Adapted from the lectures and handouts of Dr. Dolores Furtado.

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Bug Name	Manifestations	Identifying Properties	Culture / Tests	Virulence	Vaccine / Rx
Staphylococcus Aureus	Food Poisoning  Scalded Skin Syndrome  TSS Syndrome  Furuncle, Carbuncle  Bacteremia, Osteomyelitis, Endocarditis	GRAM(+) COCCI in clusters  Catalase(+)  beta-HEMOLYTIC -- Only at 4C  COAGULASE(+)  MANNITOL fermenting	Hot-Cold Hemolysin Test: beta-Hemolysin lyses at 4C  Mannitol-Salt Agar for fecal specimens	Coagulase  Exfoliatin  TSS-Toxin  Protein-A (Type-IV Hypersensitivity)  Ribitol Phosphate Peptidoglycan (Type-I Hypersensitivity)	beta-Lactamase Penicillin Resistance
Staphylococcus Saprophyticus	Symptomatic UTI's. Selectively adheres to transitional epithelium.	GRAM(+) COCCI in clusters  Catalase(+)  Coagulase (-)  Non-Mannitol Fermenting  Urease(+)
Staphylococcus Epidermidis	Catheter infections leading to local infection or bacteremia	GRAM(+) COCCI in clusters  Catalase(+)  Coagulase (-)  Non-Mannitol Fermenting  Urease(-)		Surface Glycocalyx  No Protein A
Bacillus Anthracis	ANTHRAX: Zoonotic, cattle  Cutaneous eschar (malignant pustule)  Pulmonary Anthrax  GI Anthrax (other countries)  Septicemia	GRAM(+) ROD, large with square end  Zoonotic  Penicillin-Susceptible -- string of pearls formation  gamma-Phage susceptible	Methylene blue stain shows thin capsule  Medusa-Head Colonies	Poly-d-Glutamic Acid Protein Capsule  Anthrax Toxin: Protective Antigen, Edema Factor, Lethal Factor.	Cattle Vaccine: Attenuated strain  Human Vaccine: at-risk people get multiple shots of toxoid alone.
Bacillus Cereus	Food Poisoning: Refried beans and rice  Opportunistic nosocomial bacteremia	GRAM(+) ROD  Penicillin-Resistant -- chains of rods  gamma-Phage resistant		Emetic Toxin (early vomiting)  Diarrheal Toxin (late diarrhea, heat resistant)	beta-Lactamase  Cephalosporinase
Bacillus Subtilis	Heroin users at risk -- cutaneous lesions	GRAM(+) ROD  Penicillin-Resistant
Francisella Tularensis	TULAREMIA: Zoonotic, rabbits  Ulceroglandular, oculoglandular, typhoidal, pneumonic  Painful suppuration of lymph nodes	GRAM(-) ROD: Coccobacillus  Facultative Intracellular Parasite	Cystine Agar Required -- notify lab  3 days to culture. Longer than usual  High antibody titer. Cross-rxn with Yersinia	Intracellular parasite of macrophages  Capsule	Vaccine: Live attenuated organism for at risk individuals
Yersinia Pestis	PLAGUE: Sylvatic, Bubonic, Pneumonic, Septicemic	GRAM(-) ROD  Facultative Intracellular Parasite (due to V & W antigens)	Special transport medium to protect handlers.	Fibrinolysin to dissolve the clot.  YOP's  V & W antigens allow replication inside macrophages.
Streptococcus Pyogenes (Group A)	Scarlet Fever  Pyoderma (Impetigo, Erysipela)  Pharyngitis  Bacteremia  Non-Suppurative: Rheumatic Fever, Glomerulonephritis	GRAM(+) COCCI in chains of 8 to 4  BACITRACIN-SENSITIVE  CATALASE (-): Does not bubble H2O2 in water.  beta-HEMOLYSIS: Larger zones.	Todd-Hewitt Broth shows diffuse turbidity down side of tube  Colonies go from Mucoid (capsule) ------> Smooth (capsule breaks down) ------> Rough (protein)  ASO-Test identifies Streptolysin-O	Superantigen Erythrogenic Toxin A (SEA) causes TSS-Like Syndrome  Erythrogenic Toxin causes Scarlet Fever.  Streptolysin O  M-Protein: Immunogenic, protective antibodies. 85 types.  DNAse Type-B: Diagnostic for non-suppurative sequelae	Penicillin-G is treatment of choice.
