Microbiology review 2

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

Clinical manifestations of sepsis

Drop in BP is a hallmark Fever and violent, shaking chillsAnxiety and altered mental state Rapid breathing Organs start to dysfunction Decreased urine output Cool, dusky colored extremities

Altered homeostasis of a microbiome leads to a __________ microbiome

Dysbiotic

Lateral periodontal abscess treatment

Drainage, irragation with antisceptic mouthwash(chlorhexidine) Rarely need antibiotics Assess toot(indications for extraction?)

T/F Fusobacterium necrophorum is part of the normal flora

False

T/F N. meningitidis contain LPS and have outer membrane proteins(OMP) similar to N. gonnorhoeae

False they contain LOS instead of LPS

T/F Pneumonia can be caused by bacterias only

False, Bacteria, viruses, and helminths

T/F Aggregatibacter actinomycetemcomitans may be present in oral flora of healthy patients at high levels

False, low levels

T/F gingivitis always leads to periodontal disease

False, not always

Clinical manifestations of Shigella dysenteriae

Fever Cramping Abdominal pain dysentery Nausea Vomiting Malaise Anorexia Tenesmus SHIGA TOXIN

Clinical manifestations of Shigella sonnei

Fever Malaise Anorexia Watery diarrhea(sometimes bloody with WBCs and RBCs) Tenesmus Cramping Abdominal pain

Clinical Manifestations of otitis media

Fever Pain(ear pulling) Irritability Poor sleeping

Clinical manifestations of infective endocarditis

Fever, tachycardia, extreme fatigue, breathing difficulty, murmur Most patients have obvious source of infection -Infected tooth, skin lesion, catheter, IV drug user Janeway's lesions(painless, hemorrhagic nodule on the palms and sole) Osler's nodes (small, tender nodes on the fingertips or toes) Clubbed fingers Subacute IE symptoms can take weeks to months to develop

Virulence factors of Gonococci

Fimbriae(type IV pili) LOS IgA prostease Rmp(reduction-modifiable protein): induces production of blocking antibodies

Impetigo(Pyoderma) Superficial bacteria cause infections that make the skin ______ or _______ _____________ and _____________(bacteria) Most common in __________(age group) Bacteria enter through ________ It is not serious but highly ______

Flake or peel off Staphylococcus aureus and Streptococcus pyogenes Pre-school-aged children Bacteria enter through a break in skin Contagious

Defenses of the urinary tract

Flushing action of urine Desquamation of epithelial cells lining the urinary tract Lysozyme and lactoferrin

Defenses of the eye Tear film -contain _____ and __________ Immune privilege -_________ doesn't readily occur

Lysozyme and lactoferrin

Nosocomial pneumonia Commonly associated with ___________ ventilation(e.g. ____________) Mortality rate 30-50% ______ ______- Gram negative, bacilli, oxidase + ______ ______ ______ ______-Gram negative, bacilli

Mechanical ventilation(e.g. tracheotomy) Psuedomonas aeruginosa Streptococcus pneumoniae Klebsiella pneumoniae

_______: infection of the meninges _______: infection of the brain

Meningitis Encephalitis

Treatment of bacterial vaginosis

Metronidazole(oral or vaginal gel) Clindamycin(oral or vaginal cream)

Causes of conjunctivitis Newborns -_______ ________ -_______ ________ Children and adults -_______ ________ -_______ ________

Newborns -Neisseria gonorrhoeae -Chlamydia trachomatis Children and adults -Staphylococcus aureus -Streptococcus pneumoniae

Does calculus cause periodontal disease or gingivitis?

No. The bacteria that live in and around it do

Gonococci pathogenesis Attached to ______ ______ cells and invades them The bacteria induce their own _____ and pass to the _______ ____ are recruited Gonnococci within neutrophils are released in ________ ________

Non-ciliated epithelial cells Engulfment Submucosa Neutrophils Purulent exudates

How many microbiota of the GI system are in the accessory organs

None

Sulcular and junctional epithelium mucosa lining is made up of stratified squamous _________ epithelium and lack ________ ridges

Nonkeratinized Rete ridges

Diagnosis of syphilis

Nontreponemal test; measures IgG and IgM antibodies(reagins) developed against lipids released from damaged cells -Venereal Disease Research Laboratory(VDRL) test and the rapid reagin (RPR) test Treponemal test: detects specific anti- T. Pallidum antibodies from the serum -FTA-ABS(fluorescent treponemal antibody-absorbtion) Direct visualization under dark-field microscopy -only effective during active stages of first and secondary syphilis

Clinical manifestations of Salmonella enterica

Nontyphoidal salmonella gastroenteritis -Symptoms develop 12 to 72 hours post exposure -nausea -vomiting -abdominal pain/Cramping -Diarrhea(may be bloody) -Fever(almost always) -Lasts 10 days -Short-term carriage following infection

Diagnosis of otitis media

Presence of effusion and bulging tympanic membrane with otoscope

Pre-disposing factors for sinusitis

Previous upper respiratory infection Deviated septum Enlarged lymph nodes Allergies Cystic fibrosis

Clinical Manifestations of Syphilis

Primary -painless chancre at site of inoculation filled with spirochetes -on tongue oral cavity and gingiva Secondary -untreated patients -bacteremia- 2-6 weeks after primary chancre has healed -multiple papules on trunk of patienr -Lymphadenopathy Latent -Asymptomatic -After 4 years considered non infectious Tertiary syphilis -Gummatous syphilis -Found on skin, liver, and bones - cardiovascular syphilis -destruction and necrosis of aorta Neurosyphilis syphilis -asymptomatic -pariesis -Meninghitis -Tabes doralis Congenital -After 4th month of gestation -Hutchinsons teeth(notched barrel shaped incisors)

Clinical manifestations of cholera

Profuse watery diarrhea-"rice-water stool" Vomiting Hypovolemia and hypotension Electrolyte imbalances

Transmission of leprosy

Prolonged, close contact with someone with untreated leprosy over several months Nasal secretions/droplets Incubation period is 2-7 years(average=5)

Prostatitis Inflammation of the _________ ________ prostatitis: bacteria are usually from GI tract; typically due to UTI -Reflux of infected ______ into the _______

Prostate gland Acute prostatitis Infected urine into the prostate

Clinical manifestations of ________ Fever, chills, malaise Pain in the pelvic area, lower back, or genital area Frequent urge to urinate Bloody or cloudy urine Painful urination and ejaculation

Prostatitis

Three main categories of vaginitis

Protozoan(trichomonas vaginalis) vaginitis Yeast(candida albicans) vaginitis Bacteria vaginosis(BV)

Treatment of otitis media

broad spectrum antibiotics Most common reason for prescribing antibiotics to a child Amoxicillin

Transmission of Treponema pallidum

sexual contact with an active syphilitic lesion Transplacental Less common: spread by non-genital contact or sharing of sharing of needles

Pathogenesis in upper respiratory tract

spread from another infection in upper respiratory system

Most common complication of whooping cough

Secondary bacterial pneumonia

Vibrio parahaemolyticus releases what enzyme

Secretes Beta-hemolysin

Most GI bacterial infections are _____

Self limiting

T/F late colonizers do not associate with early clononizers

True

Clinical Manifestations of bronchitis

Cough, low-grade fever, sputum production(often clear), wheezing

4 species of Shigella

1. S. dystenteriae- most virrulent, not in U.S. 2. S. flexneri- commonly isolated in U.S. 3. S. boydii- rarely isolated in U.S. 4. S. sonnei- least virulent, most common in U.S.

