What disease is caused by Chlamydia trachomatis serotypes A-C?
1. Chronic infection2. Blindness in Africa
What disease is caused by Chlamydia trachomatis serotypes D-K?
1. Urethritis/PID2. Ectopic pregnancy3. Neonatal pneumonia4. Neonatal conjunctivitis
What disease is caused by Chlamydia trachomatis serotypes L1-L3?
Lymphogranuloma venereum1. acute lymphadenitis with a positive Frei test2. ulcers3. rectal strictures
Stages of Lyme disease
1. Erythema chronicum migrans and flu-like symptoms2. Neurologic and cardiac manifestations3. Autoimmune migratory polyarthritis
Syphilis stages
1. Painless chancre (localized disease) 2. Disseminated disease with constitutional symptoms (fever, lymphadenopathy), maculopapular rash (palmes and soles), condylomata lata 3. Neurosyphilis, aortitis, gummas
What is FTA-ABS used for?
- Fluorescent treponemal antibody absorption testFTA-ABS: Find the Antibody-Absolutely - Confirmatory test for syphilis (after positive VDRL)
VDRL
- Venereal Disease Research Laboratory test (venereal: relating to sexual intercourse)1. Viruses 2. Drugs3. Rheumatic fever and rheumatoid arthritis4. Lupus and leprosy - Screening test for syphilis (blood test) - High sensitivity
What disease states can Candida albicans cause?
1. Thrush esophagitis in immunocompromised patients (neonates, AIDS)2. Endocarditis in IV drug users3. Vaginitis post-antibiotic use4. Diaper rash5. Disseminated candidiasis
Treatment Candida infection
Superficial: Nystatin Serious symptomatic: Amphotericin B
What causes a fungus ball?
Aspergillus
What disease states does Aspergillus cause?
1. Allergic bronchopulmonary aspergillosis2. Lung cavity aspergilloma3. Invasive aspergillosis
What disease states does Giardia lamblia cause?
1. Giardiasis2. Bloating3. Flatulence4. Foul-smelling diarrhea
What disease states does Cryptosporidium cause?
Diarrhoea 1. AIDS: Severe2. Non-HIV: Mild watery
What disease states does Toxoplasma cause?
1. HIV: brain abscess 2. Birth defects (ring-enhancing brain lesions)
What disease states does Plasmodium cause?
1. Cyclic fevers2. Headache3. Anaemia4. Splenomegaly5. Severe cerebral malaria (with Plasmodium falciparum)
What disease states does Leishmania donovani cause?
Visceral leishmaniasis (kala-azar or black fever): - fever- weight loss- anaemia- swelling of the liver and spleen
Which protozoa are transmitted by cysts?
1. Entamoeba histolytica2. Giardia lamblia3. Cryptosporidium4. Toxoplasma
How do you diagnose: Giardia lamblia
Trophozoites or cysts in stool (double nuclei like owl eyes) - SAFC
How do you diagnose: Entamoeba histolytica
- Trophozoites and cysts in SAFC - Serology
How do you diagnose: Cryptosporidium
- Ziehl Neelsen (acid fast stain)
Important points about Ascaris lumbricoides
Nematode (roundworm) 1. Up to 1 food in length2. Eggs in feces3. Intestinal infection (via trachea)
Important points about Enterobius vermicularis
Nematoda (roundworm) 1. Food contaminated with eggs2. Intestinal infection3. Anal pruritis: Scotch-tape test
Important points about Strongyloides stercoralis
Nematode (roundworm) 1. Larvae in soil penetrate the skin2. Intestinal infection (via trachea)
Bloody diarrhea
Campylobacter - comma-shaped organisms Entamoeba histolytica - liver abscess Enterhemorrhagic E. coli - can cause HUS, makes Shiga-like toxin Enteroinvasive E. coli Salmonella - lactose (-), has animal reservoir, especially poultry and eggs Shigella - lactose (-), very low ID50, produces Shiga toxin (human reservoir only) Yersinia enterocolitica - pseudoappendicitis
Vaginal infections
Bacterial vaginosis- bacterial overgrowth (other than Lactobacilli), eg Gardnerella- no inflammation- thin, white discharge with fishy odor- Clue cells- Treatment: Metronidazole Trichomonas vaginitis- Inflammation ("strawberry cervix")- yellow-green, foul-smelling discharge- Motile trichomonads- Treatment: Metronidazole Candida vulvovaginitis- Inflammation- thick, white "cottage cheese" discharge- Pseudohyphae- Treatment: -azoles
ToRCHeS infections
- microbes that pass from mother to fetus Toxoplasma gondii- Classic triad: chorioretinitis, hydrocephalus, intracranial calcifications Rubella- Classic triad: cataract, deafness, congenital heart disease (PDA) ± "blueberry muffin" rash Cytomegalovirus- hearing loss, seizures, petechial rash, "blueberry muffin" rash, periventricular calcifications HIV Herpes simplex virus-2- Encephalitis, herpetic (vesicular) lesions Syphilis- often results in stillbirth, hydrops fetalis
Red rashes of childhood
Coxsackie type A: Hand-foot-mouth disease- Oval-shaped vesicles on palms and soles Rubella virus- Pink coalescing macules begin at head and move down --> truncal rash; postauricular lymphadenopathy Measles virus- Beginning at head and moving down; rash is preceded by cough, coryza, conjunctivitis and Koplik spots on buccal mucosa Varizella-Zoster virus: chickenpox- Vesicular rash begins on trunk, spreads to face and extremities with lesions of different stages Human herpesvirus 6: Roseola (exanthem subitum)- asymptomatic rose-colored macules appear on body after several days of high fever; can present with febrile seizures Parvovirus B19: Erythema infectiosum- "Slapped cheek" rash on face Streptococcus pyogenes: Scarlet fever- Erythematous, sandpaper-like rash with fever and sore throat
Rash on hands and feet
- Coxsackie A virus - Treponema pallidum (syphillis) - Rickettsia rickettsii (Rocky mountain spotted fever)
