Crohns acute ulcerative colitis acute appendicitis Incubation 1
Crohn’s, acute ulcerative colitis, acute appendicitis Incubation: 1 -7 days Millions/year USA Incubation: 8 -48 hrs (can progress to bloody) 30 -40% Guillan-Barre, USA Fever, diarrhea, abdominal cramps (leukocytes) lasts 5 -10 days 73, 000 cases/yr USA Reiter’s syndrome Nausea, vomiting, 50% have fever Abdominal cramps, diarrhea 2 -4 d, Diarrhea, no pus. Self limiting 5 -7 d Diagnose by: Stool Culture Not much fever, diarrhea, cramps 3 -5% HUS( up to wks after infx) Most common cause acute kidey failure Treatment: Flush Except systemic salmonella= amp/gent
microaerophilic CD T LOS CD T Age Peaks < 1 yr 15 -44 C. Serum resistance from surface protein Incubation: 1 -7 days lasts 5 -10 days 30 -40% Guillan-Barre, USA Fever, diarrhea, abdominal cramps (leukocytes) Gastroenteritis that may become systemic Penicillin Ceph STX-TMP
Salmonella enteritidis / typhimurium CFTR receptor Fecal-Oral Vi antigen Acid tolerant p. H 3 -4 ID 15 -20 SPI-1 M SPI-2 H antigen cell Inhibits phago+lyso incub 1 -3 wks Vaccine: Vi polysac capsule antigen (IM) Ty 21 a- live, attenuated, oral Asymptom carriers Liver Gallbladder 16 million cases/yr 600, 000 die Peak: 5 -12 yrs old Incubation: 8 -48 hrs Amp & Gent Reiter’s syndrome Nausea, vomiting, 50% have fever Abdominal cramps, diarrhea 2 -4 d, Diarrhea, no pus. Self limiting 5 -7 d
DAEC rf im br ia e LT & ST CFA-1 D CAF-4 CFA-4 LEE- intimin, contact dep secretion, TIR Secrete protein cell…. . IP 3 -, IL-8 microvilli bacterial into PLC, Loss TIR CFA-2 STX-TMP Quin Pili STX-TMP Quin NO Antibiotics Removes Adenine from 28 S STX Hemolytic Uremic Syndrome 1. Hemolytic anemia 2. Thrombocytopenia 3. Glomerular Thrombosis 4. “acute renal failure” 0157: H 7 Little fever, no pus Watery Bloody STX Gb 3 TX: Transfuse and hemodialysis Develops in kids
EAEC - “Persistent Watery Diarrhea” Mostly in developing countries. VIRULENCE FACTORS Adherence – AAF pili (aggregative adherence fimbriae) and dispersin Toxins – EAST: ST-like toxin Pet: Serine protease. Hemolysin: EIEC – “Distinctively Different” Invasion of epithelium. Similar to Shigellosis but less severe. Children under 5 in developing countries. Humans are sole reservoir. Virulence genes Can lyse cell and spread laterally. STX-TMP Quin
M Shiga Toxin – HIGH INFECTIVITY ONLY released by ~100 bugs sonnei cell lysis. DOES NOT kill the invaded mucosal cells. Toxin affects vascular tissues – BLOODY STOOLS. IL-8 …PMN a 5 B 1 Quinolon 3 rd Ceph ISCA Host dies IL-1 IPa. B ICE Flexneri & dysenteriae Shiga toxin Food, fingers, feces, flies Interrupts 28 S r. RNA Reiter’s Syndrome flexneri(3%) HLA-B 27
CTX VPI-1 VPI-2 Tcp pilli(CTX receptor) Neuramindase ZOT ACE Polysaccharide cap Protease Broad Phospholipase Cl- & RIP 50% Generally self limiting 1 -2 incubation
aerotolerant pain/heaviness Corynebacterium Clostridium botulinum diphtheriae sym. paralysis (G+ rod) alpha toxin labile, spore not lecithinase-myonecrosis blocks Ach release Zn protease (60 -90%) (G+ rod) severe nausea no fever heat labile Cranial nerve palsy Incubation 12 h-8 d Blurred vision 4 -14 days incubation Clostridium difficile Clostridium diffic(G+ rod) colitis and diarrhea 5 -10 days after start of antibio or after discontinued tx: Abs to toxin penicillin (G+ rod) Clostridium tetani exotoxin Tetanospasmin- neurotox blocks glycine(inhib)
Fusobacterium sp (G+ rod) Anaerobic Meningtis Penicillin
18, 000 cases/yr USA
