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Bugs and Drugs Flashcards

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1
Q

Bacillus anthracis

A

Gram positive rod, aerobic

Dx: eschar, hemorrhagic mediastinitis, bloody diarrhea

Tx: ciprofloxacin (alt: doxycycline)

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2
Q

Bacillus cereus

A

Gram positive rod, aerobic

Dx: vomiting (heat-stable toxin), diarrhea (heat-labile toxin)

Tx: supportive

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3
Q

Clostridium tetani

A

Gram positive rod, anaerobic

Dx: localized/generalized muscle spasm/rigidity with sweating, arrhythmias, and respiratory failure

Tx: tetanus antitoxin globulin, tetanus toxoid, metronidazole or penicillin

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4
Q

Clostridium perfringens

A

Gram positive rod, anaerobic

Dx: gas gangrene, food poisoning (cramps and watery diarrhea), necrotizing enteritis

Tx: penicillin and clindamycin, wound debridement if applicable

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5
Q

Clostridium botulinum

A

Gram positive rod, anaerobic

Dx: bilateral descending flaccid paralysis from home canned foods and honey

Tx: 3 valent botulinum antitoxin, metronidazole or penicillin

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6
Q

Clostridium difficile

A

Gram positive rod, anaerobe

Dx: pseudomembranous colitis (fever, abdominal pain, non-bloody diarrhea with abx use)

Tx: metronidazole (alt: vancomycin)

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7
Q

Corynebacterium diphtheriae

A

Gram positive rod, aerobe

Dx: fever, sore throat, gray pseudomembrane on tonsils/pharynx causing airway obstruction, arrhythmias, or nerve palsy

Tx: diphtheria antitoxin, penicillin or erythromycin (preventable with vaccine)

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8
Q

Listeria monocytogenes

A

Gram positive rod, facultative

Dx: gastroenteritis (watery diarrhea), meningitis (neonates/elderly/AIDS) with sepsis

Tx: ampicillin and gentamicin (alt: TMP-SMX)

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9
Q

Nocardia asteroides

A

Gram positive rod, aerobe

Dx: weakly acid fast filament-like rods, causes nocariosis, pneumonia, cellulitis, and abscesses in immunocompromised

Tx: TMP-SMX

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10
Q

Propionibacterium acnes

A

Gram positive rod, anaerobe

Dx: acne

Tx: benzoyl peroxide (topical) –> erythromycin/clindamycin (topical) –> minocycline (oral)

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11
Q

Staphylococcus aureus

A

Gram positive cocci, catalase + coagulase +

Dz:

  • Acute osteomyelitis
  • Skin infections: impetigo, cellulitis, post-surgical wounds
  • Tricuspid valve endocarditis (IVDU) or acute endocarditis (mitral)
  • Post influenzal pneumonia with empyema (HAP and VAP)
  • Postpartum mastitis
  • Sepsis and bacteremia
  • Toxigenic: TSS, gastroenteriti, scalded skin syndrome

Tx: methicillin (MSSA), vancomycin (MRSA), linezolid (VISA/VRSA), cefazolin (prophylaxis)

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12
Q

Staphylococcus epidermidis

A

Gram positive cocci, catalase + coagulase -

Dz: implant related infections (heart valves, joints, catheters, shunts)

Tx: vancomycin

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13
Q

Staphylococcus saprophyticus

A

Gram positive cocci, catalase + coagulase -

Dz: UTI in sexually active women (2nd to E. coli)

Tx: fluoroquinolone (ciprofloxacin)

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14
Q

Streptococcus pyogenes

A

Gram positive cocci, catalase - beta-hemolytic bacitracin-sensitive

Dz:

  • Skin infections: impetigo, cellulitis, necrotizing fasciitis, lymphangitis
  • Pharyngitis
  • Acute rheumatic fever
  • Acute glomerulonephritis
  • Toxigenic: toxic shock syndrome, scarlet fever

