Quizlet - Microbiology - Clinical Patterns Flashcards
(175 cards)
1
Q
Tricky T’s: Typhoid fever
A
caused by bacterium Salmonella typhi.
2
Q
Tricky T’s: Typhus
A
caused by bacteria Rickettsia prowazekii (epidemic), Rickettsia typhi (endemic), and Rickettsia tsutsugamushi (scrub typhus)
3
Q
Tricky T’s: Chlamydia trachomatis
A
Bacteria, STD
4
Q
Tricky T’s: Treponema
A
Spirochete; causes syphilis (T. pallidum) or yaws (T. pertenue)
5
Q
Tricky T’s: Trichomonas vaginalis
A
Protozoan, STD.
6
Q
Tricky T’s: Typanosoma
A
Protozoan, causes Chagas’ dz (T. cruzi) or African sleeping sickness.
7
Q
Tricky T’s: Toxoplasma
A
protozoan, a TORCH infxn.
8
Q
Tricky T’s: Trichinella spiralis
A
Nematode in undercooked meat.
9
Q
Prions What are they? What dz’s do they cause? Normal vs. pathologic prions?
A
Infectious agents that do not contain RNA or DNA (consist only of proteins); encoded by cellular genes. Dz’s: Creutzfeldt-Jakob dz (CJD – rapidly progressive dementia), kuru, srapie (sheep), mad cow dz Associated w/ spongiform encephalopathy . Normal prions have alpha-helix conformation; pathologic prions (like CJD) are beta-pleated sheets. Pathologic conformation accumulates b/c it is resistant to proteinase digestion.
10
Q
Dominant normal flora of the: Skin
A
Staphylococcus epidermis
11
Q
Dominant normal flora of the: Nose
A
S. epidermis; colonized by S. aureus
12
Q
Dominant normal flora of the: Oropharynx
A
Viridans group streptococci
13
Q
Dominant normal flora of the: Dental plaque
A
Streptococcus mutans
14
Q
Dominant normal flora of the: Colon
A
Bacteroides fragilis > E. coli
15
Q
Dominant normal flora of the: Vagina
A
Lactobacillus, colonized by E. coli and GBS
16
Q
Neonates and normal flora
A
Neonates delivered by cesarean section havve no flora, but are rapidly colonized after birth.
17
Q
Food poisoning from: Vibrio parahemolyticus and V. vulnificus
A
Food: Contaminated seafood (V. vulnificus can also cause wound infxn from contact w/ contaminated water or shellfish)
18
Q
Food poisoning from: Bacillus cereus
A
Food: reheated rice. (Food poisoning from reheated rice? Be Serious! [B. cereus])
19
Q
Food poisoning from: S. aureus
A
Food: Meats, mayonnaise, custard (pre-formed toxin)
20
Q
Food poisoning from: Clostridium perfringens
A
Food: reheated meat dishes
21
Q
Food poisoning from: Clostridium botulinum
A
Food: improperly canned foods (bulging cans)
22
Q
Food poisoning from: E. coli O157:H7
A
Food: Undercooked meat
23
Q
Food poisoning from: Salmonella
A
Food: poultry, meat, and eggs.
24
Q
What are two bacteria that cause a food poisoning that starts quickly and ends quickly?
A
S. aureus and B. cereus
25
Bugs that cause diarrhea: Campylobacter Type of diarrhea? Findings?
Bloody diarrhea. Comma- or S-shaped organisms; growth at 42C; Oxidase (+) [bugs that cause diarrhea: type of diarrhea and findings]
26
Bloody diarrhea. Comma- or S-shaped organisms; growth at 42C; Oxidase (+) [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Campylobacter
27
Bugs that cause diarrhea: Salmonella Type of diarrhea? Findings?
bloody diarrhea. Lactose (-); Flagellar motility [bugs that cause diarrhea: type of diarrhea and findings]
28
bloody diarrhea. Lactose (-); Flagellar motility [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Salmonella
29
Bugs that cause diarrhea: Shigella Type of diarrhea? Findings?
