name diseaseclassification dx: culture dx: clinical virulence factorsrisk...

Name Disease Classification Dx:Culture Dx:Clinical VirulenceFactors RiskFactors Transmission Reservoir Treatment Prevention Tests/Extras

NeisseriaMeningitidis

AcuteBacterialMeningitis

Non-Neonatal

GramNegativeDiplococci

GramStain.LatexAgglutination.

UtilizationofGlucose&Maltose.

ChocolatewithCO2.OxidasePositive.

Meningism:Headache,NuchalRigidity,PhotophobiaPetechialRashSepticShock

WaterhouseFriderichsenSyndrome(AdrenalFailure)

PolysaccharideCapsuleLOS,Pili

IgAProtease5Serotypes

ChildrenEldery

ImmunocompromisedAsplenic

C5-8Deficiency

RespiratoryDropletsHuman

RespiratoryTract3rdGenerationCephalosporins

Vaccines(Conjugate,Polysaccharide,and

Capsular)Prophylactic

AntibioticstoBreakCarriage(Rifampin)

Brudzinski'sSign:Neckstiffnesscausespatienttoflexknees/hips

whenneckisflexed.Kernig's:Cannotstraightenleg.JOLTTest:Movingheadsideto

sidehorizontallycausesworseningofheadache

StreptococcusPneumonia


Non-Neonatal#1Cause

GramPositiveDiplococci

LancetShaped

GramStain.AlphaHemolysisNeufeld/QuellungBileSolubility

OptochinSensitive

Meningism:Headache,NuchalRigidity,Photophobia

PolysaccharideCapsuleIgAProtease

Pneumolysin,NeuraminidaseAutolysin

PhaseVariationofSurfaceAntigens

80-90Seroytypes

Anyoneolderthan1year


RespiratoryTract

Vancomycin3rdGenerationCephalosporins

Vaccines:PPSV23(2-65)

andPCV13(<5and>65)

CannotBreakCarriage




HemophilusInfluenza


Non-Neonatal

GramNegativeRodwithPRP(TypeB)

GramStain.ChocolateAgar(XandVFactors)

RapidPRPAntigenTest


PolyribitolPhosphate(PRP)Capsule

IgAProtease

ChildhoodMeningitis(>1yearsold)Unvaccinated


RespiratoryTract3rdGenerationCephalosporins

Vaccines:(HibandMenhibrix)Prophylactic

AntibioticstoBreakCarriage(Rifampin)




ListeriaMonocytogenes

AcuteBacterialMeningitisNeonatal

GramPositiveRodFacultativeIntracellularNon-SporeForming

ColdEnrichmentCatalasePositiveCAMPPositive

LikesSaltandAcid


Internalins(Phagocytosis)Listeriolysin(Lysis)

ActA(HostActinFormation)Neonates

Transplacental(GranulomatosisInfantiseptica)

Parturition(Meningitis)

AnimalGITract Antibiotics Avoidance




UropathogenicE.Coli

AcuteBacterialMeningitisNeonatal

GramNegativeRodGramStain.

LactoseFermentation.IndolePositive.


K1PolysaccharideCapsule Neonates Parturition HumanGITract AntibioticsHygeineduring

delivery




StreptococcusAgalactiae

(GBS)

AcuteBacterialMeningitisNeonatal#1Cause

GramPositiveCocci

GramStain.CatalaseNegative.BetaHemolytic.

LancefieldGroupB.CAMPPositive.

HydrolyzesHippurate.CHROMRapidTest.

PneumoniaMeningism:Headache,

NuchalRigidity,Photophobia

TypeIIICapsuleWeakHemolysin(ClyE)

CAMPFactorNeonates

ParturitionEarlyRuptureofMembranes

Caretakers(DirectContact)

HumanUrogenitaland

GITractAntibiotics

ScreenallPregnantWomen(35-37Weeks)

IntrapartumAntibiotics





CryptococcusNeoformans

ChronicMeningitis

MonomorphicEncapsulatedYeast

IndiaInk(Capsule)AntigenDetectionLatexAgglutination

SlowOnset:IntermittentFever,Headaches,Altered

PesonalityWeekstoMonths

PolysaccharideCapsularAntigen

Galactomannan(GXM)Immunocompromised AerosolizedSpores

EnvironmentBirdsadjustsoil

pH.Antifungals Education -

CryptococcusGatti

ChronicMeningitis

MonomorphicEncapsulatedYeast

IndiaInk(Capsule)AntigenDetectionLatexAgglutination

SlowOnset:IntermittentFever,Headaches,Altered

PesonalityWeekstoMonths

PolysaccharideCapsularAntigen

Galactomannan(GXM)

UnknownHealthyPeople

AerosolizedSporesEnvironment

BirdsadjustsoilpH.

Antifungals Education -


NaegleriaFowleri

Meningo-encelphalitis

(PAM)Amoeba

MicroscopyAntigenDetectionLesionsonMRI

75%DiagnosedPost-Mortem

Meningism:Headache,NuchalRigidity,PhotophobiaFocalDeficits

Olfactory/GustatoryHallucinations

CystsTrophozoites

Children/AdolescentsCribiformPlateisnot

fullyformed.

