Microbiology PDF

MICROBIOLOGY
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CULTURE AND STERILISATION
MICROBIOLOGY
CONTENTS
CULTURE AND STERILISATION ...................................................................................................................................... 8
CULTURE ................................................................................................................................................................... 8
STERILISATION........................................................................................................................................................... 8
DISINFECTION ........................................................................................................................................................... 9
BACTERIAL GENETICS .................................................................................................................................................. 10
GENERAL FEATURES OF BACTERIA .......................................................................................................................... 10
GRAM POSITIVE AND GRAM NEGATIVE ORGANISMS............................................................................................. 11
LIGAND AND HOST RECEPTORS FOR MICROORGANISMS ...................................................................................... 11
MULTIPLICATION OF BACTERIA .............................................................................................................................. 12
BACTERIAL RESISTANCE .......................................................................................................................................... 12
BIOTERRORISM AND VESICANTS ............................................................................................................................ 13
BACTERIOLOGY ........................................................................................................................................................... 14
GENERAL FEATURES OF BACTERIA .......................................................................................................................... 14
FEATURES OF STAPHYLOCOCCUS ........................................................................................................................... 16
SPECIES OF STAPHYLOCOCCUS ............................................................................................................................... 17
DISEASES CAUSED BY STAPHYLOCOCCUS ............................................................................................................... 18
TOXINS OF STAPHYLOCOCCUS ................................................................................................................................ 18
STAPHYLOCOCCAL FOOD POISONING .................................................................................................................... 19
FEATURES OF STREPTOCOCCUS .............................................................................................................................. 19
SPECIES OF STREPTOCOCCUS.................................................................................................................................. 20
DISEASES CAUSED BY STREPTOCOCCUS ................................................................................................................. 21
TOXINS OF STREPTOCOCCUS .................................................................................................................................. 21
CROSS SENSITIVITY OF STREPTOCOCCAL ANTIGEN ................................................................................................ 22
ENTEROCOCCUS ...................................................................................................................................................... 22
PNEUMOCOCCUS .................................................................................................................................................... 22
GENERAL FEATURES OF NEISSERIA ......................................................................................................................... 23
NEISSERIA GONORRHOEA ....................................................................................................................................... 23
NEISSERIA MENINGITIDIS ........................................................................................................................................ 24
GENERAL FEATURES OF CLOSTRIDIA ....................................................................................................................... 25
CLOSTRIDIUM PERFRINGENS .................................................................................................................................. 25
GAS GANGRENE ...................................................................................................................................................... 26
CLOSTRIDIUM TETANI ............................................................................................................................................. 26
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MICROBIOLOGY
GENERAL FEATURES OF TETANUS ........................................................................................................................... 26

MANAGEMENT OF TETANUS .................................................................................................................................. 27
PREVENTION OF TETANUS ...................................................................................................................................... 27
CLOSTRIDIUM BOTULINUM .................................................................................................................................... 28
BOTULISM ............................................................................................................................................................... 28
CLOSTRIDIUM DIFFICLE AND PSEUDOMEMBRANOUS COLITIS .............................................................................. 29
GENERAL FEATURES OF CORYNEBACTERIUM ......................................................................................................... 29
CORYNEBACTERIUM DIPHTHERIA ........................................................................................................................... 30
FEATURES OF DIPHTHERIA ...................................................................................................................................... 30
MANAGEMENT OF DIPHTHERIA ............................................................................................................................. 31
HEMOPHILUS .......................................................................................................................................................... 32
BORDETELLA PERTUSSIS ......................................................................................................................................... 32
BRUCELLA ................................................................................................................................................................ 33
BARTONELLA ........................................................................................................................................................... 34
ACTINOMYCES......................................................................................................................................................... 34
NOCARDIA ............................................................................................................................................................... 35
LISTERIA .................................................................................................................................................................. 35
BACILLUS ANTHRACIS ............................................................................................................................................. 36
BACILLUS CEREUS.................................................................................................................................................... 37
LEGIONELLA ............................................................................................................................................................ 37
CAMPYLOBACTER .................................................................................................................................................... 38
HELICOBACTER ........................................................................................................................................................ 38
PASTEURELLA .......................................................................................................................................................... 38
FRANSCIELLA ........................................................................................................................................................... 39
YERSINIA.................................................................................................................................................................. 39
PSEUDOMONAS ...................................................................................................................................................... 40
BURKHOLDERIA ....................................................................................................................................................... 41
GENERAL FEATURES OF ENTEROBACTERIACEAE .................................................................................................... 41
E.COLI ...................................................................................................................................................................... 41
PROTEUS ................................................................................................................................................................. 42
SALMONELLA .......................................................................................................................................................... 42
TYPHOID .................................................................................................................................................................. 43
SHIGELLA ................................................................................................................................................................. 44
FEATURES OF VIBRIO .............................................................................................................................................. 45
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MICROBIOLOGY
CHOLERA ................................................................................................................................................................. 46
HALOPHILIC VIBRIO ................................................................................................................................................. 46
ATYPICAL MYCOBACTERIA ...................................................................................................................................... 47
GENERAL FEATURES OF RICKETTSIA ....................................................................................................................... 48
ENDEMIC TYPHUS ................................................................................................................................................... 48
EPIDEMIC TYPHUS ................................................................................................................................................... 48
SCRUB TYPHUS ........................................................................................................................................................ 49
RICKETTSIAL POX ..................................................................................................................................................... 49
ROCKY MOUNTAIN SPOTTED FEVER ....................................................................................................................... 49
Q FEVER................................................................................................................................................................... 50
EHRILICHIA .............................................................................................................................................................. 50
CHLAMYDIA ............................................................................................................................................................. 50
MYCOPLASMA ......................................................................................................................................................... 51
NON VENERAL TREPONEMES.................................................................................................................................. 52
Yaw and Pinta ............................................................................................................................................................. 52
LEPTOSPIRA ............................................................................................................................................................. 53
BORRELIA ................................................................................................................................................................ 53
VIROLOGY ................................................................................................................................................................... 54
GENERAL FEATURES OF VIRUS ................................................................................................................................ 54
HERPES VIRUS ......................................................................................................................................................... 56
PARVOVIRUS ........................................................................................................................................................... 57
EBSTEIN BARR VIRUS ............................................................................................................................................... 57
CYTOMEGALOVIRUS ............................................................................................................................................... 58
ROSEOLA INFANTUM .............................................................................................................................................. 58
VARICELLA ZOSTER VIRUS ....................................................................................................................................... 58
ADENOVIRUS ........................................................................................................................................................... 59
ROTAVIRUS ............................................................................................................................................................. 60
SMALL POX .............................................................................................................................................................. 60
PAPOVA VIRUS ........................................................................................................................................................ 60
POLIO VIRUS ............................................................................................................................................................ 61
ENTEROVIRUS ......................................................................................................................................................... 62
COXSACKIE VIRUS.................................................................................................................................................... 62
INFLUENZA VIRUS ................................................................................................................................................... 62
MEASLES ................................................................................................................................................................. 63
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MICROBIOLOGY
MUMPS ................................................................................................................................................................... 64
RABIES ..................................................................................................................................................................... 65
GENERAL FEATURES OF ARBOVIRUS ....................................................................................................................... 66
DENGUE .................................................................................................................................................................. 66
CHIKUNGUNYA ........................................................................................................................................................ 67
YELLOW FEVER ........................................................................................................................................................ 67
JAPANESE ENCEPHALITIS ........................................................................................................................................ 67
WEST NILE FEVER .................................................................................................................................................... 68
KYASANUR FOREST DISEASE ................................................................................................................................... 68
HANTA VIRUS .......................................................................................................................................................... 68
RESPIRATORY SYNCITIAL VIRUS .............................................................................................................................. 69
REOVIRUS ................................................................................................................................................................ 69
RUBELLA .................................................................................................................................................................. 69
FEATURES OF HIV .................................................................................................................................................... 70
TRANSMISSION OF HIV ........................................................................................................................................... 71
EPIDEMIOLOGY OF HIV ........................................................................................................................................... 72
MANIFESTATIONS OF AIDS ..................................................................................................................................... 72
KAPOSIS SARCOMA ................................................................................................................................................ 73
DIAGNOSIS OF AIDS ................................................................................................................................................ 74
TREATMENT OF AIDS .............................................................................................................................................. 74
PREVENTION OF HIV ............................................................................................................................................... 76
PRIONS AND SLOW VIRUS ....................................................................................................................................... 77
MYCOLOGY ................................................................................................................................................................. 78
GENERAL FEATURES OF FUNGI ............................................................................................................................... 78
DIMORPHIC FUNGI .................................................................................................................................................. 79
DERMATOPHYTES ................................................................................................................................................... 79
CRYPTOCOCCUS ...................................................................................................................................................... 79
CANDIDA ................................................................................................................................................................. 80
PNEUMOCYSTIS JEROVECI ...................................................................................................................................... 81
BLASTOMYCOSIS ..................................................................................................................................................... 81
HISTOPLASMOSIS .................................................................................................................................................... 81
ASPERGILLUS ........................................................................................................................................................... 82
MUCOR ................................................................................................................................................................... 82
MADURELLA ............................................................................................................................................................ 83
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MICROBIOLOGY
SPOROTRICHOSIS .................................................................................................................................................... 83
CHROMOBLASTOMYCOSIS ...................................................................................................................................... 83
PROTOZOA .................................................................................................................................................................. 83
GENERAL FEATURES OF PROTOZOA ....................................................................................................................... 83
ENTAMOEBA HISTOLYTICA ..................................................................................................................................... 84
AMOEBIC MENINGOENCEPHALITIS ........................................................................................................................ 85
GIARDIA................................................................................................................................................................... 85
LEISHMANIA ............................................................................................................................................................ 85
TRYPANOSOMA....................................................................................................................................................... 87
TOXOPLASMA.......................................................................................................................................................... 88
BABESIOSIS .............................................................................................................................................................. 89
CRYPTOSPORIDIOSIS ............................................................................................................................................... 89
ISOSPORA ................................................................................................................................................................ 89
CYCLOSPORA ........................................................................................................................................................... 89
BALANTIDIUM COLI ................................................................................................................................................. 89
FEATURES OF PLASMODIUM .................................................................................................................................. 90
FEATURES OF MALARIA .......................................................................................................................................... 91
EPIDEMIOLOGY OF MALARIA .................................................................................................................................. 92
DIAGNOSIS OF MALARIA ......................................................................................................................................... 92
TREATMENT OF MALARIA ....................................................................................................................................... 92
HELMINTHS ................................................................................................................................................................. 94
GENERAL FEATURES OF HELMINTH ........................................................................................................................ 94
CLONORCHIS ........................................................................................................................................................... 95
DIPHYLLOBOTHRIUM LATUM ................................................................................................................................. 95
FASCIOLA HEPATICA ................................................................................................................................................ 95
FASCIOLOPSIS BUSKI ............................................................................................................................................... 95
ASCARIS ................................................................................................................................................................... 96
TAENIA SOLIUM ...................................................................................................................................................... 96
NEUROCYSTICERCOSIS ............................................................................................................................................ 96
TAENIA SAGINATA ................................................................................................................................................... 97
ECHINOCOCCUS ...................................................................................................................................................... 97
FEATURES OF FILARIASIS ......................................................................................................................................... 98
MANAGEMENT OF FILARIASIS ................................................................................................................................ 99
ENTEROBIUS ............................................................................................................................................................ 99
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MICROBIOLOGY
TRICHINELLA ........................................................................................................................................................... 99
GUINEA WORM ..................................................................................................................................................... 100
STRONGYLOIDES ................................................................................................................................................... 100
SCHISTOSOMA ...................................................................................................................................................... 100
TRICHURIS ............................................................................................................................................................. 101
HOOKWORM ......................................................................................................................................................... 101
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MICROBIOLOGY
KEY TO THIS DOCUMENT

Text in normal font Must read point.
Asked in any previous medical entrance
examinations
Text in bold font Point from Harrisons
text book of internal medicine 18th
edition
Text in italic font Can be read if
you are thorough with above two
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MICROBIOLOGY

CULTURE
Father of medical microbiology
Exceptions to Kochs postulates
NOT true about Kochs postulates
Resolution provided by light microscope
Magnification of electron microscope up to
Ultraviolet source is used in
Nutrient broth is
Fastidious organisms are grown by
McConkeys agar medium is
NOT a selective media
A substance when added to culture causes inhibition of
multiplication but on removal causes enhanced growth
In patient with UTI CLED cysteine lactose electrolyte
deficient media is preferred over McConkey media
because
pH of Sabrouds dextrose agar adjusted to
Intracellular
Organisms can NOT be cultured in cell free medium
Does NOT grow in cell free media
Viable non cultivable is used for
NOT a method of cultivation of viruses
Organism cannot be cultured
Robert Koch
M.leprae, T.pallidum, N.gonorrhea, E.coli
(cannot be grown in cell free media also)
Antibiotics cure the disease
200 nm
1,00,000
Fluorescence microscope
Basal media
Enrichment media
Differential media
Blood Agar
Bacteriostatic
Promotes growth of staphylococcus aureus and candida
4-6
Virus, Chlamydia, Rickettsia
Treponema pallidum, Pneumoystis jiroveci,
Rhinosporidium seeberi
M. leprae, Rickettisa, T. pallidum
M.leprae, Treponema pallidum
Chemically defined media
Pneumocystis jiroveci, Rhinosporidium
seeberi
STERILISATION
Asepsis means
Process of destroying all microbes including spores
NOT a complete sterilization
Most resistant to antiseptics
Decreasing order of resistance to sterilization
Sterilization of prion
Reliably used for hand washing
Savlon contains
Algae growth in water controlled by
NOT true about Phenol
Sporicidal agents
Sporicidal
Absence of pathogenic microbes

Sterilization
Sodium hypochlorite
Prion
Prions, bacterial spores, bacteria
Heating at 134*C for 5 hours, 2N
concentration NaOH
Chlorhexidine, Isopropylalcohol, Cresol
Cetrimide + chlorheximide
Bleaching powder
Phenol require organic matter to act
Glutaraldehyde, Formaldehyde, Ethylene oxide,
Halogens
Glutaraldehyde, Formaldehyde, Chlorine dioxide
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MICROBIOLOGY
Spores of bacteria are destroyed by
Glutaraldehyde is
Hypochlorites are
Principle of autoclave
Autoclaving is done at
Operating temperature in a ethylene oxide sterilization
during warm cycle
Used as control during plasma gas sterilization
Radiation can be used to sterilize
Rays used for Cold sterilization
Endoscope disinfected by
Proctoscope is sterilized by
Heat labile instruments such as plastic syringes
sterilized by
Plastic syringes are sterilized by
Glassware and syringes sterilized by
Lippes loop is sterilized by
Infant feeding bottle is sterilized by
Egg containing culture media are
sterilized by
Best method for sterilizing liquid paraffin
Oil and grease are sterilized by
Culture media sterilized by
Vaccines are sterilized by
Sterilization method for catgut suture
Surgical instruments are sterilized by
Heat labile instruments for use in surgical procedures
can be best sterilized by
Heart Lung machine is sterilized by
Operation theatre is sterilized by
In operation theatre, by using filter of 5
mm pore size with 20 air changes and
adequate ventilation, bacterial count can
be reduced to
NOT a best way to sterilize sputum
Hospital waste are disposed by
Best method to sterilize by dry heat
Gamma radiation are used for sterilizing
Irradiation NOT used to sterilize
Autoclaving at 120*C for 15 mins

Sporicidal
Virucidal
Denaturation and Protein coagulation
120 degree Celsius for 30 minutes
49-63 degree Celsius
Bacillus stearothermophilus
Bone graft, artificial tissue graft, suture
UV rays
2% glutaraldehyde for 20 minutes
Glutaraldehyde
Ethylene oxide
Ionising radiation
Hot air oven
1/2500 solution of iodine
Sodium hypochlorite
Tyndallisation
Dry heat
Hot air oven
Autoclaving
Seitz filter
Radiation
Radiation
Ethylene oxide gas
Ethylene Oxide gas
Formaldehyde gas
200 CFU/m3
Chlorhexidine
Incineration
Hot air oven
Syringes
Bronchoscope
DISINFECTION
Disinfectants
Disinfectant destroys
NOT true about disinfectants
Rideal and walker coefficient is employed for
Hypochlorites are bactericidal and inactivated by

organic matter, glutaraldehyde is sporicidal and NOT
inactivated by organic matter, formaldehyde is
bactericidal, sporicidal and virucidal
All harmful microbes but not spores
Phenol usually requires organic matter to act
Germicidal power of disinfectant
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BACTERIAL GENETICS
MICROBIOLOGY
assessment of
Standard against which disinfectants are measured
Disinfection of water by routine chlorination can be
classified as
Precurrent disinfection
Chlorine exerts disinfectant action in
Required amount of bleaching powder necessary to
disinfect choleric stools
Disinfection of sputum by
Disinfectant used for blood spills
Most powerful chemical disinfectant
Ethylene oxide is an
Disinfectant acting by causing plasma membrane
damage
Castellanis paint for disinfecting skin
contains
Frequency of microwaves for disinfection
Sputum can NOT be disinfected by
NOT true about spauldings criteria
NOT an disinfectant
NOT a test to test the efficiency of disinfectant
Most likely cause of infection after
disinfection procedure that killed
vegetative cells but does not kill spores
Phenol
Precurrent disinfection
Hand washing, pasteurization of milk,
chlorination of water
Bleaching powder, Halozone tablets, Sodium
hypochlorite
50 gm/lit
Boiling, autoclaving, burning, cresol
Sodium hypochlorite
Lysol
Intermediate disinfectant
Ammonium compounds
Phenol, resorcinol, basic fuschin, boric
acid, acetone
2450 MHz
Chorhexidine
Semi critical items need low level disinfection
100% alcohol
Hugh Leifson test (to differentiate micrococci from
staphlococci)
Clostridia
BACTERIAL GENETICS
GENERAL FEATURES OF BACTERIA
Smallest size that can be seen by naked
eye
Smallest size that can be seen by light
microscope
Smallest size that can be seen by electron
microscope
Dye used in fluorescent microscopy
Total number of microbes
Rearing of animals under sterile conditions
Prokaryotic organism have
Prokaryotes refers to organism with
Prokaryotes are characterized by
Prokaryotes have
Prokaryotic counterpart of mitochondria
200 micron
0.3 micron
10^(-4) micron
Auramine
10^30
Gnotobiotics
DNA without Nucleus
Chromosome
Absence of nuclear membrane
DNA
Mesosomes
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BACTERIAL GENETICS
MICROBIOLOGY
Prokaryotic DNA differ from eukaryotic organism by
Muramic acid is present in
Steroids are present in
Doth DNA and RNA found in
Absent in bacteria
Bacteria lacks in
Bacterial flagella confers
Lophotrichous
Dark ground microscopy used to see
Peritrichous flagella
Peritrichous flagella is NOT seen in
Bacteria growing between 25 40 * C
Bacterial genome completely recognized for
Lyophilisation means
Bacteriocins are
Dipicolinic acid is found in
Few gram negative organisms inject toxin directly to host
target cells by means of complex set of proteins
Should NOT be refrigerated before primary inoculation
Gold standard for bacterial strain analysis
No complex with proteins

