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Pathogenicity
Antigenic Variation
o N.gonorrhea pili
o Trypanosome brucie (African sleeping sickness)
o Enterobacteriaceae: capsular and flagellar antigen
o HIV : antigenic drift of gp120
IgA protease : SHiN
Strep pyogenes M protein = degrade C3b
Survive intracellular
o TB : sulfatides prevent fusion phago and lysosome
o Listeria: listerolysin O escape phagosome
Physical damage
o Entamoeba histolytica: ulceration intestine and liver
abscess
o Cysticerosis causes brain lesions seizure
Endotoxins
LPS = Gram negative (LIPID A toxic potion)
o
o
o
o
Exotoxins
Protein synthesis
o EF2 ADP ribosylation(stops translation): C.dipthernia,
Pseudomonas aueriginosa
o 28S of the 60S ribosome : Shigella, EHEC
Neurotoxin: by inhibit release NT
o C.tetani: prevent release glycine and GABA
o C.botulinum: prevent release Ach
Superantigen: staph aureus and strep pyogenes
CAP : cholera, anthrax, Ecoli ETEC, Pertusis
o CA: work via Gs
o P works via Gi
Cytolysins: ALPHA TOXIN
o Clostridium perfringens: lecithinase = GAS gangrene
o Straph aureus: cell membrane leaky
Bacteria
Structure
Cell wall protect from osmotic damage (peptidoglycan)
o Therefore penicillin will break this down
Capsule protects (only removed by OPSINIZATION)
o Bacillus anthracis made from polyglutamate can activate T
cell
Spores: bacillus and clostridium
o Diplicolinic acid, calcium dipicolinate , keratin
o Spores are made in the stationary phase when
birth=death
Growth on medias
Thioglycolate : anerobes cant breath air : clostridium,
bacterioides, actinomyces
Chocolate agar
o Neisseria ( Thayer-Martin, VNP : vancomycin, colistin,
nystatin)
Tetanus
Spores germinate in tissues
Treatment if symptomatic or no vaccine= Ig +
metronidazole(anaerobe) + diazepam for spasm
Tetanus prone
o If didnt get primary vaccination or unknown: vaccine + Ig
o If had vaccine : give vaccine if booster was 5 years ago
Perfringens
Stormy fermentation for milk + double zone hemolysis
Crepitus
ALPHA toxin/ phospholipase C = lecithinase
Identify on EGG YOLK agar
Hyperbaric chamber after debridement and clindamycin bc its
anerobic therefore die from high O2
Difficile
Autoclave things to kill spores
If rxn need
1. Stop antibiotic
2. Give metronidazole
3. Give vancomycin
4. Remove infected tissue
Listeria
PREGNANT AND HIV DONT EAT SOFT CHEESE OR DELI
Causes spontaneous abortion
Granulomatosis infantisepticum
Tumbling motility + facultative intracellular + cold grow
Corynebacterium diphtheria
Club shaped, chinese letter
Phage carried toxin ( EF2 ADP ribosylation= stop elongation
translation)
Myocarditis , ECG change, hoarsness of voice (recurrent
laryngeal)
Tinsdale/ tellurite agar
Elek test= toxin
Loeffler serum
Nocardia
1. Asteroides: causes pulomary like TB mimicks it
2. Brasiliensis = cutaneous only
Mycobacteria TB
Produces B3= niacin
Pathogenesis
o Sulfatides: prevent fusion phago and lysosome
o Cord factor= serpentile growth , inhibit WBC migration
Correlates with virulence
Gram Negative
Facultative intracell
Legionella
Francisella - granulomatous
Brucella- granulomatous
Rifampin prophylactic exposure
N.meningitisis
Hemophilus
Oxidase positive (all enterobacteriacea negative for oxidase)
Neisseria
Pseudomonas
Helicobacter
Campylobacter
Urease + PUNCH
-proteus
-urea plasma
- nocardia
-cryptococcus
-h.pylori
Spontaneous peritonitis : CHEMOTHERAPY PATIENTS ( the
epithelium damaged) enter in cause peritonitis ( also
nephrotic)
-Bacteriodes fragillis
-E.coli
Bacteria
Neisseria meningitides
Usually associated with DIC bc only gram negative to RELEASE
LPS since it over produces it
Vaccine only (YWCA) NOT B which is 50% of meningitis in US bc
capsule nonimunogenic
Gonorrhea
Gram negative diplococci INTRACELLULAR