Bloody diarrhea Lactose (-) Very low ID50 Produces Shiga toxin [bugs that cause diarrhea: type of diarrhea and findings]
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Bloody diarrhea Lactose (-) Very low ID50 Produces Shiga toxin [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Shigella
31
Bugs that cause diarrhea: Enterohemorrhagic E. coli (EHEC) Type of diarrhea? Findings?
Bloody diarrhea O157:H7 Can cause HUS Makes Shiga-like toxin [bugs that cause diarrhea: type of diarrhea and findings]
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Bloody diarrhea O157:H7 Can cause HUS Makes Shiga-like toxin [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Enterohemorrhagic E. coli (EHEC)
33
Bugs that cause diarrhea: Enteroinvasive E. coli (EIEC) Type of diarrhea? Findings?
Bloody diarrhea. Invades colonic mucosa. [bugs that cause diarrhea: type of diarrhea and findings]
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Bloody diarrhea. Invades colonic mucosa. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Enteroinvasive E. coli (EIEC)
35
Bugs that cause diarrhea: Yersinia enterocolitica Type of diarrhea? Findings?
Bloody diarrhea Day-care outbreaks Pseudoappendicitis [bugs that cause diarrhea: type of diarrhea and findings]
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Bloody diarrhea Day-care outbreaks Pseudoappendicitis [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Yersinia enterocolitica
37
Bugs that cause diarrhea: C. difficile Type of diarrhea? Findings?
Can cause both watery and bloody diarrhea. Pseudomembranous colitis. [bugs that cause diarrhea: type of diarrhea and findings]
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Can cause both watery and bloody diarrhea. Pseudomembranous colitis. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: C. difficile
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Bugs that cause diarrhea: Entamoeba histolytica Type of diarrhea? Findings?
Bloody diarrhea. Protozoan. [bugs that cause diarrhea: type of diarrhea and findings]
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Bloody diarrhea. Protozoan. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Entamoeba histolytica
41
Bugs that cause diarrhea: Enterotoxigenic E. coli (ETEC) Type of diarrhea? Findings?
Watery diarrhea. Traveler's diarrhea Produces ST and LT toxins [bugs that cause diarrhea: type of diarrhea and findings]
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Watery diarrhea. Traveler's diarrhea Produces ST and LT toxins [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Enterotoxigenic E. coli (ETEC)
43
Bugs that cause diarrhea: Vibrio cholerae Type of diarrhea? Findings?
Watery diarrhea. Comma-shaped organisms Rice-water diarrhea. [bugs that cause diarrhea: type of diarrhea and findings]
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Watery diarrhea. Comma-shaped organisms Rice-water diarrhea. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Vibrio cholerae
45
Bugs that cause diarrhea: C. perfringens Type of diarrhea? Findings?
Watery diarrhea. Also causes gas gangrene. [bugs that cause diarrhea: type of diarrhea and findings]
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Watery diarrhea. Also causes gas gangrene. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: C. perfringens
47
Bugs that cause diarrhea: Protozoa Type of diarrhea? Findings?
Watery diarrhea Giardia, Cryptosporidium (in immunocompromised) [bugs that cause diarrhea: type of diarrhea and findings]
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Watery diarrhea Giardia, Cryptosporidium (in immunocompromised) [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Protozoa
49
Bugs that cause diarrhea: Viruses Type of diarrhea? Findings?