Tx: penicillin G

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15
Q

Streptococcus agalactiae (GBS)

A

Gram positive cocci, catalase - beta-hemolytic bacitracin resistant

Dz: neonatal pneumonia, meningitis, and sepsis

Tx: Penicillin G and gentamycin if severe

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16
Q

Enterococcus (E. faecalis, E. faecium)

A

Gram positive cocci, Group D, + growth in 6.5% NaCl

Dz: subacute bacterial endocarditis, UTIs, intraabdominal infections

Tx: penicillin G and gentamycin (B-lactam resistant: vancomycin and gentamycin; Vancomycin resistant: linezolid)

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17
Q

Streptococcus bovis

A

Gram positive cocci, Group D, - growth in 6.5% NaCl

Dz: subacute bacterial endocarditis associated with colon cancer

Tx: penicillin G (alt: vancomycin)

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18
Q

Streptococcus pneumoniae

A

Gram positive cocci, alpha-hemolytic, optochin sensitive

Dz: pneumonia, meningitis, otitis media, sinusitis, sepsis in asplenic patients

Tx: penicillin G (severe infection: ceftriaxone + vacomycin or newer fluoroquinolone)

Vaccine: 7 valent-conjugated polysaccharide (< 2 yrs), 23 valent-capsular polysaccharide (> 2 yrs)

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19
Q

Viridans streptococci

(S. mutans, S. mitis, S. sanguis, S. salivarius)

A

Gram positive cocci, catalase - alpha-hemolytic optochin resistant

Dz: dental plaque (S. mutans), subacute bacterial endocarditis (S. sanguis)

Tx: penicillin + gentamycin (alt: cephalosporin or vancomycin if severe), penicillin prophylaxis for dental procedures in valve disease

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20
Q

Neisseria meningitidis

A

Gram negative cocci, oxidase +, maltose fermentation +

Dz:

  • Meningitis (CSF: icnreased PMN and protein, decreased glucose)
  • Meningococcemia (Waterhouse-Friderichsen syndrome: fever, purpura, shock, DIC, bilateral adrenal hemorrhage)
  • Pneumonia

Tx: penicillin G or ceftriaxone (alt: chloramphenicol)

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21
Q

Neisseria gonorrhoeae

A

Gram negative cocci, oxidase +, maltose fermentation -

Dz: purulent arthritis (wrist/ankle/knees), conjunctivitis, cervicitis, urethritis, pharyngitis, pustules on erythematous base

Tx: ceftriaxone and azithromycin for chlamydia

Alt: ciprofloxacin in penicillin allergy or specinomycin in pregnancy

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22
Q

Moraxella catarrhalis

A

Gram negative cocci, oxidase +

Dz: bronchitis and bronchopneumonia, otitis, sinusitis

Tx: **amoxicillin-clavulanate, cefuroxime axetil, TMP-SMX, azithromycin **

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23
Q

Escherichia coli

A

Gram negative rod, facultative, lactose fermenter

Dz:

  • Gastroenteritis (Traveler’s diarrhea):
    • EPEC/ETEC: watery diarrhea
    • EHEC: shiga toxins → bloody diarrhea, HUS
    • EIEC: dysenteric darrhea
  • UTIs
  • Neonatal meningitis, sepsis

Tx: supportive +/- rifaximin or fluoroquinolone for diarrhea, fluoroquinolone or TMP-SMX for UTIs, ceftriaxone for meningitis/sepsis

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24
Q

Klebsiella pneumoniae

A

Gram negative rod, lactose fermenter

Dz: nosocomial and community acquired infections in alcoholics, diabetics, and elderly including lobar pneumonia and UTIs

Tx: carbapenem (MDR: based on susceptibilities)

