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Sketchy Micro
Microbiology for Healthcare Professionals (BIO 35000)
The City College of New York
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Staph Aureus (Grape-granule golden)
- Grows on blood agar, yellow appearance
- Gram positive take up crystal violet stain (appear violet)
- Catalase positive (catalase converts hydrogen peroxide to water)
- Coagulase (enzyme for fibrinogen to fibrin) positive - Beta hemolytic
- Mannitol salt agar can ferment mannitol (turns it yellow) - Main Virulence Factor - Protein A prevents opsonization and phagocytosis
- Colonizes opening of nose
- Causes pneumonia (patchy infiltrate)
- Icosahedron shape
- Post viral bacterial pneumonia
- Most common cause of septic arthritis
- Cellulitis, impetigo, furuncle boils, **abscesses
- Acute bacterial endocarditis - IV drug user, R sided tricuspid valve
- Scalded skin syndrome
- Toxic shock syndrome (foreign packing in too long)
- Super antigen non specific binding of MHC II sand T cell receptors,s cytokine** **storm
- Staph food poisoning, rapid onset form preformed toxin (more vomiting than** **diarrhea) - meats or cream based foods left out for too long.
- MRSA -** altered penicillin binding proteins PBP treat with vancomycin, nafsolin - Naf for staf
Staph Epidermidis (Catalase positive, urease positive, coagulase negative)
- Infects artificial joints and implanted hardware (prosthetic joints, indwelling catheters)
- Most common cause of endocarditis affecting artificial heart valves
- Sticks to metals biofilms (polysaccharides) coating protects from immune cells
- Resistant to many antibiotics
- Treat with endocarditis with vancomycin
- Have to replace the prosthetic joints
- Staph Epi is novobiocin sensitive
Staph Saprophyticus (Catalase positive, urease positive, coagulase negative)
- Novobiocin resistant
- Common cause of UTI in sexually active females
Strep Pyogenes (Group A) - Long chains or pairs - Group A Strep is encapsulated (hyaluronic acid) major virulence factor is M protein that prevents opsonization. - We produce hyaluronic acid in our connective tissue - Beta hemolytic - Infections: impetigo “honey crusted” skin infection (also caused by Staph Aureus)
- Pharyngitis: Strep Throat
- Cellulitis and erysipelas: superficial cellulitis with well demarcated borders
- Toxin streptococcus pyogenes exotoxin (SPE): scarlet fever, strawberry tongue, pharyngitis, widespread rash that spares the face
- Toxin Shock LIke Syndrome: behaves as a superantigen.
- Flesh eating bacteria, necrotizing fasciitis, spreads rapidly, true surgical emergency
- Three types of SPE:
- SpeA - superantigen (TSLS)
- SpeB - protease (necrotizing fasciitis)
- SpeC - supernatigen (TSLS)
- Rheumatic Fever and PSGN
- Rheumatic Fever: M protein antigenic protein in cell wall main virulence factor responsible for rheumatic fever, interferes with opsonization so it is antiphagocytic (molecular mimicry) mimics myosin in heart and causes our own antibodies to attack our heart and mitral valves (Type II)
- JONEs Criteria: Joints (polyarthritis), Heart problems (valvular damage, myocarditis, pericarditis, subcutaneous nodules (elbows and knees), Erythema marginatum (thick red borders), Sydenhams korea rapid movements
- Post-Strep Glomerulonephritis: Type III
- Dark brown cola colored urine facial swelling puffiness from edema
