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staph aureus: Food 1. Asymptomatic carriage especially on skin and anterior nares
2. Superficial skin infections: folliculitis, abscesses, furuncles, carbuncles
3. Foreign body infections (stitch abscesses, etc.)
4. Soft tissue infections: cellulitis, fasciitis
5. Osteomyelitis
6. Bacteremia
7. Endocarditis

suppurative,

8. Food poisoning
9. Toxic Shock Syndrome

toxin mediated

gram poisitve cocci in clusters
-catalase positive
CNS staph epidermis: 10. Device associated infections (iv and other catheters, prostheses)

-catalase negative
strep A: . Pharyngitis and tonsillitis: diagnose with strep screens and throat culture; complications include otitis, abscesses, rheumatic fever (RF), glomerulonephritis (GN)
2. Skin infections: impetigo (crusty mouth thing around mouth), erysipelas, cellulitis, fasciitis, post-op wound infections, GN (NOT RF)
3. Scarlet fever: Pharyngitis + strawberry tongue, rash
4. Toxic shock-like syndrome: shock, renal failure, rash, respiratory failure

5. RF: carditis, polyarthritis, chorea, erythema marginatum (rash with red margin spreading from center),
subcutaneous nodules + arthralgia, fever, high ESR, EKG changes, evidence of Group A strep
6. GN: presents one week after infection edema, hypertension, hematuria, proteinur
strep b: Frequently colonizes female genital tract and gi tract
B. Important cause of neonatal sepsis and meningitis (1-3/1000 live
births, mortality 30-60%)
C. Post-surgical gyn infections
D. Infections in the elderly: uti, bacteremia, pneumonia, skin, wound
infections
E. Automatic screening of all women at 35-37 weeks gestation is recommended
IV. Group C,D,F,G Streptococci
strep c and g: Can cause purulent infections like Group A
B. No clear association with RF or GN
C. Food-borne outbreaks of pharyngitis
strep d: associated with colon
cancer
Group F includes Streptococcus milleri, usually part of the viridans group: aggressive tissue abscesses
Streptococcus pneumoniae: Colonization/infection associated with recent viral uri, airway obstruction,
immunosuppression, splenectomy, alcoholism F.
Diseases: pneumonia, otitis (in kids), sinusitis, meningitis (in adults), bacteremia
Viridans group Streptococci: endocarditis, dental infections, abcesses
Enterococcus: Diseases: bacteremia, uti, wound and soft tissue infections, endocarditis
E. Important as nosocomial pathogens
F. VRE: vancomycin resistant , also resistant to all other available antibiotics, associated with nosocomial outbreaks
Listeria monocytogenes: A major cause of bacteremia and meningitis in newborns, occasional cause of the same in imrnunocompromised adults. In both of these groups this organism may not be correctly identified: patients may have normal appearing spinal fluid and physicians may think they just have a viral syndrome.
4. The laboratory may misidentify the organism as a Corynebacterium (usually nonpathogenic) or as Group B Streptococcus (another cause of meningitis in newborn) by gram stain and colony morphology
corynebacterium species: Most often contaminants when present in cultures
(b) Can cause endocarditis on prosthetic heart valves
C. jeikeium: lymphadenitis, abscesses, meningitis, skin infections and bacteremia in immunosuppressed patients, especially neutropenic cancer patients.
c. diptheria: Pharyngitis with thick, leathery, gray membrane with surrounding edema. May extend down to larynx, trachea, bronchi. May have cutaneous ulcers instead of pharyngitis. Organism produces a protein exotoxin that affects predominantly myocardium and peripheral nervous system. Exotoxin produced only when organism contains a bacteriophage. Death caused by either asphyxiation or myocarditis.
Erysipelothrix rhusiopathiae: Causes ulcerating, erythematous skin infections called erysipeloid on exposed, abraided skin in fisherman, butchers, veterinarians
Bacillus species: . Found everywhere in the environment and often contaminate cultures
2. Large, gram-positive rods that form spores (unique among aerobic gram-positive rods)
3. Significance
Can cause bacteremia and endocarditis in drug abusers and immunocompromised
patients.
cereus: very commonly causes food poisoning, usually related to ingestion of Trndefcooked?rtc^)
anthrax: Cutaneous form is a nonpainful ulcer at a site of inoculation characterized by the formation of a black eschar in the ulcer. Inhalation disease would present with severe shortness of breath and an overall appearance of extreme toxicity with a widenedjnediastinum. GI is extremely rare, would present with abdominal pain arid bloody diarrhea