When are prophylactic antibiotics given?

3-7 days prior to procedure

How many antigenic types of botulinum exist and which are most common

7 antigenic types A,B, and E are most common

Otitis media is most common in (age group)

<3 YOA

Treatment of Clostridium tetani

Aggressive wound care Human tetanus immune globulin(HTIG) Metronidazole or penicillin G Drugs to control muscle spasms

Ludwigs angina treatment

Airway management -tracheostomy if needed Drainage Combinatorial antibiotic treatment(broad spectrum) -Penicillin G+ Metronidazole

Diagnosis of leprosy

Acid-fast stain Biopsies of skin lesion, nerve, nasal or ear specimens

__________ bacteria transport sugars and convert them to acid ________ bacteria survive and proliferate at low pH

Acidogenic Aciduric

Types of infective endocarditis

Acute and Subacute

Clinical manifestations of EnteroAggregative E. coli (EAEC)

Acute diarrhea in healthy patients Cause of persistent/chronic diarrhea in young children and AIDS patients(especially those that are malnourished) Persisten watery non-bloody diarrhea due to formation of thick mucus-bacteria biofilm Colonize in aggregates

Clinical manifestations of Rocky Mountain spotted fever

After 2- 14 of incubation, the patient experiences sudden onset of fever, chills, headache, myalgia, nausea, and vomiting Typical RMSF rash occurs 2-4 days after onset of symptoms, developing first on the wrists, forearms, ankles, then spreading over the body with petechial lesions short after Diagnostic feature of RMSF is the appearance of the rash on the palm and soles

There are two types of microbial succession

Allogenic:non-microbial factors alter community development Autogenic: microbial factors alter community development

Most cases of Rocky Mountain Spotted Fever are caused by

American dog tick

Fusobaterium necrophorum treatment

Ampicillin-sulbactam Piperacillin-tazobactam Ticarcillin-clavulanate

Treatment of pneumonia

Antibiotic choice determined by causative bacteria

Treatment of EHEC E coli

Antibiotics are controversial- they may shorten life of illness or may exacerbate it causing release of more LPS and SLT and may cause HUS Supportive care- rehydration For HUS include -Erythrocyte transfusion -Dialysis

Treatment of Gonococci

Antimicrobial resistance Dual treatment with I.M. Ceftriaxone and oral Azithromycin Can reinfect eye, even if successfully treated 0.5% erythromycin as ophthalmic ointment In 2006, CDC had 5 reccomended options for treating gonorrhea now there is only one

Pathogenesis of N meningitidis

Attaches to non-ciliated cells in nasopharynx and invade them The bacteria induce their own engulfment and pass to the submucosa Enter the bloodstream and/or cross the blood brain barrier and into the cerebrospinal fluid

Pathogenesis of EHEC E coli

Attachment via fibriae and injection of intimin receptor and exporting secretion proteins(Esps) Cytoskeleton modifications produce the attachment and effacing pedestals Shiga -like toxins produced

Treatment of whooping cough

Azithromycin, clarithromycin, and erythromycin - has little effect on course of disease during paroxysmal stage If patient is diagnosed late, antibiotic will not altar course of illness Patient is still contagious 5 days after start of antibiotics

Food intoxication most commonly associated with fried rice

Bacillus cereus

________ __________ (food intoxication bacteria) G+ spore forming rod, present in soil Spores germinate in food and bacteria secrete toxins depending on type of food Foods that are held at warming temperatures for a long time

Bacillus cerus

When bacteria is found in blood it is called

Bacteremia

Rare complications of clinical manifestations of Campylobacter

Bacteremia HUS Reactive arthritis Guillain-Barre Syndrome -40% of GBS cases are preceded by campylobacter infection -1/1000 cases of campylobacter infections lead to GBS

For Salmonella Typhi as the bacterial population increases, they can gain access to the bloodstream causing _______ The ______ endotoxin induces fever slowly increasing and persists Bacteria spread to the ___________ and the _____________ They renter the GI tract causing diarrhea

Bacteremia LPS Biliary tree Urinary tract

Pathogenesis of infective endocarditis

Bacteria enter the bloodstream directly(IV drug use,surgery,trauma) Pathogens adhere to cardiac enothelium, this in turn facilitates the deposition of platelets and fibrin at the site Circulating pathogens bind and form vegitations

Why won't you get O157:H7 E. coli from a steak cooked rare but you can from a hamburger

Bacteria gets on beef from rendering process and if it stays on the surface it will be easily killed but if it's mixed into a hamburger it needs to be completely cooked to be safe

Diagnosis of botulism

Based on clinical symptoms To confirm diagnosis: -test for presence of botulinum toxin in serum, stool, or food -Culture C. botulinum from stool, wound, or food

Diagnosis of Clostridium tetani

Based on clinical symptoms No laboratory tests

Clinical manifestation of Salmonella enterica typhi and complications

Begins with non-specific symptoms(low fever, headache, lethargy, malaise and constipation) Specific symptoms occur after the bacteria disseminate -High, spiking fever with low pulse, chills, flat or rose colored spot on abdomen and chest, abdominal tenderness, enlarged spleen & liver -Diarrhea occur when bacteria reinvade the GI tract Complications- intestinal perforation/bleeding, peritonitis, septic shock and meninghitis

Clinical manifestation of EnteroInvasive E. coli (EIEC)

Blood and puss in stool with fever Like Shigella, these bacteria can spread directly from cell-to-cell through actin polymerization Diarrhea results from cell death rather than any known toxin Does not produce shiga toxin

Diagnosis of infective endocarditis

Blood culture Echocardiogram

Diagnosis of sepsis

Blood cultures to detect pathogen Gram stain Antibiogram

Defenses of the nervous system

Bony casing of brain and spinal cord protect them from traumatic energy CSF serves as a cushion against impact Blood-brain barrier Microglial cells display phagocytic activity Brain macrophages

Pertussis(whooping cough) Etiology _______ ________(bacteria) G________ ______(oxygen usage) Strict _______ pathogen Fastidious

Bordetella pertussis G- coccobacillus Strict aerobe Strict human pathogen

Diagnosis of Actinomycosis

Gram stain and culture of pus or tissues in lesions -look for sulfur granules with Gram + filamentous bacteria

Treatment of botulism

Botulism antitoxin- arrests progression of paralysis Respiratory support Foodborne botulism: laxatives, enemas Wound botulism: Penicillin G after antitoxin has been administered

Treatment of Sinusitis

Broad spectrum anntibiotics Not treatment at all-50% self-resolve

Pathogenesis of Fusobacterium nucleatum

Butyric acid stimulates release of inflammatory cytokines from neutrophils Can invade oral epithelial cells, facilitating the entry of noninvasive bacteria by coaggregating with them -mediated by adhesin A(Fad A) Increases the invasive potential of P. Gingivalis

Fusobaterium necrophorum diagnosis

CT scan and blood culture

Plaque that becomes calcified is referred to as ___________

Calculus or tartar

Leading cause of bacterial-related diarrhea in the U.S.

