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Gram Positive:

A normal inhabitant of the oral cavity, infection can be associated with dental
procedures, with formation of lesions that erupt through the face with a purulent

Actinomycetes isrealii
[Diagnosis is by finding sulfur granules = tangles of filaments of organisms
wrapped in a matrix of calcium phosphate, imparting a yellow (sulfur) color to
the abscess and discharge]

Gram Positive:
The most severe form of this disease results from the inhalation of spores with
mediastinitis, pulmonary edema, and hemorrhage (Woolsorter's disease)

Bacillus anthracis
[Can occur as an occupational disease of textile or agricultural personnel
resulting from contact with infected hides or wool; it has been used as an agent
of biowarfare and bioterrorism]

Gram Positive:
Causes gastroenteritis and is typically associated with the consumption of
reheated rice

Bacillus cereus
[Rapid emesis or diarrhea is associated with an enterotoxin that increases cAMP
and is produced by the organism as it germinates]

Gram Positive:
Disease can be due to the ingestion of preformed toxin in home-canned foods or
by the ingestion of spores in honey by an infant

Clostridium botulinum
[Symptoms include flaccid paralysis, dry mouth, diplopia, dysphagia, and
respiratory failure]

Gram Positive:
Associated with the use of broad-spectrum antibiotics and the overgrowth of
toxin-producing bacteria

Clostridium difficile
[Results in pseudomembranous colitis and is also a major nosocomial disease]

Gram Positive:
Causes gas gangrene and is often associated with automobile and motorcycle

Clostridium perfringens
[Spores are abundant in soil and germinate in wounds; treatment includes
surgical debridement, antibiotics, and hyperbaric oxygen]

Gram Positive:
Infection is associated with traumatic inoculation of spores that germinate and
produce a toxin that causes spastic paralysis

Clostridium tetani
[The organism looks like a long rod with a dilated terminal end containing spore
that resembles a tennis racquet]

Gram Positive:
Can cause risus sardonicus, the characteristic grimace of lockjaw

Clostridium tetani
[Treatment includes the use of antitoxins produced in horses or hyperimmunized
humans, and antispasmodics such as benzodiazepines]

Gram Positive:
Causes gray pseudomembranes on the back of the throat

Corynebacterium diphtheriae
[Organisms often viewed in a "Chinese-letter" configuration]

Gram Positive:
A common cause of nosocomial infection, this organism is often resistant to
many antibiotics, including vancomycin

Enterococcus spp.
[Common cause of urinary tract infections, sepsis, meningitis, and endocarditis]

Gram Positive:
Causes a fishy smelling vaginal discharge

Gardnerella vaginalis
[Histologically characterized by the presence of "clue cells," vaginal epithelial
cells covered with bacteria, seen on a Pap smear]

Gram Positive:
As the dominant organism of normal vaginal flora, its metabolism helps maintain
the low pH of the vagina

Lactobacillus spp.
[The lactic acid produced helps prevent the overgrowth of potentially pathogenic
organisms; with the use of broad-spectrum antibiotics, such acid-producing
flora is lost, allowing for overgrowth of pathogenic species]

Gram Positive:
This cause of late onset neonatal sepsis is a facultative intracellular parasite that
spreads from cell to cell via actin rockets

Listeria monocytogenes
[This organism can be detected as short non-spore-forming rods with a
tumbling end-over-end motility]

Gram Positive:
As well as being gram positive, this organism is also weakly acid fast and causes
a pneumonia predominantly in immunocompromised patients

Nocardia asteroides
[This aeroic bacteria with filamentous growth is a common soil organism]

Gram Positive:
Part of the microbial flora of the skin, this bacilli contributes of the development
of acne

Propionibacterium acnes
[The organism produces lipases that split fatty acids that cause inflammation,
resulting in the formation of comedones]

Gram Positive:
A major cause of acute bacterial endocarditis, especially in IV drug users

Staphylococcus aureus
[Unlike subacute bacterial endocarditis, this organism can cause infection of
undamaged heart valves, typically on the right side (tricuspid) in IV drug users]

Gram Positive:
A major cause of abscesses, furuncles, carbuncles, and other skin infections such
as impetigo

Staphylococcus aureus
[This beta-hemolytic cocci grows in grape-like clusters, produces coagulase, and
grows in culture as yellowish colonies]

Gram Positive:
Part of the normal flora of the skin, it causes infection of IV lines and catheters; it
is a major cause of endocarditis in patients with prosthetic heart valves

Staphylococcus epidermidis
[Similar to Staphylococcus aureus, but grows as white colonies, does not produce
coagulase, does not ferment mannitol, and does not produce Protein A]

Gram Positive:
The second leading cause of urinary tract infection in sexually active women

Staphylococcus saprophyticus
[Differentiated from Staphylococcus epidermidis by its ability to ferment mannitol
and its resistance to novobiocin]

Gram Positive:
An important cause of neonatal sepsis and meningitis

Streptococcus agalactiae (Group B)

[This beta-hemolytic, bacitracin-resistant cocci is a normal inhabitant of the
female genital tract and can be acquired during vaginal delivery]

Gram Positive:
A major cause of dental caries

Streptococcus mutans
[A member of the viridans group, it is also alpha-hemolytic and

Gram Positive:
Lancet-shaped diplococci found in a rusty brown sputum

Streptococcus pneumoniae
[Causes >90% of all causes of lobar pneumonia]

Gram Positive:
The use of a quellung reaction helps differentiate between the 85 different
capsular subtypes

Streptococcus pneumoniae
[This alpha-hemolytic, optochin-sensitive, bile-soluble coccus grows on sheep
red blood cell agar; the vaccine contains at least 23 of these subtypes]

Gram Positive:
Infection results in pneumatic fever

Streptococcus pyogenes (Group A)

[Characterized by a constellation of symptoms including migratory polyarthritis,
erythema marginatum, pancarditis, Syndeham chorea, and subcutaneous

Gram Positive:
A major cause of pharyngitis, infection can also result in other suppurative
symptoms such as erysipelas, cellulitis, and impetigo

Streptococcus pyogenes (Group A)

[Infection with this beta-hemolytic, bacitracin-sensitive cocci can be
serodiagnosed with the detection of host antibodies to bacterial DNase B and
anti-streptolysin O (ASO)]

Gram Positive:
Infection can lead to the development of acute glomerulonephritis and mitral and
aortic stenosis

Streptococcus pyogenes (Group A)

[Immunocomplex deposition in the kidney visualized by "lumpy bump"
immunofluorescence; cross-reactive antibodies to the bacteria result in
autoimmune destruction of the heart valves]

Gram Positive:
Leading cause of subacute bacterial endocarditis

Streptoccus viridans
[This alpha-hemolytic, optochin-resistant cocci is part of the normal flora of the
human pharynx]

Gram Positive:
Chronic exposure to this group of organisms leads to the development of
hypersensitivity pneumonitis, including Farmer's Lung, Pigeon breeder's Lung,
and Humidifier Lung

Thermophilic Actinomycetes
[Exposure causes an immunologically mediated interstitial fibrosis, bronchiolitis,
and granuloma formation with progresive respiratory failure and cyanosis]

Gram Positive:
The organism is detected as PAS+ rods within the macrophages of the lamina
propria of the small intestine

Tropheryma whippelii
[The causative agent of Whipple's disease that results in abdominal pain,
malabsorption with diarrhea and weight loss, and a migratory polyarthritis]

Gram Negative:
Predominant organism in the human colon

Bacteroides fragilis
[Most often the cause of serious anaerobic infection]

Gram Negative:
Transmitted by the bite, scratch, or lick of an infected cat, resulting in low grade
fever and a characteristic enlargement of lymph nodes for several weeks

Bartonella henselae
[This is the causative agent of Cat scratch disease; infection of an
immunocompromised patient can result in Bacillary angiomatosis, cranberry-like
pustules resembling Kaposi's sarcoma]

