GRAM (+)

COCCI RODS
STAPH STREP AEROBIC ANAEROBIC
CATALASE (+) CLUSTERS CATALASE (-) PAIRS & CHAINS
Listeria monocytogenes Actinomyces israelii
COAGULASE (+) COAGULASE (-) β HEMOLYTIC α HEMOLYTIC γ HEMOLYTIC Facultative anaerobe Obligate anaerobe
β HEMOLYTIC (Complete - Clear) (Partial - Green) (NO Hemolysis) Non-spore Mouth flora
I.C. Pathogen
Staph aureus Staph epidermidis S. pyogenes (GAS) S. pneumonia Peptostreptococcus Farm animals
Facultative anaerobe Facultative anaerobe Micro-aerophilic Micro-aerophilic Micro-aerophilic Fertilizer (cow feces)
#1 Infectious agent Skin flora
Nosocomial (surgery)
≠Food
Mayo; Mustards
Corynebacterium diphtheria Clostridium Perfringens
Facultative anaerobe Obligate anaerobe
Non-spore Spore
Club-shaped ≠Food
Staph saprophyticus S. algactiae (GBS) S. viridans Meats
Facultative anaerobe Micro-aerophilic Micro-aerophilic
Vaginal flora Nasopharynx flora

S. mutans
Micro-aerophilic
Dental plaque Nocardia asteroides Clostridium Dificile
Obligate Aerobe Obligate anaerobe
Spore Spore
2' to Antibiotic use
Enterococcus Faecalis (GDS) Clindamycin
Micro-aerophilic Ampicillin
Nosocomial Imipenem

E. faecium (GDS)
Bacillus cereus Clostridium Botulinum
E. bovis (GDS) Obligate Aerobe Obligate anaerobe
Spore Spore
≠Food ≠Food
Reheated rice Canned foods

Bacillus anthracis Clostridium Tetani

Facultative Anaerobe Obligate anaerobe
Spore Spore
Soil

Bacillus thuringiense
Insecticide

Gram (+) Characteristics

 Gram (+) Characteristics
GRAM (+)
COCCI RODS
STAPH STREP AEROBIC ANAEROBIC
CATALASE (+) CLUSTERS CATALASE (-) PAIRS & CHAINS
Listeria monocytogenes Actinomyces israelii
COAGULASE (+) COAGULASE (-) β HEMOLYTIC α HEMOLYTIC γ HEMOLYTIC Motility
β HEMOLYTIC (Complete - Clear) (Partial - Green) (NO Hemolysis) I.C. pathogen
Listeriolysin O (Hemolysin)
Staph aureus Staph epidermidis S. pyogenes (GAS) S. pneumonia Peptostreptococcus Internailins
Exotoxin (Super Ag toxin) Exopolysacharide Exotoxin (Super Ag; ASO Ag) Capsule (#1 VF; Polysaccharide) Anaerobic A Bind to E-cadherins
A Binds MHC II A Biofilm (slime) - Erythrotoxin (Super Ag) IgA protease A ΦHemolysis A Phagocytotic entry
A IL-1 & IL-2 synth. ΦHemolysis A Scarlet Fever Takes up DNA ActA (VF)
Enterotoxin A (mayo, cust.) - Streptolysin O (ASO Ag) Pneumolysin (lyses host cells) β Hemolytic Yellow colonies (sulfur)
TSST (Super Ag toxin) A Rheumatic Fever Neuramidase Cold environment Y
Exfoliative toxin; α-Toxin ΦHemolysis M & F Proteins (≠Phagocytosis) Corynebacterium diphtheria Clostridium Perfringens
β-Lactamase Superoxide dismutase Hyaluronidase; S-kinase; PAF Quellung serotyping Exotoxin (via β-prophage) Exotoxin (αβ)
Surface protein (adherent) Novobiocin sensitive Bacitracin sensitive Optichin sensitive A ADP Ribosylation - α toxin (Lecithinase)
Blood agar + Yellow pigment Blood agar A ≠EF-2 A Partial lysis of RBC
Staph Saprophyticus S. algactiae (GBS) S. viridans ADP Ribosylation - β toxin
(Novobiocin resistant) Polysacc Capsule β prophage A Complete lysis of RBC
A ≠Phagocytosis Viridans = verde / grn C Diphtheria Toxin αβεζ Toxins
Optichin resistant EF-2; Granules; K Ag
S. mutans Albert's stain; ELEK test
Dextran (Adherence to teeth) Tellurite; Schick's; Loeffler's Double-hemolysis
Lactic acid (degrades enamel) Nocardia asteroides Clostridium Dificile
Clear = galactic Exotoxin
Bacitracin resistant Optichin resistant A Kills enterocytes
Superoxide dismutase A P. colitis
Enterococcus Faecalis (GDS)
Leukocyte esterase
β-Lactamase(+)

E. faecium (GDS) Weakly acid-fast

Catalase β-Lactamase(-)
A H2O2 (lysosomes) Bacillus cereus Clostridium Botulinum
A H2O + CO2 E. bovis (GDS) Exotoxin Exotoxin (Neurotoxin)
≠ACh release
Grows in 6.5% NaCl A Flaccid paralysis
Anit-Ch Sx's

Toxin used to Tx Muscular Dz's

Achalasia (LES)
Botox

Bacillus anthracis Clostridium Tetani

Exotoxin (anthrax toxin) Exotoxin (Tetanospasmin)
A ADP Ribosylation ≠Glycine release
A Adenylate cyclase A Φ(-)NT; Only (+++)NT
Anti-phag capsule A Spastic
Protective Ag
Bacillus thuringiense
OK (humans) Toxoid used for Vaccines
≠Morphogenesis of larvae Tetanus & Diphtheria

Mycobacterium T.B.
Lowenstein-Jensen Agar

Fungi
Sabouraud's Agar

Gram (+) Mechanisms

GRAM (+)
COCCI RODS
STAPH STREP AEROBIC ANAEROBIC
CATALASE (+) CLUSTERS CATALASE (-) PAIRS & CHAINS
Listeria monocytogenes Actinomyces israelii
COAGULASE (+) COAGULASE (-) β HEMOLYTIC α HEMOLYTIC γ HEMOLYTIC Meningitis (infants) Lumpy jaw
β HEMOLYTIC (Complete - Clear) (Partial - Green) (NO Hemolysis) Granulomatosis infantiseptica Sinus tracts; Sulfur granules
A Granulomas OM (facial, cervical)
Staph aureus Staph epidermidis S. pyogenes (GAS) S. pneumonia Peptostreptococcus A Death
#1 infxs agent Catheter Creeper ≈ PYRO = Red Fire!! Respiratory Infections Mixed infections
Inflammatory Dz UTI's Pharyngitis - (#1 "Strep thrt") Otitis media Cutaneous Infants and Elderly
Pneumonia (bronchial) Arthritis (prosthetics) Impetigo (pyogenic) Sinusitis Oral Pregnant women
IE (IVDU) OM (prosthetics) Rheumatic Fever (inflamm.) URTI (50% of POP) Respiratory Murky brown amniotic fluid
Arthritis IE (Prosthetic Valves) Acute GN (inflamm.) Bronchitis Female genital tract
OM (prosthetics) TSS; Tissue infxns (pyogenic) Pneumonia (95% CAP) Corynebacterium diphtheria Clostridium perfringens
Skin Lesions Erysepelas System Spread Dyphtheria Skin & Soft Tissue
Food poison (entero-T) Scarlet Fever (toxigenic) Bacteremia Pharyngitis Myonecrosis
Scalded skin (exfoliat.-T) Meningitis (elderly) Pseudomembranes Gas gangrene
TSS (TSST-1); Impetigo Staph saprophyticus S. algactiae (GBS) S. viridans LN'opathy Skin & S.T. Dz's
Adults Al' go to ya Vadge!! IE (subacute) Huge neck Diarrhea (food poisoning)
#2 UTI's (young♀) Vaginal flora = PMS Recurrent laryngeal palsy "Perforates the fringe"
Purperal fever Pneumonia S. sanguis (50% of IE) Myocarditis "Letch" = lecithinase
Skin infection Meningitis (neonatal) IE (Congenital defects)
IE (Prosthetic Valves) Sepsis (neonatal)
Neonates S. mutans Nocardia asteroides Clostridium dificile
Meningitis Dental caries Madura foot Pseudo-m colitis
Sepsis Pulmonary infxn (↓Immune) A Diarrhea (green, foul)
Pneumonia 2' to antibiotic use
Enterococcus faecalis Ampicillin / Clindamycin
"Enter & Endo"
UTI's
IE (subacute)

E. faecium (GDS)
Bacillus cereus Clostridium botulinum
E. bovis (GDS) Diarrhea (food poisoning) Flaccid paralysis
EI (α w/ CRC; Valve lesions) Brief gastroenteritis Floppy baby
Bulbar paralysis
Unreactive pupils
Descending weakness
Respiratory weakness

Bacillus anthracis Clostridium tetani

Painless ulcers (95%) Spastic paralysis
Black lesions (eschars) Lockjaw
Pneumonia (serious)
A Bacteremia
A Death
"Woolsorter's Dz"
 Gram (+) Diseases
GRAM (+)
COCCI RODS
STAPH STREP AEROBIC ANAEROBIC
CATALASE (+) CLUSTERS CATALASE (-) PAIRS & CHAINS
Listeria Actinomyces israelii
COAGULASE (+) COAGULASE (-) β HEMOLYTIC α HEMOLYTIC γ HEMOLYTIC Amino-PCN's "SNAP Tx"
β HEMOLYTIC (Complete - Clear) (Partial - Green) (NO Hemolysis) SMT / TMP PCN (1 mo)

