Childhood Exanthems Rash starting on chestextremities Lysogenized Strep Species Sandpaper feel and Pastias Lines Cicumoralpalor + strawberry

tongue Syncytium formation Koplik spots, 3Cs HIGH Fever+ColdRash starting on facetrunk Confluent rash SubacuteSclerosingPanencephelitis Teratogenic to fetus PDA, transplacental LOW fever rash on face HSR IC rash Anemia Binds to globoside on erthyroid precursor cell Slap-cheek rash Hydropsfetalis Fever Recoveryrosey rash Dew drop on rose petal vesicular rash Ramsay hunt syndrome Aspirin use in children Guarnieri bodies All lesions same stage Vesicular rash on face and extremities, moves Inward Vaccina virus is live Scarlet Fever Strep Pyogenes (GAS) / Scarlet fever Scarlet fever Scarlet fever Measles (F spikefusion) Measles Measles Measles Measles Rubella rubella Rubella Parvo virus B19 Parvo virus B19 Parvo virus B19 Parvo virus B19 (5th disease/Erythemainfectiosum) Parvo virus B19 HHV 6 roseola Chicken pox Varicella Zoster Reyes Syndrome Variola Small pox (variola) Small pox Small pox

Respiratory Tract Infections Pharyngitis

M protein PYR test POS Nonexudativepharyngitis, poorly chlorinated pools Herpangina Jones Criteria, erythemamargination, subcut nodules Post-Strep Glomerulonephritis Infected B lymphocytes (Gp350) Downey Cells Grows on Paul Brunnell antigen Does not produce thymadinekinase

Strep Pyogenes Strep Pyogenes adenovirus Coxsackie A Rheumatic Fever Type III hypersensitivity, Strep pyo (GAS) Epstein Barr Virus EBV EBV EBV

Common Cold ICAM-1 Causes common cold AND otitis media Anti-bodies NOT protective (reinfections) Another bug causing Common cold Sinusitis and Otitis Media Bulging tympanic membrane No group specific carbohydrate, lancet shaped Quelling reaction POS Neufieldrxn, alpha hemolysis, neuraminidase Beta-lactam and Penicillin resistant, normal flora Allergic Rhinitis Non-septate, ribbon-like hyphae Epiglottitis Stridor, chocolate agar, Hib vaccine Lateral x-ray of neck PRP Diptheria Diptheria Toxin Pseudomembrane, Elek test, Bull neck High Iron levels / Low iron levels One-sided nasal discharge Cysteine-potassium-tellurite (grey/black colonies) Whooping cough DPT vaccine / DaPT Pertussis toxin More Respiratory Dx Seals bark cough, non systemic Dx, HI Steeple sign Parotitis and Orchitis Systemic unlike croup, HA peplomer No hemagglutinin, G protein Rales andsubsternalretractions Oseltamavir HA an NA spikes, fusion at acid pH Binds to ACE receptor Bipolar staining, SW US, cold enrichment, productive cough, buboes Rodents through urine droppings and saliva, pul edema, segmented genome

Rhinovirus receptor on host cell Rhinovirus Coronavirus adenovirus

Bacterial infection- tx with amoxcillin Strep. Pneumoniae Strep. Pneumoniae Strep pneumoniae MoraxallaCatarhalis

Rhizopus and Mucor

HIB HIB HIB

ADP ribosylating A-B toxin, inactivates EF2 Diptheria Repressed Diptheria toxin / NON-repressed Nasal Diptheria CorneybacteriumDiptheriae

Bordatellapertussis DPT= whole cell inactiveDaPT= multivalent acellular Increase cAMP

croup Croup Mumps mumps RSV RSV Neuramidase inhibitor (TamiFlu) Influenza virus SARS Y. pestis (pneumonic plague) Hantavirus

