Q fever:
  • Caused by Histoplasma capsulatumDimorphic fungusYeast-form grows intracellularly in macrophagesForms lung lesions; 0.1% of cases become a severe, generalized diseaseAcquired from airborne conidia in areas with bird or bat droppingsLimited geographical range in the United StatesTreated with amphotericin B or itraconazole
  • Caused by Corynebacterium diphtheriaeGram-positive rod; pleomorphicForms a tough grayish membrane in the throatFibrin and dead tissueBlocks passage of air to the lungsExotoxin produced by lysogenized bacteriaCirculates in the blood; damages the heart and kidneysCutaneous diphtheriaForms skin ulcerPrevented by DTaP vaccineDiphtheria toxoid
  • Caused by Coxiella burnetiiObligately parasitic, intracellular gamma proteobacteriaAcute Q feverHigh fever, muscle aches, headache, coughingChronic Q feverEndocarditis (may occur years after infection)Transmitted to farm animals from tick bitesTransmitted to humans from the inhalation of aerosols from animals and unpasteurized milkTreated with doxycycline; chloroquine for chronic infections
  • Caused by Bordetella pertussisGram-negative coccobacillusProduces a capsuleAllows attachment to ciliated cells in the tracheaDestroys ciliated cells and shuts down the ciliary escalatorTracheal cytotoxin of cell wall damages ciliated cellsPertussis toxin enters the bloodstream
Histoplasmosis
  • Caused by Chlamydophila psittaciGram-negative intracellular bacteriumTransmitted to humans by elementary bodies from bird droppings transmitted through airFever, headache, chills, disorientationDiagnosis: growth of bacteria in eggs or cell culture Treated with tetracyclines
  • Caused by Histoplasma capsulatumDimorphic fungusYeast-form grows intracellularly in macrophagesForms lung lesions; 0.1% of cases become a severe, generalized diseaseAcquired from airborne conidia in areas with bird or bat droppingsLimited geographical range in the United StatesTreated with amphotericin B or itraconazole
  • Caused by Burkholderia pseudomalleiGram-negative rodOccurs mostly in southeast Asia and northern Australia (in moist soils)Commonly affects those with lowered immune systemsPneumonia or tissue abscesses (necrotizing fasciitis) and severe sepsisTransmission by inhalation, puncture wounds, and ingestionTreated with ceftazidime
  • Caused by Bordetella pertussisGram-negative coccobacillusProduces a capsuleAllows attachment to ciliated cells in the tracheaDestroys ciliated cells and shuts down the ciliary escalatorTracheal cytotoxin of cell wall damages ciliated cellsPertussis toxin enters the bloodstream
Pneumococcal Pneumonia:
  • Caused by Pneumocystis jirovecii No universal agreement if it is a protozoan or fungusAsymptomatic in the immunocompetent; causes pneumonia in the immunocompromisedPrimary indicator of AIDSFound in the lining of the alveoliForms a cystCysts rupture, releasing eight trophozoitesTreated with trimethoprim-sulfamethoxazole
  • Caused by Bordetella pertussisGram-negative coccobacillusProduces a capsuleAllows attachment to ciliated cells in the tracheaDestroys ciliated cells and shuts down the ciliary escalatorTracheal cytotoxin of cell wall damages ciliated cellsPertussis toxin enters the bloodstream
  • Caused by Chlamydophila psittaciGram-negative intracellular bacteriumTransmitted to humans by elementary bodies from bird droppings transmitted through airFever, headache, chills, disorientationDiagnosis: growth of bacteria in eggs or cell culture Treated with tetracyclines
  • Caused by S. pneumoniaeGram-positive; encapsulated diplococci90 serotypesInfected alveoli of the lung fill with fluids and RBCs; interferes with oxygen uptake Diagnosis: optochin-inhibition test, bile solubility test, or antigen in urine Treated with macrolides and fluoroquinolonesPrevented with conjugated pneumococcal vaccine
Coccidioidomycosis:
