Microbiology:ClinicalBacteriology Flashcards
(209 cards)
1
Q
What is the next stain that should be done on gram + cocci and what does it distinguish?
A
Catalase + → Staph
Catalase - → Strep
2
Q
What is the next stain that should be done on staph to distinguish subtypes?
A
Coagulase + → S. aureus
Coagulase - → S. epidermidis and saprophyticus
3
Q
How can S. epidermis and saprophyticus be distinguished?
A
Novobiocin sensitive → S. epidermis
Novobiocin resistant → S. saprophyticus
4
Q
What are the the three main categories of hemolysis in strep bacteria?
A
beta (COMPLETE)
alpha (PARTIAL, green)
gamma (NONE)
5
Q
What are the two groups of beta hemolytic strep?
A
Group A (S. pyogenes) Group B (S. agalactiae)
6
Q
How can Group A and B strep be distinguished?
A
Bacitracin sensitive → Group A
Bacitracin resistant → Group B
7
Q
What are the two main groups of alpha hemolytic strep?
A
S. pneumoniae
Virdians streptococci
8
Q
What are the two main things that distinguish S. pneumonia and virdans strep?
A
S.pneumo: optochin sensitive and capsulated (Qullung +)
Viridans: optochin resistant and no capsule
9
Q
What are the two main groups of gamma hemolytic strep?
A
Group D: enterococcus (ie: E. faecalis)
Non-enterococcus (ie: S. bovis)
10
Q
How are the enterococci distinguished from the nonenterococci?
A
Enterococci: grow in bile and 6.5% NaCl
Nonenterococci: grow in bile but NOT 6.5% NaCl
11
Q
What are the 4 beta hemolytic bacteria?
A
S. pyogenes
S. agalactiae
S. aureus
Listeria monocytogenes
12
Q
What is the role of protein A in S. aureus?
A
Binds the Fc of IgG, inhibiting complement fixation and phagocytosis
13
Q
What are the inflammatory diseases that S. aureus causes? (3)
A
Skin infections
Organ abscesses
Pneumonia
14
Q
What are the toxin mediated disease caused by S. aureus? (3)
A
Toxic shock syndrome (TSST-1)
Scaled skin syndrome (exfoliative toxin)
Rapid-onset food poisoning (enterotoxins)
15
Q
What makes MRSA resistant to beta lactams?
A
Altered penicillin binding protein
16
Q
What kind of bacterial endocarditis does S. aureus cause?
A
ACUTE; can infect normal valves
17
Q
What bacteria commonly infects prosthetic devices and IV catheters by producing adherent biofilms? (also contaminates blood cultures)
A
S. epidermidis
18
Q
What 4 disease is S. pneumoniae the MCC of?
A
Meningitis
Otitis media (in children)
Pneumonia
Sinusitis
19
Q
Virulence of S. pneumoniae is conferred by its:
A
Capsule
20
Q
2 main things that viridans strep causes:
A
- Dental caries (S. mutans)
2. Subacute bacterial endocarditis at damaged valves (S. sanguis)
21
Q
How can viridans strep be differentiated from S. pneumoniae? (both alpha hemolytic)
A
Viridans is resistant to optochin
22
Q
What are the 3 pyogenic sequlae of S. pyogenes infection? 3 toxigenic?
A
Pyogenic: pharyngitis, cellulitis, impetigo
Toxigenic: scarlet fever, toxic shock-like syndrome, necrotizing fasciitis
23
Q
What are the two immunologic late sequelae of S. pyogenes infection?
A
Rheumatic fever
Post-streptococcal glomerulonephritis
24
Q
Lancet-shaped, encapsulated, gram positive diplococci?
A
S. pneumoniae
25
Antibodies to ____ enhance host defense against S. pyogenes, but can give rise to rheumatic fever
M protein
26
What can be used to detect a recent S. pyogenes infection?
ASO titer (antistreptolysin O)
27
What is the criteria for rheumatic fever?