Campylobacteriosis or campylobacter enteritis

For necrotizing ulcerative periodontitis ______ ______ can also be found in patients with HIV or AIDS

Candida albicans

Shiga toxins cause

Capillary thrombosis and inflammation of the colonic mucosa-> hemorrgagic colitis-> blood in diarhea Systemic effect-> hemolytic uremic syndrome(HUS) Toxins bind to renal tissue inducing glomerular swelling and deposition of fibrin and platelets Complement-mediated platelet, leukocyte and endothelial cell activation-> systemic hemolysis and thrombosis

Virulence factors of N meningitidis

Capsule Fimbriae(type IV pili): attachment to mucosal surfaces, resistance to neutrophil mediated killing LOS: IgA protease FHBP(factor H binding protein)

If microbes gain access to the _________ system they can go to every part of the body

Cardiovascular

Diagnosis of cystitis

Classic symptoms of cystitis: no testing is warranted to make the diagnosis Urinalysis: dipstick and/or microscopic examination Urine culture

When the microbiota reaches a point of stability it is known as the

Climax community

Pathogenesis of Fusobacterium necrophorum

Causes pharynghitis Can invade blood stream and cause serious infection Produces hemagglutinin(platelet agrregation)

Rare condition in which blood clots form within the cavernous sinus Bacteria from another facial region can spread to the cavernous sinus via facial vein

Cavernous sinus thrombosis

______________ Fever, headache, swelling of conjunctiva, muscle paralysis(eye or jaw) Fatal when a thrombus forms in the cavernous sinus

Cavernous sinus thrombosis

Treatment and prevention of salmonella enterica typhi

Ceftriaxone for severe disease Ciprofloxacin for uncomplicated enteric fever 2 vaccines -Live-attenuate oral vaccine- > 6 yoa, 4 doses -Vi Capsule vaccine- > 2 yoa, 1 dose

A. israelii is most commonly associated with __________ __________(disease) A. israelii is found in ______,_______, and _______ _______ It's colonies grow in ____________

Cervicofacial actinomycosis Human plaque, calculus, and tonsillar crypts Pus forming sulfur granules

Asymptomatic carriage of salmonella typhi

Chronic asymptomatic carriage -defined as excretion of bacteria in stool or urine >12 months after acute infection -in 1 to 6% of infections

Clinical manifestations of Aggregatibacter actinomycetemcomitans

Chronic periodontitis -Localized aggressive periodontitis(adolescents) -Destructive periodontal disease(adults) As an opportunistic pathogen -Infective endocarditis

Why is xylitol considered a good control against dental caries

Claimed to be superior to other sugar substitutes because it has a direct effect on bacterial metabolism interfering with sugar metabolism by producing a competitive inhibitor

Diagnosis of Vibrio vulnificus

Clinical manisectations Risk factors Sepsis: blood culture Isolation from stools on selective/ differential media - Thiosulfate citrate bile sucrose (TCBS) agar

Diagnosis of bacterial vaginosis

Clinically done by at least 3 of the following signs -Vaginal fluid with pH>4.5 -Homogenous adherent discharge -Fishy odor -Clue cells on a saline wet mount Gram stain of discharge can be used but it requires more time and expertise

Etiology of lockjaw ________ ___________(bacteria) G____ _____(shape) "________" like spore ______(oxygen usage) Spores present in _____ Normal flora of ______

Clostidium tetani G+ Rod Drumstick Anaerobe Spores present in soil Normal flora found in GI tract of animals

________ __________ (food intoxication bacteria) G+ forming rod, present in soil Most commonly associated canned or fermented meats(fish) and vegetables without adequate sterilization Spores survive and germinate in anaerobic environment- bacteria then produce the relative heat stable toxin(inactivated by boiling for several minutes) The toxin prevents the release of acetylcholine at the neuro-muscular junction causing flaccid paralysis Incubation period is 12 to 36 hr Symptoms include difficulty in swallowing, dizziness, descending muscular paralysis and respiratory compromise

Clostridium botulinum

Botulism Etiology ________ _________(bacteria) CDC Category ___ agent Gram ____ _____(shape) "_______" like spore _________(oxygen usage" Spores present in ______ and ______

Clostridium botulinum CDC Category A agent Gram + Rod "Drumstick" like spore Anaerobe Spores present in soil and marine sediments

Second most common food intoxication in the U.S.

Clostridium perfringens

________ __________ (food intoxication bacteria) G+ forming rod, present in soil Most commonly associated with undercooked meat, fish, gravies, legumes, and vegetables Spores are in the food and germinate in the cooked food- bacteria then produce the heat LIABLE toxin Incubation period 8 to 16 Hr Symptoms include diarrhea, nausea, and abdominal cramps Does not target CNS

Clostridium perfringens

Pathogenesis of cholera

Colonization in the small intestine - Mediated by the toxin-coregulated pilus(TCP) Secretion of the cholera toxi(CT) -Toxin stimulates cAMP production -cAMP causes active secretion of Cl-,Na+,K+ and HCO3- into the lumen Sloughed cells and mucus cause the white flecks in the stool appearing as water in which rice has been washed

Treatment of infective endocarditis

Combination of broad-spectrum antibiotics(>6 weeks) May require surgical debridement of valves

In healthy people plaque has a _______ relationship with the host, but it can become _______

Commensal Pathogenic

Transmission of Cystitis

Community acquired: Endogenously Healthcare associated: Exogenously from obstructions or catheters(Pseudomonas, Serratia, and Enterococcus species)

Clinical manifestation of Sinusitis

Congestion Discharge Sinus pressure/pain Headache

___________ Thin membrane-like tissue Covers the eye(except cornea) and lines eyelids Secretes oil and mucus-containing fluid, which lubricates and protects the eye

Conjuctiva

Inflammation of the conjuctiva

Conjunctivitis or pink eye

Transmission of Vibrio vulnificus

Consumption of undercooked or raw shellfish(especially oysters) Handling seafood, exposure to open wounds or acquiring open wounds in bacteria-contaminated water

Coaggregations of the colonizers can result in unusual formations like "______"

Corn-cobs

_______ Dome-shaped central portion of the eye Over the iris 5-6 layers of epithelial cells

Cornea

Diagnosis of Salmonella enterica typhi

Culture from blood or stool(if antibiotics haven't been given) Agglutination antibodies against O(LPS) and H(flagellar) antigens

Prevention of Clostridium tetani

DTaP vaccine- children< 7 years of age Tdap vaccine- older children and adults Td(adults)- booster every 10 years

Prevention of whooping cough

DTaP- <7yoq Tdap- older children and adults

Bacterial products can cause destruction of tissue by two pathogenic mechanisms which are

Damage from direct hit -direct action of bacterial toxins & enzymes Damage from an indirect hit -exaggerated immune response that results in tissue damage

treatment of osteomyelitis

Debridement Clindamycin 8-16 weeks

Treatment of Fusobacterium nucleatum

Debridement Metronidazole

Predisposing factors of infective endocarditis

Dental disease Recent dental procedure IV drug user Rheumatic heart disease Indwelling catheters Pacemaker Immunosuppression etc

If botulism is left untreated it can progress to cause _________ __________ of ____________,____________, and ___________

