question

Acute Localized-Furunculosis Otitis Externa; Staphlococcus aureus [Streptococcus pyogenes (GAS)]

answer

Abscess or boil in hair follicle in external ear canal

question

Acute Diffuse (Swimmer’s Ear); Pseudomonas aeruginosa

answer

Itching in external ear canal, followed by swelling, erythema, blue-green discharge, often after swimming

question

Chronic-caused by repeated Acute Otitis Media; Streptococcus pneumonia [H influenzae (non-typable), M catarrhalis]

answer

Repeated bouts of pain, itching, scaling dermatitits in external ear canal, hx of recurrent otitis media

question

Invasive Otitis Externa; Pseudomonas aeruginosa [Staphlococcus aureus Streptococcus pyogenes (GAS)]

answer

Infection of external ear canal: purulent, severe pain, necrosis; problem in elderly, diabetics, immunocompromised

question

Acute Otitis Media Streptococcus pneumonia [H influenzea - non-typable, Moraxella catarrhalis, MRSA]

answer

Ear pain, diminished hearing, tympanic membrane bulging, possibly red

question

Recurrent Otitis Media Streptococcus pneumonia [H influenzea - non-typable, Moraxella catarrhalis, MRSA]

answer

Repeated bouts of ear pain, diminished hearing, tympanic membrane bulging, possible perforation of tympanic membrane

question

Chronic Otitis Media/ Mastoiditis Streptococcus pneumonia [H influenzea - non-typable, Moraxella catarrhalis, MRSA]

answer

Longstanding ear pain, diminished hearing, bulging of tympanic membrane; complicated by erosion of canal soft tissue, abscess in mastoid process; untreated can cause meningitis

question

Pharyngitis / Tonsilitis Streptococcus pyogenes (GAS) [H. Influenzae, Staphlococcus aureus, Chlamydia pneumoniae]

answer

Sore throat, dysphagia, fever, tonsilar hypertrophy, cervical lymphadenopathy, gray-white purulent exudate and small hemorrhages in posterior pharynx

question

Scarlet Fever Streptococcus pyogenes (GAS) – erythrogenic toxin

answer

Sandpaper rash starts on trunk, spreads to extremities, spares palms and soles, whiteness around mouth and nose (ciccumoral pallor), bright red tongue, desquamation of rash area, commonly post-pharyngitis

question

Complications of Streptococcus pyogenes pharyngitis

answer

Suppurative (pus-spread): otitis media, sinusitis, meningitis, osteomyelitis, endocarditis; Non-Suppurative: acute rheumatic fever, glomerulonephritis (both due to M-protein homology with native antigens), scarlet fever

question

Laryngitis Streptococcus pyogenes (GAS) [Mycobacterium tuberculosis]

answer

Vocal hoarsezness, change in pitch, possible cough

question

Epiglottitis Haemophilus influenzae type B

answer

Sore throat, fever, dry raspy cough, difficulty swallowing, asphyxiation danger, can lead to meningitis

question

Sinusitis (acute, subacute, chronic, or recurrent) Streptococcus pneumonia [Non-typable HI, Streptococcus pyogenes, Mycoplasma pneumonia, Moraxella catarrhalis]

answer

Thick, purulant nasal discharge, facial pain and tenderness, fever, cough, post-nasal drainage

question

Diptheria Corynebacterium diptheriae (diphtheria toxin AB) (dTAP vaccine)

answer

Sore throat, purulent exudate, dry cough, hoarseness, fever, nausea, gray-white pseudomembrane in posterior pharynx

question

Whooping Cough/ Pertussis Bordetella pertussis (dTAP vaccine)

answer

Violent coughing spasms with characteristic gasping, loss of bladder control, broken ribs, blood vessels burst in eyes, most serious in children, possibly linked to Guillain-Barre,

question

Acute Pneumonia (Community Acquired) Streptococcus pneumonia [Non-typable H Influenzae, Moraxella catarrhalis]

answer

Cough, sputum production, dyspnea, fever, muscle pains, GI symptoms, consolidation of lungs

question

Acute Pneumonia (Nosocomial Acquired) Gram (-) baccili [Klebsiella pneumoniae, E. Coli, Pseudomonas aeruginosa, Staphlococcus aureus, MRSA]