```
Joints (polyarthritis)
♥ carditis
Nodules (subcutaneous)
Erythema marginatum
Syndenham's chorea
```
28
What usually precedes rheumatic fever? Glomerulonephritis?
Pharyngitis
| Impetigo (sometimes pharyngitis)
29
Bacteria associated with "rusty" sputum, sepsis in sickle cell anemia, splenectomy?
S. pneumoniae
30
What is seen in Scarlet fever following S. pyogenes infection?
Scarlet rash sparing the face
Strawberry tongue
Scarlet throat
31
What bacteria causes pneumonia, meningitis, and sepsis, mainly in babies?
Streptococcus agalactiae (Group B)
32
S. agalactiae produces ____, which enlarges the area of hemolysis formed by S. aureus
_____ test positive
CAMP factor
| Hippurate test positive
33
Women would be screened for S. agalactiae at __ - ___ weeks and patients with a positive culture should get what treatment?
35-37 wk
| Intrapartum penicillin prophylaxis
34
Enterococci are normal colonic flora that are penicillin G resistant and what what 3 infections?
1. UTI
2. Biliary tract infections
3. Subacute endocarditis
35
How are enterococci distinguished from nonenterococci?
Both grow on bile, but only enterococci can grow on 6.5% NaCl
36
What nonenterococcus can cause bacteremia and subacute endocarditis in colon cancer patients?
Streptococcus bovis (Group D strep)
37
What is the exotoxin of C. diphtheriae encoded by?
beta prophage
38
What is the MOA of diphtheria toxin?
Inhibits protein synthesis by ADP-ribosylating EF-2
| **same as Pseudomonas exotoxin A
39
What are the sx of diphtheria?
Pseudomembranous pharyngitis
Lymphadenopathy
Myocarditis
Arrhythmias
40
What is the lab dix of diphtheria based on?
Gram positive rods with metachromatic (blue and red( granules
Elek's test for the toxin
41
What does C. diphtheriae grow on?
Black colonies on cystine-tellurite agar
42
What is the ABCDEFG of C. diphtheriae?
```
ADP ribosylation
Beta prophage
Corynebacterium
Diphtheria
EF2
Granules (metachromic)
```
43
At what stage of the growth curve do bacteria produce spores?
Stationary phase
44
What do spores have at their core?
Dipicolinic acid
45
How can spores be killed?
Autoclave: 121 C for 15 minutes
46
How does tetanospasmin for C. tetani work?
Cleaves snares and blocks the release of glycine and GABA from Renshaw cells of the spinal cord
Loss of inhibition leads to spastic paralysis, truisms, rises sardonicus
47
What is the MOA of the preformed, heat labile toxin from C. botulinum?
Inhibits ACh release the the NMJ
48
How does botulism occur in adults? Infants?
Adults: injection of preformed toxin from canned food
Infants: ingestion of spores from honey --> floppy baby syndrome
49
Clostridia are gram __ and obligate _____s
Gram +
| Obligate anaerobes
50
What is the classic triad of adult botulism?
Diplopia
Dysphagia
Dysphonia
51
What is the toxin produced by C. perfringens and its effect?
Alpha toxin
| Phospholipase that causes myonecrosis (gas gangrene) and hemolysis
52
What are the two toxin produced by C. difficile?
Toxin A: enterotoxin, binds bruch border
| Toxin B: cytotoxin, destroys cytoskeleton
53
What is the MCC of C. diff infection?
Antibiotic use (esp clindamycin and ampicillin)
54
How is C. diff diagnosed?
Toxin in the stool
55
Tx of C. diff?
Oral metronidazole or vancomycin
56
What is the only bacteria with a polypeptide capsule?
Bacillus anthracis (gram + and spore forming)
57
What happens in cutaneous anthrax?
Contact → black eschar (painless)
| Can progress to bacteremia and death
58
What happens in pulmonary anthrax?
Spores inhaled → flu like syndrome with fever, pulmonary hemorrhage, mediastinitis, and shock
**Woolsorter's disease
59
What is the edematous ring surrounding the black eschar in cutaneous anthrax caused by?
