Gram
+
Rod aerobe Bacillus
cereus Toxogenic
food
poisoning exotoxin
(enterotoxin) that’s
hours
old lay
exotoxins
on
rice

Black
eschar
on
skin.

Inflamed
 Herbavores,
 infected
by
spores
on
 Vaccine
available,
but


Gram
+
Rod aerobe Bacillus
anthracis GI,
NVD,
and
bloody
diarrhea.

 Toxin:
edema
factor,
protec,ve
 but
humans
 animal
products.

 Pen
G only
used
in
people
at

Bacteremia
from
spores
in
lungs. an,gen,
lethal
factor are
infected
 Skin,
GI,
respiritory. high
risk.
too
anaerobe
or

Gram
+
Rod faculta,ve Ac,nomycetes Branching
gram
‐,
not
acid‐fast
Normal
oral
 Drain
abscess
on
neck
or

Gram
+
Rod anaerobe Ac,nomyces
israelii "lumpy
jaw"
‐
abscess
in
jaw flora Branching
gram
‐,
not
acid‐fast face.

May
contain
sulfur

granules
Nocardia
asteroides lung
and
brain
abscess
in
 Branching
gram
‐,
acid‐fast

Gram
+
Rod aerobe (Ac,nomycetes) immunocompromised. soil Normal
oral
flora (don't
take
gram
stain)
Diptheria
‐
pharyngeal
and
 culture
and
demonstra,on
of

Gram
+
 Corynebacterium
diphtheriae cutaneous.

Thick
grey
in
 Inhibits
protein
synth
by
 Human
 Respiritory
droplets
 toxin
produc,on.

Looks
like
 Horse
an,toxoin,
 DPT
pleomorphic
Rod membrane
pharynx
or
ulcera,ng
 inhibi,ng
elonga,on
factor
2 nasopharynx or
direct
contact palisades
or
V/L
shaped
 penicillin,
erithromycin
skin
lesions. colonies.
conjunc,vis
in
african
and
asian
 fingers,
towel,
make‐ beper
hygene

A,
B,
C:
Chlamydia
trachoma,s countries up… Tetracyclines especially
with
eyes.
STD,
ver,cal

transmission.

50%
co‐
Urethral
discharge,
vaginal
 infect
with
(aier)
 PCR
urine/cervicle
swabs,
 Azithromycin
(single

D‐K:
Chlamydia
trachoma,s bleeding,
PID
(infer,lity,
ectopic),
 gonorrhea. ,ssue
culture,
immunofluores
 dose),
Doxycycline
(1
 Condom,
limit

dysurea,
conjunc,vis More
women pa,ent
cells
(look
for
 week) number
of
sexual

LPS
(lipid
A) age
23 50‐70%
asymptoma,c inclusion). partners
Like
a
gram
‐,
but

stains
poorly Lesions
on
genitalia
and
in
lymph
 EB
(self
similar
receptors
for
 TOO
SMALL
TO
EASILY
SEE Azithromycin
(single

Intracellular L1‐L3:
Chlamydia
trachoma,s nodes. uptake),
then
RB
then
EB
form
 dose),
Doxycycline
(1

TOO
SMALL
TO
 life
cycle
inside
inclusion
 A
through
L week)
EASILY
SEE! (40+hrs) Detec,on
of
DNA
from

Chlamydia
pneumoniae Respiratory
illness:
pharngi,s,
 atherosclero,c
plauqes
and
 Tetracyclines,
Erithromycin
pneumonia increased
an,body
,ter.
inhala,on
of
arisoled

feces
or
infected

Chlamydia
pispaci Fever,
aches,
pneumonia.
(lungs,
 zoono,c:
birds ,ssue.

Not
human
to
 Increased
an,body
,ter Tetracyclines,
Erithromycin
liver,
spleen) human.

Community

aquired.

Glu
+,
Oxidase
+
Urethral/vaginal
discharge
and

dysurea. Gram
stain Ceiriaxone,
Cefixime,
or

Culture 
of
exudates
 Floroquinolone
(increasing

Urethri,s,
cervi,,s,
PID,
 (secretes) resis,nce
to
FQ)
opthalmia
neotorum,
 LP‐oligosaccarides Human
only Condom,

Gram
‐
coccus
 epidermi,,s,
disseminated
 Pili,
protein
II,
LOS,
IgA
 STD,
orogenital Culture 
on
Thayer‐Mar,n,
or
 Tetracycline
or
 erithromycin

(diploid) microaerophilic Neisseria
gonorrhea (dispersed)
infec,ons
(sep,c
 protease More
women Chocolate
agar. Erithromycin
for
50%
 ointment
for
newborn

arthri,s). age
23 25‐50%
asymptoma,c probable
Chlamydia
 conjunc,vis.
Penase
producing Looking
for
the
diploid
coccus
 infec,on.
Upper
tract
infec,on:
pain,
fever,
 and
PMN's
bleeding May
have
resistance
to

Tests
are
less
sensi,ve
for
 Pen
or
Tet.
Pharyngi,s women.

STD/congenital.