DirectInoculation(NassalCavities)

NOTFROMDRINKING

EnvironmentWarmWater

Miltefosine-AKTInhibitor

LargelyIneffectiveAvoidance

CSF:Clear,HighWBCs,HighProteinLevels.

ViralPCR,EEG,MRI,CATScan

FlaviviridaeWestNileSt.LouisJapanese

Encephalitis

ArbovirusssRNA,EnvelopedPositiveSense

MRI/CTPairedSeraSerology

ELISA


-

ElderyAfricanAmericans

MalesHypertension

MosquitoBite Birds Antiviral VectorControlCSF:Clear,HighWBCs,High

ProteinLevels.ViralPCR,EEG,MRI,CATScan

BunyaviridaeCaliforniaLaCrosse

Encephalitis

ArbovirusssRNA,EnvelopedNegativeSenseSegmented

MRI/CTPairedSeraSerology

ELISA


- Children MosquitoBite SmallMammals Antiviral VectorControlCSF:Clear,HighWBCs,High


HerpesSimplexVirus

Meningo-encephalitis

dsDNA,EnvelopedTzanckSmear(Syncytia)

Serology,PCR


Seizures,MemoryLoss,AlteredConsciousnessErythemaMulfiforme

HSV-1:FocallesionsonTemporal/FrontalLobes+

PerivascularCuffingHSV-2:Parturition-generalizedbraininvolvedment.

ImmunocompromisedNeonates(Parturition)

DirectContactHumans(LifelongInfection)

Acyclovir,Valacyclovir,Famciclovir

AvoidanceCSF:Clear,HighWBCs,High



Rhabdoviridae:RabiesVirus

RabiesEncephalo-myelitis

ssRNA,EnvelopedNegativeSense

Ante-Mortem:RabiesAntigeninSkin/Hair

Post-Mortem:PresenceofNegriBodies(DFA)

MultipleTestsarerequiredforconfirmation

Asymptomaticfor30-90Days.Varioussymptoms

includingfever,nausea,painatsiteofbite,phyaryngeal

spasms,paralysis,confusion,coma,etc.

NeurotoxinAnimalHandlerVeterinarians

AnimalBitesBodyFluids(AnimalLickingWound)Inhalation(Rare)

WildAnimalsGroundhogs,

Bats,UnvaccinatedDomesticPets

1.Rig(Passive)aroundthewound.

2.ActiveVaccination:1,3,

7,14days

AnimalVaccinationviaBait.

HumanVaccinationforHighRiskPopulations

ClinicallyConfusingwithoutHistoryofExposure

Picornaviridae:PolioVirus

PolioPoliomyelitis

ssRNA,NOEnvelopePositiveSense

SerologyAffectstheAnteriorHorn

Cells

Asymmetric,FlaccidParalysis

GI,RespiratorySigns,Meningitis,Encephalitis70%

Asymptomatic

3SerotypesNucleocapsids(Tropism)

Unvaccinated.Travel(Afghanistan,Pakistan,Nigeria)

Fecal-OralRespiratoryDroplets

Humans Supportive

Vaccines:Sabin:Live,Attenuated

Salk:Inactivated(USA)+Boosters

Post-PolioSyndrome:NewWeaknessorMusclePainyears

afterrecovery.

ClostridiumTetani

TetanusGramPositiveRodSpore-FormingAnaerobe

ClinicalPresentation:1stSign:TrismusorRisusSardonicus(LockJaw)

Progression:Opisthotonus:Backspasms.

Musclespasmswhichleadtotetanicparalysisrangingfromlocaltosystemic.

Tetanospasmin-Plasmid-EncodedNeurotoxin--ABToxinthatblocksreleaseof

GABAandGlycinebydegradingSynaptobrevin.

EntersCNSviaNeuromuscularJunctions.

Unvaccinated.

Sporesreleasedintopoorlyvascularizedwounds(puncture

wounds)

Soil

SurgicalDebridement.Delayclosuretoincreaseoxygen

perfusion.Passive

Immunizationifunvaccinated.

Vaccination+Boosters(maintainhighIgG)

-

ClostridiumBotulinum

BotulismGramPositiveRodSpore-FormingAnaerobe

ToxinAssaysofPatientandFoodSpecimen

Symmetrical,Descending,FlaccidParalysisConstipation

7ABToxinsonLysogenizedPhagesthatblocksreleaseofAcetylcholinebydegrading

Synaptobrevin.

Anyone

Consumptionofcontaminatedfoods.

PreformedToxin(>1yr)andSpores(<1yr)

Environment Supportive

Propercleaningandstorageofcanned

foods,rootvegetables,herb-oils,fruits,and

vegetables.

