ORGANISM STAPHYLOCOCCUS -

DISEASE

IP

TREATMENT

Localized cutaneous infections F- Folliculitis F- Furuncle C- Carbuncle I- Impetigo

Vancomycin is often used to treat MRSA

Systemic infections O- Osteomyelitis B- Bacteremia

Toxigenic disease F- Food intoxication S- Staphylococcal scalded skin syndrome T- Toxic shock syndrome

COAGUASE NEGATIVE STAPHYLOCOCCI Staphylococcus Epidermidis Staphylococcus Saprophyticus

colonize implanted medical devices

STREPTOCOCCUS
Poststreptococcal Diseases: S- Scarlet fever- 2 day: sandpaper rash T- Toxic shock syndrome A- Acute Glomerulonephritis Begins: 1- 4 wks after pharyngitis 3-6 wks after skin infx R- Rheumatic Fever Begins: 3 wks after pharyngitis Latent pd: 1-4 wks
nd

Pe- Penicillin G DOC Te- Tetracyclines Ce- Cephalosporins Ma- Macrolides *Not Aminoglycosides

Streptococcus pyogenes

Local infections:

P- Puerperal fever P- Pyoderma / Impetigo P- Pharyngitis B- Bacteremia / Sepsis E- Erysipelas N- Necrotizing fasciitis C- Cellulitis S- Sorethroat

Grp A Streptococcus

S- Scarlet Fever T- Toxic Shock Syndrome

GROUP B Streptococcus Agalactiae

Children: M- Meningitis N- Neonatal Pneumonia S- Sepsis Debilitated: W- Wound infx E- Endocarditis S- Skin infx

GROUP D Enterococcus faecalis Enterococcus Faecium Enterococcus Durans

GROUP C&G

Debilitated: W- Wound infx U- Urinary infx S- Skin infx

P- Pharyngitis B- Bacteremia G- Glomerulonephritis

Streptococcus Pneumoniae

L- Lobar Pneumonia B- Bronchopneumonia

Penicillin G Vaccine:

Adults: Pneumococcal Polysaccharide Vaccine 23 (PPSV23) Children: Pneumococcal Conjugate Vaccine 7/13 (PCV 7/13)

BACILLUS Bacillus Anthracis

C- Cutaneous Anthrax Begins: 2-5 days after inoculation of spores into an exposed part of the body Within 7- 10 days: Black eschar

I- Inhalation Anthrax/ Woolsorters disease

6 wks

C- Ciprofloxacin D- Doxycycline P- Penicillin Prophylaxis: Ciprofloxacin for 4 weeks with 3 doses of vaccine Vaccination: O.5 ml IM at 0, 4 weeks then at 6,12 and 18

G- Gastrointestinal Anthrax

months followed by annual booster

Bacillus Cereus

Food Poisoning rice/ pasta dishes

Emetic Toxin: 1-5 hrs after ingestion Enterotoxin: 1-24 hrs

CLOSTRIDIUM Clostridium Botulinun

Botulism- lethal dose: 1-2 ug/ kg P- Penicillin M- Metronidazole T- Trivalent botulinum antitoxin V- Vntilatory Support

Clostridium Tetani

Tetanus

P- Penicillin H- HUMAN TETANUS IMMUNE GLOBULIN IV (HTIG) B- Benzodiazepines are also used to indirectly

antagonize the effects of the toxin Q- Quiet dark environment, sedation, and provision of an adequate airway S- Surgical debridement

Clostridium Dificile

P- Pseudomembranous colitis M- Microabscess A- Antibiotic- associated Diarrhea

C- Clindamycin A- Ampicillin F- Fluoroquiolone

Clostridium Perfringens

S- Soft tissue infx (Cellulitis, Suppurative myositis, Myonecrosis) F- Food poisoning S- Septicemia

