Streptococcus Pyogenes 

Beta Lactams or Macrolides

IA?

Gram positive

Chains of cocci

Lancefield Group A

Catalase negative

Name? Tx?

Capsule

M proteins

Hyaluronic Acid

Streptolysin S

Streptolysin O

Streptokinase

Streptodornases

Name?

Erysipelas

Impetigo

Streptococcal Toxin Shock Syndrome

Myonecrosis/ Necrotizing Fasciitis/ Gangrene

Name?

Tender, red, swollen lesions

Most unilateral some bilateral

Fever, chills, pain, leukocytosis

May follow respiratory/ skin infections

Name? CD? Tx?

Respiratory droplet

Direct contact

Endogenous spread

Clinical presentation

Anti-streptolysin O

Rapid Strep Test

Name? CD with swollen lesions?

Capsule, M proteins, Streptolysin O and S

Lancefield Group A

Pre-existing underlying diseases (diabetics, cancer, alcoholism, etc.)

Name? Dx?

Pseudomonas aeruginosa 

Natural fluorescence (UV)

Lactose non-fermentor

IA?

Gram negative

Rod

Oxidase positive

Strict aerobe

Name? Dx?

Folliculitis 

Capsule, Biofilm, Efflux pumps

Pyocyanin, Pyochelin

Exotoxin A

Name? Symptoms? Other name for it?

Inflammation of hair follicle in normally healthy people

Combo antibiotics

"Vinegar Wash" on affected area

Name? Nickname for infection?

Streptococcus pyogenes 

Contagious superficial pyoderma

Vesicles --> Pustules --> Rupture and Crusting

CD? Contagious? Tx?

Impetigo

HIGHLY contagious

Beta lactams or Microlides

Name? Symptoms?

Erysipelas

Impetigo

Toxic Shock Syndrome

Gram positive, Chained cocci,

Lancefield Group A, Catalse positive

Name? Transmission?

Exogenous infection

Soft tissue inflammation 

Bacteremia --> Septicemia

Pain, fever, chills, malaise, nausea, vomiting, diarrhea 

Shock leads to organ failure

Necrosis with HIGH mortality

Name? CD?

Streptococcus pyogenes 

Streptococcal Toxin Shock Syndrome

Symtoms? Shock? Death?

Keratitis/Keratoconjunctivitis --> Endophthalmitis

Folliculitis

Nail Infections

Otitis externa

Wound & Burn Infections
Ecythema gangrenosa

Osteomyelitis

Name? Treatment?

Nail turns green with secretions

Inflammatory response triggered --> nail crumbles

Gree colored pus

Gram negative, rod, oxidase positive

Name? CD?

Wound and Burn Infections

Combo antibotics

Hyperimmune globulin

Name? Symptoms? At Risk?

Pseudomonas aeruginosa 

Destroyed blood vessels limits phagocyte access

Staphylococcus aureus 

Mannitol positive fermentor

Catalase positive

Coagulase positive

Beta-hemolytic

CDs caused? 

Styes/ Chalazion

Folliculitis

Impetigo

Furuncles/Carbuncles

Scalded Skin Syndrome (Ritter's Disease)

Staphylococcal Toxic Shock Syndrome

Osteomyelitis

Name? Dx?

Furuncles/ Carbuncles

Associated with spider bites

Name? Symptoms? VFs involved?

Walled off  "marble-like" HARD abscesses

Chills and fever indicate systemic disease

 Name? Associated with? What are they and do they coalesce?

Staphylococcus aureus 

Spider bites

Furuncles/boils coalesce to form Carbuncles

What are furuncles? Systemic disease indicated by?

Mannitol positive fermentor

Catalase positive

Coagulase positive

Beta-hemolytic 

Wound cleansing, draining

Mupirocin (Bactraoban)

Name? Mid grade CDs?

Impetigo

Polymicrobial infection

Lacks fever or sepsis

Names of two causative agents?

Bartonella henselae 

IA?

Facultative intracellular

Gram negative 

Rod

Name?

Bartonella henselae 

Bite scratch, lick from infected animal

Disease why? Which animal? CDs?

Diseases are a consequence of intracellular growth

Cats

Cat-Scratch Disease

Bacillary Angiomatosis

Name? Transmission?

5-10 days after bite or scratch pustules at site which persist for weeks

Regional lymphadenopathy

Name? CD? Tx?

Bartonella henselae 

Cat-Scratch Disease

Needle aspiration; no antibiotics

Symtoms? 

Bartonella henselae 

Bacillary Angiomatosis

Silver stain, biopsy 

Symptoms? Blood supply? Risk? 

Proliferative, neo-vascular, cutaneous and visceral lesions

Triggers it's own angiogenic factor

HIV/Transplants/Chemo/ Leukemia

Name? CD? Dx?