Pneumonia Empyema, protein A, typical Hospital Acquired Pneumona Typical COPD and CF pts, purulent sputum, pyoverdina, nodular infiltrates Like pseudo but no green pigments Lipid A, bacterial static agents, chronic puldx Currant Jelly Comm Acquired Atypical Mulberry / fried egg, Cold agg BYCE agar, no GI manifestations Minor symptoms but massive infiltrates on x-ray Occupational Pneumonias (atypical) Widened mediastinum, string of perals Forshay test POS, rabbits, cystein Birds and poultry, paired sera Unpasteurized milk, slaughterhouse, Weil felixneg Regional pneumonia Caves / Bats Coin Lesions Broad based budding yeast Spherules in specimen Opportunistic Pneumonia Rounded cup-shaped organism Cup and saucer, honeycomb Weakly acid fast Fungus balls Septatehyphae, allergy- RAST Acute lymphocytic leukemia Sulfer granules / molar tooth colonies Parasites and some extra Serpiginousurticarial rash Tachepnia, tachycardia, hypotension Grape-like clusters in sputum Panton-Valentine Leukocidin Gram NEG spore former

s. aureus (hospital acquired)

Pseudomonas Burkholderia E. coli Klebsiella

Mycoplasma pneumonia Legionella Chalmydophilia pneumonia

Anthrax FrancisellaTuleremia Chlamydophilapsittaci Coxiellaburnetti

Histoplasmosis Histoplasmosis Blastomycosis Coccidiodes

PneumocysticJeroveci P. jiroveci N. asteroides Aspergillus Aspergillus Actinomycesisraelii ActinomycosisIsraelii

Strongloidiasis Hanta Virus StaphAureus StaphAureus CoxiellaBurnetti

Skin and Soft tissue Infections

With sharp borders, M protein Without well demarcated borders Protein A Exotoxin A, burn pts Pseudohyphae, Diabetes Dental work CATS, regional lymphadenopathy, Tox A pyodermas Cats, Warthin Starry silver stain, HIV Weakly acid fast stain, nodular lymphangitis Highly contagious vesicles (yellow/brown) Positive Nikolsky sign, TSST super Ag Toxic shock Toxin- super ag, organ failure Fluid filled bullae, No gas Alpha toxin, Naglerrxn, egg yolk agar, GAS, creptius tissue Marine water, RTX toxin Rabbits, ulcers, cysteine Agar Bite of sand fly, rodents, ulcerating skin sore Lowenstein Jensen media, aquariums, salt water Cigar shaped, rose thorns, nod lymphangitis Purple to black nectroticeschar Sheep, solitary lesion- red to violet Well circumscribed lesion, reddish, combo Abx Koilcytic cells Wrestler, Henderson Patterson bodies Transplacental, Tzanck Pruritic, Woods lamp Nonpruitic, azelic acid Group D positive, intra-abd abscess, ENT Surgical patients (abd surgery), BBE, no lipid A

Ersipelas (Strep pyo) Erysipelothrixrhusiopathiae, erysipeloid Staphaureus (Folliculitis) Pseudomonas (Folliculitis) Candida Actinomycesisraelii Pasteurella Staphaureus Bartonella Nocardiabrasiliensis S. aureus, strep pyo (impetigo) S. aureus Scalded skin syndrome Strep pyo GAS Strep pyo (necrotitizingfascitis) Clostridium perfringes Necrotixingfasciitis Francisellatularensis Leishmania MOTTs Sporothrizschenckii Bacillus anthracis Orf virus Pseudomonas HPV Molluscumcontagiousum HSV Dermatophytes Malasseziafurfur Enterococcusfaecalis Bacteroidisfragilis

Ocular infections Stye Purulent, mucopurulent Serosanquineous Most common purulent conjunctivitis, PRP, X/V S. aureus Bacterial infection Viral Haeminfluenzae

Most common nonpurulent conjunctivitis Dendritickeratitis Cereolysin, rapid progession Hot tubs, ring infiltrates, slow McCoy Cells, leading cause of blindness Progresses from keratitis to endophthamitis Fluff ball Post transplant pt Felines, pregnant woman, ring enhancing lesions Reduvid bug, poor socioeconomic

adenovirus HSV Bacillus cereus (Keratitis) Acanthamoeba* Chlamydia trachomatis P aero and B cereus Candida endophthamitis CMV (retinitis) Toxiplasmagondii (retinitis) T. cruzi (retinitis)

Nervous System Infections Bac Meningitis Infants 0-3 months Children 3 mo-6 yrs 6 yrs+ E.coli Neisseria meningitis Strep pneumo (most common)