 Penicillin
G
(beszathine)
‐

Human
only Access
via
abraded
 no
resistance Condom,
test
for
ALL

Gram
‐
mobile
 skin
or
mucous
 STD's
togeather,
 Tuskagee

spirochete Treponema
pallidum
(Syphilis) can
follow
other
STD's
in More
men membrane>
 Cannot
be
cultured
invitro Tet,
Erithro,
 prompt
treatment
 project
age
35 blood/lymph>
 Chloroamphenicol
in
pen
 and
repor,ng.
endothelium/skin/live allergic
pa,ents.
r/CNS

1
Painless
ulcer
at
incursion
site.

 Dark
field
microscopy,

Stage
I In
lymph
‐
lymphadenopathy.

 immunofluroescent,

Heal
in
3‐6wk
w/o
treatment.

Possible
gland
sores. serological
tests
Fever,
headache,
rash,
anorexia.

2
HIGHLY
infec,ous Serological
tes,ng
Stage
II Rash
‐
PALMS
and
SOLES reslovels
 (Non‐treponemal)
(2
‐
12
weeks
aier
Stage
I) Mucous
membrain
leasions
‐
oral,
genitalial spontaneously. (treponemal)
Alopecia
(hair
loss)

Laten Latent
stage
No
symptoms,
but
s,ll
serologically
+++
If
latent
for
<1year
‐
infec,ous
and
stage
II
symptoms
If
latent
for
>1year
‐
rarely
transmiped
and
asymptoma,c Serological
tes,ng
t (Non‐treponemal)
(treponemal)

3
Stage
III Gummatous
(rubbery)
lesions
(5‐50
years
aier
Stage
I) Cardiovascular
‐
aor,c
aneurism
neurosyphilis
‐
paralysis,
blindness,
insanity

Birt
In
utero
‐
death,
organ
deformi,es,
latent
infec,on
Congenital Asymptoma,c
birth
‐
later
rhini,s
or
popular
rash
Untreated
‐
bone
destruc,on,
Hutchenson's
teeth,
cardio
syphilis

Non‐Treponemal
serological
Easy
and
cheap
Non‐specific
an,body
test
for
cardiolipid
(beef
heart)
(IgG,
IgM)
Can
have
a
false
+,
but
negi,ve
in
early
cases
and
aier
treatment
Can
be
used
to
monitor
infec,on
or
detect
reinfec,on
You
look
for
a
clear
blothc
on
the
"PRP"
test
plate

An,body
specific
to
Treponemal
pallidum
Treponemal
serological Used
to
confirm
posi,ve
non‐Treponemal
tests
Cannot
be
used
to
track
response
to
treatment
or
reinfec,on

Urbun
(epidemic)
‐
 Stay
away
from
sick
or

BLACK
DEATH!
(bubonic
plague)

 Rodent
to
flea
to
 dead
animals
Swolen
lymph
(BuBo) human
and
other

Rodent
blood,
 anumals. Survey
rodents
and

Gram
‐
(but
stains
 Yersinia
pes,s Endotoxin
related
hypotension,
 LPS
(lipid
A) fleas,
other
 Sylva,c
(endmic)
‐
 Gram
stain
culture
of
blood,
 Strep
and
Tet fleas
both)
Rod fever,
DIC animals maintained
in
 lymph,
sputum
animals. Short
lived
killed

Pnumonic
plague vaccine
for
high
risk

By
air
between
 people.
humans
if
pnumonic.


Stage
I
‐
rash
aier
1
wk Doxycycline,
amoxicillin
 Prompt
removal
of


Spirochete,
no
 Stage
II
‐
move
to
cardio/neuro ASYMPTOMATI Serological
(not
good),
usually
 for
Stage
I ,cks
(within
24‐48hrs)
gram
stain Vrellia
burgdorferii
(Lime
disease) Stage
III
‐
arthri,s
of
large
joints,
 C
rodents
and
 xodes
,cks
(nymph) clinical
signs
and
history.
cardio
and
neuro animals Penicillin
or
Ceiriaxone
 was
vaccine,
but

for
later
stages business
bust

headache,
rash,
fever Human
resivior
 Human
body
louse,


Ricketsia
prowazekii
(typhus) (NOT
ZOO
 arthropods
(ver,cal
 Clinical
Brill‐Zinsser
disease:
reccuent
 ANIMALS) transmission
between

typhus
aier
50
years replicate
and
spread
in
 insects)
endothelium.

Can
spread
to

anything:
skin,
brain,
heart…
Rockey
mountain
spoped
fever Vasculi,s
is
its
hallmark Dog
,ck,
arthropods

Tiny
gram
‐
 Ricketsia
rickepsiae
(Spoped
fever) (ver,cal
transmission
 Clinical
suspi,on!!

80%
aier
 Vaccine
only
for
high

poorly
stained
 oblegate
 Vasculi,s>
hypotension>
organ
 between
insects) ,ck
bite Doxycycline,
 risk.

Reduce

rod intracellular damage>
DEATH Chloramphenicol exposure
to

arthropods.

