id board review

8/18/2019 ID Board Review

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Angsana Phuphuakrat

3 Dec 2013

ID Board Review


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Bacteria


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Haemophilus species

• Gram negative coccobaciii

Neisseria spp.

Moraxella catarrhalis

Acinetobacter species!


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Neisseria gonorrhoeae

• "ae urethra discharge

• "an# gram negative dipococci$ intraceuar


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Gram negative rod

%usobacterium sp


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Gram&negative baciiGucose 'ermenter

(es )o

*+idase Gucose o+idi,er

(es )o

• Vibrio• Aeromonas•

Plesiomonas• Pasteurella

• -nterobacteriaceae

.actose 'ermenter

• E. coli • Klebsiella• Enterobacter • Citrobacter • Serratia

(es )o

• Salmonella• Shigella• Edwardsiella• Morganella

• Proteus• Proidencia• S. marcescens

(es )o

*+idase

(es )o

• P. aeruginosa• !. cepacia• Shewanella• !. pseudomallei • Sphingomonas

• Acinetobacter • !. cepacia• S. maltophilia• Sphingomonas• P. lu"ola

*+idase

(es )o

• Neisseria• Moraxella• Alcaligenes• !ordetella

• !ordetella• A. lwo##ii


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Group A /treptococcus

• Gram positive cocci in chain

• )% t#pe 2

• Peniciin$ beta&actams$ cindam#cin


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Umbella-like

motility pattern

Best seen when theculture is incubated

at roomtemperature


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$isteria monoc%togenes

• onsumption dair# products

• "eningitis$ bacteremia

• Risk neonate$ eder#$ pregnanc#$ steroid

• R+ ampiciin aminog#coside• Peniciin aerg# co&trimo+a,oe


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Erysipelothrix rhusiopathiae


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Clostridium tetani


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Gram positive bacii

• Cor%nbacterium diptheriae

• $isteria monoc%togenes

• Er%threpelothrix rhusiopathiae

• !acillus anthracis& cereus• Clostridium tetani

• Clostridium per#ringens

• Clostridium di##icile


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Po#microbiaAnaerobic

In'ection

• "i+ed o' gram positive$ gram

negative$ rods and cocci

• 4ariabe shape


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"odi'ied A%B and A%B staining o' sputum

• Nocardia

• "#cobacteria

• 'hodococcus

• $egionella micdadei

• Aerobic actinom#ces (ordona$ )su"amurella


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Nocardia or Actinom%ces species

• .ong irreguar beaded gram positive 'iaments

• Branching


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'hodococcus e*ui • Gram positive coccobacii and

dipococci

• Positive modi'ied acid&'ast

5reatment•-r#throm#cin 2 gmda#

•4ancom#cin 16 mgkg 7 12 hr

•Imipenem pus ri'ampicin 10mgkgda#

*thers 7uinoones$ a,ithrom#cin$carithrom#cin$ aminog#cosides$

meropenem


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$egionella micdadei

mA%B staining o' peura 'uid showing short acid&'ast rods


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%ungus


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Aspergillus species

• /eptate h#phae

• Acute ange 8dichrotomus9

branching


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Mucor

Right angle,

rare septate,

board hyphae


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P%thium insidiosum

• Broad$ nonseptate h#phae$ shape&ange branching$

ribbin&ike appearance

• Risk thaassemia$ hemogominopath#$ occupationa

• Arteria occusion• R+ surger#$ terbinar'ine$ itracona,oe$ immunotherap#


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Wright-S 1000x


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Histoplasma capsulatum

• (east&ike organisms

8budding9

• Round&ova shape

• Grape&ike appearance

• -+traceuar$ intraceuar$

within macrophage


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Cr%ptococcus neo#ormans

• .arge round

• -ncapsuated budding #east

• Budding #east with negative#

stained haos 8dense

po#saccharide capsues9 and

narrow necked buds


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Penicillium mane##ei

• (east ike organism

• Peomorphic round to

sausage shape

• entra cear septum or binar#

'ission


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%unga septate h#phae

Fusarium spp.


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P. +iroeci ,Pneumoc%stis carinii-

• Giemsa stain

• 5ropho,oites 'orm

• %oam# appearance

• Amorphous dust# smoke ikecumping

• G"/ stain• #st 'orm

• Intrac#stic bodies inside


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Parasite


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Helminth eggs


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Capillaria philippinensis

• ooressbrown coor

• Peanut&shaped with 'attenedbipoar pugs

• /triated she

5reatment

"ebenda,oe 200 mg bid + 20 da#s

Abenda,oe :00 mg bid ; 10 da#s


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Ascaris lumbricoides

• /ight# ova shape$ mamiated

thick she

• Goden brown coor

• %ertii,ed egg a mass o'

uni'orm# coarse ecithin

granue

•


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Enterobius ermicularis

• D&shape$ cooress

• thick she containing arva

5reatment

"ebenda,oe 100 mg + 1

Abenda,oe :00 mg + 1

Scotch tape technique


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SCHISTOSOMA MANSONI

• Asymptomatic

• Intestinal

schistosomiasis• Hepatic schistosomiasis

• Neurologic complication

• Pulmonary complication

• Bacterial infection


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SCHISTOSOMA JAPONICUM

• Asymptomatic

• Intestinal schistosomiasis

• Hepatic schistosomiasis• Neurologic complication

• Pulmonary complication

• Bacterial infection


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SCHISTOSOMA HAMATOBIUM

• Asymptomatic

• Chronic cystitis• Chronic hematuria

• O!structi"e uropathy

• Bla##er cancer


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/putum gram stain


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Proto,oa

I b lli t difi d AFB 20X


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Isospora belli oocyst modified AFB 20X


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sospora belli

• -ongated eipsoida shape with 1&2 sporoc#sts inside

• 26&30 micron in si,e

• otrimao+a,oe is e''ective treatment

• 1 D/ =: & 10 d then 1 D/=2 & 3 weeks

FB


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mAFB x40


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#cospora ooc#st

• >!6 ? 10 micron

• /pherica ooc#sts

• otrimo+a,oe is treatment o' choice

-1 D/ = : times da# = > da#s

- ong term suppressive


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/5**. "*DI%I-D AID %A/5 /5AI)

C idi difi d FB 100X


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Cryptosporidium oocyst modified AFB 100X


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r#ptosporidium

• Deep red ooc#sts

• :&6 micron

• )o e''ective A5B

• @AAR5

• Antidiarrhea drugs


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/too modi'ied trichrome stain

Microsporidium oocyst


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Microsporidium oocystmodified trichrome stai


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)oxoplasma gondii

• Intraceuar proto,oa

• In'ection since chidhood && atent

• "ost adut disease caused b# reactivation

• ordwide distribution


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P l


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P. ovale


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B.**D /"-AR P!4!

P i


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P.vivax

P i


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P.vivax


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B.**D /"-AR P!"

P l i


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P.malariae


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P.falciparum


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P.falciparum


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ompicated P%

• Artesunate 2!: mgkg at 0$ 12$ 2: h

then 2!: mgkg *D unti D>

• Euinine 20 mgkg I4 oad

then 10 mgkg 7 h do+#c#cine


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P4$ P*$ P"

• horo7uin :&2&2&2 at 0$ C$ 2:$ : h

• Prima7uin 16&30 mg *D = 1: da#s

8e+cept P"9


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4irus


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/kin scraping smear rightFs stain


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p g g


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