Lethal factor
| Edema factor
60
What bacteria is often acquired from reheated rice?
Bacillus cereus
| **keeping rice warm leads to germination of spores and enterotoxin formation
61
What are the two types of disease caused by bacillus cereus?
EMETIC: N/V within 1-5 hr, caused by preformed toxin cereulide
DIARRHEAL: watery, nonbloody diarrhea and GI pain in 8-18 hr
62
What is a facultative IC microbe that is often acquired by injection of unpasturized milk/cheese or by vaginal transmission during birth?
Listeria monocytogenes
63
Diseases caused by Listeria:
```
Amnoionitis, septicemia, and spontaneous abortion in pregnant women
Granulomatous infantiseptica
Neonatal meningitis
Meningitis in IC patients
Mild gastroenteritis in healthy people
```
64
Though gastroenteritis from Listeria is typically self-limited, what can be used to treat infants, immunocompromised, and the elderly for meningitis?
Ampicillin
65
What two bacteria form long, branching filaments like fungi? Which one is aerobic? Anaerobic?
Actinomyces: anaerobic
Nocardia: aerobic
66
Is actinomyces or nocardia acid fast?
Nocardia
67
What does nocardia cause in the immunocompetant? Immunocompromised?
Competent: cutaneous infections after trauma
Compromised: pulmonary infections
68
How do you treat actinomyces? Nocardia?
Actinomyces: penicillin
Nocardia: sulfonamides
69
What is a Ghon complex in primary TB?
Hilar nodes AND a Ghon focus (usually in the mid zone of lung)
70
Where does secondary TB typically appear in the lung?
Upper lobes (fibrocaseous cavitary lesion)
71
What are the five main sites of extra pulmonary TB?
1. CNS (parenchymal tuberculoma or meningitis)
2. Vertebral body (Pott's disease)
3. Lymphadenitis
4. Renal
5. GI
72
What bacteria causes oral/facial abscesses that drain through sinus tracts and yellow "sulfur granules"?
Actinomyces
73
What are the "sulfur granules" seen in Actinomyces infections?
Aggregation of organisms bound by proteins (no sulfur involved)
74
When would you see a positive PPD?
Current infection
Past exposure
BCG vaccinated
75
What would you see a negative PPD?
No infection
Anergic (steroids, malnutrition, immunocompromise)
Sarcoidosis
76
What bacteria causes disseminated, non-TB disease in AIDs, which is often resistant to multiple drugs?
What is prophylactic treatment for it?
M. avium-intracellulare
| Azithromycin
77
TB sx?
Fever
Night sweats
Weight loss
Hemoptysis
78
What is the role of mycobacterial cord factor? Sulfatides?
Cord factor: inhibits MØ maturation and induces release of TNFalpha
Sulfatides: inhibit phagolysosomal fusion
79
What is an acid-fast bacillus that likes cool temperatures (infecting the superficial nerves and causing a glove and stocking loss of sensation)?
Mycobacterium leprae
80
What is the reservoir for mycobacterium leprae in the US?
Armadillos
81
What are the two forms of Hansen's disease and how does their presentation differ?
Lepromatous: presents diffusely over the skin and is communicable
Tuberculoid: limited to few, hairless skin plaques
82
What is the immune response that leads to lepromatous vs tuberculoid Hansen disease?
Lepromatous: low cell-mediated immunity with humoral Th2 response
Tuberculoid: high cell mediated immunity with Th1 response
83
Therapy for lepromatous vs tuberculoid Hansen disease?
L: 2-4 yr of dapsone, rifampin, clofazimine
T: 6 mo of dapsone and rifampin
84
What is the next test that should be done to differentiate gram negative diplococci?
Maltose fermenter: N. meningitidis
| Maltose nonfermenter: N. gonorrnoeae
85
What bacteria is often contracted by animal bites?
Pasturella
86
What does H. influenzae require for growth?
Chocolate agar with factors V (NAD) and X (hematin)
87
What should be done to distinguish gram negative, comma shaped bacteria?
