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
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.
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
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?
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