PROTOZOA- AMOEBAS E. Histolytica N.

Floweri Acanthmoeba Balmuthia M

Pathogenic Amoeba Free living amoeba Free living amoeba Free living amoeba
Trophozoite Precyst Cyst Amoeboid Flagellate Cyst Trophozoite Cyst Trophozoite Cyst
Trophozoite Trophozoite

Morphology

- Amoeba shape
- Pseudopodia ` - Quadri
- RBC ingested nucleate - Lophopodia - 2 flagella - Uninucleate - Acanthopodia - Uninucleate - Branching shape - Uninucleate
- Ingestion of contaminated food & - Swimming in fresh water bodies - Inhalation of aerosol or dust - Inhalation of aerosol or dust
water
MOT

- Quadrinucleate cyst - Amoeboid trophozoite - Trophozoite - Trophozoite

Infective form

- Only 1 has → def. host →Man - Only 1 host →Man - Only 1 host →Man - Only 1 host →Man
- Excystation occurs in caecum - CNS involved - CNS and Eye involved - CNS involved
Life cycle

Intestinal Amoebiasis - PAM (Primary Amoebic - GAE (Granulomatous Amoebic - GAE (Granulomatous Amoebic
Flask shaped under in caecum Meningoencephalitis) encephalitis) encephalitis)
Diarrhoea - Keratitis
Pathogenesis Extra intestinal Amoebiasis
- Liver abscess (Post sup.
Surface)
- Red- brown Anchovy sauce

- Direct Microscopy - Direct Microscopy - Direct Microscopy - Direct Microscopy

- Serology - Histology - Histology - Histology
- Molecular methods → (PCR)
Lab diagnosis - Radiology (For liver abscess)

- DOC= Metronidazole/ Tinidazole - Amphotericin B - Ketoconazole -

- Sx for hepatic abscess - Penicillin
T/t Prophylaxis - Chloramphenicol

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PROTOZOA- FLAGILATES G. Lamblia T. Vaginalis
Only Protozoa in small intestine (Jejunum)
Tropozoite Cyst - Only trophozoite - Pear shaped
- Tear drop/ - Oval - No Cyst form - 4 anterior flagella
Badminton - Quadrinucleate - Undulating memb.
racket/ tennis - Jerky movements
Morphology racket
- B/l symmetrical
- 4 pairs of flagella
- 2 nucleuses
- 2 axostyle

- Ingestion of contaminated food and water - Sexually

MOT
- Cyst - Trophozoite (there is no Cyst form)
Infective form

- Only 1 host → Man - Only 1 host →Man

Life cycle

Does not invade intestine, just attach on epithelial cell→ ♀ → Trichomoniasis/ strawberry Vagina/ Angry looking vagina
Malabsorption ♂→ Urethritis
Pathogenesis

- Specimen - Direct Microscopy (wet mount)

Stools - Direct Microscopy - Culture → CPLM medium
Duodenal aspirate - Serology - Serology
Lab diagnosis (Entero test) - Mol. methods - Mol. Methods
↓
Gelatine capsule with nylon
thread
DOC= Metronidazole/ Tinidazole - DOC= Metronidazole
T/t Prophylaxis
Treat both sexual partners simultaneously

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PROTOZOA- FLAGILATES T. Brucei T. Cruzi
Long Amastigote Trypomastigote
Trypomastigote form Intermediate
Short - Nucleus anterior to kinetoblast - Nucleus post to kinetoblast
- No flagella external - Flagella +
- Undulating memb +
Morphology

- Bite of Tsy-Tsy fly (Saliva Metacyclic trypomastigotes) - Bite of Reduviid bug (Faeces passed nearby)
↓
MOT Man itch
↓
faeces infects the wound
Metacyclic trypomastigote (for man) Metacyclic trypomastigote (for man)
Infective form Short trypomastigote (for Tsy-Tsy fly) Trypomastigotes (for Reduviid bug)