- 2 week after onset of strep infection or impetigo
- Strep throat treatment can prevent RF but not PSGN
- Tx: penicillin for strep infection - Virulence Factors: Streptolysin O lyse red blood cells and beta hemolytics, we generate ASO antibodies to prevent this
- Streptokinase - puts a phosphate on something converts plasminogen to plasmin (fibolynitic)
- DNase - depolymerize DNA
- Group A Strep (Pyogenes): Bacitracin Sensitive
- Group B Strep: Bacitracin Resistant
- ASO O titer can tell use if we had a recent strep infection
Streptococcus Agalactiae (Group B Strep) - Infections in newborns - Hippurate positive (hydrolysis sodium hippurate) - Polysaccharide Capsule main virulence factor - CAMP test positive when GBS is plated with Staph Aureus it has an increasing zone of hemolysis - Beta hemolytic (narrow zone of complete hemolysis) - Bacitracin resistant - Causes meningitis in neonates, sepsis , and pneumoniae - Passes through vaginal canal of mother during delivery - Culture at 35 weeks of pregnancy - If the mother is colonized with Group B strep, you give mom intrapartum penicillin
Gram Positive Bacillus
Bacillus Anthracis
- Black eschar surrounding erythematous ring (ring of fire)
- Large gram + rods in chains
- Encapsulated, capsules are unique - Capsule is made of protein (poly D-glutamate)
- Obligate aerobe (needs O2 to survive)
- 2001 Anthrax scare, ability to be weaponized. Sent in an envelope
- Can forms spores and hibernates in state highly resistant to temperatures and chemicals - Spore forming - Edema factor: (adenylate cyclase increase cAMP, fluid goes into ECF causes edema inhibits host defenses
- Lethal factor: exotoxin acts as protease that cleaves MAP-kinase, tissue necrosis - Pulmonary Anthrax → hemorrhagic mediastinitis widened mediastinum
- Fluoroquinolones or doxycycline
Bacillus Cereus - Anaerobic and spore forming - Food poisoning - Vomiting and diarrhea after eating reheated fried rice
Clostridium Tetani
- Gram +
- Obligate anaerobe (cannot survive in the presence of oxygen)
- Often found in soil, inside of a puncture wound closed off to air, rusty nails or barbed wire
- Construction worker or child near construction zone
- Neuromuscular symptoms: psastic paralysis, muscle contractions leading to rigidity (vs flaccid paralysis in botulism)
- Lockjaw symptoms
- Extension and arching of back due to spasms Opisthotonus
- Travels retrograde through motor axons to the spinal cord
- Acts as a protease, cleaves SNARE protein inhibits exocytosis of NT into the synapse
- GABA and glycine release inhibited leading to spasticity
- Rensaw: gaba and glycine release from renshaw cells is inhibited
- Tetanus vaccine: toxoid vaccine conjugated to a protein, antibody response to toxin not to the organism
Clostridium Botulinum
Improper canning of food, allows for survival of spores, heat stable toxins
Multiple family members developing neuro symptoms
Obligate anaerobe gas mask, struggling to keep bodies upright, flaccid paralysis
Descending paralysis, diplopia, ptosis
Only affects peripheral nervous system not CNS
Cleaves SNARE protein
Attacks motor neurons that release AcH, when inhibited leads to flaccid paralysis
Toxin is a protease that cleaves SNARE proteins
In babies, flaccid paralysis, “floppy baby syndrome”, adults only get it in an anaerobic environment. Normal bacterial flora outcompete it.
Babies lack this flora to protect themselves, commonly found in honey.