Prokarytoes
Eukaryotes
Bacteria
Mitochondria
Sterol
Specific antigenecity
Tuft of flagella at one pole
Flagella
E.coli, salmonella, proteus, listeria,
bacillus, clostridium
Vibrio cholera
Mesophilic
H.pylori
Preserving microorganisms
Antibiotic like substance produced by Coliform bacteria
Spores
Type III secretion (Salmonella, Yersinia, Pseudomonas)
CSF
Pulsed field gel electrophoresis
GRAM POSITIVE AND GRAM NEGATIVE ORGANISMS

GRAM POSITIVE
2 layers (inner cytoplasmic membrane,
outer thick peptidoglycan)
Low lipid
No endotoxin except listeria
monocytogenes
Teichoic acid
Associated with protein F
GRAM NEGATIVE
3 layers (inner cytoplasmic membrane,
thin peptidoglycan, LPS)
High lipid
Endotoxin
Aromatic aminoacids, indole ring (eg.
Cholera), periplasmic space, porin channel,
resistant to penicillin and lysozyme attack
Associated with Pili, Fimbriae
LIGAND AND HOST RECEPTORS FOR MICROORGANISMS

ORGANISM
P. falciparum
P. vivax
E. histolytica
Influenza
Mealses
HSV
LIGAND
Erythrocyte binding protein 175
Merozoite
Surface lectin
Hemagglutin
Hemagglutin
Glycoprotein C
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HOST RECEPTOR
Glycophorin A
Duffy antigen
N acetyl glucosamine
Sialic acid (N acetylneuramic acid)
CD 46/mosein
Heparin sulphate
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BACTERIAL GENETICS
MICROBIOLOGY
MULTIPLICATION OF BACTERIA
Phase of bacterial growth during which growth rate of
bacteria is constant
Sporulation occurs in
Sporulation does NOT occur in
A bacterium can divide every 20 minutes. how many
bacteria will be there if there is exponential growth for
3 hours
Substance when added to a culture causes inhibiton of
multiplication but on removal enhanced growth
Area of Lysis produced by Bacterial Lawn Culture
True about bacteriophage
Lambda phage
Lytic phase of bacteriophage is an

example for
NOT true about lambda phage
Bacteriophage is
Bacteriophage replication occurs through
Stationary phase
Stationary phase
Live organisms
512
Bactericidal
Plaque
It imparts toxigenicity to bacteria
In lysogenic phase it fuses with host chromosome and
remain dormant, in lytic phase it fuses with host
chromosome and replicates, in lytic phase it cause cell
lysis and releases virus particles
Type C response
Lytic and lysogenic phase occur together
Virus that invade bacteria
Transduction
BACTERIAL RESISTANCE
Bacteria may acquire characteristics by
Antibiotic resistance
Bacterial drug resistance in tuberculosis is via

MDR acts by
Tranferable resistance
F factor integrates with bacterial chromosome to form
Ability to form or grow in multicellular masses
Phenomenon responsible for antibiotic resistance in
bacteria due to slime production
Bacteria can NOT acquire characteristics by
NOT true about antibiotic resistance
Not used to introduce genome into the bacteria
NOT true about Bacteriophage
Does NOT transfer drug resistance
Organ of attachment of bacteria
Taking up soluble DNA fragments across their cell wall,

through bacteriophage, through conjugation
MC mechanism is production of neutralizing enzymes
by bacteria, Complete elimination of target is the
mechanisms by which enterococci develop resistance to
vancomycin, Alteration of target lesions lead to
development of resistance in pneumococci, Drug
resistance commonly acquired horizontally
Mutation
Cause efflux of drug
High degree of resistance, Involves resistance to
multiple drug, Plasmids play a role
Hfr
Biofilm
Biofilm formation
Incorporating part of host DNA
Plasmid mediated antibiotic resistance is always
transmitted vertically
FISH
It transfers only by chromosomal gene
Hfr
Fimbriae
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BACTERIAL GENETICS
MICROBIOLOGY
Surface appendage of bacteria function as organ of
adhesion
Organ of bacterial adherence
Phage typing is used as an epidemiological
tool for
Phage typing is NOT useful in
Phage typing NOT used as an epidemiological tool in
Segment of DNA between chromosomal and
extrachromosomal DNA molecules within the cell
Jumping gene
Horizontal transfer of R factor occurs from one bacteria
to other
Multidrug resistance is transmitted through
Transmitted through pili
Conjugation does NOT involve
Free DNA across cell membrane transferred by
Transformation is seen in
Virus mediated transfer of host DNA from one cell to
another is known as
In transduction, DNA transmitted by vector belongs to
Plasmid
Plasmid
Drug resistance most commonly transmitted by

Plasmid is responsible for
NOT true regarding plasmid
Process of host gene transfer through F
factor
E strip method is used for
Fimbriae
Pili
Staphylococcus aureus, Vibrio cholera,
Shigella dysenteriae
Salmonella
Streptococci
Transposons
Transposons
Conjugation
Conjugation
Conjugation
Bacteriophage
Transformation
Bacillus, hemophilus, pneumococcus
Transduction
Bacteria
Transferred by conjugation, mediate drug resistance,
determine pili production
Involved in conjugation and multidrug resistance
transfer, Imparts capsule and pili formation, Eliminated
by heating with radiation, Transmission of different
species, Can cause lysogenic conversion
R.Plasmid
Drug resistance
Extrachromosomal
Sexduction
Minimum inhibitory concentration
BIOTERRORISM AND VESICANTS

Category A bioterrorism agents
Category B bioterrorism agents
Category C bioterrorism agents

Strain used in anthrax bioterrorism
Vesicants
Vesicants
Treatment of mechlorethamine induced
vesicles
Anthrax, Botulism, plague, small pox, tularemia, viral

hemorrhagic fever
Brucellosis, Epsilon of clostridium perfringens, Glanders
(Burkholderia mallei), Melidiosis, Psittacosis, Q fever,
Ricinus communis, Straphylococcal enterotoxin B, Typhus
fever, viral encephalitis, food safety threat, water safety
threat
Nipah, Hanta, SARS and emerging infections
Ames strain
Mustard, lewisite, phosgene
Mechlorethamine, vincristine,
doxorubicin, BAL, phosgene oxime
Thiosulphate
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BACTERIOLOGY
MICROBIOLOGY
Treatment of vincristine induced vesicles
Hyaluronidase
BACTERIOLOGY
GENERAL FEATURES OF BACTERIA
Bacteria
Bacteria does NOT divide by binary
fission
Bacterial cell wall is composed of
Zwitter ionic pattern of capsular
polysaccharide is responsible for
Responsible for inherent virulence of organism
Bacteria survive intracellularly by inhibiting
Shape of Cocci
Normal microbial flora
Normal bacterial flora
Pharyngoscleroma is a
Difference between gram positive and gram negative
organisms is that gram negative organisms contain
Steps in gram staining
Grams stain is NOT useful in diagnosing
Which is NOT present in gram negative bacteria
NOT gram negative
Acid fast organisms
Acid fast organisms
Bipolar staining
Craiges tube differentiates

Non motile organism
Darting motility
Stain not taken by capsule if it contains
Capsulated organism
Polysaccharide capsule related antigen antibody
responses present in
Pigment produced by serratia
Safety pin appearance
Organism arranged in cubical pocket of
eight cocci
Bacteremia is associated with
Mitochondria always absent, Divide by binary fission

Chlamydia, Spirochete (Transverse fission,
Complex fission)
Muramic acid, glucosamine, mucopeptide
Abscess formation
Adhesion, capsule, lipids
Formation of phagolysosome
Spherical
Can NOT be eradicated by antimicrobial agents
Established only after neonatal period
Bacterial Disease
Aromatic amino acids
Crystal violet, iodine, decolorisation,
safranin
Streptococcal pharyngitis
Teichoic acid
Acinetobacter
Mycobacteria, Nocardia, Spores, Isospora,
Cryptosporidium, Cyclospora
Legionella, eggs of tenia saginata, head of
sperm, rhodococcus
Hemophilus ducreyi, Yersinia pestis,
pseudomonas mallei, pseudomonas
pseudomallei, campylobacter
granulomatis
Motile and non motile
Klebsiella
V.cholera, Campylobacter jejuni
Polysaccharide, protein
Klebsiella, Cryptococci
Pneumococcus, Meningococcus, Hemophilus influenza
Prodigiosin
Chlamydia, hemophilus ducreyi
Sarcina
Pneumococci, staphylococci, E.coli
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BACTERIOLOGY
MICROBIOLOGY
Toxins inhibiting protein synthesis
Toxins mediated by cAMP
Heat stable E. coli toxin is mediated by
Heat labile toxin is mediated by
Obligate aerobe
Obligate anaerobe
Facultative anerobe
Facultative aerobe
Ratio of anaerobe to aerobe in stool
Anaerobes grow in
Obligatory anerobes
Bacteroides fragilis
Bacteroides fragilis
Bacteroides may cause
Bacteroides cause
Bacteroides melaninogenica is associated
with
Bacteremia due to bacteroides fragilis do NOT cause
NOT useful in anaerobic infection
Drug of choice for bacteroides infection
Meleney gangrene
PAPA
Exotoxins are
Exotoxin
NOT true about exotoxins
Endotoxin from gram negative organism
Gram negative bacteria without endotoxin
Act by increasing c-AMP level
Heat labile toxin is associated with
Heat stable toxin is associated with
Preformed toxin is important in food poisoning due to
Preformed toxin
Heat stable enterotoxin
Diarrhea type of Bacillus cereus

Heat stable enterotoxin causing food poisoning
produced by
Food poisoning with shortest incubation period
Verotoxin of E.coli, Shigella toxin,

Exotoxin A of pseudomonas
Vibrio cholera O1, Vibrio cholera O137,
Heat labile E. coli toxin
cGMP
cAMP
Superoxide dismutase (SOD), peroxidase
(POD) and catalase present
SOD, POD, catalse negative
Two enzymes present, one absent
One enzyme present, two absent
1000:1
CDC anerobic blood agar
Clostridium botulinum, Bacteroides
Frequent anaerobe isolated from clinical samples, NOT
uniformly sensitive to metronidazole, LPS formed by
bacteroides fragilis is structurally and functionally
different from conventional endotoxin
Gram negative anaerobic non sporing bacillus
Peritonitis
Carbuncle, peritonitis, necrotizing fasciitis
Red fluorescence when exposed to UV
light
Shock and DIC
Penicillin
Metronidazole
Anaerobic bacterial synergistic gangrene
Pyoderma gangrenosum, acne, septic pyogenic arthritis
Highly antigenic
Heat labile, by both gram positive and
gram negative organisms
Heat stable
Lipopolysaccharide
Cholera
Proteus, E.Coli, Vibrio cholera
cAMP
cGMP (exception S.aureus vagal action)
S.aureus, Clostridium botulism, emetic type of B.cereus
Longer incubation period
Staphylococcus enterotoxin, enterotoxin of
klebsiella pneumonia, emetic type of
bacillus cereus, ST of ETEC, Yersinia
enterocolitic toxin, Clostridium botulinum
toxin
Heat labile
Bacillus cereus, Yersinis enterocolitica, Staphylococcus
Staphylococcus aureus
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BACTERIOLOGY
MICROBIOLOGY
Stool examination is required for diagnosis of infection
with
Pus cell in diarrhea seen in
Microorganisms invading GIT causing gasteroenteritis
Biosafety precaution grade III is followed in
Organism known to survive intracellularly
Intracellular organisms
Obligatory intracellular
Obligate intracellular parasites
Rhabdomyolysis is associated with
F fever
Sodoku
Rat bite fever is caused by
Rat bite fever is caused by
Haverhill fever is caused by
Strongly urease positive
Urease positive bacteria
Ureaplama urealyticum
Acinetobacter baumannii
Superinfection is common with

Treatment for aeromonas infection
Treatment for chrysobacterium infection
Staphylococcal food poisoning, Clostridia, Shigella,

Campylobacter, Enterobius vermicularis
Shigella, campylobacter
Shigella, Vibrio parahemolyticus, Campylobacter,
Salmonella
Human influenza virus, Coxiella burnetti,
Mycobacterium tuberculosis
N.meningitits, Salmonella typhi, legionella
pneumophilia
Virus, Chlamydia, rickettsia
Chlamydia
Prions, virus, rickettsia, chlamydia
Clostridium perfringens, Streptococcus, Clostridium
tetani
Spirillium minus, Leptospira canicola, streptobacillus
moniliformis
Spirillum infection
Spirillum minus
Streptobacillus moniliformis
Streptobaciilus moniliformis
H.pylori > Proteus
Proteus, klebsiella, staphylococci
Non gonococcal urethritis, epididymitis, bacterial
vaginosis
Combat related infection in Iraq and Afghanistan, resistant,
treated with sulbactam, carbopenem resistant
Acinetobacter baumannii is treated with colistin and
polymyxin
Immunocompromised host
Ciprofloxacin
Fluoroquinolones
FEATURES OF STAPHYLOCOCCUS
Staphylococci
Staphylococcus
Important virulent factor in

staphylococcus aureus
Abnormal neutrophil function is
30% of population is healthy nasal carriers,

epidermolysin and TSS toxin are superantigens,
methicillin resistance is chromosomally mediated
Majority of infection caused by coagulase negative
staphylococci are due to staphylococcus epidermidis.
beta lactamase production in staphylococci is under
plasmid control, methicillin resistance in staphylococcus
aureus in independent of beta lactamase production
Gram positive, blood agar, clear zone of
hemolysis, coagulase positive,
pathogenicity is indicated by coagulase
positivity
Coagulase
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BACTERIOLOGY
MICROBIOLOGY
associated with recurrent infections
caused by
Antibody marker in serum for staphylococcal
endocarditis
Staphylococcus remains in skin for longer period
because of
MC human staphylococcus aureus infection is due to
capsular subtype
MC mechanism of drug resistance in Staphylococcus
Staphylococcus aureus differs from staphylococci
epidermidis by
Differentiation of staphylococcus aureus from other
staphylococci
Protein A is the component of cell wall of
NOT true about Staphylococcus aureus
NOT true about staphylococcus
Methicillin resistance
Methicillin resistant bacteria are
Resistance in MRSA is produced by
Methicillin resistance by Staphylococci is expressed
when incubated at
MRSA resistance
MRSA resistance primarily mediated by

Infections caused by community acquired MRSA
Streptococcal gangrene is same as
Drug of choice for MRSA
Useful for MRSA
MRSA infection in ward. Best way to control infection
MRSA NOT expected to respond to
NOT used for MRSA
Antiteichoic acid
Hyaluronidase
5,8
Transduction
S.aureus is coagulase positive
Coagulase test
Staphylococci
Most common source of infection is by cross infection
from infected patients
Catalase negative
Chromosomally mediated
Staphylococcus
Alteration in penicillin binding protein (MeCA gene)
30 degree Celsius
Resistance may be produced because of
hyperproduction of beta lactamase, expression of
resistance is enhanced by incubating at 37*C during
susceptibility testing
Chromosomal MecA gene
Necrotizing fasciitis, necrotizing pneumonia, sepsis with
Waterhouse Friedrichson syndrome, Purpura fulminans
Necrotizing fasciitis
Vancomycin, Teichoplanin, Linezolid
Quinupristin/dalfopristin, Linezolid, Teicoplanin
Teicoplanin
Cotrimoxazole, Ciproflaxacin, Vancomycin
Vancomycin given empirically to all patients
Glycopeptides
Carbapenem
Cefaclor
SPECIES OF STAPHYLOCOCCUS
Staphylococcus aureus differ from staphylococcus
epidermidis by
ICU on CVP line, gram positive cocci, catalase positive
and coagulase negative
MC gram positive cause of UTI among sexually active
women
Gram positive cocci
Coagulase positive
Staphylococcus epidermidis
Staphylococcus saprophyticus
Staphylococcus saphrophyticus cause UTI in female.
micrococci are oxidase positive, pneumococci are
capsulated
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BACTERIOLOGY
MICROBIOLOGY
Novobiocin susceptible staphylococci
Staphylococcus hemolyticus, Staphylococcus

epidermidis
DISEASES CAUSED BY STAPHYLOCOCCUS

Oppurtunistic infection most commonly seen in children
with neutropenia
MC cause of surgical wound infections
MC caue of pyopneumothorax and
pyopericarditis in infants
Botryomycosis is caused by
Pedal botyromycosis is caused by
Staphylococci can cause
Pyomyositis is caused by
Postoperative parotitis is caused by
Lymphangitis is caused by
Common cause of acute borne infections
Ritters disease is caused by
A boil in staphylococcal infection of
Carbuncle caused by
Carbuncle are common in
Carbuncle is treated by
MC cause of epidural abscess
MC cause of sepsis in India within 2 months
Right sided endocarditis in IV drug abusers
MC cause of primary bacterial infection
MC cause of endocarditis in prosthetic valve
replacement within one year
MC catheter induced blood infection due to
Non coagulase staphylococci
Toxic shock syndrome is due to
Toxic shock syndrome is caused by
Toxic shock syndrome caused by
Toxic shock syndrome is associated with
Toxic shock syndrome is mainly caused by
Staphylococcus
Staphylococcus
Furuncle, sycosis barbae
Staphylococcus
Hair follicle
Staphylococcus
Lower neck
Incision and drainage
Coagulase positive staphylococci aureus
Coagulase negative staphylococci
Coagulase negative staphylococci (Staphylococcus
epidermidis)
Coagulase negative staphylococci
Infect indwelling prosthesis
Forgotten tampon
Clostridium sordelli (endometrium)
Infected measles vaccine
Large amount IL-2
Staphylococci
TOXINS OF STAPHYLOCOCCUS
Superantigens
Staphylococcus infection spreads by
Synergohymenotrophic toxin of staphylococci consists
of
Panton valentine leucocidin toxin is associated with
Panton valentine (leucocidin) toxin is
associated with
Hot cold phenomenon in staphylococcus is due to
Staphlococcal toxic shock syndrome is due to
Ritters syndrome is caused by
Epidermolysin, TSS toxin