1.Botulism(ingestedtoxin)2.InfantBotulism(FloppyBaby)

3.WoundBotulism(drugusers)

BorreliaBurgdorferi

LymeDisease-Neuritis

(2-3Stage)Spirocete

HardtoGramStainSerology,

ELISA(Screen)WesternBlot(Confirm)

Primary:ErythemaMigransSecondary:Carditis,

Meningitis,BellsPalsy,Polyarthralgias

Tertiary:ArthritisandNeurologicalDecline

EndoflagellaCampers,Hikers

NEUSATickBite

(takes18-48hours)WildAnimals Anti-Microbials

ProtectiveClothing,InsectRepellent

HLADR-2.DR-3,DR-4

Polyomaviridae:JVVirus

ProgressiveMultifocalLeuko-

encephalo-pathy(PML)

dsDNA,NOEnvelope

CT/MRI-WhiteMatterLesions.

JCVirusinCSFNon-EnhancingLesionson

BrainBiopsy

DemyelinatingDisease.Hemiparesis,Ataxia,Dysphasia,Seizures.

AffectsOligodendrocytesandAtrocytesinCNS.

70-90%ofpeopleareSeropositive

VirionslatentinKidneyandGITract

ImmunocompromisedReactivation

RespiratoryDropletsContaminatedWater

HumansImmune

ReconstitutionNone -

MycobacteriumLeprae

Leprosy/Hansen'sDisease

AcidFastRodObligateIntracellular

LikesLowerBodyTemps(Skin,NasalMucosa)

ThickenedPeripheralNerves

1.Tuberculoid(Paucibacillary)-Poorly

pigmentedskinlesionswitherythematousbordersand

sensoryloss.2.Lepromatous

(Multibacillary)-Nodules,SensoryLoss,Respiratory

CongestionAffectsSchwannCellsand

Histiocytes

-

EndemicAreas,LivingwithUntreated

CasesImmunocompromisedcausesLepromatous

Type

ProlongedContactRespiratoryDroplets

Humans

Tuberculoid:Self-LimitedLepromatous:Antibiotics

VaccinationwithBCG(againstTB)

-

GIDISEASES


CandidaAlbicans EsophagitisYeastw/

Pseudohyphae

KOHPrep:BuddingyeastswithPseudohyphaeCultureonSDA/MYC

Dysphagia,Odynophagia,Off-White,firmlyadherentplaqueswithulcerations

underneath.Curd-LikeLesions

- Immunocompromised EndogenousNormalFlora:SkinandMucusMembranes

Azoles AvoidOvergrowthEndoscopy,Biopsy,BariumX-

Ray,Culture,Serology

HerpesSimplexVirusAlpha

EsophagitisdsDNA,Enveloped

LatentinDorsalRootGanglia

Serology-SyncytiaonTzanckSmear

Dysphagia,Odynophagia,Multiple,confluentulcerswithraisededges(ruptured

vesicles)

- Immunocompromised ReactivationHumans

LifelongInfection

CiclovirsReconstitutionofImmuneSystem

PreventReactivationEndoscopy,Biopsy,BariumX-


CytomegalovirusHSVBeta

EsophagitisdsDNA,EnvelopedLatentinMonocytes

Owl'sEyeInclusions(Enlargedcellw/Basophilic

Inclusions),CondensedChromatin

Dysphagia,Odynophagia,AcidRegurgitation,

Ulcermarginsaresmooth,punchedout,and

interveningmucosaappearsnormal.

- Immunocompromised ReactivationHumans

LifelongInfection

CiclovirsReconstitutionofImmuneSystem

PreventReactivationEndoscopy,Biopsy,BariumX-



StaphylococcusAureus

Intoxication GramPositiveCocci

ClinicalDiagnosis-ShortIncubationPeriod-BetaHemolysis

CatalasePositive-MSA

Vomiting+/-Diarrhea

EmeticExo-EnteroToxin:StimulatesVagusNerve

Improperlycookedfoods:"RichorSalty"i.e.

Mayo

Consumptionoffoodscontainingpre-formed

toxinHumans

Self-Limiting24-48Hours

ProperFoodCooking

EmeticExotoxincanbepresentevenwhenbacteriaaregone.Pre-formedtoxinsalwayscause

vomiting

BacillusCereus IntoxicationInfection

GramPositiveRodSpore-FormingAerobe

Intoxication(Rapid:1-6hours)

Infection(Delayed:6-16hours)

Vomiting+/-+/-Diarrhea

1.EmeticExotoxin2.DiarrhealExotoxin

Inadequatelycleaned,cooked,storedrootvegetables,grains

1.Foodscontainingpre-formedtoxin.(rice)

2.Foodscontaminatedwithmicoorganism

(stews)

EnvironmentSelf-Limiting24-48Hours

ProperFoodCooking

Pre-formedtoxinsalwayscausevomiting.Iftheactual

organismispresent,itwillcausediarrhea.


