 If an organism gives a positive reaction

with the anti-Group A latex test, you

would also expect the bacterium to be:
 Optochin sensitive
 Bacitracin sensitive

 Coagulase positive

 Citrate positive

 Alpha hemolytic
 The major reason for failure of standard
penicillin treatment of streptococcal
pharyngitis to prevent rheumatic fever
is:
 Non-compliance of patients in taking antibiotics
 Plasmid-encoded beta-lactamase
 Chromosomal mutation in the gene encoding
the target
 Antigenic variety of bacterial antigens
 Lysogenic conversion
 A 1-year-old child is brought to the hospital in
respiratory distress. Her father reported that following
a period of increased nasal discharge and a slight
pyrexia which lasted for 5 days, she began breathing
fast and developed a paroxysmal cough.

 What other information should be elicited from the parents?

 What investigations should be carried out?
 What is the etiology of paroxysmal cough?
 What is the antibiotic of choice to treat this child?
Mycoplasmas

Dr. Noura AL-Sweih

Mycoplasmas
Definition
Bacteria which lack cell wall
 Can grow in rich artificial media
Three species associated with
infection in man
 Mycoplasma pneumoniae
 Mycoplasma hominis
 Ureaplasma urealyticum
 Fried egg
Chinese hat
Mycoplasma pneumoniae
Clinical Infections
Respiratory Infections
 Atypical pneumonia
 Children are more affected
 More during summer
 Prominent X-ray findings
 Disease course > 2 weeks
 Hemolytic anemia
Mycoplasma pneumoniae
Extrapulmonary manifestation
Hemolytic anemia
Myocarditis
Treatment
 Erythromycin ? Why not penicillin
 Tetracycline
Mycoplasma Hominis &
Ureaplasma urealyticum
Clinical Infections (same range)
Genital infections
 Male
 Non-gonococcal urethritis
 Female
 Pelvic inflammatory disease PID
 Abortion & Preterm labor
 Stillbirth
Mycoplasma Hominis &
Ureaplasma urealyticum
 Urinary tract infections
 Pyelonephritis
 M.hominis
 Renal stone  U.urealyticum

 Respiratory infections
 Newborn respiratory disease
 Treatment
 Erythromycin
 Tetracycline
Clinical Case
 A 14 year old male presents with a low-grade fever,
general malaise and cough. He was prescribed
ampicillin. One week later he returned with a
persistent low-grade fever , non- productive cough
and cold agglutinins were detected in his blood. A
chest X-ray showed a patchy bronchopneumonia with
diffuse interstitial infiltrates.
 What was the organism causing this patient infection?
 Were this patients clinical course and chest X-ray consistent
with his infection?
 How this organism can be detected in the lab?
 Why this patient did not improve on Ampicillin?
 Name other organisms known to cause
community acquired pneumonia?
 Streptococcus pneumoniae
 Haemophilus influenzae
 Mycoplasma pneumoniae
 Chlamydia pneumoniae
 Chlamydia psittaci
 Rarely Klebsiella pneumoniae