Hyaluronidase
Gamma toxin, Panton valentine toxin
Necrotizing fascitis
Furunculosis
Beta hemolysin
Enterotoxin B and Enterotoxin C (heat stable)
Exfoliative toxin
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BACTERIOLOGY
MICROBIOLOGY
Toxin responsible for SSSS
NOT a toxin of staphylococcus
Exfoliative toxin
Erythrogenic toxin
STAPHYLOCOCCAL FOOD POISONING

Staphylococcal food poisoning
Incubation period of Staphylococcal food Poisoning

Staphylococcus in stool occurs in
Food poisoning within 6 hours of intake of milk is
caused by
Vomiting and diarrhea within few hours after taking
food
MC cause of food poisoning
Gastroenteritis 4 to 6 hours after consumption of food
Mechanism of vomiting in Staphylococcal food
poisoning
NOT true about staphylococcal food poisoning
NOT true about staphylococcal food poisoning
Optimal temperature for formation of toxin 37* C,

intradietetic toxins are responsible for intestinal
symptoms, incubation period 1-6 hours
1-6 hours
Staphylococcal food poisoning
Staphylococcus
Vagal stimulation
Fever common
Toxins can be destroyed by boiling for 30 minutes
FEATURES OF STREPTOCOCCUS
Differentiation of streptococci from staphylococci
Streptococci
Streptococci
Lancefield group of streptococci is done using
Lancefield group A contains
PYR positive
Lancefield classification based on
Streptococcus pyogenes is classified on the basis of
Mainly responsible for virulence in streptococci
Nephritogenic strain of Streptococci identified by
Classification of pathogenic streptococci into group
A,B,C,D,G is based on
Streptococcus pyogenes with type 12 M protein cause
Micrococci are
A child had a skin infection, a catalase negative
organism was isolated which showed haemolysis
andwas sensitive to bacitracin. Another doctor isolated
a similar organism from the throat of the child. The
correct statement is
Boy with skin ulcer on leg reveals beta hemolysis. Sore
throat culture also revealed beta hemolysis. Similarity is
Infective skin lesions of leg in infants, gram positive
Catalase test
M protein responsible for virulence, mucoid colonies
are virulent, no resistance to penicillin has been
reported
Streptodornase cleaves DNA, Streptolysin O is active in
reduced state (oxygen labile)
Group C carbohydrate antigen
Streptococcus pyogenes alone
Enterococcus, streptococcus pyogenes
Carbohydrate antigen
M protein
M protein
M typing
Antigenicity of cell wall carbohydrate
Soft tissue infection resembling TSS of Staphylococcus
Oxidase positive
Skin infection by group D
C carbohydrate antigen is same

Bacitracin sensitivity
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BACTERIOLOGY
MICROBIOLOGY
chain cocci, hemolytic colonies. Test identifying
organism
Differentiation of group A streptococci from other beta
hemolytic streptococci
Component of streptococci pyogenes having cross
reactivity with synovium of human
Mucoid colonies
Function of adherence factor for
colonization of mucous membrane
Mucoid colonies are due to production of
Antistreptolysin titre
Streptokinase is produced from
NOT true about streptococcus
Transport medium for streptococci
Bacitracin test
Capsular hyaluronic acid
Virulent but M protein is NOT responsible
for production of mucoid colonies
Lipoteichoic acid of streptococcus pyogenes
Capsule of hyaluronic acid
Low in acute glomerulonephritis
Serotype A,C,K
Pyrogenic toxin A is plasmid mediated
Pikes media
SPECIES OF STREPTOCOCCUS
Streptococci with no lancefield antigen
classification
A patient with RHD developed infective endocarditis
after dental extraction. Most likely organism
Causative organism of late prosthetic valve endocarditis
Features of streptococcus viridans
Streptococcus causing dental caries

Bacteria causing neonatal meningitis, shows beta
hemolysis, bacitracin resistance, CAMP positive.
Meningitis acquired through birth canal is due to
Child presents with sepsis. Beta hemolysis on blood
agar, resistance to bacitracin and positive CAMP test.
Streptococcus pneumonia is
MC cause of meningitis in 1 year old child
Group B streptococcus produce
Group B streptococcus
Pathogenesis of group B streptococcal
disease in neonate
Does not affect fetus by transplacental
spread
To show identified organ group A streptococci
Enterococci and non enterococci belong to
Streptococcus bovis grows in
Longest streptococcal chain
Viridans group, pneumococci

Streptococcus viridians
Streptococcus viridans
Negative quellung test, negative inulin
fermentation, negative bile solubility,
intraperitoneal inoculation in mice is non
pathogenic
Streptococcus mutans
Streptococcus agalactiae
Streptococcus agalactiae
S.agalactiae
Alpha hemolytic
CAMP factor
Cause neonatal meningitis, hydrolyse
hippurate
In the absence of a specific antibody,
opsonization, phagocyte recognition and
killing do not proceed normally
Specific for S. pyogenes
Group D streptococci
40% bile
Streptococcus salivarius
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BACTERIOLOGY
MICROBIOLOGY
NOT a medically important streptococci
S. salivarius
DISEASES CAUSED BY STREPTOCOCCUS

Causative agent of subacute bacterial endocarditis is
cultured in
MC cause of Subacute bacterial endocarditis
MC organism causing cellulitis
Streptococcus pyogenes
Impetigo contagiosa is caused by
Necrotizing fasciitis
Erysipelas is caused by
Erysipelas
Primary pyomyositis is caused by
Erythema marginatum can be caused by
Millian sign
NOT true about erysipelas
Group A Streptococcus does NOT cause
Group B cause
Group D cause
MC agent responsible for human bite infections
Infection caused by anaerobic gram positive cocci
Chronic burrowing ulcer
Drug of choice for sore throat caused by group A beta
Used in prophylaxis of streptococcal sore throat
Treatment of streptococcal necrotizing
fasciitis
Blood agar
Streptococci
Bacitracin sensitive
Group A beta hemolytic streptococci
Infection of fascia and subcutaneous tissue, MC group A
beta hemolytic streptococci, surgical debridement is
mandatory
Beta hemolytic Streptococci
Peu de orange texture
Erysipelas
Contagious and infectious, Common in tropics
Epidermolysis bullosa
Neonatal meningitis
UTI
Anerobic streptococci
Puerperal infection
Microaerophilic streptococci
Penicillin
Injection benzathine penicillin
Debridement, penicillin, clindamycin
TOXINS OF STREPTOCOCCUS
Toxin produced by S.pyogenes
Toxin of streptococcus causing hemolysis
Toxin involved in streptococcal toxic shock syndrome
Streptococcal toxic shock syndrome is due
to
Antigenically similar to Streptolysin O
Streptolysin O is inactivated by
Post streptococcal infection is best diagnosed by
Serological marker for retrospective diagnosis of
infection due to streptococcus pyogenes
Streptococcal glomerulonephritis is best diagnosed by
Enterotoxin is NOT produced by
Streptolysin O, Erythrogenic toxin, Hyaluronidase

Streptolysin S
Pyrogenic exotoxin
M protein
Clostridium perfringens toxin, Tetanolysin
Oxygen
Streptozyme test
Anti DNAase antibody
Anti-DNAase, Anti-hyaluronidase
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BACTERIOLOGY
MICROBIOLOGY
CROSS SENSITIVITY OF STREPTOCOCCAL ANTIGEN

Capsular hyaluronic acid
Group A carbohydrate antigen
Cytoplasmic membrane antigen
Cell wall protein
Peptidoglycan
Synovial fluid
Cardiac valves
Vascular intima
Myocardium
Skin antigen
ENTEROCOCCUS
Enterococcus
Beta hemolytic bacteria resistant to vancomycin,

growth in 6.5% NaCl, Non bile sensitive
ICU, central venous line 1 week, ceftazidime and
amikacin. Spike of fever, blood culture positive for gram
positive cocci in chains catalase negative. Vancomycin
started culture remained positive even after 10 days of
therapy
Organism when isolated in blood require synergistic
activity of penicillin plus an aminoglycoside for
appropriate therapy
Intrabdominal abscess. Vancomycin, gentamycin,
ampicilin resistant. Grows well in presence of 6.5% NaCl
and arginine. Bile ascenlin hydrolysis is positive
Treatment of enterococcus infection
Drugs approved for vancomycin resistant enterococci
Enterococcus resistance
Common species are enterococcus fecalis and

enterococcus faecium, cause for peritonitis, cause for
intrabdominal abscess
Enterococcus
Enterococcus fecalis
Ampicillin
Linezolid, Quinopristin/Dalfopristin
Chromosomally mediated
PNEUMOCOCCUS
Discovery of gene transformation come
from study of
Most virulent type of pneumococci
Pneumococcus
Pneumococci
Streptococci pneumonia
Streptococcus pneumonia
Enolase binds to
Type 3
Capsule aids in virulence, commonest cause of otitis
media, respiratory tract carriers are most common
source of infection
Pneumolysin is a thiol activated toxin, exerts a variety
of events on ciliary and PMNs action, Autolysin can
contribute to pathogenesis of pneumococcal disease by
lysing bacteria, Anticapsular antibodies are serotype
specific
Bile insoluble and optochin sensitive
Alpha hemolytic, greenish color on blood agar due to
reduction of iron in hemoglobin
Fibronectin
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BACTERIOLOGY
MICROBIOLOGY
Griffith demonstrated biotransformation with
Property demonstrated by Griffith with experiments on
mice using Pneumococcus
Virulence in pneumococci due to
Thiol activated toxin
Orbital cellulitis, greenish colonies and Optochin
sensitivity
8 year old child, pain and discharge from ear, fever neck
rigidity and positive Kernigs sign. gram positive cocci
Austrian syndrome
Differentiation of pneumococci from other alpha

High grade fever respiratory distress at the time of
presentation. Alpha hemolytic colonies. gram positive
cocci, susceptible to
65 year male, chest pain, fever, cough with sputum.
Gram positive cocci. Blood agar positive result.
differentiate this from other gram positive cocci
Sputum of 70 years old male cultured on 5% sheep
blood agar. alpha hemolytic colonies next day
Draughtsman colonies
Quellung phenomenon is due to
MC infection after splenectomy
MC cause of pyogenic meningitis in 6 months to 2 years
of age
NOT true about pneumococci
NOT true about pneumococci
Prevention of pneumococcal infection in HIV
Pneumococcus
Transformation
Capsular polysachharide
Pneumolysin
Pneumococcus
Pneumococcus
Triad of meningitis, pneumonia and
endocarditis. Caused by Streptococcus
pneumonia
Optochin test
Optochin
Bile solubility
Gram positive cocci in pairs, catalase negative bile

soluble
Pneumococci
Capsular swelling (Pneumococcus)
Pneumococcal
Virulence of pneumococci depend only on production
of capsular polysachharides
Catalase positive
Pneumococcal vaccine
GENERAL FEATURES OF NEISSERIA

Neisseria is a
Most abundant gonococcal surface protein
Type IV pili is associated with
Differentiation between Neisseria gonorrhea and
Neisseria meningitides by
Complement deficiency associated with Neisseria
Thayer Martin Media for
Gas liquid chromatography
NOT true about neisseria
Gram negative cocci

Porin
Neisseria
Maltose fermentation
C5-C9 (late complement)
Neisseria
Neisseria
All strains are highly sensitive to penicillin
NEISSERIA GONORRHOEA
Features of Neisseria gonorrhea
Kidney shaped, non capsulated, ferment

glucose only
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BACTERIOLOGY
MICROBIOLOGY
Neisseria gonorrhea
Kidney shaped organism

Virulence factor of Neisseria gonorrhea include
IgA1 protease is associated with
Opacity associated protein is associated with
Most abundant gonococcal surface protein
Neisseria gonorrhea ferments
Incubation period of Gonorrhoea
Watercan perineum caused by
NOT a virulence factor for Neisseria gonorrhea
NOT true about Neisseria gonorrhea
NOT a metastatic complication of gonococci
Diagnosis of gonorrhea established by
Gonorrhea can be diagnosed by
Treatment of penicillinase producing neisseria
gonorrhea
Gonorrhea shows
QRNG means
Exclusive human pathogen, Some strains may cause

disseminated disease, Acute urethritis is the most
common manifestation in males, Most patients present
with symptoms of dysuria
Gonococci
Outer membrane protein, Pili, IgA1 protease
Pneumococci, neisseria
Neisseria gonorrhoea
Porin
Glucose only
2-8 days
Neisseria gonorrhea
M protein
Highly sensitive to penicillin
Nephritis
Complement fixation tests
Pili agglutination test
Ciprofloxacin, Cefotaxime
Marked resistance to multidrug therapy
Quinolone resistant Neisseria gonococci
NEISSERIA MENINGITIDIS
Features of Neisseria meningitides
Intracellular gram negative diplococci
Only reservoir meningococci
Protein expressed in choroid plexus of
meningeal epithelium for binding of
meningococcal endotoxin
Skin reaction in meningococcal meningitis
is due to
Subcutaneous injection of gram negative organism
evokes hemorrhagic reaction after 24 hours. On
intravenous injection of same give rise to
Neisseria meningitides is associated with
NOT found in meningococci
Female with fever, red spot on applying BP cuff
Source of infection in menigococcus is mainly
MC cause of meningitides in children
NOT a cause of neonatal meningitis
Death from meningococcal disease is due to
Prophylaxis of meningococcal infection
Meningococcal meningitis
Treatment of meningococcal infection
Lens shaped, capsulated, ferments both

glucose and maltose
Neisseria meningitides
Nasopharynx
CD46
Endotoxin
Schwartzmann reaction
IgA1 protease
Plasmid
Neisseria meningitis
Carriers
Hypovolemic shock
Penicillin, sulfonamide, rifampicin
Disease is more common in dry and cold months,
Chemoprophylaxis of close contacts of cases is
recommended, Vaccine is not effective in children
below 2 years
Cephalosporin
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BACTERIOLOGY
MICROBIOLOGY
Chemoprophylaxis of meningococcal meningitis carrier
Vaccine against Neisseria meningitides contain
Meningococcal vaccines are available for
Vaccine NOT available for
Rifampicin
Capsular polysaccharide
A, C, Y, W135
Group B meningococci
GENERAL FEATURES OF CLOSTRIDIA

Sacchrolytic clostridium
Sub terminal spores
Clostridium novyi
Drum stick appearance
Oval bulging terminal spore
Tennis racket spores
Gas in tissue should be differentiated with
Post abortal sepsis causing renal failure is likely due to
Toxins of Clostridium septicum
Citron bodies
Septicemic orchitis is caused by
Management of clostridium tertium
Cl. Welchi, Cl. Septicum

Cl.botulinium, Cl.sporogenes, Cl.sordelli
Subterminal spores
cl.tetani, cl.tetanomorphum, cl.sphenoids
Cl.tertium
Clostridium difficle, clostridium tertium,
clostridium cochleum
Clostridium novyi
Clostridium
Alpha lethal, hemolytic, necrotizing. Beta DNAase.
Gamma hyaluronidase. Delta - septicoysin
Clostridium septicum
Clostridium tertium
Vancomycin, metronidazole
CLOSTRIDIUM PERFRINGENS
Non motile clostridia
Clostridium perfringens
Clostridium welchii
Alpha toxin of clostridium perfringens
Food poisoning in Clostridium perfringens
NOT true about clostridium perfringens
NOT true about clostridium perfringens and gas
gangrene
NOT motile
Opacity around colonies of clostridium perfringes
Nagler reaction is shown by
Naglers reaction is due to
Commonest cause of gas gangrene, Normally present in
human feces, Principal toxin is alpha toxin, Gas
gangrene producing spores are NOT heat resistant,
Food poisoning producing spores are heat resistant, Gas
is invariably present in muscle compartment
Found in intestinal tract of some healthy
patients
Capsulated, non motile, type A causes gastroenteritis
A food poisoning, necrotizing enterocolitis, B and D
epsilon toxin, C enteritis necroticans, theta toxin perfringolysin
Liberation of phosphoryl choline from
lecithin and hemolysis
Stimulating calcium dependent alteration
in permeability
Gas gangrene producing strains of C.perfringens
produce heat resistant spores
Most important toxin is hyaluronidase
Lecithinase
Lecithinase
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BACTERIOLOGY
MICROBIOLOGY
Gastrointestinal enteritis necroticans caused by
Pigbel is
Vomiting and diarrhea 6-10 hours after party
NOT true about necrotizing fasciitis
Administration of immunoglobulins is life saving in
Cl.perfringens
Necrotizing enteritis
Clostridium perfringes
MC site is perineum
Clostridium welchi
GAS GANGRENE
Gas gangrene is caused by
Toxins responsible for gas gangrene
Clostridium perfringes causes
Not a cause of Gas gangrene
Gas gangrene is NOT caused by
Incubation period of clostridium septicum
gas gangrene
Incubation period of clostridium novyi gas
gangrene
Foaming liver
Hyperbaric oxygen is used in
Best way to prevent gas gangrene
Hypotension in case of gas gangrene is treated by
Treatment of gas gangrene after contaminated road
traffic accident
Treatment of gas gangrene
Cl.perfringes, Cl.septicum, Cl.novyi, Cl.histolyticum,

cl.fallax
Alpha toxin, theta toxin
Gas gangrene
Clostridium difficle
Clostridium sporogenes
1-3 days
4-6 days
Gas gangrene
Gas gangrene
Proper wound debridement
Ringer lactate
IV administration of anti gas gangrene serum, Penicillin,
Surgical debridement
Clindamycin
CLOSTRIDIUM TETANI
Clostridium tetani
Clostridium tetani
Clostridium tetani
Spherical and terminal bulging spore are seen in
Swarming growth of gram positive bacilli
Non flagellated Clostridium tetani
NOT true regarding clostridium tetani
Gram positive, Produce heat resistant spores, NO man

to man transmission
Aerobic, Gram positive, Motile
Swarming growth
Clostridium tetani
Clostridium tetani
Type 6
Seen commonly in winter and dry season
GENERAL FEATURES OF TETANUS

Cause of Localised tetanus
Tetanus is noticed usually in
Tetanus is due to
Tetanus
Period of tetanus refers to time between
If incubation period of tetanus is more than 30 days
Communicable period in tetanus
Incomplete immunity
Wounds contaminated with fecal matter
Exotoxin bound to motor end plate
Spread through nerve, Variable incubation period
First symptom to spasm
Delayed
None
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BACTERIOLOGY
MICROBIOLOGY
Main site of action of tetanus toxin
Premonitary symptoms of tetanus
Sardonic grin
Risus sardonicus
8 day old extensor posture
3 day old excessive cry, suckling difficulty, umbilical
sepsis, generalized stiffness
NOT true regarding tetanus
NOT true about tetanus
Diagnosis of tetanus is made
Indicators of elimination of neonatal tetanus includes
Presynaptic terminal of spinal cord