Descending paralysis of respiratory muscles, arms, and legs

Diagnosis of Fusobacterium nucleatum

Diagnosis based on symptoms and gram stain

Clinical manifestations EHEC E coli

Diarrhea starts out watery, then becomes grossly bloody Severe cramping Fever is not prominent -10% of children develop hemolytic uremic syndrome —Acute renal failure -3-5% -Most common in young children Thrombotic thrombocytopenic purpura (TPP) is a complication in adults

Most important causes of morbidity and mortality among infants and children

Diarrheal disease

Diagnosis of strep throat

Direct culture of pharyngeal specimen on blood agar(18 hours) Latex agglutination from throat swab specimen(10 min)

Diagnosis of Shigella

Direct microscopic observation of fresh stool sample -presence of RBCs and WBCs Culture of stool sample to isolate bacteria -Hektoen agar -Salmonella-Shigella agar PCR on stool sample

Transmission of conjuctivitis

Direct: fingers Vehicle: contact lenses, eye drops, lens cases, towels Newborns: from mom's birth canal

Chlorhexidine mouthwash prevents bacteria how?

Disrupts bacterial cell membrane(gram+/-)

Prevention of EHEC E coli

Don't eat undercooked hamburgers Wash raw vegetables

Clinical Manifestations of Botulism General: Additional symptoms in foodborne: Additional symptoms in infants:

Double, blurred vision Drooping eyelids Slurred speech Difficulty swallowing Dry mouth Muscle weakness Additional symptoms Additional symptoms in foodborne:Abdominal pain, nausea, vomiting, diarrhea Additional symptoms in infants: poor feeding, diminished suckling and crying ability, neck and peropheral weakness"floppy baby", constipation

As the pocket of the gingival crevice gets deeper redox potential goes ________ and GCF flow is _______

Down Increased

Treatment of Rocky Mountain Spotted Fever

Doxycycline for 7 days Empiric treatment should begin immediately upon suspicion before laboratory confirmation

Treatment of Actinomycosis

Drainage of localized abscess or surgical debridement Mild infections: oral penicillin V or amoxicillin for 2-6 months(alternatives to penicillins: tetracyclines, erythromycin, and clindamycin) Severe infections: Penicillin G for 4 to 6 weeks, followed by oral penicillin V/amoxicillin for 6 to 12 months

Hemorrhagic colitis caused by a strain of ___ _____ referred to as

E. coli EHEC

Escherichia coli strains with distinct pathogenic mechanism EHEC- ETEC- EIEC- EPEC- EAEC-

EHEC- hemorrhagic colitis ETEC- traveler's diarrhea EIEC- gastroenteritis EPEC- gastroenteritis in children EAEC- Persistent diarrhea in children

Treatment of syphilus

Early syphilis- primary, secondary, and latent -Penicillin G(IM) Late syphilis- tertiary -Gummatous and cardiovascular - penicillin G(IM) -Neurosyphilis - Penicillin G(IV)

Compare the two forms of Bacillus cerus that cause food intoxication

Emetic form- Found in rice and pasta Incubation 1-6 hr Vomiting and maybe diarrhea Enterotoxin-Heat stable Diarrheal form Found in meat and vegetables Incubation 8-16 hr Diarrhea and rarely vomiting Enterotoxin- Heat liable

Treatment of sepsis

Empiric antibiotic treatment until agent is known and susceptibilities are determined Drainage of abscesses and necrotic tissue Measure to correct shock and poor oxygenation

Infective endocarditis Inflammation of the _______ -Most of the time it is an infection of the heart valves often _______ or _______ -Most infections occur on ______ or _______ valves-PVE Can occur on ______ valves-NVS

Endocardium Mitral or aortic Damaged or prosthetic Native

Dermis vs epidermis Damage to the ______ does not usually result in bleeding but damage to ___________ does

Epidermis Dermis

Skin defenses

Epithelial cells produce antimicrobial peptides Sloughing off of epidermal cells(25-45 days) Gland secretions(sebum) has a low pH and and is oily Sweat contains lysozyme

T/F you are absolutely going to crush this exam

F-CK yea it's true you studied like an animal and put in the work(note: quizlet does not allow cursing)

Sinusitis is considered a _____ complication of an oral infection

Secondary

Furnucle(Boil) __________ when it reaches deeper in the tissue Can also occur in _____ glands or _____ glands Caused by ____________ Infection usually resolves after __________

Folliculitis Sebaceous glands or sweat glands Staphylococcus aureus Draining the pus

2 categories of food poisoning

Food infection- requires colonization by the infectious agent Food intoxication- this form is toxin-mediated and does NOT require colonization of the host by the pathogen

Transmission of Botulism

Foodborne botulism: food has botulism toxin. Canned or fermented meats without adequate sterilization Wound botulism Infant botulism: spores enter infant intestines where they germinate and release the toxin. Honey has been liked to some cases

Carbuncle A network of ________ connected by sinus tracts beneath the surface of the skin More frequent on the ___________ Painful Can result in ___________ Caused by _________ _________

Furnucles Back if the neck Bacteremia Staphylococcus aureus

____________ act as a bridge between early and late colonizers

Fusobacteria

Shigella G ______ ___(shape) ___(movement) ___(oxygen usage) H2S+______ Lactose fermentation _____ ______ susceptible to acid than other bacteria

G - Rod Non-motile Facultative anaerobe H2S+ negative Lactose fermentation negative Less susceptible to acid than other bacteria

Escherichia coli G __ __(shape) __(movement) __(oxygen usage) Lactose fermentation_____ Sorbitol formation______ H2S+______

G - Rod Some have flagella and all have fimbriae Facultative anaerobe Lactose fermentation with acid + (distinguishes from other enteric pathogens) Sorbitol fermentation with acid +(except for EHEC) H2S negative(distinguishes E coli from Salmonella)

Veillonella G_____ _____(shape) _____(oxygen usage) _____colonizer

G - cocci Anaerobic Early colonizer

Aggregatibacter actinomycetemcomitans G_____ _____(shape) _____(colony shape) _____(oxygen usage) _____ colonizer _____(transmission)

G- Cocccobacilli Star/crossed cigar-shaped colony Facultative anaerobe/Capnophile Late Person-to-person

Salmonella enterica G____ _____(shape) _____(movement) _____(oxygen usage) Glucose fermentation____ Lactose fermentation____ H2S+_____

G- Rod Flagella Facultative anaerobes Glucose fermentation+ Lactose fermentation - H2S+ positive

Capnocytophaga G_____ _____(Shape) _____(movement) _____(oxygen usage)

G- Rod Gliding motility Facultative anaerobe/Capnophile

Fusobacteria G____ ____(shape) ____(oxygen usage) ____(movement)

G- Rod - form long filaments(cigar shape) Strict anaerobe Non-motile

N. meningitidis G___ _____(shape) _____(oxygen usage) _____(capsule?)

G- diplococci, bean shaped Aerobe Polysaccharide capsule

EHEC G_____ _____(shape) Lactose fermentation___ Sorbitol fermentation___ H2S_____

G- rod + - -

Neisseria G____ ____(shape) ____(oxygen usage) ____(media)