answer

Cough, sputum production, dyspnea, fever, muscle pains, GI symptoms, consolidation of lungs, hospitalized patients

question

Atypical Pneumonia Mycoplasma pneumoniae

answer

Cough, sputum with WBCs but no bacteria, 5-45 yrs old, illness lasts 10 days, culture reveals colonies with “fried egg” appearance, elevated cold hemagglutins

question

Atypical Pneumonia (Parrot Fever) Chlamydia psittaci

answer

Dry cough, headache, fever, myalgia, rales, inclusion bodies within PMNs on Giemsa stain, history of contact with birds

question

Atypical Pneumonia Klebsiella pneumoniae

answer

Acute onset of fever, chills, flulike symptoms, productive cough with abundant thick blood-tinged sputum, alcoholics at risk

question

Atypical Pneumonia Chlamydia pneumoniae

answer

Dry cough, fever, sore throat, inclusion bodies within PMNs on Giemsa stain

question

Atypical Pneumonia/ Legionnaire’s Disease Legionella pneumophilia

answer

Dry cough, fever, headache, diarrhea possible, stain poorly G(-), culture on charcoal yeast, elderly smokers at risk

question

Pontiac Fever Legionella pneumophilia

answer

Dry cough, fever, muscle aches, less severe symptoms than pneumonia, one-week course, stain poorly G(-), culture on charcoal yeast

question

Chronic Pneumonia: typically acute agents [S aureus, P aeruginosa, H influenzae]; chronic agents [M tuberculosis, fungi, Actinomyces israelii]

answer

Long term, progressive pneumonia symptoms, Requires X-Ray to Diagnose

question

Tuberculosis Mycobacterium tuberculosis BCG vaccine

answer

Fever, bloody sputum, night sweats, cavitation of lungs on CXR, two phases: Latent and Reactivation, Upper lobes of lungs

question

Community Acquired Lower UTI (Cystitis/ Urethritis) Escherichia coli [Staphylococcus saprophyticus, Klebsiella, Enterobacter]

answer

Mostly young women, flank pain, painful urination, cloudy or pink Urine, leukocytes in urine, nitrite positive

question

Nosocomial Lower UTI (Cystitis/ Urethritis) Escherichia coli [Enterococcus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Candida albicans]

answer

Mostly young women, flank pain, painful urination, cloudy or pink Urine, leukocytes in urine, nitrite positive, hospitalized patient

question

Upper UTI Pyelonephritis Escherichia coli [Klebsiella, Enterobacter, Proteus (mostly males)]

answer

painful urination, nausea, diarrhea, tenderness of costovertebral angles, leukocytes, casts and nitrite present in urine, proteinuria, fever possible

question

Escherichia coli, Staphlococcus aureus, Pseudomonas aeruginosa, Mycobacterium tuberculosis

answer

Common agents of hematogenous UTIs

question

Escherichia coli, Klebseilla pneumonia, Enterbacter, Proteus (esp males)

answer

Common agents of ascending UTIs

question

Escherichia coli, Enterococcus, Staphlococcus epidermidis, Pseudomonas aeruginosa, Candida albicans, Klebseilla pneumonia, Enterbacter

answer

Common agents of nosocomial UTIs

question

Acute Prostatitis Escherichia coli [Pseudomonal aeruginosa, Staphlococcus aureus]

answer

Perineal Pain, dysuria, Back Pain, Tender, Warm, Swollen Gland, males

question

Chronic Prostatitis Escherichia coli [Klebsiella pneumonia, Proteus mirabilis]

answer

Perineal Pain, dysuria, Back Pain, Tender, Warm, Swollen Gland, Urinary frequency, longstanding symptoms, males

question

Leptospirosis/ Weil’s Disease Leptospira interrogans Icterohemorrhagiae

answer

Week long bout of flu-like symptoms, photophobia, followed by meningitis, jaundice and signs of renal failure, hemorrhagic complications (visibly apparent in eyes); endemic in Hawaii

question

Disseminated Tuberculosis

answer

Granulomatous lesions in kidney

question

Acute Poststreptococcal Glomerulonephritis (Type III Hypersensitivity) Streptococcus pyogenes (GAS)