E.ColiETEC

Non-InflammatoryDiarrhea-Afebrile

GramNegativeRodLactoseFermenterSorbitolFermenterIndolePositive

Traveler'sDiarrhea2Toxins

Heat-LabileEnterotoxin(LT):ExcesscAMP(↑Cl-)

HeatStableEnterotoxin(ST):ExcesscGMP(↓Na+)

Anyone Fecal-OralGITractofAniimals

Self-LimitingOralRehydration

FoodSafety

E.ColiEAEC



Enterotoxin

AggregativeAdherenceFimbriae(AAF):adherenceStackedBrickAppearance

ShorteningofMicrovilliaEAST1Toxin:ST-likeEnterotoxin:

ExcesscGMP(↓Na+)

AnyoneInfantsinDeveloping

WorldFecal-Oral

GITractofAniimals


FoodSafety

E.ColiEPEC



NoToxins

1.Bundle-FormingPili(InitialBinding)

2.Intimin(Intimatebinding)3.TirProtein(Rearrangement

ofActin)4.Membrane-EffacingInfection:Pedestal-Like

Structure

Anyone2ndMostCommonCauseofInfantile

Diarrhea

Fecal-OralGITractofAniimals


FoodSafety

E.ColiEHEC/STEC


GramNegativeRod

LactoseFermenterNON-SorbitolFermenter

SMACPlateIndolePositive

HemolyticUremicSyndrome(HUS)

HemorrhagicColitisBloodyDiarrhea

NotanEnterotoxin

1.Bundle-FormingPili(InitialBinding)

2.Intimin(Intimatebinding)3.TirProtein(Rearrangement

ofActin)4.Membrane-EffacingInfection:Pedestal-Like

Structure5.ShigaToxin

(STX/Verotoxin):disruptsproteinsynthesis

Anyone Fecal-OralGITractofAniimals


FoodSafety

VibrioCholeraNon-

InflammatoryDiarrhea-Afebrile

Comma-ShapedGramNegativeRod

HalophileCulture:ThiosulfateCitrateBileSaltsSucroseAgar

(TCBS)Colonies:Flat,YellowLactoseFermenterOxidasePositive

LifeThreatningDiarrheaWateryDiarrhea(14-20L/day)resultingin"Rice

Water"Stoolswithclumpsofmucus.

1.CholeraEnterotoxin:LT-Like:IncreasesCellularcAMP

(↑Cl-)2.HemagglutinationProtease(HA/P):Degradationofcell-

celladherence(TightJunction).3.Toxin-RegulatedPili(TcpA):

forattachment

AnyoneContaminatedWaterImproperlyCooked

Seafood

Fecal-OralHumans

(Transient)andFish,Shellfish

ORTTherapyforDehydration.

Vaccination+Boosters

TurgorTest:Largeamountsofwaterloss.

VibrioParahemolyticusVibrioVulnificus:Non-InflammatoryDiarrheainHealthyIndividuals,but

patientswithliverdiseasehavesevereeffects.(4thBlock)

ClostridiumPerfringens


GramPositiveRodSpore-FormerAnaerobe

Culture:EggYolkAgar(Lecithinase-Lipase

production),NaglerReaction:

DoubleZonesofHemolysis(AlphaandBeta)

LeadingcauseofFoodPoisoningintheUS

1.CPEToxinisheldintheSporeCoat(Pre-FormedToxin):DisruptsTight

Junctions2.Lecithinase(AlphaToxin):breaksdownphospholipids

ConsumptionofHighProteinFoods(reheated)

Consumption

EnvironmentAnimals

Heatingtriggersgermiantionofbacteriawhichthensporulatein

theGITract


ProperFoodCooking -

ListeriaMonocytogenes


GramPositiveRodFacultativeIntracellularNon-SporeForming

ColdEnrichmentCatalasePositiveCAMPPositive

LikesSaltandAcid

DiarrheaMayseeinvasivedisease

withSepticemiainPregnantWomenandElderly(Fever+

Chills)

Internalins(Phagocytosis)Listeriolysin(Lysis)

ActA(HostActinFormation)

Healthy:AymptomaticImmunocompromisedandPregnanyPeople:

SevereDisease

ConsumptionofContaminatedFoods

AnimalGITract Antibiotics Avoidance -


GiardiaLambliaProtozoanNon-InflammatoryDiarrhea

ExtracellularFlagellatedProtozoan

Minimumof3stoolspecimensduetoSucking

DisksFecalAntigenTests(EIA)Biopsycanshowmicrovilli

damagedbymicrobe

Giardiasis:Foul-SmellingGreasy/Oilydueto

Malabsorption:SuckingDisk(DigestionEnzymes)

SuckingDisk-MechanicalandChemicalInjurytoGITract

Consumptionofuntreatedriver/lake

water

Fecal-OralIngestionofCysts

HumansAnimals

Anti-Parasitic WaterTreatmentChronic

Lawn-MowerDestruction

CryptosporidiumParvum

ProtozoanNon-InflammatoryDiarrhea

Tiny,IntracellularProtozoan

SphericalOocystsinStool(MultipleStoolSamples

Required)EIAforAntigen

NotAutofluorescent

Cryptosporidiosis:Malabsorption:

Intracellular,butrupturesanddestroysmicrovilli.