Streptococcus Agalactiae (Group B)	Leading cause of Neonatal Meningitis (up to 3 months)	GRAM(+) DIPLOCOCCI  BACITRACIN-RESISTANT  beta-HEMOLYSIS: Small zones  CATALASE (-)	CAMP Test: Mix with Staph and it augments the zone of beta-Hemolysis  5 serotypes. Type III associated with meningitis.	Type-III capsular antigen is associated with meningitis.
Streptococcus Equi (Group C)	Major pathogen of horses  Cellulitis from skin breaks	GRAM(+) COCCI  CATALASE (-)	ASO-Test identifies Streptolysin-O  Agglutination with Group-C antigens	Streptolysin O  Streptokinase: Antigenically distinct from Strep A.
Streptococcus Bovis  (Group D)	Respiratory  Peritoneal infections	GRAM(+) COCCI  CATALASE (-)  alpha-HEMOLYTIC: Green, partial hemolysis  Penicillin-Sensitive			Penicillin
Enterococcus Faecalis  (Strep Group D)	Complication of cholecystitis.  Gi obstruction ------> bacteremia, endocarditis.	GRAM-VARIABLE COCCI  CATALASE (-)  Penicillin-Resistant	Grows in the presence of bile.  Blood agar with bile and 6.5% NaCl  Variable hemolysis in culture	Lipoteichoic Acid: Lots of lipid leads to gram-variable appearance.	Penicillin-Binding Proteins: Strong Penicillin-resistance
Streptococci Group G	Cellulitis  Synovitis  Bacteremia, Endocarditis	GRAM(+) COCCI  CATALASE (-)	ASO-Test identifies Streptolysin-O	Streptolysin O  Streptokinase  DNAse
Viridians Streptococci	Periodontal Disease opportunistic pathogen  Bacteremia will lead to endocarditis	GRAM(+) COCCI  CATALASE (-)  alpha-HEMOLYTIC  OPTOCHIN-RESISTANT	Optochin Disk Test: Grows in the presence of optochin.		Penicillin resistant
Streptococcus Pneumoniae (Pneumococcus)	PNEUMONIA  Rusty Sputum  Sudden onset, with resolution by crisis  Pericarditis, Empyema, Pleurisy  Bacteremia  Otitis Media in infants	GRAM(+) DIPLOCOCCI, Lancet-Shaped  OPTOCHIN-SENSITIVE	Very large capsule = colonies with halo.  Autolysis = middle of colony sunken in.  Serology: CIE	Thick Capsule. 85 types; some are bacteremic.  Amidase causes autolysis  Pneumolysin-O released upon autolysis: cytotoxin and anti-PMN  Forssman Antigen: Inhibits amidase and autolysis.	Pneumo-Vac Vaccine: Only the most virulent (bacteremic) blood groups. Given to old, Diabetic, HIV, splenectomy, COPD.  Penicillin is still effective
Haemophilus Influenzae	INFANTILE MENINGITIS -- #1 cause in kids 6-24 months  Epiglottitis  Cellulitis  Bacteremia  Otitis Media and Pneumonia in non-typable strains	GRAM (-) ROD, Short Pleomorphic.  Types a-f: Type-B is most virulent. There are also non-typable strains	Chocolate Agar  Absolute Growth Requirements: Hemin Precursor and NAD  Filde's Agar: enzymatically lysed RBC's.  Satellite Growth around Staph Aureus  Quellung Reaction against type-B	LOS Coat: High molecular weight is more serum-resistant.  Capsule: Polyribitol phosphate. Antibodies are protective; infants susceptible once maternal antibodies are gone.  IgA Protease	beta-Lactamase Penicillin Resistance  DPT Vaccine containing Hib-conjugate -- Diphtheria toxoid plus poly-ribitol phosphate.  Vaccine given at 2, 4, and 6 months.
