Hint | Answer |
Intracellular parasite | |
Dz: Granulomatous amebic encephalitis | |
Gram (-) coccobacilli; capsule serovar b | |
Dimorphic fungus: mold in environment, spherules filled w/ endospores in tissue | |
Dx: Gram(-) diplococci inside polymorphonuclear cells; Culture: Thayer-Martin agar | |
Reservoir: Asymptomatic carrier | |
Dx: Serologic testing; biopsy (cyst, tachyzoites) | |
Tx/Prev: Amphotericin B + flucytosine | |
VF: Infective form: cyst, oocyst; Intermediate host: other animal + humans; Oocyst -> tachyzoites -> invade macrophages -> spread to all organ systems: cyst | |
Most common pathogen (1) for bacterial meningitis in pregnant women, neonates, and immunocompromised patients | |
Prevention: 7-valent conjugate vaccine; 23-valent polysaccharide vaccine | |
Dx: Gram(+) cocci in pair + WBCs; Culture: blood agar -> α-hemolytic, optochin (S), bacitracin (R) | |
Encapsulated yeast | |
Reservoir: Soil-desert sand | |
Transmission: Enter body via olfactory neuroepithelium | |
Dz: Meningococcal meningitis, Meningococcemia (Waterhouse-Friderichsen syndrome) | |
Dx: Gram(-) coccobacilli + WBCs; Cx: Chocolate agar (X &V factors) | |
VF: Endotoxin (LPS); Capsule = poly-ribitol-phosphate (PRP) | |
Gram(-) diplococci (kidney-shaped); serogroups: A, B, C, Y, W 135 | |
Group Dx: CSF: blood, neutrophils, high protein, low glucose | |
Prevention: Hib conjugate vaccine | |
Opportunistic free-living amoebae | |
Reservoir: normal flora | |
Most common pathogens (2) for bacterial meningitis in neonates | |
Transmission: Ingestion of contaminated food, transplacentally, or during delivery | |
Tx/Prev: Empirical tx: antiviral (acyclovir) + antibacterial (ampicillin + cefotaxime) | |
Group transmission: person to person via respiratory droplets | |
Gram(+) cocci in chains, B-hemolytic, bile resistant | |
Tx: Sulfadiazine + pyrimethamine (immunocompromised host); clindamycin & spiramycin (pregnant women) | |
Group reservoir: human nasopharynx | |
| Hint | Answer |
Pathogen causing parastitic infection not otherwise specified | |
Tx: Amphotericin B + Ketoconazole | |
Reservoid: Soil enriched w/ brid droppings | |
Dx: From CSF: capsulated yeasts, cx, capsular antigen detection | |
Pathogen causing parastitic infection in immunocompetent persons | |
S/s: HA, altered mental status. Progresses slowly (several weeks) | |
VF: Facultative intracellular pathogen, cell to cell spread | |
Group Dz: subacute to chronic meningitis | |
Pathogen causing parastitic infection in immunocompromised persons | |
Gram (-) rods, Enterobacteriacea family, lactose (+) | |
S/s: Hemorrhagic skin rash (petechiae) | |
VF: pneumolysin | |
Dx: PCR (urine or CSF), Latex particle agglutination (urine), Cx (CSF, blood), CAMP test for GBS | |
Group Transmission: inhalation | |
Prevention: education for high-risk consumers | |
S/s: Rapid onset, severe HA, fever, nausea, altered sense of smell. Progresses rapidly, death in a few days | |
Dx: CSF: wet mount (motile trophozoites); Giemsa (trophozoites) | |
S/s: Non specific: fever, poor feeding, vomiting, irritability alternating w/ lethargy… | |
S/s: Self limited flu-like illness (immunocompetent host); toxoplasmic encephalitis (imminocompromised host); Maternal infxn (stillbirth, neurologic problems) | |
Group S/s: Slow onset, HA, visual disturbances, abnormal mental status, seizure | |
S/s: CNS (meningitis, encephalitis in immunocompromised patients) | |
Dz: toxoplasmosis | |
VF: K1 capsule, pili, cytotoxins, endotoxin (LPS) | |
Group s/s: Sudden onset: fever, stiff neck, severe HA (migraine-like); also n/v, photophobia, confusion, sleepiness, malaise… | |
Group VF: Blood invasion from lungs -> brain | |
Reservoir: Soil; fresh, brackish, sea water; sewage, swimming pool. Contact lens equipment | |
VF: Infective form: trophozoite & flagellated forms -> purulent, hemorrhagic inflammatory rxn | |
Reservoir: Intestine of animals and humans | |
Reservoir: Warm fresh water | |
S/s: Often follows sinusitis or otittis media | |
| Hint | Answer |
Group dx: From CSF, blood or skin lesions (meningococcus) | |
VF: Infective form: trophozoite | |
Free living amoebae | |
Transmission: Ingestion (uncooked meat w/ cyst, oocyst from fecal contamination), transplacental, blood & organ tpx | |
Dz: Pneumococcal meningitis | |
Most common pathogens (3) for bacterial meningitis in children and adults | |
Tx: Ampicillin + gentamicin | |
Group VF: Capsule, IgA protease, pili; Invasion into blood stream ->meninges -> inflammation | |
S/s: May follow respiratory or ear infections, head trauma... | |
Pathogens causing fungal infections in immunocompromised host | |
Reservoir: normal flora GI tract -> secondary spread to vagina | |
Reservoir: Cat = definitive host | |
Prevention: MPSV4; MCV4 | |
Dx: Complement fixing antibodies in serum | |
Dx: From blood or CSF: microscopy, cx (blood agar), motility test | |
Group dx: CSF: high protein, low glucose, neutrophils | |
Group tx/prev: Empirical tx: vancomycin + 3rd gen cephalosporin; Chemoprophylaxis: Rifampin | |
Transmission: Enter body via lower resp. tract, ulcerated or broken skin | |
Dz: Primary meningoencephalitis | |
Dz: Listeriosis | |
Gram(+) cocci, in chain or pairs, lancet shaped, a-hemolytic | |
Transmission: From colonized mother (delivery, infected amniotic fluid); or nosocomial transmission | |
Tx: Amphotericin B | |
S/s: Febrile gastroenteritis (immunocompetant pts); Bacteremia (fever, malaise, spread to placenta); Granulomatosis infantiseptica (stillbirth, abscesses or granulomas in neonates) | |
VF: Endotoxins (LPS, LOS): diffuse vascular damage | |
Dx: Cysts and trophozoites in tissue | |
Small gram(+) rods, non-spore forming, growth at 1°C to 45°C, motile at 25°C | |
VF: Capsule, peptidase, lytic enzymes | |
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