Def. host → Man Def. host → Man

2 Host 2 Host
Life cycle Int. host → Tse Tse fly (Genus glossina) Int. host → Reduviid bug

West African trypanosomiasis/ sleeping sickness South American trypanosomiasis/ Chagas disease
- Chancre
- CNS involved Acute Chronic
Pathogenesis - Sleepiness Chagoma Mega oesophagus
- Coma Romana Sign Mega colon
East African trypanosomiasis/ sleeping sickness
- Direct Microscopy - Direct Microscopy
- Serology - Serology
- Animal inoculation - Culture (NNN medium)
- Mol. methods
Lab diagnosis - Animal inoculation

- Early stages → Suramin/ Pentamidine - Nifurtimox and Benznidazole

- Late stages → Melarsoprol
T/t Prophylaxis

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PROTOZOA- PLASMODIUM P. Vivax P. Falciparum P. Malariae P. Ovale
V F M O
Mnemonic Very Fantastic Medical Officer
- Ring form - Mul. rings - Ring form - Ring form
(Single) (Single) (Single)

Early
Trophozoite Acole form
(headphone app.)

- Amoeboid form - Mul. rings - Band Form - Ring form

(Single)

Late Trophozoite

12-24 18-24 6-24 6-1

Meroszoite
in one Schizont
Spherical Crescent/ Spherical Spherical
Banana/ Sickle
shaped
Gametes

Schuffner’s dot Maurer’s dot Ziemann’s dots James dots

Dots

Young All Old Young

RBCs

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METAZOA- CESTODES D. Latum H. Nana E. granulosum
(Fish Tapeworm | Broad Tapeworm) (Dwarf Tapeworm) (Dog Tapeworm | Hydatid worm)
- Adult→ Scolex → -2 brothia + - Smallest tapeworm - Adult→ Scolex → - 4 suckers +
- No rostellum - - Adult→ Scolex → - 4 Suckers + - 1 Rostellum +
- No hooklet - - 1 Rostellum + - 2 rows hooklet +
3000 Strobila - 1 row hooklet + 3 Proglatids in strobila
- Egg → Bile stained + 200 Strobila - Egg → Bile stained +
- Not float in NaCl – - Egg → Bile stained – - Not float in NaCl –
Operculum seen - Float in NaCl + Contains hexacanth embryo
Morphology - Larva →1st , 2nd , 3rd stage Yolk granules seen - Larva → Hydatid cyst
- Larva →Crysticeroid

- Ingestion of undercooked Fish -Ingestion of contaminated food and water - Ingestion of contaminated food and water
- Auto infection
MOT

- 3rd stage Larva (Plerocercoid larva) - Egg - Egg

Infective form

Def. host- Man - 1 Host →def. →Man 2 Hosts - Def. host - Dog
3 Hosts – 1st Inf. - Cyclops - Reservoir→ Rodents Inf. host - Sheep, cattle, goat
2nd Int. - Fish Man is accidental host (dead end)
Life cycle

- Diarrhoea - Hymenolepiasis (diarrhoea) - Hydatid disease (Cyst in liver- unilocular)

- Pernicious anaemia (vit. B12 deficiency)
Pathogenesis

- Microscopy- Eggs in stools - Microscopy- Eggs in stools - Casoni test (skin test/type I H↑sen.
- Serology
- Radiology
Lab diagnosis

- DOC= Niclosamide & Praziquantel - DOC= Praziquantel - Sx→ Removal of Cyst

- DOC= Praziquantel and Albendazole
T/t

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METAZOA- CESTODES T. Solium T. Saginata
(Pork Tapeworm | Armed Tapeworm) (Beef Tapeworm | Unarmed Tapeworm)
- Adult→ Head → - 4 suckers+ - Adult→ Head → - 4 Suckers +
- 1 Rostellum + So called Armed - Rostellum – (so called unarmed)
- 2 row hooklet + - Hooklet –
Strobila – 800 Proglatids Strobila – 1000 Proglatids
- Egg → Bile stained + - Egg → Bile stained +
- Not float in NaCl – - Not float in NaCl -
Contain hexacanth embryo Contain hexacanth embryo
Morphology - Larva → Cysticercus cellulosae - Larva → Cysticercus bovis