answer

Follows pharyngitits or skin infection, Fever, Loin Pain, proteinuria

question

Hemolytic Uremic Syndrome Escherichia coli (EHEC) – shiga like toxin

answer

Severe anemia, follows bloody diarrhea, thrombocytopenia, acute renal failure, elderly, young children, immunocompromised at risk

question

Non-bullous Impetigo Streptococcus pyogenes (GAS) (possible sequel: glomerulonephritis) [Staphlococcus aureus]

answer

Superficial epidermal pustular eruption, usually found in one locus, puritic release can form honeycomb crust, follows minor trauma

question

Bullous Impetigo Staphlococcus aureus (exfoliative toxin)

answer

Clear or yellow flaccid bullae, rupture and exfoliate to expose red moist surfaces, with time light brown crust

question

Staphlococcal Scalded Skin Syndrome (SSSS) (systemic exfoliative toxin)

answer

Fever, widespread rash and bullae, rupture and exfoliate to expose red moist surfaces, Positive Nikolski’s Sign (exfoliation with slight rubbing), common in infants

question

Folliculitis (on eyelid called a “stye”) Staphloccus aureus [E coli (peri-nasal), P aeruginosa (after swimming), GAS (rare)]

answer

Painful red papule around hair follicles, can progress to pustule, common on extremities and scalp

question

Furuncles & Carbuncles (Carbuncle = convalescence of many furuncles) Staphloccus aureus [E coli, P aeruginosa, S pyogenes]

answer

Painful, red, raised nodule, yellow center & discharge, follows folliculitis or acne vulgaris; if convalesces with other areas, sinus draining tracks, fever, chills, bacteremia possible

question

Erythrasma Carynabacteria metesmium

answer

Dry, scaly, itchy maculopapular rash in moist areas (groin, toe webs, axilla), fluoresces coral red (reddish-brown) under wood lamp, G(+) rod

question

Erysipelas (raised due to lymphatic involvement) Streptococcus pyogenes [Staphylococcus aureus]

answer

Abrupt onset and spread of well-defined raised rash, commonly legs, butterfly pattern if on face, painful, fever possible, skin sloughing in severe cases

question

Cellulitis (on eyelid called “blepharitis”) (extent of infection likely greater than visually apparent) S pyogenes (esp when lymph blocked) [S aureus (if around wound/ulcer), P aeruginosa (nosocomial), V vulnificus (sea shore injury)]

answer

Moderately painful swelling of dermis following injury, furuncle, or erysipelas; erythema, warmth at affected site; fever, malaise, affected area not raised

question

Auricular Cellulitis Staphlococcus aureus or Streptococcus pyogenes

answer

Infection of ear auricle soft tissue, following injury, furuncle, or erysipelas; moderate pain, swelling, affected area not raised

question

Perichondritis Staphlococcus aureus (NOT GAS)

answer

Infection of auricular cartilage

question

Erysipeloid “Fish Finger, Whale Finger” Erysipelothrix rhusiopathae

answer

cellulitis on hand, purple and swollen, fish or meat handling, follows mild trauma, sepsis in immunocompromised

question

Anaerobic Cellulitis Clostridium perfringins

answer

Locally swollen dermal tissue, dark, foul smelling discharge with fat globules, painless, relatively deep infection in devitalized tissue, follows moderate trauma

question

Ecthyma Gangrenosum P aeruginosa [E coli]

answer

Round lesion of necrotic tissue 1-15 cm with halo of erythema, hx suggesting blood infection, G(-) lactose (-) rod

question

Nectrotizing Fasciitis Type I aerobe (E coli, Klebsiella, Proteus, Pseudomonas) plus anaerobe (C perfringins, Bacteroides)

answer

Rapid onset and quick spreading local edema, erythema, necrotic look following injury; severe pain, fever, chills; both aerobic and anaerobic organism cultured from would

question

Nectrotizing Fasciitis Type II (60% of Nectorzing Ds) Streptococcus pyogenes (specific M type- esp virulent) (pyogenic exotoxins A and B)