  • Inhaled organisms are phagocytized by alveolar macrophagesMycolic acids in the cell wall stimulate an inflammatory responseOrganisms are isolated in the walled-off tubercleTubercles heal and become calcified (Ghon's complexes)Tubercle breaks down, releasing bacteria into the lungs and cardiovascular and lymphatic systemsMiliary tuberculosis: disseminated infection
  • Also known as Valley fever or San Joaquin feverCaused by Coccidioides immitisDimorphic fungusArthroconidia found in alkaline desert soils of the American Southwest Form a spherule filled with endospores in tissuesMost infections are not apparent; fever, coughing, weight loss<1% of cases resemble tuberculosis Treated with amphotericin B or imidazole drugs
  • Also called primary atypical pneumonia or walking pneumoniaCaused by Mycoplasma pneumoniaeNo cell wallMild but persistent respiratory symptoms; low fever, cough, headache Common in children and young adults"Fried-egg" appearance on mediaDiagnosis: PCR and serological testingTreated with tetracyclines
  • Caused by S. pneumoniaeGram-positive; encapsulated diplococci90 serotypesInfected alveoli of the lung fill with fluids and RBCs; interferes with oxygen uptake Diagnosis: optochin-inhibition test, bile solubility test, or antigen in urine Treated with macrolides and fluoroquinolonesPrevented with conjugated pneumococcal vaccine
A 27-year-old man with a history of asthma is hospitalized with a 4-day history of progressive cough and 2 days of spiking fevers. Gram-positive cocci in pairs are cultured from a blood sample.Can you identify infections that could cause these symptoms?
  • Viral pneumonia occurs as a complication of influenza, measles, or chickenpoxFew labs are equipped to test clinical samples properly for virusesSARS-associated coronavirus (SARS)Emerged in Asia in 2003Middle East respiratory syndrome (MERS-CoV)Reported in Saudi Arabia in 2012
  • All pneumonias are accompanied by cough and fever. A culture is necessary to definitively identify the cause. In this case, Streptococcus pneumoniae was identified by the Gram reaction, morphology, and the optochin-inhibition test.
  • All of these diseases except otitis media would be accompanied by fever and sore throat. The presence of the grayish membrane is diagnostic for diphtheria.
  • Typical pneumoniaCaused by S. pneumoniaeAtypical pneumoniaCaused by other microorganismsLobar pneumoniaInfects the lobes of the lungsBronchopneumoniaInfects the alveoli adjacent to the lungsPleurisyPleural membranes inflamed
Pneumocystis Pneumonia
  • Caused by Corynebacterium diphtheriaeGram-positive rod; pleomorphicForms a tough grayish membrane in the throatFibrin and dead tissueBlocks passage of air to the lungsExotoxin produced by lysogenized bacteriaCirculates in the blood; damages the heart and kidneysCutaneous diphtheriaForms skin ulcerPrevented by DTaP vaccineDiphtheria toxoid
  • Caused by Pneumocystis jirovecii No universal agreement if it is a protozoan or fungusAsymptomatic in the immunocompetent; causes pneumonia in the immunocompromisedPrimary indicator of AIDSFound in the lining of the alveoliForms a cystCysts rupture, releasing eight trophozoitesTreated with trimethoprim-sulfamethoxazole
  • Caused by Burkholderia pseudomalleiGram-negative rodOccurs mostly in southeast Asia and northern Australia (in moist soils)Commonly affects those with lowered immune systemsPneumonia or tissue abscesses (necrotizing fasciitis) and severe sepsisTransmission by inhalation, puncture wounds, and ingestionTreated with ceftazidime
  • Caused by Histoplasma capsulatumDimorphic fungusYeast-form grows intracellularly in macrophagesForms lung lesions; 0.1% of cases become a severe, generalized diseaseAcquired from airborne conidia in areas with bird or bat droppingsLimited geographical range in the United StatesTreated with amphotericin B or itraconazole
A patient presents with fever and a red, sore throat. Later, a grayish membrane appears in the throat. Gram-positive rods are cultured from the membrane.Can you identify infections that could cause these symptoms?