- Ingestion of undercooked Pig -Ingestion of uncooked Beef

MOT

- Larva (Cysticercus) (for Man) - Larva (Cysticercus) (for Man)

- Egg (for Pig as well as man) - Egg (for Beef/ Cattle)
Infective form

Def. → Man 2 Hosts - Def. →Man

2 Hosts - Int.→ Beef/ Cattle
Int. → Pig (as well as Man)
Life cycle

- Intestinal Taeniasis (diarrhoea) - Intestinal Taeniasis (diarrhoea)

- Cysticercosis (if egg infects Man)
Pathogenesis

- Microscopy- Eggs in stools - Microscopy→ Eggs seen in stool

- Mol. methods - Molecular methods
- CT/ MRI/ X-Ray (for Cysticercosis)
Lab diagnosis

- Praziquantel= DOC - Praziquantel= DOC

- Excision (for Cysticercosis)
T/t

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METAZOA- NEMATODES A. Lumbricoides A. Duodenale N. Americanus
(Round worm) (Old world Hookworm) (New world Hookworm)
- Adult→ O→ - Adult→ 6 teeth - Adult→ 4 chitinous plates
O+ - Egg → No bile stained - - Egg → No bile stained -
- Egg → Fertilised→ Bile stain +, Float NaCl + - Float in NaCl + - Float in NaCl +
Unfertilised→ Bile stain +, Not Float NaCl- Contains 4 blastomeres Contains 4 blastomeres
- Larva → L1 to L4 - Larva → L1 to L4
- Larva → L1 to L4 L1= Rhabditiform L1= Rhabditiform
L3= Filariform L3= Filariform
Morphology

- Ingestion of contaminated food and water -Penetration through skin (walking bare foot on soil) -Penetration through skin (walking bare foot on soil)

MOT

- Egg containing Rhabditiform larva (L2) - 3rd stage larva= L3 = Filariform larva - 3rd stage larva= L3 = Filariform larva

Infective form

- Only 1 host→ def. host→ Man - Only 1 host→ def. host→ Man - Only 1 host→ def. host→ Man
- No int. host - No int. host - No int. host
Life cycle

- Adult worm→ diarrhoea, malnutrition - Adult worm→ diarrhoea, microcytic hypochromic - Adult worm→ diarrhoea, microcytic hypochromic
- Migrating larva- Loeffler’s synd. anemia anemia
Pathogenesis - Migrating larva→ Dermatitis - Migrating larva→ Dermatitis
Cutaneous larva migrations Cutaneous larva migrations
- Stool→ Adult worm or eggs seen - Microscopy Stools→ Adult worm or eggs - Microscopy Stools→ Adult worm or eggs
- Sputum→ Larva seen Duodenal aspirate→ Adult worm or Duodenal aspirate → Adult worm or
- Serology eggs eggs
Lab diagnosis - Serology - Serology

- Mebendazole= DOC - Mebendazole= DOC - Mebendazole= DOC

T/t

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METAZOA- NEMATODES S. Stercoralis E. Vermicularis T. Trichuris
(Military worm) (Thread worm | Pin worm | Seat worm)
- Adult→ O+ Ovi- viviparous - Adult→ O+ → 2000 eggs/day Trichina worm
Pathogenic worm O→→ dies after fertilisation
(O+ produce offspring without O→) - Egg → No bile stained -
O→ → Not seen - Float in saturated NaCl +
- Egg → Not detected in stools Contains tadpole larva
Hatch immediately after coming out
Morphology - Larva → L1 - L4

- Penetrating skin (walking barefoot on soil) - Ingestion of contaminated food and water - Ingestion of uncooked Pork
- Auto infection
MOT
- 3rd stage larva→ L3= Filariform larva - Embryonated eggs - 1st stage larva= L1
Infective form

- 1 host→ def. host→ Man - 1 host→ def. host→ Man - 1 host→ def. host→ Pig
- No int. host - No int. host - Man is accidental host (dead end)
Life cycle