Bordetella Pertussis	WHOOPING COUGH: Bugs infect cilia of upper airway  Bugs should be collected during Catarrhal Stage of infection  Lymphocytosis found during Paroxysmal Stage	GRAM (-) ROD, Pleomorphic.  OBLIGATE AEROBE	Collect with nasopharyngeal swab that contains no cotton. Specimen inoculated at bed-side  Bordeau-Gangeau Plate required for culture -- must notify lab  Toluidine-blue on gram-stain  Direct-FA can be done on culture only.	Filamentous Hemagglutinin (FHA): Sticks to cilia  Capsule  Pertactin  Pertussis Toxin: Blocks Gi to yield increased cAMP. Causes histamine sensitization, lymphocytosis, and hypoglycemia.	DPT Vaccine at 2, 4, and 6 months.  Initial shots are methiolate-killed whole organisms  Boosters at 15 months and 6 years: Pertussin toxoid + FHA
Corynebacterium Diphtheriae	DIPHTHERIA:  Bull neck  Pseudomembranous Necrosis of throat  Systemic Toxemia: goes to heart, nerves, kidney	GRAM (+) RODS, Slender  Ernst-Babes Bodies found on methylene blue stain	Blood-Tellurite Agar specific for Diphtheria and Staph  Coagulated Serum Agar used to test for presence of toxin, which will show creamy colonies  Precipitin Test: Test for presence of toxin. Compare before and after administration of antitoxin.	Tox-gene is phage-mediated and regulated by genome. Only activated by absence of iron.  Diphtheria Toxin binds to EL-2 to stop protein synthesis. Deadly once inside the cell.  Cornymycolic Acid	DPT Vaccine  Formalin-inactivated toxoid, with alum added  Shick Test used to determine which vaccine to give.  Hypersensitive folks get the ammonium vaccine.
Klebsiella Pneumoniae	Alcoholic, Malnourished PNEUMONIA. Focal lung abscesses  Bacteremia  Wound infections  UTI	GRAM(-) ROD  LACTOSE (+)	Selective Medium	Thick Capsule = extremely mucinous  Enterotoxin  Endotoxin	beta-Lactamase
Legionella Pneumophila	LEGIONNAIRE'S DISEASE  non-communicable  Dry, non-productive cough  Pulmonary fibrinous exudate. Multifocal lesions  Toxemia  Pontiac Fever is milder form	GRAM(-) ROD  Facultative Intracellular Parasite of PMN's  14 Serotypes. Group 1 is most common  Catalase (+)	Dieterle Silver Stain. Does not stain otherwise.  Direct-FA for Group 1  CYSTEINE absolutely required for culture -- notify lab!  Culture takes 3-5 days.	Facultative Intracellular Parasite  Catalase  Metalloprotease	beta-Lactamase
Mycobacterium Tuberculosis	TUBERCULOSIS  Very small number needed to infect  Hilar lymphadenopathy  Granulomas in lung  Miliary Tuberculosis  Reactivation Tuberculosis	ACID-FAST ROD  Obligate Intracellular Parasite  Strict Aerobe  Produces Niacin	N-Acetylcysteine will free bugs from macrophages  Culture takes 3 to 8 weeks!  Lowenstein-Jensen Medium: inhibit normal flora, plus penicillin  Liquid Bactec is faster method  Luciferase Gene used for susceptibility testing	Catalase, Peroxidase  Cord Factor = virulence  Wax-D is an adjuvant  Siderophore: Exochelin + Mycobactin  Tuberculin: antigenic  Arabinogalactan: hypersensitivity	Multi-Drug Resistance (MDR) is a problem  PPD Skin Test: > 10 mm is positive; < 5 is negative.  BCG Vaccine mostly in other countries -- live attenuated bugs.  Isoniazid is popular drug
Mycobacterium Bovis	TUBERCULOSIS	ACID-FAST ROD  Obligate Intracellular Parasite  Strict Aerobe  Does not produce Niacin	Same as M. Tuberculosis	Same as M. TUBERCULOSIS	Same as M. TUBERCULOSIS
Mycobacterium Kansasii	ATYPICAL MAC  Pulmonary Disease with single cavitation.	ACID-FAST ROD  Obligate Intracellular Parasite  Group 1 MAC: Photochromogenic.  Cross-reacting with PPD
Mycobacterium Marinum	ATYPICAL MAC  Infected from water or pools; cutaneous skin lesions	ACID-FAST ROD  Obligate Intracellular Parasite  Group 1 MAC: Photochromogenic  Cross-reacting with PPD
Mycobacterium Scrofulaceum	ATYPICAL MAC	ACID-FAST ROD  Obligate Intracellular Parasite  Group 2 MAC: Scotochromogenic
Mycobacterium Avium-Intracellulare (MAC)	MAI  Oral portal of entry ------> GI-Tract ------> Bacteremia  Prevalent with HIV	ACID-FAST ROD  Obligate Intracellular Parasite  Group 3 MAC: Non-chromogenic	SENSITIN SKIN TEST: Can be used to distinguish with Tuberculosis. It cross reacts, but look for the test that has a bigger diameter.