Gram Negative:
Causes a paroxysmal cough ending with an inspiratory "whoop" as air rushes
over the swollen glottis

Bordetella pertussis
[The vaccine includes the purified virulence factors filamentous hemagglutinin
(FHA) and pertussis toxoid, and is administered at 2, 4, 6, and 18 months along
with the vaccine for Corynebacterium diphtheriae and Clostridium tetani in the
DaPT vaccine

Gram Negative:
Transmitted by contaminated livestock and unpasteurized dairy products,
infection results in a fever that rises in the morning and falls at night (Undulant

Brucella spp.
[This granulomatous infection invades the reticulo-endothelial cells of the lymph
nodes, liver, spleen, and bone marrow]

Gram Negative:
Endemic to tropical nations, this sexually transmitted organism results in
granulomatous genital ulcers (pseudouboes) with the potential for
autoamputation of genitalia

Klebsiella granulomatis
(formerly Calymmatobacterium granulomatis)
[Diagnosis is based on finding intracellular organisms aggregated as 'Donovan

Gram Negative:
A common cause of bloody diarrhea, particularly in children in close contact with
puppues and kittens, which serve as reservoirs

Campylobacter jejuni
[These rod-shaped organisms appear as "gull wing"-shaped colonies with a
single flagellum]

Gram Negative:
Causes a bloody diarrhea and is associated with the consumption of
undercooked meat and dairy products

Enterohemorrhagic Escherichia coli

(E. coli 0157:H7)
[This dysentery-like condition is due to the elaboration of verotoxins similar to
Shiga toxin that causes cytotoxicity to the colonic mucosa]

Gram Negative:
Infection may result in hemorrhagic colitis progressing to the hemolytic uremic
syndrome (HUS)

Enterohemorrhagic Escherichia coli

(E. coli 0157:H7)
[HUS is characterized by acute renal failure, microangiopathic hemolytic anemia,
and thrombocytopenia in children]

Gram Negative:
Leading cause of urinary tract infections

Escherichia coli
[Other major causes of urinary tract infections include Proteus, Serratia,
Enterococci, Klebsiella, Pseudomonas, and Staphylococcus saprophyticus]

Gram Negative:
Causes "Traveler's diarrhea" and is also a major cause of death in children of
developing nations

Escherichia coli
[The enterotoxigenic strain produces a heat stable and a heat labile toxin that
causes an explosive watery diarrhea with cramping, abdominal discomfort, and

Gram Negative:
This zoonotic organism can be transmitted by the bite of a deerfly or tick, or
through handling or consuming rabbit products, which are the reservoir

Francisella tularensis
(rabbit fever)
[Infection can result in necrotic ulcers at the site of entry: conjunctiva
(oculoglandular), mouth (typhoidal), or lungs (pneumonic tularemia) with
disseminated granulomatous lesions of the lung, spleen, and liver]

Gram Negative:
Organism closely associated with chronic gastritis and peptic ulcer disease

Helicobacter pylori
[Also associated with an increase in the development of gastric carcinoma and

Gram Negative:
A sexually transmitted disease, results in painful genital ulcers (chancroid)

Haemophilus ducreyi
[Infection in the United States is rare, most infections occur in the tropics;
painless ulcer = T. pallidum]

Gram Negative:
Infection with this coccobacillus causes epiglottitis, otitis media in children,
sinusitis, meningitis, and pneumonia in older patients with chronic respiratory

Haemophilus influenzae
[Growth in culture of this organism requires Factor V (hemin) and Factor X (NAD),
found in chocolate agar media]

Gram Negative:
Formerly a leading cause of infection in children, the incidence of infection has
dramatically decreased with the introduction of a vaccine

Haemophilus influenzae
[Vaccine is composed of the capsular material, polyribitol phosphate (PRP),
conjugated to diptheria toxin]

Gram Negative:
Major cause of aspiration pneumonia in alcoholics

Klebsiella pneumoniae
[Organism produces a large antiphagocytic capsule, giving it a mucoid
appearance and producing a thick, bloody, "currant-jelly" sputum]

Gram Negative:
Paired, kidney bean-shaped diplococci within leukocytes in a urethral discharge

Neisseria gonorrhoeae
[Differentiated from N. meningitidis based on its ability to ferment glucose and
maltose, whereas N. gonorrhoeae ferments glucose only]

Gram Negative:
Leading cause of septic arthritis

Neisseria gonorrhoeae
[Typically presents as monoarticular arthritis of the knee, ankle, or wrist after a
bout of urethritis]

Gram Negative:
Infection of a neonate passing through an infected birth canal results in
ophthamia neonatorum and purulent conjunctivitis

Neisseria gonorrhoeae
[Babies born in the United States receive a required administration of tetracycline,
erythromycin, or silver nitrate drops to prevent this]

Gram Negative:
Sexually transmitted disease that can lead to pelvic inflammatory disease that
then predisposes to ectopic pregnancy

Neisseria gonorrhoeae
[The second most common notifiable disease in the United States]

Gram Negative:
Leading cause of meningitis among mililtary recruits and dormitory settings

Neisseria meningitidis
[Patients with deficiencies in the complement components C6-9, "the membrane
attack complex," are particularly susceptible to infection]

Gram Negative:
Septicemia resulting from this organism can result in progressive hypotension,
disseminated intravascular coagulation, widespread vascular purpura, and
bilateral adrenal hemorrhage

Neisseria meningitidis
[The shock and adrenocortical insufficiency of Waterhouse-Friderichsen
Syndrome is rapidly fatal without antibiotic treatment]

Gram Negative:
This organism is transmitted through the bite of a domestic cat or dog and can
result in an abscess, cellulitis, and osteomyelitis

Pasteurella multocida
[Short, encapsulated, bipolar staining organism is part of the nasopharyngeal
flora of domestic dogs and cats]

Gram Negative:
Urease-positive organism that causes an alkaline urine predisposing to the
formation of urinary calculi

Proteus spp.
(P. mirabilis and P. vulgaris)
[These highly motile organisms are often refractory to antibiotic treatment
because they often become trapped within stones]

Gram Negative:
Major cause of pneumonia in burn patients and cystic fibrosis patients

Pseudomonas aeruginosa
[This obligate aerobe requires only trace elements for growth and is a major
cause of nosocomial infections because it colonizes aspirators, water and ice
dispensers, IV lines, and even dilute disinfectant solutions]

Gram Negative:
Infection can result in folliculitis, swimmer's ear, pneumonia, and sepsis with the
development of characteristic skin lesions (Ecthyma gangrenosum)

Pseudomonas aeruginosa
[This organism grows well in water, especially in inadequately chlorinated hot
tubs; culture results in green colonies resulting from pigments pyoverdin and
pyocyanin, with a characteristic fruity odor]

Gram Negative:
Causes a self-limiting enterocolitis associated with the consumption of
contaminated eggs and poultry

Salmonella enteritidis
[This highly motile organism requires a large infectious dose, which
distinguishes it from Shigella spp.]