Sleeplessness, Anxious expression, Headache
Tetanus
Tetanus
Neonatal tetanus
Neonatal tetanus
Man to man transmission
Neonatal tetanus develops after passage through
contaminated birth canal
Clinically
Incidence rate < 0.1/1000 live births, TT2 injection
coverage in pregnant mothers > 90%
MANAGEMENT OF TETANUS
Drug used for tetanus
Metronidazole
PREVENTION OF TETANUS
Vaccine preventable neonatal disease
Vaccine routinely indicated in pregnancy
Maternal antibody does NOT protect neonate from
Tetanus
Immunization 10 years age, presents with clean wound
without laceration
A 37 weeks pregnant woman attends an antenatal clinic
at a primary health centre. She has not any antenatal
care till now. Best approach regarding tetanus
immunization in this case would be
Previously unimmunized against tetanus, clean non
penetrating wound sustained 2 hours before
Pregnant women, full course of tetanus immunization,
again to deliver within 11 months, she will require
No of tetanus toxoid injection to vaccinate all pregnant
woman in one year in a village with population of 1000
with birth rate of 30/1000 in one year
A full course of immunization against tetanus with 3
doses of toxoid confers immunity for
Booster dose of tetanus should be given
every
Neonatal tetanus best prevented by
Most effective way of PREVENTING tetanus
NOT done to prevent tetanus
NOT a strategy for prevention of neonatal tetanus
Dose of human tetanus Immunoglobulin for post
exposure prophylaxis
Best preventive measure against Tetanus Neonatorum
Tetanus
Tetanus
Tetanus
TT and Ig both may be given in suspected cases
Single dose of tetanus toxoid
Give a dose of tetanus toxoid and explain to her that it
will not protect the newborn and she should take
second dose after 4 weeks even if she delivers in the
meantime
Tetanus toxoid complete course
0 doses of TT
60
10 years
5 years
Toxoid to mother
Tetanus toxoid
Injection penicillin to all neonates
Giving penicillin to newborn
250 units
Active immunization of mother
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BACTERIOLOGY
MICROBIOLOGY
Complete immunization against tetanus 10 years ago,
clean wound without any laceration injury sustained 2.5
hours ago
Active immunity offered by tetanus toxoid is effective
nearly
Administration of Tetanus antitoxin serum
Neonatal tetanus is said to be eliminated when the rate
is
Human tetanus globulin and single dose of toxoid
100% of patients
Neutralizes toxin
< 0.1 per 1000
CLOSTRIDIUM BOTULINUM
Cl.botulinium causing human disease
Botulinium causing human disease
Non neurotoxic type of clostridium
botulinium
Contaminant in home canned vegetables and smoked
fish
Food poisoning associated with
constipation instead of diarrhea
Food poisoning in canned food is due to
Paralytic food poisoning is caused by
Botulinum toxin acts by
Most potent biological toxin
Botulinum toxin is
Botulinum toxin produce skeletal muscle paralysis by
A (severe), B, E
A, B, C, F
Type G (enterotoxic)
Clostridium botulism
Clostridium botulinium
Clostridia
Clostridia
Closure of ca++ channels at presynaptic membrane
Botulinium toxin
Phage mediated
Inhibiting release of acetylcholine
BOTULISM
Botulism
Botulism
Botulinum affects
Feature of botulism
Feature of Botulism
Infant botulism is caused by
Type of paralysis in botulism
Botulinium toxin
Most Powerful exotoxin

Botulinium toxin acts by
Mechanism of action of botulism toxin
Non Neurotic toxin of Botulism
Gene for botulism toxin is coded by
Caused by Exotoxin, Honey ingestion can cause infant

botulism, Constipation is seen, Detection of antitoxin in
serum can aid in diagnosis
Symmetric descending flaccid paralysis
Neuromuscular junction, preganglionic junction,
postganglionic nerves
Afebrile, Clear sensorium, Cranial nerve palsy
Diplopia, constipation, No fever, Exaggerated tendon
reflexes
Ingestion of spores
Descending paralysis
Effective for 3-4 months, Used in treatment of
Blepharospasm, static and dynamic wrinkles, Invariably
decreased Ach in Neuromuscular junction
Botulinium toxin
Inhibiting release of acetylcholine
Complete failure of all cholinergic
neurotransmission
D
Bacteriophage
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BACTERIOLOGY
MICROBIOLOGY
18 year old male, acute onset of descending paralysis 3
days duration. blurring of vision, quadriparesis,
areflexia, both pupils NON reactive
In a 6 months old baby, floppy infant syndrome is seen
commonly due to infection with
Disease not associated with antitoxin
antibodies in serum of recovering patients
MC cause of death in Untreated Botulism
Best sample for clostridium botulinium food poisoning
NOT a feature of botulism
NOT true about botulism
NOT a differential diagnosis of Botulism
NOT true about botulism
Botulism
Clostridium botulinum
Botulism
Respiratory Failure
Stool
Diarrhea
Ascending paralysis
Clostridial myonecrosis
Infant botulism is caused by ingestion of preformed
toxin
CLOSTRIDIUM DIFFICLE AND PSEUDOMEMBRANOUS COLITIS

Clostridium difficle infection is associated
with
Commonly associated with clostridium difficle colitis
Antibiotic induced colitis
Pseudomembranous colitis associated with
Pseudomembranous colitis is caused by
Toxins involved in Pseudomembranous colitis
Pseudomembranous colitis
Pseudomembrane
Punctuate yellow exudates in colon on endoscopic
examination
Pathological appearance in pseudomembranous colitis
Mushroom cloud appearance of intestinal
mucosa
Most sensitive test for Clostridium difficle infection
Most specific investigation for Clostridium difficle infection
Treatment of Pseudomembranous colitis (severe)
Treatment of clostridium difficle associated diarrhea
(mild)
Duration of antibiotic therapy for antibiotic induced
diarrhea
Prolonged antibiotic therapy,

pantoprazole, rectal thermometer,
increase in proportion of hospital stay
Clindamycin
Clindamycin
Ampicillin
Normal commensal of gut
Toxin A (Enterotoxin), Toxin B (Cytotoxin)
Organism is normal commensal of gut, treated by
vancomycin
Gram positive bacillus
Antibiotic colitis
Small ulceration with slough
Pseudomembranous colitis
Stool culture
Cell culture, cytotoxic test, PCR for C.difficle toxin B gene
Vancomycin
Metronidazole
10 days
GENERAL FEATURES OF CORYNEBACTERIUM

Ehrlich phenomenon is seen in
Multidrug resistant Corynebacterium responding only
to Vancomycin
Erythrasma is caused by
Corynebacterium
Corynebacterium jeikeium
Corynebacterium miniutissimum
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BACTERIOLOGY
MICROBIOLOGY
Alkaline encrusted cystitis is caused by
Daisy head colonies are produced by
MDR resistant corynebacterium sensitive to vancomycin
Corynebacterium urealyticum
C.diphtheria gravis
C.striatum
CORYNEBACTERIUM DIPHTHERIA
Diphtheria
Corynebacterium diphtheria
Clostridium diphtheria
Kleb Loefflers bacteria (KLB)

Eleks gel precipitation test
Non motile
Albert staining, Ponders staining
Volutin granules
Metachromatic granules made of
Metachromatic granules are stained with
Tellurite plates should be incubated for
Corynebacterium diphtheria are cultured on
NOT true about corynebacterium diphtheria
Does NOT produce spore
Diphtheroids
Preisz Nocard bacillus
Non hemolytic frogs egg colony on
cysteine tellurite blood agar
Club shaped bacillary appearance, palisades, Chinese

characters
Gram positive, lysogenic phase cause
disease
Deep invasion is NOT seen, Elek gel PRECIPITATION test
is done for toxigenecity, Metachromatic granules are
seen
Iron is required for toxin production, Local reaction is
due to membrane, Systemic effects are due to toxin,
Non sporing, Non motile, Non capsulated, Toxin
production is by Lysogenic conversion
Organism may be identified by tests of toxigenicity,
toxin act by inhibiting protein synthesis, toxin may
affect heart and nerves
Diphtheria
Metachromatic granules, seen in
mycobacteria, gardenella, diphtheria
Polymetaphosphate
Toluidine blue
Atleast 2 days before considering negative
Loefflers serum slope, tellurite blood agar
Toxin mediated by chromosomal gene
Rhodococcus equi, Corynebacterium pseudotuberculosis
Corynebacterium pseudotuberculosis
Corynebacterium intermedius
FEATURES OF DIPHTHERIA
Diphtheria
Diphtheria
Diphtheria
Diphtheria is
Diphtheria
Laryngeal diphtheria mandates tracheostomy, Child is

infectious with faucial diphtheria, Myocarditis may be a
complication
Endemic in india
Lysogenic conversion by phage
Toxemia
Incubation period 2-6 days, schick test detects
susceptibility, portal of entry is through an infective
agent
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BACTERIOLOGY
MICROBIOLOGY
Diphtheria susceptibility
Diphtheria
Bull neck adenitis
Bull neck in Diphtheria is due to
The term Leather is used for
Type of diphtheria with highest mortality
Colour of diphtheric membrane is
Common source of diphtheria
Incubation period of diphtheria
Short incubation period
Babes Ernst Granules associated with
Commonest cause of death in diphtheria
MC ocular complication of diphtheria
Single infection in diphtheria does NOT give
Diphtheria NOT associated with
Diphtheria is NOT characterized by
NOT a complication of Diphtheria
Diphtheria toxin is a powerful
Diphtheria toxin inhibitis
Diphtheria toxin is
Diphtheria toxin
Skin test based on Neutralisation reaction
Shick test does NOT indicate
Positive Schick test indicate that person is
A negative schick test indicate
Immunization against diphtheria
Percentage of herd immunity required to prevent
endemic spread of diphtheria
2-5 years
Punched out ulcer
Diphtheria
Lymphadenopathy
Diphtheria
Laryngeal
Gray
Carriers
2-6 days
Diphtheria
Diphtheria
Myocarditis
Paralysis of accommodation
Lifelong immunity
Rash
Endotoxemia
Hepatic failure
Exotoxin
Protein synthesis (blocks elongation of protein)
Exotoxin, Toxin production depends on optimal
concentration of iron, Inhibiting protein synthesis,
Schick test demonstrates circulating antitoxin
Phage mediated
Schick test
Carrier of diphtheria
Susceptible to diphtheria
Immunity to diphtheria
Will prevent toxemia but NOT a carrier state
70%
MANAGEMENT OF DIPHTHERIA
Loeffler/Tinsdale selective medium
Child present with white patch over tonsils, diagnosis
made by culture in
Diphtheroids grow on
Selective media for isolation of diphtheria from carriers
Corynebacterium diphtheria can be grown within 6-8
hours on
Investigation of choice for diphtheria carrier
Investigation of choice for diphtheria carrier
Investigation NOT done for a child with fever and
pharyngitis
Prophylaxis of household contacts of diphtheria
Prophylaxis of diphtheria
Drug of choice for Diphtheria carrier
Drug for unimmunized contacts in Diphtheria
One unit of diphtheria antitoxin is defined as the
Diphtheria
Loeffler medium
Potassium tellurite medium
Potassium tellurite medium
Loefflers serum slope
Throat swab culture
Culture in tellurite blood agar
Widal test
Erythromycin
Erythromycin
Erythromycin
Erythromycin + Antitoxin + Toxoid
100 MLD of toxin
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BACTERIOLOGY
MICROBIOLOGY
smallest amount of antitoxin required to neutralize
HEMOPHILUS
Hemophilus influenza
Hemophilus influenza produces
Gram negative coccobacilli, culture only on chocolate

agar not on blood agar
Types of hemophilus
Pfeifers bacillus
Features of hemophilus
Important role in pathogenesis
Satellitism is seen in culture of
Pleomorphism is most commonly seen in
Bacterial vitamins X and Y are required for
NOT true about influenza
Diseases caused by H.influenza
Brazilian purpuric fever is caused by
Prophylaxis of H.influenza
Beta lactamase producing hemophilus influenza,
resistant to chloramphenicol
Hemophilus ducreyi
Gram negative, grow on chocolate agar

Immunogenic antiphagocytic capsule
Serotyping is based on capsular polysaccharide, Can be
a part of normal flora in some persons, Requires hemin
and NAD for growth in culture medium, Type b is
responsible for invasive disease
Type b (capsulated) is associated with meningitis and
epiglottis. Non typable (non capsulated) is associated with
otitis media, LRI, sinusitis
Hemophilus
Satellitism on Flide medium, iridescence
on Levinthal medium
Capsular polysaccharide
Hemophilus
H.influenza
Capsular polypeptide protein is responsible for
virulence
Chancroid, Acute epiglottitis, Brazilian purpuric fever,
Meningitis
Hemophilus influenza biogroup aegypticus
Rifampicin
Third generation cephalosporins
Chocolate agar with isovitale X
BORDETELLA PERTUSSIS
Bordetella pertussis
Bordetella pertussis is
Bordetella pertussis is associated with
Organism in which capsule does not have virulence
factor
Piracy of adhesins is associated with
Aluminum paint appearance
Whooping cough
Pertussis
Strict human pathogen, Can be cultured from patient

during catarrhal stage, Leads to invasion of respiratory
mucosa, Infection is NOT prevented by acellular vaccine
Aerobic
Filamental hemagglutinin, fimbria, pertactin
Bordetella (promotes coating of H.
influenza, Pneumococci)
Bordetella
Affect children of 1 year of age, contagious in catarrhal
stage, secondary attack rate is high
Erythromycin prevent spread of disease between
children
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BACTERIOLOGY
MICROBIOLOGY
Pertussis
Pertussis
Mechanism of pertussis toxin
Incubation period of pertussis
Pertussis affect
100 day cough
A child with pertussis should be isolated for
Secondary attack rate of pertussis
NOT a feature of pertussis
Congenital passive immunity is NOT observed in
Newborns does NOT have transplacental immunity
against
Post exposure prophylaxis NOT useful in
Recurrent bouts of severe cough, audible whooph, best
specimen to isolate organism and confirm diagnosis
Child cough, inspiratory whoop. NOT immunized.
sample for investigation
Cough plate is used for
Regan Lowe characoal medium for
Treatment of pertussis contacts children
Drug of choice in pertussis
Treatment of bordetella infection
Associated with inspiratory wheeze, Droplet infection,

Pneumonia is most common complication,
Parapertussis is less severe than pertussis
Erythromycin should be given to contacts
ADP ribosylation of protein associated with receptors,
increase cyclic AMP, acts through G alpha subunit
7-14 days
Less than 5 years
Cough due to Bordetella pertussis
3-4 weeks
90%
Cerebellar ataxia
Pertussis
Pertussis
Pertussis
Nasopharyngeal swab
Nasopharyngeal swab
Bordetella
Prophylactic antibiotic for 10 days
Erythromycin
Macrolide
BRUCELLA
Brucella
Brucella melitensis is common in

Brucella
Capnophilic brucella
Brucellosis
Pyrexia of unknown origin in veterinary doctor, gram
negative short bacilli, oxidase positive
Malta fever is caused by
Undulant fever
Disease occurring both in man and animals
Brucella commonly affect
Brucella infection
NOT a method of transmission of brucella
Brucella is NOT transmitted by
Medium for Brucella
Milk ring test for
Coombs test may be useful in
Brucella abortis is capnophilic, Transmitted by aerosol

can occur occasionally, Pasteurization can occur
occasionally
Camel, sheep, goat
Melitensis in goat, abortis in cow, suis in
pig
Brucella abortus
Transmitted by ingestion of milk, cause spinal
spondylitis, causes GE
Brucella
Brucella melitensis
Brucella melitensis
Brucella abortis
Lumbar spine
Anterosuperior epiphysitis (Pedro Pon sign)
Person to person transmission
Person to person
Serum dextrose agar, Trypticose soy agar
Brucellosis
Brucellosis
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BACTERIOLOGY
MICROBIOLOGY
Investigation for Brucellosis
Serological tests for brucellosis
2 mercaptoethanol is used to detect
NOT a serological test for diagnosis of Brucellosis
Treatment of brucellosis
Drugs used for Brucellosis
NOT a treatment of Brucellosis
Standard agglutination test

2 mercaptoethanol test, Complement fixation test,
Coombs test
IgG
Standard agglutination test
Streptomycin
Rifampicin,Streptomycin,Doxycyline
Penicillin
BARTONELLA
Bartonella henslae
Bacillary peliosis primarily involve
Bartonella Quintana
Trench fever
Intermediate host for trench fever
Bartonella bacilliformis
Stages of carrion disease
Carrion disease is transmitted by
Cat flea
Bacillary angiomatosis is caused by
Cat scratch disease is caused by
Macular scar
Mollaret debra test for
Cats are NOT associated with
Incubation period of Bartonellosis
Bacillary angiomatosis
Verruca peruana is caused by
Cat scratch disease, bacillary angiomatosis, bacillary

peliosis
Liver
Trench fever
5 day fever, Quintan fever
Louse
Carrion disease (Bartonellosis)
Oroya fever, Verruga peruana
Lutzomyia
Ctenocephalides felis
Bartonella Henslae, Bartonella quinatana
Bartonella henslae
Cat scratch disease
Cat scratch fever
Bartonella quintana
14 21 days
Multiple hemangioma like lesion on AIDS patient, Biopsy
with Warthin starry stain shows bacilli
Bartonella bacilliformis
ACTINOMYCES
True of Actinomyces
Mycetoma
Granules discharged in mycetoma contains

Actinomyces is
Most common actinomyces
Actinomycetoma is caused by
Actinomycotic mycetoma is caused by
Actinomycosis is caused by
Commonest form of actinomycosis
Actinomycosis
Actinomycosis
Rivalta disease
Causes endogenous infection

