Normal flora: dominant
skin
S. epidermidis
Normal flora: dominant
nose
S. epidermidis
colonized by S. aureus
Normal flora: dominant
oropharynx
Viridans group streptococci
Normal flora: dominant
dental plaque
S. mutans
Normal flora: dominant
colon
B. fragilis > E. coli
Normal flora: dominant
vagina
Lactobacillus
colonized by E. coli & group B strep
food poisoning
reheated rice
B. cereus
food poisoning
improperly canned foods
C. botulinum
food poisoning
reheated meat dishes
C. perfringens
food poisoning
undercooked meat
E. coli
O157:H7
food poisoning
poultry, meat, eggs
Salmonella
food poisoning
meats. mayonnaise, custard
preformed toxin
S. aureus
food poisoning
contaminated seafood
V. parahaemolyticus
V. vulnificus
bugs causing bloody diarrhea
- Campylobacter
- E. histolytica
- EHEC
- EIEC
- Salmonella
- Shigella
- Y. enterocolitica
bugs causing watery diarrhea
- C. difficile
- C. perfringens
- ETEC
- Protozoa
- V. cholerae
- Viruses
common causes of pneumonia
neonates (<4 wks)
- Group B streptococci
- E. coli
common causes of pneumonia
children (4 wks - 18 yrs)
Runts May Cough Chunky Sputum
- Viruses (RSV)
- Mycoplasma
- C. trachomatis (infants - 3 yrs)
- C. pneumoniae (school-aged children)
- S. pneumoniae
common causes of pneumonia
adults (18-40 YO)
- Mycoplasma
- C. pneumoniae
- S. pneumoniae
common causes of pneumonia
adults (40-65 YO)
- S. pneumoniae
- H. influenzae
- Anaerobes
- Viruses
- Mycoplasma
common causes of pneumonia
elderly
- S. pneumoniae
- Influenza virus
- Anaerobes
- H. influenzae
- Gram-negative rods
pneumonia
alcoholic/IV drug user
- S. pneumoniae
- Klebsiella
- Staphylococcus
pneumonia
aspiration
Anaerobes
pneumonia
atypical
- Mycoplasma
- Legionella
- Chlamydia
pneumonia
cystic fibrosis
- Pseudomonas
- S. aureus
- S. pneumnoiae
pneumonia
immunocompromised
- Staphylococcus
- Enteric gram-negative rods
- Fungi
- Viruses
- P. jirovecii (w/ HIV)
pneumonia
nosocomial
- Staphylococcus
- Pseudomonas
- Other enteric gram negative rods
pneumonia
post-viral
- Staphylococcus
- H. influenzae
- S. pneumoniae
common causes of meningitis
newborn (0-6 mo)
- Group B streptococci
- E. coli
- Listeria
common causes of meningitis
children (6 mo - 6 yrs)
- S. pneumoniae
- N. meningitidis
- H. influenzae type B
- Enteroviruses
common causes of meningitis
6 - 60 YO
- S. pneumoniae
- N. meningitidis (#1 in teens)
- Enteroviruses
- HSV
common causes of meningitis
60 YO+
- S. pneumoniae
- Gram-negative rods
- Listeria
CSF findings in meningitis: bacterial
- opening pressure
- cell type
- protein
- sugar
- increased
- increased PMNs
- increased
- decreased
CSF findings in meningitis: fungal/TB
- opening pressure
- cell type
- protein
- sugar
- increased
- increased lymphocytes
- increased
- decreased
CSF findings in meningitis: viral
- opening pressure
- cell type
- protein
- sugar
- normal/increased
- increased lymphocytes
- normal/increased
- normal
osteomyelitis
assume if no other information available
S. aureus (most common overall)
osteomyelitis
sexually active
Neisseria gonorrhoeae (rare)
septic arthritis more common
osteomyelitis
diabetics & IVDA
Pseudomonas aeruginosa
Serratia
osteomyelitis
sickle cell
Salmonella
osteomyelitis
prosthetic joint replacement
S. aureus & S. epidermidis
osteomyelitis
vertebral involvement
Mycobacterium tuberculosis (Pott disease)
osteomyelitis
cat & dog bites
Pasteurella multocida
most osteomyelitis occurs in __________
children
clinical presentation of cystitis
- dysuria
- frequency
- urgency
- suprapubic pain
- WBCs in urine
clinical presentation of pyelonephritis
- fever
- chills
- flank pain
- costovertebral angle tenderness
- hematuria
- WBC casts
UTI bugs
- Escherichia coli
- Staphylococcus saprophyticus
- Klebsiella pneumoniae
- Serratia marcescens
- Enterobacter cloacae
- Proteus mirabilis
- Pseudomonas aeruginosa
common vaginal infections
- Bacterial vaginosis
- Trichomoniasis
- Candida vulvovaginitis
bacterial vaginosis
signs/symptoms
lab findings
- no inflammation
- thin, white discharge w/ fishy odor
- clue cells
- pH > 4.5
trichomoniasis
signs/symptoms
lab findings
- inflammation
- frothy, grey-green, foul-smelling discharge
- motile trichomonads
- pH >4.5
**candida vulvovaginitis **
signs/symptoms
lab findings
- inflammation
- thick, white “cottage cheese” discharge
- pseudohyphae
- pH normal (4.0-4.5)
nonspecific signs common to TORCHES infections
- hepatosplenomegaly
- jaundice
- thrombocytopenia
- growth retardation
ToRCHeS infections
- Toxoplasma gondii
- Rubella
- CMV
- HIV
- Herpes simplex virus-2
- Syphilis
red rashes of childhood
- Coxsackievirus type A
- HHV-6
- Measles virus
- Parvovirus B19
- Rubella virus
- Streptococcus pyogenes
- VZV
rash begins at the head & moves down
- Measles virus
- preceded by cough, coryza, conjunctivitis, blue white Koplik spots on buccal mucosa
- Rubella virus
- fine truncal rash
- postauricular lymphadenopathy
vesicular rash begins on trunk
spreads to face & extremities
lesions of different ages
VZV (chickenpox)
“slapped cheek” rash on face
Parvovirus B19
Erythema infectiosum (5th disease)
sexually transmitted diseases
- AIDS
- Chancroid
- Chlamydia
- Condylomata acuminata
- Genital herpes
- Gonorrhea
- Hepatitis B
- Lymphogranuloma venereum
- Primary syphilis
- Secondary syphilis
- Tertiary syphilis
- Trichomoniasis
top bugs of PID
- Chlamydia trachomatis (subacute)
- Neisseria gonorrhoeae (acute)
clinical presentation of PID
- cervical motion tenderness (chandelier sign)
- purulent cervical discharge
Fitz-Hugh-Curtis syndrome
- infection of the liver capsule
- “violin string” adhesions of peritoneum to liver
nosocomial infections
- Candida albicans
- CMV, RSV
- E. coli, Proteus mirabilis
- HBV
- Legionella
- Pseudomonas aeruginosa
the 2 most common causes of nosocomial infections
- E. coli (UTI)
- S. aureus (wound infection)
bugs affecting unimmunized children
rash
- rubella virus
- measles virus
bugs affected unimmunized children
meningitis
- H. influenzae type B
- Poliovirus
bugs affected unimmunized children
respiratory
- H. influenzae type B
- Corynebacterium diphtheriae