3 rd Ceph E. cloacae E. coli meningitis LPS Penicillin Cipro UTI ST & LT K & H antigen B-lactamase found pts tx with antibiots diabetics and indwelling cath respiratory and UTI, burns K-O-H Klebsiella pneumonia (lobar) nonmotile O O antigen capsule Ferment lac motile, capsule Serratia marcescens O H DNAse No capsule Room Temp O H O ST B-lactam 3 rd Ceph LT Catheters herion user B-lac amikacin B-lactamase
No L. monocytogenes Amp BO TH Internalin A Listeriolysin O PI-PLC Act. A PC-PLC Onset time~ 12 h large infectious dose= 1 million MORTALITY: 50% Y. pseudo. TB > 70% NO ST no diarrhea 75% 5 -20 yr VERY RARE Granulomatosis infantiseptica 30100%
Enteric Fever Y. enterocolitica Rare 1 -2 day incubation ST M cells Tetra Amino STX Yops & V ag FEVER CHILLS SHOCK liver inhibit phago MQ apoptosis cytokine (IL-8, TNF, IFN) Reactive arthritis (small %) HLA-B 27
Streptococcus mutans Actinomyces israelii (G+ rod) Anaeorobic, filamentous Propionibacterium acnes (G+ rod) Clostridium difficile (G+ rod) Gingival crevice & female UGT Penicillin r ve Li ng u L s s ab s e c n i k S Helicobacter pylori Bab. A Cag. A Fecal-oral and contaminated H 20 Type I: Ulcers and Cancer IL-8 Type II: NO Cag. A LPS Vac. A
Proteus mirabilis, motile Amp Ceph Tetra Bacteroides fragilis (G- rod) GI & brain abscess, cellulitis Capsule Collagenase Hyaluronidase Metro Clind “swarming” Treponema pallidum Perivascular infiltrate. Penicillin Caution: JH rxn B-lactam
ABCAfrica/Blindness and chronic infx Doxy Erythro Enterococcus Faecalis D-K subtypes Intestinal & oral L 1, L 2, L 3 No peptidoglycan O O Long incubation 10 -21 days Tetra Erythro 9 hrs 16 -20 hrs Type III secretion inhibits phago+lyso ATP-ADP translocase
RMSF R. rickettsii R. prowazeki Tetra transovarian tsmsm Incub 2 -14 day p. A m Fever day 5 O RIP Rash day 3 -12 25% Refugee Camp- wash clothes>50 C Doxy m actin tail filament propulsion RIP Rash begins on upper trunk day 5, macular. 40% Cough, confusion, stupor. Ho st Escape phagosome IFA/latex biopsy replicate in cytoplasm X LN 10% ICU EE DC o. A an d. N AD fro Endemic Typhus( R. typhi & R. felis) 50% rash by day 6, 50% no rash Flu like symptoms hacking non-productive cough -ray shows pulm densities AL STX-TMP, age, disease increases risk Brill-Zinsser-mild untreated Ehrlichia chaffeensis Lonestar Tick(Amblyomma americanum) Human Monocytic Ehrlichiosis(HME) Flu like- rash rare leuko/thrombopenia RIP 2 -5% morulae Anaplasma phagocytophilum spp (Lyme, babesiosis, anaplasmosis) Human Granulocytic Ehrlichiosis(HGE) Ixode
Early- Bell’s palsy, men, enceph Cardiac- AV node block, myo/pericarditis 90% anicteric, flu like, men, 1 -3 wks resolves 10% Weil’s syndrome: high fatality Late- inflamm arthritis, 1 sided, large joint Incubation 7 -14 days(can be 3 -30) Vls. E-surface, recombine little/no spread via blood ass. with collagenous tissue persistent infxn LPS enter skin or mucus membrane B-lac/tetra* 3 -4 wks Borrelia hermsii Endemic Tick-Borne Relapsing Fever SPFL B-lac tetra* (hydrocorticoid & acetaminophen) Caution: J-H Rxn VMP(variable membrane protein)- recombination Borrelia recurrentis Relapsing Fever 3 um Ornithodoros spp soft tick oral B-lac/Tetra IV 40 C spikes Incubation 1. 5 wks Louse crush juice Ethiopia Giemsa stained blood Fever, malaise. Similar to TBRF, but > fatality
½ symptomatic Coxiella burnetii (G- coccobacillus) High fever(104) 1 -2 weeks Obligate intracell, cytoplasm rep Spores Q fever Dust, meat, tick, soil RIP 1 -2% Flu like, cough, pneumo + hepatitis No rash IFA, ELISA Doxy Atypical pneumo ARDS & DIC RIP 0 -30% Day 3 Tetra Day 7 Mouth & intestine PLAGUE lymphadenopathy Perivasculitis Day 10 Orietia Lcr. Vtsutsugamushi and Yops
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