Grows in 42 C: Campylobacter jejuni
| Grows in alkaline media: V. cholerae
88
Are campylobacter jejune and V. cholera oxidase + or -?
Oxidase positive
89
What is the next test that should be done to distinguish gram negative rods?
Lactose fermentation
90
What are the lactose fermenting gram negative rods?
```
maConKEES
Citrobacter (slow)
Klebsiella (fast)
E. coli (fast)
Enterobacter (fast)
Serratia (slow)
```
91
Of the lactose non fermenting gram negative rods, which ones are oxidase negative? (3)
Shigella
Salmonella
Proteus
92
Of the lactose non fermenting gram negative rods, which ones are oxidase positive? (2)
Pseudomonas aeruginosa
| H. pylori
93
What lab test can differentiate shigella and salmonella?
Salmonella can produce hydrogen sulfide
94
How do lactose-fermenting colonies appear on MacConkey's?
| What else can E. coli be grown on to identify it?
Pink colonies
| EMB agar: E. coli will have a green sheen while other lactose fermenters will be purple/black
95
What does E. coli express that allows it to break lactose into glucose and galactose?
Beta galactosidase
96
Why are gram negative bacteria resistant to penicillin G and vancomycin?
Outer membrane inhibits entry
97
Both strains of Neisseria ferment ___ and produce __ protease
Glucose
| IgA protease
98
Which strain of Neisseria has a polysaccharide capsule?
Meningococci
99
Why is there no vaccine for N. gonococci?
Rapid antigenic variation of pilus proteins
100
Which strain of Neisseria is sexually transmitted? Transmitted by respiratory secretions?
Gonococci
| Meningococci
101
What diseases does N. gonorrhoeae cause?
```
Gonorrhea
Septic arthritis
Neonatal conjunctivitis
PID
Fitz-Hugh-Curtis syndrome: inflammation of liver capsule
```
102
What diseases does N. meningitides cause?
Meningococcemia and meningitis
| Waterhouse-Friderichsen syndrome
103
Tx for N. gonorrhoeae?
Ceftriaxone
| add azithromycin or doxy for Chlamydia coverage
104
What can be used for N. meningitides prophylaxis in close contacts?
RIFAMPIN, ciprofloxin, ceftriaxone
105
What is used for tx of N. meningitides
Ceftriaxone or
| Penicillin G
106
What are the 4 main diseases caused by haemophilus?
| *haEMOPhilus*
```
Epiglottitis
Menigitis
Otitis media
Pneumonia
**does NOT cause the flu
```
107
Most invasive disease caused by H. inf is caused by what strain?
capsular type B
108
What do nontypable strains of H. inf cause?
Mucosal infections like otitis media, conjunctivitis, bronchitis
109
What enzyme does H. inf produce that Neisseria also produces?
IgA protease
110
What media does H. influenzae grow on?
Chocolate agar with factors V (NAD) and X (hematin)
| **can also be grown with S. aureus, which provides factor V
111
How is meningitis caused by H. inf treated?
Ceftriaxone
112
What is used for prophylaxis of H. inf meningitis in close contacts?
Rifampin
113
What is the vaccine for H. inf type B directed against?
Polyribosylribitol phosphate (conjugated to diptheria toxoid)
114
What are the two diseases caused by Legionella pneumophila?
Legionnaire's disease: severe pneumonia, GI, and CNS sx
| Pontiac fever: mild, flu-like
115
How is Legionella stained?
Silver stain
116
How is Legionella cultured?
Charcoal yeast extract culture with iron and cysteine
117
How is Legionella infection detected clinically?
Presence of antigen in the urine
118
How is Legionella transmitted?
Aerosol transmission from a water source (no person to person)
119
How is Legionella treated?
Macrolides
| Quinolones
120
What will labs show during a Legionella infection?