Mycobacterium Fortuitum	ATYPICAL MAC  Cutaneous abscess	ACID-FAST ROD  Obligate Intracellular Parasite  Group 4 MAC: Rapid Grower
Mycobacterium Ulcerans	ATYPICAL MAC	ACID-FAST ROD  Obligate Intracellular Parasite  MAC: Non-Runyon slow grower
Mycobacterium Leprae	LEPROSY  Tuberculoid Leprosy  Lepromatous Leprosy (Anergic)	ACID-FAST ROD  Obligate Intracellular Parasite	Has never been grown in culture  Can be harvested in armadillos or mouse footpads.  Skin-test available (antigen derived from armadillos) to indicate prognosis	Phenolic glycolipid is key antigen  CD8-Suppressor cells involved in Lepromatous response.
Yersinia Enterocolitica  (Enterobacteriaceae)	Watery Diarrhea  Mesenteric Adenitis (5-15 yrs old)  Terminal Ileitis (15-20 yrs old)  Diarrhea  HLA-B27 arthritis	GRAM(-) ROD	Enrichment broth used before collecting, due to low number of collecting organisms.  Cold Incubation Temperature: 28C	Invasin Gene  YOP-1, including Mannose-resistant hemagglutinin  Yad-A adherence protein  Arithrotigenic Factor: for HLA B27 arthritis  Enterotoxin simulates cGMP
Campylobacter Jejuni  (Enterobacteriaceae)	Invasive Gastroenteritis  Crypt abscesses hemorrhagic necrosis.	GRAM(-) ROD, Wavy  MICROAEROPHILIC  MOTILE  NON-LACTOSE FERMENTING	High Incubation Temperature: 42C -- must notify lab  Campy Agar	Antigenic Diversity  Enterotoxin: Heat-labile, stimulates cAMP.  Cytotoxin
Campylobacter Fetus  (Enterobacteriaceae)	Bacteremia, going to meninges, lungs, and joints  Suppurative (early) and Rheumatoid (late) arthritis  No GI Manifestations	GRAM(-) ROD, Wavy  MICROAEROPHILIC  MOTILE  NON-LACTOSE FERMENTING	Campy Agar  Low Incubation Temperature: 25C -- must notify lab	Facultative Intracellular Parasite of vascular endothelial cells.  Antigenic Diversity  Protein Capsule
Helicobacter Pylori  (Enterobacteriaceae)	PEPTIC ULCER DISEASE -- Type-B (inflammatory) Gastritis	GRAM(-) ROD, Wavy  MICROAEROPHILIC  MOTILE  NON-LACTOSE FERMENTING  CATALASE (+)  UREASE (+)	Normal Incubation Temperature: 28C  Campy Agar  Urea Breath Test: Breathe out radiolabeled C.	Flagellum  Mucinase  Catalase  Oxidase  Urease	Three antibiotics plus Bisthmus as a stomach coating.