Strongyloidiasis - Pruritis in perianal area - Trichinellosis

- Nocturnal enuresis
Pathogenesis Skin Pulmonary Int. Hyper infection - Vaginitis & urethritis
↓ ↓ ↓ ↓
Urticaria Bronchopneumonia Colitis Paralytic ileus
- Microscopy→ Stool→ L3 larva - Cellophase tape method - Muscle biopsy
- Serology - NIH swab method - Serology
Lab diagnosis - Bachman intradermal test (skin test)

- Thiabendazole= DOC - Mebendazole= DOC - Mebendazole= DOC

- Ivermectin
T/t

- Only ovi- viviparous worm→ Egg hatch immediately after

laying out
- Only Parthogenic worm→ Female produce off spring without
Extra Points O→
- Causes infections in HIV & immunocompromised

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 GPC Staph. Aureus Strep. Pyogens Pneumococcus
- Grape like clusters Hemolysis - Diplococci in pairs [Flame / Lanceolate shape]
+ → S. Aureus - Chain
Introduction and - Coagulase Sen- S. Epidermis α γ -Classification Based on Capsule - 90 different
Classification - → CoNS → Novobiocin
β types
Rest- S. Saprophyticus C Carbohydrate- 21 types- Lancefield (A-W)
Type A → M Protein- 100 types- Griffith
Cap Spore mot Cap Spore mot Cap Spore mot
- - - - - - + - -
Morphology - One capsule around each pair (Indian ink,
Quellung Rx)
- Nutrient agar – Oil Paint Appearance - Blood agar → β hemolysis - Blood agar →  hemolysis
- Blood agar –  Hemolysis - Sel med. → - Crystal violet blood agar Central umbonation
Culture - Milk agar- Golden Yellow Colonies - PNF med - Draughtsman or Carrom coin appearance.
- PPA agar – Pink Colonies - Transport med. → Pike’s med.
- Sel Med. – Ludlam’s media, Mannitol salt agar
- Catalase + (unlike strep.) - Catalase - →(unlike staph) - Bile solubility (Autolytic amidase)
Biochemical Rx - Coagulase + (unlike S. Epidermis and S. Saprophyticus) - PYR → + - Optochin sensitivity (unlike st. viridians)
- Bacitracin sensitive (unlike other streptococcus) - Inulin fermentation
- Toxins - Cytolytic – , , , , PV Toxins Capsulated – smooth – virulent
- Enterotoxin (Food Poisoning)
-Toxic shock syn. Toxin (TSST) Super Ag Hemolysin Pyrogenic Non capsulated – Rough – avirulent
- Exfoliative toxin (SSSS) - SLO (A, B, C)
Virulence factors - SLS - Super Ag S → R → Repeated subalture
Free Coagulase – Tube test - Erythrogenic R → S → Griffith
- Enzymes - Scarlet fever
Bound Coagulase- Slide test - Dick test
- Schultz Dale Phen
- Cutaneous inf. – Furuncles, Boils, Abscess Suppurative - Sore throat
- Toxins - Food Poisoning (enterotoxin) - Scarlet Fever
Pathogenesis - TSS (TSST) Pneumonia Meningitis Bacteraemia
- Resp. infection
SSSS (Exfoliative tox.) (Lobar &
Rheumatic Fever
Lobular both)
Non suppurative PSGN
- Bacteriophage typing (23 phage- 80/81 MC type) - Bacitracin susceptibility
Lab diagnosis - Dick test
- Schultz Charlton Rx
- DOC – Benzyl Penicillin - DOC → Penicillin - DOC → Penicillin
- MRSA - Vancomycin - If Penicillin allergy → Erythomycin - If Penicillin resist. → cephalosporin
- VRSA – Quinupristin, linezolid or cephalosporin Vaccine
- TSS – Clindamycin St. Agalactia Gp.B - Neonatal meningitis
T/t Prophylaxis - Food Poisoning – No antibiotic - Hippurate + Polyvalent (23 type) Conjugate
CAMP+
(with diphtheria & 7 type)
St. viridians () - Dental caries
SABE
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 GPB Corynebacterium Diphtheriae Bacillus Anthracis
- Klebs- Loeffler bacilli - Zoonotic disease (man infected secondarily)
- Angular (V/L)- Chinese letter/ cuneiform arrangement (green) - Cat. A Bioterrorism
Introduction - Met Granules/ Polar/ Babes-Ernst / Volutin granules (blue) - present in chains (Bamboo- stick app.)