Can affect upper and lower extremities, Caused by
actinomycetes and filamentous fungi, Diagnosis is by
examination of pus
Fungal colonies (erodes bone)
Gram positive bacteria
Actinomyces israeli
Bacteria
Actinomyces, Nocardiosis, Streptomyces
Gram positive organism
Cervicofacial
Usually respond to antibiotics
Demonstration of filaments, actinomycosis Israeli,
suphur granules in pus, can be cultured
Actinomycosis
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BACTERIOLOGY
MICROBIOLOGY
Spidery colonies on solid media and fluffy
ball in thioglycollate liquid media
Sunray appearance
Actinomycosis is associated with
Maxillary osteomyelitis is associated with
Frozen pelvis
Most predominant constituent of sulphur granules of
Actinomycosis
Sulphur granules
Colour of granules of actinomyces
Sulphur granules is a feature of
Bread crumb colony appearance is of
Lumpy jaw is seen in
Discharging sinus
A patient with fistula and chronic pain discharge from
lower face and mandible is most commonly suffering
from
In actinomycosis of spine, abscess usually erode
Actinomycetoma
Madurella
Actinomycosis is sensitive to
Drug of choice for thoracic actinomycosis
Actinomyces israeli
Actinomycosis
Wooden fibrotic masses
Actinomyces viscosus
Pelvic actinomycosis
Organism
Misnomer, inflammatory cells with
filaments of bacteria
Yellow
Actinomyces
Actinomyces Israeli
Actinomycosis
Actinomycosis
Acinomycosis
Towards the skin

Responds to antibiotics
Does NOT respond to antibiotics
Penicillin
Penicillin
NOCARDIA
Nocardia resemble actinomyces but morphologically
NOT true about nocardia
Causative organism of mycetoma
MC cause of mycetoma in India
MC cause of mycetoma in India
Persistent fever and cough. Features suggestive of
pneumonia. Aerobic branching gram negative filaments
that are partially acid fast
MC form of Nocardia
Characteristic infection of Nocardia asteroids
Stains for Nocardia
Nocardia is stained by
Best method for selective isolation of Nocardia
Nocardia is susceptible to
Aerobic
Penicillin is the drug of choice
Nocardia
Nocardia brasiliensis
Actinomadura madurae
Nocardia asteroids
Pneumonia
Brain abscess
Acid fast, alcian blue, mucin stain
Acid fast (Ziehl Nielson stain)
Paraffin bait technique
Amikacin
LISTERIA
Listeria is a
Temperature for listeria
LLO means
Listeria
Gram positive bacilli

1 45*C
Listeriolysin
Gram positive but produces exotoxin and
endotoxin
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BACTERIOLOGY
MICROBIOLOGY
Listeria monocytogenes
Tumbling motility (end over end motility) is seen in
Not true about listeria
Listeria transmitted by
Main step in pathogenesis of listeriosis
Zipper type of phagocytosis in
Listeriosis in pregnancy
Culture media for Listeria
After 5 days of birth, baby developed poor feeding,
convulsions, fever with low protein, low sugar, high
chloride in CSF
Gram positive small to medium coccobacilli that are
pleomorphic occurring in short chains. direct wet
mount from culture show tumbling motility
d-xylose negative, d-methyl d-mannoside

positive
Listeria
Gram negative bacteria
Refridgerated food
Survival and multiplication of L.monocytogenes within
mononuclear phagocytes and host epithelial cells
Listeria
Granulomatus infantiseptica
Blood agar
BACILLUS ANTHRACIS
Anthrax bacilli is differentiated from
anthracoid bacilli by
Features of anthrax
Anthracoid bacilli
Only bacterium with capsule having
protein
Anthrax bacilli
Factors in bacillus anthracis
Largest pathogenic bacilli

Anthrax
Anthrax bacilli differs from anthracoid bacilli by being

Virulence of bacillus anthracis is associated with
McFadyean reaction
Methylene blue discolours the capsule of bacillus
anthracis, this reaction is called
String of pearl colonies on nutrient agar
Medusa head colonies
Frosted glass appearance
Inverted fir tree appearance of culture
Ascoli thermoprecipitation test
Gram positive bacilli in long chains, McFaydean reaction
Anthrax bacillus toxin
Non motile
Capsulated, non motile, response to
penicillin
Non capsulated, motile, no response to
penicillin
Bacillus anthracis (poly D glutamic acid)
Non motile, no flagella
Factor I edema factor, factor II
protective antigen, factor III lethal
factor
Bacillus anthracis
Plasmid is responsible for toxin production, Cutaneous
anthrax generally resolve spontaneously, Capsular
polysaccharide aids virulence by inhibiting phagocytosis
Non motile
Polypeptide capsule
Bacillus anthracis
McFadyean reaction
Bacillus
Bacillus anthrax
Bacillus anthracis
Bacillus anthracis
Anthrax
Bacillus anthracis
cAMP liberate edema factor, capsular polysaccharide
aids virulence by inhibiting phagocytosis, plasmid
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BACTERIOLOGY
MICROBIOLOGY
Commonest form of anthrax

Anthrax
Gasteroenteritis with high fatality is caused by

Malignant pustule (Hide Porter disease)
Cutaneous anthrax
Person working in Abattoir presented with papule on

hand which turned in to an ulcer
responsible for toxin production

Cutaneous
McFadyean reaction shows capsule, Humans are usually
resistant to infection, Sputum microscopy helps in
diagnosis
Anthrax
Anthrax of skin
Painless, Whole area is congested and edematous,
Central crustation with black eschar, Satellite nodule
around inguinal region
Trichrome methylene blue helps in diagnosis
BACILLUS CEREUS
A patient present with vomiting he had eaten rice 6
hours before. Most probable cause
Non invasive diarrhea is caused by
Characteristic of Bacillus cereus food poisoning
Selective medium for Bacillus cereus
Bacillus cereus
Bacillus cereus
Abdominal pain
Mannitol egg yolk phenol red polymyxin
agar (MYPA)
LEGIONELLA
Legionella is
Legionella
Transmission of Legionella
MC serotype isolated from humans
Toxicity of legionella through
Contaminated water source is associated
with infection of
Legionella by
28 year female, diarrhea, confusion, high grade fever,
bilateral pneumonitis
Pontiac fever is caused by
Causative agent of Pneumonia associated with Aerosols
spread
Epidemics are associated with
Legionella pneumophilia is associated with
Legionnaires disease cause
Good media for Legionnaires disease
Growth on charcoal yeast medium
Test for legionella in community
Treatment of choice for legionairres disease
Treatment for Legionella infection
Gram negative, Uncapsulated, Oxidase positive

Can be grown on complex media, legionella
pneumophila is NOT effectively killed by
polymorphonuclear leukocyte
No man to man transmission
L.pneumophilia serogroup 1
Toxin
Legionella
Inhalation of aerosol in the air conditioned room
Legionella
Legionella
Legionella
Legionella
Hyponatremia, temperature > 40%
Acute respiratory infection
BCYE agar
Legionella
Urinary antigen testing
Erythromycin
Macrolides, respiratory quinolones
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BACTERIOLOGY
MICROBIOLOGY
CAMPYLOBACTER
Microaerophilic bacteria
Microaerophilic bacteria
Campylobacter jejuni
Alpha chain disease
Campylobacter associated with seagull
NOT true about Campylobacter
Fecal leucocytes are present in
One of the leading causes of travellers diarrhea
Method of choice for culture of stool for campylobacter
jejuni
Culture media for campylobacter
DOC fo Campylobacter Jejuni associated Diarrhoea
10 % CO2
Campylobacter
Microaerophilic, tumbling motility, Invasive
Immunoproliferative small intestine disease associated with
campylobacter jejuni
Campylobacter luri
Human is the only reservoir, Spore forming
Campylobacter
Campylobacter
Culture on Skirrows medium incubated at 42*C under
microaerophilic condition
CVA medium, Skirrow medium, Campylobacter blood
agar, Regan Lowe media
Erythromycin
HELICOBACTER
Helicobacter pylori
H.pylori
H. pylori
H.pylori found in
NOT true about H.pylori
Helicobacter pylori NOT associated with
Most sensitive test for H.pylori
Even with chronic infection, urease breath test remains

positive. H.pylori remains life long if untreated,
Endoscopy is diagnostic. Toxigenic strains usually cause
ulcer, 75% of ulcers associated with H.pylori, Medical
therapy is the treatment of choice
Gram negative bacilli, curved rod, flagellated. Causes
chronic gastritis in adults due to reinfection, Treatment
prevents gastric lymphoma, C14 urease breath test is
used in diagnosis, Transmitted from man to man,
fecoorally and by orogastric route. Common in adults of
developing countries, Controlled urease breath is
negative with massive infection, Anti urease antibody
are produced only by invasive strains, Urease activity
provide protective environment to the bacilli
Vacuolated cytotoxin
Mucosa
It should be eradicated in all cases whenever detected
Gastric leiomyoma
Rapid urease test
PASTEURELLA
Mode of infection of Pasturella multocida
Common organism isolated from cat bite
Gram negative bacilli sensitive to penicillin
Features of pasteurella multocida
Animal bite or scratches

Pasteurella multocida
Pasteurella multocida
Gram negative bacilli, non motile, acid
from sucrose, indole positive, oxidase
positive, urease negative
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BACTERIOLOGY
MICROBIOLOGY
FRANSCIELLA
Ulcerated inguinal lymphadenopathy
Fransciella tularensis is related to
Tularemia
Parinaud complex is associated with
Treatment of tularemia
Fransciella
Rabbit
Ulcer with black base, chancriform lesion, buboes
Preauricular lymphnode enlargement
Gentamycin
YERSINIA
Yersinia pestis
Stalactite growth in ghee broth agar
Fermentation of glycerol is the basis of classification of
Bioterrorism agent
Plague is
Plague
Girl from shimla, fever, hypotension, malaise, axillary

and inguinal lymphadenopathy, culture in glucose broth
show stalactite growth
Most efficient vector for plague
Plague in Surat in 1995 has occurred after a silence
period of
Most dangerous type of Plague
Highly infectious clinical form of plague
Isolation is strictly recommended for
Incubation period of pneumonic plague
MC type of plague
Main reservoir of plague in India
Lifelong immunity NOT seen with
Maximum explosiveness of plague is determined by
Cheopsis index
Most effective method to break transmission chain in
plague in
Flea bite in wheat godown. Axillary lymphadenopathy
Plague patient is kept isolated till
Longest and shortest incubation period of plague are 7
days and 2 days respectively. time required to declare
an area free from plague is
Plague epidemic is controlled by
NOT done to control epidemic in plague
Treatment of plague
Drug of choice in chemoprophylaxis in contacts of a
patient of pneumonic plague
MC presentation of Yersinia enterocolitica
Gram negative non motile cocco bacilli, Repeated

cultures is diagnostic
Yersinia
Yersinia
Plague
Metazoonotic
Both sexes of rat flea bite to transmit disease, IP for
bubonic plague is 2-6 days, Infants under 6 months are
not given killed vaccine
Yersinia pestis
Xenopsylla cheopis
28 years
Pneumonic plague
Pneumonic plague
Pneumonic plague
1 3 days
Bubonic plague
Tatera indica
Plague
Cheopsis index
Average no of cheopsis per rat
Control of rat flea
Wayson staining
48 hours of treatment
14 days
Isolation of patients
Vaccination of susceptible
Streptomycin
Tetracycline
Self limiting diarrhea
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BACTERIOLOGY
MICROBIOLOGY
PSEUDOMONAS
Pseudomonas aeroginosa
Pseudomonas
Strictly anaerobic
Organism having considerable resistance to antiseptics,
disinfectants, antibiotics
Bacteria act by inhibiting protein synthesis
NOT true about pseudomonas
NOT a coccobacilli
Blue pus
Green coloured colonies
Gunmetal colonies
Fruity odour
Species of pseudomonas commonly associated with
intravenous catheter related infection
Puncture wound through sneakers in children is associated
with
Other Pseudomonas
Pseudomonas septicemia cause
Ecthyma gangrenosum is caused by
Shock associated with bullous skin lesion
Hot tub folliculitis is associated with
Green nail is due to
Does NOT cause food borne infection
Cetrimide agar for
Pseudomonas is eradicated by local
application of
Effective against pseudomonas
Pseudomonas producing extended spectrum beta
lactamase enzyme
Antibiotic potent against Pseudomonas
Drug of choice for Pseudomonas septicemia
Penicillin effective against proteus and pseudomonas
Cephalosporin active against Pseudomonas
Antipseudomonal penicillin
Antipseudmonal action
Carbenicillin
In treatment of pseudomonas infection, cabenicillin is
frequently combined with
NOT used in pseudomonas infection
NOT used for pseudomonas
NOT having good activity against pseudomonas
aerugenosa
NOT used against pseudomonas
NOT antipseudomonal
NOT an antipseudomonal
Oxidase positive, Polar flagellate, Obligate aerobe

Pili, flagella, LPS, Type III secretion system, proteases,
phospholipases, exotoxin
Pseudomonas
Pseudomonas
Pseudomonas
Ferments glucose forming acid and gas
Pseudomonas
Pseudomonas
Pseudomonas
Pseudomonas
Pseudomonas
Pseudomonas aeruginosa
Pseudomonas osteomyelitis
Burkholderia, Stenotrophomonas (soil organism)
Ecthyma gangrenosum
Pseudomonas
Pseudomonas
Pseudomonas
Pyocyanin
Pseudomonas
Pseudomonas
Acetic acid
Colistin, Piperacillin, Ciprofloxacin, Cefoperazone,
Ceftazidime
Imipenem and amikacin
Colistin
Tobramycin + Ticarcillin
Carbenicillin
Ceftazidime
Cloxacillin
Cefoperazone
Effective in pseudomonas infection
Gentamicin
Vancomycin
Azithromycin
Cephadroxil
Oxacillin
Vancomycin
Cephalexin
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BACTERIOLOGY
MICROBIOLOGY
BURKHOLDERIA
Melidiosis is caused by
Chronic alcoholic agricultural worker, chills rigor,
bilateral crepitation with scattered rhochi, multiple
subcutaneous nodules on extensor surface. Gram
negative bacilli with bipolar staining, distinct rough
corrugated grey white colonies on blood agar. motile
oxidase positive
Melidiosis
Syndrome of respiratory distress and septicemia in cystic
fibrosis (Cepacia syndrome)
Burkholderia psedomallei
Melidiosis
Common form pulmonary infection, bipolar staining of

etiological agent is with methylene blue stain, gram
negative aerobic bacteria
Burkholderia cepacia
GENERAL FEATURES OF ENTEROBACTERIACEAE

Enterobacteriaceae
Flagellar pattern in enterobacteriaceae
Enterobacteriaceae
Non lactose fermenters
Fever, leucopenia, DIC and hypotension
caused by members of enterobacteriaceae
family are strongly associated with
ELISA for virulence marker antigen(VMA) is done to
detect virulence in
Glucose is NOT fermented by all members of the family,

All are oxidase negative
Peritrichous
Glucose in NOT fermented by all members of the family
Shigella, salmonella
Lipid A
Enteroinvasive E.coli, shigella
E.COLI
Many E.coli isolated from UTI
E.coli
E.coli
E.coli
E.coli attached to surface with the help of
Lactose fermenting colonies on EMB agar
Serotype of E.coli causing hemorrhagic colitis
Enterohemorrhagic E.coli
EHEC
Enteroaggregative E.coli
Stacked brick pattern of adherence
Enterotoxigenic E.coli
Attach to uroplakin by mannose binding type I pili

Labile toxin in ETEC act via CAMP, UTI causing E.coli
attaches through pili, EIEC invasiveness under plasmid
control
Aerobe and facultative anaerobe, E.coli is motile by
peritrichate flagella
Non capsulated
Fucose
E. coli
O157:H7
Hemolytic uremic syndrome
Ferments sorbitol, Causes HUS, Elaborates shiga like
exotoxin
Persistent diarrhea
Enteroaggregative E. coli
Travellers diarrhea
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BACTERIOLOGY
MICROBIOLOGY
ETEC
ETEC
ETEC spread by
Enteroinvasiveness of E. coli is under
control of
Enteroinvasive E.coli
Sereny test is positive in
EPEC is associated with
Enteropathogenic E.coli
A microbiologist wants to develop a vaccine for
prevention of attachment of diarrheagenic E.coli to
specific receptors in GIT. Fimbrial adhesion NOT a
appropriate candidate
Eiken test for E.coli
Verocytotoxin of E.coli act by
E.coli heat labile toxin resembles action of
Incubation period 6-7 hours for
Preformed toxin is NOT important in food poisoning
due to
MC cause of liver abscess
E.coli gives pink colour with
Culture media used for EHEC O157:H7
ELISA for Virulence Marker Antigen is done to detect
virulence
Common cause of acute watery diarrhea in children in

developing countries
Heat labile enterotoxin
Contaminated water
Plasmid
Produce disease similar to Shigellosis
EIEC
Epidemic
Cause acute gastroenteritis in infants
P1 pili
Precipitin test
Decreasing protein synthesis
Vibrio cholera
E.coli food poisoning
ETEC
E.coli
McConkey medium
Sorbitol McConkey media
Enteroinvasive E.Coli
PROTEUS
Proteus
Phenylalanine deaminase positivity is
shown by
Proteus
Dienes phenomenon
Maximum urease production
Seminal smell on culture
Swarming growth
To prevent swarming, the percentage of Nutrient agar is
increased to
Forms struvite stone, Proteus cause deamination of

phenylalanine to phenylpyruvic acid
Proteus
Urease positive
Proteus mirabilis, Proteus vulgaris
Proteus
Proteus
Proteus mirabilis
4%
SALMONELLA
Organism requiring tryptophan for
growth
Microorganism that can enter freshly laid eggs
Feature common to all species of Salmonella
Antigen blocking agglutination of salmonella by O
antiserum
S.typhi
Salmonella
Indole negative
Vi
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BACTERIOLOGY
MICROBIOLOGY
Salmonella is associated with
Ebeth Gaffky Bacillus
Only salmonella not producing H2S
Only non motile salmonella
Fever for 3 weeks, splenomegaly, hypoechoic shadow in
spleen near hilum. Gram negative bacilli isolated on
culture
Salmonella infection
Food poisoning after 16 hours
Enrichment media of choice for Salmonella
DT104 strain belong to
Prolonged salmonella septicemia is caused
by
Non typhoid salmonella
NOT true about non typhoid salmonella
Type III secretion

Salmonella typhi
Salmonella typhi
S. gallinarum pyllorum
Salmonella
Blood culture is positive in 3-7 days

