Appendix

Bacteriology Summary
1
taBleS and trigger WordS
Summary: Gram-Positive Bacteria
OrGaniSm DiSeaSe FeatureS iDentiFicatiOn PathOGenic FactOrS tranSmiSSiOn PreventiOn/treatment*
Actinomyces spp. Abscesses with Gm(+); filamentous; Unknown (normal Endogenous spread Débridement and
draining sinus anaerobic colonizer of upper across mucosal penicillin
tracts, especially in Seen as macroscopic respiratory and GI barriers after
cervicofacial region “sulfur” granules in tracts) trauma or disease
Mycetoma clinical specimens
Bacillus anthracis Cutaneous anthrax: Gm(+) rod; spore- Exotoxin consisting Spores from animal Attenuated vaccine for
ulcerated lesions former; nonmotile; of a protective products or soil at-risk groups
and septicemia aerobic factor, edema factor, through skin or by Penicillin, ciprofloxacin,
Pulmonary anthrax: Medusa-head colonies and lethal factor; inhalation doxycycline
often fatal on blood agar antiphagocytic
Gastrointestinal polypeptide capsule
anthrax (developing
countries)
Bacillus cereus Food poisoning: Gm(+) rod; spore- Heat-stable exotoxin Preformed toxin Refrigeration of foods
emetic disease (early former; motile (emetic disease); in reheated rice Supportive therapy
vomiting); diarrheal Aerobic heat-labile exotoxin (emetic form);
disease (later onset) (diarrheal disease) spores in meat and
Traumatic eye vegetables
infections
Clostridium Classic botulism: Gm(+) rod; spore- Heat-resistant spores; Preformed toxin Discard bulging cans
botulinum weakness, bilateral former; anaerobic A-B type toxin in canned foods of food; no honey for
descending paralysis inhibits release of (classic); spores, infants
Infant form: floppy acetylcholine often in honey Trivalent antitoxin IgG;
baby syndrome, (infant) Trivalent antitoxin
constipation Respiratory support
Wound form: similar Penicillin (infant and
to classic but longer wound)
onset
Clostridium Pseudomembranous Gm(+) rod; spore- Growth after antibiotic Opportunistic Cessation of causative
difficile colitis with bloody former; anaerobic; depletion of intestinal flora; antibiotic
diarrhea: associated ELISA detection of competing intestinal nosocomial Metronidazole or
with antibiotic use toxin in stool flora; enterotoxin A spread vancomycin
culture, antigen in (fluid loss); cytotoxin
stool B (mucosal damage)
Clostridium Myonecrosis (gas Gm(+) large, boxcar- Cytolytic alpha toxin; Spores in food and Proper cooking and
perfringens gangrene), Cellulitis shaped rod; spore- heat-labile enterotoxin soil; endogenous refrigeration of foods
Food poisoning (watery former; aerotolerant (fluid loss); other spread from GI Wound cleaning and
diarrhea) anaerobe toxins (increased tract to sterile débridement
Double zone of vascular permeability, sites Penicillin
hemolysis tissue necrosis)
Clostridium tetani Tetanus: lockjaw Gm(+) small rod A-B type exotoxin Spores via cut or stab Toxoid vaccine (childhood
(trismus), (tennis racket); (tetanospasmin) wound DPT vaccine); booster
spastic paralysis terminal spore; strict blocks release every 10 years; Antitoxin
(opisthotonos), anaerobe of inhibitory immunoglobulin
grinning expression neurotransmitters to neutralize toxin
(risus sardonicus) (e.g., GABA, glycine) Penicillin
Continued