Watery diarrhea. Rotavirus, adenovirus, Norwalk virus (norovirus). [bugs that cause diarrhea: type of diarrhea and findings]
50
Common causes of pneumonia in neonates (< 4wks)
Group B streptococci E. coli
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Common causes of pneumonia in children (4wks - 18yrs)
Viruses (R SV) M ycoplasma C hlamydia pneumoniae S treptococcus pneumoniae (R unts M ay C ough S putum)
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Common causes of pneumonia in adults (18-40yrs)
Mycoplasma Chlamydia pneumoniae Streptococcus pneumoniae
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Common causes of pneumonia in Adults (40-65yrs)
Streptococcus pneumoniae H. influenzae Anaerobes Viruses Mycoplasma
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Common causes of pneumonia in the elderly (>65)
Streptococcus pneumoniae Viruses Anaerobes H. influenzae Gram (-) rods
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Common causes of nosocomial (hospital-acquired) pneumonia
Staphylococcus Enteric Gram (-) rods
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Common causes of pneumonia in the immunocompromised
Staphylococcus Enteric Gram (-) rods Fungi Viruses Pneumocystis jiroveci (w/ HIV)
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Common cause of pneumonia w/ aspiration
Anaerobes
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Common cause of pneumonia in alcoholics/IV drug users
Streptococcus pneumoniae Klebsiella Staphylococcus
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Common causes of pneumonia in CF
Pseudomonas
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Common causes of post-viral pneumonia
Staphylococcus H. influenzae
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Common causes of atypical pneumonia
Mycoplasma Legionella Chlamydia
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Common causes of meningitis in newborn (0-6 months
Group B streptococci E. coli Listeria
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Common causes of meningitis in children (6mos - 6yrs)
Streptococcus pneumoniae Neisseria meningitidis Haemophilus influenzae type B Enteroviruses
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Common causes of meningitis (6-60yrs)
N. miningitidis Enteroviruses S. pneumoniae HSV
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Common causes of meningitis in 60+ year-olds
Streptococcus pneumoniae Gram (-) rods Listeria
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Viral causes of meningitis
Enteroviruses (esp. coxsackievirus) HSV HIV West Nile virus VZV
67
Common causes of meningitis in HIV
Cryptococcus CMV Toxoplasmosis (brain abscess) JC virus (PML)
68
Incidence of H. influenzae meningitis?
Has decreased greatly w/ introduction of H. influenzae vaccine in last 10-15 years.
69
CSF findings in meningitis: Bacterial [Pressure? Cell type? Protein? Sugars?]
Increased pressure Increased PMNs Increased protein Decreased sugar
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Increased pressure Increased PMNs Increased protein Decreased sugar [CSF findings in meningitis -- what is the bug?]
Bacterial
71
CSF findings in meningitis: Fungal/TB [Pressure? Cell type? Protein? Sugars?]
Increased pressure Increased lymphocytes Increased proein Decreased sugar
72
Increased pressure Increased lymphocytes Increased proein Decreased sugar [CSF findings in meningitis -- what is the bug?]
Fungal/TB
73
CSF findings in meningitis: Viral [Pressure? Cell type? Protein? Sugars?]
Normal/increased pressure Increased lymphocytes Normal/increased protein Normal sugar
74
Normal/increased pressure Increased lymphocytes Normal/increased protein Normal sugar [CSF findings in meningitis -- what is the bug?]
Viral
75
Osteomyelitis in most ppl is due to...? Who gets most osteomyelitis?
Staph aureus in most ppl. Most osteomyelitis occurs in children.
76
Elevated CRP and ESR in osteomyelitis?
Classic findings, but nonspecific
77
Osteomyelitis in sexually active pt
Neisseria gonorrhoeae (rare) Septic arthritis more common
78
Osteomyelitis in diabetics and drug addicts
Pseudomonas aeruginosa
79
Osteomyelitis in Sickle cell
Salmonella
80
Osteomyelitis in prosthetic replacement
S. aureus and S. epidermis
81
Osteomyelitis in vertebra
Mycobacterium tuberculosis (Pott's dz)
82
Osteomyelitis with cat and dog bites/scratches
Pasteurella multocida
83
3 Most common causes of ambulatory UTI
1.) E. coli (50-80%) 2.) Staphylococcus saprophyticus (10-30%): 2nd most common cause of UTI in young, sexually active, ambulatory women 3.) Klebsiella (8-10%)
84
Common causes of UTI in a hospital setting
E. coli Proteus Klebsiella Serratia Pseudomonas
85
Gender and epidemiology of UTIs
10:1 women to men (b/c of short urethra colonized by fecal flora)
86
Predisposing factors to UTIs
Flow obstruction Kidney surgery Catheterization Gynecologic abnormalities Diabetes Pregnancy
87
Mechanisms of UTI infxn
Mostly caused by ascending infxns. In males: babies w/ congenital defects, elderly w/ enlarged prostates
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Sx of UTI
Dysuria Frequency Urgency Suprapubic pain
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Sx of Pyelonephritis
Fever Chills Flank pain CVA tenderness (costovertebral angle -- tender above kidneys on back)
90
UTI bugs: Serratia maracescens Features?