Staph aureus Staph epidermidis S. pyogenes (GAS) S. pneumonia Peptostreptococcus

PCN (P-ase-R) Vancomycin PCN (#1) PCN (#1) PCN
Nasty Messy Ox Clox Ab to M protein Vancomycin (for PCN-R) Cephalosporins
Dicloxacillin Bacitracin Erythromycin (#2) Clindamycin
Oxacillin Chloramphenicol (#3) Metronidazole
Nafcillin
Methicillin Vaccine (23 IgG anti-capsule) Corynebacteria Clostridium perfringens
Vancomycin (For MRSA) Elderly; ↑Risk Px's Antitoxin (Equine diphtheria AT) PCN + Debridement
Bacitracin Not for kids or CA's PCN; Erythromycin Anti-toxin
Vaccine (DPT)
Staph saprophyticus S. algactiae (GBS) S. viridans Food poisoning
PCN PCN (P-ase-R) PCN A Self-limiting

S. mutans
Nocardia asteroides Clostridium dificile
"SNAP Tx" Vancomycin (#1)
SMX / TMP (sulfur) Metronidazole
Bacitracin
Enterococci
ΦRx effective
Syncercid (experimental)
Fosfomycin

Bacillus cereus Clostridium botulinum

Self-limiting Anti-toxin (human)
ΦRx's Respiratory support

Bacillus anthracis Clostridium tetani

PCN Tetanus toxoid
Anti-toxin (Ig)
Respiratory support
Muscle relaxants
Antibiotic (PCN; Metronidazole)
DPT Vaccine (Diphth-Pert-Tet)
Gram (+) Treatment
 GRAM (-)
COCCI RODS
MALTOSE (+) MALTOSE (-) AEROBIC ANAEROBIC
NEISSERIA NEISSERIA
FASTIDIOUS GROWTH REQ'S SIMPLE GROWTH REQ'S Bacteroides fragilis
N. Meningitis N. Gonorrhoeae Obligate anaerobe
Obligate aerobe Obligate aerobe I.C. GROWTH (+) I.C. GROWTH (-) OXIDASE (+) OXIDASE (-) Colon Flora

Brucella H. Influenza P. Aeruginosa LACTOSE (+) LACTOSE (-) Bacteroides melaninogenicus

Obligate aerobe Micro-aerophilic Obligate aerobe Obligate anaerobe
≠Food Pleomorphic rods #1 Opportunistic Klebsiella Salmonella enteritidis Trauma
Dairy products Nosocomial Facultative Anaerobe Facultative Anaerobe
Cows H. ducreyi Burn victims GI Flora I.C. Pathogen
Pleomorphic rods CF Rods w/ halos ≠Food
"School of Fish" pattern Ventilator Px's Poultry; Eggs; Meat
STD Reptiles; Turtles
Salmonella typhi
Facultative Anaerobe
Francisella Campylobacter jejuni Vibrio cholera Fecal-oral
Obligate aerobe Micro-aerophilic Comma-shaped
MO; AK; OK areas (50%) Comma shaped Ogana (AB) Enterobacter Shigella sonnei
≠Vector ≠Food (#1) Inaba (AC) Facultative Anaerobe Facultative Anaerobe
Rabbits; Deer Poultry dishes Hikojima (ABC) GI Flora Food; Fingers
Tick bite Birds; Aviaries Nosocomial Feces; Flies
V. vulnificus
V. parahemolyticus
≠Food
Seafood
Legionella Helicobacter pylorus Pasteurella multicocida
Obligate aerobe Micro-aerophilic Micro-aerophilic
Pleomorphic thin rods Comma-shaped Cat bite E. Coli Proteus
Dog bite Facultative Anaerobe Facultative Anaerobe
Colon Flora GI Flora
GI Flora Nosocomial
Vaginal Flora
#1 Nosocomial (UTI mostly)
≠Food (EHEC)
Undercooked meat
Bordetella pertussis ≠Water (ETEC)
Obligate aerobe
Serratia marcescens Yersinia pestis
Facultative Anaerobe Facultative Anaerobe
GI Flora I.C. Pathogen
Nosocomial ≠Vector (SW U.S.)
Flees; Animal host
Bipolar rod
Yersinia enterocolytica
Facultative Anaerobe
Pet feces
Pediatric mini-epidemics
Citrobacter
Facultative Anaerobe
GI Flora
Nosocomial

Gram (-) Characteristics

 Gram (-) Characteristics
GRAM (-)
COCCI RODS
MALTOSE (+) MALTOSE (-) AEROBIC ANAEROBIC
NEISSERIA NEISSERIA
FASTIDIOUS GROWTH REQ'S SIMPLE GROWTH REQ'S Bacteroides fragilis
N. Meningitis N. Gonorrhoeae Capsule (polysaccharide)
Capsule (#1 VF) = N-a acid Capsule I.C. GROWTH (+) I.C. GROWTH (-) OXIDASE (+) OXIDASE (-) Endotoxin
IgA protease IgA protease β-Lactamase
Maltose(+) β-Lactamase Brucella H. Influenza P. Aeruginosa LACTOSE (+) LACTOSE (-)
Glucose(+) - Dextrose Glucose(+) - Dextrose Intra-macrophage Capsule (#1 VF) Endotoxin (Sepsis) Superoxide dismutase (-)
Pili; Adhesins PII (binding) ≠PMN degranulation IgA protease Exotoxin A Klebsiella Salmonella enteritidis A Super-O ion --> H2O2
A Enters PMN vacuoles B most virulent A ADP ribosylation Non-motile ↑ID50 = Non-virulent A H2O2 --> O2 H2O
Ag Variation (Pili) Erythritol-phillic Polyribitol-P capsule (B) A ≠EF-2 Encapsulated (thick; mucoid) Vi Polysaccharide Ag All anaerobes lack this
Thayer-Martin media Thayer-Martin (VCN) A Affinity for placenta Satellite growth (S. Aureus) Mucoid (resists Ab's+Comp) Invades GI mucosa
Chocolate agar Chocolate agar Chocolate agar Fe2+ compounds (toxic) A Motile (Salmon swim)
Factors V & X Trypticase agar; Fruity odor A Hematogenous
V = NAD (HL) A Blue pigment (pyocyanin) ↓O2; ↓pH (Mac lysosome)
X = Hematin (HS) Tripticase; Blood agar; EMB A Induction of VF Genes
Francisella tulerensis Campylobacter jejuni Vibrio cholera Viscous, creamy colonies S. typhi replicate in Macs
Invades colonic epithelium Exotoxin (Choleratoxin) MacConkey's or EMB agar H. sulfide(+)
A Reproduces in Mes. LN's A Binds GM1 Ganglioside Enterobacter Shigella sonnei
A Enteric Fever A ADP ribosylation Vit K synthesis ↓ID50 = VIRULENT!! All Enteros
Depends on host signaling A ↑Gs --> ↑cAMP Bile salt conjugation Shiga toxin MacConkey's agar
A Cl / H20 into gut Hormone conjugation A ≠60S Ribosome EMB agar
Turns the faucet "on" on Colicin / bacteriocin A ≠Protein synthesis A Lactose(+)
Flagella (motility; adherence) A Prevent pathogens Adhesins; Invasins A Δcolor of agar
Cysteine ↓O2 Tension String Test(+) A Invades GI mucosa
↑pH (Citrate; Bile; Th'sulfate) A Reproduce in cytosol Enteros
Legionella Helicobacter pylorus Pasteurella multicocida Fast fermenter A Ulcers Motile (ΦShigella)
Intra-macrophage Oxidase(+) Oxidase(+) MacConkey's or EMB agar Pili
A/C or Water source Urease(+) E. Coli Proteus Polysacc Capsule
Req's Fe2+ & Cysteine ETEC Motile Endotoxins (LPS)
Complement-R Exotoxin (HLT) Urease(+) Ferment GLU
Mycobacterium T.B. A Invades macrophage A ADP Ribosylation A ↑pH K, H, O Antigens
Lowenstein-Jensen Agar A Ad. cyclase A Struvite crystals Oxidase (-)
↓O2 Tension A ↑cAMP
Fungi Fe+ + Cysteine Slow growing Fast growing HLT - cAMP ("head lAMP") H. sulfide(+); Indole(-)
Sabouraud's Agar Charcoal yeast-extract agar Chocolate agar SLT - cGMP ("slow GMP") Swarming on agar (motile)
Bordetella pertussis EHEC (O157:H7) Ag used for Weil-Felix test
Exotoxin (Pertussis toxin) Verotoxin (shiga-like)
A ≠Ribosylation A ≠Protein synthesis Yersinia pestis
A ↓Gi --> ↑cAMP K1 pili bind mannose Protease
A W. Cough A Activates plasminogen
Cleaves complement
Whooping Cough MacConkey's or EMB agar Yersinia enterocolytica
turns off off Serratia marcescens - Flora Pathogenicity island
Pili; H-gluttinins A Bacterial proteins
Bordet-Gengou (potato) agar A ≠Host signaling
Slow fermenter
Red "maraschino" pig.
MacConkey's or EMB agar
Citrobacter- Flora