Clostridium Difficile	Pseudomembranous Colitis  Endogenous infection: antibiotics  Exogenous infection: nosocomial	GRAM(+) ROD  OBLIGATE ANAEROBE	Toxin Assay done on fecal filtrate. Not all specimens contain toxin.	Exotoxin-A: Damages intestinal mucosa  Exotoxin-B: AB-toxin disrupts cytoskeleton.	High relapse rate to treatment
Escherichia Coli  (Enterobacteriaceae)	EPEC: Traveler's Diarrhea  ETEC: Watery Diarrhea  EIEC: Dysentery  EHEC: Hemolytic Uremic Syndrome (HUS)  Neonatal Meningitis (less than 3 months) -- #2 cause	GRAM(-) ROD  LACTOSE-FERMENTING  MOTILE  MANNOSE-SENSITIVE HEMAGGLUTININ (F1)  F2-F10: Pili antigens are Mannose-Resistant  B Flagellar subtype reported with meningitis	Selective Medium: Inhibits Gram (+) strains and contains lactose	Labile Toxin (LT): Kicks out the water (cAMP). In small intestine.  Stable Toxin (ST): Prevents the water from coming back in (cGMP). In small intestine.  Verotoxin: (EIEC) Shiga-Like toxin is cytotoxic and works in the colon.  Invasin  Hemolysin is an EHEC strand.
Shigella  (Enterobacteriaceae)	DYSENTERY -- ulcerative colitis.  Communicable and very low infective dose.	GRAM(-) ROD  NON-MOTILE  NON-LACTOSE FERMENTING	Special transport medium required. Shigella is killed by the organic acid byproducts of normal flora.	Hemolysin  Actin-polymerization mechanism to get into other cells.  Shiga Toxin (S. Dysenteriae only): Removes adenine from the 28s rRNA and irreversibly inactivates protein synthesis at 60s ribosomal subunit.	Must treat with antibiotics
Salmonella Enterocolitica  (Enterobacteriaceae)	Enterocolitis: Non-bloody diarrhea  Large infective dose  No bacteremia	GRAM(-) ROD  MOTILE  NON-LACTOSE FERMENTING  MANNOSE-SENSITIVE HEMAGGLUTININ  High antigenic diversity.  Biphasic expression of the flagellar antigen.	Selective Medium including bile and lactose.  Bugs like bile.	Flagellum (H antigen)  Polysaccharide (O Antigen)  Capsule (K Antigen)  Pili: Mannose-sensitive hemagglutinins  LPS Endotoxin  Enterotoxin similar to E. Coli  Cytotoxin in colon
Salmonella Typhi  (Enterobacteriaceae)	TYPHOID FEVER  Constipation  Then bacteremia, sustained fever  Rose-spot rashes  Diarrhea  Carrier state for up to a year after resolution  Organisms go from small intestine --> RES --> liver --> bile ducts --> back to small intestine.	GRAM(-) ROD  MOTILE  NON-LACTOSE FERMENTING  Facultative Intracellular Parasite of monocytes	Selective medium containing lactose and bile.	Vi Capsular Antigen: Antiphagocytic, serum-resistant. Enhances survival inside monocytes.  Endotoxin  Flagellar Antigen: Biphasic expression  Outer Membrane Proteins: enhances resistance to chlorinating agents inside monocytes.	May need cholecystectomy.  TAB Vaccine: For travelers, short-term passive protection against Vi antigen.
Vibrio Cholerae  (Enterobacteriaceae)	CHOLERA: Profuse non-invasive rice-water diarrhea  dehydration	GRAM(-) ROD, comma-shaped with long flagellum  MOTILE  NON-LACTOSE FERMENTING  OXIDASE (+)  HALOPHILIC  Does not grow in 8% NaCl	Transport medium contains pH > 8 to supress other flora.  Darkfield stain only.  Serology test for O1 Serotype to test for Tox-gene  Then test for Cholera El Tor by hemolysis. It is a less virulent strain.	Polar flagellum  Mucinase  Cholera Toxin: AB-toxin, binds to Gs-subunit, blocking it on, leading to high cAMP.	Live attenuated vaccine provides short-term protection.  Oral rehydration therapy.