Some strains produce a red pigment; often nosocomial and drug-resistant.
91
Features: Some strains produce a red pigment; often nosocomial and drug-resistant. Which UTI bug is this?
Serratia maracescens
92
UTI bugs: Staphylococcus saprophyticus Features?
2nd leading cause of community-acquired UTI in sexually active women.
93
Features: 2nd leading cause of community-acquired UTI in sexually active women. Which UTI bug is this?
Staphylococcus saprophyticus
94
UTI bugs: Escherichia coli Features?
Leading cause of UTI. Colonies show metallic sheen on EMB agar.
95
Features: Leading cause of UTI. Colonies show metallic sheen on EMB agar. Which UTI bug is this?
Escherichia coli
96
UTI bugs: Enterobacter cloacae Features?
Often nosocomial and drug resistant.
97
Features: Often nosocomial and drug resistant. Which UTI bug is this?
Enterobacter cloacae
98
UTI bugs: Klebsiella pneumoniae Features?
Large mucoid capsule and viscous colonies
99
Features: Large mucoid capsule and viscous colonies Which UTI bug is this?
Klebsiella pneumoniae
100
UTI bugs: Proteus mirabilis Features?
Motility cuases swarming on agar. Produces urease; associated w/ struvite stones.
101
Features: Motility cuases swarming on agar. Produces urease; associated w/ struvite stones. Which UTI bug is this?
Proteus mirabilis
102
UTI bugs: Pseudomonas aeruginosa Features?
Blue-green pigment and fuity odor. Usually nosocomial and drug-resistant.
103
Features: Blue-green pigment and fuity odor. Usually nosocomial and drug-resistant. Which UTI bug is this?
Pseudomonas aeruginosa
104
List of UTI bugs
SSEEK PP S erratia marcescens S taphylococcus saprophyticus E scherichia coli E nterobacter cloacae K lebsiella pneumoniae P roteus mirabilis P seudomonas aeruginosa
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Diagnostic markers of UTI
Leukocyte esterase: (+) = bacterial Nitrite test: (+) = Gram(-) organism
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ToRCHeS infxns What are they? List?
These important infxns are transmitted in utero or during vaginal birth: T oxoplasma gondii o R ubella C MV H IV H SV-2 e S yphilis
107
Other important congenital infxns that do not fit into ToRCHeS
Listeria E. coli Group B streptococci All can be acquired placentally or from birth canal.
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ToRCHeS infxns, organism: Toxoplasma gondii Major clinical manifestations?
Classic triad of chorionitis, intracranial calcifications, and hydrocephalus. May be asymptomatic at birth.
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Major clinical manifestations: Classic triad of chorionitis, intracranial calcifications, and hydrocephalus. May be asymptomatic at birth. Which ToRCHeS organism is this?
Toxoplasma gondii
110
ToRCHeS infxns, organism: Rubella Major clinical manifestations?
Deafness Cataracts Heart defects (PDA, pulmonary artery stenosis) Microcephaly Mental retardation Blueberry muffin baby due to rash
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Major clinical manifestations: Deafness Cataracts Heart defects (PDA, pulmonary artery stenosis) Microcephaly Mental retardation Blueberry muffin baby due to rash Which ToRCHeS organism is this?
Rubella
112
ToRCHeS infxns, organism: CMV Major clinical manifestations?
Petechial rash Intracranial calcifications Mental retardation Hepatosplenomegaly Microcephaly Jaundice 90% are asymptomatic at birth.
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Major clinical manifestations: Petechial rash Intracranial calcifications Mental retardation Hepatosplenomegaly Microcephaly Jaundice 90% are asymptomatic at birth. Which ToRCHeS organism is this?
CMV
114
ToRCHeS infxns, organism: HIV Major clinical manifestations?
Hepatosplenomegaly Neurologic abnormalities Frequent infxns
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Major clinical manifestations: Hepatosplenomegaly Neurologic abnormalities Frequent infxns Which ToRCHeS organism is this?