Gram Negative:
Causes an enteric fever with the development of characteristic "rose spots" on
the abdomen

Salmonella typhi
[After recovery, a small percentage of patients may become carriers because the
organisms colonize the gallbladder, a state that may require cholecystectomy]

Gram Negative:
This organism is a common cause of nosocomial infections; some strains
produce a red pigment

Serratia marcescens
[Causes pneumonia, bacteremia, endocarditis, and is often multidrug-resistant]

Gram Negative:
Infection with a small dose of organisms results in dysentery that is only
transmitted among humans with no animal reservoir

Shigella dysenteriae
[This cause of a bloody, mucoid, low-volume diarrhea can result in
life-threatening dehydration and acidosis and is often associated with insanitary

Gram Negative:
Major cause of secretory diarrhea with life-threatening dehydration, particularly
in developing nations

Vibrio cholerae
[These comma-shaped rods with a polar flagellum adhere to the intestinal
mucosa and elaborate an exotoxin, but never invade]

Gram Negative:
Causes nausea, cramping, and is associated with the consumption of raw

Vibrio parahaemolyticus
[Although this free-living salt bacteria is related to Vibrio cholerae, the
symptoms are much milder]

Gram Negative:
Rodents are the reservoir for this organism, transmitted by the bite of a flea,
resulting in the plague

Yersinia pestis
[Transmission is also possible between humans in the case of the pneumonic

Gram Negative:
Infection can result in pustules and enlargement of draining lymph nodes that
rupture through the skin to form buboes

Yersinia pestis
[This organism displays bipolar staining resulting in a safety pin appearance]

Poorly Staining:
Late stages of infection may lead to a severe autoimmune arthritis,
life-threatening heart block, and facial nerve palsy

Borrelia burgdorferi
[The vaccine was available for this organism to prevent development of Lyme
disease, but was found to have autoimmune side effects and was withdrawn.
There is a vaccine for dogs, and new vaccines are being researched using outer
surface protein C (OspC) and glycolipoprotein as methods of immunization]

Poorly Staining:
Transmitted by the Ixodes tick bite that results in a characteristic bull's eye
lesion (Erythema chronicum migrans)

Borrelia burgorferi
[Infection occurs mainly in the Northeast during the summer months, when the
deer tick (Ixodes) is found]

Poorly Staining:
Transmitted by the human body louse, this organism causes relapsing fever

Borrelia recurrentis
[Causes a febrile disease that fades as antibodies develop and relapses as the
organism undergoes antigenic variation of its variable major protein]

Poorly Staining:
Previously known as the TWAR agent, it is a common cause of sore throats and
interstitial pneumonia

Chlamydia pneumoniae
[As with all Chlamydial species, it exists as either elementary bodies, the
infectious form, or as intracellular reticular bodies, the metabolically active form]

Poorly Staining:
Causes an interstitial type pneumonia and is associated with exposure to
contaminated parrots and parakeets and other domestic birds

Chlamydia psittaci
[The causative agent of Psittacosis, transmitted by birds of the psittacine family;
a similar disease, Ornithosis, is also seen upon exposure to other birds such as
pigeons, ducks, and chickens]

Poorly Staining:
This cause of chronic keratoconjunctivitis results in corneal scarring and is one
of the leading causes of blindness worldwide

Chlamydia trachomatis
[Chlamydia tracomatis is divided into serovars based on serology and
symptomatology; in this case, the pathology is due to C. trachomatis A, B, an C]

Poorly Staining:
This organism is the leading cause of sexually transmitted bacterial disease,
resulting in urethritis, cervicitis, salpingitis, and neonatal conjunctivitis

Chlamydia trachomatis
[Infection in a female can progress to pelvic inflammatory disease, resulting in
the potential for ectopic pregnancy or sterility]

Poorly Staining:
This organism is closely associated with the development of conjunctivitis,
urethritis, and arthritis (Reiter's syndrome)

Chlamydia trachomatis
[This autoimmune phenomenon resulting from cross-reactive antigens between
the organism and affected tissues is associated with the HLA-B27]

Poorly Staining:
Causes Lymphogranuloma venereum, characterized by nodules and vesicles on
the genitals, venereal buboes, and elephantiasis of the genitals with rectal

Chlamydia trachomatis
[Results from infection of the most invasive serovars L1, L2, and L3; this sexually
transmitted disease progresses through primary, secondary, and tertiary stages]

Poorly Staining:
Causes Q fever, an interstitial pneumonia, resulting from the inhalation of the

Coxiella burnetii
[Unlike other rickettsial diseases, this organism is not transmitted by the bite of
an arthropod, does not cause a rash, and cannot be detected by the classical
serologic test for Rickettsia, the Weil-Felix Test]

Poorly Staining:
This organism grows in warm, moist environments (contaminated air conditioner
systems) and causes a potential life-threatening pneumonia in patients with lung

Legionella pneumophila
[This organism, often visualized with Dieterle silver stain, also causes a less
severe form of pneumonia known as Pontiac fever]

Poorly Staining:
One of the most common opportunistic bacterial infections in AIDS patients

Mycobacterium avium-intacellulare (MAC)

[This disease presents similarly to TB and is acquired from soil, birds, or other

Poorly Staining:
Infection results in the destruction of skin and cartilage, resulting in a leonine
facies and limb deformities

Mycobacterium leprae
[Leprosy, or Hansen disease, presents as a spectrum between two extremes,
from tuberculoid leprosy associated with good prognosis to lepromatous leprosy,
in which numerous acid-fast bacilli are stuffed in macrophages = Lepra cells]

Poorly Staining:
Infection results in the destruction of peripheral nerves, resulting in anesthesia
followed by atrophy and autoamputation

Mycobacterium leprae
[This acid-fast bacilli has a long generation time, approximately 13 days, and
cannot be cultivated in the laboratory]

Poorly Staining:
Primary infection results in subpleural parenchymal lesions and enlarged caseous
lymph nodes (Ghon complex) and reactivation can result in cavitary lesions in the
upper lung lobes

Mycobacterium tuberculosis
[Diagnosis is confirmed by finding acid-fast bacilli in the sputum or in cultures
that take several weeks to grow]

Poorly Staining:
The classic presentation of infection with this organism includes fever, night
sweats, fatigue, and weight loss

Mycobacterium tuberculosis
[Presents similarly to other granulomatous infections such as histoplasmosis or

Poorly Staining:
Infection can result in the involvement of vertebrae (Pott's disease) with spread to
form a psoas abscess and, in immunocompromised patients, overwhelming
miliary dissemination

Mycobacterium tuberculosis
[Although rare in the United States, incidences of infections are increasing in
immunocompromised patients and urban populations, with high incidence of
multidrug-resistant strains]

Poorly Staining:
Immunization employs the use of Bacillus Calmette Guerin (BCG), one of the few
live attenuated bacterial vaccines available

Mycobacterium tuberculosis
[The test for exposure to TB involves injection of a small amount of partially
purified derivative (PPD) and detecting a delayed type hypersensitivity reaction;
recipients of the vaccine (an attenuated strain of M. bovis) have a positive PPD]

Poorly Staining:
A prominent cause of community-acquired pneumonia, symptoms normally
include a hacking, nonproductive cough (atypical pneumonia)

Mycoplasma pneumonia
[One of the smallest free-living bacteria, has no cell wall, and causes an
interstitial inflammation rather than intra-alveolar exudates]

Poorly Staining:
Causes "Walking pneumonia" with the potential to develop a self-limiting
hemolytic anemia

Mycoplasma pneumoniae
[Untreated patients develop IgM autoantibodies to red blood cells, termed acute
cold agglutinins]

Poorly Staining:
Associated with overcrowding and transmitted by the human body louse, this
organism causes Epidemic typhus

Rickettsia prowazekii
[Characterized by extreme fever, myalgias, and a rash; a less sever form of the
disease, Endemic typhus, results from Rickettsia typhi]

Poorly Staining:
Transmitted by ticks, infection results in a petechial rash with involvement of the
palms and soles

Rickettsia rickettsii
[The causative agent of Rocky Mountain spotted fever is an obligate intracellular
organism seen with Giemsa staining; despite its name, it is endemic to the
eastern United States]

Poorly Staining:
Transplacental infection can result in a triad of interstitial keratitis, Hutchinson
teeth, and 8th cranial nerve deafness

Treponema pallidum
[Infection results in osteochondritis and periostitis and contributing as well to
other defects such as destruction of the vomer, leading to saddle nose deformity;
other bone defects include mulberry molars and saber shin deformities]