answer

Rapid onset and quick spreading local edema, erythema, necrotic look following injury; very aggressive – destroys up to 1 in of tissue per hour, no obvious margin, purplish bullae filled with blood or foul smelling “dishwater” pus; prognosis: DIC, shock, death within 2 days

question

Fourniere’s Gangrene (subset of Type I NF) aerobe (E coli, Klebsiella, Proteus, Pseudomonas) plus anaerobe (C perfringins, Bacteroides)

answer

Necrotizing fasciitis of male genitalia in debilitated, hospitalized pts; common in diabetics, elderly, alcoholics, chronic steroid users

question

Clostridial Myonecrosis (Gas Gangrene) Clostridium perfringens

answer

Sudden onset of pain, heaviness, edema after deep wound; gas production in surrounding soft tissue, hemorrhagic bullae, bronze skin, serosanguinous discharge, crepitice and gas release on palpation, systemic symptoms

question

Bacterial Pyomyositis Staphlococcus aureus

answer

Localized muscle pain, edema, fever, swollen muscle, pain, commonly legs (esp quadricepts), more common in tropics, untreated leads to sepsis

question

Fish Tank / Swimming Pool Granuloma Mycobacterium marinum

answer

Ulceration lesions on skin following exposed wound contact with slime in fresh or salt water, sticks around for months, acid fast bacilli

question

Mycobacterium chelonae, Mycobacterium fortuitum

answer

Raised abscesses on skin, often after exposure to inadequately treated pools or hot tubs, Typically in immunocompramised, especially diabetics (get cold abscesses around needle sticks), acid fast bacilli

question

Disseminated TB Skin Infection Mycobacterium tuberculosis

answer

Skin and soft tissue infections anywhere in the body in pts with TB history

question

Toxic Shock Syndrome (TSS) Staphlococcus aureus (TSST-1 and 2) [Streptococcus Pyogenes (SPE-A)]

answer

With Trivial Infection, Abrupt fever, vomiting, diarrhea, hypotensive, hypovolemic shock, sunburn rash, Near end of infection skin scalding

question

Childbed Fever/ Puerperal Fever Streptococcus Pyogenes (SPE-A)

answer

Sepsis in postpartum women

question

Tetanus Clostridum tentani

answer

Lock Jaw, Sardonic Smile, Rigidity, Spaspms, Spastic Paralysis

question

Neonatal Tetanus Clostridum tentani

answer

Generalized weakness, Spasms, Failure to thrive in neonate, starts at umbilical stump or at circumcision

question

Leprosy Mycobacterium leprae

answer

Plaque-like skin lesions, thickened cheeks, deformed nose, peripheral sensory loss, progresses to nodular rash, Not in USA

question

Microbemia/ Bacteremia commonly E coli, P aeruginosa, S aureus, S pneumoniae

answer

Bacteria present in blood culture; may be asymptomatic; Fever, Chills, Fatigue, Myalgia, Arthralgia, Sweating indicate sepsis

question

Acute Infective Endocarditis Staphlocous aureus [Streptococcus pneumonia, Nisseria gonorrhea, Streptococcus pyogenes, E. fecalis]

answer

Fever, heart murmur early, valve vegetations on imaging; later emboli cause petechial “Janeway” lesions on palms and soles, and possible infarcts; long term signs are Roth Spots (autoimmune retinal hemorrhages), Osler’s nodes (painful red lesions of toe pulp on palms and soles, autoimmune)

question

Subacute Infective Endocarditis Viridan Streptococcus [Haemophilus, Enterococci, S epidermidis (prosthetic valve)]

answer

Symptoms similar to CHF (tachypnea, cyanosis, edema; hx of underlying heart disease, fever, weight loss, insidious onset

question

Osteomyelitis Staphlococcus aureus (90%)

answer

Abscess of Bone, Children: Long Bones, Insidious, pseudoparalysis, Adults: Vertebral Column, LBP, Fever

question

Septic Arthritis S aureus (<15 and>30 yrs) N gonorrhoeae (15-35 yrs)

answer

Acutely Painful Swollen Joints, Fever, Effusions, Warm, high PMN in CBC

question

Septic Bursitis Staphlococcus aureus

answer

Inflammation Around Joints, Spongy on palpation, Redness, Warm, Purulent fluid with WBCs, fever, chills, malaise, commonly a/c joint