lactobacillus species: Virtually always protectiveâ€”infections are associated with failure to see or grow lactobacilli. Rare case reports of endocarditis with lactobacilli exist
Clostridium perfringens: Sudden onset of nausea, vomiting, abdominal pain within a few hours of ingestion of toxin
Clostridium tetani: involvement, the cranial nerves if inoculation occurs on the head, or generalized. Generalized disease characterized by trismus, stiff neck, difficulty swallowing, rigidity of abdominal muscles, and fever. Severe cases
accompanied by risus sardonicus, and opisthotonis. Some cases associated with autonomic disturbances with fluctuating blood pressure, tachycardia, sweating, hyperthermia and cardiac arrhythmiaâ€™s
Clostridium botulinum: weakness, malaise, and dizziness, dry mouth.^.'A constipation, and urinary retention. Descending paralysis follows in one to three days with diplopia, blurred vision, photophobia, dysphonia, dysarthria, and dysphagia first, then weakness of extremities in descending order. Disease should be suggested by a combination of postural hypotension, dilated, unreactive pupils, dry mucous membranes, descending paralysis with progressive respiratory weakness, and the absence of fever
Wound botulism: occur in innocuous appearing lesions from 4 to 14 days after injury and appears similar clinically to food-bourn disease
Infant botulism: 20 week old infant with constipation, weak suck, feeble cry, pooling of secretions in the mouth, absent gag reflex, descending flaccidity, ptosis, and ophthalmoplegia. This syndrome has now also been described in adults.
Clostridium difficile: Well recognized association with antibiotic associated pseudomemranous colitis
(ii) Patients receiving antibiotics develop fever, diarrhea, abdominal pain with exudate and ulcer formation in large intestine. Failure to recognize and treat may lead to bowel perforation and peritonitis
Propionibacterium acnes: Significance
Common contaminant
Causes infections in prosthetic devices, especially central nervous system shunts
Associated with acne
Nocardia (ACTINOMYCETES ): pneumonia that produces cavities and extends to the chest wall if untreated 50% of patients with infection are immunocompromised, and infection often disseminates to multiple organs, especially brain May also be inoculated directly into skin and cause chronic draining lesions with sinus tracts
Actinomyces ACTINOMYCETES: Cause infections of mucosal surface areas with some local damage.
Once initiated will continue to borough through tissue planes without treatment.
Drainage that occurs often contains small, yellow-orange, hard colonies of
organisms called sulfur granules.
Sites of infection include mouth and jaw, especially following dental work, lung
with abscess formation and spread to the pleura, abdomen following GI tract
problems, and pelvis, especially of the endometrium in 1UD users
Enterobacteriaceae: 1.Urinary tract infections most common
2. Diarrhea (gastrointestinal)
3. Meningitis (elderly, neonates, neurosurgical patients)
4. Bacteremia (sepsis)
5. Pneumonia (especially hospital acquired)
6. Wounds and abscesses
e. coli: diarrheal followed by rising serum creatinine after 15 days
Klebsiella: Second most common urinary pathogen
b. Pneumonia (Friedlander's pneumonia (red jelly phlem))
c. Nosocomial (hospital) infections - multiple drug resistance a problem in this setting
Enterobacter: b.contaminated intravenous solutions
c.Multiple drug resistance is a problem
Serratia: Some strains may have red pigment
2. Truly an opportunistic pathogen (S. marcescens)
4. Multiresistant
E. Citrobacter: biochemically similar to Salmonella

-neonatal meningitis and bacteremia
P. mirabilis, P. vulgaris: causes urinary, wound and bloodstream infections
-swarm" over agar surface
G. Providencia, Morganella: nosocomial spread, especially among patients with indwelling urinary catheters
enterotoxigenic i. coli: contaminated food and water

-no fever
Traveler's
diarrhea,
Childhood
diarrhea
interoinvasive e. coli: Large
intestine
Necrosis,
ulceration
inflammation
Sporadic,

Common fever

diarrhea, bloody, Scanty,
purulent
etnterohemorrhagic e. coli: Copius,
bloody diarrhea, no fever
enteropathogenic e. coli: Infantile,
Childhood
-Copius,
watery diarrhea
Absent blood
-fever
enteroaggregative e. coli: Occasional fever
Watery diarrhea