Vibrio Para-haemolyticus  (Enterobacteriaceae)	Raw shellfish  high infective dose  Self-limiting diarrhea  Wound-infections	GRAM(-) ROD  HALOPHILIC  Grows in 8% NaCl	Salty (3% NaCl) selective medium	in-vivo hemolysin	Not usually treated
Escherichia Coli  (Enterobacteriaceae)	UTI's: #1 cause	GRAM(-) ROD  LACTOSE-FERMENTING  MOTILE  MANNOSE-SENSITIVE HEMAGGLUTININ (F1)  MANNOSE-RESISTANT P-ANTIGEN	Mid-stream clean catch	P-Antigen: Correlates with likelihood of Pyelonephritis (Pili antigen 2-10).  K-Antigen (Capsule): Associated with adherence to transitional epithelium.
Proteus Vulgaris  (Proteaceae)	10-15% of Hospital Acquired UTI's  Wound infections	GRAM(-) ROD  UREASE (+)  Metabolizes Tryptophan to Indole	Swarming Growth in culture, forming rings of growth	Urease: alkaline urine can lead to calculi and kidney stones  Lots of peritrichous flagella  Pili: Adhesin in renal pelvis	Ampicillin-Resistant. Await sensitivity test results
Proteus Mirabilis  (Proteaceae)	Same as P. Vulgaris	GRAM(-) ROD  UREASE (+)  Does not Metabolize Tryptophan to Indole	Same as P. Vulgaris	Same as P. Vulgaris	Ampicillin-Sensitive
Pseudomonas Aeruginosa  (Pseudomonaceae)	UTI's -- 3rd most common cause  Burn infection  Opportunistic pneumonia, especially in CF patients. Micro-abscesses seen in lungs.  Otitis Externa  Eye infection	GRAM(-) ROD  STRICT AEROBE  NON-FERMENTING of all sugars  OXIDASE (+)  Juicy-Fruit Smell  Pyocins (against same species) used in hospital for typing strains.	Blood Agar: beta-Hemolytic blue-green colonies.  Direct microscopy not helpful	Pyocyanin: against Staph Aureus  Pyoverdin: Ciliastatic, acquire iron  Flagella: Adhere to urinary tract  Pili: Adhere to respiratory tract  Exotoxin-A: Binds to EL-2, stop protein synthesis.  Exotoxin-S  beta-Hemolysin  Alginate: In CF patients  Elastase  Alkaline Protease	Highly drug resistant -- big problem.
Neisseria Gonorrhea  (Gonococcus)	GONORRHEA  Bacteremia leading to septic arthritis -- #1 cause in young adults  Neonatal conjunctivitis	GRAM (-) DIPLOCOCCI, Kidney-shaped  CATALASE (+)  OXIDASE (+)  GLUCOSE-FERMENTING  NON-MALTOSE FERMENTING  Facultative Intracellular Parasite	Stain is only useful on urethral exudate -- not swab.  Thayer-Martin Medium: Contains Vancomycin, Colistin, Nystatin, iron.	PI: Complexes with PIII to form Porin  PII: Adhesin, autoagglutination  PIII: Complexes with PI to form Porin  LOS  IgA Protease, two types.  Catalase, Superoxide Dismutase, Peroxidase	By law, prophylactic treatment for neonatal conjunctivitis.  Penicillin-Resistant, due to both beta-Lactamase and altered PBP's.
Hemophilus Ducreyi	CHANCROID:  Painful  Purulent Exudate  Non-indurated	GRAM(-) ROD	Chocolate Agar, but difficult to grow.	Pili	beta-Lactamase Penicillin Resistant
Treponema Pallidum	SYPHILIS:  Primary Syphilis:  Painless  Serous Exudate  Indurated  Secondary Syphilis: Rash  Tertiary Syphilis	SPIROCHETE	Cannot be cultured  RPR Test: IgG against cardiolipin, lecithin, and cholesterol  FTA Test: Antibody against the bug itself  FTA-Absorbed: More specific and diagnostic	Hyaluronidase.  Little known because it hasn't been grown in culture.	Jerisch-Herxheimer Reaction: Systemic illness from killing bugs with Penicillin in asymptomatic patients.