Penicillin

ESCHERICHIA Uropathic E.coli Enterotoxigenic E. Coli Enteropathogenic E. Coli Enterohemorrhagic E. Coli Enteroinvasive E. Coli Enteroaggregative E. Coli SHIGELLA
Endotoxin C- CIPROFLOXACIN A- AMPICILLIN D- DOXYCYCLINE T- TRIMETHOPRIM- SULFAMETHOXAZOLE Shigella dysenteriae exotoxin Toxic lipopolysaccharide irritation of the bowel UTI Travelers diarrhea Watery diarrhea B- Bloody diarrhea H- Hemolytic Uremic Syndrome Like shigella By pattern (localized, diffuse, stacked)

As enterotoxin: diarrhea

As neurotoxin: meningismus, coma DYSENTERIAE SYNDROME

1-2 days

SALMONELLA
S- Septicemia E- Enteric fever E- Enterocolitis variable 10-14 days 8-48 rs

Salmonella typhi

T- Typhoid fever

A- AMPICILLIN T- TRIMETOPRIM- SULFAMETHOZAZOLE 3- 3

RD

GENERATION CEPHALOSPHORIN

C- CHOLECYSTECTOMY WITH DRUGS- carriers persist in gallbladder

VIBRIO
Rice- water stools

Vibrio parahaemolyticus Vibrio vulnificus

Diarrhea: watery diarrhea, occasionally dysentery Sepsis & wound infx Fulminant bacteremia

Vibrio mimicus Vibrio alginolyticus CAMPYLOBACTER Campylobacter jejuni

Watery diarrhea Cellulitis

Diarrhea Associated with GBS (ascending paralytic disease)

HELICOBACTER
P- PUD A- Antral gastritis U- Gastric ulcers M- Gastric mucosa associated lymphoid tissue A- Gastric adenocarcinoma

Helicobacter pylori

H- Hypochlorydria U- Ulcer (duodenal) G- Gastritis

PPI + amoxicillin and clarithromycin (7-10 days) PPI + metonidazole + tertracycline + bismuth (10 days)

HAEMOPHILUS Children: Meningitis Adult: Upper and Lower respiratory tract infections Others: 3 Generation Cephalosphorins Vaccine: Haemophilus B conjugate vaccine
rd

S- Septicemia P- Pneumonia E- Epiglotitis C- Cellulitis S- Septic arthritis

Haemophilus ducreyi

Chancre

A- Azithromycin 1g C- Ceftriaxone: IM O- Oral Ciprofloxacin O- Oral Erythromycin

BORDETELLA Bordetella Pertussis

Whooping cough 4-21 days Catarrhal stage: Erythromycin First year of life: 3 injections of Pertussis vaccine (2,4,6 mos) 2 booster injections: 15-18 mos, 4-6 yrs old In combination with Diphtheria, Tetanus

PSEUDOMONAS
P- Pulmonary infections P- Pseudomonal Endocarditis C- Corneal ulceration U- UTI

B- Burn wound, skin, & soft tissue infx E- External otitis: MALIGNANT OTITIS EXTERNA SWIMMERS EAR E- Eye infx: PSEUDOMONAS KERATITIS

Pseudomonas Aeruginosa

Echthyma gangrenosum

P- Piperacillin A-Aztreonam C- Carbapenems C- Ceftazidime C- Cefoperazone C- Cefepime A- Aminoglycosides F- Fluoroquinolones M- Multidrug ressistance: Chromosomal Beta Lactamase Efflux pumps Extended expectrum beta lactamases Porin Channel mutation

LEGIONELLA Legionella pneumophilia- prototype

Legionnaires disease Ma- Macrolides Qu-Quinolones Te- Tetracyclines Prevention: Hyperchlorination and superheating of water

PROTEUS
P- Pneumonia U- UTI B- Bacteremia F- Focal lesions

KLEBSIELLA
H- Hospital Acquied infx U- UTI

B- Bacteremia

Klebsiella granulomatis Klebsiella pneumonia subspecies rhinoscleromatis MYCOBACTERIA Mycobacterium Tubercuosis

Granuoma inguinale

Destructive granuloma of the nose and and pharynx (rhinoscleroma)