Infants should avoid honey
Adults = preformed toxin
Babies = spores
Clostridium Difficile - Spore forming - Nosocomial diarrhea (while hospitalized) - Thorough wash with soap and water - Antibiotics wipe out normal flora - Clindamycin commonly cause C infections - Improper handwashing is a common way it is transmitted - Exotoxin A and Exotoxin B - Apple workstation: binds to brush border of intestine, inflammation cell death watery diarrhea. Exotoxin A targets the brush border causing diarrhea. - Exotoxin B is for black licorice - Disrupts cytoskeleton integrity by disrupting actin, yellowish gray exudate that covers colonic mucosa. Pseudomembranous colitis. Actin depolymerization. - Tx: oral vancomycin or fidaxomicin. Metronidazole
Clostridium Perfringens
Motorcycle accidents and deep penetrating wounds from military combat
Large amount of flesh exposed to dirt or dust
Spore former, found in dirt and soil
Obligate anaerobe
Two diseases
Soft tissue necrosis (gangrene): clostridial myonecrosis, gas is produced under infected tissue, crepitus, crackling sound on palpation, organism consumed carbohydrates involves an alpha toxin (lecithinase cleaves lecithin and damages cell membrane by damage lipoproteins)
When red cell membranes are affected hemolysis occurs in vivo and vitro
Double zone of hemolysis on blood agar
Tx: IV penicillin G
Spores germinate in gut and then create the toxin inside, late onset of symptoms (10- hours after food poisoning symptoms)
Watery diarrhea, transient usually doesn't require antibiotic treatment
Slow coarse - non tender lump on jaw, abscess, sinus tracts drain infection site through skin, thick yellow pus ( **yellow sulfur granules)
Penicillin G**
Nocardia Species - Obligate Aerobe, acid fast (weak) - Found in soil - Gram positive filamentous branching rod (similar to actinomyces) - Mycolic acid → light acid fast staining carbol fuchsin stain - Catalase positive → chronic granulomatous disease (CGD) increased risk of infection of catalase positive organism - Urease positive - Affects immunocompromised patients impaired cell mediated immunity (HIV, transplant patients, patients on glucocorticoids - More men>women - Main sites of infection: pulmonary, CNS, cutaneous - Pulmonary: pneumonia with lung abscess formation cavitary lesions in the lungs - Once in lungs t can disseminate it has a high affinity for neural tissue → brain abscesses - Cutaneous infections after trauma in immunocompetent (gardening, carpentry) → indurated lesions and inflammatory reaction - Tx: sulfonamides
Gram Negative Cocci Overview
Neisserias Species
- Gram negative diplococci
- Oxidase positive **- Chocolate Agar, cannot grow in blood agar
- Heated blood agar → chocolate agar**
- Growth on VPN (vancomycin, polymyxin and nystatin)
- Thayer Martin aka VPN agar
- Complement deficiency C5-C9, unable to form Membrane attack complex (MAC) leading to increased infections
- Virulence Factors: Pilus (allow for attachment, also has frequent genetic rearrangement, antigenic variation, difficult for immune system to target it)
- Produced IgA protease cleaves IgA at hinge point survival of mucosal surfaces
- Both ferment glucose
Neisseria Meningitidis - Spread by respiratory droplet - College kid in close quarters - Only meningitidis ferments maltose in addition to glucose
- Colonizes the nasopharynx first, transmitted by sneezing coughing kissing, sharing drinks - Polysaccharide capsule → virulence factor inhibits phagocytosis
- Given before college, vaccine contains the capsule **- Type B capsule is not included in the vaccine
- Most caused by Type B strain**
- Sickle cell and asplenic patients are at higher risk because it is encapsulated
- Establishes infection by spreading hematogenously, massive inflammatory response generated by lipooligosaccharides (LOs) proteins enveloped version of LPs, outgrows surface of bacteria and blebs off, the blebs cause the inflammatory response
