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pharyngoconjuctival fever

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adenovirus

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nonenveloped, DS linear DNA with an icosahedral nucleocapsid

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adenovirus

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environmentally stable and replication occurs in host nucleus; transmitted by contact, fecal oral or waterborne route

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adenovirus

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inhibits protein synthesis

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adenovirus

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secondary complication includes ARDS, Cystitis and GI problems

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adenovirus

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symptoms include fever, sore throat, tonsillar exudates leukocytosis, and atypical cells

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EBV

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hepatosplenomegaly a symptom

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EBV

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a DNA virus (gamma herpes virus)

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EBV

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contains viral antigens VCA, EA, and EBNAs

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EBV

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considered an oncogenic virus

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EBV

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transmitted by salivary secretions in developed countries; infects B lymphocytes

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EBV

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inhibits cell apoptosis to remain in latency

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EBV

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test for it includes detection of heterophile antibodies

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EBV

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treat with suppurative care and acyclovir

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EBV

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gram +, beta hemolytic, catalase -

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strep pyogenes

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main cause of strep pharyngitis

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strep pyogenes

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has a cell surface carbohydrate antigen

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strep pyogenes

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contains an M protein which helps evade phagocytosis

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strep pyogenes

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treat with penicillins and cephalosporins (erythromycin for those allergic to penicillin)

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strep pyogenes

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main complications are acute rheumatic fever, scarlet fever and rheumatic heart disease

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strep pyogenes

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causes a bull neck appearance (cervical adenopathy)

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diptheria

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club shaped, gram +, forms gray/black colonies

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diptheria

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causes respiratory stridor, exudative pharyngitis, yellow leathery oral membranes

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diptheria

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produces A-B toxin which inhibits protein synthesis by ADP ribosylation of EF-2

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diptheria

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can treat with penicillin, erthromycin or vaccination with DTP initially

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diptheria

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causes parotid and submaxillary tenderness

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mumps

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causes leukopenia and leukocytosis

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mumps

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an RNA virus part of the paramyxoviridae family

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mumps

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a single stranded, - sense, non segmented virus with multinucleated giant cells

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mumps

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infects and multiplies in the oropharynx; can have hematological dissemination to cause meningitis

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mumps

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treat symptoms with analgesics, inhibit swelling and can use a MMR vaccine

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mumps

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barking cough and steeple sign

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parainfluenza

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envelope contains H and F proteins; H for attachment and F for entry and spread

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parainfluenza

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a single stranded RNA virus, - sense, nonsegmented with synctia produced in infected cells causing cell to cell fusion

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parainfluenza

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normally found in children under 6 yrs of age; transmitted by respiratory droplets

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parainfluenza

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treat with humidification, epinephrine, and glucocorticoids

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parainfluenza

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causes cyanosis, paroxysmal cough and post cough vomiting

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b. pertussis

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non motile, gram - aerobic rods

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b. pertussis

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nutritionally fastidious and attach via hemagluttinin

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b. pertussis

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cause cilia paralysis via toxin; inhibit the Gi complex via ADP ribosylation which increases cAMP

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b. pertussis

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produces a hemolysin which kills mucosal epithelium

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b. pertussis

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treat with suppurative care, macrolide administration; vaccine is DTP

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b. pertussis

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causes respiratory distress, wheezes/rhonci, yellow/green sputum

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h. influenzae (AECB)

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gram - coccobacillary rods

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h. influenzae (AECB)

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require X and V growth factors

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h. influenzae (AECB)

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has 2 groups: group 1 has a polysaccharide capsule found in children and group 2 is unencapsulated and is found in adults

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h. influenzae (AECB)

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type B of this pathogen can be treated by 3rd generation cephalosporins such as cefotaxime

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h. influenzae (AECB)

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symptoms include high fever, chills, rusty sputum, dullness to percussion and lobar consolidation

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strep. pneumoniae (pneumococcal pneumonia)