Absent blood
s. Dysentery: Abdominal cramps

b. Tenesmus - painful straining to pass stools

c. Fever

d. Bloody, mucoid stools
S.sonnei: Fever

b. Systemic symptoms

c. Watery diarrhea

3. -large numbers of fecal leukocytes
-Associated with daycare centers
Salmonella: nursing homes, hospitals, mental institutions

a) Exotic pet turtles, reptiles
S. typhimurium, Typhoid Fever (enteric fever): multiorgan-system. infection
2) - 14 days
3) fever, relative bradycardia, headache

Faint rash occurs with early fever (rose spots)

b) Fever persists for weeks

4) Constipation is more common than diarrhea
5) Bacteremia may lead to infection at other sites
6) Intestinal perforation may occur
7) Infection in biliary tree leads to chronic cami er state
Y enterocolitica: Enterocolitis

1) Fever

2) Diarrhea

3) Abdominal pain

b. Acute mesenteric lymphadenitis
c. Terminal ileitis
d. Septicemia
Yersiniapseudotuberculosis: Acute mesenteric lymphadenitis

1) Fever
2) Pain
3) Nfimics acute appendicitis
4) Diagnosis is made by isolation of organisms from lymph nodes, less commonly from blood
E. coli 0157:H7: contaminated beef, milk, cider, water, cause HUS (blood in kidneys
Vibrio cholerae: e) mucus in stool imparts "RICE WATER" appearance
(f) tenesmus is absent--often a decrease in irritability, as enormous amounts of fluid passed effortlessly
(g) vomiting a common occurrence
(h) rapid, faint heart beat
(i) skin is cold, clammy, wrinkled
j)oliguria eventually occurs
(k) may have painful muscle cramps and CNS abnormalities
(1) loss of fluid continues 1-7 days and dehydration may be profound
(m) may have profound complications depending on fluid therapy
HALOPHILIC (SEA WATER) VIBRIOS -Vibrio parahemolyticus: causes acute gastroenteritis after ingestion of contaminated sea food such as raw fish or shell fish
2. coastal areas (or air transport of fresh fish)
3. self limited disease, may require rehydration
vibrio vulnificus HALOPHILIC (SEA WATER) VIBRIOS: skin lesions from abraded skin and sea water contact
2. systemic disease, septicemia and death. Major illness occurs in individuals with chronic liver disease who have excess iron storage
3. coastal areas of Gulf of Mexico
Campylobacter jejuni (enteric disease: Rapid onset of fever, other constitutional symptoms, B. Abdominal pain in 90% of patients, especially in those with fever and anorexia, C. Some, < 50% have emesis, nausea, malaise, headache, myalgia
-diarrhea usually develops within 1 day of abdominal pain and fever (1-7 day incubation
2.Usually foul smelling, may be frankly bloody
1. Usually profuse, watery, may be mucoid, bile-stained

-May last 2-9 days, but usually 3-5 days
helicobacter: urease activity, gastritis, peptic ulcer
campylobacter jejuni: most common cause of diarrhea in us, oral fecal
anaerobic (Bacteroides Fusobacterium ): Needle and syringe aspirate of abscesses and normally sterile body fluids
(b) Transtracheal aspirate or direct lung aspirate of pulmonary sources
(c) Culdocentesis and possibly double-lumen-protected swabs of endometrial contents.
(d) Suprapubic aspiration of urine
(e) Biopsies of normally sterile tissue
anaerobic cocci ; Peptococcus / Peptostreptococcus.: Common infections include postoperative wounds, orofacial, skin, pleuropulmonary, intraabdominal, and pelvic infections, brain abscess, and diabetic foot ulcers.
NON-FERMENTERS; pseudomonas aeruginosa: Cystic fibrosis: colonizes respiratory tract, doesn't invade, but strains develop alginate, a thick, mucopolysaccharide that makes secretions tenacious and adherent
g. Skin infections: folliculitis from hot tubs, swimming pools
h. Osteomyelitis: nail puncture wounds
i. Urinary tract infections in hospitalized patients
BURKHOLDERIA: Common species seen in US is cepacia