Cap Spore Mot Cap (Polyglutamic) Spore (Central/ non bulging) Mot
Morphology - - - + + -
- Hiss serum water → turbidity Gravis - Daisy head - Nutrient agar → Medusa head/ Frosted glass
- Loeffler’s serum slope → Cream Col. – Int. - Frog’s egg - Gelatine stab → Inverter Fir app.
- Sel. Med. Telluride → Black col. ---------- Mitis - Poached egg - Solid Med with Pn→ String of Pearls app.
Tinsdale (cysteine- Black/brown) - Sel. Med → PLET
- Giemsa → Bac. purple, cap. red
Culture - Polychrome methylene blue → Mc Fadyean's reaction

- Ferment→ Glucose + Maltose - Duckering → destruction of spores in animal products

Biochemical Rx - H2S +
Toxin Toxin
- Exotoxin/ tox gene/ lysogenic conversion/ Beta phage - PA/ OF/ LF
- Heat labile Heat MOA - MOA → Stimulates Adenyl Cyclase → ↑CAMP
- Extremely potent - Toxoid Formalin Inhibit Protein Synth
Virulence factors - Fe is req. Acid pH

- Tissue→ Myocardium, adrenal, nerves

- Diphtheria is toxaemia (not bacteraemia) Cutaneous = Hide Porters disease

Local effects – Pseudo membrane Anthrax Pulmonary = Wool sooter’s disease
- Sys. Effects – Toxaemia Gastro inf.
Pathogenesis Complication- MC - myocarditis
2nd MC- toxic neuritis

Tox. St. → line of ppt. + -

- Virulence test → Eleks gel ppt.
Lab diagnosis Non Tox. St. → line of ppt. -

T/t Cases → Anti toxic + Antibiotic (Pn/Erythromycin) DOC = Doxycycline

Carrier → Antibiotic (Erythromycin) - Animal vaccine – sterne vaccine
T/t Prophylaxis Vaccine → DPT → 0.5ml, IM, 6 weeks

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 GPB CI. Perfringens Cl. Tetani Cl. Botulinum CI. difficile

Introduction

Cap Spore (Subterminal) Mot Cap Spore (Terminal) Mot Cap Spore (Subterminal) Mot Cap Spore (Terminal) Mot
Morphology + + - - + + - + + - + +
-Blood agar →Target (Double zones  + ) - Blood agar → Swarming/ Field’s tech. - Blood agar →  hemolysis
- RCM - Pink – (Saccharolytic) - RCM → Black (Proteolytic) - RCM → Black (Proteolytic)
- Egg – Yolk → Opalescence + - Egg- Yolk → Opalescence - - Egg Yolk → Opalescence +
Culture - Reverse CAMP +

- Sugar ferm → Acid + Gas - Sugar Ferm → Absent

- Litmus Milk- B→R - MR –
Stormy ferm - VP –
Biochemical Rx - H2S –

12 Toxins 2 Toxins 8 Toxins (A-G) 2 Toxin

- Exotoxin
4 Major 8 Minor Tetanolysin Tetanospasmin - Most toxic subs. Enterotoxin (A) Cytotoxin (B)
, , , i (hemolysin) (Neurotoxin) - Type A most potent Diarrhoea
↓ - Heat labile
Virulence factors - Lacithinase C MOA Blocks inhibitory GABA - Neurotoxin
- Gas gangrene - MOA → Block Production of Acetyl Ch.
- Nagler's Rx

Tetanus→ - Opisthotonus Food borne-Canned food Clostridium difficile ass. Colitis

Gas gang Food Poison Necrotising - Jaw lock Botulism Infant-Honey-Floppy Baby sy Antibiotic ass. Colitis (Pseudomemb)
Pathogenesis enteritis Wound