189
 190 Microbiology and Immunology

Summary: Gram-Positive Bacteria—cont’d

OrGaniSm DiSeaSe FeatureS iDentiFicatiOn PathOGenic FactOrS tranSmiSSiOn PreventiOn/treatment*
Corynebacterium Respiratory diphtheria: Gm(+) club-shaped rod A-B type exotoxin Aerosol droplets Toxoid vaccine
diphtheriae pseudomembrane Black colonies on inhibits protein (asymptomatic (childhood DPT
on throat (“bull tellurite agar (Löffler synthesis by ADP carriage); contact vaccine); booster every
neck”), sore throat medium) ribosylation of EF-2; with skin of 10 years
Cutaneous diphtheria toxin encoded by infected person Antitoxin immunoglobulin
Systemic toxemia gene on phage (cutaneous) to neutralize toxin
Penicillin,
erythromycin
Enterococcus faecalis UTI Gm(+) cocci in pairs or Widespread antibiotic Endogenous spread Ampicillin (UTI)
Endocarditis (especially chains resistance from normal flora Aminoglycoside +
in those with Variable hemolysis; of GI tract ampicillin for systemic
genitourinary growth in bile- disease
manipulation) esculin; salt tolerant Vancomycin for ampicillin
resistant strains
Listeria Meningitis and sepsis in Gm(+) rod; tumbling Intracellular growth Food-borne Ampicillin ± gentamicin
monocytogenes immunocompromised motility in macrophages; (unpasteurized
and neonates (early  Hemolysis listeriolysin O; cold dairy products,
onset) enrichment raw vegetables);
Late-onset transplacentally
neonatal disease or during birth to
(granulomatosis infected mother
infantisepticum)
Multiple-organ
abscesses and
granulomas
Staphylococcus Toxin mediated: food Gm(+) cocci in Antiphagocytic Preformed toxin Methicillin, cephalosporins
aureus poisoning; toxic clusters capsule; protein A; in lunch meats, MRSA: vancomycin,
shock syndrome; Salt tolerant; enterotoxins; TSST creamy foods, linezolid daptomycin,
scalded skin coagulase(+); (superantigen); custards; normal tigecycline
syndrome catalase(+) cytolytic toxins and skin and nasal
Pyogenic infections: enzymes; coagulase; flora; endogenous
skin lesions, catalase; penicillinase spread
endocarditis, (-lactamase) in
osteomyelitis, many strains; Panton-
nosocomial Valentine leukocidin
pneumonia (PVL) toxin CA-MRSA
Staphylococcus Infection around Gm(+) cocci in clusters Colonizes implanted Endogenous spread of Vancomycin, linezolid,
epidermidis catheters and other Coagulase(–); devices; tissue- normal skin flora; IV daptomycin
implants catalase(+); sensitive degrading enzymes drug use
Wound infections to novobiocin
Staphylococcus UTI in young women Gm(+) cocci in clusters Adheres to transitional Sexual contact Quinolones
saprophyticus Coagulase(–); epithelium
catalase(+); resistant
to novobiocin
Streptococcus Neonatal meningitis, Gm(+) cocci in chains Antiphagocytic capsule; Colonization of GI and Third-trimester screening
agalactiae pneumonia, sepsis  Hemolysis; catalase(–); hemolysins and vaginal tract in some and ampicillin before
(group B) Postpartum sepsis + cAMP test other degradative women delivery
enzymes
Streptococcus Pneumonia Gm(+) football-shaped Antiphagocytic capsule; Normal throat Capsular vaccine for
pneumoniae Sinusitis, otitis media cocci in chains IgA protease; and nasal flora; high-risk groups
Bronchitis  Hemolysis; pneumolysin person-to-person (children, elderly)
Meningitis catalase(–); quellung spread via contact Penicillin, amoxicillin,
reaction; sensitive to and aerosol ceftriaxone,
Optochin (P disk) droplets fluoroquinolones,
macrolides
Streptococcus Pharyngitis Gm(+) cocci in chains M protein and Aerosol droplets, Penicillin G, cephalosporins
pyogenes Skin lesions,  Hemolysis; hyaluronic person-to-person
(group A) necrotizing fasciitis catalase(–); acid capsule
Toxin mediated: sensitive to (antiphagocytic); F
scarlet fever, toxic bacitracin (A disk) protein (adherence);
shock syndrome streptolysins O and
Sequelae: S; exotoxins
rheumatic fever,
glomerulonephritis
*Drugs other than those listed may also be effective.
ADP, adenosine diphosphate; BL-BLI, -lactam antibiotic with -lactamase inhibitor; cAMP, cyclic adenosine monophosphate; ELISA, enzyme-
linked immunosorbent assay; GABA, -aminobutyric acid; GI, gastrointestinal; Gm(+), gram positive; IV, intravenous; MRSA, methicillin-
resistant Staphylococcus aureus; CA-MRSA, community acquired MRSA; UTI, urinary tract infection.
 Bacteriology Summary Tables and Trigger Words 191