B. Similar to P. aeruginosa in colonizing solutions, commercial products, and hospital supplies
C. More resistant to antibiotics that P. aeruginosa
D. Drug of choice sulfa-trimethoprim
E. Infections in lung, bloodstream
F. Common infection in cystic fibrosis assoc with decreased survival
ACINETOBACTER: Gram-negative coccobacilli
B. Oxidase negative
C. Non-motile
D. Faint blue-tinted colonies on MacConkey agar
E. Infections: pneumonia, urinary tract infections, soft tissue infections
STENOTROPHOMONAS MALTOPHILIA: Second most frequently isolated nonfermenter
B. Oxidase negative
C. Lavender green colonies
D. Utilizes maltose and glucose
E. Opportunistic infections, very resistant to antibiotics in hospitals that use meropenems
FLAVOBACTERIUM MENINGOSEPTICUM: Yellow pigmented colonies
B. Long, filamentous gram-negative rods
C. Non-motile
D. Associated with neonatal meningitis/bacteremia
Brucella abortus Acute Disease: undulant fever most prevalent

Not a serious disease, case fatality is low. Recovery spontaneous after 1-3 months. Morbidity is quite high. Blood cultures are positive in the first 2-3 weeks, negative after building up of antibodies. Relapse frequent-blood cultures become again positive.
Subacute or Latent Disease brucells: May be weakly symptomatic. Blood cultures rarely positive. Agglutinins usually positive. Transient-usually clears up after a while with no further symptoms
Chronic Disease brucella: Persistent form of disease- 1-20 years. Nocturnal sweats with intermittent fever, anorexia. Undulating attacks. Probably an allergic response to the microorganism and its products.
complications of brucella: Osteomyelitis; acute inflammation of any of the viscera; focal lesions of the lungs; lymph nodes; spleen; kidneys; biliary tract; urinary tract; genital organs.
brucella: Goats-melitensis
b. Cattle-abortus

ingestion (raw milk)
b: direct contact
c. Inhalation
d. Inoculation (Laboratory
-ELISA test

c. Swine-suis
d. Dogs-canis
francisella tularensis: An intracellular parasite
2. Phagocytized but not destroyed by the phagocytic mechanisms
3. Mortality rate low. Untreated 5-7%
4. Morbidity rate very high. Highly infectious Edit
3 modes of Transmission 1. Direct contact
2. Insect vector transmission
a. Deer flies
b. Ticks
Reservoir of infection for rodent populations
3. Human to human transmission highly improbable, but increasing
reports of cat to human spread'
Yersinia pestis; bubonic plague: Disease of the .. lymphatics