- Stool → toxin A or B +
Lab diagnosis - Stool → Toxin Prod. Difficale
- Pseudomemb In colon
- Control spasm - Intensive supportive therapy - Metronidazole = DOC
- Antibiotic= Pn + Metronidazole + - Maintain Airway - Antitoxin - Vancomycin = 2nd DOC
AminoG - Antitoxin - Antiserum
T/t Prophylaxis - Hyperbaric O2 - Antibiotic
- Immunisation

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 Vacc. → Tetanus toxoid

GNC Neisseria Meningitidis Neisseria Gonorrhoeae

- Diplococci - Diplococci
- Half-moon shaped - Kidney / Bean shaped
Introduction and - One cap. around each pair - No capsule
classification - Based on cup → 12 types → A, B, C, X, Y, Z, W-135, 29-E, H, I, K, L

Cap Spore Mot Cap Spore Mot

Morphology + - - - - -

- Blood agar → γ hemolysis Thayer martin / Thayer martin - Blood agar → γ hemolysis
Culture - Chocolate agar – Large colonies - Martin - Lewis - Chocolate agar/ Muller- Hilton agar – Large colonies
- Sel. Med. – New- York City Med - Sel. Med. → Thayer martin
- Catalase + - Catalase +
- Oxidase + - Oxidase +
Biochemical Rx - Ferment both Glucose + Maltose - Ferment only Glucose

- Cap. is must for virulence - Pilli is must for virulence

Virulence factors (Plasmid usually absent) (Plasmid usually +)

Meningitis Gonorrhoea

1st Stage 2nd Stage 3rd Stage Males Female O+ Adolescent Female Neonate
Pathogenesis Nasopharyngeal inf. Septicaemia Meningitis - Urethritis - Cervicitis - vaginitis Ophthalmia
- Watercan Perineum - Fitz- High Curtis Syn. Neonatorum
-

Lab diagnosis

DOX → 3rd gen. Cephalo. (Cefotaxime or Ceftriaxone ) Doc → Ceftriaxone

Chemoprophylaxis → Rifamycin (A, C) No vaccine available
-- Bivalent (A, C)
Immunoprophylaxis -Trivalent (A, C, W-135,)
T/t Prophylaxis Tetra (A, C, W-135, Y)
Not given < 2 Yr.

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 GNB Salmonella Vibrio
Robert Koch
A B Halophilic Non-halophilic
Typhoidal Non Typhoidal - V. Parahaemolyticus -V. Cholera
Introduction and - S. typhi - S. typhi nuriuss O1 Non O1 (O2 -200) - V. mimicus -Non O1 V. Cholera
classification - S. Paratyphi A, B, C - S. enteridis
Classical E1 tor

Ogawa, Inaba, Hikojima

Cap Spore mot Cap Spore mot
Morphology + - - - - +
(Peritrichous Flagella) (Except S. Gallorum & Pullorum) (Polar Flagella) (Fish in stream/ swarm of gnat)
- Nut. agar - translucent
- Blood agar - γ hemolysis
- McConkey - Pale Transport Enrichment Selective
- Sel. - DCA- Yellow - VR - Alkaline peptone water - BSA
Culture - XLD- Red with black centre - Cary Blair - Monsur’s taurocholate water - GTTA
- SS- green with black centre -TCBS
- HE- Jet black (H2S)
Wilson & Blair
- Enrichment med. – Sel. F broth, Tetrathionate broth
I M V C - Sugar Ferm. → Late lactose ferm
Biochemical Rx - + - + - Cholera red Rx → Indole + & N→N
- H → Flagella, HL, Strong immunogenic Cholera toxin
- O → Cell wall, HS, less immunogenic - Exotoxin - 6 subunits
Virulence factors - Vi → Envelop, HL, Poor immunogenic ( Carrier) - HL - MOA → stimulates adenyl cyclase & ↑ CAMP

- Enteric Fever Typhoid – Long ulcers, step ladder fever, Rose spots - Painless watery diarrhoea= Rice water stool
Para typhoid - Dehydration
- Gastroenteritis – Egg (S. typhinurium) - Acidosis
Pathogenesis - Septicaemia - H↓K (muscle cramps)