Salmonella
Selenite F broth
Salmonella typhimurum
Salmonella cholera suis
Transmission is most commonly associated with eggs,
poultry and undercooked meat, common in
immunocompromised individuals, resistance to
fluoroquinolones are emerged
Blood culture is more sensitive than stool culture in
gastroenteritis in adults
TYPHOID
Both lactose positive and lactose negative
colonies on EMB agar
NON gas producing salmonella
Agglutination with O antigen of S.typhi is inhibited by
Infective dose of Salmonella typhi
Food poisoning after 24 hours
Salmonella gastroenteritis
Salmonellosis
Typhoid
Typhoid
Incubation period of typhoid
Reserve and source of infection are same
for
10 year old child 10 days continuous fever, enlarged
spleen
Rose spot
Erythema marginatum
Coma vigil is seen in
Typhoid in children
Salmonella typhi infection in intestine
Pea soup stool
Muttering delirium is associated with
Salmonella typhi
Salmonella typhi
Vi antigen
10^2 to 10^5 bacilli
Salmonella gastroenteritis
Caused by animal products, Symptoms appear between
4 to 48 hours
Increased incidence in developed countries, Antacid
and prolonged antibiotic administration promote
infection, Food borne to man and animal
Urinary carriers are more dangerous, Vi ab is used for
detecting carrier, Urine carrier is associated with
anomalies
Male carriers though less are more dangerous
3 21 days
Enteric fever
Enteric fever
Enteric fever
Enteric fever
Enteric fever
Mild splenomegaly is usual
Affects Peyer patches
Typhoid
Typhoid
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BACTERIOLOGY
MICROBIOLOGY
Perforation of gut associated with
Massive splenomegaly is NOT seen in
NOT a feature of typhoid
NOT common in typhoid
Highest incidence of typhoid fever
Incubation period of typhoid
Isolation in salmonellosis done till
Maximum isolation period of enteric fever
Enrichment media for Salmonella typhi
Which gives strong evidence of typhoid fever carrier
status
Chronic carrier state in typhoid is diagnosed by
Widal test
Antibody to H antigen
Widal test is an
rd
Diagnosis of typhoid in 3 week
st
Typhoid is diagnosed on 1 week by
NOT true about widal test
NOT true about Widal test
Typhoid carriers are NOT detected by
Drug of choice for carriers of typhoid
Most successful method for treatment of
typhoid carriers
Drug of choice for treatment of typhoid fever in
pregnancy
Treatment of salmonella typhi
Treatment of Chloramphenicol resistant typhoid
infection
NOT commonly used against enteric fever
Chemoprophylaxis is NOT done for
Ty21a is a
Typhoid oral vaccine is given
Immunization of choice for typhoid in India
Typhoid
Typhoid
Non involvement of ileum
Constipation
5-19 years
10-14 days
Stool culture negative for three times
Till three consecutive negative urine/stool culture
samples are obtained from the patient
Selenite F broth
Isolation of Vi antigen
Vi agglutination test
Tube agglutination test, Previous infection affects Widal
test, H antigen titre remains positive for several months
and reaction to it is rapid
Appears first and persists for long period
Agglutination test
Widal test
Blood culture
O antibodies are least useful
First test is confirmatory
Widal test
Ampicillin
Cholecystectomy with ampicillin
Ceftriaxone
Ciprofloxacin
Ciprofloxacin
Amikacin
Typhoid
Oral vaccine
1,3,5 days
Monovalent vaccine
SHIGELLA
Role of plasmid in conjugation first
described by Lederberg and tatum in
Shigella can be differentiated from E.coli by
Shigella
MC species of shigella in India
Most virulent shigella
Exotoxin is produced by
Shigella are subdivided based on their ability to ferment
Shigella does not produce gas from glucose, Shigella
does not ferment lactose, Shigella is non motile
SMALL dose can cause infection, Associated with HUS,
causes bloody diarrhea, Gut pathology is due to toxin
Shigella flexneri
Shigella dystenteriae
Mannitol
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BACTERIOLOGY
MICROBIOLOGY
Shigella does not have
Lactose fermenter
Acrogenic shigella
Enterotoxin produced by
Toxin acts by inhibiting protein synthesis
Shigella is associated with
Gold standard test for Shigella dysentery
Shigellosis is best diagnosed by
Medium for shigella
Selective media for shigella
Differential media for shigella
H antigen
Shigella sonnei
Shigella dysenteriae, shigella sonnei, shigella boydii
Shiga toxin
Toxic megacolon
Isolation from feces
Stool culture
Deoxycholate citrate agar
Hektoen enteric agar
Triple sugar iron agar
FEATURES OF VIBRIO
Robert Koch discovered Vibrio cholera in
Vibrio cholera first isolated by
Cholera caused by
O139 vibrio is derived from
Vibrio cholera O139
Stain of vibrio cholera in Bengal
Pathogenecity of O139 vibrio is due to
Recent infection of cholera in india is caused by
Types of O1 vibrio
Eltor vibrio differentiated from classical cholera by
El tor cholera
El tor vibrio
El tor vibrio
Seventh pandemic of cholera caused by
Vibrio cholera
Vibrio cholera
Napiform liquefaction in gelatin swab

Optimal growth of Vibrio cholera
Growth of Vibrio cholera is inhibited by
Virulence is controlled by
Quorum sensing
Endotoxin of the following gram negative bacteria does
not play any part in pathogenesis of natural disease
Vibrio cholera toxin is similar to
Bacteria acts by increasing cAMP
V.cholera able to stay in GIT because of
Diarrhea due to vibrio cholera
Africa
Koch
Vibrio cholera 0.01
El tor
Clinical manifestations are similar to O1 el tor strain,
epidemiologically undistinguished from O1 El tor strain
O:139
O antigen
O139 vibrio ogawa
Classical, El tor
Chick erythrocyte agglutination
Infection is mild and asymptomatic, resistant to
polymyxin unit disc, chronic carriers are common
Humans are only reservoir, can survive in cold water for
2-4 weeks, killed by boiling for 30 seconds
More subclinical cases, less mortality, able
to survive longer, harder
E1 tor
Transported in alkaline medium, gram negative aerobic,
ferments glucose, grows on simple media, non
halophilic, man is only natural host
Has marked tolerance of alkaline pH, El tor is milder
than classical, Produces indole and reduces nitrate,
Synthesize neuraminidase
Vibrio cholera
0.5 1%
7% NaCl
Quorum sensing
Incessant chatting of microbes
Vibrio cholera
ETEC (but more potent)
Vibrio cholera
Motility, Binds to specific receptors
Neutophilia, Occurrence of many cases in the same
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BACTERIOLOGY
MICROBIOLOGY
Cholera red reaction is tested by adding

Selective media and best suitable media for vibrio
Transport medium for Cholera
Selective medium for vibrio cholera
locality
Sulphuric acid
TCBS
VR Medium
TCBS-Thiosulphate, Citrate, Bile salt, Sucrose
CHOLERA
Incubation period less than 1 week
Prevalence of cholera measured by
Cholera transmission by
Mode of spread of cholera
Cholera
A convalescent case of cholera remain infective for
Cholera toxin acts by
Cholera toxin in small intestine acts by
Cholera toxin
Function of B subunit of cholera toxin

Modification occurring in Gs subunit leading to watery
diarrhea in cholera
Cholera toxin
Vibrio cholera diarrhea is associated with
Washerwoman skin is associated with
Cholera gravis
Death in cholera is due to
Drug of choice for treating cholera in pregnant woman
Drug of choice for treating cholera in children
Antibiotic of choice for treating cholera in an adult is a
single dose of
Mechanism by which cholera might be maintained
during intervals between peak cholera session is
Best approach to prevent cholera epidemic in a
community
Tetracycline used in prophylaxis of
Drug of choice for chemoprophylaxis of cholera
NOT a measure recommended for controlling outbreak
of cholera
Best disinfectant for cholera stools
Cholera
Vibriocidal antibody
Food and healthy carriers
John snow
Culture medium TCBS agar, produces indole and reduce
nitrate, synthesize neuraminidase
14-21 days
Stimulation of adenylate cyclase
ADP Ribosylation of G regulatory protein
Oligomeric protein composed of one A subunit and five
B subunits (AB5). A subunit detaches and becomes
activated by proteolytic cleavage, allowing it to catalyze
the ADP ribosylation of the Gs subunit of the
heterotrimeric G protein resulting in constitutive cAMP
production.
To bind GM1 ganglioside receptor
ADP ribosylation
Causes continued activation of adenylate cyclase
Neutrophilia
Cholera
Life threatening diarrhea
Hypovolemic shock
Furazolidone
Cotrimoxazole
Doxycycline
Continuous transmission in man
Safe water and sanitation
Cholera
Tetracycline
Mass chemoprophylaxis
Cresol
HALOPHILIC VIBRIO
Halophilic vibrio
Vibrio parahemolyticus, V.alginolyticus, V.flovalis
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BACTERIOLOGY
MICROBIOLOGY
Vibrio parahemolyticus associated with
Vibrio parahemolyticus
Toxin is NOT a pathogenic mechanism in
Recently visited sea coast presented with ulcer over left
leg
Cellulitis is associated with
Vulfincus means
Shell fish
Food borne enteritis, Kanagawa phenomenon hemolysis on
Wagatsuma agar
Vibrio parahemolyticus
Vibrio vulnificus
Vibrio vulvifuncus
Wound maker
ATYPICAL MYCOBACTERIA
Mycobacterial species differentiated by
Mycobacterium other than tuberculosis
Tubercle bacilli showing yellow orange pigment
MC cause of non tubercular mycobacteria pulmonary
disease
Mycobacterium avium
NOT photochromogen
Lady windermere syndrome is caused by
Prevention of MAC in HIV
Second most common cause of non tubercular mycobacteria
pulmonary disease
Can cause disease indistinguishable from tuberculosis
Exposure to the organism having antagonistic effect on
BCG
Rapidly growing atypical organism NOT involved in lung
infection
Scotochromogens
Photochromogens
Mycobacterium siniae is
Rapid growers
Rapid grower and pathogenic to humans
Cutaneous lesions produced by
Mycobacterium can be grown in 1-2 weeks
Pedicure bath and leg shaving is associated with
Swimming pool granuloma (fish tank)
Mycobacterium that grows best at 45*C
Battey bacillus
Mycobacterium ulcerans
Non pathogenic
Mycobacterium vaccae
Most useful in treatment of mycobacterium avium
complex
Active against atypical mycobacteria
Drug of choice for treatment of skin infection with
Catalase test, Niacin, Amidase

Causes decreased efficacy of BCG due to cross immunity
Atypical
Mycobacterium avium complex
Do NOT form pigment
Mycobacterium avium
Mycobacterium avium complex
Azithromycin
M.kansasii
M.kansasii
M.kansasi
M.kansasi
M.szulgai, M.scrofulaceum, M.gordonae/acquae
M.kansasii, M.marinum, M.asiaticum, M.siniae
Photochromogen
M.fortuim, M.chelonei, M.smegmatis
M.chelonei
M.tuberculosis, M.leprae, M.ulcerans, M.marinum,
M.hemophilum
M.fortuitum
M. fortuitum
M.marinum
M.smegmatis
Mycobacterium intracellulare
Tropic zone geographic distribution, cause
chronic progressive ulcer, no pigment
production in light, rarely cause ulcer in
mouse foot pad
M.smegmatis, M.paratuberculosis, M.phlei
Immunomodulator
Clarithromycin
Clarithromycin, Rifabutin, Ciprofloxacin
Cotrimoxazole
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BACTERIOLOGY
MICROBIOLOGY
M.marinum
NOT a treatment of MAC (avium)
Pyrazimanide
GENERAL FEATURES OF RICKETTSIA

Rickettsia
Primary site of multiplication of Rickettsial organisms
Transovarial transmission occurs in
Only rickettsiae able to grow in cell free media
Oriental Spotted fever is caused by
Rash starting peripherally is a feature of
Murine typhus
Mediterranean spotted fever is caused by
Vector for R.conori
African tick bite fever
Maculatum disease
Tick borne lymphadenopathy is caused by
Flea borne spotted fever
Tunica reaction
Antigen used for Weil felix reaction obtained from
Typhus fever is diagnosed by
Weil felix reaction is POSITIVE in
Weil felix reaction is
Weil Felix reaction is NEGATIVE in
Neil Mooser reaction given by
Neil Mooser reaction is positive in
OK-19 is positive in
Gram negative, non motile

Endothelial cells of small vessels
Rickettsiae
R.quintana
Rickettsia japonica
Indian tick typhus
R. typhi (transmitted by Xenopsylla)
R.conori
Mite
R.africae
R.parkeri
R.slovaca
R.felis
R. mooseri
Proteus
Weil Felix reaction
Epidemic typhus
Agglutination reaction
Q fever, R.pox and trench fever
Rickettsial infection
R.typhi
Epidemic typhus, endemic typhus, Brill
Zinser disease
ENDEMIC TYPHUS
Endemic typhus
Vector for endemic typhus
Mooser bodies
Caused by R.typhi, Transmitted by bite of fleas (rat flea)

Flea
Endemic typhus
EPIDEMIC TYPHUS
Epidemic typhus is also known as
Only rickettsial disease showing
recrudescence
Man presents with fever, chills 2 weeks after a louse
bite, maculopapular rash on trunk, which spreads
peripherally
Chills and fever following louse bite 2 weeks before,
rashes all over body, delirious at the time of
presentation. vasculitis due to Rickettsial infection
Sutama (Crouching)
Epidemic typhus
Epidemic typhus
R.prowazekii
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BACTERIOLOGY
MICROBIOLOGY
Vasculitis due to rickettsia by
Jail fever is associated with
Rickettsiae prowazeki is transmitted by
Epidemic typhus is transmitted by
Brill Zinser disease
Rickettsia prowazekii
Rickettsia prowazeki
Louse
Louse
Recrudescence
SCRUB TYPHUS
Scrub typhus
Rash starting peripherally

Disease caused by mite
Which transmit both rickettsial disease(R pox) and
oriental disease (scrub typhus)
Leptotrombidium deliensis
Transovarian transmission is associated
with
NOT true about scrub typhus
Weil felix reaction is
Weil felix reaction with OXK
Adult mite feeds only on plants, R.tsutusgamushi

Vector is trombiculid mite, Tetracycline is the drug of
choice, Eschar indicates the location of mite bite,
Spread by infected chigger
Scrub typhus
Scrub typhus
Trombiculid mite
Trombiculid mite
Scrub typhus
Transmitted by adult mites when feed on hosts
OX-K
R.tsutsugamushi
RICKETTSIAL POX
Rickettsial pox is caused by
Rickettsial pox transmitted by
Vector for Rickettisal pox
Herald spot
R.akari
Mite
Gamasid mite
Rickettsial pox
ROCKY MOUNTAIN SPOTTED FEVER

Most severe form of Rickettsial infection is
caused by
Rocky mountain spotted fever is caused by
RMSF transmitted by
RMSF is transmitted by
Rocky mountain spotted fever
RMSF resembles
OX-2 and OX-19 positive in
Rumpel Leede test for
NOT a viral hemorrhagic fever
MC serological test for RMSF
Rickettsia rickettsii
R.rickettsii
Tick
Dog tick (Dermacentor)
Pinpoint, petechial lesions of palm and volar aspect of wrist
Bacterial meningitis
Indirect immunofluorescence
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BACTERIOLOGY
MICROBIOLOGY
Q FEVER
Q fever is caused by
Q fever
Q fever
Coxiella burnetti
Rash is absent in
Mode of transmission of Q fever
Lice is NOT a vector for
Organism NOT needing vector for transmission
Coxiella burnetti
Zoonotic disease, Human disease is characterized by an
interstitial pneumonia, No rash is seen
Highly infectious zoonotic disease, mode of
transmission is by inhalation, no rash or local lesion
Transmitted by inhalation of aerosol of unpasteurized milk
Q fever
Inhalation of aerosol
Q fever
Coxiella burnetti
EHRILICHIA
Ehrilichiosis
Human granulocytic ehrilichiosis is caused by
Human monocytic ehrlichiosis is caused by
Cytoplasmic mulberries (morula) are seen
in blood granulocyte in which of the
following
Tick borne bacterial infection

Anaplasma phagocytophilum
Ehrlichia chaffeensis
Ehrlichiosis
CHLAMYDIA
Chlamydia
Chlamydia is also known as
Chlamydia
Obligate parasite
Infectious part of chlamydia
Chlamydia escape killing by
Chlamydia grow in
Hep2 cells are example of
Ornithosis is caused by
NOT true about Chlamydia
Young male with UTI, pus cells but no organisms
45 year female, lower abdominal pain and vaginal
discharge, cervicitis along with mucopurulent cervical
discharge. best approach to isolate possible causative
organism
Fitz Hugh Kurtis syndrome
Chlamydia is associated with
Chlamydia does NOT cause
Chlamydia does NOT cause
Gram negative but do not have

peptidoglycan, do not have muramic acid
Basophilic viruses
Their cell wall lacks a peptidoglycan layer, Can NOT
grow in cell free media, Obligate intracellular bacteria
Chlamydia
Elementary body
Molecular mimicry
HeLa,HeP2,McCoy
Continuous cell lines
Chlamydia
Can grow in cell free culture media
McCoy culture
Culture on McCoy cells
Perihepatitis in female caused by Chlamydia

trachomatis
Coronary artery disease
Parotitis
Community acquired pneumonia
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BACTERIOLOGY
MICROBIOLOGY
Isolation of Chlamydia from tissue specimen is done by
Method of isolation of Chlamydia from clinical
specimen
NOT a method of isolation of Chlamydia from clinical
specimens
NOT useful for Chlamydia
Chlamydia
Chlamydia can NOT grow in
Drug of choice of Chlamydia infection in Pregnancy
NOT useful in Chlamydia treatment
Chlamydia trachomatis is a
Chlamydia trachomatis
In reticulate body of Chlamydia

Halber Steadter Prowazeki bodies
Chlamydia trachomatis serovars D-K cause
Burning micturition in sexually active male, ulcer in
genitals, 50 WBC, leucocyte esterase positive.
gonococcal culture negative
Chlamydia trachomatis is NOT associated with
Chlamydia trachomatis NOT associated with
Chlamydia is isolated by
Most sensitive test for detecting cervical Chlamydia
trachomatis infection
Serology of choice for Chlamydia
Drug of choice for Chlamydia trachomatis infection in
pregnancy
Chlamydia pneumonia
Chlamydia showing only one serotype
Chlamydia psittaci
Levinthal colle lille bodies
NOT true about Chlamydia psittaci
Yolk sac inoculation