Tuberculosis

Anti-tuberculous drugs 1 line 2 line DOT Multi-drug resistant tuberculosis BCG Vaccine against tuberculosis that is prepared from a strain of the attenuated (weakened) live bovine tuberculosis bacillus, Mycobacterium bovis, that has lost its virulence in humans by being specially subcultured in a culture medium Capreomycin Ciprofloxacin Ofloxacin Kanamycin Ethionamide,Cycloserine
nd st

Pyrazinamide Ethambutol Rifampicin INH

Mycobacterium Leprae

Leprosy

Da- Dapsone Mi- Minocycline F- Fluoroquinolones C- Clofazimine C- Clarithromycin

Mycobacterium avium complex

Opportunistic infx among AIDS

C- Clarithromycin A- Azithromycin Others: C- Clofazimine A- Amikacin F- Fluoroquinolones

Mycobacterium kansaii

Pulmonary and systemic disease (like TB)

R- RMP E- EMB I- INH

Mycobacterium scrofulaceum Mycobacterium marinum and ulcerans

Adults: Chronic lung disease Children: Cervical lymphadenitis Swimming pool granuloma (superficial skin lesions)

Surgical excision of cervical LN

Surgical excision Tetracyclines EMB RMP

ACTINOMYCETES Actinomycetes israelii and gerencseriae- prototype

Actinomycosis Cervicofacial: lumpy jaw Abdominal: ruptured appendix or ulcer Thoracic: subacute pulmonary infx P- Penicillin : 6 To 12 months E- Excison Or Drainage C- Clindamycin/Erythromycin if with allergy to Penicillin

SPIROCHETES TREPONEMA Treponema pallidum

Syphilis Primary: 10 days to several Secondary: 3 mos after primary lesion Latent: may last for years o Benzathine penicillin G o Single injection 2.4 million units in early cases Repeated wkly x 3 wks in late cases

In patients allergic to penicillin o o Erythromycin Tetracycline

Ceftriaxone

LEPTOSPIRA Leptospira interrogans

Leptospirosis / Weils disease 1-2 wks Mild Oral doxycycline Ampicillin Amoxicillin Severe IV penicillin or ampicillin

10

BORRELIA Borrelia recurrentis

Relapsing fever 3-10 days P- Penicillin E- Erythromycin T- Tetracyclines

Borrelia burgdorferi

Lyme disease

Stage 1: 3 days- 4 wks after a tick bite Stage 2: wks to mos later Stage 3: wks to mos later

D- Doxycycline A- Amoxicillin C- Cefuroxime - for 14-21 days

CHLAMYDIA Chlamydia trachomatis

Trachoma Neonatal pneumonia 3-10 days 6 wks to 6 mos S- Single dose Azithromcyn O- Oral erythromycin : 14 days

SEROVARS D-K

Genital infection Men: N- Non gonococcal urethritis E- Epididymitis Women: C- Cervicitis U- Urethritis P- PID

D- Doxycycline A- Azithromycin

SEROVARS D-K

Inclusion conjunctivitis

7-12 days after delivery

Tetracycline Erythromycin

SEROTYPES LI, L2, L3

Lymphagranuloma venerum

Doxycycline: Both sex partners and offspring

11

Chlamydia pneumoniae

S- Sinusitis O- Otitis media A- Atypical pneumonia P- Pharyngitis B- Bronchitis

Ma- Macrolides Qu- Quinolones x 10-14 days Te- Tetracycline

Chlamydia psittaci

P- Psittacosis P- Pneumonia F- Fever of unexplained origin

MYCOPLASMA Mycoplasma pneumoniae

Primary atypical pneumonia/ walking pneumonia 1-3 wks Ma- Macrolides Flu- Fluoroquinolones TE- Tetracyclines

Mycoplasma hominis

S- Salpingitis T- Tuboovarian abscess P- Postabortal or postpartum fever

Ureaplasma urealyticum Mycoplasma genitalum

Men: Non gonococcal, non chlamydial urethritis Premature infants: Lung disease Men: chronic non gonococcal urethritis Women: S- Salpingitis E- Endometritiss C- Cervicitis I- Infertility