1)Infection at ..
-the point of bite of flea.
Yersinia pestis; pneumonic plague: Secondary to the lymphatic plague
-humans to humans has not been seen since 1900, in US)
-mortality rate 100%
Yersinia pestis; terminal stage: fulminating septicemia.
-Subcutaneous hemorrhage results in petechial spots, necrosis
Yersinia pestis: Primarily a disease of rodents
-intermediate host is indian fat flea
RICKETTSIAL DISEASES: fastidious obligate intracellular parasites
Properties of Rickettsiae: Pleomorphic, small, coccobacilli
2. Stain blue with Giemsa stain
3. Cell walls are similar to gram-negative bacteria
thypus group spotted fever group: found in the cytoplasm; in the nucleus
rickettsia pathogenic: maintained in nature in an arthropod-animal reservoir-arthropod cycle.
-accidental host in this cycle.
epidemic typhus: human- body louse cycle
Rocky Mountain Spotted Fever-Rickettsia rickettsii * e. Rickettsialpox- Rickettsia akari': Spotted Fever Group
. Epidemic Typhus-Rickettsia prowazekii * b. Murine Typhus - Rickettsia typhi: 2. Typhus Group
Pathogenesis of Rickettsial Infection: - enter the body through skin via the
bite of an infected arthropod vector. Once in the bloodstream multiply in the endothelial cells of small blood vessels and produce vasculitis.
Rocky Mountain Spotted Fever 1 a. parasite of ticks 1) . the wood tick (Dermacentor andersoni) is the vector 2) the dog tick (Dermacentor variabilis) is the vector 3) the Lone Star tick (Amblyomma americanum) is the vector: Most important rickettsial disease in North America
-Rickettsia rickettsii is a
-In the western U.S
-In the eastern U.S.
-In the southwest
RMSF: Sulfonamides are contraindicated
Louse-borne typhus: prototype of the typhus group caused by R. prowazekii: begins on the trunk in the axillary folds and moves distally until the
entire body is covered
R. prowazekii: disease spread by the body louse.
The southern flying squirrel
Brill-Zinsser: recrudescent form of the disease called R. prowazekii
Rickettsialpox: Compared to RMSF, disease is mild.
- same as above.
Murine typhus flea bites.: Caused by R. typhi and found worldwide; most cases in the U.S. are found in southern
Texas and California.
2. Transmitted to humans by
EHRLlCHIA chaffeensis- (Human Monocytic Ehrlichiosis: transmitted by tick vector
-fever, headache, nausea, vomitin, chills
-8X more frequen than rmsf
2. Rash is infrequent
-doxycyclin, chloramphenicol is not effective
ANAPLASMA Phaqocytophilum (Formerly Human Granulocytic Ehrlichiosis: deer tick Ixodes scapularis and the dog tick
-
doxycycline
A. Coxiella burnetii, Q FEVER: is not an obligate intracellular parasite
Coxiella burnetii, Q FEVER: transmitted to humans by inhalation of contaminated particles, usually in association with cattle, sheep, goats or through ingestion of raw or contaminated milk.
Coxiella burnetii, Q FEVER (acute disease): Incubation period 2 to 6 weeks, followed by abrupt onset of fever (>38.5°C), severe headache, malaise, myalgias. , rash is absent. include atypical pneumonia and hepatitis.
Coxiella burnetii, Q FEVER (chronic): Endocarditis is the most frequently described entity.
b. Most patients have predisposing valvular heart disease
tetracycline: tx for most zoonoges
BARTONELLA bacilliformis: )Oroya fever: Severe anemia
2)Verruga Peruana: Hemangiomatous nodules
BARTONELLA 1. Bartonellosis: bacteria adhere to red blood cells and deform them, producing anemia
f.1) chloramphenicol
2) blood transfusions for severe anemia
B. quintana: ) relapsing high fever
2) generalized myalgias with focal shin pain
3) headache
Bartonella hense/ae and Bartonella c/arridgeiae: contact with cat
-+ blood test
-neg for other causes of lymphadenopathy
-histopahtology of skin node
Bartonella. quintana: endocarditis in homeless man ; immunocompetent pt no history of valvular hisease (maybe scabies or fleas)
B. henselae: endocarditis w/ history of valvular disease and contact w/ cants
-bartonella quintana -bartonella henselae: imunocompromised AIDS
-angiomatosis;a proliferative disease of small blood vessels of the skin and
viscera
-quintana -henselae: peliosis;characterized by numerous blood-filled cystic structures of the
viscera especially the liver and spleen
bartonella: CSDâ€”usually self-limiting illness and antibiotics are given only in severely ill or
complicated cases; choice of antimicrobial therapy is unclear (pen doesnt work)
Treponema pallidllm and syphilis: One of the major sexually transmitted diseases worldwide
B Associated with lower socioeconomic status
Primary syphilis: Occurs 3-4 weeks after exposure
-Consists of a skin lesion called a chancre. Shallow ulcer with raised edges that is soft and painless. Usually occurs in the genital area, but can be in other locations including the lip, oral mucosa, and rectum. Ulcer lasts 1- 5 weeks and heals
Secondary syphilis: 6-8 weeks after exposure (up to 6 months)
-Consists of generalized rash and systemic flu-like illness. The rash is called a papulosquamous rash with discrete lesions a few millimeters up to 1 cm in diameter that have a scaly surface. This rash includes the palms and soles. Patients may also experience fever, myalgias, arthralgias, headache, hair loss, and mucous patches in the mouth and on genitalia during this stage. This stage also spontaneously resolves after 1-2 weeks.
Early latent syphilis: after secondary syphilis and lasts up to 4 years. There are no symptoms, but tests for syphilis will be positive
Late (tertiary) syphilis: 4-20 years after exposure . Only 1/3 of untreated patients will have active disease.
- infiltrative process with proteinaceous material in various body locations, usually superficial.
Can be disfiguring, but usually doesn't cause major illness.
test for syphilis: Direct examination: a wet prep from a chancre viewed with a darkfield
Nontreponemal serologic tests (VDRL, RPR: There are biologic false positive results with this test, hence a positive must be confirmed with additional testing.
Tests begin to turn positive 4-6 weeks after infection, hence some with primary disease will still have negative results. By secondary disease, all tests are positive. Nonspecific tests may revert to negative over time in untreated disease whether it rem: Interpretation of syphylis tests
-when turn positive?
-secondary?
-what happens to non-specific tests?
-specific tests
Borrelia burgdorferi -Lyme disease): -Diagnosis is -by clinical history that includes appropriate rash, tick exposure, and serology
-New England, upper Atlantic coast, and upper Midwest. Rare to nonexistent in Utah
Borrelia burgdorferi primary,: rash called Erythema Chronicum Migrans (unique, has circles), a discrete red rash that increases in size over a 1-2 week period to be several centimeters in size
Borrelia burgdorferi secondary,: cardiac manifestations mostly heart block or neurological manifestations most often individual peripheral nerve palsies
Borrelia burgdorferi tertiary: arthritis
Of patients with primary disease: 10-20% will have secondary disease; of those with secondary disease 10- 20% will have tertiary disease. The entire clinical illness rarely lasts longer than I year: Borrelia burgdorferi ;relationship bw primary/secondary
-duration of entire illness
B. Borrelia recurrentis: 1 Endemic in other parts of the world, not U.S.
2 Transmitted to humans by ticks or lice
3 Clinical illness is characterized by relapsing fever: patient has shaking chills and high fever for 3-5 days, feels well for 4-10 days, then experiences the fever again. Relapses correlate with changes in the surface protein of the organism to the extent that the body believes it is a new infection.
-diagnosed by seeing spirochete on blood smear
Neisseria gonorrhoeae: transmission;

