Infectious and Parasitic Diseases I

Coordinator: Jim Fishback, M.D.

SUPPLEMENTAL IMAGE DATABASE

Bacterial infections

• Taxonomy primer, UT, Houston (FYI only, not on exam)

• Antimicrobial susceptibility testing

  • Vancomycin resistant enterococci, CDC recommendations

  • E test, used in determining an MIC
  • Kirby-Bauer, E. coli
  • Rapid beta-lactamase test

Pyogenic Gram-positive cocci (pg. 354-359)

• Staphylococcus spp.

  • Staphylococcus aureus
    • Staphylococcus aureus colony morphology
    • agglutination reaction - Staphaurex
    • Catalase reaction - Staphylococcus aureus
    • Methicillin-resistant Staph aureus (MRSA)
    • Coagulase-negative Staphylococci - often contaminants, rarely need speciation by the clinical microbiology lab.

• Streptococci

• Streptococcus pyogenes
• Streptococcus pneumoniae
  • Streptococcus pneumoniae, (Pneumococcus) Gram stain, sputum
  • Pneumococcal pneumonia, Chest x-ray
  • Pneumococcal lobar pneumonia
  • pneumococcal meningitis
  • brain abscess
  • pleural empyema
  • mastoiditis, CT scan gross

  • CDC recommendations, Penicillin-resistant Pneumococcus

• Group B Strep

• CDC recommendations on Group B strep

Bacterial Infections of Childhood

• Recommendations for childhood vaccinations

• Diphtheria (rare, briefly discussed in class. Vaccine available. Notify lab for special culture requirements)
• Pertussis (rare, briefly discussed in class. Vaccine available. Notify lab for special culture requirements)
• Hemophilus influenza (H. flu). Becoming rare in the U.S., except for non-typical strains. Vaccine available. (pg. 360-361)
• Neisseria meningitidus Vaccine available. (pg. 361-362)

Sexually transmitted diseases

• Gonococcus (pg. 362-364)
  • Gonococcus
• Chanchroid (pg. 364)
• Granuloma inguinale (pg. 364-365)
• Clue cell, bacterial vaginosis, due to Gardnerella vaginalis

• Treatment of STDs

Enteropathogenic Bacterial Infections (all Gram-negative)

• CDC info on traveler's diarrhea
• Escherichia coli (pg 365-368)
• Salmonella enterocolitis and typhoid fever (pg. 368-369)

  • Typhoid vaccine information

  • Shigellosis (pg 369-371)
  • Cholera (pg. 371-372)
  • Campylobacter jejuni (pg. 372-373)
  • Helicobacter pylori, Steiner stain
  • Yersinia Infection (rare, will not be discussed in class)

Pulmonary Infections with Gram-negative Bacteria

• Klebsiella pneumoniae
• Legionnaire Disease (Legionellosis)
  • Legionella spp. immunofluorescent stain of sputum
  • Legionella spp., deiterle (silver impregnation) stain of alveolar exudate
• Pseudomonas aeruginosa
• Meloidosis (rare, will not be discussed in class)

Clostridial diseases

• Clostridial Food Poisoning
• Necrotizing Enteritis
• Gas Gangrene (Clostridial myonecrosis)
• Tetanus
• Botulism
• Clostridium difficile Colitis, gross, pseudomembrane

Bacterial infections with animal reservoirs or insect vectors

• Brucellosis, osteomyelitis, CT scan
• Plague
• Tularemia
  • Skin eschar
  • Axillary lymph node, necrosis
• Anthrax
  • Skin eschar
• Listeriosis
• Cat-scatch disease
• Glanders (rare, will not be discussed in class)
• Bartonellosis (rare, will not be discussed in class)

Filamentous bacterial infection

• Actinomycosis
• Nocardiosis

Spirochetal infections

Syphilis

• syphilitic aortitis, chronic inflammation, media, H/E
• syphilitic aortitis, media, elastic stain
• RPR test, syphilis

Non-venereal treponematoses

• Yaws (rare, will not be discussed in class)
• Bejel (rare, will not be discussed in class)
• Pinta (rare, will not be discussed in class)
• Lyme disease
• Leptospirosis (rare, will not be discussed in class)
• Relapsing Fever

Fusospirochetal infections (rare, will not be discussed in class)

Chlamydial infections (pg. 394-396)

• Chlamydia, fluorescent antibody, tissue culture

Rickettsial infections (pg. 396-399)

• Typhus (rare, but important as the prototypical Rickettsial infection)
• Rocky Mountain Spotted Fever (RMSF)
  • "typhus" nodule, Rocky Mountain Spotted Fever, brain
  • Rocky Mountain Spotted Fever, rash, hand

Mycoplasma infections (pg. 399-400)

Mycobacterial infections (pg. 400-408)

Tuberculosis

• Caseating granulomas, tuberculosis, lymph nodes, gross
• caseous necrosis, tuberculosis, micro
• Millet seeds, namesake for miliary Tb
• modified acid fast stain, Mycobacterium tuberculosis
• auromine-rhodamine, Mycobacterium tuberculosis
• auromine-rhodamine, Mycobacterium tuberculosis, cording phenomenon

• Tb prevention, CDC recommendations

• Multidrug resistant Tb, CDC treatment recommendations

• Recommendations on the use of BCG in the USA

Leprosy

Mycobacterium avium complex (MAC or MAI)

• Mycobacterium avium complex, spleen, AFB stain
• Mycobacterium avium complex, lymph nodes, mesentery, gross
• M. tuberculosis complex and Mycobacterium avium complex, colony morphology, LJ slants
• Mycobacterium avium colony morphology, LJ slant ("condom colonies")

"Atypical" mycobacteria