Gram Negative Infections Flashcards by carolyn Ellis

pseudomonas greenish-blue, yellow-green, and black pigment causes

greenish-blue: pyocyanin
yellow-green: fluorescein
brown-black: pyomelanin

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recurrent infections with n. meningitidis caused by?

late complement deficiency (C5-C9)

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glanders: 1. bug, 2. vector, 3. presentation, 4. txt

burkholderia mallei
contact with horses
ulcerated nodule at inoculation site, LAD, farcy buds
sulfonaminde

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Tularemia: 1. aka, 2. bug, 3. vector, 4. presentation, 5. txt

francisella tularensis
rabbits (ticks, deer flies) - hunters
hands- HSM, violaceous papulonodular eruption
doxy w/ rifampin

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vibrio infection 1. bug, 2. vector, 3. presentation, 4. txt

vibrio vulnificus
raw seafood, wound in seawater
fever, chills, abd pain, red-violaceous macules –> painful hemorrhagic bullae with cellulitis
TCN PO

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plague 1. bug, 2. vector, 3. presentation, 4. txt

yersinia pestis
flea
fever, small papule/pustule at site of flea bite w/ swollen painful fluctuant lymph nodes (buboes)
streptomycin IM

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malakoplakia 1. bug, 2. presentation, 3. histo, 4. txt

e. coli (also pseudomonas, proteus, klebsiella)
uti, weeping perianal plaque or polypoid mass
michaelis-gutmann bodies
cipro, surgery

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rhinoscleroma 1. bug, 2. transmission, 3. presentation, 4. histo, 5. txt

klebsiella rhinoscleromatis
inhalation droplets, fomites
infectious granulomas in nasal mucosa, resp tract, epistaxis, Hebra nose (destruction cartilage)
mikulicz cell, russell bodies
cipro

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rat-bite fever: 1. aka, 2. bug, 3. vector, 4. presentation, 5. txt

haverhill fever
streptobacillus moniliformis
rodents, contaminated food
fever, arthritis, ulceration at site of bite, generalized morbilliform eruption with acral invoment
PCN

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cat bite: 1. bug, 2. txt

pasteurella multocida

augmentin +/- tetanus ppx

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dog bite bug/txt

pasturella canis and multocida, capnocytophaga canimorsus

augmentin +/- tetanus

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human bite bug/txt

eikenella corrodens

augmenting +/- tetanus

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bartonella bug, vector, pathogenesis

gram neg intracelluar
ticks, fleas, sand flies, mosquitos
bacilliformis adheres to and invades RBCs
all 3 types produce endothelial-stimulating factor –> proliferation endothelial cells and blood vessels

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oroya fever aka, bug, vector, 2 stages, txt

carrion’s ds, verruga peruana, Peruvian wart
bartonella bacilliformis
sanfly lutzomyia verrucarum
acute stage (oroya) = fever + hemolytic anemia
chronic stage (verruga) = erythematous papules/nodules for years
acute txt chloramphenicol (covers salmonella coinfection)
chronic txt TCN or PCN

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cat-scratch disease bug, vector, presentation, txt

bartonella henselae
cat flea ctenocephalides felis (comb)
u/l tender LAD 2-4 wks after scratch in axilla/epitrochlear node
spontaneous resolution, doxy/erythro

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parinaud oculoglandular syndrome: 1. bug, 2. presentation

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bartonella henselae (cat-scratch ds)
u/l conjunctivitis and regional LAD

trench fever aka, bug, vector, presentation, txt

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shinbone fever
bartonella quintana
body louse pediculus humanus corporis
relapsing fever, tender shins, back pain, transient macular eruption
doxy/erythro

pediculus humanus corporis carries causes what 3 diseases

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trench fever (bartonella quintana)
epidemic typhus (rickettsiae prowazekii)
louse-born relapsing fever (borrelia recurrentis)

rocky mountain spotted fever bug, vector, presentation, txt

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rickettsiae rickettsii
dermacentor andersoni, dermacentor variabilis
fever, HA, myalgias –>purpuric or hemorrhagic macules & papules on wrists & ankles –> trunk, hands, feet
doxy (15-25% mortality w/o txt)

mediterranean spotted fever aka, bug, vector, 2 forms, txt

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boutonneuse fever
rickettsiae conorii
brown dog tick rhipicephalus sanguineus
1. tache noir = indurated papule at site of tick bite –> necrotic ulcer
1. exanthem = erythematous papules over lower limbs
doxy or chloramphenicol

rickettsialpox bug, vector, presentation, txt

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rickettsiae akari
mouse mite liponyssoides sanguineus
papule or vesicle at site of bit –> eschar & LAD –> fever, chills, HA, diffuse vesicular rash
doxy, chloramphenicol

epidemic typhus bug, vector, reservoir, presentation, txt

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rickettsiae prowazekii
body louse pediculosis humanus corporis
flying squirrel
fever, chills, HA –> pale red macules on trunk –> diffuse petechial papules (spares face, palms, soles)
vascular inflammation of skin, CNS, heart, kidneys, muscle
doxy or chloramphenicol

endemic typhus aka, bug, vector, presentation, txt

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murine typhus
rickettsiae typhi
rat flea xenopsylla cheopis (no comb)
fever, HA, myalgias, transient truncal maculopapular exanthem
doxy, chloramphenicol

scrub typhus bug, vector, presentation, txt

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rickettsiae tsutsugamushi
chigger mites (trombiculid - larval stage)
HA, chills, eschar at inoculation w/ LAD –> maculopapular rash on trunk +/- cardiac and pulm ds
doxy, chloramphenicol

ehrlichiosis, 2 bugs and types, 2 vectors and types, txt

ehrlichiosis chaffeenis - ambyloma americanum = monocytic e. phagocytophilia - ixodes scapularis & pacificus = granulocytic tetra or doxy