HIV
116
ToRCHeS infxns, organism: HSV-2 Major clinical manifestations?
Encephalitis Conjuntivitis Vesicular skin lesions Often asymptomatic at birth Most infxns are transmitted during birth thru an infected maternal genital tract.
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Major clinical manifestations: Encephalitis Conjuntivitis Vesicular skin lesions Often asymptomatic at birth Most infxns are transmitted during birth thru an infected maternal genital tract. Which ToRCHeS organism is this?
HSV-2
118
ToRCHeS infxns, organism: Syphilis Major clinical manifestations?
Cutaneous lesions Hepatosplenomegaly Jaundice Saddle nose Saber shins Hutchinson teeth CN VIII deafness Rhinitis (snuffles)
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Major clinical manifestations: Cutaneous lesions Hepatosplenomegaly Jaundice Saddle nose Saber shins Hutchinson teeth CN VIII deafness Rhinitis (snuffles) Which ToRCHeS organism is this?
Syphilis
120
Red rashes of childhood
Measles Rubella HHV-6 (roseola) Scarlet fever (group A streptococcus) Parvovirus B19 (slapped cheek rash)
121
STD's: Gonorrhea Organism? Clinical features?
Neisseria gonorrhoeae Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy purulent discharge
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Neisseria gonorrhoeae Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy purulent discharge Disease?
Gonorrhea
123
STD's: Primary syphilis Organism? Clinical features?
Treponema pallidum Painless chancre
124
Treponema pallidum Painless chancre Disease?
Primary syphilis
125
STD's: Secondary syphilis Organism? Clinical features?
Treponema pallidum Fever, lymphadenopathy, skin rashes, condylomata lata
126
Treponema pallidum Fever, lymphadenopathy, skin rashes, condylomata lata Disease?
Secondary syphilis
127
STD's: Tertiary syphilis Organism? Clinical features?
Treponema pallidum Gummas (a non-cancerous growth, a form of granuloma) Tabes dorsalis General paresis Aortitis Argyll Robertson pupil
128
Treponema pallidum Gummas (a non-cancerous growth, a form of granuloma) Tabes dorsalis General paresis Aortitis Argyll Robertson pupil Disease?
Tertiary syphilis
129
STD's: Genital herpes Organism? Clinical features?
HSV-2 Painful penile, vulvar, or cervical ulcers; can cause systemic Sx such as: fever, HA, myalgia
130
HSV-2 Painful penile, vulvar, or cervical ulcers; can cause systemic Sx such as: fever, HA, myalgia Disease?
Genital herpes
131
STD's: Chlamydia Organism? Clinical features?
Chlamydia trachomatis (D-K) Urethritis, cervicitis, conjunctivitis, Reiter's syndrome, PID
132
Chlamydia trachomatis (D-K) Urethritis, cervicitis, conjunctivitis, Reiter's syndrome, PID Disease?
Chlamydia
133
STD's: Lymphogranuloma venereum Organism? Clinical features?
Chlamydia trachomatis (L1-L3) Ulcers, lymphadenopathy, rectal strictures.
134
Chlamydia trachomatis (L1-L3) Ulcers, lymphadenopathy, rectal strictures. Disease?
Lymphogranuloma venereum
135
STD's: Trichomoniasis Organism? Clinical features?
Trichomonas vaginalis Vaginitis Strawberry-colored mucosa
136
Trichomonas vaginalis Vaginitis Strawberry-colored mucosa Disease?
Trichomoniasis
137
STD's: AIDS Organism? Clinical features?
HIV Opportunistic infxns, Kaposi's sarcoma, lymphoma
138
HIV Opportunistic infxns, Kaposi's sarcoma, lymphoma Disease?
AIDS
139
STD's: Condylomata accumulata Organism? Clinical features?
HPV 6 and 11 Genital warts, koilocytes
140
HPV 6 and 11 Genital warts, koilocytes Disease?
Condylomata accumulata
141
STD's: Hepatitis B Organism? Clinical features?
HBV Jaundice
142
HBV Jaundice Disease?
Hepatitis B
143
STD's: Chancroid Organism? Clinical features?