- LOS envelope proteins on fire (inflammatory response) → Permeability of capillaries → leakage of fluid into extravascular space → hypovolemia - Petechial rash → thrombocytopenia → can progress to DIC (bleeding gums, **oozing at injection sites)
- Capillary leakage can lead to hypovolemia and shock** → peripheral vasoconstriction increases and leads to renal insufficiency (often fatal)
- Waterhouse friderichsen sen syndrome, hemorrhage of adrenals
- 3rd gen cephalosporin → penetrate blood brian barrier ceftriaxone
- Close contacts → give prophylaxis (rifampin)
Neisseria Gonorrhoeae - STI: genitalia of men and women - Men: urethritis → prostatitis, orchitis - Women: pelvic inflammatory disease (PID) → scarring → infertility → ectopic pregnancy - White purulent discharge (thicker than chlamydia) - Gram negative diplococci facultative intracellular PMNs - Not encapsulated - Can spread into peritoneal → adhesions → violin string adhesions - Fitx Hugh Curtis syndrome → spread of PID to peritoneum - Polyarthritis → knee asymmetric - Purulent synovial fluid that doesn't gram stain because infection in intracellular - Expecting Mother pass it onto baby during delivery - Purulent conjunctivitis first 5 days N. Gonorrhoeae - Chlamydia → delayed (1 week after birth) - Tx: Cefriaxone, assume coinfection with Chlamydia
Enterobacter - Gram negative bacilli - Lactose fermenter (pink on MacConkey agar) - Multidrug resistance - Motile - Causes pneumonia and UTIs
Virulence factor: Type 3 secretion system detects eukaryotic cells protein helps with infectivity
Shigella Sonnei Uncomplicated watery diarrhea in developed countries
Gram negative enteric gastroenteritis → bloody diarrhea Green colonies on hektoen agar Immotile Acid-stable (fewer organisms to cause infection) Peyer's patches M cells (sample things in lumen and bring back antigens on other side) Shigella induces M cells tto phagocytosis them and they escape from phagolysosome once in cytoplasm they use actin cytoskeleton to create a tail to propel itself Use of actin filaments invasion of M cells Facultative intracellular Damages tissue and releases cytokines Fecal blood and leukocytes (inflammatory diarrhea)
Shigella Dysenteriae Infection can precipitate HUS Prodromal diarrhea, acute renal failure Glomerular damage activates platelets but drops platelet count, lyse red blood cells, schistocytes Children < 10 y/o Shiga Toxin: binds to 60s subunit of ribosomes and inhibits translation Type III secretion system (inflammatory cytokines)
Escehrichia Coli Lactose fermenting (pink on MacConkey agar) Encapsulated K antigen: present on capsule used for serotyping Eosin methylene blue: metallic green sheen Catalase positive Fimbriae (pili): necessary for bug to cause UTIs #1 cause of UTIs Gram negative sepsis: LPS endotoxin in outer cell membrane Neonatal meningitis, only if it has the K antigen
Enterohemorrhagic E. Coli (EHEC)
Eating undercooked meat (hamburgers) Bloody diarrhea Unique only E. coli that does not ferment sorbitol Same toxin Shiga, Shiga-like toxin: binds to 60s subunit Can cause HUS in children < O157:H7 serotype outbreaks
Enterotoxigenic E. Coli (ETEC)
Traveler’s diarrhea Water sources Mexico Heat Labile increases cAMP (similar to cholera toxin) Heat Stable increases cGMP
Yersinia Enterocolitica Gram negative coccobacillus bipolar staining (on two ends ) looks like a safety pin Encapsulated Transmitted through puppy species Kids playing with dogs, can also be transmitted through contaminated milk products (also listeria) Resistant to cold temperatures Causes bloody diarrhea Fever leukocytosis and abscess, intestinal perforation Main: mimic appendicitis (pseudoappendicitis)
Yersinia Pestis Cause of the black plague (Bubonic plague) Killed 25 million people Humans are incidental host Main reservoir is rodents (prairie dogs now) Fleas that bite them and then bite Swollen tender lymph noodles (buboes) DIC and cutaneous hemorrhage caused by endotoxin necrosis of digits and or appendages Exotoxins Yersinia associated outer proteins Cause macrophage and neutrophil dysfunction Organism replicates Type III secretion mechanism