Slow grower
MacConkey's or EMB agar
 Gram (-) Mechanisms
GRAM (-)
COCCI RODS (UTI's)
MALTOSE (+) MALTOSE (-) AEROBIC ANAEROBIC
NEISSERIA NEISSERIA
FASTIDIOUS GROWTH REQ'S SIMPLE GROWTH REQ'S Bacteroides fragilis
N. Meningitis N. Gonorrhoeae Abscesses (purulent)
Meningitis Urogenital Dz I.C. GROWTH (+) I.C. GROWTH (-) OXIDASE (+) OXIDASE (-) / GLU (+) Peritonitis
DIC Gonorrhea; Urethritis
Waterhouse-Fridrichsen Orchitis; PID Brucella H. Influenza P. Aeruginosa LACTOSE (+) LACTOSE (-)
Salpingitis; Sterility Brucellosis MOPE w/ H Flu Sx's "Aer" = air; PSEUdO
Pharyngitis Undulating fever Meningitis (<6yrs) Pneum. (CF; Nosoc) Klebsiella Salmonella enteritidis Bacteroides melaninogenicus
Septic arthritis (#1 in healthy) LN-opathy Otitis media (#2 bug) Sepsis UTI's (10%) Enterocolitis (#1 of Salm) Oral abscess
Opthalmia (neonatal) Hepatosplenomegaly Pneumonia (2' to V. flu) Ecthyma gangrenosum Pneumonia (lobar) Diarrhea (RBC; PMN)
Epiglotitis UTI's (catheters) Alcoholics; DM "Salmon colored"
Abortion (spontaneous) Conjunctivitis (#1) Burns Upper lobe cavitations Constipation
H. ducreyi Otitis externa (#1) Foul sputum Bacteremia
Chancroid (STD) Corneal kerititis (Contacts) Current jelly sputum OM (Sickle Cell Dz)
Random cut on foot!! Sepsis Salmonella typhi
Francisella tulerensis Campylobacter jejuni Vibrio cholera Typhoid fever; Carrier
Tularemia "Campfire in jejunum" Diarrhea (H2O) LOTS! GI; Spleen; Liver; BM; GB
Plague-like Diarrhea (RBC; PMN) A Na+, Cl-. Bicarb loss Enterobacter Shigella sonnei
LN-opathy Enterocolitis-->Arthritis UTI Diarrhea (RBC; PMN)
Sepsis 1-2 days incubation V. parahaemolyticus 1-2 wks
Ulcers + necrosis V. vulnificus Fever 3-4 days
C. fetus Food poison (seafood) Yersinia enterolytica Carrier state
Bacteremia in I.C. Hosts Soft tissue Dz; Blisters Enterolytic = "lyses GI"
Diarrhea (RBC)
Pet feces (fecal-oral)
Legionella Helicobacter pylorus Pasteurella multicocida
Legionnaires Dz PUD Cellulitis Sepsis (abdominal)
Pneumonia Duodenal ulcer (90%) Dz < 24hrs of bite E. Coli Proteus
A Death (30%) Gastritis #1 UTI's (80%) UTI's
Pneumonia (infants) Struvite stones
Meningitis (infants)
Diarrhea
ETEC
Diarrhea (H2O; 3-6d)
"Traveller's diarrhea"
Bordetella pertussis EHEC (O157:H7) - RBC
Whooping Cough Food poison (meat) Sepsis (abdominal)
Seal cough HUS Yersinia pestis
Convalescence Diarrhea (RBC; WBC) Bubonic plague
Sepsis (abdominal) LN-opathy (Bubos = groin)
Pneumonia
Serratia marcescens Sepsis
UTI Yersinia enterocolytica
Abdominal sepsis Diarrhea (RBC; PMN)
Mesenteric lymphadenitis
Pediadric mini-epidemic

Citrobacter
Lung Dz
Abdominal sepsis
 Gram (-) Diseases
GRAM (-)
COCCI RODS
MALTOSE (+) MALTOSE (-) AEROBIC ANAEROBIC
NEISSERIA NEISSERIA
FASTIDIOUS GROWTH REQ'S SIMPLE GROWTH REQ'S Bacteroides fragilis
N. Meningitis N. Gonorrhoeae Clindamycin
PCN G Ceftriaxone (#1) I.C. GROWTH (+) I.C. GROWTH (-) OXIDASE (+) OXIDASE (-) Metronidazole
Tetracycline (Doxy)
Prophylaxis Prophylaxis for neonates Brucella H. Influenza P. Aeruginosa LACTOSE (+) LACTOSE (-)
A Rifampin A Macrolide Tetracycline Cephalosporins 2x Rx Therapy:
Silver Nitrate Ceftriaxone (meningitis) Aminoglycosides Klebsiella Salmonella enteritidis
+/- Ampicillin (40% resistant) Ticar / Piperacillin Cephalosporin (3rd) Self-limiting (usually)
Vaccine (A, C, Y, W) ≠PCN (β-Lactamase) Ciprofloxacin UTI = Cefazolin (1st G) ORT + Antibiotics (kids)
Not B No Vaccine Vaccine (H Flu B < 18 mo) Aztreonam Aztreonam Ampicillin; Tetracycline
+ Tetanus toxoid ≠Opiates
+ Diphtheria toxoid
+ N mening. prot. Salmonella typhi
Chloramphenicol
Francisella tulerensis Campylobacter jejuni Vibrio cholera
Aminoglycoside Macrolide (#1) Cholera cot
Vaccine (attenuated) Quinolone ORT Enterobacter Shigella sonnei
Tetracycline; Ampicillin Ciproflaxacin
≠Opiates Ampicillin
TMP/SMX
V. parahaemolyticus Yersinia enterolytica
V. vulnificus
Tetracycline; Ampicillin

Legionella Helicobacter pylorus Pasteurella multicocida

Macrolide (#1) 3X Tetracycline
Metronidazole E. Coli Proteus
Amoxicillin Cephalosporin
Bismuth TMP / SMX (UTI)
3X ETEC Tx:
Metronidazole Ciproflaxacin (#1)
Chlorythromycin TMP/SMX (kids)
PPI EHEC Tx
Support
Bordetella pertussis
Macrolide (#1)
Vaccine (killed; acellular) Serratia Yersinia pestis
S. marcescens Streptomycin (10 days)
Cephalosporin
Aztreonam

Yersinia enterocolytica
ORT

Citrobacter
Gram (-) Treatment
↑↓ BUG / Dz PROCEDURE / PERPARATION FINDINGS
Stains
Bacteria
Gram Stain

Mycobacteria (high lipid wall)

Acid-Fast Stain

Fungi
PAS Amoeba

Cryptococci
Mucicarmine

Cryptococcus neoformans
India Pink

Campylobacteria
Chlamydia
Giemsa Leishmania
Malaria
TB
Ziehl-Neelsen

Tripanema pallidum
Silver Stain Legionella
Pneumocystis carinii
Treponemes (Trip in the dark)
Dark Field

Herpes family (HSV; VZV) Giemsa or Wright Stain Multinucleate giant cells
Tzanck Preparation Smear of open-skin vesicle Hyperpigmented nuclei
A Multinucleated Giant Cells
Microsporum = Green (ΦTrichophyton tonsurans) Long-wave UV light
Erythrasma (corynebacteria) = Coral red
Porphyria cutanea tarda = Pink
Wood's Light Depigmentation (Vitiligo) = Chalk-white
Hypopigmentation (tinea versicolor; post-inflamm.) = Whitish
TB sclerosis = Leaf spots
Viruses
Rickettsiae (esp. Coxiella)
Ab Probes Chlamydia (cytoplasmic inclusions; Ab fluorescence)
Triponemes (Ab fluorescence)
Viruses Mycobacteria TB
DNA Probes Bacteria (E. coli; Gonorrhea)
Protozoa
Triponema Venereal Disease Research Laboratory Viral (EBV; Hep)
Beef cardiolipin Less specific Drugs
VDRL False(+) = EBV; Hep viruses; Rh. F.; RA; SLE; Leprosy; Rx's React w/ beef cardiolipin Rh. Fever; RA
Lupus; Lipid; Leprosy
Triponema Most specific for Triponemes
FTA-Ab's (+) early and late

Mycoplasma hominus
Eastons Agar

Mycoplasma pneumonia (Ag-Ab Glycolipid)

Complement Fixation

Bartonella henselae (Cat scratch)

Warthin-Starry Silver

Group B Strep distinguisher

CAMP S. algalactiae

C. diphthyria
ELEK
↑↓ BUG / Dz PROCEDURE / PERPARATION FINDINGS

Stains
Randome Tests
Pemphigus Pressure applied laterally to bulla
Nikolsky's Sign Toxic epidermal necrolysis A Extension of blister (crawls laterally)

Urticaria pigmentosa Dev't of wheal upon stroking lesion

Darier's Sign Solitary Mastocytoma

Psoriasis Dev't of pinpoint bleeding upon picking off scale

Auspitz's Sign α w/ papillary dermal dilatation of capillaries

Dermatofibroma Lesion dimples inward upon pinching with thumb + forefinger

Dimple Sign Distinguishes pigmented dermatofibroma vs. other pig. lesions

Granulomatous lesions = apple-jelly color Press glass slide against lesion

Diascopy Purpura vs. vascular dilatation

↓Ca2+; ↓PTH Troussaeo = Tourniquet (cuff --> spasm)

Trousseau's Sign

↓Ca2+; ↓PTH Chvostek's Sign = Chvostek's Cheek (tap --> twitch)

Chvostek's Sign

1st test for Thyroidisms

TSH

Measures TBG-affecting Dz's

T3 Does NOT measure thryoid function

Tests
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Bacteria
Epigastric pain (at night) DU > PU ↑H+; ↓HCO3-; ↓Mucus H. pylori (70%); Z-E Syndrome Tx: H. pylori - Chlorythromycin; Azole; PPI
PUD / Duodenal Ulcer Nausea; Vomiting; "Heartburn" Duodenal Ulcer (90%) Upper GI Bleed; Urease(+) NSAIDS; Alcohol; Smoking ≠NSAIDS; H2 Blocks; Antacids
Pain relieved by eating & antacids PUD Stool Ag(+); Serum Ag(+) Trauma; Surgery; Physical stress Surgery (for perforation; severe)
Green vaginal discharge Vaginal epithelial cells + bug Gardnerella vaginalis Tx = Metronidazole
Vaginitis Fishy smell
Painless
M. TB Acid Fast(+)
M. kansasii (~TB)
Mycobacteria M. scrofulaceum (cervical LN-itis in kid "Scarf = scrof. (ie neck LN's)"
M. avium-I.C. (Dissem. Dz in AIDS Px's)
M. leprae (leprosy)
Leprosy; Skin nodules; Leonine facies AKA = Hansen's Dz Acid Fast(+) M. leprae Lepromatous = Slowly progressive
Burns; Cuts; Self-mutilation ≠Skin; ≠Nerves Lepromin test Obligate I.C. parasite Tuberculous = self-limiting
Mycobacteria Leprae ↓Sensitivity ↓Pigmentation over ≠skin A Infection of superficial skin + nerves - Tuberculous (Macs; Giants) Person-to-person (aerosol) Death not due to leprosy
+ Lepromatous (ΦT cells) Armadillo reservoir Tx = Rifampin; Clofazimine; Dapsone
Kids Strep pyogenes Tx = PCN G
Rheumatic Fever Pharyngitis; Fever; Chills; Polyarthritis GAS - β-hemolytic
Swollen tonsils
Kids
Scarlet Fever Strawberry tongue

