NEISSERIA

            G (-) diplococci

            Aerobic / CO2

            Normal Flora: MM

            Requires blood media

            Virulence Factors

                        a) Capsule

                        b) Fimbria

                        c) Endotoxin: causes severe tissue destruction

                        d) Beta lactamase resistance

                        e) Iron

                        f) Protease

            DX: Organism in culture fluid

            TX : AB

            Prevention:

            Neisseria gonorrheoeae

                        STD : Pus à scarring

                        5-7 day incubation

                        Bacteremia à arthritis, meningitis, endocarditis

            Neisseria menigitidis

                        Transmission: Respiratory droplet

                        3-5 day incubation

                        Throat à bacteremia à meningitis [50% fatality]


CHLAMYDIA

            “Gram neg” spherical bacteria (cell wall is similar to gram neg bacteria)

            Obligate intracellular parasites of epithelial cells [require ATP]

            Virulence factor: surface peptides resemble heart myosin

            2 main ecological groups

                        Group A: STD> eye and genitourinary

                        Group B: zoonotic

            DX: Isolation, IFA, Ab titer

            TX: AB

                        Chlamydia trachomonas        

                        Chlamydia pneumoniae

                        Chlamydia psittaci


SPIROCHAETACEAE

            G (-) spiral rods

            Low O2 requirements

            Motile with polar flagella

            DX: Lesions, IFA

            TX: AB

                        Treponema pallidum

                                    STD: syphilis

                                    Transmission: Oral > Direct, Indirect; Congentital

                                    Clinical course: 3 stages over a period of months to years

                                                * papulosquamous erosive lesions

                                                * progression to eye, skin, blood, CSF

                                                * Latent à If reoccurs affects bones and Nervous system

                        Treponema pertenue

                                    Yaws

                                    Transmission: poor hygiene

                                    Incubation: several weeks

                                    Clinical: ulcerative granulomatous à bones

                        Borrelia burgdorferi

                                    Lyme disease

                                    Transmission: Arthropod vector [Tick]

                                    Incubation: 6-8 weeks

                                    Clinical course: Bullseye rash à arthritis à Nervous

                        Borrelia recurrentis

                                    Relapsing fever

                                    Transmission: Arthropod vector [Tick, lice]

                                    Incubation: 3-11 days

                                    Clinical course: Rash à fever à organ enlargement

                                                Resolves after fever, reoccurs to create organ damage

                                                Repeats several times, ultimately ends in cardiac failure

                        Leptospirosis

                                    Zoonotic

                                    Transmission: Direct and Indirect urinated contaminated

                                    Incubation: 1-2 weeks

                                    Clinical course: 2 phases   Flu like;  Neuropathy/Renal/Blood

                        Spirillum

                                    Rat bite fever

                                    Incubation 2-3 weeks

                                    Clinical course: fever à lymphadentitisà rash à endocarditis


RICKETSIA

            “Gram negpleomorphic short rods with very permeable cell membrane

            Aerobes, but prefer higher CO2

            Obligate intracellular parasites: need exogenous cofactors

            Infect vascular endothelial cells

            Transmission: Arthropods

            Virulence Factor: Endotoxin

            DX:

            TX: AB

                 Ricketsia ricketsii [Tick vector]

                        Causative agent of RMSF: fever, headache, chills à rash

                 Ricketsia prowazekii [louse vector]

                        Causative agent of louse-borne typhus fever: fever à maculopapular rash

                Ricketsia typhi [Flea vector]

                        Causative agent of endemic typhus: fever, myalgia à macopapular rash

                Ricketsia akari [Mite vector]

                        Causative agent of rickettsial pox: fever à papulovesicular rash

                Ricketsia tsutsugamushi [Mite vector]

                        Causative agent of scrub typhus: fever à rash

                Ehrlichia sp.[Tick vector]

                        Causative agent of Ehrlichiosis: thrombocytopenia

                Coxiella [No arthropod vector, spread by respiratory droplets, inhale tick feces]

                        Causative agent of Q fever: atypical interstitial pneumonia à cardiac

                Bartonella henselae

                        Causative agent of

                                    cat scratch fever : lymphadenopathy

                                    bacillary angiomatosis: angiomas that resemble Kaposi’s sarcoma


MYCOPLASMAS

            Smallest known free living organism; bacteria that lack rigid cell wall = no G stain

            Related to Low G + C Gram Positive Bacteria

            Pleomorphic, filamentous appearance

            DX

            TX: AB

                        Mycoplasma pneumoniae virulence factors à interstitial pneumonia

                        Mycoplasma hominis [STD] > affect placenta à infertility

                        Ureaplasma urealyticaum [STD] > UTI