Poorly Staining:
Long-term consequences of untreated disease include tabes dorsalis and
aneurysms of the ascending aorta

Treponema pallidum
[Tertiary syphilis can lead to paresis and is the leading cause of aneurysms of the
ascending aorta with a characteristic tree-barking appearance]

Poorly Staining:
The disease can manifest with a maculopapular rash on the palms and soles, and
condyloma lata

Treponema pallidum
[Secondary syphilis presents with a rash and gray flattened wart-like lesions on
the anogenital, axillary, and oral areas; these condyloma lata are not to be
confused with condyloma acuminatum seen with HPV infection]

Poorly Staining:
Initial infection presents with a painless ulcer on the genitals known as a chancre

Treponema pallidum
[The characteristic lesion of primary syphilis is highly contagious and contains
numerous spirochetes viewed by dark field light microscopy or by
immunofluorescent microscopy]

Poorly Staining:
Patients with SLE are often positive for serologic tests for this organism even if
not infected (biologic false positive)

Treponema pallidum
[Screening test like the rapid plasma reagin or Venereal Disease Research
Laboratory (VDRL) are based on finding antibodies to cardiolipin, which patients
with SLE make; the most specific test is the fluorescent treponemal antibody
(FTA-Abs test)]

Poorly Staining:
The organism is exquisitely sensitive to penicillins; treatment can result in rash,
fever, and hypotension (Jarisch-Herxheimer reaction)

Treponema pallidum
[Treatment results in rapid death of the organism with release of toxic products
that cause symptoms that can be relieved by anti-inflammatory agents]

Poorly Staining:
This organism that lacks a cell wall is the cause of recurrent urinary tract

Ureaplasma urealyticum
[Related to Mycoplasma pneumoniae, infection is associated with the
development of urinary calculi]

Virulence Factors:
Produces a trivalent exotoxin composed of protective antigen, edema factor, and
lethal factor

Bacillus antracis
[Protective antigen mediates cell binding, edema factor is a secreted adenylate
cyclase, and lethal factor causes CNS depression]

Virulence Factors:
One of the virulence factors of this organism is an anti-phagocytic capsule
composed of D-glutamic acid

Bacillus anthracis
[Although typically composed of polysaccharides, other organisms with unique
capsular components include sialic acid in Streptococcus agalactiae and
hyaluronic acid in Pasteurella multocida]

Virulence Factors:
Produces a typical AB toxin that catalyzes the transfer of ADP-ribose from NAD
to the inhibitory G protein subunit (Gi)

Bordetella pertussis
[Interference of G protein-coupled receptors such as those employed by
chemokines results in significant lymphocytosis; other virulence factors include
filamentous hemagluttinin and tracheal cytotoxin]

Virulence Factors:
Produces and exotoxin that blocks the release of actylcholine at the
neuromuscular junction

Clostridium botulinum
[Treatment includes the used of an antitoxin produced in horses, with the
possibility of serum sickness]

Virulence Factors:
The toxin produced by this organism can be used in minute amounts to treat
dystonias, strabismus, and wrinkles

Clostridium botulinum
[Toxin causes a flaccid paralysis of the injected muscles]

Virulence Factors:
Produces and AB toxin that ADP-ribosylates the small GTP binding protein Rho

Clostridium difficile
[Results in the depolymerization of the cytoskeleton with necrosis of the colonic

Virulence Factors:
Produces a lecithinase and hyaluronidase that results in cellulitis and

Clostridium perfringens
[The lecithinase can be demonstrated by culturing on egg yolk agar; normally the
organism produces a double zone of hemolysis on blood agar]

Virulence Factors:
The toxin elaborated by this organism inhibits the release of the inhibitory
neurotransmitters, GABA and glycine, resulting in a spastic paralysis

Clostridium tetani
[The DaPT vaccine includes the highly immunogenic tetanus toxoid; a booster is
recommended every 10 years and also after a puncture wound]

Virulence Factors:
A virulence factor produced by these two organisms is a typical AB toxin that
catalyzes the transfer of ADP-ribose from NAD to elongation factor-2

Corynebacterium diptheria and Pseudomonas aeruginosa

[ADP ribosylation of EF-2 (elongation factor-2) results in the inhibition of protein
synthesis and death of the cell]

Virulence Factors:
Produces a heat stable toxin Sta, that stimulates the production of cGMP, with
similar effects to those of increased cAMP

Enterotoxigenic Escherichia coli

[In addition, the organism produces a STb toxin that is cyclic nucleotide

Virulence Factors:
Virulence factor found in the outer leaflet of the cell wall of gram-negative

Lipopolysaccharide (LPS)
[Composed of Lipid A, a core polysaccharide, and O antigen, LPS leads to
activation of macrophages with the release of IL-1, with the development of
disseminated intravascular coagulation and septic shock]

Virulence Factors:
The virulence factors associated with this organism include the ability to grow
intracellularly and the production of cord factor

Mycobacterium tuberculosis
[Cord factor is thought to contribute to the formation of granulomas]

Virulence Factors:
Produces a toxin that irreversible inactivates the 60S ribosomal subunit with the
cessation of protein synthesis and cell death

Shigella dysenteriae
[Toxins similar to Shiga toxin are produced by enterohemorrhagic E. coli and are
known as verotoxins]

Virulence Factors:
Produces exfoliant toxin

Staphylococcus aureus
[The toxin causes an exfoliative dermatitis, Scalded skin syndrome, that appears
as a sunburn-like rash]

Virulence Factors:
Produces Toxic shock syndrome toxin

Staphylococcus aureus
[Toxic shock syndrome, associated with the use of superabsorbent tampons,
results from the production of this toxin, which causes polyclonal activation of T
cells through antigen-independent activation of the T-cell receptor]

Virulence Factors:
Protein A is a major virulence factor

Staphylococcus aureus
[Binds to the Fc region of the antibody, preventing complement fixation and

Virulence Factors:
The three major pyogens for which a polysaccharide capsule is the major
virulence factor

Streptococcus pneumoniae
Haemophilus influenzae
Neisseria meningitidis
[The capsule prevents opsonization by host cell immunoglobulins]

Virulence Factors:
Produces erythrogenic toxin, resulting in Scarlet fever

Streptococcus pyogenes (Group A)

[Erythrogenic toxin is a phage-encoded superantigen that causes the rash often
accompanying pharyngitis]

Virulence Factors:
M antigen is the most important virulence factor

Streptococcus pyogenes (Group A)

[Prevents phagocytosis, and antibodies to this molecule underlie the long-term
sequelae of infection, namely chronic rheumatic heart disease]

Virulence Factors:
Produces an AB toxin that transfers ADP-ribose from NAD to the stimulatory G
protein subunit (Gs)

Vibrio cholerae
[Similar to the labile toxin (LT) of enterotoxigenic E. coli, this toxin results in the
increase of cAMP with hypersecretion of Cl and HCO with the osmotic reflux of
up to 30 L of water/day]

Produces a toxin that results in liver damage upon ingestion of wild mushrooms

Amanita species
[Ingestion may result in life-threatening fulminant hepatitis, requiring liver

Produces the carcinogen aflatoxin and is a common contaminant of moldy nuts
and grains

Aspergillus favus
[Aflatoxins contribute to the development of hepatocellular carcinoma and act
synergistically with HBV to promote carcinogenesis]

Proliferation of this organism within the lung causes a "fungus ball" that must be
removed surgically

Aspergillus fumigatus
[Microscopically the organism grows as septate hyphae, branching at 45 angles]

Although an opportunistic mycosis, it can cause hypersensitivity pneumonitis
such as Farmer's Lung

Aspergillus fumigatus
[Resulting from inhalation of moldy hay]

Systemic mycosis that begins as lower respiratory tract infection and may
disseminate to cause warty-like skin lesions