LN-opathy Pleomorphic rod (Afipia) Bartonella henselae

Cat Scratch Dz Cat scratch Silver impregnation stain AKA R. henselae

Bacterial Infections
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Bacterial Infections
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Chlamydiae, Rickettsiae & Mycoplasmas
NGU (non-gonococcal urethritis) Elementary bodies --> Enter via endocytosis; Infectious Giemsa(+) Chlamydia trachomatis Tx = Tetracycline; Erythromycin
Arthritis; Conjunctivitis Reticulate body --> Fission replication in cell; ≠Infxs Frei test(+) = L1, L2, L3 I.C. parasite (chlamys = cloak) Urethritis; PID; Ectopic pregnancy
Lymphogranuloma; Trachoma Chandalier Sign = Cervical motion pain L. venereum ΦMuramic acid in cell wall Neonatal infection
Chlamydia trachomatis Reiter Syn (♂) Chlamydia invades columnar epithelial cells Granulomatous infl. A, B, C = Africa; Blindness; Chronic Conjunctivitis
Genital infection + A Urethritis; Lymphogranuloma venereum; Trachoma D-K = Neonatal pneumonia + Conjunctivitis Pneumonia
Conjunctiviits; Polyarthritis L1, L2, L3 = Lymphogranuloma venereum
Fever; Headache; Cough; Anorexia Avian farms; Cockatiels
Chlamydia psittaci I.C. parasite (chlamys = cloak)
ΦMuramic acid in cell wall
Rickettsia
Headache; Fever; Rash Weil-Felix(+) Rickettsia Thrombi or hemorrhage
RMSF = centriPetal (inward rash) R. rickettsii = Rocky Mt. Spotted Fever (tick) - SE U.S. Anti-R Ab's Arthropod vector Typhus fever = gangrene on tips
Typhus = centriPHugal (outward rash) R. typhi = Endemic typhus (fleas) X-react w/ Proteus Obligate I.C. bugs; Need CoA + NAD Fingers; Nose; Ears; Penis; Vulva
R. prowazekii = Epidemic typhus (human louse) - SE U.S. Q = Weil-Felix(-) Coxiella (aerosol) = Sheep wools; Hides Multi-organ vasculitis
Rickettsia Q = Queer (no rash); Atyp. pneumonia Coxiella burnetii = Q Fever (aerosols) Infect endothelial and vascular Smooth mm. A Shock; Renal Failure
R. tsutsugamushi = Scrub typhus (chigers) - WWII; West A Vasculitis + perivascular inflammation
A Mutli-organ failure (Shock; RF)
Tx = Tetracycline
East coast endemic Rocky Mt. Spotted Fever Multi-organ vasculitis
Headache; Fever Rash pattern also seen in A Shock; Renal Failure
R. rickettsii Rash (palms; feet; wrists; ankles) Coxsackievirus A (Hand, foot and mouth Dz)
Shock; Renal Failure Syphilis
Tx = Tetracycline
Mycoplasma
M. pneumonia Eaton agar (mycobacterium)
U. urealyticum Require sterols for growth
Mycoplasmas M. hominus (postpartum fever) U.U. = sterols + urea

Military; Young Px's < 30 yrs old Walking pneumonia (#1 cause) Diffuse I.S. infiltrate M. pneumonia Tx = Erythromycin; Tetracycline
Insidious onset; Headache; Dry cough Signs worse than Sx's IgM cold agglutinins (O+ RBC) Only bacterium with cholesterol membrane PCN-R b/c no cell wall
Mycoplasma pneumoniae Strep MG Agglutinins (S. saliv.)
DNA probe 16s Ribosome
Very slow growing Pregnant women are often ASx carriers
Ureaplasma urealyticum Eatons agar A Neonate infected
Requires urea + sterol to grow ΦCell wall (no Gram stain; No PCN)
Spirochetes
Northeastern U.S. Ixodes tick (live on deer - life cycle) --> Tick bite Spiral bugs + Axial filaments BLT to screw Tx = Ceftriaxone (#1)
Lyme Dz A Erythema chronicum migrans; Flu-like Sx's Giemsa(+) A Lyme Dz Tetracycline; Erythromycin; PCN
Flu-like Sx's A Bull's eye rash (E. migrans); LN-opathy; Myalgia B. recurrentis
Borrelia burgdorferi Bull's eye rash (Erythema migrans) A ≠CNS (meningitis) A Relapsing fever
Arthritis ≠Heart (arrhythmias) - 70% of Px's Jarisch-Herxheimer reaction
A Chronic arthritis
Leptospirosis Spiral bugs + Axial filaments BLT to screw
Leptospira A

Painless genital chancre (local Dz) 1' (3 wks) = Painless, red, raised genital chancre Spiral bugs + Axial filaments BLT to screw; TORCHS Neurosyphilis
Maculopapular rash (palms; soles) A 2' (2-10 wks) = Rash on palms+soles; Fever; Heada Outer membrane; Helical prot A Syphilis (T. pallidum) Tabes dorsalis
Condylomata lata Arthritis; LN-opathy; White oral lesions Obliterative Endarteritis Yaws (T. pertenue) Congenital Syphilis
Treponema pallidum Tabes dorsalis A 3' (15 yrs) = Aortitis; Heart lesions Dark field microscopy Micro-aerophilic Abortion; Stillbirth
Neurosyphilis (paresis) Gummas; Tabes dorsalis; CNS lesions Non-specific: VRDL(+); RDR(+) Rash (early 2' Syphilis in newborn)
Personality; Affect; Reflexia Specific: FTA; TPHA; MHTP Teeth abnormalities (late syphilis)
Eyes; Sensory; Intellect; Speech PCR; TPI (immobilization test)
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

CRM & Spirochetes

↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Fungal Infections
Cold = Mold (soil)
Fungi Heat = Yeast (body temp)
Sabouraud's agar = Fungi
Tinea
Kids; ≠Scalp ≠Striatum corneum Dermatophytes (fungi in soil + animals) Tx = Topical azole
Tinea Capitis Crusting; Erythema; Scale KOH; Branching hyphae
Scalp; Hairless patches Athroconidia
♂ (mostly) Uncommon ≠Striatum corneum Dermatophytes (fungi in soil + animals) Tx = Topical azole
Tinea Barbae ≠Beard KOH; Branching hyphae
Athroconidia
Children; ≠Body Common ≠Striatum corneum Dermatophytes (fungi in soil + animals) Tx = Topical azole
Tinea Corporis Plaques: Erythematous KOH; Branching hyphae Predisposing factors = Heat; Humidity; Animals
Scaling w/ elevated border (ringworm) Athroconidia
Obese men; ≠Striatum corneum Dermatophytes (fungi in soil + animals) Tx = Topical azole
Tinea Cruris ≠Inguinal area KOH; Branching hyphae Predisposing factors = Heat; Humidity
Patches: Most; Red; Scaling borders Athroconidia
Erythema; Scaling AKA = Athlete's Foot ≠Striatum corneum Dermatophytes (fungi in soil + animals) Tx = Topical azole
Tinea Pedis Interdigital spaces Common; 40% of people affected at some point in life KOH; Branching hyphae
Athroconidia
Upper trunk ≠Striatum corneum Dermatophytes (fungi in soil + animals) Tx = Topical azole
Tinea Versicolor Macules: Polymorphic; ↑/↓Pigmented KOH; Branching hyphae Malassezia furfur
Peripheral scaling Athroconidia
Brown spot ≠Striatum corneum Cladosporidium werneckii Tx = Topical salicylic acid
Tinea Nigra KOH; Branching hyphae
Athroconidia
ΔNail ≠Striatum corneum Dermatophytes (fungi in soil + animals) Tx = Topical azole
Onchomycosis A Discoloration; Thickening; Deformity KOH; Branching hyphae
Athroconidia
Opportunistic Fungal Infections
Px's = Neonates; AIDS; DM; Steroids Yeast (in humans) Budding yeast (white) Normal flora of mouth, skin, and GI Disseminated infection
Thrush (Neonates; Steroids) Pseudohyphae Proteinases (degrade host tissue) Microabscesses (severe invasion)
Candida albicans Endocarditis (IVDU) 37C germ tube formation Surface molecules (bind host cells)
Vaginitis (Steroids; DM) Not dimorphic Adenosine (≠PMN O2 radical synth) Tx = Nystatin (superficial)
Diaper rash Amphotericin B (systemic)
Cryptococcal meningitis Cyclospora (AIDS stool) = oval orgs; Acid fast; Fluoresc Yeast; Capsular halo Soil; Pigeon droppings
Cryptococcus neoformans Soap bubble lesions in gray matter C. neoFormans = Fungus; C. Parvus = Protozoa Narrow-based budding Encapsulated (Polysacch Ag)
Inhalation of yeast --> Meningoencephalitis (↓Immune) India Pink(+); Latex agglutinin RF = Corticosteroids
Allergic bronchopulmonary infection α w/ Asthma like Sx's 45' angle hyphae; ΦDimorphic Mold Invasive aspergillosis
Aspergillus fumigatus Pneumonia (Brewer's lung) Necrotizing pneumonia w/ "target lesions" Lung cavity "fungus ball" Grow on surface of peanuts Secrete aflatoxin (carcinogen)
Sinusitis (severe) Target lesions = Gray foci; Hemorrhagic borders "Target lesions" in lung Secrete aflatoxin (carcinogen) A Liver CA (Africa)
Microvascular occlusion (DM; Leukemi Enter Nasal sinuses; Lungs; GI tract 90' angle hyphae Bread mold fungi
Mucormycosis A Ischemia of distal tissues A Invasion of vascular walls --> Proliferation of fungi Wide-angle branching Mucor; Rhizopus
A Tissue necrosis Absidia; Cunninghamella
Pneumonia (AIDS Px's) Yeast most likely (~protozoan) - still unverified Silver stain(+); Giemsa(+) Inhaled Formerly #1 Cause of death in AIDS Px's
Pneumocystis carinii ↓Organelles; Phyogenetic similarity to fungi Foamy edematous fluid Tx = TMP/SMX; Pentamidine
Chitin-containing cell wall (like fungi) Start prophylaxis at CD4 < 200
Sporotrichosis Yeast Cigar-shaped budding yeast Vegetation Tx = Itracanazole; K+Iodide
Sporothrix schenckii Ascending lymphangitis Rosettes conidia Rose thorn (rose shank)
Dimorphic
Systemic Mycoses
Southwestern U.S.; San Joaguin Valle Inhalation of asexual spores Spherule in tissue Tx = Fluconazole; Ketoconazole
Coccidioidomycosis Valley fever; Desert bumps Dimorphic Amphotericin B (systemic)
"Cocksuckers in LA"
Latin America Inhalation of asexual spores Captain's Wheel formation Tx = Fluconazole; Ketoconazole
Paracoccidioidomycosis "Para latinos" Dimorphic Amphotericin B (systemic)

