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Flashcards in Microbiology Deck (41):

The only two gram positive bacteria we need to know

Strep Pneumoniae and staph aureus


Discuss the structures of our gram positive bacteria

Strep Pneumoniae is a diplococci
Staph Aureus is a cocci in clusters


When do we see strep pneumoniae? What about staph aureus?

Strep - Most frequent community aquired and most common in debilitated and elderly.

Staph - Often a complication of influenza, viral pneumoniaes or blood borne infection in IV drug abusers. Also seen in hospitalized patients, the elderly and those with chronic lung diseases.


Presentation of staph aureus vs strep pneumoniae?

Bronchopneumonia with staph, strep is lobar and produces rust colored sputum


Complications and treatment for Strep Pneumoniae?

Comp - Empyema
Treatment - PCNs, cephalosporins, macrolides, some quinolones


Complications for Staph Aureus and treatment?

Comp - Abscess, empyema, bacterial endocarditis

Treat with oxacillin, nafcillin, vancomycin, linezolid


This gram negative coccobacillus requires hematin and NAD+ for culture

H Influenza


In whom and in what way does H. Influenza present?

Usually infants but we can see it in adults with COPD.



Complications and treatment for H. Influenza

Comp - Meningitis, epliglottitis in infants and kids

Treat with cephalosporins or TMP-SMX


How do we distinguish between Klebsiella and Pseudomonas aeruginosa?

They are both gram negative rods!

Klebsiella is more frequent in diabetic or alcoholic patients with a high mortality rate in the elderly.

Pseudomonas appears blue-green when cultured and is a common cause of nosocomial pneumonia and pneumonia in immune compromised and CF patients


Complications of Klebsiella and how we treat it

Large amounts of damage to the alveolar walls leading to necrosis and abscess formation..

Treat with aminoglycosides and cephalosporins


Complications of Pseudomonas and how we treat it

Focal hemorrhage and necrosis

Treat with combination therapy of cillins and gentamicin


What bacteria requires special charcoal yeast agar with iron and cysteine?



Legionella has a relatively high mortality rate if left untreated. How do we treat it?

Macrolides and quinolones


What bacteria produces red currant-jelly sputum? What type of PNA do we see with this bacteria?

Klebsiella and we typically see a bronchopneumonia


Discuss the characteristics of moraxella catarrhalis and who we see it in

This is a gram negative diplococci seen in the elderly and patients with COPD.

It constitutes a bronchopneumonia


How do we treat M. Catarrhalis?

Cephalosporins, macrolides, quinolones


Aspiration pneumoniae usually contains these bacteria and we treat them this way:

Bacteria that are native to you! Treatment is just PCN and clindamycin


Mycoplasma pneumoniae is our young adult pneumonia. As a review, what kind of PNA does it cause and what is it associated with it.

Interstitial and is associated with nonspecific cold agglutinins


This bacteria is found in parrot feces and causes a certain condition

C. Psittaci and it causes psittacosis


Chlamydophila pneumoniae is a ___ bacteria that targets ____ and causes ____ PNA.

Obligate intracellular
Columnar epithelium


We treat Chlamydophila with this (in your answer provide an example of each)

Macrolides like erythromycin
Tetracyclines like Doxycycline


Complications of Coxiella and how we treat it

Can cause hepatitis or myocarditis.

We treat with Doxycycline


We have a bunch of viral pneumonias that can get kids. Which ones can we treat and how?

Influenza A:: Amantadine and rimantadine
Influenza A and B: Zanamavir and oseltamivir
RSV (Prophylactically): Palivizumab and ribavirin


This is an AIDs defining classic sign

Ground glass opacitis on CT, associated with Pneumocystis jirovecci.

We can also see on silver stain alveolar cysts


How do we treat AIDS bacteria?

TMP-SMX: Always give prophylactically if CD4+ count is less than 200


What yeasts do we need to be aware of

Candida Albicans
Cryptococcus neoformans


How do the two yeasts we need to know present?

Candida Albicans - Fever, tachypnea, patchy infiltrates on chest film

Cryptococcus Neoformans - Often asymptomatic, but can have productive cough, fever, and weight loss


Discuss who we tend to get candida albicans in and how we deal with it

This is a very uncommon cause of PNA, however in immune-compromised patients this can present in a hematogenous spread.

We treat with Amphotericin B and fluconazole


Cryptococcus neoformans is associated with this finding and can lead to this.

Associated with pigeon poop and can lead to cryptococcal meningitis.


Cryptococcus neoformans treatment

Cryptococcal meningitis - Give amphotericin B with Flucytosine

If it is non-CNS cryptococcis, give Fluconazole


Narrow angle branching hyphae = what and how do we treat

Aspergillus. Treat with amphotericin B or itraconazole


Asperigillus is a ____



Blastomycoses, coccidiodomycoces and histoplasmosis are all what?

Dimorphic fungi


Blastomycoses and coccidiomycoces presentation

Present with constitutional symptoms.

Blasto - Skin lesions, bone lesions, GU involvement
Coccidio - CP, HA


Our dimorphics present in different locations.Where are they?

Blasto - Midwest and Southeast U.S.
Coccidio - Southwest U.S., Mexico, South America
Histoplasmosis - River valleys of central U.S.


Cellularity of Blasto

Budding yeast inhaled from soil that causes PNA like lung disease.


Cellularity of histoplasmosis

Round/oval yeast from soil contaminated by bat and bird shit. Elicits caseating granuloma formation in tissue.

Can cause multisystem issues with infiltrating macrophages filled with intracellular fungi.


Ceullarity of Coccidio

Fungal spherules containing endospores are found within granulomas.


Treatment for our dimorphic yeasts

Blasto - Ampho B or itraconazole
Histo - Ampho B with or without itraconazole
Coccidio - Ampho B and/or surgery


Appearance and testing for cryptococcus

Organism's encapsulated appearence can be seen with India ink stain and latex agglutination test