Cases(SB) - Microbiology Cases Organism Features Host...

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Microbiology CasesOrganismFeaturesHost ResponseClinical PresentationDiagnosisTreatmentStreptococcus pneumoniae(pneumonia)#1 cause community-acquired pneumoniagram +, catalase -, bullet shaped diplococcuscapsule = most important virulence factorspread via resp dropletssecretory IgApneumonia (sudden-onset, fever, productive cough, +/- blood in sputum)common cause of sinusitis & otitis mediacomplications = bacteremia & meningitisgram stain culture: small/medium mucoid colonies w/alpha hemoloysis, optochin succeptible, bile succeptible antigen testpenicillin if pen-resistant ceftriaxone or clindamycin7-valent vaccine for children!Neisseria Meningiditis(meningitis)one of the usual suspects for meningitis (S. pneumo, N. meningiditus, H. flu….GBS in neonates)capnophillic, gram – cocci in pairs (coffee-bean shaped)has LOS instead of LPS meningitis belt in sub-Saharan Africa complement and Ig’smeningococcemia can start with flu-like sx, then petichial rashthen pustules, bullae…sepsis DIC in a matter of hours+/- meningitis (HA, neck stiff, altered mental state, vomiting)gram stainculture (prefers chocolate agar)penicillin G or ceftriaxone ASAPtetravalent vaccine (polysaccaride capsular protein conjugate) for serotypes: A, C, Y, W135* no coverage for serotype B
Salmonella typhi (Typhoid fever)motile gram – rodsstrictly human dz, spread thru contaminated food/watertyphi enters thru GI and disseminates thru blood. Non-typhoid salmonellas (typhimurium and enteritidis) stay in GI and cause enterogastritis)risk if immunocomp or sickle cell dztyphi: survives in Φ’s by messing with phagolysosome fusion distrib to organs and get organ-specific dz.non-typhi: stays in GI, get GI dz, granulocyte responseTyphoid feverpresent with fever of unknown origin (“PUO”). Fever, HA, ab discomfort, const or diarrhea…+/- bradycardia, “rose spots,” and hepatosplenomegaly+/- anemia and leukopeniacomplications: cholecystitis, endocarditis, osteomyelitis~5% of ppl carriers (typhoid Mary)Non-typhoid salmonellaself-limited diarrhea 12-48 hr incubationisolate and ID the organismTyphoid feverampicilling, cipfofloxacin, or chloramphenicolvaccine-preventable (says in case but I’ve never heard of it)non-typhoid salmonellasupport & fluidsE. coli(UTI)UTI most often caused by E. coli. Other suspects are proteus, staph. Saprophyticus (young sexing woman), and pseudomonas (hospital) E. coli is gram – rod with peritrichous flagella and LPSUTI caused by normal bowel flora & more in women bc short urethra E. coli adheres to epithelial cells & prods toxinprotected from host immune by K1 capsular antigenIgA and IgG prodcystitis (normal UTI): frequency of urination, dysuria (painful pee), and abdominal tendernesspyelonephritis (up to kidney): loin pain, fever, and above sxcomplications: septicemia, renal scarring failure

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Term
Spring
Professor
staff
Tags
Sickle cell dz, rash bc rash, ppl fever

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