Ohio River Valley Inhalation of asexual spores Dimorphic Bird / Bat droppings Tx = Fluconazole; Ketoconazole
Histoplasmosis "Histo = Ohio" I.C. (Macs) Amphotericin B (systemic)

East of Mississipi river Broad-Based Budding Tx = Fluconazole; Ketoconazole

Blastomycoses Central America Dimorphic Amphotericin B (systemic)
"Blast the East Coast"
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

Fungi
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Protozoa
Amebiasis E. histolytica attaches to colonic epithelium (lectin) Cysts or trophozoites in stool Cysts in water Liver abscess
Entamoeba histolytica Diarrhea (RBC); Dysentery A Lyse epithelial cells (pore-forming protein) Flask-shaped colonic ulcers
RUQ pain A Invade bowel wall Tx = Metronidazole
Giardiasis #1 GI Protozoan Cysts or trophozoites in stool Cysts in water
Giardia lamblia Diarrhea (WBC); Foul smelling stool G. lamblia attach to duodenal epithelium via sucker disk Clubbed villi; Shallow crypts Binucleate parasites
Bloating; Flatulence A ≠Absorption of food --> Osmotic diarrhea Tx = Metronidazole
AIDS Px's mostly Crytposporidia invade intestinal epithelium Cysts in stool Cysts in water No Tx
Cryptosporidium parvum Severe, debilitating diarrhea (AIDS) C. neoFormans = Fungus; C. Parvus = Protozoa Inflammation of lamina propria Sand filters in sanitation systems

Immunocompromised Px's only #1 Parasitic infection in U.S. (+/- world) Biopsy (CNS abscess) TORCH Life carrier
AIDS Px's mostly 60-80% of population infected --> ASx Life carriers Serology(+) Cysts in meat; Cysts in cat poop Dormant until immunosuppressed
≠CNS Sx's Ingestion of oocysts in cat feces; Uncooked pork I.C. protozoan Congenital toxoplasmosis
Toxoplasma gondii Birth defects A Penetration of ANY host cell (unique to T. gondii) Hx of mom cleaning catboxes
ie. Can penetrate placenta --> organ damage
CNS lesions (most common in AIDS Px's) Tx = Sulfadiazine + Pentamidine
AIDS Px's mostly Lung lavage(+); Biopsy(+) Inhalation of aerosol
Pneumocystis carinii I.S. Pneumonia (diffuse) Silver stain(+)
Tx = TMP / SMX; Dapsone; Pentamidine
Plasmodium
Malaria Blood smear(+) Mosquito (anopheles) Cerebral malaria (severe)
P. vivax Cyclic fever; Headache; Anemia Genetic resistance Tx = Chloroquine; Primaquine
Splenomegaly HLA-B53 in liver cells; Sickle Cell Dz
Malaria Blood smear(+) Mosquito (anopheles) Cerebral malaria (severe)
P. ovale Cyclic fever; Headache; Anemia Genetic resistance Tx = Chloroquine; Primaquine
Splenomegaly HLA-B53 in liver cells; Sickle Cell Dz
Malaria Blood smear(+) Mosquito (anopheles) Cerebral malaria (severe)
P. malariae Cyclic fever; Headache; Anemia Genetic resistance Tx = Chloroquine; Pyrimethamine
Splenomegaly HLA-B53 in liver cells; Sickle Cell Dz
Malaria #1 Fatal Parasite Blood smear(+) Mosquito (anopheles) Cerebral malaria (severe)
P. falciparum Cyclic fever; Headache; Anemia Infects liver cells --> infects RBC's Genetic resistance Tx = Quinolones; Pyrimethamine
Splenomegaly A RBC lysis; CNS infarcts HLA-B53 in liver cells; Sickle Cell Dz Tx = Artemethol (severe falciparum)
Trypanosoma
Chagas Dz #1 Cause of HF in Brazil Blood smear(+) Riduviid bug Tx = Nifurtimox
Acute Chagase T. cruzi binds to E.C. matrix proteins via penetrin prot. Parasitized myocytes I.C. parasite
Myocardial necrosis + I.S. infl. A Invades host cell Chronic inflammation; E'phils Decay accelerating factor (VF)
T. cruzi Chronic Chagas (20%)
Cardiomegaly; Mural thrombi
RBB arrhythmias; Dilated esoph.
African sleeping sickness Demyelinating panencephalitis Blood smear(+) Tsetse fly Tx = Suramin (blood-borne)
T. gambiense West Africa Variable suface gP (VF) Melarsoprol (CNS infxn)
Large rubbery chancre at bite
African sleeping sickness Demyelinating panencephalitis Blood smear(+) Tsetse fly Tx = Suramin (blood-borne)
T. rhodesiense East Africa Variable suface gP (VF) Melarsoprol (CNS infxn)
Large rubbery chancre at bite
Greenish vaginal discharge Trophozoite on wet mount STD Tx = Metronidazole
Trichomonas vaginalis Foul, fishy smelling
Itching; Burning
Skin Leishmania Chronic inflammatory Dz Macs w/ amastigotes Sandfly Involuted healing < 6 mo's
Itchy indurated papule Skin (L. major; L. aethiopica; L. mexicana) Obligate I.C. parasite
A Shallow expanding irregular ulcer Mucous membranes (L. brasiliensis) Resist acid and proteases of Macs
Disfiguring keloids on skin (rare) Viscera (L. donovani; L. chagasi) T-cell immune response
Leishmania Visceral Leishmania
Fever; ↓Wt.; ↑Pigmentation (kala-azar / black fever)
Hepatosplenomegaly; LN-opathy Tx = Pentavalent Antimony
Pancytopenia Na-Stibogluconate
Babesiosis B. microti invades RBC Hemolytic anemia Ixodes tick Tx = Quinine; Clindamycin
Babesia microti A Mild fever; Hemolytic anemia Blood(+); ΦRBC pigment Malaria-like protozoan
A Maltese Tetrads (Dx)
Meningoencephalitis Amebas in CSF Swimming in fresh water lakes No Tx
Naegleria A Rapid death
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

Protozoa
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Helminths
Cestodes (Tapeworms)
Cysticercosis Ingestion of undercooked pork CNS lesions Undercooked pork
Taenia solium Mild abdominal pain A Attachment to stomach wall w/ scolices Minor inflammation
≠Mental; Convulsions A Release of eggs --> Bloodborne --> CNS cysts
Hydatid Dz Ingestion of tapeworm eggs E. granulosus (unilocular cysts; dog feces) Rupture
Echinococcus granulosus Cysts in liver A Hatch in duodenum E. multilocularis (rodents) A Anaphylaxis
A Invade liver, lungs or bones
Trematodes (Flukes)
Liver & Spleen cysts #1 Helminth Dz (200M infected annually) Hepatic granulomas + fibrosis Snails (fresh water) Portal HTN
S. mansoni S. mansoni (side spine) --> Colon venules Eggs --> Granulomas S. mansoni (Latin America; Africa; Mid Ea A Splenomegaly
A Liver Granulomas + Portal fibrosis S. japonicaum (no spine) --> Small bowel venules Macs; L'cytes; PMN's; E'phils S. japonicaum (Northeast Asia) Esophageal varices
Schistosoma S. japonicaum S. hematobium (middle spine) --> Bladder venules S. hematobium (East Asia) Ascites
A Liver Granulomas + Portal fibrosis A Cercariae penetrate skin --> Loose tails
S. hematobium A Schistosomulae mature in liver --> Hepatic granules
A Hematuria; Chr. obstructive uropathy A Mature adults migrate to Bowel and Bladder Tx = Praziquantel
Biliary tract infection Undercooked fish
Clonorchis sinensis

Lung inflammation Undercooked crab Tx = Praziquantel

Paragonimus westermani A 2' Bacterial lung infection
Tx = Praziquantel
Nematodes (Roundworms)
GI infection Larvae penetrate feet Anemia Hookworm Tx = Mebendazole; Pyrantel Pamoate
Anemia A Lung Anticoagulants
Ancylostoma duodenale A GI Antioxidants
A Worms consume 0.2 mL of blood / worm / day Anti-ACh-ase
A Anemia Hyalinuronidase
Anal pruritus Pinworm Tx = Mebendazole; Pyrantel Pamoate
Enterobius vermicularis

GI infection Giant roundworm Tx = Mebendazole; Pyrantel Pamoate

Ascaris lumbricoides Eggs in human feces

Myositis; Fever Undercooked pork Tx = Thiobendazole

Trichinella spiralis Periorbital edema

GI infection Strong penetration of feet Larvae penetrate feet Tx = Thiobendazole; Ivermectin

Strongyloides stercoralis A GI

River blindness; Pruritic dermatitis (chr Major cause of blindness in Africa Sclerosing keratitis ♀Blackfly Tx = Ivermectin
Onchocerca volvulus Subcutaneous nodule (onchocercomat Oncho river / Ivermectin A Opacification of cornea
Leopard skin (atrophic + ↑pigement) Black fly on the river
Skin infection + ulceration Drink the dracunc ≠Water Tx = Niridazole
Dracunculus medinensis The unculus ulcerates

