Gram Positive Bacillus

Erysipelothrix

          E. rhusiopathiae

                   Saprophyte

                   Nonmotile, nonsporeformer

                   Microaerophilic

                   Capsule

                             Transmission

                                      Fecal contamination

                             Disease

                                      Maculopapular rash

                             TX : AB


Listeria

          L. monocytogenes

                   Soil, mammal gut

                   Noncaspule, nonspore

                   Motile

                   F.A.

                             Transmission

                                      Direct

                                      Vertical

                             Disease

                                      Skin à bacteremiaàendocarditisànervous

                             TX: AB


Nocardia

          N. asteroids

                   Saprophyte: soil

                   Filamentous, branching

                   Weakly acid fast

                             Transmission

                                      Susceptible individuals: immunosuppressed

                             Diseases

                                      Respiratory: resemble TB

                                      Skin: abscesses

                             TX: AB


Baccillus

          B. anthracis

          B. cereus

          B. anthracis

                   F.A.

                   Capsule

                   Sporeformer

                   Nonmotile

                   Reservoir: hoof stock

                   Diseases:

                             Cutaneous

                             Inhalation

                             Gastrointestinal

                   Virulence

                             * capsule

                             * spore

                             * exotoxin

                             * protective antigen

          B. cereus

                   Aerobe

                   nonencapsulated

                   Motile

                   Sporeformer

                   Diseases

                             Food poisoning

                             Catheter sepsis

                             Ocular

                   Virulence

                             *spores

                             *enterotoxins

                             *hemolysins

                             * lecithinase [phospholipase C]


Clostridia

          Obligate anaerobes

          Motile

          Spore former

          Various extotoxins

          C. tetani

                   A-B neurotoxin [tetanospasm]: blocks release of inhibitory

                   Tonic spasms

                             * Localized

                             * Cephalic

                             * Generalized

          C. perfringens

                   Membrane disrupting toxin (phospholipids)

                             * Gas gangrene

                             * Food poisoning

          C. botulinum

                   A-B neurotoxin [botulinum toxin]: blocks ACH @ NMJ

                   Jaw à Limbs à Respiratory m.

                             * Type A: proteolytic, heat resistant

                             * Type B: both

                             * Type E: nonproteolytic, heat labile

          C. difficile

                    Nosocomial Antibiotic induced colitisà diarrhea

                             Enterotoxin

                             Cytotoxin


Actinomycosis

          Anaerobic

          Oral cavity

                   Location: Jaw, Thoracic, Abd, Pelvic, Generalized

                   Disease: abscesses, purulent discharge with sulfur granules


Mycobacteriaceae Family

          Acid Fast [“G (+) rod”]à mycolic acid in cell wall

          Aerobic

          Non-spore former

          Non-motile

          Reservoir: Humans

          Transmission: Respiratory Droplet

                   M. tuberculosis

                             Slow growing = more virulent

                             Pulmonary TB: nodular scars, caseous necrosis

                             Disseminated TB / Extrapulmonary TB:

                                                Brain, kidney, LN, bones, skin, GI

                             Disease Stages

                                      a) primary

                                      b) latent

                                      c) recrudescent

                             Virulence Factors

                                      * waxy cell wall: decreased phagocytosis

                                      * catalase

                                      * mycobactin: Iron chelator

                             DX: organism in fluids, chest X-rays, culture

                                      Tuberculin skin test as a screen

                             Tx: multidrug therapy

                   M. leprae

                             Tuberculoid leprosy

                                      Rash with plaques, possible nerve damage

                             Lepromatous Leprosy

                                      Erythema nodosum

                                      Neuritis of somatic sensory

                                      Skin appendage loss

                                      Ulceration with secondary infection à bacteremia

                                      Other:  nasal, testes, renal

Corynebacterium diptheriae

          Weakly Acid Fast [G (+) bacillus]

          Coryne = club ; diptheriae = leather hide

          (see family characteristics)

                   Disease : Diptheriaà Pseudomembrane

                             ^ primarily pharynx and tonsils

                             ^ other mm

                                      nasal à discharge

                                      laryngealà extension or primary

                                      external auditory canalà OM

                                      conjunctival

                                      vulvo-vaginal

                   Complications due to toxin production:

                             * edema

                             * myocarditis

                             * neuritis (motor nerves)

                             * Cutaneous (rash)

              Virulence Factors

                   1) Diptheria toxin: A-B exotoxin

                                                inactivates translation of proteins

                   2) Neuraminidase

                   3) Protease (Dipthin) : inactivates IgA

              DX: Culture on Tellurite media

                     Schick test

                     ID toxin

              TX: AB

                     Antitoxins

             Prevention: DTP vaccine