Anaerobes Flashcards
(24 cards)
What is the general treatment for anaerobes?
drainage of accumulated fluid
Pen G for all but Bacteroides and Prevotella
Metronidazole and clindamycin for Bacteroids and Prevotella (2nd line is 2/3rd gen ceph + carbapenems)
What does Bacteroides fragillis look like?
G- rod
60% of abdominal bacteria
What does Prevotella melaninogenica look like, and what are the clinical presentations?
G- coccobacillus
found in mouth, brain and lung abscesses
What does Porphyromonas gigivalis look like, and what are the clinical presentations?
G- rod
oral abscesses and gingivitis
What does Fusobacterium look like, and what are the clinical presentations?
G- fusiform
oral and colonic infections
What does Peptostreptococcus look like, and what are the clinical presentations?
G+ coccus
bacteremia and pleura/lung infections
What does Propionibacterium acnes look like, and what are the clinical presentations?
G+ pleomorphic rod
epidermal infections, acne, brain abscesses
What does Clostridium look like?
G+ rod with rounded ends
SPORES (with Bacillus)
Clinical presentation and treatment of Clostridium botulinum?
descending flaccid paralysis
trivalent or polyvalent antitoxin (not abx, because it’s not an infection)
Epidemiology and virulence factor of C. botulinum?
home-canned foods, and infants eating honey
AB neurotoxin: B binds to motor neuron end plates, A prevents fusion of Ach vesicles and release of neurotransmittor
Clinical presentation and treatment of Clostridium tetani?
rigid paralysis
TDap vaccine + boosters
TIG antitoxin if early
muscle relaxants and respirator
metronidazole has limited effectiveness
Mode of transmission of C. tetani?
fomites
Clinical presentation and treatment of Clostridium perfringens?
gas gangrene: infected would, foul discharge, necrosis, toxemia, shock & death; (food poisoning if ingested)
Prompt amputation
Penicillin, metronidazole, and clindamycin to prevent multiplication
Clinical presentation of Clostridium difficile?
4-10 days after borad spec oral clindamycin (or prolonged PPIs)
watery diarrhea
pseudomembrane forms in colon
Treatment of C. difficile?
stop previous antibiotic
diagnose with anti-toxin B
van + metro to kill C. diff
fecal transplant if possible
Epidemiology of C. diff?
normal flora, overgrows when antibiotics disrupt normal flora, nosocomial in 94% of cases
What does Actinomyces israelii look like?
G+ branching filaments
facultative anaerobe
Clinical presentation and treatment of Actinomyces israelii?
“Lumpy jaw”: swollen pyogenic (pus producing) abscess
cervicofacial, lungs, abdominal, feet skin
yellow “sulfur” granules
Pen G then Pen V for 6-12 months
prophylaxis Pen before/after oral surgery
Epidemiology of A. israelii?
tooth extraction or poor oral hygiene, lung aspiration, perforated gut or ruptured appendix, soil
mainly affects immunocompromised
Clinical presentation and treatment of Nocardia asteroids?
lobar pneumonia in immunocompromised –> lung abscesses –> bacteremia –> meningitis and brain abscesses
SxT
carbopenems + ceph
Mode of transmission of Mocardia asteroids?
opportunistic soil bacterium
lung infection from aspirated vomit
What do Aeromonas hydrophila and Plesiomonas shigelloides look like?
G-
facultative anerobes
Clinical presentation and treatment of Aeromonas hydrophila and Plesiomonas shigelloides?
gasteroenteritis (watery and bloody diarrhea)
cellulitis
myconecrosis (gas gangrene)
(similar to V. vulnificus, but fresh water)
diarrhea is self-limiting
SxT & tetracycline for cellulitis
Mode of transmission of Aeromonas hydrophila and Plesiomonas shigelloides?
freshwater seafood
fish hook trauma
biofilms on scuba breathing apparatus