Treatment: aminoglycosides (streptomycin and tetracycline) Killed vaccine used to prevent
CampyloBacter Jejuni Gastroenteritis and Diarrhea Guillain-Barre Syndrome Prefers to grow in heat Lives sin intestinal tract of other animals (poultry reservoir) Fecal oral transmission Slaughter process Curved gram negative rod Oxidase positive Bacteremia Invasive Reactive arthritis (writer syndrome) camp B infection Autoimmune response demyelination of PNS → ascending paralysis
Bloody Diarrhea
Vibrio Cholerae Profuse watery diarrhea (high volume) Rice water diarrhea Fecal - Oral via poor sanitation Cholera does not invade the mucosa Uses fimbria to attach itself and then releases cholera toxin Increases cAMP Blinds to adenylate cyclase and activates sit (Gs pathway)
Endemic to south east asia Genus Vibrio Comma shaped bacteria Tx: water rehydration
folliculitis Sepsis → toxin that causes cutaneous necrosis (ecthyma gangrenosum) Otitis Externa (very painful outer ear (swimmers ear) Pseudomonas Toxin (Exotoxin A) → Ribosylated target elongation factor 2 Inhibits protein synthesis and cell death → same as diphtheria exotoxin
Bordetella Pertussis
War hero after wounded Highly contagious respiratory droplets Attaches to respiratory epithelium using pili Release toxins that cause symptoms Filamentous hemagglutinin (antibodies against it help protect against infection) Pertussis toxin: increases cAMP by ADP-ribosylation of Gi (Toxin inhibits Gi) Inhibits an inhibitor → rise in cAMP Also disables chemokine receptors for lymphocytes, get stuck in bloodstream Massive lymphocytosis Adenylate cyclase toxin: same toxin as edema factor in bacillus anthracis Increase in cAMP Tracheal toxin: peptidoglycan wall of pertussis damage ciliated cells in respiratory epithelium (cleaves long cilia like grass) Symptoms: non specific symptoms first (conjunctival injection lacrimation) Paroxysmal stage: “whooping cough”usually in children intense bout of coughing post tussive emesis Convalescent stage: gradual reduction of symptoms 100 day cough Tx: macrolides treat early Protection: prevent respiratory droplets Two vaccines killed and acellular Killed is no longer available only use the cellular one (purified antigens of bacteria) usually given to children along with diphtheria toxoid and tetanus toxoid DTap
Haemophilus Influenzae
Gram negative bacteria Coccobacilli Special media: chocolate agar (hematin and NAD+) Factor V: NAD+ nicotinamide Factor X: hematin Aerosol transmission First respiratory track → pneumonia (1) Epiglottitis → inflamed epiglottis, inspiratory stridor, drooling (2) Otitis media Vaccine for type B capsule Increased risk for asplenic patients of sickle cell Polysac of haemophilus capsule conjugated with diphtheria toxoid → strong IgG response
Between 2-18 months to vaccinate child Tx: beta lactam antibiotic Meningitis or systemic disease → ceftriaxone Rifampin used for prophylaxis in meningitis in close contacts
Legionella Gram negative, oxidase positive but need to use a silver stain to see it better Buffered charcoal yeast extract in presence of cysteine and iron Legionnaires disease: occurs in smokers, atypical pneumonias CXR: patchy infiltrate with consolidation of one lobe Highly variable presentation Clinical presentation: - Associated with hyponatremia (wasting salt) - Neurologic symptoms (confusion headache) - Diarrhea - High fever (greater than 104) Testing: Rapid urine antigen test Tx: macrolides or fluoroquinolones Pontiac Fever: fever and malaise usually self limiting
Bartonella Henselae
Cat scratch disease, Gram negative Warthin-Starry (special silver stain) Cat scratch fever transmitted with cat scratches Involve regional lymph nodes, painful and large Lymphadenitis at axillary occurs in immunocompetent Bacillary angiomatosis also transmitted through cat bites (immunocompromised patient) Tx: Doxycycline Self-limiting Azithromycin or macrolides