  • All pneumonias are accompanied by cough and fever. A culture is necessary to definitively identify the cause. In this case, Streptococcus pneumoniae was identified by the Gram reaction, morphology, and the optochin-inhibition test.
  • Macrolides are a class of antibiotics derived from Saccharopolyspora erythraea (originally called Streptomyces erythreus), a type of soil-borne bacteria.
  • All of these diseases except otitis media would be accompanied by fever and sore throat. The presence of the grayish membrane is diagnostic for diphtheria.
  • Pharyngitis: Sore throatLaryngitis, Tonsillitis, Sinusitis: Usually self-limitingEpiglottitis: Most life-threatening disease of the upper respiratory system
Diphtheria:
  • Caused by Coxiella burnetiiObligately parasitic, intracellular gamma proteobacteriaAcute Q feverHigh fever, muscle aches, headache, coughingChronic Q feverEndocarditis (may occur years after infection)Transmitted to farm animals from tick bitesTransmitted to humans from the inhalation of aerosols from animals and unpasteurized milkTreated with doxycycline; chloroquine for chronic infections
  • Caused by Histoplasma capsulatumDimorphic fungusYeast-form grows intracellularly in macrophagesForms lung lesions; 0.1% of cases become a severe, generalized diseaseAcquired from airborne conidia in areas with bird or bat droppingsLimited geographical range in the United StatesTreated with amphotericin B or itraconazole
  • Caused by Corynebacterium diphtheriaeGram-positive rod; pleomorphicForms a tough grayish membrane in the throatFibrin and dead tissueBlocks passage of air to the lungsExotoxin produced by lysogenized bacteriaCirculates in the blood; damages the heart and kidneysCutaneous diphtheriaForms skin ulcerPrevented by DTaP vaccineDiphtheria toxoid
  • Caused by Burkholderia pseudomalleiGram-negative rodOccurs mostly in southeast Asia and northern Australia (in moist soils)Commonly affects those with lowered immune systemsPneumonia or tissue abscesses (necrotizing fasciitis) and severe sepsisTransmission by inhalation, puncture wounds, and ingestionTreated with ceftazidime
Scarlet Fever:
  • competition with the normal flora of the lungs.
  • Tetracycline is a broad spectrum polyketide antibiotic produced by the Streptomyces genus of Actinobacteria. It exerts a bacteriostatic effect on bacteria by binding reversible to the bacterial 30S ribosomal subunit and blocking incoming aminoacyl tRNA from binding to the ribosome acceptor site. It also binds to some extent to the bacterial 50S ribosomal subunit and may alter the cytoplasmic membrane causing intracellular components to leak from bacterial cells.
  • Erythrogenic toxin produced by lysogenized S. pyogenes
  • Stage 1: catarrhal stage, like the common coldStage 2: paroxysmal stage, violent coughing, gasping for airStage 3: convalescence stage, may last for monthsPrevented by DTaP vaccineTreated with erythromycin or other macrolides
Cephalosporins:
  • Viral pneumonia occurs as a complication of influenza, measles, or chickenpoxFew labs are equipped to test clinical samples properly for virusesSARS-associated coronavirus (SARS)Emerged in Asia in 2003Middle East respiratory syndrome (MERS-CoV)Reported in Saudi Arabia in 2012
  • Caused by Histoplasma capsulatumDimorphic fungusYeast-form grows intracellularly in macrophagesForms lung lesions; 0.1% of cases become a severe, generalized diseaseAcquired from airborne conidia in areas with bird or bat droppingsLimited geographical range in the United StatesTreated with amphotericin B or itraconazole
  • Typical pneumoniaCaused by S. pneumoniaeAtypical pneumoniaCaused by other microorganismsLobar pneumoniaInfects the lobes of the lungsBronchopneumoniaInfects the alveoli adjacent to the lungsPleurisyPleural membranes inflamed
  • The cephalosporins are a class of β-lactam antibiotics originally derived from the fungus Acremonium, which was previously known as "Cephalosporium".‎Discovery and development · ‎Cephalosporin C · ‎Cephalosporin antibiotics