G- Diplococci(bean shaped) Aerobes Require enriched media and CO2

Clinical manifestations of Vibrio vulnificus

Gastroenteritis Sepsis(diabetics,HIV, Liver disease, Cancer)-rapid onset Wound infection- 7 days, intense pain & swelling; cellulitis, necrotizing vasculitis and bacteremia

Vibrio parahaemolyticus clinical manifestations

Gastroenteritis Incubation: 24 to 72 hours Ranges from mild watery diarrhea to a frank, dysentery-like syndrome Also, abdominal cramps, nausea, vomiting and low-grade fever

Clinical manifestations of Gonococci

Genital infections -Purulent vaginal discharge -Dysuria -Abdominal pain -Menstrual abnormalities Pharyngeal infection -usually asymptomatic, but may cause sore throat Rectal infection Conjunctiva:severe, acute, purulent

Bacterial vaginosis is caused by a reduction in the number of "___________ bacteria" Overgrowth of certain ___________ bacteria in the vagina(part of flora in low numbers) Is the most common vaginal infection in women ages _____

Good Anaerobic 15-44

What do pioneer species all have in common

Gram + facultative anaerobes

Campylobacter G____ ___(shape) ___(movement) ___(oxygen usage) Campylobacter _____ is the most common Releases what toxin?

Gram - Curve rod Polar fkagellum Microaerophillic Cytolethal distending toxin (CDT) Campylobacter jejuni is the most common

Vibrio G_____ _____(Shape) _____(movement) _____(oxygen usage) _____(Salt tolerance) _____(ideal temperature) _____(environment)

Gram - Curved rod Highly motile(polar flagellum) Facultative anaerobe Halophillic Grows better in warmer temp(May-Oct) Commonly found in marine and brackish water

Enterobacteria G_____ _____(shape) _____(glucose fermentation) Oxidase _____ _____(Enviroment)

Gram - Rods Glucose fermentation + Oxidase - Free-living and part of human and animal flora

What do members of the red complex all have in common?

Gram - Anaerobes

O157:H7 E. Coli is a part of normal flora in the

Gut flora of cattle

Sexually transmitted infections Not nationally reportable:

HPV(most common STI inU.S.) Herpes Trichomonas vaginalis

HACEK organisms

Haemophilus Aggregatibacter Cardibacterium Eikenella Kingella

Folliculitis Superficial infection of the ______ Bacteria form _______ Caused by ________ When it occurs in eyelashes it is a ______

Hair follicle Bacteria form pus Caused by Staphylococcus aureus Stye

Clinical manifestation of Fusobacterium nucleatum

Halitosis(breath malodor) Necrotizing ulcerative gingivitis(NUG) -trench mouth

Virulence factors of Vibrio vulnificus

Hemolysins Metalloproteases- breaks down basement membrabe so bacteria can invade blood stream Mucinase- breaks down mucin DNAse Gram negative LPS Capsule

Teeth have a high or low microbial load?

High due to non-shedding surface

Savila has a high or low microbial load?

High load but cannot be maintained due to rate of swallowing

Reservoir of Shigella and routes of transmission

Humans are the only reservoir Transmission by fecal-oral route -person-to-persom, contaminated food or water, fomites, and sexual contact Outbreaks commonly occur in daycares, nusing homes, mental institutions/hospitals

Reservoir of Salmonella enterica serovar Typhi

Humans are the only resevoir Contaminated water or food via fecal-oral route

Transmission of N.meningitidis

Humans only natural host(asymptomatic carriers-nasopharynx) Person-to-person via inhilation of respiratory droplets Close, prolonged contact

Clinical manifestation of septic shock

Hypotension- Despite fluid resuscitation Organ failure Death

Diagnosis of Rocky Mountain Spotted Fever

IFA to detect antibodies in Public Health or reference labs In addition, immunohistology or PCR of biopsy from rash lesions Antibodies appear around day 7 to 10 of illness

Acute infective endocarditis is common among ________ and the most common etiologic agents are _________ and ________

IV drug users Staphylococcus aureus Streptococcus pneumoniae

Complications of Rocky Mountain Spotted Fever

If left untreated, the lesions can develop into gangrene Complications incluse thrombocytopenia, encephalitis, vascular collapse, thrombosis, renal and heart failure

Clinical manifestation of _________ Blisters become cloudy and as they fill with bacteria Blisters burst and become yellow crusts which weep pus Skin peels off

Impetigo

Defenses of Genital/Reproductive system in men and women

In males: Desquamation along urethra provides protection In females: The vaginal canal is lined with mucosal tissue and mucus -During reproductive years pH is low Exact microbiota flora compositions vary between men and women

Pathogenesis of Campylobacter

Infected cells within the ileum of the small intestine(can include the jejunum and colon) - Bacteria burrow into mucus layer - Entry facilitated by the flagellum - Entrance into cells in vacuole - Membrane ruffles formation - Secretion of CDT - arrest cell cycle of affected cells by DNA cleavage - Inflammatory response

Clinical manifestations of gingivitis

Inflamed-red gingiva Moderate bleeding Pocket depth increases

Pathogenesis of bacterial vaginosis

Inhibitors produced by Lactobacillus spp. prevent colonization or overgrowth by less desirable vaginal flora -H2O2 is produced by some strains of lactobacillus ` — most anaerobes lack catalase and peroxidase and can't eliminate H2O2 -Lactic acid production inhibits anaerobic species

Pathogenesis of Shigella

Invasion across M cell to macrophages Enterocyte invasion leading to cell-to-cell spread via actin tail Disruption of enterocyte cell-to-cell junction by transmission of polymorphonuclear neutrophils(PMNs) -PMNs effectively kill and cause more tissue damage Create ulcers, bleeding, necrosis of colonic mucosa Denuded areas of the intestines form covered with pus and blood

Diagnosis of Cholera

Isolation V. cholerae from stool culture -Thiosulfate citrate bile sucrose(TCBS) agar Immunoassays for CT or O1 and O139 LPS antigen from stool sample

Diagnosis of Salmonella enterica

Isolation from clinical specimen(feces,blood) and growth on selective agar(inhibit growth of G+ bacteria) -Hektoen agar -Salmonella-Shigella agar

Diagnosis of Campylobacter jejuni

Isolation from stool sample on CAMPY-agar -Microaerophillic environment at 42 Celsius

Diagnosis of Vibrio parahaemolyticus

Isolation from stools on selective/differential media -TCBS agae

Clinical manifestations of bacterial vaginosis

Itching and burning sensation Vaginal discharge -Homogenous, thin, grayish-white -Fishy smelling(from metabolic products of anaerobic) -Contain vaginal epithelial cells covered in bacteria(seen by microscopy)

Clinical Manifestations of Clostridium tetani

Jaw cramping, muscle spasms, painful muscle stiffness, trouble swallowing, seizures, headache, fever, sweating, changes in BP and fast HR, can lead to repiratory failure Neonatal tetanus- unhygenic practice during childbirth, unvaccinated mothers, infetion of umbelical cord, about 4 to 14 days after birth, baby becomes irritable and develops muscle spasms, infant can no longer feed, causes respiratory failure

The tongue' doral and lateral surface have specialized mucosa made up of stratified squamous ________ epithelium with hundreds of small protruding _____ of various types