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gram +, lancet shaped diplococci

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strep. pneumoniae (pneumococcal pneumonia)

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alpha hemolytic, catalase -, optochin sensitive

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strep. pneumoniae (pneumococcal pneumonia)

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most common cause of community acquired pneumonia

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strep. pneumoniae (pneumococcal pneumonia)

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can use penicillin, cefotaxime + macrolide, or vancomycin for treatment

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strep. pneumoniae (pneumococcal pneumonia)

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complications include otitis media, empyeme, AECB, meningitis, bacteremia, endocarditis

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strep. pneumoniae (pneumococcal pneumonia)

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blood tinged sputum found with alcohol use

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klebsiella pneumoniae (bacterial pneumonia)

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part of the enterobacterinacea family

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klebsiella pneumoniae (bacterial pneumonia)

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gram - bacilli that are lactose fermenting, urease + and indole -

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klebsiella pneumoniae (bacterial pneumonia)

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non motile, non flagellated with a polysaccharide capsule (K antigen) which inhibits C3b, causing antigenic mimicry

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klebsiella pneumoniae (bacterial pneumonia)

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common cause of nosocomial pneumonia; high risk in alcoholics

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klebsiella pneumoniae (bacterial pneumonia)

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treat with pipercillin (extended spectrum)

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klebsiella pneumoniae (bacterial pneumonia)

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symptoms include dry cough, clear sputum, low fever, with patchy infiltrates

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mycoplasma pneumoniae

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no cell wall, cholesterol in membrane

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mycoplasma pneumoniae

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ciliostasis (prolonged cough) common

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mycoplasma pneumoniae

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non productive cough, no bacteria on smear, no beta lactam response

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mycoplasma pneumoniae

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complications include steven johnson syndrome and tracheobronchitis

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mycoplasma pneumoniae

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treat with azithromycin or doxycycline

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mycoplasma pneumoniae

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symptoms include high fever, dry cough, patchy interstitial infiltrates, headache, confusion, muscle aches

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legionella pneumophilla (legionellosis)

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motile, flagellated, pleomorphic rods

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legionella pneumophilla (legionellosis)

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stain faintly on gram stain (gram - features)

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legionella pneumophilla (legionellosis)

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nutritionally fastidious, aerobic, motile, flagellated

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legionella pneumophilla (legionellosis)

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found in water reservoirs, not person to person

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legionella pneumophilla (legionellosis)

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complications include legionairres disease or pontiac fever

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legionella pneumophilla (legionellosis)

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treat with a macrolide, fluroquinolone

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legionella pneumophilla (legionellosis)

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penetrates mucus layer and inhibits phagolysosome formation

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legionella pneumophilla (legionellosis)

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symptoms include acute respiratory distress, prostration, fever, chills, frequent weak cough and a normal chest x ray

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influenza

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single stranded RNA, - sense, segmented

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influenza

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has hemagluttinin and neuraminidase spikes (H for attachment to sialic acid receptors and N for degrading protective mucus to gain access)

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influenza

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can undergo antigenic shift or drift

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influenza

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has mainly systemic symptoms with viremia absent

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influenza

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type A treated with amantidine and rimantidine

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influenza

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secondary infection very common, annual vaccination available

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influenza

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complications include reyes syndrome, hepatoencephalopathy, and pneumonia

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influenza

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symptoms include respiratory distress, atelectasis, rhinorrhea and crackles; peribronchial infiltrates present with hyperinflation

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RSV

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part of the paramyxoviridae family

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RSV

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- sense, single stranded RNA, nonsegmented

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RSV

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has a large enveloped glycoprotein (F and G)

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RSV

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no hemagluttinin present; multinucleated syncitium present

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RSV

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treatment is symptomatic, contact isolation and use of ribaverin

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RSV

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symptoms include chronic fever, cough, weight loss, night sweats, blood tinged sputum

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