Legionellosis
  • Also known as Valley fever or San Joaquin feverCaused by Coccidioides immitisDimorphic fungusArthroconidia found in alkaline desert soils of the American Southwest Form a spherule filled with endospores in tissuesMost infections are not apparent; fever, coughing, weight loss<1% of cases resemble tuberculosis Treated with amphotericin B or imidazole drugs
  • Caused by Histoplasma capsulatumDimorphic fungusYeast-form grows intracellularly in macrophagesForms lung lesions; 0.1% of cases become a severe, generalized diseaseAcquired from airborne conidia in areas with bird or bat droppingsLimited geographical range in the United StatesTreated with amphotericin B or itraconazole
  • Also called Legionnaires' diseaseCaused by Legionella pneumophilaAerobic, gram-negative rodGrows in water and air conditioning, biofilms, and waterborne amebaeTransmitted by inhaling aerosols; not transmitted person to personSymptoms: high fever and coughSimilar to symptoms of Pontiac feverTreated with erythromycin and macrolides
  • Over 200 different virusesRhinoviruses (30-50%)Thrive in temperatures lower than body temperatureCoronaviruses (10-15%)Sneezing, nasal secretion, congestionCan lead to laryngitis and otitis mediaNot accompanied by feverAntibiotics are of no useRelief via cough suppressants and antihistamine
Bacterial Pneumonias:
  • Caused by Pneumocystis jirovecii No universal agreement if it is a protozoan or fungusAsymptomatic in the immunocompetent; causes pneumonia in the immunocompromisedPrimary indicator of AIDSFound in the lining of the alveoliForms a cystCysts rupture, releasing eight trophozoitesTreated with trimethoprim-sulfamethoxazole
  • Also called primary atypical pneumonia or walking pneumoniaCaused by Mycoplasma pneumoniaeNo cell wallMild but persistent respiratory symptoms; low fever, cough, headache Common in children and young adults"Fried-egg" appearance on mediaDiagnosis: PCR and serological testingTreated with tetracyclines
  • Typical pneumoniaCaused by S. pneumoniaeAtypical pneumoniaCaused by other microorganismsLobar pneumoniaInfects the lobes of the lungsBronchopneumoniaInfects the alveoli adjacent to the lungsPleurisyPleural membranes inflamed
  • Viral pneumonia occurs as a complication of influenza, measles, or chickenpoxFew labs are equipped to test clinical samples properly for virusesSARS-associated coronavirus (SARS)Emerged in Asia in 2003Middle East respiratory syndrome (MERS-CoV)Reported in Saudi Arabia in 2012
Common cold
  • Over 200 different virusesRhinoviruses (30-50%)Thrive in temperatures lower than body temperatureCoronaviruses (10-15%)Sneezing, nasal secretion, congestionCan lead to laryngitis and otitis mediaNot accompanied by feverAntibiotics are of no useRelief via cough suppressants and antihistamine
  • Infection of the middle earFormation of pus puts pressure on the eardrumCausesStreptococcus pneumoniae (35%)Nonencapsulated Haemophilus influenzae (20-30%)Moraxella catarrhalis (10-15%)S. pyogenes (8-10%)Staphylococcus aureus (1-2%)Common in childhood due to smaller auditory tubeTreated with broad-spectrum penicillins
  • InfluenzavirusContains eight RNA segments and an outer lipid bilayerChills, fever, headache, and muscle aches No intestinal symptoms30,000 to 50,000 deaths in the United States annuallyAvian, swine, and mammalian strainsSwine serve as "mixing vessels" for new strains
  • Caused by Histoplasma capsulatumDimorphic fungusYeast-form grows intracellularly in macrophagesForms lung lesions; 0.1% of cases become a severe, generalized diseaseAcquired from airborne conidia in areas with bird or bat droppingsLimited geographical range in the United StatesTreated with amphotericin B or itraconazole
Pertussis (Whooping cough)
