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Staphylococcus aureus
Gram positive cocci in clusters, catalase positive, coagulase positive
Staphylococcus aureus
Most common infection in open fractures?
Staphylococcus saprophyticus
Gram positive cocci in clusters, catalase positive, coagulase negative, Novobiocin resistant
Staphylococcus epidermidis
Gram positive cocci in clusters, catalase positive, coagulase negative, Novobiocin sensitive
Staphylococcus aureus
(Affects the tricuspid valve)
An IV drug user who develops endocarditis. What is the causative agent
Staphylococcus epidermidis
A patient with a prosthetic heart valve develops endocarditis. What is the causative agent?
Viridans Streptococci
A patient who underwent dental surgery develops endocarditis. What is the causative agent?
Colonoscopy to determine presence of Colon cancer
A patient with marantic endocarditis. Culture done showing growth of S. bovis. What is the next best step?
Enterococcus faecalis
A patient who underwent GI/GU surgery who develops endocarditis. What is the causative agent?
Streptococcus agalactiae
Gram positive cocci in chains, catalase negative, beta hemolytic, bacitracin resistant, CAMP positive
Streptococcus pyogenes
Gram positive cocci in chains, catalase negative, beta hemolytic, bacitracin sensitive, PYR test positive
Polyarthritis
Carditis
Subcutaneous nodules
Erythema marginatum
Sydenham chorea
Jones criteria for acute rheumatic fever includes:
Streptococcus pneumoniae
Gram positive cocci in chains, catalase negative, alpha hemolytic, optochin sensitive and bile soluble. Positive Quellung reaction
Streptococcus bovis
Gram positive cocci in chains, catalase negative, gamma hemolytic, no growth in 6.5% NaCl
mecA gene
Gene that mediates methicillin resistance in
S. aureus
Brodie abscess
Sequestered focus of osteomyelitis caused by S. aureus arising in the metaphyseal area of a long bone
Stratum granulosum
In Ritter disease, separation of epidermis happens at what layer?
Toxic Shock Syndrome
A case of fever, hypotension, strawberry tongue, desquamating rash and multi -organ involvement (>3) in patients with history of using tampon or nasal packing of epistaxis
S. aureus has no site of pyogenic inflammation and blood CS negative
Difference in Toxic Shock Syndrome caused by S. aureus and S. pyogenes
Erythrogenic toxin
Toxin that causes Scarlet fever
Anti-Streptolysin O
Elevated titers suggest antecedent Streptococcal pharyngitis
Anti-DNAse B
Elevated titers suggest antecedent Streptococcal skin infection
Streptococcus pyogenes
An 8 year old female presented to the ER hypotensive and suddenly went to cardiac arrest. History revealed that she had multiple migrating sites of arthritis, serpiginous rashes on the trunk and fever prior to the onset of hypotension. Pathology report showed presence of Aschoff bodies and Anitschkow cells in the myocardium. What is the most likely causative agent in this patient's condition?
Erysipelas
(Different from Erysipeloid caused by Eryslipelothrix)
Superficial infection extending into dermal lymphatics
Alpha toxin
Toxin of Staphylococcus that causes necrosis of the skin and hemolysis
Exotoxin B
Toxin of Streptococcus that rapidly destroys tissue and causes Necrotizing Fasciitis
Acute Rheumatic Fever
(due to cross-reacting antibodies to M-protein)
A case of fever, migrating joint pains in the knees and
elbows, and has raised erythematous serpentine-like lesions on the back with history of pharyngitis in the past. What is the most likely diagnosis?
Streptococcus agalactiae
Most common cause of neonatal pneumonia, sepsis, and meningitis
35-37 weeks
Pregnant women should be screened for Group B Streptococci colonization at what age of gestation?
Streptococcus pneumoniae
Most common cause of CAP across all ages
Rusty colored sputum
Characteristic sputum of patients infected with S. pneumoniae?
Both are spore-forming, but Bacillus species are aerobic while Clostridium species are anaerobic
Difference between Bacillus and Clostridium species
Bacillus anthracis
A 30-year-old male was noted to have a malignant pustule. Culture showed that the organism present is gram (+) bacilli, spore-forming, aerobic and non-motile.
Cutaneous anthrax
Most common form of anthrax
Inhalational Anthrax
Most severe form of anthrax
Ciprofloxacin
Drug of choice for cutaneous anthrax
Gram (+) spore-forming bacilli, aerobic, motile
A case of food poisoning after eating reheated fried rice. What is the characteristics of this organism?
Metronidazole
A 40-year-old carpenter sustained a punctured wound on his right hand a week ago. He noted to experience muscle rigidity thus came for consult. What is the preferred antibiotic for this case?
Inhibiting the release of GABA by cleaving of synaptobrevin 2
What is the mechanism leading to the patient in the previous case to develop such symptoms?
Blocking the release of acetylcholine
Mode of action of botulinum toxin
Ingestion of spores in household dust or honey
Most common source of infection in Floppy Baby Syndrome
Clostridium perfringes
A 30 year old female suffered major injuries to her left arm after a motorcycle accident. She was brought to the ER due to high grade fever. Her left arm is swollen with dark serous fluid draining from the wound. Crepitus can also be felt. What is the most likely causative agent?
Lecithinase
Toxin responsible for gas gangrene
Egg yolk agar
Agar used for C. perfringens
Clindamycin, 2nd and 3rdCephalosporins and Ampicillin
Antibiotics that can cause pseudomembranous colitis
Stop the antibiotic responsible for the infection
1st step in treating C. difficile infection
Vancomycin
Antibiotic of choice for treatment of C. difficile
Inhibits protein synthesis by adding ADP-ribose to elongation factor 2
What’s the mechanism of the exotoxin of C diphtheria?
Loeffler’s medium or Potassium tellurite
Culture media of C. diphtheria
Erythromycin
Antibiotic choice for C. diphtheria
-Ingestion of unpasteurized milk products
-Across placenta or contact during delivery
A newborn who was diagnosed with neonatal sepsis was admitted in the hospital. Culture shows a facultative intracellular rod that exhibits cold enhancement and a narrow zone of beta hemolysis. This organism can be transmitted by:
Listeriolysin
The organism discussed in the previous case escapes from the phagosome via which toxin?
Actinomyces israelii
A 30yr old man got into a fight and broke his jaw a few days ago which now has developed an abscess with draining pus. Anaerobic culture showed molar tooth colonies. What is the causative agent?
Penicillin
Treatment of choice for the causative agent discussed in the previous case?
Nocardia asteroides
A 40yr old HIV patient came due to chronic cough. PPD showed a negative result. Fite faraco stain demonstrated that organism is weakly acid fast. Culture showed orange colonies. What is the causative agent?
Co-trimoxazole
Drug of choice for Nocardia infection