Yolk sac inoculation, Tissue culture using irradiated
McCoy cells and BHK cells
Enzyme immunoassay
Blood culture
Nucleic acid amplification
Ordinary media
Azithromycin
Cefotaxime
Bacteria
Elementary body is NOT metabolically active, biphasic,
reticulate body divides by binary fission, evades
phagocytosis inside the cell, genital chlamydial
infections are often asymptomatic, can be cultured,
inclusion conjunctivitis caused by C.trachomatis
serotype D and K
RNA > DNA
Urethritis
Group specific antigen is responsible for production of

complement fixing antibodies
Community acquired pneumonia
Yolk sac inoculation
Polymerase chain reaction(Nucleic acid amplification)
Microimmunofluorescence
Azithromycin
Group specific antigen is responsible for the production
of complement fixing antibodies
Chlamydia Pneumoniae
Acquired from bird droppings, pneumonia. tetracycline
Psittacosis
Cause non gonococcal urethritis
MYCOPLASMA
Mycoplasma
Mycoplasma
Mycoplasma differ from Rickettsia by
NOT obligate intracellular organism, Smallest

prokaryotic organisms that can grow in cell free media,
Lack cell wall, Resistant to beta lactams, Affinity for
mammalian cell membrane, Can pass through filters of
450 mm pore size, Multiply by binary fission, Requires
sterols for their growth, Raised ESR, Diagnosed by
serum cold antibody
May be commensal in growth, L form is commonest
No cell wall
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BACTERIOLOGY
MICROBIOLOGY
Positive cold agglutination test is seen in infections with
Gliding motility
Mycoplasma is stained by
Dappes stain
Dienes method
Cell wall deficient organisms
Eaton agent
Fried egg colonies
L forms are found in
Pleomorphic organism
Pleuropneumonia like organisms
Multiply by binary fission, can grow in cell free media,
require sterol for growth
NOT true about mycoplasma
NOT true about mycoplasma
Mycoplasma and Penicillin G
Mycoplasma pneumonia is differentiated
from other forms of mycoplasma and
other L forms of bacteria by
Metabolizes arginine
Mycoplasma
Mycoplasma
Dienes method
Mycoplasma in cell culture
Mycoplasma
Mycoplasma
Mycoplasma
Mycoplasma
Mycoplasma
Mycoplasma
Mycoplasma
Mycoplasma
Obligate intracellular parasites
Inhibited by penicillin
Resistant
The ability of its colonies to adsorb sheep
blood cells
Mycoplasma hominis
NON VENERAL TREPONEMES

Does NOT develop resistance to penicillin
Non veneral treponemal infection
Non veneral treponemas
Yaws caused by
Yaws
Yaws
Yaw
Yaw
NOT true about Yaw
NOT true about Yaws
Yaw and Pinta
Pinta caused by
Pinta
Pinta is associated with
Bejel is caused by
Treponema
Yaws, Pinta, Endemic syphilis
T.pertenue, T.carateum
Treponema pertenua
NOT sexually transmitted, Caused by T.perteune,
Secondary yaw can involve bone
Treponema pertunae, non venerally, secondary yaws
can involve bone
T. pertenue, skin to skin transmission, occurs in early
childhood, ulcerative papilloma in extremities, destructive
gumma
Also known as pian, framboesia, bouba, raspberry like, crab
like gait, gangosa
Later stages involve heart and bone
Spread by sexual transmission
CANNOT be differentiated by serological tests
T.carateum
T. carateum, skin to skin transmission, late childhood, non
ulcerative papule, non destructive, dyschromic or achromic
macule
Purpura
Treponema endemicum
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BACTERIOLOGY
MICROBIOLOGY
LEPTOSPIRA
Most widespread zoonotic disease in world
Rat, rain, rice fields
True about leptospirosis
Reservoir of Leptospirosis
Transmitted by Rat urine
Characteristic feature of Leptospira
Leptospira
Disease seen in Sewer worker
Leptospirosis
Accidental and dead end host in leptospirosis

Leptospirosis
Leptospirosis
High grade fever, altered sensorium, comatosed and

conjunctival hemorrhage, elevated serum bilirubin and
serum urea, negative peripheral blood for malarial
parasite
Weils disease caused by
Features of Weils disease
NOT true about Leptospirosis

NOT used in leptospirosis
NOT true about leptospirosis
EMJH medium
Korthof culture media for
Culture medium for Leptospirosis
14 year boy, icterus, conjunctival effusion, hematuria.
serological test
Diagnosis of Leptospirosis
Treatment of leptospirosis
Drug having no effect of leptospira
Leptospirosis
Leptospirosis
Rats are prime reservoirs
Rat
Leptospira
Hooked ends
Viable as long as 10 days at room temperature in blood
Leptospirosis
Zoonosis, Man acts as accidental host and dead end,
Rats are the reservoir, person to person transmission is
rare
Man
Urine may show microscopic hematuria, Incubation
period in leptospirosis ranges from 2 20 days
Infection acquired by direct contact with infected urine.
mortality is 5-15% in severe cases, penicillin, antibodies
NOT usually detectable in first week
Weils disease
Leptospira icterohemorrhagica
Hepatorenal damage, jaundice, renal failure,
albuminuria, bleeding diathesis, purpuric hemorrhages,
pyrexia
Quinolones are drug of choice
Weil felix reaction
Lice act as vector
Leptospirosis
Leptospirosis
Korthof
Microscopic agglutination test
Microscopic agglutination test
Penicillin G
Erythromycin
BORRELIA
Lymes disease
Lyme disease
Bulls eye lesion

Lyme disease
Borrerlia burgdorferi, Transmitted by Ixodes tick (deer

tick), Rodents act as natural host, Erythema chronicum
migrans may be a clinical feature
Borrelia burgdorferi replicates locally and invades
locally, Infection progresses inspite of good humoral
immunity, Intrathecal IgA confirms meningitis
Lymes disease
CSF pleocytosis
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VIROLOGY
MICROBIOLOGY
Bannwarth syndrome(meningopolyneuritis) is
Erythema migrans is a feature of
Skin feature of lyme disease
NOT true about lymes disease
NOT true about Lyme disease
Relapsing fever
MC symptom of tick borne relapsing fever
Treatment of relapsing fever
Organism using antigenic variation as a major means of
invading host defences
Louse borne relapsing fever caused by
NOT associated with tick borne relapsing
fever
Tick borne relapsing fever caused by
Noguchi medium
Barber Stonner Kelly medium
Kellys medium
Borrelia infection is confirmed by
Misdiagnosis of Lyme disease
Treatment of Lyme disease
Lymes diseae
Lyme disease
Acrodermatitis chronic atrophica
Intrathecal specific IgA antibodies is diagnostic
Polymorphonuclear lymphocytes in CSF suggest
meningitis
Tick borne relapsing fever (Ornithodoros tick), Louse borne
relapsing fever also known as epidemic relapsing fever
caused by Borrelia recurrentis
Headache
Chloramphenicol, doxycycline, erythromycin, penicillin
Borrelia recurrentis
Borrelia duttoni, Borrelia hermsii, Borrelia parkeri
Borrelia
Borrelia
Borrelia
Stain for inculsion bodies within the cells
involved in rash
Chronic fatigue syndrome
Doxycycline (oral), Ceftriaxone (IV)
VIROLOGY
GENERAL FEATURES OF VIRUS
National institute of virology is located in
Viroids
Viroids
Virion
Virus contains
Virus
DNA covering material of virus is called
Virus grows well on
Von magnus phenomen
nd
One virus particle prevents multiplication of 2 virus.

this phenomena is called
Virulent strain has ability to
Electron microscope is used to study the morphology of
Plaque formation in virus is done for
Plaque assay is done for
Viral plaque made for
Pune
Resistant to heat
Infectious nucleic acid
Extracellular infectious virus particle
Either DNA or RNA
Form extracellular infectious particle, heat labile, NOT
affected by antibiotics
Capsid
Cell culture
Virus yields high hemagglutinin titre but
low in infectivity
Viral interference
Invade and multiply
Viruses
Quantitative assay of infectivity of virus
Measuring the number of infectious virus particles
Quantitative assay of infectivity of virus
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VIROLOGY
MICROBIOLOGY
Pocks on chick embryo is formed by
Hemadsorption is exhibited by
Property of elution (reversal of
hemagglutin due to presence of
neuraminidase that destroys receptor)
NOT a cytopathic effect of virus
NOT a test for lab diagnosis of viral
respiratory track infection
Single stranded viruses
Double stranded viruses
Negative stranded viral RNA
Negative stranded RNA viruses
RNA viruses undergoing replication in

nucleus
Segmented double stranded RNA virus
Non enveloped DNA virus
Simian virus 40 is
Cytoplasmic vacuolation is associated with
MC cause of URI
Ideal temperature for Rhinovirus
Virus causing gasteroenteritis
Viruses showing renal involvement
Virus associated with malignancy
Virus is definitely associated with
New infectious agents
Latent infection is associated with
Reverse transcriptase PCR is used in diagnosis of
Reverse transcriptase polymerase chain reaction can
NOT aid in diagnosis of
NOT a method for detection of viral respiratory tract
infection
Continuous cell lines for virus are
Non cultivable virus
SARS is caused by
Super spreaders are associated with
Incubation period of SARS
SARS is identified on
Crimean congo fever is caused by
Crimean Congo Hemorrhagic fever
NOT common in India
Virus etiology is NOT implicated in
Vector for vaccine preparation
Used for vaccine preparation
Orf
Arena virus
Variola, vaccinia, cowpox

Rabies virus, measles vaccine
Myxovirus
Budding
Detection of viral hemagglutinin
inhibiting antibodies in single serum
specimen
Papova virus
Pox virus, reovirus
Requires a special polymerase in virion
Rhabdoviridae, Filoviridae,
Paramyxoviridae, Orthomyxoviridae,
Bunyaviridae, Arenaviridae, Reoviridae
Retrovirus, orthomyxovirus
Reovirus
Adenovirus, Parvo virus, Papova virus
DNA virus
SV40
Rhinovirus
33*C
Rotavirus, Adenovirus, Norwalk virus, Enterovirus
CMV,HIV,HBV
Herpes virus, Retrovirus, Papova virus
Burkitts Lymphoma, Hairy cell leukemia
Nipah virus, Corona virus, SARS
HSV 2, HIV, EBV, CMV
Astrovirus, Picorna virus, Rota virus
Adenovirus
Direction of viral hemagglutinin inhibiting HAI
antibodies in single serum specimen
Vero, Hela, Hep2
Rota virus, Norwalk virus, Molluscum contagiosum
Corona virus
Corona virus
2 7 days
2003
Nairo virus
Zoonosis, Develop petechial patches, Recently reported
in Gujarat, Has high fatality
Lassa fever
Condyloma lata
Vaccinia
Adenovirus
Parapox virus
Old world virus eg. Lassa virus, Lymphocytic
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VIROLOGY
MICROBIOLOGY
choriomeningitis
Bunyaviridae eg. Nairo virus, Hanta virus
Orapouche, Punta toro infection, Sandfly fever, Toscana
fever
Bunyaviridae
Heamagogus virus
Flavivirus
Ebola virus
Bromide green dye for PCR
Transovarian transmission is seen in

Bunyaviridiae cause
Ganjam virus belongs to
Mayor fever is transmitted by
Ebola virus
Bowl of sphagetti appearance
Ebola virus is diagnosed by
HERPES VIRUS
Herpes group virus
Ether sensitive, may cause malignancy, HSV II involve

below diaphragm
Herpes virus
Double stranded DNA virus
Herpes virus
Herpes
Lipid envelope is found in

HSV is a
Varicella, EBV belong to
Focal degeneration (pocks in
chorioallantoic membrane)
Cold sore is caused by
Encephalitis is caused by
Scrum pox is common in
HSV II
Neonatal herpes is caused by

Virus B6-7 is causative agent in
Roseola infantum or Exanthem subictum is caused by
HHV 6B cause
Nagayama spot
Rash usually appears after fever has
subsided
Kaposi sarcoma caused by
Castleman disease is caused by
Herpetic whitlow in
NOT a treatment of herpetic whitlow
Herpetic gladiatorum
Herpes virus may remain dormant in
Genital herpes simplex can be diagnosed by
Biopsy of herpes simplex viral lesion
Cowdry A intranuclear acidophilic
inclusion bodies
Drug of choice for Herpes simplex
Acyclovir
HSV-1
HSV 1
Rugby players
Primary infection is usually widespread, Recurrent
attacks are due to reactivation of latent infection,
Encephalitis can be caused by HSV II, Newborn can
acquire infection via birth canal at the time of labour,
Treatment is with acyclovir
HSV II
Focal encephalitis
HHV 6
Focal encephalitis
Exanthema subictum
Exanthema subictum and erythema
infectiosum
HHV8
HHV- 8
Finger
Surgery
Wrestler
Sacral ganglia
Tzank smear
Multinucleated keratinocytes
Herpes simplex, varicella zoster
Acyclovir
Inhibits DNA synthesis and viral replication, low toxicity
for host cells, renal impairment necessitates dose
reduction
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VIROLOGY
MICROBIOLOGY
Mechanism of action of acyclovir
Famcicyclovir
Valacyclovir
Inhibits HSV polymerase

Prodrug of peniclovir
Prodrug of acyclovir
PARVOVIRUS
Parvovirus
Parvovirus B19
Parvovirus B19
Virus with smallest genome

Smallest DNA virus
Target for parvovirus
Parvovirus cause
th
5 disease is caused by
Predominant route of parvovirus
Common manifestation of Parvovirus infection in adult
Erythema infectiosum
Lazy reticular rash is associated with
Slapped cheek appearance
Glove and stock syndrome is a variant of
Non enveloped, SINGLE stranded DNA virus, linear DNA,

icosahedral symmetry
DNA virus, severe anemia, aplastic crisis, crosses
placenta frequently
Spread by respiratory route, Has affinity for erythrocyte
progenitor cells, Causes transient aplastic crisis,
Transplacental transfer occur in 30% of cases
Parvovirus
Parvovirus
Immature cells in erythroid lineage
Erythema infectiosum, Aplastic anemia, Arthropathy
Parvovirus B19
Repiratory route
Arthropathy
Parvo virus, Slapped cheek appearance
Erythema infectiosum (Parvovirus)
EBSTEIN BARR VIRUS

EBV
EBV belongs to
EBV
EBV
Virus spreading through both
hematogenous and neural route
Infectious mononucleosis is caused by
Diseases associated with EBV
HHV 4
Herpes group
Gp350 binds to CD21
EBV
Infectious mononucleosis is caused by

Oral hairy leukoplakia is associated with
Patient with sore throat having positive paul bunnel
test
Lymphoid interstitial pneumonitis in HIV infected
individual is commonly caused by
Epitrochlear lymphadenopathy is
associated with
African Burkitts lymphoma is caused by
EBV cause autoimmunity by
Sore throat and positive paul bunnel test
Epstein barr virus

Infectious mononucleosis, Nasopharyngeal carcinoma,
Oral hairy leukoplakia, Hodgkins and Non Hodgkins
lymphoma, Ca tonsil, Burkitts lymphoma
EBV
EBV
Epstein Barr virus
EBV
EBV
EB virus
Polyclonal B cell activation
EBV
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57
VIROLOGY
MICROBIOLOGY
EBV is associated with
NOT caused by EBV

Ebstein Barr Virus does NOT cause
EBV is NOT associated with
Inclusion bodies are NOT seen in
Paul bunnel test is done for
Most sensitive test for diagnosis of infectious
mononucleosis
Ampicillin NOT given in EBV infection because of
Post transplant lymphoreticular disease,

Non Hodgkins lymphoma, Bells palsy,
carcinoma tonsil
Kaposis sarcoma
Adult T cell Leukemia
Thrombocytopenia
Infectious Mononucleosis
Infectious mononucleosis
Monospot test
Skin rash
CYTOMEGALOVIRUS
Cytomegalovirus is
Post kidney transplantation caused by
Mononucleosis like syndrome is caused by
MC presentation of congenital CMV
Maternal viremia most commonly spreading to fetus in
utero
CMV rarely cause
In CMV infection of brain, viruses are present in
Owl eye appearance on picture
Congenital CMV infection
Great concern for CMV infection
Congenital CMV infection in infant established by
Does NOT establish diagnosis of congenital CMV in

neonate
Drug used in CMV infection
Famciclovir is a prodrug of
HHV 5
CMV
CMV
Hepatosplenomegaly
CMV
CNS infection
WBC
CMV
Hepatosplenomegaly
2nd month after transplantation
Urine culture of CMV, Intranuclear inclusion bodies in
hepatocytes, CMV viral DNA in blood by polymerase
chain reaction
IgG CMV antibodies in blood
Gancyclovir
Penciclovir
ROSEOLA INFANTUM
A patient had fever and coryza for last 3 days developed
maculopapular erythematous rash which lasted for 48
hours and disappeared without leaving behind
pigmentation is commonly due to
Roseola infantum
Fever stops and rash begins is diagnostic of
Roseola infantum
HHV 6 and 7, Rash appear in trunk, During

deferverescence rash appears
Roseola infantum
VARICELLA ZOSTER VIRUS

Varicella zoster virus
Varicella are classified under
HHV 3
Herpes virus
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58
VIROLOGY
MICROBIOLOGY
Virus causing chicken pox belongs to
NOT a pox virus
Herpes zoster is caused by
Varicella
Chicken pox
Chicken pox
Rash of chickenpox
Rash pattern in chickenpox
Dew drop on petal appearance
Pleomorphic rash
Incubation period of Varicella Zoster
Infectivity of chickenpox lasts for
Varicella zoster remains latent in
MC extraskin manifestation of Varicella
Intrauterine infection associated with limb reduction
defects and scarring of skin
Hypoplasia of limb and scarring caused by
MC complication of chickenpox in children
Known complication of chicken pox
NOT a complication of chicken pox
NOT true about chicken pox
NOT true about chickenpox
NOT true about varicella infection
Multiple calcification in chest X ray
Sensitive test for VZV
Prevention of VZV in HIV
Herpes virus (HHV3)

Chicken pox virus
Varicella
No recurrence(single infection gives lifelong immunity),
All stages of rash are seen at same time, Rash
commonly seen in flexor area, Secondary attack rate is
90%
Centripetal rash, Pleomorphic rash, Rapid progression
from macule to vesicle, Lesion appear in crops
Rash appears on first day, Rash can occur in axilla
Quick prodromal period, quick evolution, rash begins on
trunk
Centripetal
Varicella
Chicken pox
1 2 weeks
6 days after onset of rash
Trigeminal ganglion
CNS
Varicella
Varicella
Secondary bacterial infection
Pancreatitis
Enteritis
Scabs are infective
Crusts contain live virus
Only single stage infection found at a time
Following chickenpox
FAMA (Fluorescent antibody to membrane antigen), ELISA
VZ immunoglobin
ADENOVIRUS
Adenovirus
Grape clump appearance is associated
with
Virus with space vehicle appearance
Basophilic inclusion body
Disease caused by Adenovirus
Shipyard eye is caused by
Virus causing hemorrhagic cystitis, diarrhea,
conjunctivitis
Pharyngoconjunctival fever is caused by
Serotype 1,2
Serotype 3,7
Serotype 4, 7
Serotype 40, 41
Serotype 11,12