  • Caused by Chlamydophila psittaciGram-negative intracellular bacteriumTransmitted to humans by elementary bodies from bird droppings transmitted through airFever, headache, chills, disorientationDiagnosis: growth of bacteria in eggs or cell culture Treated with tetracyclines
  • Caused by Bordetella pertussisGram-negative coccobacillusProduces a capsuleAllows attachment to ciliated cells in the tracheaDestroys ciliated cells and shuts down the ciliary escalatorTracheal cytotoxin of cell wall damages ciliated cellsPertussis toxin enters the bloodstream
  • Caused by Pneumocystis jirovecii No universal agreement if it is a protozoan or fungusAsymptomatic in the immunocompetent; causes pneumonia in the immunocompromisedPrimary indicator of AIDSFound in the lining of the alveoliForms a cystCysts rupture, releasing eight trophozoitesTreated with trimethoprim-sulfamethoxazole
  • Caused by S. pneumoniaeGram-positive; encapsulated diplococci90 serotypesInfected alveoli of the lung fill with fluids and RBCs; interferes with oxygen uptake Diagnosis: optochin-inhibition test, bile solubility test, or antigen in urine Treated with macrolides and fluoroquinolonesPrevented with conjugated pneumococcal vaccine
Mycoplasmal Pneumonia
  • Typical pneumoniaCaused by S. pneumoniaeAtypical pneumoniaCaused by other microorganismsLobar pneumoniaInfects the lobes of the lungsBronchopneumoniaInfects the alveoli adjacent to the lungsPleurisyPleural membranes inflamed
  • Also called Legionnaires' diseaseCaused by Legionella pneumophilaAerobic, gram-negative rodGrows in water and air conditioning, biofilms, and waterborne amebaeTransmitted by inhaling aerosols; not transmitted person to personSymptoms: high fever and coughSimilar to symptoms of Pontiac feverTreated with erythromycin and macrolides
  • Also known as Valley fever or San Joaquin feverCaused by Coccidioides immitisDimorphic fungusArthroconidia found in alkaline desert soils of the American Southwest Form a spherule filled with endospores in tissuesMost infections are not apparent; fever, coughing, weight loss<1% of cases resemble tuberculosis Treated with amphotericin B or imidazole drugs
  • Also called primary atypical pneumonia or walking pneumoniaCaused by Mycoplasma pneumoniaeNo cell wallMild but persistent respiratory symptoms; low fever, cough, headache Common in children and young adults"Fried-egg" appearance on mediaDiagnosis: PCR and serological testingTreated with tetracyclines
Viral pneumonia
  • Infection of the middle earFormation of pus puts pressure on the eardrumCausesStreptococcus pneumoniae (35%)Nonencapsulated Haemophilus influenzae (20-30%)Moraxella catarrhalis (10-15%)S. pyogenes (8-10%)Staphylococcus aureus (1-2%)Common in childhood due to smaller auditory tubeTreated with broad-spectrum penicillins
  • Viral pneumonia occurs as a complication of influenza, measles, or chickenpoxFew labs are equipped to test clinical samples properly for virusesSARS-associated coronavirus (SARS)Emerged in Asia in 2003Middle East respiratory syndrome (MERS-CoV)Reported in Saudi Arabia in 2012
  • InfluenzavirusContains eight RNA segments and an outer lipid bilayerChills, fever, headache, and muscle aches No intestinal symptoms30,000 to 50,000 deaths in the United States annuallyAvian, swine, and mammalian strainsSwine serve as "mixing vessels" for new strains
  • The cephalosporins are a class of β-lactam antibiotics originally derived from the fungus Acremonium, which was previously known as "Cephalosporium".‎Discovery and development · ‎Cephalosporin C · ‎Cephalosporin antibiotics
Treatment of TB:
  • Also known as Valley fever or San Joaquin feverCaused by Coccidioides immitisDimorphic fungusArthroconidia found in alkaline desert soils of the American Southwest Form a spherule filled with endospores in tissuesMost infections are not apparent; fever, coughing, weight loss<1% of cases resemble tuberculosis Treated with amphotericin B or imidazole drugs