Summary: Gram-negative Bacteria

OrGaniSm DiSeaSe FeatureS iDentiFicatiOn PathOGenic FactOrS tranSmiSSiOn PreventiOn/treatment*
Bacteroides Intra-abdominal Gm() rod; anaerobic, Antiphagocytic capsule; Endogenous spread of Surgical intervention
fragilis abscesses; pelvic produce foul- cytolytic enzymes; normal colonic flora Metronidazole, imipenem,
infections; peritonitis smelling fatty acids weak endotoxin; promoted by surgery clindamycin, BL-BLI
Bacteremia mixed infections or trauma
Wound infection common
Bordetella Whooping cough Gm() coccobacillus; A-B type exotoxin Respiratory droplets Acellular or inactive whole
pertussis capsule increases cAMP from cough of cell vaccine (childhood
Oxidase(+); growth on by inhibiting infected person DPT vaccine)
Bordet-Gengou agar “off” G protein; Azithromycin
hemagglutinin;
tracheal cytotoxin
Brucella spp. Undulant fever: Gm() coccobacillus; Growth in phagocytes Zoonotic spread Pasteurization of dairy
malaise, chills, facultative and spread to spleen, via contaminated products
sweats, weight loss, intracellular liver, lymph nodes, milk and cheese or Tetracycline +
fever in waves bone marrow; contact with animal streptomycin, or
granuloma formation hosts TMP-SMX
Campylobacter Gastroenteritis: Gm() comma- Ulceration of Zoonotic spread via Symptomatic treatment
jejuni profuse watery or shaped rod; motile mucosal surfaces contaminated milk, Fluoroquinolones
bloody diarrhea, Growth on Campy of jejunum and water, poultry, meat
pus in stool, fever, plate; oxidase(+); colon; very infective
cramps catalase(+) (low ID50)
Escherichia coli Watery diarrhea Gm() rod; Oxidase(); Endotoxin in all Fecal-oral spread of Ampicillin or sulfonamides
in infants and lactose(+) strains; enterotoxins normal GI tract (UTI)
travelers (ETEC, in ETEC (increases flora (nosocomial, TMP-SMX and rehydration
EPEC, EAggEC) cAMP or cGMP); contaminated food (diarrhea, not EHEC)
Dysentery (EIEC) verotoxin in EHEC and water, self- Cephalosporins
Hemorrhagic colitis (inhibits 28S inoculation) (septicemia) quinolones
(EHEC); hemolytic rRNA); pili in UPEC
uremic syndrome (adherence)
(strain O157:H7)
Urinary tract infection
(UPEC)
Septicemia, neonatal
meningitis
Francisella Tularemia: skin ulcers, Gm() coccobacillus; Antiphagocytic Zoonotic spread from Attenuated vaccine for
tularensis lymphadenopathy, facultative capsule; growth in animal reservoirs at-risk individuals
eye ulcers (ocular intracellular macrophages; very (rabbits, ticks) Streptomycin
form) Growth on cysteine infective (low ID50)
media
Haemophilus Chancroid: painful Gm() coccobacillus Pili that adhere to Sexual contact Ceftriaxone, azithromycin
ducreyi genital ulcer; Catalase(); factor genital and perianal
inguinal buboes X (heme) but not mucosa
with purulent factor V (NAD)
exudate needed for growth
Haemophilus Infantile meningitis, Gm() coccobacillus Colonization of upper Endogenous spread Hib vaccine at 2, 4, 6,
influenzae pediatric epiglottitis, Catalase(+); factor X respiratory tract; from upper and 15 mo
otitis media (children (heme) and factor endotoxin; systemic respiratory tract; Ceftriaxone
and adults) V (NAD) needed for infection only by respiratory droplets BL-BLI
Pneumonia (elderly, growth encapsulated strains
those with chronic (e.g., Hib)
pulmonary disease)
Helicobacter pylori Type B gastritis Gm() curved rod; Motility; epithelial Ingestion Triple-drug therapy:
Gastric and duodenal highly motile damage mediated bismuth +
ulcers Urease(+); by urease products, metronidazole +
oxidase(+); mucinase, and tetracycline + H2 blocker
catalase(+) cytotoxin Omeprazole + amoxicillin+
clarithromycin
Klebsiella Pneumonia Gm() rod Large antiphagocytic Aspiration of respiratory Cephalosporins, BL-BLI
pneumoniae (especially in Oxidase(); mucoid- capsule droplets
alcoholics and those appearing colonies
with poor lung in culture
function)
UTI (especially
in catheterized
patients)
Bacteremia
Continued
 192 Microbiology and Immunology

