Micro Review FA p'178181

1
Micro Review (FA p.178-181)

• Bugs to cover
• Anthrax
• Actinomyces vs. Nocardia
• Bugs that cause Food Poisoning
• Bugs that cause Diarrhea
• Watery vs. Bloody
• Enterobacteriacea
• Haemophilus influenza
• Legionella pneumophila
• Pseudomonas aeruginosa

2
Micro Review contd

• Helicobacter pylori
• Lactose-fermenting enteric bacteria
• Cholera and Pertussis toxins
• Zoonotic bacteria
• (B. burgdoferi, Brucella spp., Francisella
  tularensis, Yersinia pestis, Pasteurella
  multicoda)
• Garderella vaginalis
• Neisseria
• Mycobacteria
• Primary vs. Secondary TB
• Mycobacteria spp.
• Leprosy

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Anthrax

• Description
• Black skin lesions vesicular papules covered by
  BLACK ESCHAR (my AUNT with the nice Rack drives
  a BLACK CAR)
• Two Forms Contact vs. Inhalation
• Contact Painless Ulcers- bacteremia and death
• Inhalation Woolsorters Disease
  life-threatening pneumonia

4
Actinomyces vs. Nocardia

• Histology Gram Positive Rods- Long Branching
  filaments
• Actinomyces israeli (normal oral flora)
• Yellow sulfur granules-(sulfur boogers) in
  sinus tracts
• Oral/facial abscesses with Sulfur Granules that
  may drain through sinus tracts to skin
• Nocardia asteroides (causes nasty inf.)
• Pulmonary infection in immunocompromised
• Weakly acid-fast

5
Actinomyces vs Norcardia

• Long Branches tend to SNAP
• Sulfa for Norcadia
• Actinomyces use Penicillin

6
Bugs in my Food- SECCondS can Be Very dangerous

• Staph aureus Meats, mayo, custards starts and
  ends quickly
• E. coli 0157 H7 undercooked meat
• Clostridium perfringins- reheated meat dishes
  Id Prefer not eat that reheated leftover meat
  for dinner.
• C. botulinum improperly canned food (Cans that
  Bulge, recall Honey/Corn Syrup infect infants)
• Salmonella poultry, meat, and eggs

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Bugs in my Food SECCondS can Be Very dangerous

• Bacillus cereus Be Serious! Food poisoning
  from Reheated Fried Rice!
• Vibrio parahaemolyticus and V. vulnifus
  transmitted in contaminated seafood (think a
  PAIR of
• crab claws ?)

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Diarrhea and Typical Findings

• Campylobacter and Cholera Comma shaped (with
  Camp growth at 42 Celsius)
• E. coli (Cole likes alcohol) -- ferments lactose
• Yersinia enterocolitica Transmitted from pet
  feces ie. Puppies Your (yer) darn colis
  (enterocolitica) diarrhea gave me diarrhea!!!!)

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Diarrhea and Typical Findings

• Salmonella and Shigella dont ferment lactose
  (both salmon and sugar ray do not like alcohol),
  but both invade intestinal mucosa
• Salmonella are motile (salmon swim and can
  disseminate ? symptoms may be prolonged with
  antibiotic treatment) Salmonella has Animal
  Reservoir
• Shigella (think sugar ray is retired, so hes
  nonmotile now) transmission Food, Fingers,
  Feces, Flies
• Infectious Dose Virulence
• Shigella (10 1 org.) gt Salmonella (10 5 org.)

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Watery Diarrhea

• The VET PROfessor lectured on Watery Diarrhea
• Vibrio cholera and Viruses (Rota-kids,
  Calici/Norwalk/Astro-adults)
• Enterotoxigenic E. coli (travelers diarrhea)
• Protozoa (Cryptosporidium HIV/AIDS and Giardia)

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CASSEY has Bloody Diarrhea

• Campylobacter jejuni
• Amoebas (Entamoeba histolytica)
• Salmonella
• Shigella
• Enterohemorrhagic/Enterinvasive (0157H7) E. coli
• Yersinia enterocolitica

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Enterobacteriaceae

• Which bacteria are included in this group?
• Think...a PROfessional SEEKS KOFFEe
• PRO Proteus
• S Salmonella
• E E.coli
• E Enterobacter
• K Klebsiella
• S Serratia

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Enterobacteriaceae

• KOFFEe
• K capsular K antigen -- virulence of the bug
• O O Antigen polysaccharide of the endotoxin
• F Flageller (H) antigen found in motile
  species
• F Ferment Glucose all ferment glucose and are
  oxidase negative
• E -- Enterobacteriaceae

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HAEMOPhilus Influenza

• HAEMOPhilus causes
• A IgA protease Aerosal transmission
• E epiglottitis
• M meningitis (the One you Tri first with
  meningitis is Ceftriaxone)
• O otitis media
• P pneumonia

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HAEMOPhilus Influenza

• Invasive disease is caused by capsular type B (B
  is Bad, so we have a vaccine that contains Type B
  polysaccharides conjugated to Dip toxoidgiven
  between 2-18 months of age)
• Culture on Chocolate agar requires factors V
  (NAD) and X (hematin) for growthso
• When a child has the flu mom goes to FIVE (V)
  and Dime (X) store to buy some chocolate.
• Rifampin for prophylaxis in close contacts