Hyponatremia (by destroying the juxtaglomerular apparatus, no secretion of renin)
121
What diseases is pseudomonas associated with?
| *PSEUDOmonas
```
Pneumonia (esp in CF)
Sepsis (black lesions on the skin)
Eexternal otitis (swimmers ear)
UTI
Diabetic osteomyelitis
Hot-tub folliculitis
**VERY common burn infections
```
122
Is pseudomonas aerobic or anaerobic?
Oxidase positive or negative?
Lactose fermenting?
Aerobic
Oxidase positive
Non lactose fermentin
123
What is the pigment produced by pseudomonas
Pyocyanin (blue-green); grape-like odor
124
Tx for pseudomonas?
Aminoglycoside + extended-spectrum penicillin (piperacillin or ticarcillin)
125
What diseases caused by E coli are the following virulence factors important for:
1. Fimbriae
2. K capsule
3. LPS endotoxin
1. Cystitis and pyelonephritis
2. Pneumonia and neonatal meningitis
3. Septic shock
126
What strain of E coli causes dysentery?
EIEC: invades the mucosa, causing necrosis and inflammation (no toxins)
**similar clinically to shigella
127
What strain of E coli causes traveler's diarrhea (watery)?
ETEC: labile toxin and stabile toxin increase secretion and decrease reabsorption; no invasion or inflammation
128
What strain of E coli often causes diarrhea in children?
EPEC: no toxin - flattens villi and prevents absorption
129
What is the MC serotype of EHEC?
0157:H7
130
Think ____ in burn victim infections
Pseudomonas
131
What two diseases does EHEC cause?
Dysentery (shiga-like toxin)
| HUS - anemia, thrombocytopenia, acute renal failure
132
How can EHEC be distinguished from the other strains of E. coli with a lab test?
EHEC does NOT ferment sorbitol
133
What are the "4 As" of Klebsiella?
```
Aspiration pneumonia
Abscesses of the lungs and liver
Alcoholics
diAbetes
**also cause nosocomial UTIs
```
134
Who gets pneumonia from Klebsiella?
Alcoholics and diabetics get aspiration lobar pneumonia
135
What is characteristic of Klebsiella colonies? Of the sputum?
Mucoid due to abundant polysaccharide capsule
| Red "current jelly" sputum
136
What differs between the motility and the spread of salmonella vs shigella?
Salomonella: flagellum and spreads hematogenously
Shigella: no flagellum, cell to cell transmission
137
What is the effect of antibiotics on salmonella and shigella infections?
Salmonella: prolongs sx
Shigella: prolongs the excretion of organism in the feces
138
Upon invading the intestinal mucosa, what kind of response does salmonella elicit? Shigella?
Salmonella: monocytic
Shigella: PMN
139
What kind of diarrhea do both salmonella and shigella cause?
Bloody diarrhea
140
What causes typhoid fever? Presentation?
Salmonella typhi
| Rose spots on the abdomen, fever, headache, and diarrhea
141
Where is Salmonella typhi found in the carrier state?
Gallbladder
142
What bacteria is a common antecedent to Guillain Barre syndrome and reactive arthritis?
Campylobacter jejuni
143
Campylobacteri jejuni is the major cause of:
| Transmitted by:
Bloody diarrhea in kids
| Fecal oral transmission though poultry, meat, unpasturized milk
144
Campylobacter jejuni is oxidase __ and grows at __ degrees C
```
positive
42 degrees (warm, CAMPfire!)
```
145
How does vibrio cholerae produce rice-water diarrhea?
Permenant activation of Gs, increasing cAMP
146
V. cholerae is oxidase __ and grows in ___ media
Oxidase positive
| Alkaline media
147
What bacteria is often transmitted by pet feces (puppies), contaminated milk, and pork, and causes mesenteric adenitis that mimics appendicitis or Crohns?
Yersinia enterocolitica
148
What causes 90% of duodenal ulcers?
H. pylori
149
What is H. pylori a RF for? (3)
Peptic ulcers
Gastric adenocarcinomas
Lymphomas
150
What biochemical feature of H. pylori allows dx?
Urease positive (can use urea breath test)
151
What kind of environment does H. pylori create?
