Bacterial and Fungal Diseases – Flashcards
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| Acute Localized-Furunculosis Otitis Externa; Staphlococcus aureus [Streptococcus pyogenes (GAS)] |
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| Abscess or boil in hair follicle in external ear canal |
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| Acute Diffuse (Swimmer’s Ear); Pseudomonas aeruginosa |
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| Itching in external ear canal, followed by swelling, erythema, blue-green discharge, often after swimming |
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| Chronic-caused by repeated Acute Otitis Media; Streptococcus pneumonia [H influenzae (non-typable), M catarrhalis] |
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| Repeated bouts of pain, itching, scaling dermatitits in external ear canal, hx of recurrent otitis media |
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| Invasive Otitis Externa; Pseudomonas aeruginosa [Staphlococcus aureus Streptococcus pyogenes (GAS)] |
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| Infection of external ear canal: purulent, severe pain, necrosis; problem in elderly, diabetics, immunocompromised |
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| Acute Otitis Media Streptococcus pneumonia [H influenzea - non-typable, Moraxella catarrhalis, MRSA] |
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| Ear pain, diminished hearing, tympanic membrane bulging, possibly red |
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| Recurrent Otitis Media Streptococcus pneumonia [H influenzea - non-typable, Moraxella catarrhalis, MRSA] |
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| Repeated bouts of ear pain, diminished hearing, tympanic membrane bulging, possible perforation of tympanic membrane |
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| Chronic Otitis Media/ Mastoiditis Streptococcus pneumonia [H influenzea - non-typable, Moraxella catarrhalis, MRSA] |
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| Longstanding ear pain, diminished hearing, bulging of tympanic membrane; complicated by erosion of canal soft tissue, abscess in mastoid process; untreated can cause meningitis |
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| Pharyngitis / Tonsilitis Streptococcus pyogenes (GAS) [H. Influenzae, Staphlococcus aureus, Chlamydia pneumoniae] |
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| Sore throat, dysphagia, fever, tonsilar hypertrophy, cervical lymphadenopathy, gray-white purulent exudate and small hemorrhages in posterior pharynx |
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| Scarlet Fever Streptococcus pyogenes (GAS) – erythrogenic toxin |
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| 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 |
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| Complications of Streptococcus pyogenes pharyngitis |
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| 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 |
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| Laryngitis Streptococcus pyogenes (GAS) [Mycobacterium tuberculosis] |
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| Vocal hoarsezness, change in pitch, possible cough |
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| Epiglottitis Haemophilus influenzae type B |
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| Sore throat, fever, dry raspy cough, difficulty swallowing, asphyxiation danger, can lead to meningitis |
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| Sinusitis (acute, subacute, chronic, or recurrent) Streptococcus pneumonia [Non-typable HI, Streptococcus pyogenes, Mycoplasma pneumonia, Moraxella catarrhalis] |
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| Thick, purulant nasal discharge, facial pain and tenderness, fever, cough, post-nasal drainage |
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| Diptheria Corynebacterium diptheriae (diphtheria toxin AB) (dTAP vaccine) |
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| Sore throat, purulent exudate, dry cough, hoarseness, fever, nausea, gray-white pseudomembrane in posterior pharynx |
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| Whooping Cough/ Pertussis Bordetella pertussis (dTAP vaccine) |
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| 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, |
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| Acute Pneumonia (Community Acquired) Streptococcus pneumonia [Non-typable H Influenzae, Moraxella catarrhalis] |
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| Cough, sputum production, dyspnea, fever, muscle pains, GI symptoms, consolidation of lungs |
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| Acute Pneumonia (Nosocomial Acquired) Gram (-) baccili [Klebsiella pneumoniae, E. Coli, Pseudomonas aeruginosa, Staphlococcus aureus, MRSA] |
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| Cough, sputum production, dyspnea, fever, muscle pains, GI symptoms, consolidation of lungs, hospitalized patients |
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| Atypical Pneumonia Mycoplasma pneumoniae |
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| 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 |
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| Atypical Pneumonia (Parrot Fever) Chlamydia psittaci |
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| Dry cough, headache, fever, myalgia, rales, inclusion bodies within PMNs on Giemsa stain, history of contact with birds |
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| Atypical Pneumonia Klebsiella pneumoniae |
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| Acute onset of fever, chills, flulike symptoms, productive cough with abundant thick blood-tinged sputum, alcoholics at risk |
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| Atypical Pneumonia Chlamydia pneumoniae |
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| Dry cough, fever, sore throat, inclusion bodies within PMNs on Giemsa stain |
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| Atypical Pneumonia/ Legionnaire’s Disease Legionella pneumophilia |
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| Dry cough, fever, headache, diarrhea possible, stain poorly G(-), culture on charcoal yeast, elderly smokers at risk |