Neisseria Meningitidis  (Meningococcus)	MENINGITIS  #2 cause of infantile meningitis (6 months - 24 months)  Bacteremia leads to rash with lots of bugs in it.	GRAM (-) COCCI  CATALASE (+)  OXIDASE (+)  GLUCOSE-FERMENTING  MALTOSE-FERMENTING  Serotypes: Type-B is most virulent -- we don't make antibodies to it.	Quellung Reaction to look for Type-B  CIE, Latex Agglutination  Thayer-Martin Medium	Capsule: Thick and antiphagocytic  LPS: Induces Shwartzman reaction, leading to rash and necrosis.  Pili  IgA Protease  Iron-uptake by energy dependent mechanism.	Vaccine for military recruits, not including Type-B.
Brucella	BRUCELLOSIS, UNDULATING FEVER  Taken up by fixed macrophages in RES/ Occasionally released back into bloodstream	GRAM (-) ROD: Coccobacillus  CATALASE (+)  OXIDASE (+)  Facultative Intracellular Parasite of Macrophages	Brucella Agar is selective and contains Erythritol.	Catalase  LPS  5'-GMP and Adenine: inhibit release of peroxidase in macrophages.
Listeria Monocytogenes	LISTERIOSIS  Neonatal and in-utero disease.  Tropic for CNS  Bacteremia: meningitis and endocarditis  Aseptic meningitis and rash as sequelae	GRAM (+) ROD  Facultative Intracellular Parasite of Macrophages  beta-Hemolytic	Blood Agar: Small colonies, narrow zone of beta-hemolysis.  Can grow in cold	Listeriolysin-O: Cytotoxic, hemolytic  Actin polymerization to infect neighboring cells  Cell Wall Lipid
Leptospira Interrogans	LEPTOSPIROSIS  Liver, kidneys, CNS  Tropic for endothelial cells in the CSF  Carried in animals' urine	SPIROCHETE  beta-Hemolytic	Dark Microscopy: Two axial filaments per pole with hook at end.	Cell Wall Lipids = 25% of dry weight of cell. LPS-like symptoms  Hemolysin  Surface antigens	Dog Vaccine
Borrelia Recurrentis	RELAPSING FEVER  Spread by head lice.	SPIROCHETE  MICROAEROPHILIC	Dark Field Microscopy: 15-20 axial filaments per pole.  Can be visible under light microscope	Antigenic Shift
Borrelia Burgdorferi	LYME DISEASE  Spread by Dear Tick  Erythema Chronicum Migrans  Later: Neurological, cardiac, rheumatoid. Strong immunologic sequelae	SPIROCHETE  MICROAEROPHILIC	Dark Field: 7-11 flagella at each pole, but no axial filaments.  Kelly's Medium: Enriched agar with fatty acids.	Outer Membrane Proteins: Polyclonal activation of B-Cells, responsible for sequelae.	Bugs probably killed by Ab + Complement (few PMN's).  Rx = Penicillin
Bacteroides Fragilis  (Enterobacteriaceae)	PID  Peritonitis  Sustained Bacteremia	STRICT AEROTOLERANT ANAEROBE  CATALASE (+)	Anaerobic Transport Medium required  Direct FA  Gas-liquid chromatography	Capsule  LPS, not as bad as E. COLI	Surgically drain abscesses
Clostridium Perfringens	GAS GANGRENE: Type-A  Necrotizing Enteritis: Type-C  Food-Poisoning: Type-A	GRAM (+) ROD, Spore-Forming  STRICT AEROTOLERANT ANAEROBE	Stain: Rods with square ends and a capsule.  Egg-Yolk Agar: Lecithin is present to test for lecithinase.  Double-Zone of hemolysis.	Very fast replicating  Alpha Toxin: Lecithinase, responsible for zone of incomplete hemolysis  Beta Toxin: Cytotoxin, responsible for necrotizing enteritis.  Theta Toxin: Oxygen labile hemolysin, responsible for smaller zone of hemolysis.  Enterotoxin: Only released upon hemolysis.	Antibiotics.  Hyperbaric oxygen treatment.
