Horizontal Gene Transfer

11.19.17

2 more days until break

Music mood: Mili - Miracle Milk

Virus Classification

Killed, inactivated Vaccines Available in the US

Killed vaccines induce only HUMORAL immunity

RIP   ACE 

R abies

I nfluenza (injected)

P olio (salk)

.

A Hepatitis

C holera 

E ncephalitis viruses (eg Japanese encephalitis)

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Actinomyces israelii

Gram+, anaerobic, non-spore forming, branching rod

Endogenous transmission (dental crevices -bad higiene, dental trauma- ; female genital tract -IUD-)

Dx: branching rods in “sulfur granules”; colonies resemble a molar tooth.

Not painful but very invasive penetrating tissues, including bone.

Draining abscess (sinus tracts) CULTURE THAT PUS

Disease: ACTINOMYCOSIS in low O2 tissues

Cervicofacil: “Lumpy jaw”, mycetoma on jaw line

Pelvic: from IUD

CNS: solitary abscess

Abdominal: qx, trauma

Thoracic: aspiration

Cysteine Growth Requirements

MICROBIOLOGY MNEMONIC

BoyFriend Lost Penis

B rucella

F rancisella

L egionella

P asteurella

or….

The four sisters “Ella” worship in the “cystein” chapel

Brucella

Francisella

Legionella

Pasteurella

Medically Important Fungi

Diphtheria is known for creating a slimy/sticky/smelly exudate in the throat and mouth, but there are quite a few variations on its etiology and presentation.

A. Common type of diphtheria. Child three years old, seen on fourth day of illness. Exudate covering pharynx, tonsils, and uvula. Received 16,000 units of antitoxin. Throat clear on sixth day. Discharged cured.

B. Follicular type of diphtheria. Child seven years old, seen on second day of illness. The membrane involved the lacunae of the tonsils. Resembles follicular tonsillitis. Received 6,000 units of antitoxin total.

C. Hemorrhagic type of diphtheria. Child seven-and-a-half years old, seen on sixth day of illness. Tonsillar and post-pharyngeal exudate. Severe nasal and post-pharyngeal hemorrhages during exfoliation of membrane. Received in all 15,000 units of antitoxin. Throat clear on ninth day of illness. Myocarditis developed. Case discharged cured four weeks after admission. 

D. Septic type of diphtheria. Child eight years old, seen on fifth day of illness. The pseudo-membrane in this case covered the hard palate and extended in one large mass down the pharynx, completely hiding the tonsils.

Diseases of Infancy and Childhood. Louis Fischer, M.D., 1917.

11.19.17

2 more days until break

Music mood: Mili - Miracle Milk

Neisseria gonorrhoeae

PMN filled with Neisseria gonorrhoeae => Gram- diplococci, glucose fermenter, non maltose fermenter, oxidase positive.

Very inflammatory response: exudate with high number of PMN. TX with ceftriaxone and always ALWAYS test for Chlamydia trachomatis (since is more common and exudate is similar)

How to tell them apart? 

N. gonorrhoeae’s exudate is more purulent than C. trachomatis.

N. gonorrhoeae’s exudate is “greenish-yellowish” but C. trachomatis’s is whiter.

N. gonorrhoeae is always inside a PMN while C. trachomatis is not 

Grows in Thayer-Martin medium (chocolote agar + antibiotics, is a selective medium)