Summary: Gram-negative Bacteria—cont’d

OrGaniSm DiSeaSe FeatureS iDentiFicatiOn PathOGenic FactOrS tranSmiSSiOn PreventiOn/treatment*
Legionella Legionnaires disease: Gm() coccobacillus; Growth in Aerosols from Chlorination of water
pneumophila atypical pneumonia silver stain; facultative macrophages; contaminated sources
Pontiac fever: self- intracellular degradative water sources (no Erythromycin, new
limited, febrile BCYE agar (need enzymes kill person-to-person macrolides,
illness cysteine and iron) parasitized cells spread) fluoroquinolones
Urine antigen
Neisseria Acute gonorrhea: Gm() diplococcus; Pili; strong endotoxin Sexual contact; during Condoms
gonorrhoeae urethral or vaginal no capsule effect; protein I birth from infected Prophylaxis with silver
(gonococcus) discharge Ferments glucose (intracellular mother nitrate or erythromycin
PID and salpingitis (not maltose); survival); protein II for neonates (for eyes)
Septic arthritis growth on Thayer- (adhesin); Ceftriaxone +
Neonatal conjunctivitis Martin or chocolate IgA protease; antichlamydial drug
Dermatitis-arthritis agar -lactamase
syndrome
Neisseria Meningitis Gm() diplococcus; Antiphagocytic Respiratory droplets Anticapsular vaccine
meningitidis Meningococcemia: capsule capsule; strong Penicillin, chloramphenicol,
(meningococcus) generalized petechial/ Ferments glucose and endotoxin effect ceftriaxone
purpura rash, maltose; growth on Fluoroquinolones for
septicemia Thayer-Martin or contacts
chocolate agar
High protein and low
glucose in CSF
Proteus mirabilis UTI often with renal Gm() rod; Increased urine pH Endogenous spread Ampicillin, TMP-SMX
stone formation swarming growth due to urease activity of normal GI tract Cephalosporins
on agar promotes renal flora
Urease(+); oxidase(); stones and is toxic
lactose() to uroepithelium
Pseudomonas Nosocomial infections Gm() rods; motile Pili; capsule; A-B type Ubiquitous in Fluoroquinolones,
aeruginosa Burn infections with Oxidase(+); flat exotoxin inhibits environment and ceftazidime,
bacteremia colonies; fruity protein synthesis water; nosocomial polymyxin, aztreonam,
UTI (catheters) odor; blue-green by ribosylation of spread via water aminoglycoside, special
Pulmonary infections pigment EF-2; leukocidin; reservoirs -lactams
(cystic fibrosis) degradative enzymes
Keratitis, “swimmer’s
ear,” “hot-tub
folliculitis”
Malignant external
otitis in diabetics
Salmonella Gastroenteritis with Gm() rod Antiphagocytic capsule; Fecal-oral via water Rehydration
enteritidis vomiting, nonbloody Oxidase(); Lactose(); exotoxin; intracellular or food (raw eggs, No antibiotics used
diarrhea colonies with black growth poultry, dairy
center (H2S) on SS products)
agar
Salmonella typhi Typhoid fever: Same as S. enteritidis Antiphagocytic capsule; Same as S. enteritidis Chloramphenicol,
increasing fever, but is motile invasion of Peyer cephalosporins,
necrosis and patches quinolones
hemorrhage of GI
tract, bacteremia
Shigella spp. Shigellosis (bacterial Gm() rod Invades and replicates Fecal-oral usually via Rehydration in mild cases
dysentery): fever, Oxidase(); lactose(), within colonic hands Ampicillin in severe cases
cramps, tenesmus, colorless colonies mucosa; A-B type
and bloody stools (no H2S) on SS agar exotoxin (Shiga
S. sonnei: mild disease toxin) that inhibits
(day care centers) 28S rRNA (S.
S. flexneri, S. dysenteriae: dysenteriae)
more severe disease
(less common)
Vibrio cholerae Cholera: rice-water Gm() comma- Adherence to gut Fecal-oral via water, Rehydration
stools, profuse shaped rod; motile mucosa; A-B type fish, and shellfish; Tetracycline
watery diarrhea Salt tolerant; exotoxin increases shedding by
oxidase(+) cAMP by stimulating asymptomatic
“on” Gs protein, carriers
causing loss of water
and ions from cells
Vibrio Gastroenteritis with Same as V. cholerae Invasion and Ingestion of Usually self-limited
parahaemolyticus explosive, watery destruction of contaminated
diarrhea, cramps, colonic epithelium shellfish
nausea
 Bacteriology Summary Tables and Trigger Words 193