  • Most common viral respiratory disease in infantsAlmost all children are infected by age 24500 deaths annuallyCauses cell fusion (syncytium) in cell cultureCoughing and wheezing for more than a weekDiagnosis: serological test for viruses and antibodiesTreated with ribavirin and palivizumab
  • Minimum of 6 months of drug therapy due to slow growth and dormancyFirst-line drugs: isoniazid, ethambutol, pyrazinamide, rifampinSecond-line drugs: aminoglycosides, fluoroquinolones, para-aminoslicyclic acid (PAS)Multi-drug-resistant (MDR) strains: resistant to first-line drugsExtensively drug-resistant (XDR) strains: resistant to second-line drugs
  • Caused by S. pneumoniaeGram-positive; encapsulated diplococci90 serotypesInfected alveoli of the lung fill with fluids and RBCs; interferes with oxygen uptake Diagnosis: optochin-inhibition test, bile solubility test, or antigen in urine Treated with macrolides and fluoroquinolonesPrevented with conjugated pneumococcal vaccine
Tetracyclines:
  • Caused by Burkholderia pseudomalleiGram-negative rodOccurs mostly in southeast Asia and northern Australia (in moist soils)Commonly affects those with lowered immune systemsPneumonia or tissue abscesses (necrotizing fasciitis) and severe sepsisTransmission by inhalation, puncture wounds, and ingestionTreated with ceftazidime
  • Tetracycline is a broad spectrum polyketide antibiotic produced by the Streptomyces genus of Actinobacteria. It exerts a bacteriostatic effect on bacteria by binding reversible to the bacterial 30S ribosomal subunit and blocking incoming aminoacyl tRNA from binding to the ribosome acceptor site. It also binds to some extent to the bacterial 50S ribosomal subunit and may alter the cytoplasmic membrane causing intracellular components to leak from bacterial cells.
  • The cephalosporins are a class of β-lactam antibiotics originally derived from the fungus Acremonium, which was previously known as "Cephalosporium".‎Discovery and development · ‎Cephalosporin C · ‎Cephalosporin antibiotics
  • Also called Legionnaires' diseaseCaused by Legionella pneumophilaAerobic, gram-negative rodGrows in water and air conditioning, biofilms, and waterborne amebaeTransmitted by inhaling aerosols; not transmitted person to personSymptoms: high fever and coughSimilar to symptoms of Pontiac feverTreated with erythromycin and macrolides
otitis media:
  • Minimum of 6 months of drug therapy due to slow growth and dormancyFirst-line drugs: isoniazid, ethambutol, pyrazinamide, rifampinSecond-line drugs: aminoglycosides, fluoroquinolones, para-aminoslicyclic acid (PAS)Multi-drug-resistant (MDR) strains: resistant to first-line drugsExtensively drug-resistant (XDR) strains: resistant to second-line drugs
  • Caused by Histoplasma capsulatumDimorphic fungusYeast-form grows intracellularly in macrophagesForms lung lesions; 0.1% of cases become a severe, generalized diseaseAcquired from airborne conidia in areas with bird or bat droppingsLimited geographical range in the United StatesTreated with amphotericin B or itraconazole
  • Infection of the middle earFormation of pus puts pressure on the eardrumCausesStreptococcus pneumoniae (35%)Nonencapsulated Haemophilus influenzae (20-30%)Moraxella catarrhalis (10-15%)S. pyogenes (8-10%)Staphylococcus aureus (1-2%)Common in childhood due to smaller auditory tubeTreated with broad-spectrum penicillins
  • Caused by Burkholderia pseudomalleiGram-negative rodOccurs mostly in southeast Asia and northern Australia (in moist soils)Commonly affects those with lowered immune systemsPneumonia or tissue abscesses (necrotizing fasciitis) and severe sepsisTransmission by inhalation, puncture wounds, and ingestionTreated with ceftazidime
Bacterial Diseases of the Upper Respiratory System:Strep Throat
  • Streptococcal pharyngitisCaused by group A streptococci (GAS)Streptococcus pyogenesResistant to phagocytosisStreptokinases lyse clotsStreptolysins are cytotoxicLocal inflammation, fever, tonsillitis, enlarged lymph nodesDiagnosis by enzyme immunoassay (EIA) tests