Bartonella henselae 

Facultative intracellular

Gram negative rod

CD? Dx? Tx?

Cat-Scratch Disease

Bacillary Angiomatosis

Silver stain, biopsy

Needle aspiration for CSD

PROLONGED Macrolides for BA 

Name? IA?

Nocordia brasiliensis 

IA?

Gram positive branching rods

Weakly acid fast

Member of Actinomycetes

Name?

Gram positive rods

Weakly acid fast

Cell wall contains trehalose dimycolate

Found in environment/soil

Name? CD?

Pustules, fever, and tender lymphadenitis

Macrocolonies of sulfer granules under microscope

Name? CD? Tx?

Immunocompromised

Aspirates show branching gram positive rods which are partially acid fast

Macrocolonies (sulfer granules) in exudate

Culture shows waxy, chalky colonies in 3-5 days

Name? CD? Transmission?

Cell wall contains trehalose dymycolate

Microscopy shows macrocolonies

Found in soil

Name? CD? Tx?

Streptobacillus moniliformis 

IA?

Gram negative

Pleomorphic rod

Forms filaments which appear as tangles

Name?

Gram negative pleomorphic rod 

Found in the nose/throat of rodents

Transmitted from bites or scratches

Name? CD? Tx?

Streptobacillus moniliformis 

Rat Bite Fever

Penicillin

IA? Reservoir? Transmission?

Relapsing fever

IP:1-22 days after intitial wound

Chills, headache, migratory arthralgias and myalgias

Nonpuritic rash over palms, soles, extremities

Asymmetrical polyarthritis (knees)

Name? CD? Dx? 

Streptobacillus moniliformis 

Rat Bite Fever

Positive exposure Hx

Pleomorphic rods in microscopy

Symptoms? 

Streptobacillus moniliformis 

CD? Same name as CD caused by _______?

Rat bite fever

Spirillum minus

What other agent causes Rat bite fever?

Streptobacillus moniliformis 

Gram negative

Pleomorphic rod

Forms filaments

CD? Fever? Cell wall?

Rate Bite Fever

RELAPSING FEVER

Cell wall less form can spontaneously occur during infection

Name? IA?

Streptobacillus moniliformis 

Rat Bite Fever

Transmission? Complications?

Bite or scratch from rodent or other animal

Untreated causes endocarditis myocarditis and degenerative disease of kidneys and liver

Name? CD?

Eikenella corrodens 

IA? Transmission?

Gram negative

Anaerobic rod

Human bites; polymicrobial wound infections, opportunisit in immunocompromised

Human bites; polymicrobial wound infections, opportunisit in immunocompromised

Pustules

Pain at site, stifness with inflammation

IP is a week

Foul smelling discharge from pustules

Name? Reservoir? Tx?

Eikenella corrodens 

Normal flora in mouth

Penicillins, Cephalosporins or Tetracyclines

Transmission? CD? Symptoms?

Could cause osteomyelitis

Dx is X-rays showing swelling and air pockets

Small, graying colonies that ERODE medium (turn green)

Smells like bleach  (hypochlorite)

Name? CD?

Occurs in "Clenched fist" injuries, cancer patients, diabetics, nail biters, and IDUs

Name? IA?  CD?

 Eikenella corrodens 

Gram negative

Anaerobic rod

Pustules

Risk?

Candida albicans 

Budding yeast and pseudohyphae on microscopy

SDA

Skin CD? Variations?

Candidiasis

Mucous membrane or oral --> Thrush

Skin --> Diaper rash, folliculitis

Between fingers

Under nails

Name? Dx?

Local inflammatory disease; most damage is bystander

Diabetics or those with weakened immune systems

Yeast producing pseudohyphae

Name? CD? Can it become systemic?

Systemic becomes septicemia, endocarditis, and meningitis

Amphotericin B for systemic disease

Name? CD?

Actinomyces israeli 

IA? Similar Dx as ____? 

Gram positive

Filamentous

Anaerobic

NON ACID FAST

Nocordia brasillensis

Name?

Abscess-fibroses --> woody feel, uneven, lumpy

Sinus tract formation (maybe granulomas too)

Hematogenous spread

Name? CD? Tx?

Actinomyces israeli 

Cutaneous Actinomycosis

Penicillin G for weeks to months!

Symptoms?

Actinomyces israeli 

Normal flora

Filamentous gram positive rod

Anaerobic

Non acid fast

Risk? Dx? Similar to?

Trauma, dental work, surgery

Branching gram positive NOT ACID FAST on micro

Presence of sulfer granules in pus

"Molar tooth" shaped colony

Nocordia brasilliensis

Name? Reservoir? IA?

Pasteurella multocida 

Capsule, Fimbrae/pili

Leukotoxin, ToxA protein

IA? Reservoir?

Gram negative rod

Bipolar staining

Zoonotic, oral cavity of healthy animals

Name? Structural Features? VFs?