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| Pontiac Fever Legionella pneumophilia |
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| Dry cough, fever, muscle aches, less severe symptoms than pneumonia, one-week course, stain poorly G(-), culture on charcoal yeast |
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| Chronic Pneumonia: typically acute agents [S aureus, P aeruginosa, H influenzae]; chronic agents [M tuberculosis, fungi, Actinomyces israelii] |
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| Long term, progressive pneumonia symptoms, Requires X-Ray to Diagnose |
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| Tuberculosis Mycobacterium tuberculosis BCG vaccine |
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| Fever, bloody sputum, night sweats, cavitation of lungs on CXR, two phases: Latent and Reactivation, Upper lobes of lungs |
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| Community Acquired Lower UTI (Cystitis/ Urethritis) Escherichia coli [Staphylococcus saprophyticus, Klebsiella, Enterobacter] |
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| Mostly young women, flank pain, painful urination, cloudy or pink Urine, leukocytes in urine, nitrite positive |
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| Nosocomial Lower UTI (Cystitis/ Urethritis) Escherichia coli [Enterococcus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Candida albicans] |
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| Mostly young women, flank pain, painful urination, cloudy or pink Urine, leukocytes in urine, nitrite positive, hospitalized patient |
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| Upper UTI Pyelonephritis Escherichia coli [Klebsiella, Enterobacter, Proteus (mostly males)] |
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| painful urination, nausea, diarrhea, tenderness of costovertebral angles, leukocytes, casts and nitrite present in urine, proteinuria, fever possible |
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| Escherichia coli, Staphlococcus aureus, Pseudomonas aeruginosa, Mycobacterium tuberculosis |
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| Common agents of hematogenous UTIs |
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| Escherichia coli, Klebseilla pneumonia, Enterbacter, Proteus (esp males) |
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| Common agents of ascending UTIs |
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| Escherichia coli, Enterococcus, Staphlococcus epidermidis, Pseudomonas aeruginosa, Candida albicans, Klebseilla pneumonia, Enterbacter |
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| Common agents of nosocomial UTIs |
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| Acute Prostatitis Escherichia coli [Pseudomonal aeruginosa, Staphlococcus aureus] |
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| Perineal Pain, dysuria, Back Pain, Tender, Warm, Swollen Gland, males |
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| Chronic Prostatitis Escherichia coli [Klebsiella pneumonia, Proteus mirabilis] |
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| Perineal Pain, dysuria, Back Pain, Tender, Warm, Swollen Gland, Urinary frequency, longstanding symptoms, males |
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| Leptospirosis/ Weil’s Disease Leptospira interrogans Icterohemorrhagiae |
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| 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 |
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| Disseminated Tuberculosis |
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| Granulomatous lesions in kidney |
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| Acute Poststreptococcal Glomerulonephritis (Type III Hypersensitivity) Streptococcus pyogenes (GAS) |
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| Follows pharyngitits or skin infection, Fever, Loin Pain, proteinuria |
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| Hemolytic Uremic Syndrome Escherichia coli (EHEC) – shiga like toxin |
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| Severe anemia, follows bloody diarrhea, thrombocytopenia, acute renal failure, elderly, young children, immunocompromised at risk |
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| Non-bullous Impetigo Streptococcus pyogenes (GAS) (possible sequel: glomerulonephritis) [Staphlococcus aureus] |
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| Superficial epidermal pustular eruption, usually found in one locus, puritic release can form honeycomb crust, follows minor trauma |
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| Bullous Impetigo Staphlococcus aureus (exfoliative toxin) |
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| Clear or yellow flaccid bullae, rupture and exfoliate to expose red moist surfaces, with time light brown crust |
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| Staphlococcal Scalded Skin Syndrome (SSSS) (systemic exfoliative toxin) |
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| Fever, widespread rash and bullae, rupture and exfoliate to expose red moist surfaces, Positive Nikolski’s Sign (exfoliation with slight rubbing), common in infants |
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| Folliculitis (on eyelid called a “stye”) Staphloccus aureus [E coli (peri-nasal), P aeruginosa (after swimming), GAS (rare)] |
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| Painful red papule around hair follicles, can progress to pustule, common on extremities and scalp |
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| Furuncles & Carbuncles (Carbuncle = convalescence of many furuncles) Staphloccus aureus [E coli, P aeruginosa, S pyogenes] |
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| Painful, red, raised nodule, yellow center & discharge, follows folliculitis or acne vulgaris; if convalesces with other areas, sinus draining tracks, fever, chills, bacteremia possible |
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| Erythrasma Carynabacteria metesmium |
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| Dry, scaly, itchy maculopapular rash in moist areas (groin, toe webs, axilla), fluoresces coral red (reddish-brown) under wood lamp, G(+) rod |
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| Erysipelas (raised due to lymphatic involvement) Streptococcus pyogenes [Staphylococcus aureus] |