Brudinski / Kernig Sign, rash Camp test positive, penicillin G Unpasteurized milk pdts, neonates, escapes Pigeon droppings Tick bite, spirochete, bulls eye rash Heated swimming pool / hot tub / lake Negri body, G protein spikes, hydrophobia Oligodendrocytes and astrocytes Drum stick / tennis racquet appearance on culture Lepromin skin test POS, rash Lepromin skin test NEG, humoral, nodular lesions, eye Tsetse fly Intermittent fever Winterbottom sign

NeiserriaMeningitis Strep agalactae (Strep B) Listeria Cryptococcus neoformans Borreliaburgdorferi (lymedx) NaegleriaFowleri (brain-eating amoeba), PAM Rabies JC virus (Progressive multivocalleuko) ClostirdiumTetani Tuberculoid leprosy Lepromatous leprosy Trypnasomabrucei Trypnasomabrucei Trypnasomabrucei swollen lymph nodes visible enlargement of the glands of the posterior cervical region Prion diseases Cruetzfeldt-Jacob

Beta-pleated sheets Amyloid tangles

Genitourinary Infections White blood cell casts in urine Pyelonephritis

High pH + smell of ammonia Noscomia UTI Urease production Uncomplicated UTI Complicated UTI Sexually active women, 2nd cause of UTI Cystitis and pyelonephritis, P fimbre, acetate Young sexually active women, negative on salt agar Hospitalization, catheteriation, MDR Struvite stones, non lactose fermenter, nephrolithiasis Renal transplant, hemorrhagic cystitis, ureteralstenosis White gray discharge, clue cells, whiff test Thick curd/cottage cheese Strawberry cervix, smelling greenish foamy discharge Most common cause of urethritis and cervicitis Fitz hughcurtis syndrome, violin string, thick and creamy, Thayer martin Reiters syndrome, inclusion bodies, erythromycin, THIN, fitzhughcurtis Cell wallless, mycoplasma, fried egg look Painless hard ulcer with raised borders Nonspecific test VDRL, RPR-cardiolipin Specific test FTA-ABS Damage to teeth and long bones, infection across placenta Granulamatous lesion, painless ulcers, hard Endemic syphilis, Bejel Gummas, Yaws Pinta, depigmentation LOS CW, painful genital ulcercations, soft chncres Homosexual men in US and Europe, pseudo buboes, plainless, beefy red open sores, Donovan bodies

Proteus S. saprophyticus Proteus E coli and S. sapro E. coli, klebsiella, proteus, enterococcus, pseudomonas S. sapro E coli S. saphro Klebsiella Proteus BK virus Gardenerella (gram variable), BV Candida Trichomoniasis Chlamydia trachomatis Gonorrhea Chlamydia trachomatis Ureaplasma Syphilis Syphilis Syphilis (confirmatory) Congenital syphillis Gunmmatous syphilis Syphillisendemicum Syphilis pertenue Syphilis carateum Haemophilusducreyi (Chancroid) Granulomainguinale (Calymmatobacgranulomatis)

Gp120, CCR5, nonsyncytial- macrophage Gp120, CXCR4- syncytia inducing-T cells Protease inhibitors (HAART) Inhibit HIV integration- stop integrase activity Fusion inhibitors block g41- (Envelope) Dental, mixed alpha and gamma hemolysis Invasive procedures, fever, murmur Indwelling lines

Circulatory HIV HIV HIV HIV HIV Strep viridans (endocarditis) Stachspp (endocarditis) Staph epidermis (endocarditis)

IDUs, vegetiations on triscuspid Slow growing, fastidious, opportunistic Megaesophagus, megacolon, Romanas sign Cause both pericarditis and myocarditis Bind to CAR, myocarditis Artherosclerosis, hide in macrophages, resp transmission Heterophile positive, Paul Bunnell Ag Heterophile negative, no pharyngeal exudate Duffy Ag on host RBC PfEMP1 Ag on parasite Latent liver form hypnozoite Type III HSR India Signet ring Maltese cross (tetrad) Renal failure, fatal in asplenic Cape cod, hard ticks, trasviral transmission Fever, headache and rash triad Hypotension and shock, relapsing fever, human lice Ticks, monocytes, systemic neutrophils