MechanicalDamageAIDS-Associated

Diarrhea(Immunocompromised)

IngestionofContaminatedFoods

(Water,Fruits,Vegetables)

AnimalsReptiles

FishHumans

Self-LimitinginHealthy

ORF/ORTforDehydration

ReconstitutionofImmuneSystem

WaterTreatmentChronic

SpottyDestruction

CyclosporaCayetanesis

ProtozoanNon-InflammatoryDiarrhea

SmallIntracellularProtozoan

SphericalOocystsinStool(MultipleStoolSamples

Required)EIAforAntigenAutofluorescent

Malabsorption:Intracellular,butrupturesanddestroys

microvilli.MechanicalDamage

AnyoneImportedFruitsandVegetableshave

beenlinkedtooutbreaksinUS.

Fecal-OralRequirestimetomatureintheenvironment

Humans Anti-Parasitic FoodSafetyChronic

SpottyDestruction


NorwalkVirusesViralNon-

InflammatoryDiarrhea

ssRNA,Non-EnvelopedPositiveSenseCaliciviridae

PCRforGiVirusesinGeneral(NotSpecific)

NegativeStoolsWateryDiarrhea+Emesis -

AllAgesConsumptionof

contaminatedfoods(includingShellfish)and

water.

Fecal-OralSmallinfectiousdose

requiredHumans


SanitationRe-infectionsPossible

MostCommoncauseofDiarrheainAdults

CruiseShips

AdenovirusesViralNon-


dsDNA,Non-EnvelopedSpikes

Adenoviridae

EIAforAntigenPCR

NegativeStoolsWateryDiarrhea+Emesis - Children Fecal-Oral Humans


Re-InfectionsPossibleinNon-Immunized

Primarycauseofdiarrheainchildren

RotavirusesViralNon-


dsRNA,Non-EnvelopedSegmentedReoviridae

EIAforAntigenPCR

NegativeStoolsWateryDiarrhea+Emesis

PRODUCESENTEROTOXINNSP4

InfantsAdults:AsymptomaticChildren:SymptomaticInfants:SevereDisease

Fecal-Oral HumansSelf-Limiting

OralRehydration

VaccinationRe-InfectionsPossibleinNon-Immunized

Leadingcauseofdeathfromdehydrationininfants.


Shigella(S.Dysenteriae)

BacterialInflammatoryDiarrhea

GramNegativeRodFacultativeIntracellular

HektoenAgarLactoseNon-FermenterDoesNOTproduceH2S

WateryDiarrhea+Pus+/-Blood+FEVER(Febrile)Dysentary+TenesmusShigellosis/BasicallyDysentery:BIPHASICSmallIntestineAffectedFirst,thenmovestoLarge

IntestineSequela:

1.HUSinyoungchildren.(Triad:Thrombocytopenia,HemolyticAnemia,Acute

RenalFailure)2.ReactiveArthritis

Enterotoxin:ShET1/ShET2-blockNaUptake

CytolethalDistendingToxin(CDT):apoptosisofhostcells.ShigaToxin(Verotoxin):ABTypeToxin:InhibitsProtein

SynthesisRearrangeshostcellactinforintracellularmovementand

celltocellinfection.

PediatricDisease(upto10years)

EpidemicsinDaycareCenters

Fecal-OralContaminatedFomites,

Water,Food

Humans(NOANIMALRESERVOIR)


CiprofloxacinNOVACCINESanitationFoodSafety

BIPHASIC:StartsasNon-InflammatoryDiarrheaandprogressestoInflammatoryFrankBlood(VisibleinStool)OccultBlood(useGuaiacAcid

Test)PositiveLactoferrinTest

LowerHematocritandLowPlateletCount=HUS

EnteroinvasiveE.Coli



CultureLactoseFermenterIndolePositive

WateryDiarrhea+Pus+/-Blood+FEVER(FEBRILE)

Dysentary+TenesmusSequela:ReactiveArthritis

SimilartoShigellaCytolethalDistendingToxin(CDT):apoptosisofhostcells.

NoEnterotoxin

AnyoneConsumingGroundBeef

Children<5inDevelopingCountries

Fecal-Oral AnimalsSelf-Limiting

OralRehydration

CiprofloxacinSanitationFoodSafety

PositiveLactoferrinTest

CampylobacterJejuni


GramNegativeComma/SpiralShaped

RodExtracellular

AgDetectionCulturebestat42Degrees(ChickenBodyTemperature)Campy/SkirrowSelective

Media


Dysentary+TenesmusSequela:Bacteremia,

Guillain-BarreSyndrome(AscendingMuscle

Weakness/Paralysis),andReactiveArthritis

CytolethalDistendingToxin(CDT):apoptosisofhostcells.