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25
Enterobacter cloacae
Gram negative rod, lactose fermenter Dz: nosocomial infections including pneumonia and UTI Tx: **carbapenem** (MDR: based on susceptibilities)
26
Serratia marcescens
Gram negative rods, lactose fermenter Dz: nosocomial infections in immunocompromised including pneumonia and UTI Tx: **G3 cephalosporin + gentamicin** (MDR: based on susceptibilities)
27
Shigella dysenteriae
Gram negative rod, non-lactose fermenter, oxidase -, H2S - Dz: bacillary dysentery (fever, cramps, tenesmus, blood stools with neutrophils and mucus) Tx: supportive care +/- **fluoroquinolone** or TMP-SMX
28
Salmonella typhi
Gram negative rod, non-lactose fermenter, oxidase -, H2S + Dz: enteric (typhoid) fever (bradycardia, abdominal pain, diarrhea and constipation, rose spots on trunk, hepatosplenomegaly, delirium, GI bleeding (\*developing countries) Tx: **ciprofloxacin** or ceftriaxone (alt: chloramphenicol), cholecystectomy if chronic carrier in gallbladder
29
Salmonella enteritidis
Gram negative rod, non-lactose fermenter, oxidase -, H2S + Dz: enteritis (fever, nausea, vomiting, abdominal pain, bloody or nonbloody diarrhea) Tx: self-limited, **supportive only**, no abx
30
Proteus mirabilis
Gram negative rod, non-lactose fermenter, oxidase -, H2S +, urease + Dz: nosocomial UTI with struvite stones (catether associated) Tx: **ampicillin** or SMX-TMP
31
Yersinia enterocolitica
Gram negative rod, non-fermenter, oxidase -, H2S - Dz: enterocolitis, autoimmune complications (**Reiter's syndrome, reactive polyarthritis, erythema nodosum**) Tx: **fluoroquinolone** or TMP-SMX
32
Yersinia pestis
Gram negative rod, non-lactose fermenter, oxidase -, H2S- Dz: bubonic plague, pneumonic plague, septicemic plague Tx: **streptomycin**, doxycycline
33
Campylobacter jejuni
Gram negative rod (comma shaped) Dz: acute enteritis (bloody diarrhea), autoimmune (Guillain-Barre, Reiter's syndrome, reactive arthritis) Tx: **supportive** if mild, erythromycin if severe
34
Helicobacter pylori
Gram negative rod (comma shaped), urease breath test + Dz: gastritis, peptic ulcers, gastric carcinoma Tx: **omeprazole + amoxicillin + clarithromycin **
35
Vibrio cholerae
Gram negative rod (comma shaped) Dz: cholera (severe watery diarrhea with electrolyte loss) Tx: fluid and electrolyte replacement, **doxycycline** or TMP-SMX
36
Vibrio parahaemolyticus
Gram negative rod (comma shaped) Dz: explosive watery diarrhea from undercooked seafood Tx: **rehydration**, self-limited, no abx
37
Pseudomonas aeruginosa
Gram negative rod, non-lactose fermenter, strict aerobe, oxidase +, catalase + Dz: * Pneumonia in CF * Eyes/Ears: corneal infections, external otitis (malignant), hot tub folliculitis * Osteomyelitis and endocarditis in IVDU * Burn wound infections * UTIs with catheters * Sepsis Tx: **ticarcillin + tobramycin** (aminoglycoside) or **cefepime** or **imipenem + ciprofloxacin **
38
Bordetella pertussis
Gram negative rod (coccobacillus) Dz: whooping cough Tx: **erythromycin** Vaccine: killed vaccine in infants, acellular vaccine in children \> 15 months
39
Legionella pneumophila
Gram negative rod, faint gram stain, silver stain +, urine antigen + Dz: Legionnaires' disease (atypical pneumonia) in elderly and immunocompromised, Pontiac fever (flu-like) Tx: **azithromycin** (macrolides) or fluoroquinolones
40
Coxiella burnetii