Blastomyces dermatiditis
[Results in granulomatous lung lesions similar to tuberculosis; may also result in
skeletal and genitourinary manifestations]

Systemic mycosis endemic to the southeastern United States

Blastomyces dermatitidis
[Fungi appears in infected tissue as yeast with broad-based budding]

Causes a cottage cheese-like vaginal discharge

Candida albicans
[Predisposing factors include immunosuppression, diabetes, obesity, and the use
of broad-spectrum antibiotics]

Causes white curd-like patches on mucocutaneous membranes of the mouth and
extend downward to cause esophagitis in immunocompromised patients

Candida albicans
[In addition to causing thrush, C. albicans is a common cause of tinea unguium
(fungal infection of the nails) and diaper rash]

Most common mycotic pathogen

Candida albicans
[Although a yeast, it can form pseudohyphae in infected tissue and form
characteristic germ tubes at 37C under laboratory conditions]

Systemic mycosis endemic to the San Joaquin Valley in southern California

Coccidioides immitis
[Causes "Valley Fever," characterized by arthralgias, cough, and fever]

Found within infected tissue as spherules that rupture to release endospores

Coccidioides immitis
[Dimorphic fungi with contraction of infection by inhalation of arthrospores in
the sand and soil]

The only mycotic pathogen with a capsule

Cryptococcus neoformans
[Visualized with an India ink test; capsule excludes ink, providing contrast]

Causes meningitis in patients with underlying immunodeficiency, especially AIDS

Cryptococcus neoformans
[Associated with pigeon droppings, this fungus grows within the Virchow-Robin
vascular spaces of the brain, resulting in "soap bubble lesions"]

Causes cutaneous infections such as tinea corporis, tinea cruris (jock itch), and
tinea pedis (athlete's foot)

[Typically caused by dermatophytes of the genera Trichophyton spp. and result
in scaly hypo- or hyperpigmented annular pruritic lesions]

Associated with the inhalation of spores from bird or bat droppings in the Ohio
and Mississippi River Valley

Histoplasma capsulatum
[Histologically characterized by macrophages stuffed with numerous yeast cells]

Causes tinea versicolor, which manifests as patches of hyper- and
hypopigmentation on the trunk

Malassezia furfur
[Found in skin scales and has a characteristic spaghetti and meatballs
appearance (yeast clusters and short, curved septate hyphae)]

Most common pulmonary mycotic infection with symptoms ranging from
asymptomatic to tuberculosis-like symptoms

Histoplasma capsulatum
[In immunocompetent individuals, infection often resolves, with calcification of
hilar lymph nodes]

Most common cause of tinea capitis, ringworm of the scalp

Microsporum canis
[Common in prepubescent children with pets; the natural inhibitor or
Microsporum spp. growth, undecylenic acid, is produced in the sebum of
postpubertal individuals]

Results in rhinocerebral disease, primarily in patients with diabetic ketoacidosis
or leukemia

Mucor and Rhizopus species

[Distinct from other human fungal pathogens in that these species cause disease
in their sexual life cycle and display nonseptate hyphae branching at a 90 angle
or wider]

This organism grows as multiple budding yeasts that appear as a "captains
wheel" and causes disease almost exclusively in men

Paracoccidioides braziliense (brasiliensis)

[This granulomatous lung disease occurs primarily in Central and South America,
with >90% of cases seen in males]

Causes an alveolar pneumonia, typically in AIDS patients

Pneumocystis (carinii) jirovecii

[Previously thought to be a protozoa, this fungus causes a foamy, amorphous
alveolar exudate and is seen as cup- or boat-shaped cysts upon staining with
silver methenamine]

Causes the most common subcutaneous mycosis, Rose handler's disease

Sporothrix schenckii
[Transmitted by the prick of a contaminated thorn; treated with a dilute solution
of potassium iodide (KI) in milk]

Transmitted by the same tick as that which carries Lyme disease, infection results
in similar manifestation as malaria

Babesia microti
[Often mistaken for P. falciparum, the organism can be detected in RBCs as a
"Maltese cross," which is diagnostic]

Causes a self-limiting diarrhea in immunocompetent individuals or
life-threatening intractable diarrhea in AIDS patients

Cryptosporidium parvum
[Infection is associated with the consumption of water contaminated with
infected animal feces]

Dissemination to the liver can result in abscess formation with a characteristic
anchovy paste aspirate

Entamoeba histolytica
[The organism can form an amoeboma with the potential for penetration of the
serosa and peritonitis]

Common cause of amebic dysentery, infection leads to the formation of
flask-shaped ulcers in the colonic mucosa

Entamoeba histolytica
[The finding of trophozoites with ingested RBCs is pathognomonic]

The only common pathogenic protozoa of the small intestine

Giardia lamblia
[A heart-shaped symmetrical trophozoite with two nuclei, four pairs of flagella,
and a large sucking disk for adherence to the mucosal surface]

Causes flatulence and diarrhea with steatorrhea and the production of bulky
greasy foul-smelling stool

Giardia lamblia
[Infection is more common among day-care children, campers consuming
contaminated stream water, and homosexuals engaging in oral-anal contact]

Infection with different species results in dermal, mucocutaneous, and visceral
forms of the disease

Leishmania spp.
[Dermal leishmaniasis is due to L. tropica, the mucocutaneous form is due to L.
braziliensis, and the most severe form, visceral leishmaniasis, is due to L.
donovani and can result in skin hyperpigmentation of kala-azar]

Transmitted by the sandfly, the amastigote stage survives and multiplies within

Leishmania spp.
[The only protozoan parasite capable of replication within the phagolysosomes of
reticuloendothelial cells]

Free-living flagellated amoeba, acquired by swimming in freshwater ponds,
causing a fulminant meningoencephalitis with death within a week

Naegleria fowleri
[Another free-living amoebum, Acanthamoeba castellani, causes less severe
disease, typically limited to corneal ulceration and keratitis]

Blackwater fever

Plasmodium falciparum
[Seen in P. falciparum malaria, in which infected cells are abnormally adherent
and cause thrombosis and ischemia with hemolysis, resulting in hemoglobinuria]

Transmitted by the female Anopheles mosquito, with infection of RBCs and

Plasmodium spp.
[An obligate intracellular parasite, Plasmodium is typically seen as ring- or
crescent-shaped forms within RBCs on a Giemsa-stained peripheral blood smear]

Some resistance to infection is provided to patients with sickle cell disease/trait,
glucose-6-phosphate dehydrogenase deficiency, and thalassemia

Plasmodium spp.
[Symptoms of malaria include cyclic fevers (every 48 hr = P. falciparum, every 72
hr = P. malariea), headache, anemia]

Exposure of nonimmune mothers results in fetal transmission with the potential
for stillbirth and intracerebral calcifications

Toxoplasma gondii
[Infection may be acquired from cysts in raw or undercooked meat or
aerosolization of infected cat feces from litter boxes]

Usually asymptomatic in immunocompetent individuals, infection in an AIDS
patient can result in fulminant, life-threatening encephalitis

Toxoplasma gondii
[Visualized radiographically as a ring-enhancing mass on CT scan; other
ring-enhancing masses include cerebral abscess and Glioblastoma multiforme]

A common cause of vaginitis, it often presents with vulvo-vaginal pruritis, with a
profuse frothy discharge

Trichomonas vaginalis
[Causes strawberry mucosa, spotty reddening and edema of the affected mucosa]

Identified as pear-shaped, flagellated trophozoites with undulating movements
on a wet-mount slide of vaginal or urethral discharge

Trichomonas vaginalis
[Typically a sexually transmitted disease, growth is associated with an
abnormally alkaline pH of the vagina]

Transmitted by the tsetse fly, this protozoa causes African sleeping sickness,
characterized by cyclic fevers, encephalitis, slurred speech, and somnolence