Fever,
cough,
malaise,
NO
RASH Sheep,
caple,
 Aerosol Serological
‐
4X
,ter
increase


Coxiella
burne,i
(Q‐fever) goats,
 ONE
organism
can
 over
two
weeks
(hepa,,s,
pnumonia,
 everything… infect
endocardi,s) Weil‐Felix
test

Mainly
host
response
since

there
is
no
endo/exotoxin
Cord
factor
‐
glycolipid
that
 ALWAYS
use
MULTIPLE
(3‐
confers
growth
in
parallel
 PDD
skin
test
(hard
to
read,
 4)
drugs
due
to
 Treat
latent

Mycolic
acid
and
 colonies BCG
vaccine,
anergy:
shows
 SPONTANEOUS
resistance .

 infec,ons,
treat
PPD

wax
in
cell
wall delayed
hypersensi,vity
 Takes
6‐9
months. converts,
children

Mainly
lung
disease,
but
can
 alvioli
macrophages
ingest>
TB
 reac,on)
‐
10mm
or
greater
is
 exposures,
and
PPD+

Acid
fast
slim
rod Intracellular Mycobacteria
tuberculosis establish
in
miningies,
kidnies,
 mul,ply>
lymph>
CD4+
 Humans aerosol,
slow
20
hr
 a
pisi,ve. Rifampin,
 immunosuppressant
Lipid
rich
cell
wall bone,
throughout
body. immune
response.

T's
release
 mul,ply streptomycin…Kanamycin

gamma,
more
macrophage,
 X‐ray,
acid
fast
stain
culture. (2nd
line) apenuated
bovis

not
easy
to
see,
 cell
mediated
keeps
infec,on
 strain
for
vaccine

small
and
sparse sequestered
(latent) Egg
agar
3‐4
weeks. Xtreme
Mul,ple
Drug
 (BCG)
‐
 LIVE
vaccine!
Resistant
(XMDR)
strains.
Enters
blood
and
forms
loci
all

over
body.

Delayed

hypersensi,vity
causes

granulomas.

May
poten,ally
reac,vate

from
latent
infec,on
from

decreased
systemic
immunity.

cause
disease
in
 Mycobacterium
avium‐ environmental
 NOT
spread
human
to


Intracellular Mycobacterium
Other
Than
TB
 inmmunocompromised
pa,ents.

 intracellulare
(MAI
or
MAC)
‐
 water
bacteria.

 human.

Environment
 Normally
use
3‐4
drugs,

(MOTT) Defining
disease
in
AIDS. cause
pulmonary
disease
that
 Human
only. to
human
only. use
5‐6
in
this
case.
looks
JUST
like
TB.

Acid
fast
stain
of
skin
or
nasal

Acid
fast
slim
rod Hypopigmented
skin
lesion
and
 secre,ons,
PDD
skin
test

Lipid
rich
cell
wall Mycobacterium
Leprae
‐
 thick
superficial
nerves
with
 (delayed
hyper
sensi,vity).
Tuburculoid
Leprosy some
numbness.
not
easy
to
see,
 Good
cell
mediated
immune
 Mul,drug
small
and
sparse replicates
intracellularly
skin
 Person
to
person
by
 response Rifampin/Clofazimine
histocytes,
endothelial,
schwan
 Mouse
and
 nasal
secri,ons.


Intracellular cells. Armadillo
foot
 Requires
prolonged
 Treat
for
2
years
and

pads exposure.

5‐10yr
 Acid
fast
stain
of
skin
or
nasal
 some,mes
life
long.


Slow
12
day
cycle.

30deg
C incuba,on. secre,ons,
PDD
skin
test
 However
pa,ents
are
non

Mul,ple
nodular
skin
lesions,
 (delayed
hyper
sensi,vity). infec,ous.
Mycobacterium
Leprae
‐
 peripheral
nerves
numbness
 Lepromin
skin
test
negi,ve
Leproma,ous
Leprosy leading
to
repeated
trauma
and

loss
of
digits. Bad
cell
mediated
immune

response

pneumonia,
upper
respiritory
 in
 Doxycycline,
Macrolide,


Mycoplasma
pneumoniae children/young . FQ

pneumonia nosocomial,
age,

Gram
+
 Biggest
cause
of
pneumonia
at
 alcohol,
flu,
drugs,
 beta‐lactam,
Doxycycline,

diplococcus aerobic Streptococcus
pneumoniae 20‐60%
of
cases encapsulated HIV,
airway
 FQ,
community
aquired,
lethal,
and
 obstruc,on
bactermic
aquired
Prosthe,c

Gram
+
coccus Staphlococcus
aureus pneumonia device
biofilm nosocomial
Prosthe,c

Gram
+
coccus Staphlococcus
epidermidis device
biofilm
Streptoccus
Enterococcus VRE
so
use


EMB:
gram
‐
rod
selec,on
kleb
lac
+
e.coli
lac
+
shigella
lac
‐
salmon
lavc
‐
candle
jar
homopholus
influensa
‐

chocolate
V/X
nisseria