-Women may have initial asymptomatic infection, then have it flair and disseminate
-Except in newborns this is a sexually transmitted disease
2. Humans are the only host (need contact)
3. -Women and men may be asymptomatic and can transmit the infection
4. -Women may have initial asymptomatic infection, then have it flair and disseminate during menses
Tl and T2 subtypes have the pili that increase their ability to attach to cells and cause infection: Neisseria gonorrhoeae with pilli
joint pain: differentiates gonnhereia from staph
neisseria -capsule meningococci only:: Gram negative diplococci
2. Pathogenic species are often/always intracellular
3.Oxidase positive
4. Pathogenic species more fastidious:

-Capsule: prevents phagocytosis
-saliva
Neisseria meningitidis -Meningococcemia:: organism in upper respiratory tract, spreads to blood stream, may cause only mild symptoms or fever, may also be associated with meningitis, petechial rash, overwhelming infection including peripheral vasospasm and loss of digits
Neisseria meningitidis: -Colonization rates increase in closed populations
Waterhouse-Frederichsen Syndrome: overwhelming, rapidly progressive meningococcemia with shock, purpura fulminans, multiple organ failure, adrenal necrosis, and death
-after colonization if it happens at all sporadically and in epidemics 6. Groups B, C, and Y 5. . complement deficiencies, especially of C6, C7, or C8: neiserria miningitidis

infection usually occurs
-Infections occur both
-groups _____ cause the most and most severe disease
-Recurrent or severe disease in an individual is often associated with ....
A polysaccharide vaccine against types A, C, Y, and W135 exists; there is no B vaccine 2. Prophylaxis for CLOSE contacts of cases is usually given: rifampin is the most common agent used.: tx of niesseria
Chlamydia trachomatis; associated with types A, B, C, not seen in US: Trachoma: conjunctivitis that can lead to blindness

what types
Chlamydia trachomatis; -by types D-K,: Inclusion Conjunctivitis: Most common cause of neonatal conjunctivitis in US (2-6% ofnewboms), caused by
-acute copious purulent discharge
Chlamydia trachomatis; d-k: STD: urethritis, epididymitis, cervicitis, salpingitis just like gc
-can be transmitted to infants during delivery causing conjunctitis above or pneumonitis
Amplification now the most sensitive for most common syndromes.: Diagnosis of Ct infections
Chlamydia psittaci: , high fever, severe diffuse headache, malaise, muscle aches, dry hacking cough, interstitial lung infiltrates with hilar adenopathy, hepatosplenomegaly. May be complicated by myocarditis, hepatitis, and encephalitis
-has parrots
C. Chlamydia pneumoniae (TW AR: Outbreaks occur in closed populations
2 Clinical manifestations
Pharyngitis, laryngitis, bronchitis, sinusitis, pneumonia, ± association with coronary artery disease
Mycoplasma and Ureaplasma: B. Different from other bacteria by lack of a cell wall

-insensitive to cell wall active antibiotics such as 13-lactams
Mycoplasma: C. Smallest free-living microorganisms
Mycoplasma pneumoniae: . cold agglutinins-nonspecific
-mononuclear cells but no organisms
Mycoplasma hominis: post¬partum or post-abortal fever
B Clinical Manifestations
ureaplasma urealyticum: nongonococcal, nonchlamydial urethritis in men

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Number of cards 136