Trypanosoma brucei
[The organism evades the immune system by genetic rearrangement of its
variable surface glycoprotein (VSG)]

Can destroy the myenteric plexus, resulting in mega-esophagus and megacolon

Trypanosoma cruzi
[Transmitted by the droppings of the reduviid bug ("kissing bug"), often with the
initial development of unilateral swelling of the eyelids (Romana's sign)]

A major cause of heart disease in Central and South America

Trypanosoma cruzi
[Acute forms of Chagas disease lead to direct invasion of the myocardium with
inflammation; the chronic forms of disease involve autoimmune destruction with
the development of dilated cardiomyopathy with life-threatening arrhythmias]

Chronic infection with this hookworm constitutes an important cause of anemia

Ancylostoma duodenale ("hookworm")

[Leads to iron deficiency anemia because each worm consumes as much as 0.25
ml blood/day]

Migration of larval nematodes below the skin results in serpiginous urticarial
trails on the skin (Creeping eruptions)

Ancylostoma braziliense and other animal hookworms

[Infection is acquired by contact with sand-containing feces of dogs and cats]

Most common helminth infection in humans worldwide

Ascaris lumbricoides
[As much as of the world population is infected; infection causes GI
obstruction, granulomas of the biliary tree, liver abscesses, and hypersensitivity

Infection is associated with damage to the biliary tract and development of

Clonorchis sinensis
[Associated with the consumption of infected freshwater fish]

Infection can be associated with megaloblastic anemia

Diphyllobothrium latum
[This enormous fish tapeworm absorbs dietary vitamin B, resulting in B
deficiency in the host]

Removal of this nematode is traditionally accomplished by slowly twisting it
around a stick to remove it from beneath the skin

Dracunculus medinensis
[Infection is acquired by consuming water contaminated by the intermediate
host, the cyclops, a microscopic crustacean]

Larvae form large space-occupying hydatid cysts in the liver and lung, and
leakage of fluid can result in anaphylaxis

Echinococcus granulosus (dog tapeworm)

[Because herbivores such as sheep are usually an intermediate host for the dog
tapeworm, infection commonly presents in the context of a sheep farmer with
many sheepdogs]

Causes perianal pruritis, diagnosis
confirmed by the recovery of eggs from the anus with scotch tape

Enterobius vermicularis (pinworm)

[Most common helminth infection in the United States and often associated with
day-care institutions]

Infection results in subcutaneous "caliber/calabar" swellings and can be seen
migrating across the eye beneath the conjunctiva

Loa loa filariasis

[Infection is transmitted by the bite of a mango fly, Chrysops]

Endemic to Africa, especially along river basins, infection can result in River

Oncocerca volvulus
[Transmitted by the blackfly, this nematode also causes loss of elasticity of the
skin with significant dependent edema (i.e. hanging groin)]

Infection of the bladder is associated with the development of squamous cell
carcinoma of the bladder

Schistosoma hematobium
[Endemic to Egypt and Sudan and associated with wading through moist soil
while barefoot; diagnosis is confirmed by finding spherical eggs with a terminal
spine in the urine]

The smallest of all intestinal nematodes, high worm burden is possibly the result
of autoinfection

Strongyloides stercoralis
[It is the only intestinal nematode capable of completing its life cycle within the
human host]

One of the most common cestode infections in the United States, and associated
with the consumption of improperly cooked contaminated beef

Taenia saginata (beef tapeworm)

[Usually results in vague abdominal pain, although the tapeworm can grow to
several meters in length]

Infection with the larval form of this tapeworm from feces-contaminated water
can lead to cysticercosis

Taenia solium (pork tapeworm)

[Results in the growth of the larvae in brain, resulting in a Swiss cheese
appearance of the cerebral hemispheres]

Accidental transmission of these nematodes from pet feces (in sandboxes or on
sandy beaches) results in Visceral larva migrans

Toxocara canis and Toxocara cati

[Symptoms include eosinophilia, pneumonitis, and vision loss]

Infection is acquired by consuming cysts in undercooked, contaminated pork

Trichinella spiralis
[Infection results in flu-like symptoms, diarrhea, myalgias, and periorbital

Rectal prolapse is a potential complication in children resulting from straining
during defecation with infection of this nematode

Trichuris trichiura (whipworm)

[Diagnosis is based on finding bile-stained, barrel-shaped eggs with polar plugs]

Filariasis (Elephantiasis)

Wucheria bancrofti
[Organism causes obstruction of lymph vessels resulting in edema with swelling
of the legs and genitalia]

DNA Viruses:
Major cause of epidemic conjunctivitis (pink eye)

[Various subtypes are also associated with pharyngitis and gastroenteritis]

DNA Viruses:
Major cause of retinitis, leading to blindness in an immunocompromised patient

Cytomegalovirus (CMV)
[Can cause life-threatening interstitial pneumonia in such patients and
heterophil-negative infectious mononucleosis in immunocompromised

DNA Viruses:
Most common viral cause of congenital abnormalities in the United States

Cytomegalovirus (CMV)
[Infected cells display characteristic "owl eye" intranuclear viral inclusions]

DNA Viruses:
Infection results in the production of heterophil antibodies

Epstein-Barr Virus (EBV)

[Viral infection results in the polyclonal activation of B cells with the production
of antibodies to sheep RBCs (heterophil antibodies) that can be detected with the
monospot test]

DNA Viruses:
Major cause of infectious mononucleosis

Epstein-Barr Virus (EBV)

[Characterized by weeks of fever, malaise, and lymphadenopathy, the peripheral
blood contains an abundance of atypical lymphs, which are T cells that recognize
EBV-infected cells]

DNA Viruses:
Infection is associated with Burkitt's lymphoma and nasopharyngeal carcinoma

Epstein-Barr virus (EBV)

[Burkitt's lymphoma is more commonly associated with EBV in Africa;
nasopharyngeal carcinoma is more common in patients from Asia]

DNA Viruses:
This virus encodes an RNA-dependent DNA polymerase (reverse transcriptase)

Hepatitis B Virus (HBV)

[The virus produces its DNA genome through a single mRNA transcript, requiring
the presence of a reverse transcriptase]

DNA Viruses:
Appear in the serum as Dane particles and as large amounts of filaments of
excess surface antigen

Hepatitis B Virus (HBV)

[The surface antigen (HBsAg) is produced by recombinant DNA technology and is
given as a vaccine]

DNA Viruses:
A major cause of hepatocellular carcinoma worldwide

Hepatitis B Virus (HBV)

[Although less likely to progress to either cirrhosis or carcinoma than is HCV, the
worldwide prevalence especially in Africa makes HBV the leading cause]

DNA Viruses:
Major cause of sexually transmitted and vertically transmitted hepatitis

Hepatitis B Virus (HBV)

[Histologically, infected cells appear as ground glass hepatocytes because of the
presence of excess surface antigen within the cytoplasm]

DNA Viruses:
Infection with this virus is a leading cause of corneal blindness in the United

Herpes simplex virus-1 (HSV-1)

[Keratoconjunctivitis results in dendritic ulcers that can be visualized with
fluorescein staining]

DNA Viruses:
Infection results in Cowdry Type A intranuclear inclusions and multinucleated
giant cells

Herpes simplex virus-1 (HSV-1)

[One of the most common human viral infections, the virus enters broken skin
and remains latent in the trigeminal ganglion, with spontaneous reactivation
triggered by axonal injury, stress, or UV light]

DNA Viruses:
Leading cause of sporadic encephalitis in the United States

Herpes simplex virus-1 (HSV-1)

[Commonly affects the temporal lobe]

DNA Viruses:
Most common cause of vesiculo-ulcerative lesions on the penis or vagina

Herpes simplex virus-2 (HSV-2)

[Reactivation of the virus is common because the virus remains latent in the
lumbar and sacral ganglia; detected using the Tzanck test]