Summary: Gram-negative Bacteria—cont’d

OrGaniSm DiSeaSe FeatureS iDentiFicatiOn PathOGenic FactOrS tranSmiSSiOn PreventiOn/treatment*
Yersinia Enterocolitis with Gm() rod; motile Antiphagocytic capsule; Zoonotic via Aminoglycosides,
enterocolitica bloody diarrhea, Oxidase(); lactose(); intracellular growth; contaminated food, TMP-SMX
fever, abdominal cold tolerant endotoxin; cold water, or blood
pain tolerant products
Yersinia pestis Bubonic plague: Gm() rod Antiphagocytic capsule; Zoonotic via flea Killed vaccine
high fever, Oxidase(); lactose() intracellular growth; vectors Streptomycin,
painful buboes, exotoxin; fibrinolysin chloramphenicol
conjunctivitis
*Drugs other than those listed may also be effective.
BL-BLI, -lactam antibiotic with -lactamase inhibitor; cAMP, cyclic adenosine monophosphate; cGMP, cyclic guanosine monophosphate;
CSF, cerebrospinal fluid; GI, gastrointestinal; Gm(–), gram negative; PID, pelvic inflammatory disease; rRNA, ribosomal RNA; TMP-SMX,
trimethoprim-sulfamethoxazole; UTI, urinary tract infection.