Q fever bug, presentation, txt

- coxiella burnetii - no skin findings, limited febrile illness +/- organ involvement - doxy

lyme disease bug, vector, 3 presentations, dx, txt

- borrelia burgdorferi - eastern US: ixodes dammini/scapularis; western: ixodes pacificus; europe: ixodes ricinus - early localized: flu + erythema migrans 1-2 wks post bite, disappears in 4 wks w/o txt - early disseminate: satellite erythema migrans, bell's palsy, arthralgias, carditis - chronic: acrodermatitis chronic atrophicans (loss of subcu fat w/atrophic skin) - PCR, tissue cx - doxy or amox x 14-21 days

borrelial lymphocytoma aka, 2 bugs, presentation, txt

- lymphocytoma cutis - borrelia afzellia, borrelia garinii - firm bluish-red tumor or plaque on ear lobes of children or areolae of adults - doxy

louse-borne relapsing fever: 1. bug, 2. vector, 3. presentation, 4. txt

1. borrelia recurrentis 2. body louse pediculus humanus corporis 3. paroxysmal fevers, myalgias, no specific cutaneous findings 4. doxy

tick-born relapsing fever: 1. bugs, 2. vector, 3. presentation, 4. txt

1. borrelia parkeri & hermsii 2. soft ticks ornithodoros 3. paroxysmal fevers, no specific cutaneous findings; risk of Jarisch-Herxheimer rxn 4. doxy

leptospirosis: 1. aka's, 2. bug, 3. transmission, 4. presenation, 5. txt

1. fort bragg fever, pretibial fever, weil ds 2. leptospira interrogans 3. direct skin contact w/ animal urine in water 4. fever, HA, painful pretibial plaques, conjunctivitis, jaundice, diffuse exanthem 5. PCN or macrolide or doxy

yaws: 1. aka, 2. bug, 3. transmission, 4. primary, secondary, tertiary presentation

1. frambesia 2. treponema pallidum (pertenue) 3. direct contact 4. primary: erythematous papules at inoculation ("mother yaw) --> enlarges, ulcerates, disappears with scar secondary: daughter yaws symmetrically over body 5. tertiary: gummata, keratoderma, midfacial destruction, bony inflammation/damage

pinta: bug, transmission, primary, secondary tertiary presentation

treponema carateum direct contact primary: smooth papule at inoculation secondary: psoriaform yellowish-brown papules & plaques (pintids) tertiary: depigmented vitiligo-like lesions over face, wrists, trochanteric areas

endemic syphilis: 1. aka, 2. bug, 3. transmission, 4. primary, secondary presentation

1. bejel 2. treponema pallidum endemicum 3. direct skin contact 4. primary: skin lesions rare secondary: mucosal patches, condylomata lata, LAD +/- osteitis, periostitis, bony damage, gummata

chancroid 1. bug, 2. presentation, 3. gram stain findings, 4. txt

1. haemophilus ducreyi 2. soft painful ulcer w/purulent base & ragged borders, buboes w/ suppuration. no healing w/o txt. 3. school of fish pattern 4. azithro 1g x 1 or ceftriaxone IM x1 or cipro 500 mg bid x3d

granuloma inguinale: 1. aka, 2. bug, 3. presentation, 4. histo finding, 5. txt

1. donovanosis 2. klebsiella (calymmatobacterium) granulomatis 3. painless subcu nodule --> ulcerates to painful beefy red granulation tissue. does not heal w/o txt 4. donovan bodies 5. 3 wks with: azithro 1g qwk or bactrim ds bid or cipro 750 mg bid or doxy 100 my bid

lymphogranuloma venereum 1. aka, 2. bug, 3. presentation, 4. txt

1. tropical buob 2. chlamydia trachomatis L1-L3 serotypes 3. stage I w/ papule --> painless ulcer w/ gray base. stage II w/ u/l suppurative bubo & groove sign 4. gamma-favre bodies 5. 3 wks with: azithro 1g qwk or erythro qid or levo 500mg qd, or doxy 100mg bid

gonorrhea: 1. bug, 2. presentations (4), 3. txt

1. neisseria gonorrhoeae 2. men: urethritis w/ dysuria and pus women: urethritis & purulent cervicitis ascending: salpingitis or PID disseminated: fever, arthralgias, pustualr hemorrhagic lesions 4. azithro 1g x1 or ceftriaxone IM x1 or doxy 100 mg bid x 1wk

Gram Negative Infections Flashcards

(38 cards)