question

Disseminated Gonococcal Infection (DGI) Neisseria gonorrhoeae

answer

Dermatitis, Septic Arthritis, Tendon Inflammation, Migratory Polyarthralgia, possible vasculitic rash (can look like meningococcemia), G(-) diplococci in synovial fluid, hx of gonococcal infection

question

Blepharitis Staphlococcus aureus

answer

Cellulitis of the Eyelid, Frequently Bilateral, Swelling, Redness, Exudates that crust on eyelashes

question

Acute Conjunctivitis Streptococcus pneumoniae [H influenzae, S aureus]

answer

Burning, Irritation of eyes, Lots of Tears, Pronounced Purulent Discharge, Frequently Bilateral, Self Limiting

question

Inclusion Conjunctivitis Chalmydia thrachomatis (serotypes D-K)

answer

Copious mucoid discharge, red eyes, common in infants infected by mother during birth, adults = autoinoculation

question

Hyperacute Conjunctivitis/ Opthalmia Neonatorum (infants) (serious, threatens eyesight) Neisseria gonorrhoeae

answer

Copious Yellow-Green Discharge from eyes that re-accumulates immediately with clearing, tenderness, G(-) diplococci on choc agar

question

Chronic Conjunctivitis Staphlococcus aureus

answer

Long term eye itching, Burning, Morning Eyelid Crusting, flaking of eyelids, loss of eyelashes

question

Keratoconjunctivitis (corneal & conjunctival inflammation) (Trachoma) Chalymdia trachomatis (serotypes A-C)

answer

Repeated infections lead to plaque formation of vascular tissue, scarring of eyelid, corneal abrasion; leading cause of blindness in world, more common with poor hygiene (rare in US), preventable

question

Keratitis (corneal inflammation) Staphlococcus aureus [Streptococcus pyogenes, Chalymidia trachamastis, Pseudomonas aeriginosa]

answer

Significant eye pain, Photophobia, Red Eye, thick ropy, mucopurulant discharge, typically follows trauma, can lead to cloudiness or ulceration of cornea and diminished visual acuity

question

Epidemic Typhus Rickettsia powezekii

answer

Maculopapular rash beginning on trunk and spreading to extremities (spares palms soles and face), fever, headache, myalgia, Vascular endothelium damaged, louse born, antibody serology

question

Endemic Typhus Rickettsia mooseri

answer

Maculopapular rash, fever, malaise, louse born, antibody serology

question

Rocky Mountain Spotted Fever Rickettsia rickettsi

answer

Maculopapular rash begins on extremities and spreads to trunk (spares palms soles and face), fever, headache, myalgia, vascular damage (possible CNS damage, organ failure), dog tick or deer tick, East coast, antibody serology

question

Lyme Disease Borrelia burgdorferi

answer

Stage 1: Early – Localized: Erythema migrans (bulseye rash); Stage 2: Early – Disseminated: Secondary lesions, macupapular rash, CNS signs: meningitis, bell’s palsy; Stage 3: Late – Persistent: Months to years later, Joint swelling, autoimmune; Deer tick, Cape Cod, 36 to 48 hrs to transfer from Deer Tick, most common vector borne disease in US, ELISA and Western blot to dx

question

Relapsing Fevers Borrelia recurrentis

answer

Night Sweats with relapsing fever (due to antigenic variation of pathogen), soft tick vector, many animal reservoirs, Western US

question

Cat-Scratch Disease Bartonella henselae

answer

Lymphadenopathy near cat, flea, or tick bite, fever, immunocompetent, often kids, labs to rule out other causes of lymphadenopathy

question

Bacillary Angiomatosis Bartonella henselae

answer

Small skin nodules that represent proliferation of capillary bundles (angiomatosis), typically in AIDS patients, contact with cats, dx with silver stain

question

Pasteurella Pasturella multocida

answer

From Bite of Dog or Cat, Soft tissue swelling, erythema, pain, lymadenoapthy, G(-) nonmotile coccobacilli, hazardous to immunocompromised