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Legionella pneumophila

• Legionaires Disease
• Gram neg rod that stains poorly, so use SILVER
  stain
• Grow on charcoal yeast extract culture with iron
  and cysteine
• Aerosol transmission from environmental water
  habitat (air conditioning, water tower, produce
  mister at the grocery store)
• NO person-to-person transmission
• TX Erythromycin

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Legionella pneumophila

• French Legionnaire (soldier) with his Silver
  (silver stain) helmet, sitting around a campfire
  (charcoal) with his Iron (with culture) dagger
  with his friends (no person-to-person
  transmission) he is no Sissy (cysteine-with
  culture)

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Pseudomonas aeruginosa

• Pseudomonas causes wound and burn infections
• P Pneumonia (especially with CF)
• S Sepsis (black lesions on skin)
• E External Otitis (Swimmers ear)
• U UTI and hot tub folliculitis
• Non-lactose fermenting
• Endotoxin - fever and shock Exotoxin A
  inactivates EF-2
• TX Aminoglycoside and extended spectrum
  antibiotics (piperacillin, ticarcillin)

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Pseudomonas aeruginosa

• AERuginosa AERobic (think water connections and
  blue-green pigment)
• Think PseudoMOANas with burn victims
  pseudomonas cause burn victims to MOAN

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H. pylori

• Causes gastritis and up to 90 of duodenal ulcers
• Increased risk with PUD and Gastric Carcinoma
• Gram Neg Rod, Urease Positive (Breath test both
  H. pylori and Proteus are urease postive)
• Creates Alkaline environment
• TX Triple Therapy

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Lactose-fermenting enteric bacteria

• Lactose is KEE
• Bacteria grow Pink colonies on MacConkeys agar
• Examples of Lactose-Fermenting enteric bacteria
  include
• K Klebsiella
• E Enterobacter
• E E. coli and Citrobactor

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Cholera and Pertussis toxins

• Both toxins act via ADP ribosylation that
  activates adenyl cyclase resulting in increased
  cAMP (activating CFTR).
• Cholera turns the on on ? activates Gs, causing
  RICE-WATER diarrhea
• Pertussis turns the off off ? disables Gi,
  causing WHOOPING COUGH
• Pertussis also promotes lymphocytosis by
  inhibiting chemokine receptors

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Zoonotic bacteria --Species/Dz/Transmission and
Source

• Big Bugs From Your Pet
• B Borrelia burgdorferi Lyme Disease ? Tick
  bite, Ixodes Tick that live on deer and mice
• BU Brucella spp. Undulant Fever ? Undulants,
  Unpasteurized dairy products
• F Francisella tularensis Tularemia ? Tick
  bites, rabbits, deer
• Y Yersinia pestis Flea bites, rodents,
  prairie dogs ? Plague
• P Pasteurella multocida Cellulitis ? Animal
  bites, cats, dogs

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Gardnerella vaginalis

• Cinderallas not so cute cousin
• Gram Variable rod that causes Vaginosis
• Greenish (gardner) vaginal discharge with FISHY
  SMELLnon painful
• Associated with Mobiluncus, an anaerobe
• TX Metronidazole (get her on the Metro bus as
  fast as possible)
• Diagnostic clue Clue Cells ? vaginal epithelial
  cell covered with bacteria

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Gardnerella vaginalis

• GET a
  CLUE,
• 
  Gardnerella!! You Smell
• 
  Like FISH!

• Hurry up and get on the Metro Bus and get out of
  here!

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Neisseria Gonococci vs. Meningococci

• Gram Neg Cocci
• GoNO-COC-ci
• NO polysaccharide capsule
• NO maltose fermentation
• NO vaccine
• Causes (NO-COC Mainly female associated
  diseases) Gonorrhea, septic arthritis, neonatal
  conjunctivitis, pelvic inflammatory disease

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Neisseria Gonococci vs. Meningococci

• Meningococci
• Polysaccharide capsule
• Maltose fermentation
• Vaccine
• Causes meningococcemia and meningitis,
  Waterhouse-Friderichsen syndrome

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Primary and Secondary TB
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Mycobacterium

• Mycobacterium tuberculosis (TB-often resistant to
  multiple drugs
• M. kanasii (pulmonary like TB symptoms
• M. scrofulaceum (cervical lymphadenitis in kids)
• M. avum intracellulare (resistant to multiple
  drugs, Disseminated disease in AIDS
• ALL MYCOBACTERIUM ACID FAST ORGANISMS
• SX Fever, Night Sweats, weight loss, Hemoptysis

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? Horseshoe Nuclei Langhans Giant Cell

• M. Tuberculosis red color on ACID FAST stain

Large Caseous Lesions and Miliary lesions in the
surrounding hilar node
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Mycobacterium leprae

• Hansons Disease (Two Forms)
• Lepromatous
• Tuberculoid (failed cell-mediated immunity and
  self-limited)
• LEpromatous is LEthal
• Likes Cool Temps
• Infects Skin and superficial Nerves
• Reservoir in US Armadillos

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Leonine Facies -Loss of Eyebrows -Lumpy
Earlobe -Nasal Collapse
Treatment -Long-term oral Dapsone (Toxicity
hemolysis and methemoglobinemia) Alt. Treament -
Rifampin and combination of clofazimine and
daposone