SevereDiseaseinYoungChildren

ImmunocompromisedFecal-Oral

AnimalsPoultry,Pets,Unpasteurized

Milk


Ciprofloxacin PositiveLactoferrinTest

EntamoebaHistolytica


AmoeboidProtozoan

Cysts(4Nuclei)MotileTrophozoites

(MultipleStoolsRequired)ELISA/AgglutinationAssay


Dysentary+TenesmusChronic

RightUpperQuadrantPain(LiverAbscesses)

UlcerationofLargeIntestineSequela:Flask-Shaped

Ulcers

ProteolyticEnzymesCysteineProteinases(tissue

damage)Amebapore:Lysisofhostcells

viachannelformation

WaterBoyScouts

Fecal-Oral

HumanCarriersAnimalCarriersCystssurviveinsoilandwater

MetronidiazoleORTTherapyforDehydration.

CiprofloxacinSanitation


YersiniaEnterocolitica


GramNegativeRodExtracellular

BipolarStaining

Growsat4Degrees(Stoolsat25Degrees)


Dysentary+TenesmusChronicSequela:

MesentericLymphadenitis:LowerRightQuadrantPain-

PsuedoappendicitisBacteremia

-

DairyProductsPorkPets

MeatProductsUnpasteurizedMilkBloodProducts

SeriousDiseaseinChildren

Fecal-OralTransfusions

AnimalsSelf-Limiting

OralRehydrationCiprofloxacinFoodSafety


Non-TyphoidalSalmonellaEnterica



HektoenAgarLactoseNon-Fermenter

ProducesH2S

WateryDiarrhea+Pus+/-Blood

Dysentary+TenesmusSalmonellosis

Sequela:ReactiveArthritisandBacteremia

SopE:IncreasescAMP(LikeETECLT)

Sips(Ssps,SopB):TriggerActinRearrangement

AnyoneConsumingEggs/Chicken

Fecal-Oral ?Self-Limiting

OralRehydrationCiprofloxacinFoodSafety



ClostridiumDifficile

AntibioticAssociatedDiarrhea/

PseudomembranousColitis

GramPositiveSpore-FormingRodAnaerobe

ToxinAssaysFecalAntigen

NAATS

AntibioticAsociatedDiarrhea(AAD)-AcuteNon-Inflammatoryto

InflammatoryPseudomembranousColitis

(PMC)-ChronicInflammatory+

Psuedomembrane(PlaqueFormation)

Enterotoxin(ToxinA):ChemotacticforNeutrophils,

HypersecretionofFluidCytotoxin(ToxinB):

DepolymerizationofActin,LossofCytoskeleton(Pro-Inflammatory)Targetfor

Zinplava

Colonization:HospitalizedPatientsImmunocompromised

Disease:AssociatedwithuseofBroadSpectrum

Antibiotics

EndogenousEnvironmentalvia

SporesHumans

MetronidazoleProbiotics

FecalTransplantsZinplava-MonoclonalAntibody

(Target:ToxinB)

Difficult

Associatedwithuseof:Clindamycin,Lincomycin,

Cephalosporins,Amoxicillin,Ampicillin


SalmonellaTyphi TyphoidFeverEntericFever

GramNegativeRodH2SProducing

BloodCulture(+at1week)StoolCulture(Week3)

BiopsyMarroworLiverifRoseColoredSpotsPresent

TyphoidNodules(aggregatesofmacrophages)

WidallTest:AntibioticsagainstOandHAntigens--

agglutinationreaction

Multi-SystemIllness:Fever(upanddown),Bacteremia,Constipation,Rose-Colored

Spots

OAntigenFlagellarAntigens(H)andSurfaceAntigens(Vi)

UnvaccinatedTravelers

EndemicAreasFecal-Oral

HUMANGITract(NOANIMALRESERVOIRS)

Antibiotics

LiveAttenuatedVaccine(7years)orCapsular/ConjugateVaccine(2years)

+Boosters

WidallTest


TaeniaSaginataHelminthicGIInfectionsWeightLoss

BeefTapewormDetectionof

worm/proglottids/ovainstool

TaeniasisAsymptomatic

Non-InflammatoryDiarrheaWeightLoss

UpsetStomachConstipation

- Anyone

Ingestionofundercookedmeatcontaininglarvae

(encysted)

Cattle Anti-ParasiticDrugs FoodSafety

Egg:Thickcapsule,striations

TaeniaSoliumHelminthicGIInfections

MassLesionsPorkTapeworm

Detectionofworm/proglottids/ovain

stoolNeurocysticerosis:

MigratingLarvae/CystsinNeuralTissue.

RingEnhancing=ActiveNon-RingEnhancing=

Calcified

TaeniasisAsymptomaticWeightLoss

UpsetStomachConstipation

Sequela:MassLesions(EGGS)--Seizures,

Headaches,Vomiting

-

Consumptionofundercooked/infectedPork(EncystedLarvae)Neurocysticerosis:ConsumptionofEggs

Tapeworn:ingestionofinfectedpork(Encysted

Larvae)Neurocysticercosis:consumptionofeggs

Swine(Major)Humans(Minor)