- B – Blood culture – 1st wk-

- A- Antibody det. (Widal)- 2nd wk- O titre > 1:100
Lab diagnosis - S- Stool culture- 3rd wk H titre > 1: 200
th
- U- Urine culture- 4 wk
-Cases → DOC = Ceftriaxone - Replacement of Fluid & electrolyte (ORS)
- Carrier → DOC → Pn - DOC → Doxycycline
Typhim Vi → IM/SC → Vi Ag - DOC in pregnancy → Flurazolidone
Vacc. - DOC in children → Cotrimoxazole
T/t Prophylaxis Typhoral → Oral → live attenuated Prophy Chemo → DOC → Tetracycline
Vaccine Killed → 6000 million (O+I 12000)
Oral Dukoral (WC-rBS)
Sanchol & MORC
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 GNB E. Coli Klebsiella Proteus Shigella
O (173) (Cell Wall) K. Pneumonic - Proteus- PV, PM Manitol Lac. &
Ag -- K (103) (Capsule) - Pneumonae= Friedlander’s b - Morganella Sucrose
- H (75) (Flagella) - Ozaenae = Frish b. - Prodividencia 4 A- S. dysentery - -
Introduction F (Fimbria) - Rhinoscleromatis type-- B- S. Flexneri + -
- C- S. Boydil + -
K. Oxytoces D- S. sonnei + +
Cap Spore mot Cap Spore mot Cap Spore mot Cap Spore mot
- - + + - - - - + - - -
Morphology (Peritrichous Flagella) (Peritrichous Flagella)

- MacConkey →Pink (Lactose Fermented) MacConkey = Pink (LF) - MacConkey → Yellow (NLF) - Nut. agar→ Translucent col.
(Mucoid due to capsule) - Nutrient → - Swarming - Blood agar- γ hemolysis
- Dienes Ph. - MacConkey - Yellow (except S. sonnei)
- Sel. - DCA- Yellow col.
Culture - XLD- Red col.
- SS
HE- Green col.
- Enrichment med- Sel. F. broth
- Sugar Ferm → Acid + Gas - Urease + - Urease +
I M V C
Biochemical Rx + + - -

LT → St. Adenyl cyclase ↑CAMP - Phosphate stones in kidneys - Invasiveness→Most imp. & must
Toxin 3 ST→St. guanyl cyclase ↑CAMP - UTI - Toxin→MOA→ Inhibit Prot. synthesis
Verotoxin VT→ Inhibit Prot. Sys. - Pyelonephritis
Virulence factors

- UTI EPEC- adhere to villi K. Pneumonae - Intestinal→ Diarrhoea & dysentery

- ETEC- Traveller’s d,Tox- (LT/ST) (Friedlander Pneumonia) - Extraintestinal→HVS, Arthritis,
- Diarrhoea - EIEC- Invasive, Sereny test Seizures
- EHEC- VT, HUS, HC, O157:H7 K. Ozaenae
Pathogenesis - Pyogenic EAEC- EAST toxin, stacked (Atrophic Rhinitis)
inf. brick

-Septicaemia

Lab diagnosis

T/t Prophylaxis
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 Superficial
Tinea Versicolor Tinea Nigra Piedra Dermatophytosis
Mycosis

Introduction

Malassezia Furfur Hortaea werneckii Black- Piedraia hortae –Trichophyton- s, h, n

White- Trichosporon beigelii –Microsporum- s, h
Causative Agent –Epidermophyton- s, n

–hypo- hyperpigmentation of skin Painless black patch –Nodules in hair shaft –Tinea capitis (Kerion, Favus, Ectothrix, Endothrix)
–Seborrheic dermatitis Palm & soles –Tinea corporis
–Folliculitis –Tinea cruris
–Tinea barbae
–Tinea faciei
–Tinea imbricata
C/F –Tinea unguium
–Tinea manum

–Direct micro→ Spaghetti & meat ball appearance –Wood lamp→ Fluor
–Culture- Fried egg colonies –Direct Micro→ Septate hyphae and arthrocondia
–Wood lamp ex.- G-Y Fluro –Culture