Summary: Other Bacteria

OrGaniSm DiSeaSe FeatureS iDentiFicatiOn PathOGenic FactOrS tranSmiSSiOn PreventiOn/treatment*
Borrelia burgdorferi Lyme disease: Large spirochetes; Induced cell-mediated Zoonotic via ticks Doxycycline and
rash (erythema microaerophilic; and inflammatory (Ixodes spp.); amoxicillin (early)
chronicum migrans); numerous flagella responses; weak Northeast, upper Ceftriaxone (late)
severe fatigue; Serologic tests for endotoxin effect Midwest, and Pacific
involvement of heart, antibodies Northwest
CNS, and joints
Chlamydophila Atypical pneumonia: Obligate intracellular Similar to C. Respiratory droplets Same as C. trachomatis
pneumoniae children and young No peptidoglycan in trachomatis
adults at greatest cell wall
risk; association
with coronary artery
disease
Chlamydophila Psittacosis (parrot Obligate intracellular Similar to C. Aerosols from dried Same as C. trachomatis
psittaci fever): dry cough, No peptidoglycan in trachomatis bird feces
pneumonitis, cell wall
splenomegaly, CNS
involvement
Chlamydia Strains A-C: trachoma Obligate intracellular Extracellular inert Sexual contact or via Tetracycline, erythromycin,
trachomatis (conjunctivitis) No peptidoglycan in form (elementary birth canal; contact new macrolides,
leading to blindness cell wall; iodine- body) enters target with tears (strains fluoroquinolones
if untreated staining inclusion cells; active form A-C) (respiratory)
Strains D-K: urogenital body; serologic (reticulate body)
infections, neonatal tests replicates within
conjunctivitis cells leading to
Strains L1-L3: cell lysis and host
lymphogranuloma inflammatory
venereum response
Coxiella burnetii Q fever: usual Obligate intracellular Aerosols of urine or Tetracycline
symptoms of feces and contact
rickettsial disease but with birth products
no rash from infected
Atypical pneumonia, animals (no insect
endocarditis, liver vector)
involvement
Mycobacterium Tuberculoid leprosy: Acid-fast rod; obligate Cell wall phenolic Direct contact with Tuberculoid form:
leprae few skin lesions with intracellular glycolipids; host lesions; inhalation of dapsone + rifampin
few bacilli Positive lepromin skin TH1 response  infectious droplets (6 mo)
Lepromatous leprosy: test; infects cool tuberculoid form; Lepromatous form:
numerous skin tissues host TH2 response  dapsone +
lesions with many lepromatous form rifampin + clofazimine
bacilli, tissue (2 yr)
damage, loss of
sensation
Mycobacterium Tuberculosis: young Acid-fast rod; facultative Cord factor, mycolic Respiratory droplets Prophylactic isoniazid
tuberculosis children, elderly, and intracellular acid; intracellular from coughing by BCG vaccine (rare in United
immunocompromised Slow growth on growth; granuloma infected person States)
at greatest risk Löwenstein-Jensen formation and Multidrug therapy for 6-9
medium; caseation due mo
+ PPD skin test, IFN- to induced DTH
tests response
Continued
 194 Microbiology and Immunology

Summary: Other Bacteria—cont’d

OrGaniSm DiSeaSe FeatureS iDentiFicatiOn PathOGenic FactOrS tranSmiSSiOn PreventiOn/treatment*
Mycobacterium Disseminated infections Mycobacterial Like M. tuberculosis Respiratory droplets Azithromycin or
avium- of AIDS and other characteristics but even more of clarithromycin +
intracellulare immunocompromised an opportunistic ethambutol + rifabutin,
complex (MAC) infection NOT isoniazid
Mycoplasma Atypical (“walking”) No cell wall; sterols Adherence to Respiratory droplets Erythromycin, tetracycline,
pneumoniae pneumonia in cell membrane; respiratory quinolones
Pharyngitis, obligate aerobe epithelium; damage
tracheobronchitis Granular colonies to epithelium due
on Eaton agar to H2O2 and lytic
enzymes
Nocardia spp. Cutaneous infections Acid-fast (weakly), Colonization of Ubiquitous soil Sulfonamides
(mycetoma) filamentous, oropharynx or organisms; inhaled Surgical intervention
Pneumonia with aerobic wounds with and aspirated to
cavitation and subsequent lower airways or
spread to CNS or necrosis and enter via wounds
skin (abscesses) in abscess formation
immunocompromised
Rickettsia spp. Rocky Mountain spotted Obligate intracellular Invasion and R. rickettsii, deer tick Tetracycline,
fever (R. rickettsii): Weil-Felix reaction destruction of vector; R. typhi, flea chloramphenicol
inward-spreading rash to distinguish endothelial cells vector; R. prowazekii,
Endemic typhus (R. typhi): rickettsial species; person-to-person via
rash on trunk serology body lice
Epidemic typhus (R.
prowazekii): outward-
spreading rash
Treponema pallidum First-degree syphilis: Thin spirochetes Hyaluronidase (tissue Sexual contact, Penicillin
painless skin ulcers visualized by dark invasion); protective transplacental,
(chancres), buboes field microscopy outer coat; induced transfusion with
Second-degree syphilis: VDRL or RPR test host response contaminated
flu-like syndrome, for cardiolipin blood
disseminated rash FTA-ABS test for
Third-degree syphilis treponemal
(rare): gummas, antibodies
aortitis, CNS
involvement
Congenital: triad—
unusual teeth,
deafness, interstitial
keratitis, + other
*Drugs other than those listed may also be effective.
AIDS, acquired immunodeficiency syndrome; CNS, central nervous system.