Alkaline
152
What triple therapy is used for H. pylori infections?
```
PPi *
Metronidazole
Clarithromycin*
Amoxicillin
(Tertacycline)
```
153
What are the 3 spirochetes?
Borrelia (seen with Wright or Giemsa)
Leptospira
Treponema (dark field microscopy)
154
What bacteria is found in water contaminated with animal urine?
Classic person to get it?
Leptospira interrogans
| Surfers in the tropics
155
What are the sx of Leptospira interrogans infection?
Flu-like symptoms
Jaundice
Photophobia with conjunctivitis
156
What is Weil's disease?
Severe Leptospira infection: causes jaundice and azothemia from liver and kidney dysfunction, fever, hemorrhage, and anemia
157
What bacteria causes Lyme disease and what transmits it?
| Natural reservoir?
Borrelia burgdorferi
Ixodes (also the factor for Babesia)
Mouse
158
Tx for Lyme disease?
Doxy
| Ceftriaxone
159
What are the 3 stages of lyme disease?
1: erythema chronic migraines and flu-like sx
2: facial nerve palsy and AV nodal block
3: chronic monoarthritis and migratory polyarthritis, encephalopathy/polyneuropathy, and cutanenous manifestations
160
What bacteria causes syphilis?
| Tx?
Treponema pallidum
| Penicillin G
161
What is seen with primary syphilis? How is it screened for/confirmed?
Localized disease with painless chancre
| * Screen with VDRL and confirm with FTA-ABS
162
What is seen in secondary syphilis?
| How is it screened for/confirmed?
Constitutional sx
Maculopapular rash on palms and soles
Condylomata lata
* Screen with VDRL and confirm with FTA-ABS
163
What is seen in tertiary syphilis?
| How is it tested for?
```
Gummas (chronic granulomas)
Aortitis (vasa vasorum destroyed)
Neurosyphilis (tabes dorsalis)
Argyll Robertson pupil
*VDRL of spinal fluid
```
164
What is seen in congenital syphilis?
```
Saber shins
Saddle nose
CN VIII deafness
Hutchinson's teeth
Mulberry molars
```
165
What is Argyll Roberton pupil?
Constricts with accommodation but is not reactive to light
| **seen with tertiary syphilis
166
VDRL detects a nonspecific antibody that reacts with:
beef cardiolipin
167
What causes false positives of the VDRL test for syphilis?
V iral infections (mono and hepatitis)
D rugs
R heumatic fever
L upus and leprosy
168
What is Jarisch-Herxheimer reaction?
Flu-like syndrome after starting antibiotics due to killed bacteria releasing pyrogens
169
What bacteria causes cat scratch disease? Transmission?
Bartonella
| Cat scratch
170
What bacteria causes Lyme disease? Carrier?
```
Borrelia burgdorferi
Ixodes ticks (on deer and mice)
```
171
What bacteria causes undulant fever? Source?
Brucella
| Unpasturized dairy
172
What bacteria is the MCC of bloody diarrhea? Source?
Campylobacter
| Livestock, puppies (fecal oral)
173
What bacteria causes an atypical pneumonia transmitted by parrots and other birds?
Chlamydophila psittaci
174
What is broad based ataxia, positive Romberg, Charcot joints, and stroke w/o HTN a sign of?
Tertiary syphilis
175
What bacteria causes Q fever? Source?
Coxiella burnetti
| Aerosols of cattle/sheep amniotic fluid
176
What bacteria does the Lone Star Tick transmit?
Ehrlichia chaffeensis (causes Ehrlichiosis)
177
What bacteria is transmitted by rabbits, ticks, and deer flies?
Francisella tularensis
| **Skin lesion with black base or pneumonia
178
What bacteria is transmitted by animal urine?
Leptospira (causes leptospirosis; flu-like, jaundice, photophobia)
179
What bacteria has a reservoir in armadillos?
Mycoplasma leprae (Leprosy)
180
What bacteria causes cellulitis and osteomyelitis after an animal bite?