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| Abrupt onset and spread of well-defined raised rash, commonly legs, butterfly pattern if on face, painful, fever possible, skin sloughing in severe cases |
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| 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)] |
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| Moderately painful swelling of dermis following injury, furuncle, or erysipelas; erythema, warmth at affected site; fever, malaise, affected area not raised |
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| Auricular Cellulitis Staphlococcus aureus or Streptococcus pyogenes |
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| Infection of ear auricle soft tissue, following injury, furuncle, or erysipelas; moderate pain, swelling, affected area not raised |
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| Perichondritis Staphlococcus aureus (NOT GAS) |
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| Infection of auricular cartilage |
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| Erysipeloid “Fish Finger, Whale Finger” Erysipelothrix rhusiopathae |
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| cellulitis on hand, purple and swollen, fish or meat handling, follows mild trauma, sepsis in immunocompromised |
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| Anaerobic Cellulitis Clostridium perfringins |
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| Locally swollen dermal tissue, dark, foul smelling discharge with fat globules, painless, relatively deep infection in devitalized tissue, follows moderate trauma |
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| Ecthyma Gangrenosum P aeruginosa [E coli] |
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| Round lesion of necrotic tissue 1-15 cm with halo of erythema, hx suggesting blood infection, G(-) lactose (-) rod |
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| Nectrotizing Fasciitis Type I aerobe (E coli, Klebsiella, Proteus, Pseudomonas) plus anaerobe (C perfringins, Bacteroides) |
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| Rapid onset and quick spreading local edema, erythema, necrotic look following injury; severe pain, fever, chills; both aerobic and anaerobic organism cultured from would |
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| Nectrotizing Fasciitis Type II (60% of Nectorzing Ds) Streptococcus pyogenes (specific M type- esp virulent) (pyogenic exotoxins A and B) |
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| 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 |
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| Fourniere’s Gangrene (subset of Type I NF) aerobe (E coli, Klebsiella, Proteus, Pseudomonas) plus anaerobe (C perfringins, Bacteroides) |
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| Necrotizing fasciitis of male genitalia in debilitated, hospitalized pts; common in diabetics, elderly, alcoholics, chronic steroid users |
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| Clostridial Myonecrosis (Gas Gangrene) Clostridium perfringens |
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| 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 |
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| Bacterial Pyomyositis Staphlococcus aureus |
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| Localized muscle pain, edema, fever, swollen muscle, pain, commonly legs (esp quadricepts), more common in tropics, untreated leads to sepsis |
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| Fish Tank / Swimming Pool Granuloma Mycobacterium marinum |
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| Ulceration lesions on skin following exposed wound contact with slime in fresh or salt water, sticks around for months, acid fast bacilli |
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| Mycobacterium chelonae, Mycobacterium fortuitum |
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| 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 |
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| Disseminated TB Skin Infection Mycobacterium tuberculosis |
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| Skin and soft tissue infections anywhere in the body in pts with TB history |
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| Toxic Shock Syndrome (TSS) Staphlococcus aureus (TSST-1 and 2) [Streptococcus Pyogenes (SPE-A)] |
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| With Trivial Infection, Abrupt fever, vomiting, diarrhea, hypotensive, hypovolemic shock, sunburn rash, Near end of infection skin scalding |
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| Childbed Fever/ Puerperal Fever Streptococcus Pyogenes (SPE-A) |
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| Sepsis in postpartum women |
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| Tetanus Clostridum tentani |
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| Lock Jaw, Sardonic Smile, Rigidity, Spaspms, Spastic Paralysis |
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| Neonatal Tetanus Clostridum tentani |
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| Generalized weakness, Spasms, Failure to thrive in neonate, starts at umbilical stump or at circumcision |
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| Leprosy Mycobacterium leprae |
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| Plaque-like skin lesions, thickened cheeks, deformed nose, peripheral sensory loss, progresses to nodular rash, Not in USA |
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| Microbemia/ Bacteremia commonly E coli, P aeruginosa, S aureus, S pneumoniae |
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| Bacteria present in blood culture; may be asymptomatic; Fever, Chills, Fatigue, Myalgia, Arthralgia, Sweating indicate sepsis |
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| Acute Infective Endocarditis Staphlocous aureus [Streptococcus pneumonia, Nisseria gonorrhea, Streptococcus pyogenes, E. fecalis] |
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| 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) |
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| Subacute Infective Endocarditis Viridan Streptococcus [Haemophilus, Enterococci, S epidermidis (prosthetic valve)] |
