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** The following are some of the charts that I made during my preparation for the Micro Shelf examination.

Though they are NOT


exhaustive, I would HIGHLY recommend MEMORIZING EVERYTHING in the Clinical Features, Pathogenicity, and Diagnosis columns since
that will be the bulk of your block 3 and shelf examination. Osama
NOTE: The highlighted text doesnt necessarily reflect any high-yield material but is information that I had trouble memorizing.
Species (Type)
Chlamydia
trachomatis

Treponema
Pallidum

Clinical Features
1) Inclusion conjunctivitis
Non-gonococcal urethritis;
cervicitis; pain on
urinating + fever +
exudate
2) Lymphogranuloma
venarum = Elephantitis
due to swollen LNs
3) Follicular conjunctivitis
(Trachoma) = Inversion of
eye-lashes corneal
scarring + blinding
1) Non-tender
chancer
2) Maculopapular
rash (on
extremeties) +
condylomata lata
+ patchy alopecia
3) CNS inflammation

Pathogenicity
Obligate Intracellular
aerobe
Elementary + Reticulate
body

Obligate Extracellular
Pathogen

Epidemiology/Transm
ission

Structure/Feature
s

STD

Cell Wall w/ muramic


acid

Trachoma Hand to eye +


Flies

STD
Transplacental

Chronicity

Gram () ve

Diagnosis/Treat
ment
Cytoplasmic inclusion
bodies

REDO

Axial filaments
Spirochetes

(Tabes
Dorsalis);
aortitis; gummas

Disseminate
d Notched
Teeth

+ infectious
rhinitis +

Maculopapular
rash
Haemophilus
Influenza

1) Otitis Media
2) Epiglottitis
3) Children
meningitis
4) Bronchitis
5) Pneumonia

Polysaccharide
capsule Type
B

IgA
protease

Respiratory Droplets

Gram () ve bacilli
Pleiomorphic

Chocolate
Agar
Factors X and
V

Satellite
Phenomenon Staph
Aureus
Diagnosis:

Rickettsia Ricketsii

Yersinia Pestis

Rocky Mountain spotted


fever
Influenza-like
symptoms
Centripetally
spreading
petechial rash
(starts from
extremities)
Ankle + wrist
swelling
Bubonic plague
Rapid fever
Conjunctivitis
Regional buboes
Pneumonic plague
Patient-to-patient
local spread

Escherichia coli

1) UTI Frequency,
urgency, hematuria

Obligate intracellular
aerobe

Dermacentor tick bite


Occurs in the Spring/summer

Vasculitis - invading
endothelial cells

Serologic

Facultative intracellular
(granulomatous response)
w/ coagulase
Praire dog (disease )
flea bites and gets it
coagulase causes the
content to stick
together and be
regurgitated when
biting the next person
infection spread
person has disease
progression -- swollen
LNs axilla + groin
disseminated
intravascular
coagulation
blackening of peripheral
digits etc. person w/
disseminated disease
can spread bug
pneumonic plague
F1 envelope Ag inhibits
phagocytosis
Facultative anaerobes

Reservoir: Zoonotic rodents

3) Sepsis
LPS Lipid A Triggers
shock
4) Diarrhea
ETEC, EHEC, EPEC, EIEC,
EAEC, DAEC

Toxins:
LT
ST
Shiga-Toxin 1/2

Gram () ve bacilli

Transmission: Flea bite +


Respiratory droplets (human
to human for pneumonic
plague)

IFA

test

Diagnosis:
Blood culture/LN
Biopsy
Coagulase (+)ve

Bipolar
staining
Treatment
Aminoglycosides
Vaccine: Army

Reservoir: Colon, vagina,


urethra

Pilli
2) Neonatal
Septicemia/meningitis
K Capsule: important

Gram () ve bacilli

Latex Particle
Agglutination
Treatment w/out
confirmation

Transmission: Oral-fecal,
endogenous, maternal fecal,
bovine substances,
catheters (UTIs + Sepsis),
cytotoxic drugs increase
endogenous transmission

Gram () ve bacilli

Oxidase () ve

Lactose Fermenters

UTI: DOC:
Sulfanomides
Diarrhea
ETEC: Self-limiting

Diagnosis:

EHEC : non-sorbitol
fermenter Smack
plate
Normal Flora:
Pink
EHEC: Clear

ETEC: Mexico Watery

Diarrhea
LT toxin: Adenylate
cyclase
ST toxin:
guanylate cyclase
Colony Factor Adhesins:
Allows binding
EPEC: Second mostcommon cause of diarrhea
in infants
EIEC: Invasive E. Coli
inflammatory response
Bloody Diarrhea,
Jet-trails

Bordetella
pertussis

Neisseria
meningitidis

EHEC: NON-invasive
Bloody Diarrhea (VTEC)
Hemorrhagic Uremic
syndrome (<5 yo children)
NON-inflammatory
thus no PMNs or
fever
Toxins: Shiga-like toxin
does the damage that
causes dysentery DO
NOT use antibiotics will
release toxins
1) Whooping Cough

1) Meningitis
Fever
Stiff Neck

Toxins:
1. Pertussis Toxin
cAMP inducing
Blocks immune
cells
Increased
Histamine
Sensitivity
2. Filamentous
Hemagglutinin
Ciliated epithelium
3. Adenylate Toxin
4. Tracheal Toxin
Stages:
Incubation Catarrhal
Paroxysmal Convalescent
Complications
Secondary
infection
Encephalopathy
1) Capsule Type B
2) IgA protease

Reservoir: Vaccinated
Humans (older)

Gram () ve bacilli

Transmission: Respiratory
Droplets

Vaccine: DTaP
(acellular)/DTP
immunity vanes after
4-6 years (trying to
protect children)
Diagnosis: Culture
Best chance during
Catarrhal stage
Media:

Diplococci
Flattened sides

ReganLowe

Vaccine: (+) NOT


Type B

Vomitting
Rash Later
2) Waterhouse
Friderichsen syndrome

Neisseria
gonorrhea

1) Urethritis + Proctitis
Pain upon urination
(male)
2) Endocervicitis
3) Ophthalmia
blindness
4) Pharyngitis

Oxidase (+)

3) Endotoxin (LPS) septic


shock

Encapsulated

4) Complement Deficiency
More susceptible

Pilli: Antigenic variation


Lengthy infection

Diagnosis:

Thayer-Martin
(Chocolate Agar w/
antibiotics)

Maltose Fermenter
Birth-canal

Diplococci
Flattened sides

Invasive triggers
inflamm.

Oxidase (+)

Vaccine: (-)
Beta-Lactamases
Diagnosis:

Thayer-Martin
(Chocolate Agar w/
antibiotics)

PMNs in Urethral exudate


inflammation

NON-Maltose
Fermenter
Differential: w/
Chlamydia (more
common than
Gonorrhea)
nongonococcal
urethritis
NON-purulent
(whitish)
Treatment:
Ophthalmia
Erythromycin at birth

Moraxella

Corynebacterium
Diphtheriae

Clostridium

Otitis Media (3rd)


Sinusitis
Bronchitis +
Bronchopneumonia
COPD patients + Elderly
1) Diphtheria:
Pseudo-membrane
(grey)
Bull-neck
Recurrent
laryngeal n. palsy
Respiratory
obstruction
possible

Toxin: Protein-synthesis
inhibition prophage w/
transduction, effects
Psuedomembrane
Possible trachea
obstruction
Heart + Nerves
Non-invasive organism
Obligate anaerobe (ABC)
Spore-forming

Respiratory Pathogen

Gram (-)

Normal Flora: Respiratory


Tract

Gram (+) rod

Diplococci

Transmission: Respiratory
Droplet

Diagnosis: ChineseLetter formation


Tellurite Media
ELEK Test
differentiate normal +
pathogenic

Gram (+) rod


Tennis Racquets
due to spores at ends

Clostridium tetani

Tetanus
Spastic paralysis:
1) Locked jaw (risus
sardonicus)
2) Extreme muscle
spasms

Clostridium
botulinum

Toxin: Tetanus toxin via


infection by spores
vegetative cells toxin
production

Transmission:

Spores

Soil etc.