Pasteurella multocida 

Leukotoxin 

ToxA protein

CD? Dx?

Soft Abscess

BAP (will not grow on Mac)

Bipolar staining - looks like "safety pins"

Name? VFs?

Bite, scratch or lick of an open wound by an animal

Acute inflammatory response 

Swelling and tenderness after 24 hours

Regional lymphadenopathy

May become systemic

Name? CD? Tx?

Pasteurella multocida 

Soft Abscess

Amoxicillin-clavulantate; resistant to Macrolides

Transmission?

Symptoms?

Systemic?

Capsule

Structural features? Dx? Tx?

Scalded Skin Syndrome

Exfoliative toxins found on lysogenized phage

Serine proteases

Name? Other name for CD

Exfoliative toxins - Serine proteases

Desquamation of epithelium

Returns to normal in 7-10 days

No scarring

Name? CD? 

Staphylococcal Toxic Shock Syndrome

Infection through vaginal or wound

Quorum sensing induces toxin production

SuperAg toxins released into bloodstream 

Name? VFs? Endogenous or Exogenous?

 Staphylococcus aureus 

Toxic Shock Toxins (TSST): Superantigens

Endogenous

CD? How does it happen? Toxin release?

Fever

Capillary leak syndrome with hypotension

Diffuse macular red rash

PAIN RARE

Name? CD? Desquamation?

Streptococcus pyogenes 

Patients with current bad disease

Similar presentation to a CD of S. aureus

CD? 

Streptococcal Toxic Shock Syndrome (M Type 1 and 3)

Name? Risk? Similar to?

Exogenous infection

Bacteremia --> Septicemia

Pain, fever, chills, malaise, GI issues

SHOCK --> organ failure

PAINFUL

Name? CD? 

Staphylococcal TSS

Origin?

Pain?

Rash?

Bacteremia?

Necrosis?

Mortality?

Endogenous

RARE pain

Rash COMMON

LOW frequency of bacteremia

RARE tissue necrosis

LOW mortality

Name?

Exogenous

COMMON pain

LESS common rash

HIGH frequency of bacteremia

COMMON necrosis

HIGH mortality

Name?

Streptococcal TSS

Origin?

Pain?

Rash?

Bacteremia?

Necrosis?

Mortality?

Clostridium perfringens 

Alpha toxin - Lecithinase

Fermentative toxins

CD? IA?

Myonecrosis = Gas Gangrene

Gram positive

Spore former

Anaerobic rod

Name? VFs?

Transmission?

Symptoms? Sounds?

Spores introduced into wounds

Begins as cellulitis - mottled (splotchy red/purple)

Gas from microbial fermentation of skin and tissue

Crackling or Popping sound

Name? CD? Reservoir?

Clostridium perfringens 

Gram positive

Spore former

Anaerobic Rod

Dx? Tx?

Clinical presentation

Alpha AND Beta hemolysis

Egg yolk agar (Nagler Rxn) for toxin

Empirical treatment

Surgical debridement

High dose penicillin

Hyperbaric oxygen

Name? IA?

Egg yolk agar

Alpha and Beta hemolysis

Alpha toxin (Lecithinase)

Fermentative toxins

Name? CD? Risk?

Clostridium perfringens 

Myonecrosis = Gas Gangrene

Trauma, Diabetics, poor peripheral circulation

Dx? VFs?

Streptococcus pyogenes 

Myonecrosis/ Necrotizing Fasciitis/ Gangrene

Active VFs? What's different from Clostridium?

Streptolysin S and Streptolysin O

Streptokinase Streptodornases (DNase)

Fluid filled bullae; NO gas filled lesions

Name? CD?

Deep tissue infection - damage to fat and muscle

Initial cellulitis followed by gangrene and systemic problems --> organ failure

Fluid filled bullae; NO gas filled lesions

Name? CD? Tx? Dx? Is Dx culture?

Streptococcus pyogenes 

Myonecrosis/ Necrotizing Fasciitis/ Gangrene

Surgical debridement and Penicillin G

Normal culture and biotyping

BUT culture often NEGATIVE so test for Abs

Symptoms? Anything unique?

Vibrio vulnificus 

IA? VFs?

Motile

Gram negative curved rod

Capsule

RTX toxin

Cytolysin and other extracellular enzymes

Name?

Necrotizing Fasciitis

Motile, gram negative curved rod

Culture and biotyping

Name? Reservoir? Transmission

Infected skin lesions within 24-48 hours after exposure

erythema, edema, bullous lesions, ulcers --> tissue destruction and sepsis

Sepsis has fever, chills, dec. BP (septic shock) and blistering skin lesions

50% are fatal

Name? CD?

RTX toxin forms holes in plasma membranes

Contaminated oysters

Necrotizing Fasciitis

Name? Tx? Risk?