Gram negative rod, intracellular, Giemsa stain + Dz: Q fever (fever, pneumonia, hepatitis, meningoencephalitis, and endocarditis) Tx: doxycycline
41
Haemophilus influenzae
Gram negative rod (coccobacillus), grows on heme enriched chocolate agar, PRP + Dz: pneumonia, otitis media, sinusitis, epiglottitis, meningitis Tx: **ceftriaxone** for meningitis or epiglottitis, **amoxicillin clavulanate** or cefuroxime axetil or TMP-SMX or azithromycin for otitis media/sinusitis
42
Haemophilus aegyptius
Gram negative rod (coccobacillus) Dz: conjunctivitis (pink eye) Tx: **azithromycin** (topical)
43
Haemophilus ducreyi
Gram negative rod (coccobacillus) Dz: chancroid Tx: **azithromycin** (macrolide) or ceftriaxone
44
Pasturella multocida
Gram negative rod (coccobacillus) Dz: cellulitis and lymphadenitis from cat or dog bites Tx: **penicillin G**
45
Brucella abortus/melitensis/suis
Gram negative rods (coccobacillus), zoonotic Dz: brucellosis (udulant fever, adenopathy, hepatosplenomegaly, septic arthritis, vertebral osteomyelitis) Tx: **streptomycin + doxycycline** (alt: TMP-SMX in pregnancy and children)
46
Bacteroides fragilis
Gram negative rod, anaerobe Dz: bacteremia/sepsis, abdominal and pelvic abscesses, peritonitis, cutaneous and soft tissue infections Tx: metronidazole Prophylaxis: cefoxitin before abdominal or pelvic surgery
47
Fusobacterium nucleatum
Gram negative rod, anaerobe Dz: abscesses (brain, lung, abdominal, pelvic) Tx: **metronidazole**
48
Prevotella melaninogenica
Gram negative rod, anaerobe Dz: abscesses (brain, lung) Tx: **metronidazole**
49
Bartonella henselae
Gram-variant rod, silver stain + Dz: cat-scratch fever (fever and purulent lymphadenitis), bacillary angiomatosis (wide spread vascular lesions and nodules) and bacillary peliosis (vascular lesions in liver/spleen) in immunocompromised Tx: **azithromycin**
50
Gardnerella vaginalis
Gram-variant rod Dz: bacterial vaginosis (foul smelling discharge with clue cells) Tx: metronidazole
51
Mycobacterium tuberculosis
Mycobacteria, aerobic, acid fast stain + Dz: * Pulmonary TB: fever, sweats, weight loss, hemoptysis * Primary: Ghon complex * Secondary: fibrocaseous cavitary lesions in apices * Extrapulmonary TB: spread to LN, pleura, CNS, GU, GI, and vertebral bodies * Miliary TB: hematogenous dissemination in immunocompromised Tx: **isoniazid + rifampin + pyrazinamide + ethambutol**
52
Mycobacterium leprae
Mycobacterium, aerobe, acid fast stain + Dz: * Tuberculoid leprosy: hypopigmented and anesthetic skin plaques associated with enlarged peripheral nerves (few bacilli in granulomas) * Lepromatous leprosy: symmetrical widespread skin nodules/plaques (many bacilli in foamy macrophages of granulomas) Tx: dapsone + rifampin for tuberculoid, **dapsone + rifampin + clofazimine** in lepromatous
53
Chlamydia trachomatis
Obligate intracellular bacteria Dz: trachoma (blindness), neonatal conjunctivitis/pneumonia, STD (urethritis, cervicitis, epididymitis, PID), lymphogranuloma venereum, Reiter's syndrome Tx: **azithromycin** (tetracycline for LGV)
54
Chlamydia psittaci
Obligate intracellular bacteria, Giemsa stain +, infection from aerosolized bird feces Dz: psittacosis (atypical pneumonia) Tx: **doxycycline**
55
Rickettsia rickettsii
Obligate intracellular rod, Giemsa stain + Dz: Rocky Mountain Spotted Fever (maculopapular to petechial rashes spreading from wrists and ankles to trunk, involves palms and soles), encephalitis Tx: **doxycycline** (alt: chloramphenicol or ciprofloxacin)
56
Mycoplasma pneumoniae