SEPTIC arthritis in sexually active young KNEE
Causes ophthalmia like chlamydia
o Chlamydia also has PNEUMONIA
Pseudomonas aeruginosa
In respirators, in flowers and water, and raw vegetables therefore
not allowed in burn units
LIVER PRIMARY TARGET ( Diptheria was <3 and nerves with same
toxin)
Capsule
Colonize eschar in burn victim
Neutropenia, burn patient, and CGD
Legionella
Pool boy, air conditioner, fountains
Pathy infiltrate = atypical pneumonia
Diagnose: DFA ( direct fluorescent antibody)
Silver stain, and CYE/BCYE ( buffer charcoal yeast extract=
cysteine and iron))
Francisella tularensis
Tick bite or traumatic= ulceroglandular = ulcer and regional
lymph
Pneumonia if inhaled
Serology diagnose ( NEVER CULTURE, ALSO BRUCELLA AND
YERSINIA)
Brucella
Unpasteurized dairy (GOATS MILK)
SWEATING AND HEPATOMEGALLY ( leptospira other
hepatomegaly)
Chronic: DEPRESSION + sweating
Bordetella pertussis
Unvaccinated (immigrant, Jehovahs, religious)
Have filamentous hemagglutinin
Camp by inhibit Gi
Also tracheal cytotoxin: interfere with cilia ( therefore need to
cough hard to get it up)
o Whooping cough= paroxysmal cough ending with
gasp(whoop)
o Repetitive cough with GASP at end, and may vomit
Causes hypoglycemia
Campylobacter jejuni
Curved, microaerophile, oxidase + (like Helicobacter)
Grows at 42 degrees
Polar flagella (gulls wings)
Guillain barre( O:19 serotype) and Reiter
Vibrio cholera = a lot of fluid loss
Ringers lactate give them = replenish the K+ and HCO3 Vibrio vulnificus : from swimming salty water ( oysters etc)
o Get cellulitis and gastroenteritis(if ingested)
Enterbobacteriaceae
1.
2.
3.
4.
-H= flagella
-K= capsule
-K1: E.coli
-Vi: Salmonella typhi
Lactose: CEEK
Motile and H2S: Salmonella, Proteus
Nonmotile and no H2S: Shigella and Yersinia
E.coli
1. Typhi
= TYPHOID FEVER
* never cause of gastroenteritis or osteomyelitis
only btw humans
Lives in macrophages bc prevent fusion phago and
lysosome like TB
Concentrated in gall bladder where bile
concentrated ( therefore resistant to bile)
Week 1 in blood, rose coloured spots
Week 3 in stool
CONSTIPATION more common than diahrea
2. Others: typhimurium, enteritidis
Widal test: antibodies to antigen O,H, Vi
Chickens and reptile pets
Osteomyelitis in sickle cell ( kid played with turtle)
Haemophilus influenza
Type b capsule ( polyribitol phosphate )
3 month- 2 years not vaccinated
o meningitis
o epiglottitis (thumb print on lateral Xray)
o pneumonia
* still cause otitis media + sinusitis by nontypable (but strep penumo
#1)
HACEK endocarditis subacute
- Haemophilus aphrophilus
- Actinobacillus actinomycetemcomitans
- Cardiobacterium homonis
- Eikenella corrodens : HUMAN BITES
- Kingella kingae: HUMAN BITES
Treponema Pallidum
Primary
Painless chancre (open sore)
Secondar
y
Tertiary
Gummas(granulomas)
Aortitis
CNS
Tabes dorsalis
Argyll Roberston pupil
Dark field
Fluorescent
microscopy
1) Serology : VDRL
sensitive (Ab to
cardiolipin)
2)Specific: FTA-ABS
Only FTA-ABS
Congenit
al
Rickettsia
Obligate
No ATP
Normal
Mycoplasma
No
Normal ATP
No peptidoglycan has
cholesterol instead
Chlamydia penumoniae:
ATHEROSCLEROSIS
Atypical pneumonia #2 ( after mycoplasma)
Intracytoplasmic inclusions
Diseases
Chlamydia trachomatis
o Causes conjunctivitis and atypical pneumonia in neonate
o Staccato cough : inspiration btw each cough
o Need erythromycin drops after birth into eye (N.gonorrhea
also causes conjunctivitis but NO PNEUMONIA
Listeria can cause SPONTANEOUS abortions, or infant
granulomas all over
Lymphogranuloma venereum : chlamydia L1-L3
o PAINLESS, lymph nodes large painful buboes
o Genital elephantiasis
o Enlarged abscess lymph node = Buboes
Chancroid: painful nonindurated
Syphilis primary :PAINLESS chancre heals spontaneously
o No buboes
Virus