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| Symptoms similar to CHF (tachypnea, cyanosis, edema; hx of underlying heart disease, fever, weight loss, insidious onset |
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| Osteomyelitis Staphlococcus aureus (90%) |
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| Abscess of Bone, Children: Long Bones, Insidious, pseudoparalysis, Adults: Vertebral Column, LBP, Fever |
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| Septic Arthritis S aureus (<15 and>30 yrs) N gonorrhoeae (15-35 yrs) |
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| Acutely Painful Swollen Joints, Fever, Effusions, Warm, high PMN in CBC |
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| Septic Bursitis Staphlococcus aureus |
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| Inflammation Around Joints, Spongy on palpation, Redness, Warm, Purulent fluid with WBCs, fever, chills, malaise, commonly a/c joint |
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| Disseminated Gonococcal Infection (DGI) Neisseria gonorrhoeae |
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| Dermatitis, Septic Arthritis, Tendon Inflammation, Migratory Polyarthralgia, possible vasculitic rash (can look like meningococcemia), G(-) diplococci in synovial fluid, hx of gonococcal infection |
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| Blepharitis Staphlococcus aureus |
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| Cellulitis of the Eyelid, Frequently Bilateral, Swelling, Redness, Exudates that crust on eyelashes |
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| Acute Conjunctivitis Streptococcus pneumoniae [H influenzae, S aureus] |
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| Burning, Irritation of eyes, Lots of Tears, Pronounced Purulent Discharge, Frequently Bilateral, Self Limiting |
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| Inclusion Conjunctivitis Chalmydia thrachomatis (serotypes D-K) |
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| Copious mucoid discharge, red eyes, common in infants infected by mother during birth, adults = autoinoculation |
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| Hyperacute Conjunctivitis/ Opthalmia Neonatorum (infants) (serious, threatens eyesight) Neisseria gonorrhoeae |
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| Copious Yellow-Green Discharge from eyes that re-accumulates immediately with clearing, tenderness, G(-) diplococci on choc agar |
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| Chronic Conjunctivitis Staphlococcus aureus |
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| Long term eye itching, Burning, Morning Eyelid Crusting, flaking of eyelids, loss of eyelashes |
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| Keratoconjunctivitis (corneal & conjunctival inflammation) (Trachoma) Chalymdia trachomatis (serotypes A-C) |
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| 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 |
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| Keratitis (corneal inflammation) Staphlococcus aureus [Streptococcus pyogenes, Chalymidia trachamastis, Pseudomonas aeriginosa] |
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| 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 |
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| Epidemic Typhus Rickettsia powezekii |
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| Maculopapular rash beginning on trunk and spreading to extremities (spares palms soles and face), fever, headache, myalgia, Vascular endothelium damaged, louse born, antibody serology |
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| Endemic Typhus Rickettsia mooseri |
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| Maculopapular rash, fever, malaise, louse born, antibody serology |
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| Rocky Mountain Spotted Fever Rickettsia rickettsi |
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| 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 |
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| Lyme Disease Borrelia burgdorferi |
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| 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 |
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| Relapsing Fevers Borrelia recurrentis |
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| Night Sweats with relapsing fever (due to antigenic variation of pathogen), soft tick vector, many animal reservoirs, Western US |
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| Cat-Scratch Disease Bartonella henselae |
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| Lymphadenopathy near cat, flea, or tick bite, fever, immunocompetent, often kids, labs to rule out other causes of lymphadenopathy |
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| Bacillary Angiomatosis Bartonella henselae |
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| Small skin nodules that represent proliferation of capillary bundles (angiomatosis), typically in AIDS patients, contact with cats, dx with silver stain |
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| Pasteurella Pasturella multocida |
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| From Bite of Dog or Cat, Soft tissue swelling, erythema, pain, lymadenoapthy, G(-) nonmotile coccobacilli, hazardous to immunocompromised |
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| Anthrax Bacillus anthracis |
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| 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 |
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| Rabbit Fever, Deer-Fly Fever Francisella tularensis (Gram (-), Aerobic, Non-Spore Forming, Intracellular Diplococci) |
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| 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 |
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| Bubonic Plague |
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| 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 |
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| Acute Meningitis various etiology |
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| 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 |
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| Signs of Acute Meningitis |
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| 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) |