Anti-HelminthicDrugsSurgery

HygeineFoodSafety

-

DiphyllobothriumLatum

HelminthicGIInfectionsAnemia

FishTapeworm

HypersegmentedNeutrophilsDetectionof


Diphyllobothriasis:B12Deficiency

(Megaloblastic/PerniciousAnemia)-LargeRBCsIntestinalObstruction

-

Consumptionofundercooked/infectedFishFishermenin

PacificNEUS

Fecal-OralFreshWaterFish-

FishEatingCarnivores

Anti-ParasiticDrugs FoodSafety

Egg:Oval,1End-Cap

TrichurisTrichiura


WhipwormDetectionof


BloodyDiarrhea,AbdominalPain,Flatulence

Chronic/HeavyInfections-MicrocyticAnemia-Small,

HypochromicRBCRectalProlapse

- Anyone Fecal-Oral Humans Anti-ParasiticDrugs Sanitation

Egg:Oval,2End-Plugs

AncyclostomaDuodenale/Necator

Americanus


Hookworm Eggs(Ova)inStool

AbdominalPain,LossofApetite

Severeproteindeficiencyorirondefieincyanemia

(MicrocyticAnemia-Small,HypochromicRBCs)Ulcer-LikeSymptomswithBlood

Loss

- -

DirectSkinPenetration-LarvaeDevelopinEnvironment-

ContaminatedSoil

Humans Anti-ParasiticDrugs SanitationandSHOES

Egg:Thinshellwitharolledupwormontheinside--noplugs,

nocaps.

SchistosomaHematobium

HelminthicGIInfections

TissueFibrosis

Trematode(BloodFluke)

EggsinStoolUrineinBloodTest

Schistosomiasis:BiliaryorUrinaryFibrosis

AbdominalPainHematuria

Target:VeinsofUrinaryBladder

CercardialDermatitis:Swimmer'sItch

PruritisandUrticaria

Swimmingincontaminatedwaters

Immigrants/TravelerstoEndemicAreas

DirectSkinPenetration(viaCercariaelifestage)

Snails(Intermediate

Host)Humans

Anti-ParasiticDrugsRemovalofSnailsSewageTreatment

Egg:VentralSpine

SchistosomaJaponicum


TissueFibrosis




AbdominalPainGIBleeding,Diarrhea

LiverDamage,Hepatosplenomegably

ClayPipeFibrosisTarget:SmallBranchesofInferiorMesentericVein

andLiver






Snails(Intermediate

Host)Humans


Egg:SmallerVentralSpine

SchistosomaMansoni


TissueFibrosis




AbdominalPainGIBleeding,Diarrhea

LiverDamage,Hepatosplenomegably

ClayPipeFibrosisTarget:SmallBranchesofInferiorMesentericVein

andLiver






Snails(Intermediate

Host)Humans


Egg:PolarSpine

EnterobiusVermicularis

HelminthicGIInfectionsCuteanousExcoriations

Pinworm(US)

ScotchTapeTestStrubeTubes

SampleEggs/LarvaeMicroscopicExamination

TypeIVImmuneResponseagainstFemale/Eggs

SevereItching/Excoriations-

PoorHygeineSmallChildrenCrowding

Fecal-Oral Humans Anti-ParasiticDrugs Hygeine

Eggs:LemonShaped

TrichinellaSpiralis


Edema,MusclePain,Vasculitis

HelminthicRoundworm

BloodTestAntibodiesEosinophilia

Biopsy:EncystedWormsinMuscle

MuscleAches,Diarrhea,PeriorbitalEdema

(Vasculitis)Severe:CNSandHeart

Involvement(TissueDestruction)

- Anyone

ConsumptionofRaw/UndercookedMeatsofInfected

AnimalsLarvaeTravelfrom

BloodtoIntestinestoStriatedMuscles

ZOONOTICSwineWildAnimals

(Seal/Walrus)Humans:

AccidentalHost

Anti-ParasiticDrugs

FreezePork,CookThoroughly,CookMeatFedtoPigs,

Sanitation

Eggs:EncystedLarvae


HelicobacterPylori

PepticUlcersGramNegative

Curved/SpiralRodMicroaerophilic

BiofilmsPolarFlagella

Oxidase,Catalase,UreasePositive

FecalAntigenTestUreaseBreatheTest:IngestradioactiveUrea(C-13),MeasureLabeledCO2MicroscopyImaging:BariumSwallowCulture,Serology,

Antibiogram

Abdominal/EpigastricBurning"Heartburn"GastricUlcers:PainincreaseswithmealsDuodenalUlcers:Paindecreaseswith

mealsSevere:

Hematemesis:Vomitingblood"CoffeeGrounds"-

SeriousConditionMelena:Dark-Colored

Stools

1.Mucinase:degradesmucus,allowsforcolonizationatneutralpH2.Urease:neutralizesGastricAcid,

neutralpH3.HeatShockProtein:

EnhancesUreaseproduction4.AcidInhibitoryProtein:

Inhibitsgastricacidproduction

5.VacA(BiotypeIStrain):avacuolingcytotoxin:apoptosis

ofgastricepithelium6.CagAPAI:ChemotaticforImmuneCells(IL-8)and(PAF):PlateletAggregatingFactor:

HypersecretionofGastricAcid5.&6.causeUlceration

ManyUnknownSmokingAlcohol

ObesityHighStress

Fecal-OralOral-Oral

Humans

Triple/QuadrupleTherapy

2-3AntibioticsProtonPumpInhibitor

Cyto-ProtectiveAgent

(DecreaseAcidinStomach)

None

50-80%ofpeoplehaveH.Pylori,sodetectionofthe

organismisnotdiagnosticofthedisease.Youmusthavethehistoryofulcerstomakethe

diagnosis.