Vaccine: (+) Toxoid

Lack of inhibition:
GABA + Glycine

so cant cause
disease

Flaccid Paralysis

Toxin: Botulinum toxin

Adult Botulism

Toxin genes
Transduction

Prevents ACh release

Anti-toxin + Antibiotic
Toxin binds
irreversibly so
must go through
half life

Transmission:

Spores (heatsensitive)

Canned Foods usually


TOXIN ingestion
(reversible paralysis)
Symptoms:
1) Flaccid Paralysis
2) Vision problems
3) Nausea/vomiting
4) Respiratory arrest

Food Borne (canned


foods)
Honey

Treatment:
Adult Antitoxin
(Igs)
Infant Antitoxin

NOT
Antibiotics
(Igs)

Infant Botulism

Clostridium
Perfringens

Honey
SPORES ingestion
Floppy baby
syndrome
(reversible
paralysis)

Gas Gangrene

Toxin:
Alpha toxin
Phospholipase C
Lecithinase
Enterotoxin watery
diarrhea selfresolving (reheated
meats)

Transmission:
Traumatic
Implantation
Reservoir:
Soil
Feces

Media:
1) Milk STORMY
fermentation
2) Blood agar
Double
Hemolysis zone
Diagnosis: Nagler
Reaction
Treatment:
Antibiotics
Delay closure
Self-limiting
gastroenteritis
Prevention:
Debridement

Antibiotic
administration
Diagnosis: Toxin
Assay
**Part of normal flora

Clostridium dificile

Toxin Related
Diseases:
Diarrhea
Colitis
Pseudomembranous
Colitis

***Growth following
antibiotic
administration

Normal Flora: GI Tract


Transmission: Endogenous

Resistant to Broadspectrum Antibiotics

Treatment:

1) Stop antibiotics
2) Use =
Metronidazole +
Vancomycin

Toxin:

Toxin A

Toxin B

Streptococcus
Group A Strep.
(pyogenes)

Carbohydrates in Cell-Wall
used in serotyping
1) Pharyngitis
Fever
Malaise
Sore throat
2) Scarlet-Fever:
Sand-paper rash - NOT
on palms or soles
(Exotoxins)
Strawberry Tongue
Nausea/Vomiting
Impetigo Honey
Crusted lesions
Very red at groin

Virulence Factor:
M Protein
Anti-phagocytic
manner
Glomerulonephritis
Streptolysin O
Streptolysin S

Chain-Form
Gram (+) Cocci
Catalase (-)
Reservoir: Throat
Transmission:
Respiratory Droplet
Direct Contact

Spreading Factor:
Streptokinase
Hyaluronidase
DNAse
Exotoxins
Scarlet Fever
Super-Antigens
3) Glomerulonephritis
Type 3 HSR immune
mediated

Diagnose:

PYR-positive
Bacitracin Sensitive
Blood Agar - Betahemolytic
Streptolysin O
Antibodies (ASO) >
200
Treatment:
Beta-Lactams
Prophylaxs Rheumetic
fever patients

4) Rheumatic Fever Type


2 HSR Ab mediated

Group B Strep.
(agalactiae)

Streptococcus
Pneumo.

5) Cellulitis/Necrotizing
Fasciitis VERY fastacting
Neonatal Meningitis (#
1 Cause)

Beta-hemolytic

Reservoir: Vaginal Mucosa


Transmission:
Birth Canal

MOST Common cause of:


Typical Pneumonia
Otitis Media
Adult Meningitis
CSF w/

Capsule VERY important

Predisposing Factors:
Asplenia
Alcoholism
COPD
CHF

Diagnose:

CAMP positive
Bacitracin Resistant
Blood Agar - Betahemolytic
Treatment:
Treat During
Delivery
Diagnose:
Alpha-Hemolytic
Optochin Sensitive
Quelling Positive
Latex-Agglutination

neutropenia and
hypoglycemia

capsule in CSF

Prevention:

Streptococcus
Viridans

MOST Common cause of:


Cavities
Subacute endocarditis

Enterococcus

Endocarditis (Similar to
viridans)

Reservoir: Oral Pharynx


Transmission: Endogenous

Drug Resistance
(Vancomycin)

Reservoir: Colon

Gram (+) Cocci


Catalase (-)

Transmission: Endogenous
UTI Catheter Associated

Pseudomonas

Healthy
GI infections
Hot-tub folliculitis
(leading cause S.
aureus)
Eye infections
Burn Patients
Cellulitis (blue-green
pus) septicemia

STRICT Aerobe Non


fermenter
Virulence Factors
Encapsulated
Pseudomonas
Exotoxin Protein
inhibiting
Endotoxin (LPS)