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| Streptococcus agalctiae (GBS) [E. coli, Listeria monocytogenes – passed from mother in birth] |
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| Acute meningitis in neonates |
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| Listeria monocytogenes |
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| Acute meningitis in pregnant women |
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| Streptococcus pneumonia |
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| Acute meningitis in < 2 y/o |
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| Haemophilus influenzae B |
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| Acute meningitis in 2 – 6 y/o & Unvaccinated |
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| Nisseria meningitis [Streptococcus pneumoniae] |
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| Acute meningitis in 6 – 25 y/o |
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| Gram (-) Rods E. coli or Proteus [Listeria monocytogenes, Streptococcus pneumonia, H influenzae B] |
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| Acute meningitis in patients with chronic disease (diabetes, alcoholism, elderly) |
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| Strep pneumoniae [Neisseria meningitides, Listeria monocytogenes, Pseudomonas aeruginosa] |
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| Acute meningitis in immunocompromised |
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| Meningococcemia without meningitis (dangerous – means fast spread) Neisseria meningitis |
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| Fever, chills, petechial rash spreads over trunk, eye hemorrhage; complications: toxic shock, DIC, hemorrhages - adrenal (Waterhouse-Friderichsen syndrome), pulmonary edema, endocardium, tricuspid valve |
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| Meningococcal meningitis Neisseria meningitis |
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| Acute meningitis symptoms, diplococci in blood |
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| Subacute Meningitis Mycobacterium tuberculosis [Trepanium pallidum, fungal agents] |
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| Acute meningitis, lasts days to months |
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| Lyme Borreliosis Borrelia burgdorferi |
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| mild meningitis with Bell’s palsy; years later encephalitis or meningoencephalitis |
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| Neurosyphilis Treponema pallidum |
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| Mild meningitis in secondary or tertiary stages of syphilis; years later encephalitis, stroke, progressive dementia |
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| Chlaymidia pneumoniae |
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| High antigen and antibodies from infection with possible autoimmune link to multiple sclerosis |
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| Urethritis / Cervicitis Chlamydia trachomatis (serotypes D to K) |
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| Dysuria, pyuria, inflammation of urethra, yellow to white thin discharge with leukocytes but no bacteria |
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| Epididymitis Chlamydia trachomatis (serotypes D to K) [Neisseria gonorrhea] |
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| Men, unilateral scrotal pain, fever, tenderness, swelling, recent history of (and possibly continuing) dysuria, pyuria, yellowish penile discharge with leukocytes but no bacteria |
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| Lymphogramuloma Venereum (LGV) Chlamydia trachomatis (serotypes L1 to L3) |
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| 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 |
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| Acute Urethritis Neisseria gonorrhoeae |
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| Occurs in Men, Purulant discharge, dysuria, periurethral abscess, discharge with white cells and G(-) diplococci |
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| Cervicitis / Urethritis (Bartholinitis) Neisseria gonorrhoeae |
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| 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 |
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| Proctitis Neisseria gonorrhoeae |
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| Bloody anal discharge most common in women and homosexual males, diplococci |
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| PID (salpingitis) Neisseria gonorrhoeae |
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| Ascending infection, tubo-ovarian abscess, pelvic peritonitis, tenesmus (false urge to defecate), complication of ascending cervicitis, possible sequella: Fitz-Hugh-Curtis |
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| Mycoplasma Genetalium Mycoplasma hominis (more common) -or- Ureplasma Urealyticum Ureplasma (less common) |
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| 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 |
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| Cancroid Haemophilus ducreyi |
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| 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 |
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| Granuloma Inguinale/ Donovanosis Klebsiella granulomatis |
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| 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 |
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| Bacterial Vaginosis (NOT Vaginitis!) Gardnerella vaginalis |
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| Irritation, Greenish Discharge, Low pH (<5), Bleeding, Amine-Odor (Fishy Smell), “Clue” cells present in vaginal scraping |
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| Syphilis Treponema pallidum |
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| (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 |
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| Congenital Syphilis (Saddle Nose) (Hutchinson’s Disease) Treponema pallidum |
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| Spontaneous abortion, fetal skin lesions, destruction of bones, Hutchinson’s teeth, passed from mother through placenta |