Extracellular atypical bacteria Dz: Atpical pneumonia (patchy interstitial infiltrates with fever and nonproductive cough) which can be complicated by erathema multiforme, Raynaud's, arthalgias, hemolytic anema, and Guillain Barre Tx: **macrolides** (azithromycin) or tetracycline
57
Borrelia burgdorferi
Spirochete, Giemsa stain +, silver stain + Dz: Lyme disease * Stage 1: erythema chronicum migrans (bull's eye rash) * Stage 2: neuropathy (meningitis, polyneuritis) and cardiopathy (AV block) * Stage 3: arthritis Tx: **doxycycline** in early stages (amoxicillin for kids), **ceftriaxone** in late stages
58
Treponema pallidum
Spirochete, viewed in darkfield microscopy Dz: syphilis * Primary: chancre * Secondary: widespread maculopapular rash involving palms and soles, condylomata lata, non-tender lymphadenopathy, meningitis, mucous patches * Tertiary: granulomas, aortitis, neurosyphilis (paresis, tabes dorsalis, Argyll Robertson pupil) Treatment: **penicillin G** or doxycycline
59
Malassezia furfur
Dimorphic spherical budding yeasts with short chain-like hyphae Dz: tinea versicolor (hypo/hyperpigmentations with scales and itching) Tx: **miconazole** or selenium sulfide (topical), itraconazole (oral)
60
Trichophyton rubrum/tonsurans/schoenlenii
Mold with filamentous septate hyphae Dz: dermatophytoses (tinea capitis, tinea pedis, tinea corporis, tinea cruris, favus, onychomycosis) Tx: **miconazole** (topical for pedis, corporis, cruris), **griseofulvin** (oral for capitis and onychomycosis)
61
Coccidioides immitis
Fungus, endemic to southwest US and Latin America Dz: Valley fever (pneumonitis and erythema nodosum) Tx: **itraconazole** or amphotericin B for disseminated infections
62
Histoplasma capsulatum
Fungus, from bird and bat droppings in the Mississippi and Ohio River Valleys Dz: histoplasmosis (atypical pneumonia or disseminated infections in immunocompromised) Tx: **itraconazole** or amphotericin B for disseminated infections
63
Blastomyces dermatitidis
Fungus, endemic to northeast US Dz: blastomycosis (pulmonary infection that can spread to skin or bone forming ulcerated granulomas) Tx: **itraconazole** or amphotericin B for disseminated infections
64
Candida albicans
Opportunistic fungus (yeast only) Dz: candidiasis (thrush, vulvovagintitis, skin/nail infections (diaper rash), right sided endocarditis in IVDU, UTI in catheters) Tx: **nystatin** (topical), **fluconazole** (vulvovaginitis), **amphotericin B** (systemic infections)
65
Cryptococcus neoformans
Opportunistic fungus (yeast only) from bird droppings, thick walled capsule on India Ink stain Dz: meningitis (AIDS), pulmonary infections Tx: **amphotericin B + flucytosine** for induction and **fulconazole** for maintenance
66
Aspergillus fumigatus
Opportunistic fungus (mold only with septate hyphae) Dz: aspergillosis * Allergic bronchopulmonary aspergillosis * Fungus ball in preexisting TB cavities Tx: **amphotericin B**, caspofungin, surgical removal of fungus ball
67
Mucor and Rhizopus
Opportunistic fungus (mold only) with irregular broad aseptate hyphae Dz: mucormycosis (invasion leads to ischemic necrosis in sinuses and brain, as well as lungs and GI tract) Tx: **amphotericin B** and surgical removal of necrotic tissue
68
Pneumocystis jiroveci
Opportunistic fungus, methenamine-silver stain + Dz: pneumonia (diffuse bilateral interstitial infilatrates with ground-glass appearance) Tx: **TMP-SMX** (also used for prophylaxis in CD4 \< 200)