question

Anthrax Bacillus anthracis

answer

Reservoir in domestic animals, Cutaneous: Tiny papule to vesicle to black necrotic ulcer that is painless; Inhalation: Inhalation of spores, Primary Phase - Sore throat, fever, Secondary Phase – dyspnea, Edema, Hypoxia, Sepsis, “woolsorters”; GI: Ingestion of spores, Lesions at base of tongue, Pharyngitis, White plaque on pharynx, Nausea, anorexia, Blood vomiting, Sepsis; Hemorrhagic Meningeoenchphalitis: Extension of inhalation, only in bio-warfare

question

Rabbit Fever, Deer-Fly Fever Francisella tularensis (Gram (-), Aerobic, Non-Spore Forming, Intracellular Diplococci)

answer

Rodents, Rabits reservoirs; Seems like plague, Requires break in skin, mucosa, etc. Multiply within macrophages; Ulceroglandular: Cutaneous pustule that ulcerates, usually on hands due to animal handling; Glandular: Lymphadenopathy w/o cutaneous disease; Occuloglandular: Finger or Splash Eye Contamination, Ulceration of conjunctiva; Oropharyngeal: From Ingestion of contaminated products, Exudative pharyngitis, Ulcer production in posterior and inferior pharynx, Cervical lymphadenopathy, Looks like strep throat; Pulmonary: Inhalation of contaminated dust / aerosols, Can come from hemorrhagic spread, Cough, Purulant Sputum, pneumonia, Quickly progresses to Sepsis; Typhoidal: Just means systemic, No known anatomical location, Fever, Weight loss, Muscle Aches and Pains; Tuleremia Sepsis: Sepsis, DOC, Shock, Diarrhea, Vaccine does exist, dx: fluorescent Ab, Elisa, PCR

question

Bubonic Plague

answer

Abrupt onset of hemorrhagic lymphadenopathy (bubos), fever, malaise, sepsis; followed by hemorrhagic consolidations in lung (bloody, frothy sputum), shock, DIC, Tachycardia, hx of contact with rodents, dx: culture on MacConkey, immunofluorescence, Rodent reservoir, transmitted to humans by Rat Fleas

question

Acute Meningitis various etiology

answer

Fever, Headaches, Altered mental status; also: nuchal rigidity, photophobia, nausea, vomiting, drowsiness, sensory changes, high protein and low glucose in CSF, PMN in CSF, bacteria in CSF

question

Signs of Acute Meningitis

answer

Kernig sign (can’t extend leg when thigh at right angle); Brudzinski sign (passive flexion of neck or one leg causes movement of other leg)

question

Streptococcus agalctiae (GBS) [E. coli, Listeria monocytogenes – passed from mother in birth]

answer

Acute meningitis in neonates

question

Listeria monocytogenes

answer

Acute meningitis in pregnant women

question

Streptococcus pneumonia

answer

Acute meningitis in < 2 y/o

question

Haemophilus influenzae B

answer

Acute meningitis in 2 – 6 y/o & Unvaccinated

question

Nisseria meningitis [Streptococcus pneumoniae]

answer

Acute meningitis in 6 – 25 y/o

question

Gram (-) Rods E. coli or Proteus [Listeria monocytogenes, Streptococcus pneumonia, H influenzae B]

answer

Acute meningitis in patients with chronic disease (diabetes, alcoholism, elderly)

question

Strep pneumoniae [Neisseria meningitides, Listeria monocytogenes, Pseudomonas aeruginosa]

answer

Acute meningitis in immunocompromised

question

Meningococcemia without meningitis (dangerous – means fast spread) Neisseria meningitis

answer

Fever, chills, petechial rash spreads over trunk, eye hemorrhage; complications: toxic shock, DIC, hemorrhages - adrenal (Waterhouse-Friderichsen syndrome), pulmonary edema, endocardium, tricuspid valve

question

Meningococcal meningitis Neisseria meningitis

answer

Acute meningitis symptoms, diplococci in blood

question

Subacute Meningitis Mycobacterium tuberculosis [Trepanium pallidum, fungal agents]

answer

Acute meningitis, lasts days to months

question

Lyme Borreliosis Borrelia burgdorferi

answer

mild meningitis with Bell’s palsy; years later encephalitis or meningoencephalitis