  • Typical pneumoniaCaused by S. pneumoniaeAtypical pneumoniaCaused by other microorganismsLobar pneumoniaInfects the lobes of the lungsBronchopneumoniaInfects the alveoli adjacent to the lungsPleurisyPleural membranes inflamed
  • Streptococcus
  • Upper respiratory systemNose, pharynx, middle ear, and eustachian tubesSaliva and tears protect mucosal surfacesLower respiratory systemLarynx, trachea, bronchial tubes, and alveoliCiliary escalator moves particles toward the throat via ciliary actionAlveolar macrophages destroy microorganisms in the lungsRespiratory mucus protects mucosal surfaces
Psittacosis (Ornithosis)
  • Caused by S. pneumoniaeGram-positive; encapsulated diplococci90 serotypesInfected alveoli of the lung fill with fluids and RBCs; interferes with oxygen uptake Diagnosis: optochin-inhibition test, bile solubility test, or antigen in urine Treated with macrolides and fluoroquinolonesPrevented with conjugated pneumococcal vaccine
  • Caused by Chlamydophila psittaciGram-negative intracellular bacteriumTransmitted to humans by elementary bodies from bird droppings transmitted through airFever, headache, chills, disorientationDiagnosis: growth of bacteria in eggs or cell culture Treated with tetracyclines
  • Caused by Bordetella pertussisGram-negative coccobacillusProduces a capsuleAllows attachment to ciliated cells in the tracheaDestroys ciliated cells and shuts down the ciliary escalatorTracheal cytotoxin of cell wall damages ciliated cellsPertussis toxin enters the bloodstream
  • Caused by Pneumocystis jirovecii No universal agreement if it is a protozoan or fungusAsymptomatic in the immunocompetent; causes pneumonia in the immunocompromisedPrimary indicator of AIDSFound in the lining of the alveoliForms a cystCysts rupture, releasing eight trophozoitesTreated with trimethoprim-sulfamethoxazole
Normal Microbiota of the Respiratory System
  • Macrolides are a class of antibiotics derived from Saccharopolyspora erythraea (originally called Streptomyces erythreus), a type of soil-borne bacteria.
  • The cephalosporins are a class of β-lactam antibiotics originally derived from the fungus Acremonium, which was previously known as "Cephalosporium".‎Discovery and development · ‎Cephalosporin C · ‎Cephalosporin antibiotics
  • Normal microbiota suppress pathogens by competing for nutrients and producing inhibitory substancesLower respiratory system is nearly sterile
  • epiglottitis.
TB:
  • Caused by Histoplasma capsulatumDimorphic fungusYeast-form grows intracellularly in macrophagesForms lung lesions; 0.1% of cases become a severe, generalized diseaseAcquired from airborne conidia in areas with bird or bat droppingsLimited geographical range in the United StatesTreated with amphotericin B or itraconazole
  • Caused by Blastomyces dermatitidis Dimorphic fungusGrows in soil Symptoms resemble bacterial pneumonia; cutaneous abscesses; extensive tissue damage 30 to 60 deaths annuallyTreated with amphotericin B
  • Caused by Mycobacterium tuberculosisAcid-fast rod; obligate aerobe20-hour generation timeLipids in the cell wall make it resistant to drying and antimicrobialsOther causesMycobacterium bovisBovine tuberculosis; <1% of U.S. casesMycobacterium avium-intracellulare complexInfects people with late-stage HIV infection
  • Caused by Bordetella pertussisGram-negative coccobacillusProduces a capsuleAllows attachment to ciliated cells in the tracheaDestroys ciliated cells and shuts down the ciliary escalatorTracheal cytotoxin of cell wall damages ciliated cellsPertussis toxin enters the bloodstream
Which one of the following produces the most potent exotoxin?Mycobacterium tuberculosisBordetella pertussisStreptococcus pneumoniaeStreptococcus pyogenesCorynebacterium diphtheriae
  • Cornyebacterium diptheriae
  • Mycobacterium.
  • Streptococcus
  • Coccidioides
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