Clostridium Tetani	TETANUS: Spastic Paralysis and respiratory failure	GRAM (+) ROD, Spore-forming  STRICT ANAEROBE  Somatic Antigen O has only one serotype, so virus is easy.	Diagnosis is clinical -- not by culture  Swarming Growth in culture.	Tetanospasmin: Blocks release of GABA and Glycine at post-synaptic terminal	Alum-precipitated Toxoid given at 2, 4, 6, 18 months  Boosters every 10 years are ammonium-ppt  Give both vaccine and antitoxin for treatment.
Clostridium Botulinum	BOTULISM: Food, infantile, and wound botulism.	GRAM (+) ROD, Spore-forming  STRICT ANAEROBE	Blood Agar. Heat to boiling to induce sporulation.	Botulin Toxin: Most potent toxin known to man. Acetylcholine blocker. Heat-labile.	Alum-ppt toxoid available for lab workers.  Gastric lavage and antitoxin administered as Rx
Coxiella  (Rickettsiaceae)	Q FEVER: No rash, insect-vector	STRICT INTRACELLULAR PARASITE of endothelial cells.			Tetracycline
Ehrlichia (Rickettsiaceae)	Arthropod-vectored, infects WBC's	STRICT INTRACELLULAR PARASITE of endothelial cells.			Tetracycline
Rickettsia Rickettsiae  (Rickettsiaceae)	ROCKY MOUNTAIN SPOTTED FEVER: Prominent Rash + Endotoxin symptoms.	STRICT INTRACELLULAR PARASITE of endothelial cells.	Egg or Tissue Culture  Direct-FA on endothelial cells	LPS  Phospholipase: Helps bugs get into endothelial cells.  Actin-polymerization for cell-to-cell infection.	Tetracycline.
Chlamydia Trachomatis  (Chlamydiaceae)	CHLAMYDIA  Lymphogranuloma Venereum  Leading cause of preventable blindness in the world.	OBLIGATE INTRACELLULAR PARASITE  Stains brown with Iodine  No Peptidoglycan Layer  A-C: Keratoconjunctivitis  D-K: Chlamydia  L1-L3: Lymphogranuloma Venereum	Iodine test for inclusion bodies containing glycogen -- stains brown  Take scrapings and look for inclusion bodies in epithelia.	ATPase  ATP-ADP Translocase  Cylindrical Projections to get nutrients.  LPS: Just antigenic, not endotoxic.	Tetracycline  By law Prophylaxis for infantile blindness.
Chlamydia Pneumonia  (Chlamydiaceae)	Walking Pneumonia: infects columnar epithelium of upper airway	OBLIGATE INTRACELLULAR PARASITE  No Peptidoglycan Layer			Tetracycline
Chlamydia Psittaci  (Chlamydiaceae)	PSITTACOSIS: Dry hacking cough, severe CNS symptoms (headache).	OBLIGATE INTRACELLULAR PARASITE  No Peptidoglycan Layer  Does not stain brown with Iodine	Iodine Test is negative.  Indirect FA		Tetracycline
Mycoplasma Pneumonia  (Mycoplasmaceae)	WALKING PNEUMONIA: Monocytic response. Ciliastatic in upper airway like Whooping Cough.  Bullous Myringitis in adults	OBLIGATE INTRACELLULAR PARASITE  Needs Cholesterol, nucleotides for growth	Biphasic Enriched Broth/Agar  Cholesterol required for Growth  Cold-Agglutination Antibody Test: Agglutinates with Type-O blood-group antigen in the cold.  Complement Fixation test	P1 Protein: Adhesin for GI, UG, respiratory epithelia. Gliding motility.	Tetracycline
Ureaplasma Urealytica  (Mycoplasmaceae)	Urethritis, maybe asymptomatic.	OBLIGATE INTRACELLULAR PARASITE  UREASE (+)  Needs Cholesterol, nucleotides for growth	Add a pH indicator to medium to test for Urease degradation.	Urease	Tetracycline

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