Lab ∆

–Sulfide shampoo, Ketoconazole shampoo, Terbinafine cream –

T/t

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Subcutaneous Mycosis Mycetoma Chromoblastomycosis Rhinosporidiosis Sporotrichosis
Madurai→ Madhura Foot/ Rose Gardener’s disease
Maduramycosis

Introduction

Eumycetoma→ Fungus Fonsecaea Pedrosoi Rhinosporidium seeberi Sporothrix schenckii

Actinomycetoma → Bacteria Phialophora verrucosa Prev.→ Fungus
Botryomycosis→ Staph. aureus Now→ Aquatic
Protista parasite
Causative Agent

∆ (Feet)→ Verrucose (MC)/ Ulcerative / nodular Friable polyp (Nose) Linear Noduloulcerative lesion
Tumor like swelling along lymphatics
Discharging sinuses
Discharge of granules
C/F

Direct ex→ Histopath→ Histopath→ Spherules Histopath→ Asteroid bodies/ Cigar

Eumycetoma→ KOH mount Sclerotic bodies/ copper pennies bodies
Actinomycetoma→ Gram st
Nocardia→ Mod. ZN stain

Lab ∆ Histopath→ Sun-ray appearance

Culture→
Eumycetoma→ SDA
Actinomycetoma→ L-J
Sx→ (Antifungal/ Antibiotic) Sx→ Itroconazole Sr→ Dapsone Itraconazole

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 Systemic Mycosis Histoplasmosis Blastomycosis Coccidiomycosis Para coccidiomycosis
Darling’s disease North American Blastomycosis Desert Rheumatism –South American blastomycosis
Gilchrist’s disease Chicago disease Valley Fever –Lutz-Splendore-de Almeida disease
California Fever

Introduction

Histoplasma capsulatum Blastomyces dermatitidis C. immitis P. brasiliensis

Causative Agent

–Pulmonary –Pulmonary –Pulmonary –Pulmonary

–Mucocutaneous –Skin –Skin –Skin
–Disseminated –Osteomyelitis –Arthritis –Oral mucosa
–CNS –Disseminated
C/F

Yeast cell with narrow base budding Double walled yeast cell with broad –Spherules filled with endospores –Mickey Mouse or Pilot wheel
within macrophages base budding (8) –Fragmented hyphae appearance

Lab ∆

Amphotericin B Amphotericin B Itraconazole Itraconazole

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Opportunistic Mycosis Candidiasis Cryptococcosis Zygomycosis Aspergillosis
–MC fungal infection –European Blastomycosis –Aseptate fungus
–Yeast like fungus –Torulosis

Introduction

–C. albicans –C. neoformans –Rhizopus –A. Fumigatus

–C. gatti –Mucor –A. Flavus
–A. Niger

Causative Agent

–Invasive Candidiasis –Pulmonary –Rhinocerebral (mcc of orbital –Pulmonary

–Mucosal Candidiasis –CNS cellulitis) ▪ ABPA
–Cutaneous Candidiasis –Skin –Pulmonary ▪ Asthma
–Allergic Candidiasis –Bone –Cutaneous ▪ Aspergilloma
C/F –GI ▪ Angioinvasive
–Disseminated ▪ Chronic

–Gram st→GP budding yeast with pseudo –Negative staining→capsule Histopath→broad aseptate hyphae –Histopath→ Narrow septate hyphae
hyphae with wide angle branching with acute angle branching
–Culture (SDA) → Cream
–Species identification→ Culture→ Culture→
1. Germ tube test Rhizopus→Salt & Papper app
Lab ∆ 2. Corn Meal Agar (Dalmau Plate Culture Mucor→White cotton woolly colony
Technique)
3. CHROM agar Lactophenol cotton blue (LPCB) test→
–-d-Glucan assay Rhizopus→Rhizoids+
Mucor→Rhizoids-
Topical azole Fluconazole/Capsofungin Fluconazole Amphotericin B ABPA→ Itraconazole
Invasive→Voriconazole

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