Staphaureus (endocarditis) HACEK (endocarditis) T. cruzi (myocarditis) Coxsackie B Adenovirus Chlamydia pneumo EBV CMV P vivax P falicparum P vivax and P ovale Malaria P vivax Malaria Babesia Babesia RickettsiaRickettsia RickettsiaRickettsia Borreliarecurrentis Ehrlichiachaffeensis * Anasplamaphagocytophilum

GI tract Esophagitis Yellow white mucosal plaques, adherent ulcers, mid eso Confluent ulcers, volcanic ulcers, distal third Large, shallow ulcers, punched out, well circumscribed, mideso Candida HSV CMV

GI intoxications Cream filled donut, heat stable enterotoxin, TNF alpha, IFN gamma, 1-6 hrs (onset) Root veggies, fried rice and pasta, cerulide toxin

B cereus- intoxication, emetic

Heat labile toxin, enterotoxin (cAMP), vanilla sauce B cereus- diarrheal syndrome and milk Home canned foods- intoxication C. botulinum Honey- infection 12-72 hrs Meats poultry, gravy, 8-16hrs, heat labile, no fever C perferinges

Noninflammatory Diarrhea

LT- cAMP accumulates (cholera like), heat labile ST- cGMP- heat stable Stacked bricks, AAF, influx of Ca, EAST Newborns, Bfp, Tir, Intimin, pedestal like, destroy microvilli Contaminated food and water Improperly cooked seafood Raw oysters O1 and 0139, rice water stools, TCBS agar, loss of skin turgor, Cholera toxin-hypersecretion Explosive watery diarrhea Escapes phagosome Beaver no fever, campers, foul smelling, greaser PALCAM agar, black halo

ETEC EAEC EPEC V cholera V parahaemolyticus V vulnificus V cholera V parahaemolyticus Listeria Giardia Listeria

String test Oocysts infected upon excretion, contaminated water, farm workers, non autoflor Oocystes need days or weeks after passed in bowel, autoflor, Guatemalan raspberries In envt for 2-3 days before infective, relaspse occurs, autoflor, slender, oval Star of david, cruise ship, institutional outbreaks, reinfection Fever, vomit, diarrhea, coryza and cough, #1 diarrhea in children, wheel like Rotateq- reassorted virus 2nd cause of dia, children and adults

Giardia Cryptosporidum Cyclospriasis Isospora belli Calicviridae Rotavirus Rotavirus Astrovirus

Inflammatory Diarrhea ShE1 and 2, HUS, Reiters syndrome, no black precip, non H2S producer H2S producer, systemic infections, invasion of intestinal mucsoa, increase in cAMP Colonization of GB, produces H2S, rose spots NO shiga like toxin, invasive, low dose, pink colonies on MacConkey- doesnt ferment sorbitol Shiga like toxin, Abx release toxin or dead bac High dose, Campy Bac, heat labile toxin similar to shiga toxin, foul smelling, tenesmus Mimics appendicitis Psuedomembranous colitis, AB toxin, LT Abx use Flask shaped lesion, RUQ pain, homosexual, fecal oral Metablastic anemia, cholecytitis, sushi Type 1 rxn Live attenuated virus Inactivated Hep A virus Dane particle, ds DNA, RT IFN alpha and Lamivudine Pegylated IFN and ribavirin flaviviridae picornaviridae calciviridae Ss negative

Shingella Salmonella non typhoidal Salmonella typi and paratyphi EIEC EHEC Camphylobacterjejuni Yersinaentercolitica, pseudotuberculosis C. difficule Entaoebahistolytica Diphyllobotheriumlatum (fish tapeworm) echinococcus Yellow fever Hep A Hep B Hep B Hep C Hep C and G Hep A Hep E Hep D

Emerging Dx India, mosquitos, joint edema and pain Mastomys Rat, urine or feces from rodents, back pain, bradycardia Deafness, Swollen baby syndrome

Chikungunya virus Lassa virus Lassa virus

Consumption of water (copecods), Dracunculus chorniccutenaouse ulcers Large infective dose, lymphedema, orchitis, Wucheriabancrofti epdidymitis, suppress TH1 Microfilariae in blood smear, no blindess, mango fly Loa loa Microfilariae in skin, leopard skin and lizard skin, blindness Black fly Onchocerciasis Onchocerciasis