Brucella Cattle or farm animals (Gram negative) Cow and pig Direct contact with farm animals vet or rancher Indirect contact via recent consumption of milk or cheese products Ingestion of unpasteurized dairy products Facultative intracellular ( can live intracellularly or extracellularly) Prevents phagocytosis Symptoms: fever, chills, anorexia Undulant Fever, Replicate intracellularly, Enlargement of spleen, liver and lymph nodes Osteomyelitis (chronic brucella infection) Tx: tetracyclines (doxycycline) or rifampin as adjunctive for primary treatment
Francisella Tularensis
Rabbit named francis Main reservoir for francisella (handling rabbits or eating rabbits) Indirect through a tick vector ( Dermacentor Tick) Aerosolized (used in bioterrorism) - mandatory to report to CDC Gram negative and looks like a radish (coccobacilli) Facultative intracellular Recovery from infection depends on CMI Bacteria enters at site and develops of painful ulcer Rotting radishes → enter through the ulcer goes into macrophage and travels through the lymph systems to lymph nodes, granulomas with caseation necrosis
Rifampin Isoniazid Pyrazinamide Ethambutol
Prophylaxis: rifampin and isoniazid 9 months
Mycobacterium Leprae Thrives in cool temperatures (extremities of the body) Acid fast bacteria (mycolic acid carbol fuchsin stain) Reservoir (armadillo) Leprosy (Hansen’s Disease) Two presentations: Tuberculoid: Th1 response with cell mediated immunity Able to contain bacteria within macrophages Symptoms are mild: well demarcated hairless hypoesthetic skin plaque Lepromin skin test ID injection of antigens to test for immune reaction Positive test means good CMI intact
Lepromatous Leprosy: Th2 cells predominant immune response → humoral response High transmission human to human (theorized respiratory droplets) Symmetric neuropathy (stock and glove pattern) Numerous poorly demarcated raised lesions mostly on extensor surfaces Biopsy skin lesions → large amount of bacteria Profound facial deformity (thickening of skin loss of eyelashes, collapses of nose, nodulary ear lobes) Look like a lion
Present within a spectrum usually Tx: Multidrug therapy (long time)
Th1 (tuberculoid): Dapsone and rifampin for 6 months Th2 (lepromatous): Dapsone and rifampin, add clofazimine (2-5 years)
Spirochetes (spiral shaped bacteria)
Borrelia Burgdorferi North Eastern US (new hampshire and connecticut) Ixodes scapularis (involved in Lyme Disease, ehrlichiosis, babisiolsis) Larvae feasts in white headed mouse (reservoir) and white tailed deer is host of adult tick, tick is the vector Incidental host Spirochetes do not gram stain Wright stain and Giemsa stain Lyme green Three stage of Borrelia: (1) Erythema chornica migrans (bulls eye rash) - Not painful or pruritic - 1 month after tick bite
- Flu like symptoms (2) Heart block caused by myocarditis
- Bilateral facial nerve palsy (bell's palsy) (3) Arthritis of large joints (knee), may move from joint to joint migratory polyarthritis
- CNS effects: memory difficulty , cognitive slowing, lymphocytic meningitis (encephalopathy) Tx: doxycycline or ceftriaxone (more severe presentations)
Leptospira Interrogans Leptospirosis Endemic in tropical regions (highest incidence is in Hawaii) Spirochete small thin and spiral shaped (question marked shape) Commonly found in rodents and dogs, excreted in their urine Transmitted to humans when they swim in the water (water sports) Flu-like symptoms fever intense headaches Conjunctival suffusion Lack of inflammatory exudate (red with no pus) Whale’s Disease: travels through bloodstream multiply in various organs (renal dysfunction and jaundice for liver damage) Hematogenous spread Kidneys: Fever and high creatinine levels and azotemia Liver dysfunction and jaundice
Treponema Pallidum STD syphilis Palladium observatory Transmission: sexually transmitted Spirochete (spiral shaped bacteria) may be described as spiral shaped Dark Field microscopy needed for direct visualization of the organism Main screening test: VDRL (treponema) not specific just antibody reactivity to a particular antigen RPR: rapid plasmin reagent Many false positives due to cross reactivity with other antigens (MONO, RF, SLE, LEP, DRG) Confirmatory Test: FT A-b (treponemal test to confirm positive a screening result) Symptoms:
Early stages: 1st year (primary secondary and early latent) Primary: painless genitalc chancre a few weeks after inauguration, invading small blood vessels, small areas of necrosis, takes out nerves (painless),
Secondary: Macularpapular rash, on hands and soles of feet , condyloma lata (bumps on mucous membranes) Visualizes the spirochete sin condyloma lata with dark field microscopy
Late: Tertiary and Late latent
Tertiary: Gummas, small growths with firm necrotic center (skin bones organs). Aortitis, ascending thoracic aorta, ascending thoracic aneurysms), tree barking appearance of aorta. Destroys the small blood vessels that supply the thick part of the aorta. Microbe damages small vessels. Weakening of aortic wall and aneurysm formation. Vasa vasorum endarteritis and obliteration Damage to posterior column of spinal cord, ocular effects
nodes lymphatics. Painless genital ulcer but weeks to months later a tender lymphadenopathy with draining lymph nodes
Reactive arthritis → maladaptive antibody response cross react and attack the body sacroiliac joint and knee
Reiter's syndrome: cant see, can't pee, cant bend my knee Arthritis, uveitis, and urethritis
Chlamydophila pneumoniae
Atypical pneumonia (walking) More common in elderly than adults
Chlamydophila psittaci Transmitted by bird “parrots” → respiratory problems
Coxiella Burnetii Q Fever, no rash (vs. rickettsia borrelia that does have rash) Gram negative Obligate intracellular Spore like structure in animal droppings or dirt Transmitted to humans via aerosol transmission Farm animals are reservoir or a vet exposed to placental excretions Also causes hepatitis and pneumonia symptoms Self-limiting and goes away in two weeks Rare → endocarditis ‘ Pasteurizing milk, acellular vaccine given to vets
Gardnerella Vaginalis
Gram variable rod, stain as gram positive or gram negative gram variable Lactobacilli Bacterial overgrowth that disrupts the normal flora Thin malodorous fish discharge from vagina Fly traps look like aa vulva (grayish-white discharge) pH 4 and up infection occurs 10% KOH test Whiff test Microscopic exam Wet mount preparation shows clue cells that are epithelial cells diffusely coated with bacteria Clue cells - epithelial cells coated with clue cells Tx: metronidazole
Mycoplasma Pneumoniae
Walking pneumoniae No cell wall → cannot appear on gram stain Cholesterol in cell membrane (sterols stabilize cell membrane and allow them to be more flexible) May not appear sick clinically X-ray appears much worse than the parents do physically “patchy infiltrate” Increased incidence in young adults close contact military recruit in close
quarters Confirm Dx: IgM molecules that agglutinate erythrocytes in cold temperatures Cold agglutinins only in 50-75% of patients Eaton's Agar Treatment: Macrolides (azithromycin)
TORCHES Infection
Toxoplasma
transmission: cat feces, raw meat
mother: lymphadenopathy
newborn: blueberry muffin rash, retinitis, hydrocephalus, intracranial calcification
Rubella
transmission: respiratory droplets
mother: rash, lymphadenopathy, arthritis
newborn: “cant see, cant hear” cataracts, sensorineural hearing loss, PDA, blueberry muffin
rash
CMV (herps 5)
transmission: sexual, organ transplant
mother: mononucleosis
newborn: blueberry muffin rash, hearing loss, seizures, petechiae, periventricular calcifications
HIV
sexual contact and needle sticks
maternal: aids symptoms
newborn: recurrent infections (SCID), chronic diarrhea
HSV-
- skin contact
Herpetic lesions Herpetic lesions encephalitis perioral rash
Syphilis
Transmission: Sexually Mother: Three stages for mom
Sketchy Micro
Course: Microbiology for Healthcare Professionals (BIO 35000)
University: The City College of New York
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