DNA Viruses:
Infection causes Roseola infantum or Sixth disease

Herpes Virus 6
[A common, mild, childhood disease characterized by high fever and a skin rash]

DNA Viruses:
Causes cranberry-pigmented lesions on AIDS patients

Herpes Virus 8
[Kaposi sarcoma is a tumor of blood vessels characterized by a disarray of
vascular channels filled with RBCs]

DNA Viruses:
Infection is linked to premalignant lesions on the vulva, cervix, penis, and anus

Human papilloma virus (HPV)

[Viral oncoprotein E6 binds to p53 and viral oncoprotein E7 binds to Rb,
stimulating infected cells to undergo uncontrolled growth]

DNA Viruses:
Infection of keratinized tissue results in the formation of warts on the hands and

Human papilloma virus (HPV)

[Typically caused by infection with HPV 1-4, with the development of warts on
the hands (Verruca Palmaris) and feet [Verruca Plantaris)]

DNA Viruses:
Infection causes cauliflower-like lesions on the external genitals or perianal areas

Human Papilloma Virus (HPV)

[Condyloma acuminatum is microscopically characterized by the presence of
vacuolated infected cells, termed koilocytes]

DNA Viruses:
Reactivation of latent viral infection in immunocompromised patients can result
in Progressive multifocal leukoencephalopathy (PML)

JC Virus
[This polyomavirus causes foci of demyelination surrounded by oligodendrocytes
with viral inclusions]

DNA Viruses:
This contagious virus causes benign epithelial tumors that appear as pearly,
umbilicated nodules with a central caseous plug

Molluscum contagiosum
[These lesions caused by the pox virus occur as clusters on the trunk, genitalia,
and extremities; it is transmitted by towels, barbers, swimming pools, and sexual

DNA Viruses:
Causes aplastic crisis in patients with sickle cell anemia, thalassemias, and
acquired hemolytic anemias

Parvovirus B19
[Virion replicates best in rapidly dividing erythroblasts, resulting in cell lysis]

DNA Viruses:
Infection of a child results in a "slapped cheek" appearance

Parvovirus B19
[This single-stranded DNA virus causes Erythema infectiosum or Fifth disease]

DNA Viruses:
The only DNA virus that replicates solely in the cytoplasm and that carries its
own DNA-dependent polymerases

[The largest of all viruses, it appears brick-shaped by electron microscopy, and
causes characteristic Guarnieri inclusion bodies when replicating in cells]

DNA Viruses:
Found as a contaminant in preparations of polio vaccines produced in monkey
cell culture

[This polyoma virus is typically a simian virus, which can cause tumors in mice,
although no pathogenic effects have been reported in humans]

DNA Viruses:
Causes chickenpox upon initial infection, and shingles upon reactivation

Varicella-zoster virus (VZV)

[The only herpes virus with a live attenuated vaccine; reactivation most
commonly occurs along the dermatomal distribution of the ophthalmic division
of the trigeminal nerve]

DNA Viruses:
Infection results in the successive appearance of macules, papules, vesicles, and
crusts all seen simultaneously

Varicella-zoster virus (VZV)

[Severe infection can result in pneumonia with multinucleated giant cells]

DNA Viruses:
Associated with Reye syndrome when the accompanying fever is treated with

Varicella-zoster virus (VZV)

[Reye syndrome is an acute encephalopathy associated with fatty infiltration of
the liver, which is often fatal]

RNA Viruses:
Group of Togaviruses transmitted by mosquitoes leading to encephalitis

[This genus includes Eastern equine encephalitis virus (EEE), Western equine
encephalitis virus (WEE), and Venezuelan equine encephalitis (VEE)]

RNA Viruses:
A grouping of viruses that are transmitted by mosquitoes and ticks

[The group contains members of the Flavavirus family, Togavirus family, and
Bunyavirus family]

RNA Viruses:
Only bunyavirus member causing diseases endemic to the United States

California encephalitis virus

(including La Crosse virus)
[Results in a mild encephalitis, sometimes only meningitis]

RNA Viruses:
Causes pleurodynia (Bornholm disease)

Coxsackie B virus
[Sudden onset of stabbing chest pain with waxing and waning symptoms]

RNA Viruses:
Most common cause of viral myocarditis

Coxsackie B Virus
[Usually self-limiting, but may cause fatal arrhythmias or lead to dilated

RNA Viruses:
Causes herpangina

[Discrete vesicles on the throat and tongue with pain and difficulty swallowing]

RNA Viruses:
Infection may result in destruction of the pancreas with resultant
insulin-dependent diabetes mellitus

Coxsackieviruses B3 and B4
[May be due to molecular mimicry owing to shared antigens between virus and
pancreatic beta cells]

RNA Viruses:
Causes a severe hemorrhagic fever with outbreaks in Zaire and Sudan

Ebola virus
[Another filovirus family member, Marburg virus, has been associated with
infection of laboratory personnel working with monkey tissue]

RNA Viruses:
Infection leads to severe hemorrhage and renal failure

[A member of the Bunyavirus family with three segments of RNA]

RNA Viruses:
Infection is associated with ingestion of raw shellfish from fecally contaminated

Hepatitis A virus (HAV)

[The virus is transmitted via the fecal/oral route and causes an acute hepatitis
with no chronic carrier state]

RNA Viruses:
Major cause of post-transfusion hepatitis

Hepatitis C virus (HCV)

[This Flavavirus often results initially in subclinical infection although it is a major
cause of chronic hepatitis and cirrhosis in the United States; it is the hepatitis
virus most likely to result in hepatocellular carcinoma]

RNA Viruses:
Replication-deficient virus, requiring the presence of hepatitis B virus for
productive infection

Hepatitis D virus (HDV)

[The HDV viral particle, known as the Dane particle, requires packaging into
hepatitis B surface antigen to be infectious]

RNA Viruses:
Infection is associated with a high mortality rate in infected pregnant women

Hepatitis E virus (HEV)

[This Calcivirus is transmitted by the fecal/oral route, as with hepatitis A, and is
most prevalent in developing nations]

RNA Viruses:
Infection leads to destruction of T cells, with the development of life-threatening
opportutnistic infections

Human immunodeficiency virus (HIV)

[Opportunistic infections include CMV infection, Kaposi sarcoma, Pneumocystis
carinii, Toxoplasma gondii, and Mycobacterium avium-intracellulare]

RNA Viruses:
Virus binds to CD4+ cells via viral glycorotein gp120

Human immunodeficiency virus (HIV)

[Entry of virus requires the presence of chemokine receptors CCR5 on
monocyte/macrophages or CXCR4 on T lymphocytes]

RNA Viruses:
Retrovirus that causes oncogenic transformation of CD4+ T cells

Human T-cell lymphotropic virus-1 (HTLV-1)

[This virus, related to HIV, is endemic to Japan and the Caribbean basin, and also
causes Tropical spastic paraparesis]

RNA Viruses:
Treatment with salicylates for this viral cause of respiratory symptoms may result
in Reye syndrome in children

Influenza virus (Orthomyxovirus)

[In children, this virus can also cause croup, otitis media, muscle aches, and a
high fever; influenza and retroviruses are the only RNA viruses to replicate in the

RNA Viruses:
Changes in the viral surface proteins resulting from point mutations;
reassortment of genome segments result in epidemics and pandemics

Influenza virus (orthomyxovirus)

[Point mutations in viral hemagglutinin (HA) or neuraminidase (NA) result in
antigen drift, whereas reassortment of genes results in antigenic shifts]

RNA Viruses:
Major viral cause of pneumonia, and infection typically predisposes to secondary
bacterial pneumonia

Influenza virus (orthomyyxovirus)

[Decrease in respiratory mucosal viscosity by viral neuraminidase and destruction
of the respiratory epithelium lower the resistance to bacterial superinfection by
Staphylococcus spp., Streptococcus spp., and Haemophilus spp. infection]

