Glossary of Micro - pneumonias
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- What are 6 agents of community-acquired pneumonia?
- 1.Strep pneumoniae
- How does Pseudomonas stain? Where is it found in the environment?
- *G- rod
*ubiquitous in environment
- What agent is most closely associated with ventilator-associated pneumonia?
- What causes the blue-green color often seen with Pseudomonas?
- Describe the mucoid morphotype of pseudomonas seen in CF patients. Why is it so hard to eradicate? What causes damage to the lung tissue?
- *able to form and grow in a mucoid biofilm which makes it difficult to eradicate
*heavy PMN activity inflicts tissue damage
*cycle of repeated chronic infections
Pseudomonas is generally amenable to treatment with PCN.
- False: Pseudomonas has multiple drug resistance issues.
- How does H. influenzae stain? What are its culture characteristics? Where can it be found normally?
- *G- rod
*will not grow on SBA or MAC due to NAD+ requirements
*normal flora of the URT
- Name 3 forms of invasive disease caused by H. influenzae. What serotype is usually responsible for these conditions?
- The vaccine for H. influenzae is a conjugated protein vaccine. What population is afforded protection as a result of conjugation? Why?
- *children under 2 yrs
*they are otherwise unable to generate a T-dependent response against a polysaccharide immunogen
- What common childhood condition can be caused by nontypable H. influenzae?
- Otitis media
- How does Mycoplasma pneumoniae stain?
- It does not accept a Gram stain because it lacks a cell wall.
- How is M. pneumoniae transmitted? How is the bug able to colonize the epithelia?
- *p-p by aerosol secretions
*use a specialized attachment tip to adhere to respiratory cilia
- Does M. pneumoniae invade host cells? What is a virulence factor it produces?
- *it remains extracellular
*produces cmpds (e.g. H2O2) that inhibit ciliary beating
- M. pneumoniae causes walking pneumonia - what are the symptoms of this? In what part of the lungs does it occur?
- *cough, fever, low sputum production
*ltd to bronchial mucosa - no lobar or alveolar involvement
- Because of its ubiquitous nature, M. pneumoniae can be hard to identify as a pathogen. What is one test that can be used to ID it?
- *cold agglutins
- Which would be the better treatment for M. pneumoniae - PCN-G or erythromycin? Why?
- Erythromycin - the bug lacks a bacterial cell wall, thus B-lactams would be highly ineffective.
- How does Bordetella stain? What are its growth characteristics in culture?
- *G- rod
*grows only on specialty agar
*yields "mercury colonies"
- Which is more contagious - bordatella or legionella?
- Bordatella is highly contagious whereas there is no p-p spread for legionella.
- What are of the body does bordatella colonize?
- Ciliated epithelium of nasopharynx.
- What are the 3 stages of infection with bordatella? What are the symptoms of each? How long does each last?
- 1.Catarrhal: URI symptoms; 1-2 wks
2.Paroxysmal: mucus accumulation, coughing fits; 2 wks
3.Convalescent: decreased coughing; <8 wks
- Does bordatella penetrate the host cells? What are some virulence factors it produces?
- *colonize mucosal surface and do not penetrate
*pertussis toxin: ADP-ribosylates G-protein to activate adenylate cyclase
*tracheal cytotoxin: destroys cilia and ciliated cells
- What causes the "whoop" seen in whooping cough?
- Bordatella colonizes the mucosal surface and destroys cilia. Pts are unable to clear respiratory secretions and mucus and this leads to violent paroxysms of coughing followed by a sharp inspiration.
- What might be abnormal about the CBC of a pt infected with bordatella?
- This infection causes lymphcytosis so a large number of WBC would be expected.
- Is Bordatella typically fatal?
- No; but it can be for patients with underlying heart or pulmonary conditions.
- What type of vaccine is in use for bordatella? Has this always been the case?
- *an acellular vaccine of purified protein filtrates is currently in use
*this replaced a whole cell attenuated vaccine removed for publlicity purposes
- Where might legionella be found in the environment? How is it acquired?
- *aqueous environments
*inhalation of droplets
- How is Legionella able to survive in macrophages? Whta kind of immune response is required to clear the infection?
- *prevents fusion of phagosome with lysosome and acidification
*T-cell mediated; also TNF-a which inhibits intracellular growth
- What are the symptoms of Legionnaire's disease?
- *flu-like symptoms develop into pneumonia
*NO cough or sputum
*N/V/D fairly common
- What are the symptoms of Pontiac Fever? What treatment is recommended?
- A mild flu that is self-ltd. No treatment recommended.
- How is infection with Legionella usually diagnosed?
- *Culture is difficult
*urine Ag test
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