Granulomatous Dz Toxocara ~ Toxoplasma = Granulomatous infection ≠Food (eggs) Tx = Diethylcarbamazine (Toxo; Witchy; Loa)
Toxocara canis Blindness (if in retina)

≠Lymphatic drainage Mosquito --> Elephant = Witchcraft Circulating parasites ♀Mosquito Tx = Diethylcarbamazine (Toxo; Witchy; Loa)
Wuchereria bancrofti A Elephantitis Chronic lymphatic filariasis W. bancrofti
Lymphedema in groin downward Meyers-Kouvenaar bodies Brugia malayi
Worm crawls across conjunctiva Look Look a Dear!! Dear Fly Tx = Diethylcarbamazine (Toxo; Witchy; Loa)
Loa loa Swelling in skin Look Look a worm in your eye!!
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

Helminths
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Viruses - Characteristics
Mostly like human DNA (infectious to us)
Envelope = plasma membrane (ΦHerpes)
Haploid = 1DNA or 1RNA (ΦRetro = 2ssRNA)
All Viruses

Like Human DNA

dsDNA (ΦParvos) Parvo is "part of a" viruse (ssDNA)
Linear (ΦPapovas; ΦHepadnas) -AdnA / OvA is like an oval (circular)
DNA Viruses Icosahedral (ΦPox - complex) Pox is complex
Replicate in nucleus (ΦPox) Pox carries own DNA-dependent RNA
Enveloped (ΦPAP) Need to be naked for a PAP smear
Like Human RNA (mRNA)
ssRNA (ΦRios) Rio = repeato virus (dsRNA); A river has 2 beaches (strand)
Linear (ΦArena; ΦBunya; ΦDelta) Circular like an Arena a Bunion and a "D"elta
RNA Viruses Enveloped (ΦPicorna; ΦCalici; ΦRe Porn stars of Rio and Cali are naked!!
Replicate in cytoplasm (ΦInfluenza; ΦRetro)

Naked nucleic acids of:

Infectious dsDNA (Pox; HBV)
(+)ssRNA
Naked nucleic acids of:
Non-infectious (-)ssRNA
dsRNA
Measles (late sequela)
Slow Viruses PML (JCV) - AIDS

BOAR (all RNA viruses)

Bunya
Segmented Viruses Ortho = Influenze (8 segs)
Arena
Reo
ARthropod BOrne
Arboviruses Flavi; Toga; Bunya

A = Enteric; Fecal - oral A & E = Vowels hit your bowels A = Self-limiting

B = STD; Perinatal; Blood; Parenteral B = Chronic hep; Cirrhosis; HCC
Hepatitis Transmission C = Needle (IVDU) C = Chronic hep; Cirrhosis; HCC
D = HBsAg HBV coinfection D = ~B
E = Enteric; Water-borne Epidemics A & E = Vowels hit your bowels E = ~A; ♀Pregant mortality
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

Viruses - Characteristics
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
DNA Viruses
Like Human DNA
dsDNA (ΦParvos) Parvo is "part of a" viruse (ssDNA)
Linear (ΦPapovas; ΦHepadnas) -AdnA / OvA is like an oval (circular)
DNA Viruses Icosahedral (ΦPox - complex) Pox is complex
Replicate in nucleus (ΦPox) Pox carries own DNA-dependent RNA
Enveloped (ΦPAP) Need to be naked for a PAP smear
Papovaviridae
Genital warts; Cauliflower-like ΦEnvelope ; Nucleocapsid
HPV CIN dsDNA; Circular
Cervical cancer
AIDS Px's (mostly) ΦEnvelope ; Nucleocapsid
JC Progressive Multifocal Leukoencephalopathy dsDNA; Circular

Kidney transplant Px's "Brand new Kidney" ΦEnvelope ; Nucleocapsid

BK dsDNA; Circular

Red eye - Conjunctivitis aDeno = DNA ΦEnvelope; Nucleocapsid

Adenovirus Sore throat - Pharyngitis aRena = RNA dsDNA; Linear
Lung Dz - Pneumonia
Parvoviridae
"Slapped cheek"; Erythema infectiosu Slap the pervert ΦEnvelope ; Nucleocapsid
B12 Aplastic crisis (SCD) PVB12 makes part of a RBC (SCD; Aplastic anemia) ssDNA; Linear

Adeno-associated viruses ΦEnvelope ; Nucleocapsid

AAV ssDNA; Linear

Herpesviridae (CHEV)
Oral (+/-genital) lesions #1 Cause of corneal blindness in U.S. Pink Cowdry A (I.N.) Incl. TORCHS Envelope (nuc m) Neonatal TL Encephalitis; Pneumonia; DIC
HSV-1 Herpes labialis; Corneal blindness Replicate in epithelium --> Vesicular lesions in skin Multinucleated syncytia (Dx) Saliva dsDNA; Linear
Gingivostomatitis; Keratoconjunctivitis A Latency in ganglia --> Reactivation (sun; stress) Tzanck preparation Respiratory sec. Tx = Acyclovir; Steroids (keratitis)
Genital (+/-oral) lesions Pink Cowdry A (I.N.) Incl. TORCHS Envelope (nuc m)
HSV-2 Neonatal herpes encephalitis Replicate in epithelium --> Vesicular lesions in skin Multinucleated syncytia (Dx) STD dsDNA; Linear
A Latency in ganglia --> Reactivation (sun; stress) Tzanck preparation Perinatal Tx = Acyclovir; Steroids (keratitis)
Respiratory infection --> 2 wks to pox Infects mucus membranes, skin, and neurons Dew-drop skin lesions (pox) α Group Envelope (nuc m)
VZV A Chicken pox; Centrifugal spread A Infects satellite cells around neurons in DRG Pink Cowdry A (I.N.) Incl. Saliva; Aerosols dsDNA; Linear
Zoster; Shingles A Latency in DRG --> Recurrence (shingles) Tzanck preparation Respiratory sec. Tx = Live vaccine; Acyclovir; Famciclovir
Mononucleosis (15-20 yrs old) EBV fusion w/ B-cell plasma membrane Monospot test γ Group Envelope (nuc m) Self-limiting Dz
Fever; Pharyngitis A EBV enters B Cell Heterophil Ab's: EBV+CVA Saliva dsDNA; Linear B-Cell Lymphoma
EBV LN-opathy (Post. Auricular nodes) A B Cell immortalization (vie EBNA2; LMP-1) Sheep RBC Agglutination Respiratory sec. Burkitt's Lymphoma t(8;14)
Hepatosplenomegaly Nasopharyngeal CA (Asia) Atypical T's; Reed-Sternbergs
Neonates; Immunosuppressed Px's Infects endothelial and epithelial cells Hemolytic anemia; ↓Plt's β Group; TORCHS Envelope (nuc m) Blindness in AIDS Px's
Hepatosplenomegaly; Jaundice Esophagitis; Colitis; Hepatitis; Pneumonitis; Owl's eye influsions (urine sed Saliva dsDNA; Linear Deafness
CMV Purpura; Anemia Renal tubulitis; Meningoencephalitis; Choriotinitis Atypical T L'cytes STD; Perinatal
Infectious Mono (if not EBV) Serology; IgM or IgG Ab's Transfusion
Roseola Envelope (nuc m)
HHV-6 Exanthum subitum dsDNA; Linear

Monkey bite Envelope (nuc m)

HHV-7 A Fatality dsDNA; Linear

AIDS Px's (mostly) Envelope (nuc m)

KSHV-9 Kaposi's Sarcoma dsDNA; Linear

Small pox (eradicated; ~warfare) Largest dsDNA dsDNA Envelope Vaccine (cow pox)
Poxvirus Molluscum contagiosum Linear

HBV HBsAg = Surface; Carrier state IgM (acute); IgG (chronic) dsDNA Envelope
Hepatitis HBsAb = Immunity; Fights virus Serology test Partially Circular
HBcAg = Core Ag (never seen b/c inside)
Hepadnavirus HBcAb = Recent Dz HBcAb
HBeAg = Transmissability (Beware) HBeAg HBeAb
HBeAb (low transm) HBsAg W HBsAb
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

DNA Viruses
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
RNA Viruses
Like Human RNA (mRNA)
ssRNA (ΦRios) A river has 2 beaches (Rio = 2 Strande)
RNA Viruses Linear (ΦArena; ΦBunya; ΦDelta) Circular like an Arena a Bunion and a "D"elta
Enveloped (ΦPicorna; ΦCalici; ΦRe Pico (small) Calico cat on the River cannot be enveloped
Helical
Influenza virus Mucosal hyperemia BOAR (segmented) Superinfection (S. aureus; S. pyogenes)
A Influenza Edema + Swelling Hemagluttinin; Neuraminidase Ag's A Death
Orthomyxoviruses Rapid reassortment of genes --> Variation Mono infiltrate H1; H2; H3; N1; N2
Shift (major) --> Pandemic (swine + human virus co CT-Killers --> Clear virus Antigenic Shift + Drift Tx = Amantadine; Rimantadine (A only)
Worldwide Flu epidemics Drift (slight) --> Epidemic (mutation) Zanamivir (A & B); Killed vaccine
Paramyxoviruses (PRM)
Croup 4 Serotypes
Parainfluenza