trigger Words: Bacteria

Actinomyces spp. Sulfur granules in draining sinuses
Anaerobic
Filamentous
Bacillus anthracis Sheep, goat, goat hair
Fur, spore
Bioterror
Malignant pustule
Wool-sorters’ disease
Bacillus cereus Rice, preformed toxin
Heat-stable toxin—vomiting
Heat-labile toxin—diarrhea
Bacteroides fragilis Foul smelling
Mixed infection
Abscess
 Bacteriology Summary Tables and Trigger Words 195

trigger Words: Bacteria—cont’d

Bordetella pertussis Bordet-Gengou agar
Lymphotoxin (lymphoid leukocytosis)
Whooping cough
DPT vaccine
Borrelia burgdorferi Deer tick
High grass
Lyme disease
White-tail deer reservoir of spirochete
Erythema chronicum migrans (bite site)
Disabling arthritis; bilateral Bell palsy
Brucella spp. Undulant fever
Unpasteurized milk and cheese
Intracellular growth
Goats and sheep
Campylobacter jejuni Bloody diarrhea
Undercooked poultry
Puppies
Thin, curved gram negative
Association with Guillain-Barré syndrome
Chlamydia trachomatis Sexually transmitted disease, urinary tract infection
Pelvic inflammatory disease,
lymphogranuloma venereum
Trachoma
Iodine stain
Intracellular inclusion bodies
Elementary bodies (infective particle)
Reticulate bodies
Chlamydia psittaci Birds, parrots
Clostridium perfringens Boxcar shaped
Double zone of hemolysis
Lecithinase
Toxins
Gas gangrene (myonecrosis)
Diarrhea
Anaerobe
Clostridium difficile Spores
Pseudomembranous colitis
Toxin A + B
Antibiotic associated
Clostridium botulinum Botulism
Floppy baby
Honey (spores; infant)
Food-borne (adults; preformed toxin)
A-B toxin
Anaerobe
Continued
 196 Microbiology and Immunology

trigger Words: Bacteria—cont’d

Clostridium tetani A-B toxin
Anaerobe
Lockjaw
DPT
Twitching spasms, sardonic grin
No protective antibodies
Corynebacterium diphtheriae Pseudomembrane
DPT vaccine
A-B toxin
Schick test
Toxic myocarditis (cause of death)
Enterococcus spp. Entero-feces-gut bug
Nosocomial
Vancomycin resistant (VRE)
Escherichia coli Diarrhea
Neonatal meningitis
EIEC, EHEC, ETEC, EAEC, EPEC
Lactose positive
O157:H7
Urinary tract infection
Acute cholecystitis, diverticulitis, appendicitis
Septic shock in hospital
Francisella tularensis Intracellular
Rabbit
Ulcer
Tularemia
Haemophilus spp. X and V factors
Hib
Capsule
Meningitis uncommon due to vaccine
Epiglottitis
Otitis media; sinusitis
Helicobacter pylori Gastric or duodenal ulcer
Urease
Urease breath test
Stool antigen test (active versus inactive disease)
Stomach cancer (adenocarcinoma, lymphoma)
Klebsiella pneumoniae Currant jelly (blood) sputum
Alcoholic
Pneumonia, aspiration
Capsule
Legionella pneumophila Air-conditioning, warm mist (rain forest)
Shower and other lukewarm water sources
Charcoal yeast agar (BCYE agar)
 Bacteriology Summary Tables and Trigger Words 197