Pasturella multocida
181
What bacteria causes epidemic typhus?
Endemic typhus?
**transmitted by:
Epidemic: R. prowazekii; louse
Endemic: R. typhi; fleas
182
What bacteria causes Rocky Mountain Spotted Fever?
| Transmitted by:
Rickettsia rickettsii
| Dermacentor tick bite
183
What bacteria causes the plague? Transmitted by:
Yersinia pestis
| Fleas (rats and prairie dogs are reservoirs)
184
What is a gram variable, pleomorphic rod that presents with gray vaginal discharge and fishy smell?
Gardnerella vaginalis
185
What is visible under the microscope with a Gardnerella vaginalis infection?
Clue cells: vaginal epithelial cells covered with bacteria
| "I don't have a clue why i smell fish in the vagina garden" -FirstAid
186
Tx of Gardnerella vaginalis?
Metronidazole
187
What is the tx for all Rickettsial diseases and vector-bourne illness?
Doxycycline
188
What is the spread of the rash seen in Rocky Mountain Spotted Fever?
Starts at the wrists and ankles
| Spreads to the trunk, palms, and soles
189
Rickettsiae are obligate IC organisms that need __ and ___ to survive
CoA
| NAD+
190
What are the three circumstances where a palm and sole rash is seen?
*use palms and soles in CARS
Coxsackievirus A (hand food and mouth disease)
Rocky Mountain Spotted Fever
Secondary syphilis
191
What are the 2 forms of typhus and the pattern of the rash seen?
Endemic (fleas) - R. typhi
Epidemic (louse) - R. prowazekii
**Rash starts centrally and spreads out, sparing the palms and soles
192
When will you see monocytes with morula in the cytoplasm? Granulocytes with morula in the cytoplasm?
Monocytes: Ehrylichiosis
Granulocytes: Anaplasmosis
**both Tick-transmitted
193
What is abnormal about fever in comparison to other Rickettsial-like diseases?
Coxiella burnetti has no vector
No rash
Can survive outside the host in its endospore form
194
What are the two obligate intracellular bacteria that can't make ATP?
Chlamydia
| Rickettsia
195
What are the two morphological/infectious states that Chlamydia can be found in?
```
Elementary body (small and dense): infectious
Reticular body: binary fission
```
196
What is the reservoir for Chlamydiophila psittaci?
Avian reservoir
197
How is the lab dx of Chlamydia made?
Cytoplasmic inclusions seen on Giemsa or fluorescent antibody-stained smear
198
What is unusual about the chlamydial cell wall?
Lacks muramic acid
199
What strain of Chlamydia causes reactive arthritis, conjunctivitis, nongonococcal urethritis, and PID?
Chlamydia trachomatis
200
What two strains of Chlamydia cause atypical pneumonia?
C. pneumoniae and psittaci
201
What at two possibilities for Chlamydia tx?
Azithromycin (1x treatment)
| Doxycycline
202
What do serotypes A, B, and C of Chlamydia trachomatis cause?
Chronic infection; blindness due to follicular conjunctivitis in Africa
203
What do serotypes D-K of Chlamydia trachomatis cause?
Urethritis/PID --> ecotopic preg
Neonatal pneumonia (staccato cough)
Neonatal conjuntivitis
204
What do serotypes L1, L2, and L3 of Chlamydia trachomatis cause?
Lymphogranuloma venereum
205
What is the classic cause of atypical/walking pneumonia?
| Clinical features?
Mycoplasma pneumoniae
| Insidious onset, headache, nonproductive cough, diffuse interstitial infiltrate
206
What will there be a high titer of with Mycoplasma pneumoniae?
Cold agglutinins (IgM); agglutinate or lyse RBCs
207
What media is used to grow M. pneumoniae?
Eaton's agar
208
What does the bacterial membrane of M. pneumoniae contain?
Sterols for stability (no cell wall)
209
What is used to treat M. pneumoniae?
Macrolide or fluoroquinolone
| **no cell wall so penicillin won't work