HepatitisA HepatitisPicornaviridae

ssRNANon-EnvelopedPositiveSense

IndistinguishablefromHepatitisE

HAV-IgM:AcuteHAVIgG:PastInfectionor

ImmunizedLyticCytopathology

Acute

AbdominalPainJaundice(Icterus)

LightStoolsDarkUrine

ElevatedAST/ALTLevelsNoSequelae

NoChronicInfections

- Unvaccinated

Fecal-Oral(LowInfectiousDose)

CloseContactContaminatedFood,Water,Shellfish,

ProduceBloodExposureIVDrugUseTransfusions

Humans SupportiveCare

ActiveImmunity:InactivatedHepatitisA

Virus(Institutions)

PassiveImmunity:Ig(CloseContacts)LifelongImmunity

IP:28DaysDuration:2-12Weeks

QuickImmuneResponseClinicalIllness+Jaundice:>5

yearsChronicInfection:<5years

HepatitsB HepatitisHepeviridae

dsDNAEnvelopedCircular

HBsAg:OverproducedbyVirus-Infected

HBsAb(Anti-HBs):DocumentsVaccinationor

ResolvedInfectionAnti-HBcIgM:AcuteInfectionMarker

Anti-HBcIgG:PastorChronicInfectionMarkerHBeAg:ActiveReplication-highlycontagiousAnti-

HBe:LatentInfectionHBV-DNA:MonitoringTherapyResponseBuddingReplication



ElevatedAST/ALTLevelsChildren<5mayprogressto

ChronicHBVWindowPeriod:Asvirusis

producingHBsAg,theimmuneresponseisslow.TheHBsAbbindstheHBsAgandequalizesit,causingbothtobenegative.YouCANseetheAnti-HBc.

ReverseTranscriptaseInfected

CellsProduceHBsAgevenbeforeDNAReplication

UnvaccinatedIDUs

NeonatesofChronicMothers

ParenteralSexualPerinatal

Humans

80%SelfLimiting20%:

PegylatedInterferona+Entecavir+Tenofovir

(RTInhibitors)

RecombinantVaccinePost/Pre-Exposure:

HBVIgGActiveandPassiveImmunizationwithin12Hoursofbirth

IP:60-90DaysSlowImmuneResponse

ChronicInfectionsClinicalIllness+Jaundice:>5

yearsChronicInfection:<5years

HepatitisC Hepatitis

ssRNAEnveloped

PositiveSense6Genotypes

SerologyforTotalIgPCR

BuddingReplication



ElevatedAST/ALTLevelsChronicInfectionin80-90%:LiverCirrhosisandHepatocellularCarcinoma

IDUsTattoos

HemodialysisBloodProducts

ParenteralSexualFetus

Humans

PegylatedInterferona/Ribavirin-

dosagebywtPLUSProteaseInhibitors

orSovaldi/Sofobuvir(RNAPolymerase

Inhibitors)

Screeningblood/organs.

HighRiskBehaviorModificationVaccine

inClinicalTrials

SlowImmuneResponseChronicInfections

HepatitisD Hepatitis

ssRNAEnveloped

NegativeSenseDefective

HBsAgInserted

Serology:HDVAntibodies

HBsAgBuddingReplication



ElevatedAST/ALTLevelsRequiresCo-Infectionwith

HBVSuper-Infection:

Chronic/Fulminating-LiverFailure

- - ParenteralRoutes Humans TreatHBVInfection

Coinfection:Pre/PostExposureProphylaxistoPreventHBV-Low

riskofChronicInfection.

Superinfection:Educationtoreduceriskbehaviors-

ChronicHBV+HDV

SlowImmuneResponseChronicInfections

HepatitisE Hepatitis

ssRNANon-EnvelopedPositiveSense4Serotypes

IndistinguishablefromHepatitisASerology

HEV-IgM:AcuteHEVIgG:PastInfectionor

ImmunizedLyticCytopathology

Acute



ElevatedAST/ALTLevelsNoChronicInfection

-

Consumptionofcontaminedmeat,water,shellfish

TraveltoEastern/SouthAsia

Recently:US

Fecal-OralContaminatedWaterMeatfromInfected

AnimalsShellfish

TransfusionofInfectedBlood

PregnantWomentoFetus(Vertical)

HumansAnimals

SupportiveCareAvoidExposure

VaccineAvailableinChina

IP:40DaysDuration4-6WeeksFulminatingDisease:

PregnantWomen(Eclampsia,Hemhorrhage,LiverFailure,

Stillbirth)QuickImmuneResponse