Brionhiolitis (infants) SSPE (Subacute Sclerosing Panencephalitis) SSPE

RSV Bronchopneumonia (infants) Giant cell pneumonia
Tx = Ribavirin
Measles SSPE (Subacute Sclerosing Panencephalitis) ≠Stensons ducts T-cell immunity
Koplik spots (blue-gray buccal mucosa) Oral ulcerations (Koplik spots) A Measles rash on reintroduction
Cough; Conjunctivitis; Coryza (runny nose) Necrosis; PMN's; Vasc. SSPE; Inclusion-body encephalitis
Measles Maculopapular rash (blotchy) Follicular hyperplasia of LN's ≠CNS; Mental change;
Warthin-Finkeldey cells ≠Visual; IgG in CSF
E'philic I.N. + I.C. Inclusions Myoclonus; Cerebral atrophy
Pathognomonic
Mumps --> Bumps 15% of all asceptic meningitis in U.S. I.S. edema Mumps virus Sterility
Mumps A Parotitis; Meningitis Histiocytes; L'cytes; Plasmas Human reservoir
Orchitis (20%)
Rabies Bat; Dog; Racoon bite Negri bodies (cyt. Inclusions) Rhabdovirus
Rhabdovirus Fatal encephalitis; Seizures A wks - 3mo incubation Hippocampus Bullet-shaped capsule
Hydrophobia A Migrates retrograde PNS axons --> CNS G Protein; M Protein; Nucleocapsid
Common cold Crown of the common colds
Coronaviruses

Meningitis aDeno = DNA BOAR (segmented)

Arenaviruses LCV - Lymphocytic Choriomeningitis aRena = RNA

Bunyavirus
Along southern Rocky Mountain states Hantavirus (deer mice) - BOAR (segmented) Hantavirus (60% death)
Fever; Myalgia; ≠GI (3-4 days)
Hantavirus A Cough; Dyspnea; Tachypne
A ARDS --> Death
Kids < 10 yrs; Midwestern U.S. Arbovirus (sandfly) - BOAR (segmented)
California Encephalitis Fever; Headache; Nausea; Vomiting
Photophobia

Rift Valley Fevers

Crimea-Congo Hem. Feve

Ebola
Filovirus Marburg hemorrhagic fever Arbovirus
Fatal!!
Hepatitis Incomplete RNA virus
HDV HBV co-infection only
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

RNA Viruses - Helical

↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Icosahedral
Picornaviruses (PERCH) Little bird: PERCHES on Rhino's Cock Pole; He Echos (screams) and they HAVe a good time
Polio Polio replicates in: PicoRNA (small RNA) ΦEnvelope Tx = Polio-Salk/Sabin vaccines (IPV/OPV)
Poliovirus A Anterior horn of SC --> Muscular paralysis Nucleocapsid
Bulbar (brain stem) neurons --> Respiratory paralysis
Asceptic meningitis PicoRNA (small RNA) ΦEnvelope
Echovirus Nucleocapsid

Common cold Rhino has a runny nose IgA + IgG Ab's PicoRNA (small RNA) ΦEnvelope
Rhinovirus Rhinovirus bind ICAM-1 of URT > 100 serotypes Nucleocapsid
A Bradykinin release --> Mucus secretion
Asceptic meningitis (herpangina) PicoRNA (small RNA) ΦEnvelope
Febrile pharyngitis; Rash (Cox A) Nucleocapsid
Coxsackievirus Hand, foot, and mouth Dz (Cox A)
Myo-pericarditis (Cox B)
Acute hepatitis PicoRNA (small RNA) ΦEnvelope
HAV Jaundice Nucleocapsid

Caliciviruses
Young; Elderly; Epidemic Fecal-oral ΦEnvelope
Norwalk virus Gastroenteritis

Hepatitis ΦEnvelope
HEV

Reoviruses
Colorado Tick Fever BOAR (segmented) ΦEnvelope
Reovirus Nucleocapsid

Kids < 6 yrs old; Epidemic #1 Cause of fatal diarrhea in kids Contaminated water ΦEnvelope
Rotavirus Diarrhea (severe; fatal) Rota rooter --> Right Out of The Anus BOAR (segmented)

Flaviviruses

St. Louis

Fever Councilman body in liver Arbovirus (Aedes mostquito)

Yellow Fever Black vomit Monkey or human reservoir
Jaundice
C. America; S. America; Mexico AKA = Break-bone fever Arbovirus (mosquito) Hemorrhagic dengue (prior exposure)
Dengue Sever aching bone pain Variant = Hemorrhagic Shock Syndrome (Southeast Asia)
Rash
IVDU Hepatic cirrhosis
HCV Chronic hepatitis

Togaviruses
Encephalitis
Eastern Equine

Encephalitis
Western Equine

URTI; Rash; LN-opathy AKA = German measles Thrombocytopenia Rubellavirus; TORCHS

Rubella Hepatosplenomegaly ≠CNS (encephalitis; cataracts; retinopathy; hearing loss)
Purpura; Pneumonia; Encephalitis ≠Heart (Patent DA; Pulm. Arterial hypoplasia) Tx = ΦRx; Live vaccine
Retroviruses (Retro = RNA)
AIDS Acute (p24-Ag; ↓CD4+; Φab) ELISA (out) / Western Blot (in)
A Latent (↓p24-Ag; ↑Ab's to p24 + p120; =CD4+)
HIV A Immunodeficiency (↓CD4+ < 200; ↓Ab's; ↑p24-Ag) Ab's: p24+p120
p24 Ag p24-Ag
T Cell Leukemia
HTLV
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

RNA Viruses - Icosahedral

↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
STD's
Urethritis; Cervicitis N. gonorrhea PID; Prostatitis; Epididymitis
Gonorrhea Arthritis

Chancre; Very painful H. ducreyi

Chancroid

Vaginitis Trichomonas vaginalis

Trichomoniasis

Genital warts HPV 6, 11

Condylomata acuminata Koilocytes

NGU (non-gonococcal urethritis) Elementary bodies --> Enter via endocytosis; Infectious Giemsa(+) Chlamydia trachomatis Tx = Tetracycline; Erythromycin
Arthritis; Conjunctivitis Reticulate body --> Fission replication in cell; ≠Infxs Frei test(+) = L1, L2, L3 I.C. parasite (chlamys = cloak) Urethritis; PID; Ectopic pregnancy
Lymphogranuloma; Trachoma Chandalier Sign = Cervical motion pain L. venereum ΦMuramic acid in cell wall Neonatal infection
Chlamydia trachomatis Reiter Syn (♂) Chlamydia invades columnar epithelial cells Granulomatous infl. A, B, C = Africa; Blindness; Chronic Conjunctivitis
Genital infection + A Urethritis; Lymphogranuloma venereum; Trachoma D-K = Neonatal pneumonia + Conjunctivitis Pneumonia
Conjunctiviits; Polyarthritis L1, L2, L3 = Lymphogranuloma venereum
Painless genital chancre (local Dz) 1' (3 wks) = Painless, red, raised genital chancre Spiral bugs + Axial filaments BLT to screw; TORCHS Neurosyphilis
Maculopapular rash (palms; soles) A 2' (2-10 wks) = Rash on palms+soles; Fever; Heada Outer membrane; Helical prot A Syphilis (T. pallidum) Tabes dorsalis
Treponema pallidum Condylomata lata Arthritis; LN-opathy; White oral lesions Obliterative Endarteritis Yaws (T. pertenue) Congenital Syphilis
Tabes dorsalis A 3' (15 yrs) = Aortitis; Heart lesions Dark field microscopy Micro-aerophilic Abortion; Stillbirth
Gummas; Tabes dorsalis; CNS lesions Non-specific: VRDL(+); RDR(+)
Genital warts; Cauliflower-like ΦEnvelope ; Nucleocapsid
HPV CIN (HPV 6, 11) dsDNA; Circular
Cervical cancer (HPV 16, 18, odd 30's)
Oral (+/-genital) lesions #1 Cause of corneal blindness in U.S. Pink Cowdry A (I.N.) Incl. TORCHS Envelope (nuc m) Temporal lobe encephalitis
HSV-1 Herpes labialis; Corneal blindness Replicate in epithelium --> Vesicular lesions in skin Multinucleated syncytia (Dx) Saliva dsDNA; Linear Mono's --> Neovascularization --> Sarring
Gingivostomatitis; Keratoconjunctivitis A Latency in ganglia --> Reactivation (sun; stress) Tzanck preparation Respiratory sec. Tx = Acyclovir; Steroids (keratitis)
Genital (+/-oral) lesions Pink Cowdry A (I.N.) Incl. TORCHS Envelope (nuc m)
HSV-2 Neonatal herpes encephalitis Replicate in epithelium --> Vesicular lesions in skin Multinucleated syncytia (Dx) STD dsDNA; Linear
A Latency in ganglia --> Reactivation (sun; stress) Tzanck preparation Perinatal Tx = Acyclovir; Steroids (keratitis)
Mononucleosis (15-20 yrs old) EBV fusion w/ B-cell plasma membrane Monospot test γ Group Envelope (nuc m) Self-limiting Dz
Fever; Pharyngitis A EBV enters B Cell Heterophil Ab's: EBV+CVA Saliva dsDNA; Linear B-Cell Lymphoma
EBV LN-opathy (Post. Auricular nodes) A B Cell immortalization (vie EBNA2; LMP-1) Sheep RBC Agglutination Respiratory sec. Burkitt's Lymphoma t(8;14)
Hepatosplenomegaly Atypical T's; Reed-Sternbergs
Neonates; Immunosuppressed Px's Infects endothelial and epithelial cells Hemolytic anemia β Group; TORCHS Envelope (nuc m) Blindness in AIDS Px's
Hepatosplenomegaly; Jaundice Esophagitis; Colitis; Hepatitis; Pneumonitis; Thrombocytopenia; Saliva dsDNA; Linear Congenital CMV
CMV Purpura; Anemia Renal tubulitis; Meningoencephalitis; Choriotinitis Atypical T L'cytes STD; Perinatal Periventricular Ca2+; Encephalitis
Infectious Mono (if not EBV) Nasopharyngeal CA (Asia) Serology; IgM or IgG Ab's Transfusion Deafness
HBV HBsAg = Surface; Carrier state IgM (acute); IgG (chronic) dsDNA Envelope
Hepatitis HBsAb = Immunity; Fights virus Serology test Partially Circular
HBcAg = Core Ag (never seen b/c inside)
Hepadnavirus HBcAb = Recent Dz HBcAb
HBeAg = Transmissability (Beware) HBeAg HBeAb
HBeAb (low transm) HBsAg W HBsAb
AIDS Acute (p24-Ag; ↓CD4+; Φab) ELISA (out) / Western Blot (in) HIV Bacterial = TB; M. avium / I.C.
Immunodificiency A Latent (↓p24-Ag; ↑Ab's to p24 + p120; =CD4+) Viral = HSV; VZV; CMV; JC; KSHV
Opportunistic infections A Immunodeficiency (↓CD4+ < 200; ↓Ab's; ↑p24-Ag) Ab's: p24+p120 Fungal = Cryptococcus; Candida; Histo
HIV p24 Ag p24-Ag Protozoan = Toxo; Cryptosporidiosis
Lymphoma
Meningitis (Cryptococcus; CMV; JCV)
CNS Abscess (Toxoplasmosis)
Toxoplasma
Rubella
TORCHES Bugs CMV
HSV; HIV
Syphilis
Salpingitis Chlamydia trachomatis (subacute PID) Ectopic pregnancies
Aendometritis N. gonorrhea (acute PID) Infertility
PID Hydrosalpinx Gardnerella (clue cells) Chronic pelvic pain
Tubo-ovarian abscess Trichomonas (motile on wet prep) Adhesions
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