question

Neurosyphilis Treponema pallidum

answer

Mild meningitis in secondary or tertiary stages of syphilis; years later encephalitis, stroke, progressive dementia

question

Chlaymidia pneumoniae

answer

High antigen and antibodies from infection with possible autoimmune link to multiple sclerosis

question

Urethritis / Cervicitis Chlamydia trachomatis (serotypes D to K)

answer

Dysuria, pyuria, inflammation of urethra, yellow to white thin discharge with leukocytes but no bacteria

question

Epididymitis Chlamydia trachomatis (serotypes D to K) [Neisseria gonorrhea]

answer

Men, unilateral scrotal pain, fever, tenderness, swelling, recent history of (and possibly continuing) dysuria, pyuria, yellowish penile discharge with leukocytes but no bacteria

question

Lymphogramuloma Venereum (LGV) Chlamydia trachomatis (serotypes L1 to L3)

answer

Painless papules at site of inoculation, resolve in wk, then lymphadenopathy, inguinal nodes enlarge, ulcerate, spread infection; perirectal abscesses, rectal fistulas and strictures, pencil stools, weight loss, fever, rash, vomiting, arthralgia

question

Acute Urethritis Neisseria gonorrhoeae

answer

Occurs in Men, Purulant discharge, dysuria, periurethral abscess, discharge with white cells and G(-) diplococci

question

Cervicitis / Urethritis (Bartholinitis) Neisseria gonorrhoeae

answer

Occurs in Women, heavy purulent and foul-smelling cervical discharge, vaginal bleeding, dysuria, occurs with rectal infection, diplococci, can transmit in birth a opthalmia neonatorum

question

Proctitis Neisseria gonorrhoeae

answer

Bloody anal discharge most common in women and homosexual males, diplococci

question

PID (salpingitis) Neisseria gonorrhoeae

answer

Ascending infection, tubo-ovarian abscess, pelvic peritonitis, tenesmus (false urge to defecate), complication of ascending cervicitis, possible sequella: Fitz-Hugh-Curtis

question

Mycoplasma Genetalium Mycoplasma hominis (more common) -or- Ureplasma Urealyticum Ureplasma (less common)

answer

Clear to cloudy urethral discharge, dysuria, itching, tender genitals, ascends causing testicular swelling (men) PID (women); can also present in anus (purities, pain) and oral (sore throat), fried egg colonies on glucose

question

Cancroid Haemophilus ducreyi

answer

Papules a pustules a purulent painful ulcers, rip and bleed easily, HSV(-), no T. palladium in darkfield, Gram (-) coccobacilli with characteristic wavy pattern, women may be asymptomatic

question

Granuloma Inguinale/ Donovanosis Klebsiella granulomatis

answer

Progressive ulcerative disease on genitals – begins in mucus membranes, small painless papule becomes nodular, skin erodes, beefy red ulcer forms, no lymphadenopathy, travel hx to New Guinea, S Africa, Caribbean, Donovan bodies on staining

question

Bacterial Vaginosis (NOT Vaginitis!) Gardnerella vaginalis

answer

Irritation, Greenish Discharge, Low pH (<5), Bleeding, Amine-Odor (Fishy Smell), “Clue” cells present in vaginal scraping

question

Syphilis Treponema pallidum

answer

(1) Painless chancre with raised edges, local lymphadenopathy, resolves; (2) months later macropapular rash on trunk with copper hue, genital and anal warts (condylama lata), athralgia, fever, malaise, resolves; latent phase, can relapse; (3) years later autoimmune damage to soft tissue and bone (gummas – large rubbery lumps everywhere), CV tissue (aortitis, aneurysm), CNS (meningitis, tabes dorsalis – degeneration of sensory neurons), joints (Charcot’s Disease); dark field microscopy reveals spirochetes

question

Congenital Syphilis (Saddle Nose) (Hutchinson’s Disease) Treponema pallidum

answer

Spontaneous abortion, fetal skin lesions, destruction of bones, Hutchinson’s teeth, passed from mother through placenta

Bacterial and Fungal Diseases – Flashcards

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