Keratinized Papillae

Types of epithelium in the mouth

Keratinized: gingiva, hard palate and tongues' dorsal and lateral surface Nonkeratinizd: sulcular and junctional epithelium and lining mucosa(lips,buccal,alveolar,softpalate/tongue's ventral surface,floor of the mouth )

Pyelonephritis ________ infection Caused by same causative agents as _______ Bacteria can ascend the ______ to the ______ Sypmtoms of cystitis accompanied by ________ and _____________ Can result in permanent damage to the ________ If it is inadequately treated, it can lead to_______ ____________ __________ therapy should be initiated promptly

Kidney infection Cystitis Ureters to the kidneys Back pain and high fever kidneys Septicemia Empiric antimicrobial therapy

Pathogenesis of Aggregatibacter actinomycetemcomitans

LPS(endotoxin) -Stimulates bone reabsorbtion Leuktoxin IgG protease Collagenase Can invade gingival epithelium

Veillonella uses _____ for growth, and aquires it from nearby bacteria(_________). It then converts it to _______ acids(mainly. ______ acid). Thereby ________ the pH of dental plaque having a ______ effect on dental caries

Lactate Streptococcus weaker Propionic acid Raising Beneficial

Treponema are _____ colonizers

Late

Nesseria contain _______ instead of LPS They also have _____ and _____ membrane proteins

Lipooligosaccharide(LOS) Fimbriae and outer membrane proteins

Diagnosis of bronchitis

Listening to chest reveals bubbling bronchi Sputum samples

A lateral periodontal abscess is an infection usually next to a ________ tooth whit an established ________ ________

Live tooth(not one where pulp is infected) Periodontal pocket

Dorsum of the tongue has a high or low microbial load?

Load is high

Buccal mucosa has a high or low microbial load?

Load is low due to epithelial desquamation, inhabitants of oral epithelium require adhesins for attachment

Symptoms of a pneumonia __________- on one discrete area of the lung(one lobe) Symptoms: chest pain, blood in sputum, high grade fever, chills, and a productive cough, fast onset _________- Inflamation around bronchi or bronchioles(patchy) Symptoms: chest pain, blood in sputum, low grade fever, chills, and a productive cough, slow onset _________- Dry, non-productive cough, fever malaise

Lobar pneumonia Bronchial pneumonia Atypical pneumonia

Forms of aggressive periodontitis

Localized -Adolescents -primarily affects first molars and incisors teeth -robust serum antibody response to infecting agents Generalized -In young adults -Affects at least 3 teeth other than the first molars and incisors -Episodic nature of destruction

______ ________ Tissues of the lower face and neck become markedly swollen and tense leading to difficulty breathing Hardening of the floor of the mouth Malaise fever

Ludwig's Angina

Diagnosis of N meningitidis

Lumbar puncture to obtain CSF -Gram stain -Culture on blood agar

When the composition and size of the microbiota within the biofilm changes over time because of a series of complex interactions and becomes more diverse, it is known as a process called

Microbial succession

Clinical manifestation of EnteroPathogenic E. coli (EPEC)

More common in developing conditions than the U.S. The cause of epidemic infantile diarrhea Traveler's diarrhea No toxin production Diarrhea due to cellular invasion and cell death Produce watery diarrhea containing mucus (non-bloody) with vomiting and fever

Clinical manifestations of Shigella flexneri

More severe manifestations with dysentery(mucus, blood, pus, WBCs)

Etiology of Bacterial vaginosis Most commonly associated with _____ _________ G____ ______(oxygen usage) Not sole etological agent Includes mixed _______ flora

Most commonly associated with Gardnerella vaginalis G+(but gram variable) Facultative anaerobe Not sole etologic agent Includes mixed anaerobic flora

Treatment of Escherichia Coli

Most infections are self limiting Antibiotics are rarely given Rehydration with fluids and electrolytes

Treatment of Shigella

Most infections are self-limiting Antibiotics are rarely given Rehydration with fluids and electrolytes Ciprofloxacin for severe disease

Treatment of Salmonella enterica

Most patients recover without antibiotics Rehydration with fluids and electrolytes Antibiotics for those at risk for complications- ceftriaxone

Treatment of leprosy

Multidrug therapy Tuberculoid form- Daily dapsone and rifampicin for 6 to 12 months Lepramatous form- Daily clofazimine, dapsone, rifampicin for 12 to 24 months

Leprosey etiology _______ _______ (bacteria) Acid fast ______(shape) Cell wall with tons of ______ __________(live in) __________(growth rate) Grown on ______ and _____

Mycobacterium leprae Acid fast bacilli unique phenolic glycolipid (type of mycolic acid) Obligate intracellular pathogen Very slow growth Grown on armadillos and mouse foot pads

Clinical manifestations of __________ __________ -___________: fever, headache, painful/stiff neck, petechiae(rash), increased WBC in CSF -___________: fever, shock, widespread purpura, disseminated intravascular coagulation(DIC), thrombocytopenia and adrenal insufficiency Every 100 survivors will have long term disabilities such as loss of limb(s) deafness, nervous system problems, or brain damage

N meningitidis -Acute purulent meningitis -Meningococcemia

Choleras natural habitat and how it is spread

Natural habitat is brackish water(sea water+ fresh water) and coastal seawater Spread by contaminated food or water(mostly seafood)

Flora in which Salmonella enterica is found and most common route of transmission

Normal flora in poultry, cattle, and reptiles Most common route is contaminated foods- often prepared on contaminated surfaces Can also occur from bacteria on hands after handling pets and not washing properly

Oral spirochites normal flora and oxygen usage

Normal flora of gingival margin and crevice Strict anaerobes

Transmission of Fusobacterium necrophorum

Not exactly known, thought to be person-to-person, but animals also infected

Antigenic structures of Enterobacteria

O-LPS K-polysaccharide capsule H-flagellar protein

Most common antigenic numbers for hemorrhagic colitis

O157:H7

Clinical manifestation of Capnocytophaga

Opportunistic pathogen -Associated with gingivitis and infectios in immunocompromised patients Some sttrains produce IgA protease

Two types keratinized epithelium

Orthokeratinized: cells with keratin only Parakeratinized: cells with keratin and nuclei(found in higher levels)

Fusobacterium nucleatum _____(flora) _____(importance in oral bacteria)

Part of normal oral flora found in gingival crevice Very important to bridge early and late colonizers during plaque formation

For whooping cough the patient is contagious when?

Patient is contagious from beginning of catarrhal stage through 3rd week after onset of paroxysms

What forms as soon as a tooth is cleaned?

