)

Exotoxin

(Chemistry)

Exotoxin

(Location of Genes)

Exotoxin

(Toxicity)

High

(fatal dose on the order of 1 ug)

Exotoxin

(Antigenicity)

Exotoxin

(Vaccines)

Exotoxin

(Heat Stability)

Destroyed rapidly at 60 C

(except Staph enterotoxin)

Exotoxin

(Typical Diseases)

Endotoxin

(Source)

Endotoxin

(Secreted?)

Endotoxin

(Chemistry)

Lipopolysaccharide

(structural part of bacteria; released when lysed)

Endotoxin

(Location of Genes)

Endotoxin

(Toxicity)

Low

(fatal dose on the order of hundreds of micrograms)

Endotoxin

(Clinical Effects)

Endotoxin

(Mechanism)

Endotoxin

(Antigenicity)

Endotoxin

(Vaccine)

Endotoxin

(Heat Stability)

Endotoxin

(Typical Diseases)

Meningococcemia

Sepsis by G- rods

Diphtheria toxin

(Corynebacterium diphtheriae)

Exotoxin A

(Pseudomonas aeruginosa)

Shiga toxin

(Shigella spp.)

Shiga-like toxin

(EHEC; O157:H7)

Corynebacterium diphtheriae Exotoxin

(Toxin)

Corynebacterium diphtheriae Exotoxin

(Mechanism)

Corynebacterium diphtheriae Exotoxin

(Manifestation)

Pseudomonas aeruginosa Exotoxin

(Toxin)

Pseudomonas aeruginosa Exotoxin

(Mechanism)

Pseudomonas aeruginosa Exotoxin

(Manifestation)

Shigella spp. Exotoxin

(Toxin)

Shigella spp. Exotoxin

(Mechanism)

Shigella spp. Exotoxin

(Manifestation)

GI mucosal damage > dysentery

Toxin also enhances cytokine release > HUS

EHEC E. coli Exotoxin

(Toxin)

EHEC E. coli Exotoxin

(Mechanism)