STD's
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Infectious Agent Descriptions
Spongiform encephalopathies Modified host protein (PrPsc)
Prions CJD; Mad cow; Kuru; Scrapie ΦRNA; ΦDNA (therefore not a virus)
Neurodegenerative Dz
Cold; Flus Obligate I.C. organisms
Viruses Enteritides DNA or RNA
Chronic (HBV; HIV; HCV) Protein capsid (protein) +/- envelope (lipid)
Mobile
Bacteriophages & Plasmid DNA or RNA

Extracellular or Intracellular
Rigid cell wall (phospholipid bilayers 2(+); 1(-)
Bacteria ΦNuclei; Φmitochondria
e- transport in cytoplasmic membrane
Extracellular or Intracellular
Chlamydiae, Rickettsiae Rigid cell wall (except mycoplasma)
& Mycoplasmas Φnuclei; No metabolic ability in chalmydia
Systemic infections; Necrosis Superficial infections (tinea) Thick, chitin-containing cell walls
Fungi Hemorrhage; Vasc. Occlusion Abscesses (sporotrichosis) Yeasts in humans
P. carinii = Pneumonia Granulomas (Coccidio; Histo; Blasto)
Trichomonas vaginalis Plasmodia Single cells
Protozoa E. histolytica Leishmania Pliable plasma membrane w/ organelles
Giardia lamblia Nucleus
Nematodes (roundworms) = GI; Tissues Multicellular organisms w/ complex lifecycles
Helminths Cestodes (tapeworms) = GI; Tissue (cysts)
Trematodes (flukes) = Schistosome
Ticks Lice Arthropods attached extracorporally
Ectoparasites Bugs
Fleas
Invasion
Acute; Abortive Dz Bind to host cell surface proteins Inhibit host cell DNA, RNA, or prot. Synth.
Viruses Latent; Chronic Dz A Translocate into cytosol or nucleus ≠Cell membrane; Lyse cells
A Replicate via virus-specific or host enzymes Induce host immune response
Adhesins and pili allow attachment
Bacteria Endotoxins; Exotosxins
Cytosolic or Phagolysosomal reproduction
Inflammatory Responses
↑Vascular permeability, leukotaxis PMN's Pyogenic bacteria
Suppurative A Suppurative inflammation Gram(+) cocci
Gram(-) rods
L'cytes Viruses Spirochetes
Mononuclear Macs I.C. bacteria Helminths
I.C. parasites
Inclusion bodies (CMV) Viruses (CMV; HSV; HPV; Measles)
Cytoproliferative Polykaryons (measles) ΦInflammatory response
Blisters; Warts
Necrosis Uncontrolled viral infections (HBV)
Necrotizing ΦInfiltrates Bacterial exotoxins (C. perfringens)
Protazoa (E. histolytica)
Acute infections (Gonococcal salpingitis)
Chronic Chronic infections (Schisto)

Inflammation & Background

↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Inflammation & Background
Respiratory Infections

Rhinovirus (Cold)

Influenza Viruses

Haemophilus influenza

Tuberculosis

Histoplasma

Coccidioides
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

Respiratory Infections
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
GI Infections
Viral Enteritis

Rotavirus

Norwalk Virus

Enteric Adenovirus

Bacterial Enteritis

Shigella

E. coli

E. coli

Campylobacter jejuni

Yersinia

Salmonella

Vibrio cholera

Parasitic Enteritis

Entamoeba histolytica

Giardia lamblia
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

GI Infections
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
STD's

HSV - I

HSV - II

Chlamydia trachomatis

Neisseria gonorrhea

Teponema pallidum

Trichomonas vaginalis
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

STD's
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Childhood & Adolescent Infections

Measles

Mumps

EBV

VZV

Poliovirus

Whooping Cough

Diphtheria
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

Childhood Infections
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Opportunistic Infections

CMV

Pseudomonas auruginosa

Legionella pneumophila

Listeria monocytogenes

Candida albicans

Cryptococcus neoformans

Aspergillus fumigatus

Mucormycosis

Pneumocystis carinii

Cryptosporidium parvum

Cyclospora cayetanensis

Toxoplasma gondii
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

Opportunistic Infections
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Tropical Infections

Denguevirus

Rickettsiae

Chlamydia trachomatis

Mycobacterium leprae

Yersinia pestis

Borrelia bergdorferi

Babesi microti

Leishmania

Trypanosoma

T. rhodesiense

T. gambiense

T. cruzi

Trichinella spiralis

Hookworm

Teaenia solium

T. saginatum

Hydatid Dz

Wuchereria bancrofti

Onchocerca volvulus

Tropical Infections
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Tropical Infections
Schistosomas

S. mansoni

S. japonicum

S. haemotobium

Plasmodium Species

P. falciparum

P. vivax

P. malariae

P. ovale
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

Tropical Infections
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx
Gram(+) Bacteria
Cocci

Staph aureus

Strep pneumoniae

Strep pyogenes

Strep agalactiae

Strep viridans

Strep mutans

Enterococcus faecalis

Rods

Clostridium perfringens

Clostridium tetani

Clostridium botulinum

Clostridium defficile
↑↓ Sx's & SIGNS CLINICAL FINDINGS LAB DIFFERENTIALS ETIOLOGY COMPLICATIONS / Tx

Gram (+) Bacteria

GRAM(+) & GRAM(-) CELLS WALL STRUCTURES ETIOLOGY

Potential pathogen

Pharynx

Vagina
++ 100%

Skin
+ Common
≈ Rare
BACTERIUM
Staphylococcus epidermidis ++ ++ ++
Staphylococcus aureus +  + + Leading cause of bacterial Dz in humans
Streptococcus mitis  + +
Streptococcus  viridans ++  Endocarditis (subacute)
Streptococcus mutans + Plaque formation; Caries; Dental Dz
Enterococcus faecalis ≈ + Antibiotic-resistant, nosocomial pathogen
Streptococcus pneumoniae + ≈ URT in 1/2 the population. 95% of all Bact. Pneum.
Streptococcus pyogenes ≈ + ≈ Refers to the Group A, Beta-hemolytic streptococi
Neisseria species ++  +
Neisseria meningitidis ++ + Gram(-) cocci; Bacterial meningitis; Host immunity
Veillonellae species
Enterobacteriaceae* (E. coli) ≈ + GI Infections; UTI's; Neonatal meningitis
Proteus species + + Neighbors = Klebsiella, Enterobacter and Citrobacter
Pseudomonas aeruginosa ≈ Nosocomials!!; Gram(-) Infections; #1 opport. p'gen
Haemophilus influenzae +  2nd invader to viral influenza; H Flu type B vaccine
Bacteroides species ≈ ~Initiate colitis and colon cancer
Bifidobacterium bifidum Prevents colonization by potential pathogens
Lactobacillus species + ++ Acid formation --> dental caries & vaginal ↓pH
Clostridium species Commonly in feces; Diarrhea / P. colitis (2' to Antibiotics)
Clostridium tetani 25% of population has in feces; Does not colonize GI
Corynebacteria ++ + + Acne; C. diphtheria; Consistent skin flora
Mycobacteria + ≈
Actinomycetes +
Spirochetes +
Mycoplasmas + +

GRAM(-) CELL WALL PATHOPHYSIOLOGY

Bacterium Bacterial ligand Host cell receptor Attachment site

Streptococcus pyogenes Protein F Amino terminus of fibronectin Pharyngeal epithelium
Streptococcus mutans Glycosyl transferas Salivary glycoprotein Pellicle of tooth
Streptococcus salivarius Lipoteichoic acid Unknown  Buccal epithelium of tongue
Streptococcus pneumoniae Cell-bound protein N-acetylhexosamine-galactoseMucosal epithelium
Staphylococcus aureus Cell-bound protein Amino terminus of fibronectin Mucosal epithelium
Neisseria gonorrhoeae N-methylphenyl- alaGlucosamine-galactose carbohUrethral/cervical epithelium
Enterotoxigenic E. coli Type-1 fimbriae Species-specific carbohydrate(Intestinal epithelium
Uropathogenic E. coli Type 1 fimbriae Complex carbohydrate Urethral epithelium
Uropathogenic E. coli P-pili (pap) Globobiose linked to ceramide Upper urinary tract
Bordetella pertussis Fimbriae Galactose on sulfated glycolip Respiratory epithelium
Vibrio cholerae N-methylphenylalaniFucose and mannose carbohy Intestinal epithelium
Treponema pallidum Peptide in outer Surface protein (fibronectin) Mucosal epithelium
Mycoplasma Membrane protein Sialic acid Respiratory epithelium 
Chlamydia Unknown Sialic acid Conjunctival or urethral epithelium

NOTES
Bacteria Found in Human Feces
Bacteroides > Lactobacilli > E. coli > Enterococci > C. perfringens
Fimbriae ("filamentous hemagglutinin")
Normal Flora