Pellicle

Complications of bacterial vaginosis

Pelvic inflammatory disease, infertility, adverse pregnancy outcomes

treatment of strep throat

Penicillin V or Amoxicillin Cephalosporin if allergic to penicillin

Campylobacter rectus Isolated from _______ diseases Produces _______ - Stimulates human ________ _______ to produce proinflamatory cytokines - Similar to Aggregatibacter actinomycetemcomitans

Periodontal diseases Cytotoxin Human gingival fibroblasts

____________ provides the support necessary to maintain teeth in function

Periodontium

Toxins released in whooping cough

Pertussis toxin-results in excessive mucus production Tracheal cytotoxin- destroys ciliated cells

Clinical manifestations of Fusobaterium necrophorum

Pharynghitis(adolescents & young adults) Throat or tonsil infection -Persistent fever -acute pharynghitis -Tonsillitis -Peronsillar abscess Can leave throat and enter jugular vein(about 1 week) -neck tender -sepsis symptoms Lemierres syndrome -Infectious thrombophlebitis of the internal jugular vein

_______ phase: suspended in the saliva _______ phase: attached to oral surface

Planktonic phase Sessile/biofilm phase

NUG treatment

Plaque control -debridement Metronidizale -rapid clinical improvement Oral hygiene

Infection of the lung involving the alveoli

Pneumonia

Aggressive periodontitis is rare and usually happens to patients around the age of __________ or younger and is more common in (Males/Females)

Puberty Females

Clinical manifestations of conjunctivitis

Redness of conjuctiva Pain, irritation, eyelid swelling Thick, white/yellow/green discharge(eyes "" glued shut) Sensitivity to light

Clinical manifestations of strep throat

Redness of the pharynx and tonsils White pus nodules may appear on tonsils Fever, malaise, headache

Treatment of Vibrio parahaemolyticus

Rehydration

Treatment of Cholera

Rehydration with fluids and electrolytes -Oral rehydration preffered as more efficient at providing Na+ to gut mucos Antibiotic can reduce duration and severity -Single dose of azithromycin is the preferred therapy

The cornerstone of periodontal therapy is

Removal of plaque and calculus

Most common site of pathogen entry

Respiratory tract

Complications of strep throat

Rheumatic fever Scarlet fever Acute glomerulonephritis

Etiology of Rocky Mountain Spotted Fever G_____ ______(shape) _______ ________ growth Uses a ________ to leave the phagosome

Rickettsia rickettsii G- small coccobacillus Obligate intracellular Pospholipase

The most common FATAL tick-borne infection in the U.S.

Rocky Mountain Spotted Fever

Most virulent form of shigella

S. dysenteriae- most virulent not in U.S.

Oral bacteria do not encounter naked host surface because of

Saliva

Complications of Salmonella enterica

Salmonella bacteria can penetrate into deep tissue and enter the blood stream. Once bacteria spread beyond intestines -osteomyelitis -pneumonia -UTIs -endocarditis -meninghitis

Species of Salmonella that is the only one of concern for human health

Salmonella enterica

Treatment of Aggregatibacter actinomycetemcomitans

Scaling and root planing Metronidazole and amoxicillin

Aggressive periodontitis treatment

Scaling and root planing Antibiotics to eliminate A actinomycetemcomitans -Metronidazole and amoxicillin combo

Treatment and prevention of campylobacter

Self limiting -fluid and electrolyte replacement Antibiotics should only be given for those who are immunocompromised or those with persistent diarrhea > 1 week - erythromycin or ciprofloxacin

When bacteria flourish, grow, and divide in the bloodstream it is called

Sepsis/ Septicemia

Clinical manifestations of Campylobacter

Severe abdominal cramps- CAN MIMIC APPENDICITIS Fever Diarrhea- frequently bloody with mucus(contain WBCs) Nausea and vomiting may also be present 5-10% chance of relapse

EHEC releases what toxin

Shiga toxin(SLT-I,SLT-II)

How in EHEC E. coli differentiated from other strains

Sorbitol fermentation -

Diagnosis of EHEC E coli

Sorbitol-MacConkey Agar ELISA or PCR to detect the presence of SLT-I/II in stool Blood testing to determine development of HUS

Spirochetes _____(shape) _____(movement) _____(toxin production) Cell wall similar to G ___

Spiral shape Motile by endoflagellum/axial filament Toxin production Cell wall similar to G-

Pathogenesis of Botulism

Spore germination favored by anaerobic environment Botulinum toxin released Absorbed from intestines and carried via blood to peripheral nerves synapses Then, it blocks the release of stimulatory neurotransmitter(acetylcholine) Leading to flaccid paralysis

Pathogenesis of Clostridium tetani

Spore germination is favored by necrotic tissue and poor blood supply Tetanospasmin(tetanus toxin/neurotoxin) released It is taken up by peripheral motor neurons and transported to the spinal cord then, it blocks the release of inhibitory neurotransmitters at spinal synapses Leading to spasmodic contraction of muscle

Transmission of Clostridium tetani

Spores get into the body through broken skin usually through injuries from contaminated objects

Stages of whooping cough

Stage 1: catarrhal stage, like common cold(1-2 weeks) Stage 2: paroxysmal stage—violent coughing sieges(1-6 or even 10 weeks) Stage 3: convalescence stage(2-3 weeks)

Most common food intoxication in the U.S.

Staphylococcus aureus

________ __________ (food intoxication bacteria) G+ cocci Enterotoxin is heat stable Commonly found in high lipid-content food snd processed (high salt) meats Food that has been left unrefrigerated for a few hours Incubation 1 to 6 hours Toxin stimulate nerves leading to nausea, cramping, diarrhea, and vomiting

Staphylococcus aureus

Acute infective endocarditis bacteria

Staphylococcus aureus Streptococcus pneumoniaw

Strep throat Etiology _____ _______(bacteria) G______ ________(shape and formation) ________(movement) ________(spore fomation) ________(oxygen usage) Catalase____ Coagulase____ ___-hemolytic

Steptococcus pyogenes G+ cocci arranged in chains Not motile Non-spore forming Facultative anaerobe Catalase - Coagulase- Beta-hemolytic

The oral epithelium is made of __________ _________ keratinized epithelium that contain _____ ridges and fibrous connective tissues underneath(_____ _____)

Stratified squamous epithelium Rete ridges Lamina propia

Localized alveolar ostetitis cause

Street name: Dry socket Cause: a partial or total disintegrated blood clot within the alveolar socket(not really known if bacterial are involved but there is some proof)

Pioneer species is usually ____________

Streptococcus

Lead actors/ major players of carious lesions ___________ _________ ___________ __________ - Involved in progression of deep enamel lesions(rather than initiation) Primarily, root caries: _______________ ______

Streptococcus mutans Lactobacillus spp. Actinomyces spp.

More than 60 percent of sinusitis cases are caused by _____________ and _______________

Streptococcus pneumoniae Haemophilus influenzae

Most acute cases of otitis media are caused by

Streptococcus pneumoniae Haemophilus influenzae

Bronchitis is most commonly associate with

Streptococcus pneumoniae Haemophilus influenzae, or Mycoplasma pneumoniae

Community acquired pnemonia 40%-__________ __________- Gram positive, diplococci, Alpha hemolytic 10%-__________ __________ -Aerobic, lack cell wall __________ __________ -Used to be a major cause but vaccine has reduced it __________, other bacteria and fungi 30%- __________

Streptococcus pneumoniae Mycoplasma pneumoniae Haemophilus influenzae Legionella Viruses

Pharyngitis 20-30% due to ________ 10-30% due to _________

Streptococcus pyogenes Fusobacterium necrophorum

Clinical manifestations of Cystitis

Sudden onset of symptoms Pain or burning while urinating(dysuria) Frequent urination Feeling the need to urinate despite having an empty bladder Low grade fever Cloudy or bloody urine(hematuria) Pressure or cramping in the groin or lower abdomen.