69
Plasmodium vivax/ovale/malariae/falciparum
Protozoa transmitted by mosquito bite Dz: malaria (fever chills, sweats, hemolytic anemia, and hepatosplenomegaly), black water disease (P. falciparum - above plus cerebral malaria, lung edema, renal failure from hemoglobinuria, and death) * P. malariae: endemic to Asia, Africa, and Latin America and targets mature RBC * Tx: **chloroquine** * P. vivax/ovale: endemic to Asia, Africa, and Latin America and targets reticulocytes and remains latent in hepatocytes * Tx: **chloroquine** and **primaquine** (for dormant form) * P. falciparum: endemic to SE Asia, E Africa, and South America and targets all age RBC * Tx: **mefloquine** or quinine + doxycycline
70
Babesia microti
Protozoa (sporozoites, trophozoites, merozoites) trasmitted by Ixodes tick in NE US Dz: babesiosis (fever, chills, hemolytic anemia, hepatosplenomegaly) - blood smear shows ring-like trophozoites or Maltese cross-like merozoites Tx: **quinine + clindamycin **
71
Naegleria fowleri
Amoeba that invades nasal mucosa and eats brain in southwest US Dz: primary amebic meningoencephalitis Tx: **amphotericin B + miconazole + rifampin** or don't put head underwater
72
Toxoplasma gondii
Protozoa from ingestion of undercooked meat or contact with cat feces Dz: * Congential toxoplasmosis: abortion, stillbirth, hepatosplenomegaly, or triad of intracranial calcification, hydrocephalus, and chorioretinitis * Mononucleosis in immunocompetent * Encephalitis, brain abscess, pneumonia, myocarditis in immunocompromised Tx: **sulfadiazine + pyrimetamine** and avoid cats/raw meat if pregnant
73
Leishmania donovani (tropica/mexiana/braziliensis)
Intracellular parasite that infects bone marrow and spleen (transmitted by sandfly bite) Dz: * L. donovani: visceral leishmaniasis (fever, hepatosplenomegaly, skin hyperpigementation, and bone marrow suppression causing pancytopenia, infections, and bleeding) * L. tropica/mexicana: cutaneous leishmaniasis (nodules and ulcers) * L. braziliensis: mucocutaneous leishmaniasis (granulomatous ulcerating lesions) Tx: **sodium stibogluconate** or **amphotericin B**
74
75
Trypanosoma cruzi
Flagellated trypomastigotes and nonflagellated amastigotes (reduviid bug bite) Dz: Chagas' disease (facial edema and nodules, chronic dilated cardiomyopathy, arrhythmias, megacolon, megaesophagus) Tx: **nifurtimox** or benznidazole
76
Trypanosoma gambiense/rhodesiense
Flagellated trypomastigotes in blood/CSF without nonflagellated amastigotes in tissue Dz: sleeping sickness (recurring fever, lymphadenopathy, encephalitis leading to coma and death) Tx: **suramin** and **melarsoprol** for encephalitis
77
Entamoeba histolytica
Trophozoites and cysts Dz: * Amoebic dysentery: bloody diarrhea and abdominal pain * Hepatic abscesses (anchovy sauce-like pus) Tx: **metronidazole**
78
Giardia lamblia
Trophozoites and cysts Dz: giardiasis (watery, fatty, foul-smelling diarrhea) Tx: **metronidazole** and supportive care
79
Cryptosporidium parvum
Ingestion of oocysts (acid fast) which form sporozoites then trophozoites Dz: cryptosporidiosis (watery diarrhea, worse in immunocompromised) Tx: self-limited with normal immunity, **paromomycin** for immunocompromised
80
Trichomonas vaginalis
Trophozoites with no cysts transmitted by sexual contact Dz: trichomoniasis (foul smelling, greenish vaginal discharge) Tx: **metronidazole**

Medicine (4 decks)

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