trigger Words: Bacteria—cont’d

Atypical pneumonia
Urine antigen test
Listeria spp. Meningitis
Intracellular growth
Baby
Cold enrichment
Milk products
Motility
Undercooked meat, soft cheese
Mycoplasma spp. Walking pneumonia
No cell wall
Atypical pneumonia, crowded conditions
Association with Guillain-Barré syndrome
Cold agglutinins
Neisseria meningitidis Gram-negative diplococci in cerebrospinal fluid
Meningitis
Lipooligosaccharide
Endotoxin
Septic shock
Petechiae, purpura
Waterhouse-Friderichsen syndrome
Neisseria gonorrhoeae Gram-negative diplococci
Urethritis
Sexually transmitted disease
Thayer-Martin medium
Chocolate agar
Mycobacterium leprae Nerve damage, anesthetic skin lesion
Lepromatous leprosy—TH2
Tuberculoid leprosy—TH1
Mycobacterium tuberculosis Mantoux reaction
PPD
Acid-fast
Granuloma
Caseation
Opportunistic disease
Ghon complexes (primary disease)
Intestinal tuberculosis (swallowed
organisms in primary lung disease)
Isoniazid
Proteus mirabilis Urinary tract infection
Swarmer
Urease
Alkaline urine pH
Ammonia smell
Continued
 198 Microbiology and Immunology

trigger Words: Bacteria—cont’d

Pseudomonas aeruginosa Nosocomial infection
Cystic fibrosis
Opportunistic
Green pigment in sputum
Fruity smell
Burn patient
Hot tub folliculitis
Malignant external otitis in diabetic
Osteomyelitis in punctured rubber foot wear
Rickettsia spp. Tick
Southeastern Atlantic and south central states
Palmar petechia
Weil-Felix reaction
Obligate intracellular growth
Staphylococcus aureus Grapelike clusters
Coagulase
Catalase
Toxins, TSST
Methicillin-resistant Staphylococcus aureus
Pus
Impetigo
Staphylococcus epidermidis Catalase
Coagulase negative
Catheters, shunts, prosthetic devices
Salmonella spp. Dairy foods
Motile
Animal reservoirs
Raw eggs and chicken
Nonlactose fermenter
Nonbloody diarrhea
Osteomyelitis in sickle cell disease
Shigella spp. Watery, bloody diarrhea
Gram-negative bacillus
Lactose negative
No hydrogen sulfide
Shiga toxin
Streptococcus pneumoniae Gram-positive diplos
 Hemolysis
Capsule
P disk (Optochin) sensitive
Polysaccharide vaccine
Pneumonia
Meningitis
Otitis media
 Bacteriology Summary Tables and Trigger Words 199

trigger Words: Bacteria—cont’d

Sinusitis
Spontaneous peritonitis
Streptococcus pyogenes  Hemolysis
Streptolysin O and S
A disk (group A) bacitracin sensitivity
Gram-positive cocci in chains
Necrotizing fasciitis
Pus
Erysipelas, scarlet fever
Rheumatic fever, poststreptococcal glomerulonephritis
Treponema pallidum Syphilis
FTA-ABS
Painless ulcer (chancre)
Palm and sole rash
Spirochete
Gumma
Unculturable
VDRL, RPR tests
FTA-ABS confirm disease
Sexually transmitted disease
Vibrio cholerae Comma (S) shaped
Rice-water secretory diarrhea
Shellfish
A-B toxin
Yersinia pestis Plague, fleas, rodent and other animal host, buboes