Pathogenesis of syphilis

Surface mucoid coat proteins act as adhesins for host cell Dense coat of fibronectin is thought to inhibit specific antibody attachment Slow multiplication produces endarteritis and granulomas Spreads rapidly to the bloodstream Clinical stages reflect interaction of bacteria with host and host's response

Treatment of Vibrio vulnificus

Surgical debridement or amputation Minocycline or doxycycline plus either cefotaxime or ceftriaxone

Diagnosis of Sinusitis

Symptoms or CT scan

Diagnosis of whooping cough

Symptoms(whooping) Culture(gold standard) -Regan-Lowe Agar -Samples from posterior nasopharynx(not throat) PCR ELISA to detect IgG against perstussis toxin

NUP tratment

Systemic antibiotic - Generally for patients with loss of attachment -Clindamycin, ampicillin, metronidazole, amoxicillin Dental intervention -debridement and repair

Oral spirochetes species

T denticola- more proteolytic and degrades collagen and dentine(member of red complex) T vicentii T pectinovarum T socranskii

Diagnosis of pneumonia

Tapping on chest -dull sound indicates fluid(consolidation) Chest X-ray Culture sputum sample

Pathogenesis of leprosy

Target cells: Schwann cells of nerves, macrophages, skin histiocytes Phenolic glycolipid: defense against oxidative killing Laminin-binding protein: facilitates binding to basal lamina of peripheral nerve axon unit Internalization of bacteria induces an inflammatory response by the immune system Cell injury and demyelation of peripheral nerve cells Causes local anesthesia and changes in the skin

Best defense of the eye

Tear film

Pathogenesis of Rocky mountain spotted fever

The bacteria spread via the lymphatic system and attach to vascular endothelial cells causing apoptosis Infection leads to direct systemic vascular injury Increasing vascular permeability, hypovolemia and hypotension The damage leads to the measles-like rash and petechial lesions Loss of fluid can lead to necrosis of extremities and other complications

How is the bacteria of hemorhagic colitis generally identified

Their O(LPS) and H(flagellar) antigenic numbers

Treatment of impetigo

Treated with topical mupirocin or retapamulin

Treatment and prevention of N meningitidis

Treatment: Penicillin G or ceftriaxone Prevention: Prophylaxis to those in close contact with the index case(rifampin ciprofloxacin) Vaccine: Meningococcal Conjugate VaccineChildren 11 to 12 yoa with booster at 16 yoa(recommended schedule)

Syphilis Etiology _________ ____________(bacteria) G_______ ________(shape) _______(movement) Obligate ________ pathogen Too thin for transmitted _____ microscopy

Treponema pallidum G- Spirochete Motile Obligate human pathogen Light

Treatment of cystitis

Trimethoprim-sulfamethoxaxole, fluoroquinolone, third or later generation cephalosporin

Treatment of prostatitis

Trimethoprim-sulfamethoxazole or fluoroquinolone

T/F Treponema pallidum does not have LPS in outer membrane

True

T/F Veillonella is not considered a pathogen

True

T/F both the cornea and conjunctiva are exposed to the environment

True

T/F in food intoxication there is no inflammation process and is not transmissible from person to person

True

Clinical manifestation of leprosys ____________: Less severe Hypo-pigmented plaquelike skin lesions with red edges Most common on the face, trunk, and limbs Decreased sensation in lesions(nerve damage) Thickened superficial nerves Strong cell-mediated immunity Limited bacterial growth ____________: More severe Multiple nodular skin lesions Most common on the face with thickening of the looser skin of the lips, forehead, and ears Can lead to loss of nasal bones and fingertips Loss of sensation Can lead to secondary infection Massive demyelination of nerve cells Reduced or absent cell-mediated immunity High numbers of the bacteria in the skin and superficial nerves

Tuberculoid leprosy Lepromatous leprosy

How is Typhi and nontyphoidal salmonella different in pathogenesis

Typhi -induces a mononuclear response instead of an inflammatory response and neutrophil infiltration extended multiplication in macrophages -Typhi remains within a vacuole in an extended replication cycle -Typhi can inhibit the oxidative metabolic burst

How is Typhi and nontyphoidal salmonella similar in pathogenesis

Typhi follows the same invasion and damage of M cells and epithelial cells as nontyphoidal salmonella

Pathogenesis of Cystitis

UPEC uses fimbriae(Type 1 pilli) to attach to perineal and urethra mucosa Some bacteria are lost with void of bladder Can use flagella to help reach target They can use another fimbriae(P-pilli) to achieve a strong binding in the bladder The cells multiply and the LPS induces an inflammatory reaction In some cases the bacteria can ascend the ureter to the kidneys

Diagnosis of prostatitis

Urinalysis Urine Gram stain and culture Direct rectal examination

Diagnosis of Gonococci

Urine,urethral(men),endocervical or caginal, pharyngeal or rectal specimens NAAT Culture:Thayer martin medium Gram smear: Gram - diplococci within neutrophils

Cystitis 80% caused by ________________ Other causative agents include _______ and ______ species or ___________ ___________

Uropathogenic Echerichia coli(UPEC) Klebsiella Proteus Staphyococcus saprophyticus

Virulence factors of bacterial vaginosis

Vaginolysin- adherence to vaginal epithelium Biofilm formation Symbiotic relationship with anaerobes

Treatment of Cavernous sinus thrombosis

Vancomycin plus ceftriaxone for Staph and Strep Metronidazole for anaerobic bacteria

Rickettsia rickettsii has obligate intracellular growth in ___________ ________ cells

Vascular endothelial cells

Transmission of whooping cough

Via respiratory droplets(highly infectious!) Mothers have historically been the most common reservoir of transmission

Cholera eptiology ________ _____ G____ _______(shape) _______(movement) _______(oxygen usage) _______(salt) Sucrose fermentation ____

Vibrio cholerae G- Curved rod Polar flagella Facultative anaerobe Halophillic Sucrose fermentation +

Major cause of seafood-borne illness in asia(mostly japan) The most commonly reported vibrio species in the U.S. Transmitted by consumption of undercooked or raw shellfish(especially oysters)

Vibrio parahaemolyticus

Leading cause of shellfish associated deaths in the U.S.

Vibrio vulnificus

Subacute infective endocarditis bacteria

Viridans streptococci Enterococcus spp. Staphylococcus epidermidis HACEK organisms Fungi(Candida, Aspergillus)

Major species of Vibrio

Vulnificus Parahaemolyticus Cholerae

Prevention of Cholera

Water must be boiled or chlorine/iodine treated- even for brushing teeth Bottled water only while traveling Newly approved vaccine- Vaxchora -Only for O1 serotype

Subacute endocarditis progress over______(period of time), and the main etological agents are _________ and are mainly found in the ______ _______

Weeks to months Viridans streptococci(S. Sanguinis, S oralis, S mutans, S mitis, and S salivarius) Oral cavity

UTIs are more common in ________(sex) and may involve urethra(________), bladder(______), or kidneys(________)

Women Urethritis Cystitis Pyelonephritis

For salmonella all non-typhoidal subspecies are _____ in origin

Zoonotic

Infectious dose of cholera

at least 1 million bacteria

Blister formation causes a separation of the _______ and _______

dermis and epidermis

Infection of the middle ear

otitis media

Prevention of pneumonia

pneumococcal vaccine Hib vaccine


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