Sexually transmitted infections (STIs)
source: Novan’s notes, by George Novan, MD, and Joanna Breems, MD Last update: September 2023 The terms STIs (sexually transmitted infections) and STDs (sexually transmitted diseases) are nterchangeable. However, more authors now favor using STI because not all “infections” are manifest as “disease”—that is, they are not clinically evident or symptomatic. A note on terminology. […]
Micro-ID topics
Sexually transmitted infections (STIs): Urethritis, cervicitis, vaginitis, and PID
Learning goals Compare the epidemiology, microbiology, pathogenesis, clinical presentations, and potential complications for Chlamydia trachomatis serovars D-K and Neisseria gonorrhoeae Compare the epidemiology, microbiology, pathogenesis, clinical presentations, and potential complications for yeast vaginitis, bacterial vaginosis, and trichomoniasis Describe the approach to diagnosis, treatment, and prevention in patients presenting with urethritis, cervicitis, vaginitis, and pelvic inflammatory […]
Sexually transmitted Infections (STIs): Genital ulcers and warts
Learning goals For the organisms of interest causing genital ulcer disease and genital warts: Compare the microbiology, pathogenesis, epidemiology, clinical presentations, and potential complications for genital herpes (HSV), Treponema pallidum, Haemophilus ducreyi, Chlamydia trachomatis serovar L1-L3, Klebsiella granulomatis, and Human Papilloma virus (HPV) Describe the approach to diagnosis, treatment, and prevention in patients presenting with […]
Microbiome, normal flora, and antimicrobial stewardship
High-yield summary Microbiome basics Microbiome = all microbes + their genomes + the environment they occupy. Humans have ~38 trillion microbial cells (more than human cells). Major phyla: Firmicutes (Gram+ anaerobes) Bacteroidetes (Gram– anaerobes) Proteobacteria (Gram– facultative rods) Actinobacteria (Gram+ bacilli) Normal flora by site Carrier state: colonization with potential pathogen (e.g., S. aureus). […]
Key zoonoses
Naturally transmitted from animals to humans. Arthropod-borne bacteria and parasites Fleas Endemic typhus/murine typhus/Rickettsia typhi, epidemic typhus/Rickettsia prowazekii, Tunga penetrans Flies Sand Fly/Phlebotomus-cutaneous and visceral leishmaniasis, Tsetse Fly-African Sleeping Sickness/ T. brucei), Black Fly/Simulium-Onchocerciasis, Mango Fly/Chrysops-Loa Loa, Bot flies-Myiasis Mites/Chiggers Scrub typhus/Orientia tsutsugamushi, Scabies, Hair follicle mite/Demodex Mosquitos Malaria/Plasmodium, lymphatic filariasis/e.g. Wuchereria (many ARBO viruses […]
Notable bacterial toxins and mechanisms
These are exemplars of the most notable toxins and their mechanisms. Organisms such as Clostridia perfringens, Staphyloccoccus aureus, and Pseudomonas have a variety of toxins, some of which use similar mechanisms. Anthrax A/B toxin with three-protein components. Cell binding component is called protective antigen. There are two enzyme components: Edema factor Acts as adenylate cyclase […]
Infections based on predominant disease location (tropism)
Healthy Organisms associated with a healthy microbiome Bacteroides (GI tract) Lactobacillus (Vagina) Staphylococcus epidermidis (Skin) Head Central Nervous System (CNS) Meningitis: Differentiate by age (newborn, adult, elderly) and by “septic” (culture +) vs “aseptic” (culture negative – usually virus, prior antibiotics, or drug-induced). Bacteria: Neonate: E. coli, Group B Strep, Listeria Infant: Neisseria meningitidis, Strep […]
Outline of parasitic diseases and organisms according to site/specimen
Blood Plasmodium, Babesia, Trypanosoma, Microfilaria (Leishmania and Toxoplasma can be blood-bourne, but are not usually seen on the peripheral blood smear.). CSF Trypanosoma brucei, Naegleria, Angiostrongylus (eosinophilic meningitis). Brain Neurocysticercosis (Tinea solium), Toxoplasma. Eye Acanthamoeba, Toxoplasmosis, Onchocerciasis, Loa loa, visceral larva migrans (Toxocariasis). Mouth/Throat Ascaris. Sputum/Lung Ascaris, Strongyloides, Pneumocystis, Paragonimus. Abdomen/Ascites Echinococcal cysts, Entamoeba histolytica […]
Pharmacology: Introduction to antimicrobial therapy
High-yield summary Learning goals Understand five mechanisms of antibiotic action Differentiate empiric vs. directed therapy Recognize bacterial resistance mechanisms Apply PK/PD principles: bacteriostatic vs. bactericidal, time vs. concentration dependence Mechanisms of action Cell Wall Synthesis Inhibition: Penicillins, Cephalosporins, Carbapenems, Vancomycin. Protein Synthesis Inhibition: Aminoglycosides (30S), Macrolides, Clindamycin, Tetracyclines (50S). Cell Membrane Disruption: Daptomycin, Polymyxins. […]