Risk Groups:
Burn Patients
Neutropenic patients
Transmission:
Water (ubiquitous)

Gram (-) Rods


Oxidase (+)
Blue-Green appearance
Grape-like Odor

Vaccine Strep.
Pneumo
Children: Fewer
serotypes
Adults/at risk
individuals: More
serotypes
Diagnose:
Optochin Resistant
Alpha-hemolytic
Prevention:
Prophylax after dental
work
Diagnose:
PYR-positive
Bile Esculin turns
black
Prevention:
Prophylax when
undergoing surgery
Diagnose:
Non-lactose
fermenting on
McConkey Agar

Prevention:

Prevent contact w/
water

Neutropenic patients
Catheterized Patients
Cystic Fibrosis
Recurrent pneumonias
thick slimy mucous

Salmonella Typhi
(typhoid fever)

Chronic granulomatous
disease
Sepsis
Ecthyma gangrosum
Typhoid Fever (enteric
fever)
Constipation
Peyers patch
necrosis
Cholecystitis

Serotypes O antigen
M-cell transfer Infects
Macrophages underneath
mucosa travels through
blood seeds organs
(liver, spleen) primary
septicemia chronic

Reservoir: Chronic humans


only (typhi) Gall-bladder

Gram (-) Rods


Oxidase (-)

Transmission: Oral-fecal
since gall bladder infected
constant release

Flagella

Typhoid Mary

Motile

Diagnose:

Week 1: 80% blood


culture +
Week 3: 85% stool
culture +
H2S producer
Non-lactose

infection of gall-bladder
secondary septicemia

fermenting
Rose-spots on trunk
Acid-sensitive
Motile

Virulence:
Macrophage survival:
decreased fusion of
phagosome +
lysosome
complement
survival
etc.

Salmonella
enterica

Enterocolitis/gastroenteriti
s (campylobacter # 1
cause in USA, salmonella
# 2 cause of bacteria
gastroenteritis)
Nausea
Vomiting
Bloody sometimes

Prevention:

Vaccine present (3
types)

Virulence
INVASIVE
organisms: watery
diarrhea
dysentery
NO TOXIN
Diarrhea from
Invasion

Reservoir: Chickens, turtles

Diagnose:

Transmission: Oral-fecal
since gall bladder infected
constant release

Black on Hektoen (HE)


Agar to differentiate
between shigella and
salmonella

Virulence: Toxins
Lethal factor
Edema factor
cAMP
Protective antigens

Reservoir: Animals + large


events

INTOXICATION (not an
infection)

Reservoir: Chinese fried-rice

H2S producer
Non-lactose
fermenting
Acid-sensitive
Motile

Osteomyelitis Sickle Cell


patients (typhi can cause
this)

Bacillus Anthracis

Bacillus Cereus

Sepsis (NOT enterica)


Pulmonary Anthrax:
Inhalation of spores
Highly fatal
Mediastinal widening
Cutaneous Anthrax
Necrotizing lesion
Black Escher formation
Uncomplicated non-bloody
gastroenteritis

Gram + Aerobic Bacillus

Transmission: Inhalation +
direct contact w/ spores

Transmission: Food-borne

Listeria
Monocytogenes

Legionella
Pneomophilus

Healthy individuals:
Uncomplicated
Gastroenteritis
Pregnant females:
Early: Septicemia
+ disseminated
granulomas in
baby
Post-delivery:
Neonatal
meningitis (#3)
Atypical pneumonia
Pneumonia

Virulence: Toxins
Emetic toxin
Facultative Intracellular
organism

Reservoir: Cold meats +


cheese + ice cream

Actin Jet Motility

Transmission: Food-borne

Gram + Rods Aerobic

CSF wet mount


Tumbling motility
Cold-growth
Beta-hemolytic
Blood culture in
sepsis
CSF culture in baby

Tumbling motility
Cold growth

Facultative intracellular
organism

Reservoir: Air-conditioners

Diagnose:

Gram Rods Aerobic

Diagnose:

Buffered charcoal

Mental Retardation
Diarrhea (no
bacteria in GI)
Pontiac fever
Pneumonitis

Transmission: Inhalation of
aerosolized water
Risk Groups: Smokers

yeast extract

Fluorescent
Antibody test