Haemophilus ducreyi (it's so painful, you do cry ) Painful genital ulcer, inguinal adenopathy.
144
Haemophilus ducreyi (it's so painful, you do cry ) Painful genital ulcer, inguinal adenopathy. Disease?
Chancroid
145
STD's: Bacterial vaginosis Organism? Clinical features?
Garnderella vaginalis Noninflammatory, malodorous discharge (fishy smell) Positive whiff test Clue cells
146
Garnderella vaginalis Noninflammatory, malodorous discharge (fishy smell) Positive whiff test Clue cells Disease?
Bacterial vaginosis
147
Top bugs that cause Pelvic inflammatory dz
Chlamydia trachomatis (subacute, often undiagnosed) Neisseria gonorrhoeae (acute, high fever) Chlamydia trachomatis (the most common STD in the USA: 3-4milliion cases/year)
148
Signs and Sx's of Pelvic inflammatory dz
Cervical motion tenderness (chandelier sign) Purulent cervical discharge. May include: Salpingitis, endometritis, hydrosalpinx, and tubo-ovarian abscess.
149
Pelvic inflammatory dz can lead to... ?
Fitz-Hugh-Curtis Syndrome: infxn of the liver capsule and violin string adhesions of parietal peritoneum to liver.
150
What is salpingitis a risk factor for?
Ectopic pregnancy Infertility Chronic pelvic pain Adhesions
151
Other STD's that cause PID
Garnderella (clue cells) Trichomonas (corkscrew motility on wet prep)
152
Nosocomial pathogen: CMV, RSV Risk factor?
Newborn nursery
153
Risk factor for a nosocomial pathogen: Newborn nursery
What is the pathogen? CMV, RSV
154
Nosocomial pathogen: E. coli, Proteus mirabilis Risk factor?
Urinary catheterization
155
Risk factor for a nosocomial pathogen: Urinary catheterization What is the pathogen?
E. coli, Proteus mirabilis
156
Nosocomial pathogen: Pseudomonas aeurginosa Risk factor?
Respiratory therapy equipment
157
Risk factor for a nosocomial pathogen: Respiratory therapy equipment What is the pathogen?
Pseudomonas aeurginosa
158
Nosocomial pathogen: HBV Risk factor?
Work in renal dialysis unit
159
Risk factor for a nosocomial pathogen: Work in renal dialysis unit What is the pathogen?
HBV
160
Nosocomial pathogen: Candida albicans Risk factor?
Hyperalimentation
161
Risk factor for a nosocomial pathogen: Hyperalimentation What is the pathogen?
Candida albicans
162
Nosocomial pathogen: Legionella Risk factor?
Water aerosols
163
Risk factor for a nosocomial pathogen: Water aerosols What is the pathogen?
Legionella
164
The 2 most common causes of nosocomial infxns?
E. coli (UTI) S. aureus (wound infxn)
165
Presume Pseudomonas aeruginosa as the cause of a nosocomial infxn when...?
Presume Pseudomonas AIR uginosa when AIR or burns are involved.
166
When do you suspect Legionella as a cause of nosocomial infxn?
Suspect Legionella when a water source is involved.
167
Bug hints (if all else fails):Pus, empyema (collection of pus in pre-existing anatomical cavity), abscess What is the bug?
S. aureus
168
Bug hints (if all else fails):Pediatric infxn What is the bug?
haemophilus influenzae (including epiglottitis)
169
Bug hints (if all else fails):Pneumonia in CF, burn infxn What is the bug?
Pseudomonas aeruginosa
170
Bug hints (if all else fails):Branching rods in oral infxn What is the bug?
Actinomyces israellii
171
Bug hints (if all else fails):Traumatic open wound What is the bug?
Clostridium perfringens
172
Bug hints (if all else fails):Surgical wound What is the bug?
S. aureus
173
Bug hints (if all else fails):Dog or cat bite What is the bug?
Pasteurella multocida
174
Bug hints (if all else fails):Currant jelly sputum What is the bug?
Klebsiella
175
Bug hints (if all else fails):Sepsis/meningitis in newborn What is the bug?
group B strep