RNA Viruses:
Infection has been associated with subacute sclerosing panencephalitis (SSPE)

Measles virus
[Caused by a defective virus encoding a defective M protein]

RNA Viruses:
Infection leads to an immune-mediated maculopapular rash on the head, trunk,
and limbs

Measles virus
[The presence of Koplik spots, small bluish-white ulcerations on the oral
mucosa, are pathognomonic]

RNA Viruses:
Giant-cell pneumonia and encephalomyelitis are potential complications

Measles virus
[Vaccination for this previously common viral infection is included in the MMR
vaccine, along with mumps and rubella]

RNA Viruses:
Infection can result in orchitis, which can lead to sterility

Mumps virus
[Orchitis complicates parotidits in 20% of infected males]

RNA Viruses:
Infection results in swelling of one or both parotids

Mumps virus
[May result in aseptic meningitis and pancreatitis]

RNA Viruses:
Major agent of epidemic gastroenteritis in adults

Norwalk agent
[Outbreaks of this Calcivirus are common in institutional settings and on cruise

RNA Viruses:
Leading cause of croup

Parainfluenza virus
[Also known as laryngotracheobronchitis, obstruction of the larynx results in a
characteristic seal-bark cough]

RNA Viruses:
Infection leads to the destruction of the cells of the anterior horn of the spinal

[Viral infection with this picornavirus can lead to denervation atrophy of
innervated muscles with flaccid paralysis]

RNA Viruses:
Infection is associated with an aversion to water, foaming at the mouth, and
choking (hydrophobia)

Rabies virus
["Bullet-shaped" virion can be seen by electron microscopy; causes intracellular
viral inclusions in infected cells known as Negri bodies]

RNA Viruses:
Only virus for which postexposure vaccination is indicated

Rabies virus
[Long incubation period allows for the development of a protective immune
response, without which CNS symptoms lead invariably to death]

RNA Viruses:
Infection is associated with symptoms of sympathetic over-reactivity

Rabies virus
[Virus binds to the nicotinic acetylcholine receptor]

RNA Viruses:
Most important cause of lower respiratory tract infection in infants

Respiratory syncytial virus (RSV)

[Virally infected cells often form multinucleated syncytia]

RNA Viruses:
Virion contains two identical strands of positive RNA (diploid-like genome)

[The virion also carries and RNA-dependent RNA polymerase, a reverse
transcriptase, and an integrase for integration into the host cell genome]

RNA Viruses:
Major cause of upper respiratory tract infections in humans

[This picornavirus binds and enters epithelial cells via attachment to ICAM-1 and
replicates best at 33C, explaining its predilection for the mucosa of the

RNA Viruses:
Major cause of diarrhea (gastroenteritis) in young children

[This reovirus contains 10-12 segments of dsRNA within two concentric capsids]

RNA Viruses:
Teratogenic virus leading to congenital defects of the heart, brain, and eye

Rubella virus
[A member of the TORCH group of infectious agents that are capable of crossing
the placenta and infecting the developing fetus]

RNA Viruses:
This cause of mosquito-borne encephalitis can also be transmitted via blood
transfusions and organ transplants, and causes life-threatening symptoms in
elderly and immunosuppressed patients

West Nile Virus

[Although first reported in Africa in the 1930's, the appearance of the Flavivirus
family was first reported in the United States in 1999; recent years have seen
large outbreaks with thousands of cases and nearly 200 deaths]

RNA Viruses:
Arbovirus that causes severe hepatitis with jaundice and severe gastrointestinal
hemorrhage with black vomit

Yellow fever virus

[Infection by this Flavivirus, transmitted by the Aedes mosquito, can be
prevented using a vaccine developed from the 17D strain]

A unique class of infectious agents that can result in Spongiform encephalitis

[Composed only of proteinaceous material, it is highly resistant to most forms of
sterilization and can be transmitted iatrogenically (e.g. surgical instruments,
cadaveric material), or from consuming contaminated meats]

Opportunistic infections common in AIDS patients:

Bacterial: Mycobacterium avium-intracellulare

Fungal: Pneumocystis carinii
Protozoal: Toxoplasma gondii & Cryptosporidium parvum
Viral: Cytomegalovirus (CMV) & Kaposi sarcoma virus

Major sexually transmitted diseases in the United States:

Bacterial: Chlamydia trachomatis & Neisseria gonorrhoeae

Protozoal: Trichomonas vaginalis
Viral: Herpes simplex virus-2 (HSV-2), Human Immunodeficiency virus (HIV) &
Human papilloma virus (HPV)

Major causes of meningitis:
Young adults?
Elderly (>60 years)?
AIDS patients?

Newborns: Streptococcus agalactiae & Escherichia coli

Children: Haemophilus influenzae
Young adults: Neisseria meningitidis
Elderly: Streptococcus pneumonia
AIDS patients: Cryptococcus neoformans

Major cause of pneumonia:
Children (6 weeks-18 years)?
Elderly (60 years)?
Alcoholics & IV drug users?
Cystic fibrosis patients?

Neonates: Streptococcus agalactiae & Escherichia coli

Children: Respiratory syncytial virus (RSV) & Streptococcus pneumoniae (<4
Adults: Mycoplasma pneumonia
Elderly: Streptococcus pneumoniae
Alcoholics & IV drug users: Klebsiella pneumonia
Post-viral: Haemophilus influenza
Cystic fibrosis patients: Pseudomonas aeruginosa

Common nosocomial infections associated with:
Urinary catheterizations?
Renal dialysis units?
Respiratory therapy equipment?
Water aerosols?

Newborns: Respiratory syncytial virus (RSV) & Cytomegalovirus (CMV)

Urinary catheterizations: Escherichia coli & Proteus spp.
Renal dialysis units: Hepatitis B virus (HBV)
Respiratory therapy equipment: Pseudomonas aeruginosa
Water aerosols: Legionella pneumophila

Major causes of endocarditis:
Subacute endocarditis?
Acute endocarditis?
IV drug users?
Patients with prosthetic valves?

Subacute endocarditis: Streptococcus viridans

Acute endocarditis: Staphylococcus aureus
IV drug users: Staphylococcus aureus
Patients with prosthetic valves: Staphylococcus epidermidis

Major causes of osteomyelitis:
General population?
Sexually active?
Drug users?
Sickle cell anemia patients?

General population: Staphylococcus aureus

Sexually active: Neisseria meningitidis
Drug users: Pseudomonas aeruginosa
Sickle cell anemia patients: Salmonella spp.

Organisms causing a watery diarrhea

Cryptosporidium parvum
Escherichia coli
Vibrio cholerae
Giardia lamblia
Norwalk Agent

Major causes of urinary tract infections

Escherichia coli (most common)

Enterococcus faecalis
Klebsiella pneumonia
Proteus mirabilis
Proteus vulgaris
Pseudomonas aeruginosa
Serratia marcescens
Staphylococcus saprophyticus

Organisms causing a bloody diarrhea (dysentery)

Campylobacter jejuni
Escherichia coli (enteroinvasive and enterohemorrhagic)
Salmonella spp.
Shigella dysenteriae
Entamoeba histolytica

Major causes of food poisoning

Bacillus cereus
Clostridium perfringens
Staphylococcus aureus
Vibrio parahaemolyticus

Major cause of transplacental neonatal infections

Toxoplasma gondii
Treponema pallidum
Rubella virus
Cytomegalovirus (CMV)
Herpes simplex virus (HSV)
Human immunodeficiency virus (HIV)
[Collectively known as the TORCH group, many of these infections can lead to
congenital defects if acquired in utero]

Major causes of transcervical neonatal infections (acquired by vaginal delivery)

Candida albicans
Escherichia coli
Listeria monocytogenes
Streptococcus agalactiae