Adenovirus
Adenovirus
Adenovirus
Pneumonia, Pharyngitis, conjunctivitis
Adenovirus
Adenovirus
Adenovirus
Respiratory disease
Pharyngoconjunctival fever (swimming pool conjunctivitis)
Military recruits respiratory distress
Diarrheal illness in children
Hemorrhagic cystitis in children
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VIROLOGY
MICROBIOLOGY
Serotype 8, 19, 37
Cowdry B intranuclear basophilic bodies
Epidemic keratoconjunctivitis
Adenovirus
ROTAVIRUS
Rota virus
Segmented gene
Rota virus
Reassortment is typically seen in
Virus enterotoxin detected as a possible mechanism of
action
Rota virus commonly affects
Rota virus infection in children below
MC cause of gastroenteritis in children
Rota virus
Diarrhea in Rotavirus infection due to
Rota virus are responsible for
Rota virus detected by
Rota virus is diagnosed by
Best vaccine for Rota virus
Culture can NOT be done, Rota B can grow in cell

culture, Rota C can cause diarrhea in children
Rota virus
VP6, virus shed in stool
Rotavirus
Rota virus
Children
5 years
Rotavirus
Terminal ileum villi destroyed
Decreased absorption by villi
Infantile diarrhea
Antigen in stool
Presence of antigen in stools by ELISA
Genetic reassortment
SMALL POX
Largest DNA virus
DNA virus with complex capsid
symmetery
Pox virus
Pox virus
Poxviridae
Inclusion bodies in cytoplasm is seen with

Pox virus
Guarneri bodies are seen in
Most sensitive method for diagnosis of small pox
Protection against small pox by previous infection with
cowpox represents
Successful eradication of small pox because of
Small pox eradication was NOT due to

India become small pox free in
Bollinger bodies
Double standed DNA virus encoding

DNA dependent RNA polymerase
Pox virus
Complex shape, relicate and assemble in cytoplasm (unique
feature)
Small pox
Smear test
Antigenic cross reactivity
Subclinical cases did not transmit the disease, A highly
effective vaccine was available, Infection provided
lifelong immunity
Cross immunity with animal pox virus
April
Fowl pox
PAPOVA VIRUS
Papova virus
DNA virus, non enveloped icosahedral virus, warts and
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VIROLOGY
MICROBIOLOGY
papilloma, SV 40 is oncogenic
Viral warts resolve spontaneously, Plantar warts should
not be excised, Callosity are formed occupationally
Warts
POLIO VIRUS
Picorna viruses
Polio virus
Type I polio virus
Type II polio virus

Type III polio virus
Main portal of polio virus
Wide polio outbreak in 2nd half of 2007
Polio
Polio
Disease transmitted by water
Virus that spread by both hematogenous and Neural
route
Isolation NOT needed for
Bilateral phrenic nerve palsy
Neuronophagia is seen in
Biots respiration
Acute stage of poliomyelitis lasts for
NOT seen in non paralytic polio
NOT a feature of poliomyelitis
NOT true about polio patient who had paralysis
Acute flaccid paralysis in children aged
Under AFP surveillance, follow up examination is done
after
Epidemiological trend of Polio
Prevalence of all clinical cases of polio can be estimated
by multiplying the no of residual paralytic cases
For every case of poliomyelitis, the subclinical cases of
poliomyelitis to be estimated
Sample used to isolate polio virus earliest
Cowdry B intranuclear acidophilic
inclusion bodies
Kenny packs were used in treatment of
Best way to stop epidemic poliomyelitis spread
Pulse polio immunization
Polio virus, foot and mouth virus, encephalomyocarditis

Transmitted by fecooral route, Asymptomatic infections
are common in children, Live attenuated vaccine
produces herd immunity, Increased muscular activity
leads to increased paralysis
Responsible for most epidemics, very difficult to
eliminate, responsible for vaccine induced paralytic
polio
Highly antigenic
Vaccine induced paralysis due to
mutation
GIT
Type 3
IM injection and increased muscular activity increases
the risk of paralytic polio
Paralytic polio is most common
Polio
Polio virus
Polio
Polio
Poliomyelitis
Bulbar poliomyelitis
1-5 days
Extensor plantar
Progressive course
Can transmit it by nasal discharge
0-15 years
60 days of onset of paralysis
Sporadic to epidemic, increasing in tropics, Affects
higher age groups
1.33
1000 children and 75 adults
Stool
Polio
Poliomyelitis
OPV drops to all children
All children between 0-5 years of age on a single day,
irrespective of their previous immunization status
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VIROLOGY
MICROBIOLOGY
Target age group under pulse polio programme
OPV
OPV strain
Concentration of type 3 virus in OPV
Salk vaccine
Under 5 years
Poliomyelitis in recipients, Poliomyelitis in contacts of
recipient
Poor growth in stable cell line of monkey kidney
3,00,000 TCID 50
Prevent paralysis, Oral polio can be given as booster,
Easily transported
ENTEROVIRUS
Total sheet degeneration is associated with
MC cause of Rubelliform(discrete) rash
Epidemic hemorrhagic conjunctivitis caused by
Enterovirus associated with
Enterovirus 71 is associated with
Bornholm disease
Hallmark of pleurodynia
Summer grippe
Virus shed in stool in
Enterovirus does NOT cause
Enterovirus
Echovirus 9
Picorna virus (enterovirus which is a subtype of Picorna
virus)
Myocarditis, Pleurodynia, Herpangina
Hand foot mouth disease, herpangina
Pleurodynia
Servere muscle pain
Non specific febrile illness seen in enterovirus infection
Herpangina
Hemorrhagic fever
COXSACKIE VIRUS
Coxsackie virus causes
Herpangina, Hand foot mouth disease, Infantile

myocarditis
Aseptic meningitis
Vesicles on hand
Cox sackie A virus
Bornholm disease
Erythema subictum
Coxsackie virus
Cox sackie group A commonly causes

Cox sackie A 16 is associated with
Herpangina is caused by
Cox sackie virus does NOT cause
Coxsackie virus does NOT cause
Suckling mice is used for culture of
INFLUENZA VIRUS
Segmented RNA virus
M protein in orthomyxovirus maturation
Influenza A
All pandemic of influenza by
Pandemic of influenza is caused by
Influenza
Influenza
Influenza virus
Serves as a recognition site for
nucleocapsid at the inner face of plasma
membrane
Hemagglutinin and neuraminidase is strain specific
Influenza A only
Antigenic shift
Primary infectious pneumonia is less common than
secondary bacterial pneumonia
Major epidemics are due to antigenic SHIFT, Antigenic
drift is gradual antigenic change over a period of time,
Antigenic shift is due to genetic recombination of virus,
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VIROLOGY
MICROBIOLOGY
Segmented RNA
H5N1
H1N1 swine flu was found on
Gradual and sequential change in antigenic structure at
regular intervals
Influenza causes new epidemic by
Antigenic shift
Shift occurs only with
Reye syndrome is associated with
Antigenic variation NOT seen in
Influenza
Influenza is associated with
Most serious complication of Influenza B
Immunofluorescence
Amantidine and rimantidine are active against
Amantidine is most effective for
Which is a Neuraminidase Inhibitor
Avian influenza treated by
Oseltamivir is used to treat
Oseltamivir inhibit
Mechanism of action of oseltamivir
Dose of oseltamivir in adults

Newer influenza vaccine
Influenza A is subjected to frequent antigenic variations

Influenza
Bird flu virus
2009
Antigenic drift
Antigenic drift
Gradual
Influenza A
Influenza B
Influenza C
Affects all sexes and ages, Incubation period 18 72
hours
Myositis and rhabdomyolysis
Reye syndrome
Detection of influenza
Influenza A only
Influenza A
Oseltamivir
Oseltamivir
Influenza A & B
Neuraminidase
Inhibition of a viral enzyme that aids the
spread of virus through respiratory mucus
and is required for release of progeny
virus
75 mg BD
Split virus vaccine, Neuraminidase, Recombinant
vaccine
MEASLES
Moribilli
Measles
Measles virus
Syncitium formation is associated with
NOT a teratogenic virus
Measles
Measles
Measles
Measles
Epidemiology of measles
Measles
Single stranded negative sense RNA virus
Paramyxovirus
Measles
Measles
Higher secondary attack rate, Only one strain cause
infection, Infectious in prodromal period, Infections
confer lifelong immunity, Meningoencephalitis can
precede parotitis, Flaring up of TB
Fever occurs 7-10 days after occurrence of infection,
immunity develops after 7 days of vaccination, single
dose of vaccine gives 95% protection
Immunosuppression
Koplik spots appear in prodromal stage, Fever stops
after onset of rash
Secondary attack rate of measles is less than that of
rubella
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VIROLOGY
MICROBIOLOGY
Epidemiological determinants of measles
Reservoir for measles
Incubation period of measles
Measles is infectious
Koplik spot appear
Clinical manifestation of measles appearing last
Rash in measles occur first in
Fever with centrally distributed maculopapular eruption
Macular rash with red margins
Remission in Nephrosis
Comphys sign (white patches due to degenerated
squamous epithelium occurring on buccal mucosa and
gums)
A line of conjunctival inflammation in lower eyelid
margin is diagnostic of
Warthin finkedly cells (giant cells)
Bolognini symptom (a feeling of crepitation occurring
from gradual increasing pressure on the abdomen)
Hetch giant cell pneumonia
MC complication of measles in children
Infection having most neurological complications
Least common complication of measles
MC cause of post measles death
Cause of death in measles
Bronchopneumonia in measles due to
Ice berg phenomenon NOT seen in
Chronic carrier NOT seen in
NOT true about measles
NOT a complication of Measles
Chemoprophylaxis not done in
Measles vaccination strategy in 9 months to 4 years
Catch up, keep up, follow up for
Epidemiological determinants of measles

Man
10 days
4 days before rash and 5 days after rash
1 day before rash
Rash
Post auricular region
Measles
Measles
Measles
Measles
Measles
Measles
Measles
Measles
ASOM
Measles
SSPE
Diarrhea
Pneumonia
Immunomodulation
Measles
Measles
Not infectious In prodromal stage
Pancreatitis
Measles
Catch up
Measles
MUMPS
Mumps virus belongs to
Virus easily cultured from CSF
Virus NOT causing pneumonia
NOT transmitted transplacentally
Presternal edema is seen in
Mumps
Mumps cause
Commonest complication of mumps
MC complication of mumps in children
MC ocular manifestation of mumps
NOT a complication of mumps
Paramyxovirus
Mumps
Mumps
Mumps
Mumps
Menigoencephalitis can precede parotitis
Aseptic meningitis in children
Orchitis and oophoritis
Aseptic meningitis
Dacroadenitis
Parotid abscess
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VIROLOGY
MICROBIOLOGY
RABIES
Vesicular stomatitis virus
Rabies virus RNA
Rabies
Shape of rabies virus
Rabies
Rabies
Rabies virus inactivated by

Paralytic rabies is caused by bite of an infected
Incubation period of rabies depends on
Characteristic manifestation of rabies
MC type of pathological change in Rabies
Rabies is transmitted by
Rabies NOT transmitted by
Mode by which Rabies virus NOT transmitted
Foaming at mouth is associated with
Rabies free area
FALSE about Rabies
Bite of which of the following animals do not result in
human rabies
Rabies free country
Rabies is NOT found in
Most suitable clinical sample that can confirm the
antemortem diagnosis of Rabies
Rabies best diagnosed by
Intracytoplasmic inclusion bodies
Negri body seen in
Negri bodies commonly seen in
Negri body
Babes nodule in rabies
Negri bodies are NOT found in
NOT used for confirming rabies
encephalitis
In case of dog bite, biting animal observed for
NOT done for dog bite
Class II exposure in animal bite
Which should be injected in and around wound in class
II rabies bite
NOT a treatment of class III bite
Antiseptic/disinfectant is best for local
wound application in case of dog bite
Rabies vaccine first developed by
Commercially available rabies vaccine
NOT a commercially available rabies vaccine
Rhabdoviridae
Negative polarity
Multiple strains are seen
Bullet shape
Intracytoplasmic basophilic inclusion bodies are seen in
brain cells
Vaccine virus has fixed incubation period, IP depends on
site of bite, All bites on fingers with laceration are class
III injuries
Phenol, UV radiation, BPL
Vampire bat
Site of bite
Meningitis
Brainstem encephalitis
Dogs, Vampire bat, Jakal
Ingestion
Sexual
Rabies
No indigenously acquired case for 2 years
Limited to brain
Mouse
Australia, Britain
Lakshwadeep, Andaman Nicoar islands
Corneal impression smear for immunofluorescence
stain
Immunofluorence study
Rabies
Rabies
Cerebellum > Hippocampus
Eosinophilic cytoplasm
Microglia
White matter
PCR
10 days
Immediate wound closure
Licks on a fresh wound
Antirabies serum
Immediately stitch wound under antibiotic coverage
Alcohol
Louis Pasteur
Killed sheep brain vaccine, Human diploid cell vaccine,
Vero continuous cell vaccine
Recombinant glycoprotein vaccine
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VIROLOGY
MICROBIOLOGY
Vaccine prepared by embryonated hens egg
Number of HDCV for pre exposure prophylaxis of rabies
Pre exposure prophylaxis of rabies
Post exposure prophylaxis for rabies
Rabies
3
0,7,28 and booster dose after 2 years
HDCV 0,3,7,14,30 booster dose 90 days
GENERAL FEATURES OF ARBOVIRUS

Arboviral disease
Arboviruses are
Suckling mice used for cultivation of
Arboviral diseases
Only group A arbovirus causing epidemic disease in
India
KFD, West Nile fever, Ganjam virus, Puumala virus

Heat labile
Arbovirus
Yellow fever, Japanese encephalitis, Dengue
Dengue, Chikungunya fever
DENGUE
Break bone fever caused by
Dengue virus is a
In India, dengue viruses associated with human
infections
Dengue virus appears to have direct man to man cycle
in India. mechanism of dengue virus survival in the inter
epidemic period
Dengue
Infective fever of aedes mosquito for classical dengue
fever
Infective period of Aedes mosquito in Dengue
Dengue fever
Dengue
Classical dengue fever

Saddle back temperature
Classical dengue fever is transmitted by
Dengue hemorrhagic fever is caused by
5 year petechial rash, Lymphadenopathy, Reduced air
entry into Right lung
Dengue hemorrhagic fever is due to
NOT true about dengue hemorrhagic fever
NOT a feature of dengue shock syndrome
Minimum platelet count for diagnosis of Dengue
Most sensitive diagnostic test for dengue
Most specific dengue diagnosis
Arbovirus
Flavi virus
All 4 types
Transovarian transmission of virus
Endemic in india
Life long
Till death
Most common arboviral infection, Can be both
epidemic as wall as endemic, Can survive in ambient
temperature, Vector is Aedes aegypti
Increased hematocrit, Decreased platelet, Positive
tourniquet test, Vector aedes aegypti usually bite
during day time, Pleural effusion present
Case fatality is low, break bone fever, self limiting
disease
Dengue fever
Aedes mosquito
Reinfection with different serotype of dengue virus
Dengue hemorrhagic fever
Infection by another strain of dengue virus
Shock
Decreased hemoglobin
100000
Neutralization test
IgM ELISA
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VIROLOGY
MICROBIOLOGY
CHIKUNGUNYA
Chikungunya
Epidemic caused by Type A arbovirus in India
Vectors for Chikungunya
Vector for Chikungunya fever
Alpha virus
Chikungunya
Aedes, culex, mansonia
Aedes
YELLOW FEVER
Arboviral disease NOT reported in India
Yellow fever
Yellow fever
Yellow fever is NOT present in India because

Incubation period of yellow fever
Quarantine period for Yellow fever
Torres bodies
Yellow fever reference centre
No risk of yellow fever if aedes aegypti index remains
below
Vector control for yellow fever around an airport is
done upto a distance of
Validity of yellow fever vaccination certification
Yellow fever
Subclinical cases present, One attack gives lifelong
immunity, Hepatic and renal involvement in severe
cases, Caused by flavi virus, Case fatality rate upto 80%,
Transmitted by aedes, Incidence is increased by
humidity, Vaccine is 17D
Incubation period is 3-6 days, Validity of international
certificate lasts up to 10 years, Urban form is controlled
by 17D vaccine, Aedes aegypti index should be less than
1%
Virus is NOT present
3-6 days
6 days
Yellow fever
Central institute kasauli
1%
400 m
10 years starting 10 days after vaccination
JAPANESE ENCEPHALITIS
Old name for Japanese encephalitis
Mosquito borne encephalitis caused by
JE does NOT cross react with
Japanese encephalitis
Subclinical infection is common with
Japanese encephalitis commonly seen in
Von economo encephala

Group B Arbovirus (Flavivirus)
Dengue virus
Man is incidental dead end host, Culicine and anopheles
vectors involved, 85% of cases occur in children <15
years of age
Pigs are amplifiers for flavivirus, Rice fields are breeding
places, Transmitted by culex, Primary doses of vaccine
consists of two doses
Two or three cases per village suggest epidemic,
children frequently affected, ratio of inapparent to
apparent infection >100:1
Zoonoses
Pigs
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VIROLOGY
MICROBIOLOGY
Amplifier host of Japanese encephalitis
Only domestic animal showing signs of encephalitis due
to JE virus
Man in Japanese encephalitis
Japanese encephalitis in India is associated with
Most important vector of Japanese encephalitis in
south India
Japanese encephalitis is associated with
Aedes does NOT transmit
Vector for Japanese encephalitis
Epidemic in Japanese encephalitis is declared if
Abnormal signals in bilateral thalami on
MRI brain
NOT true about Japanese encephalitis
NOT true about Japanese encephalitis virus
NOT true about Japanese encephalitis
NOT a feature of Japanese encephalitis
Major
deterrant
in
elimination
of
Pig
Horses
Dead end host
Culex vishnui
Culex tritaeniorhynchus
Culex tritaenorrhyunchus
Culex
2-3 cases in a village
Man to man transmission
Four doses of vaccine
90-100% mortality rate
Infected pigs manifest symptom of encephalitis
Large inapparent infections
WEST NILE FEVER

Found in India
Culex transmit
Polio like encephalopathy
West Nile fever

West nile fever
West Nile fever
KYASANUR FOREST DISEASE

Flavivirus closely related to Russian spring summer
encephalitis causing virus
KFD
Viral encephalitis
Viral infection transmitted by tick
KFD transmitted by
NOT useful in prevention of KFD
KFD
Zoonosis, affects monkeys, caused by virus
KFD
Kyasanur forest disease
Hard tick Hemophysalis
Deforestation
HANTA VIRUS
Sin Nombe virus
Hanta virus
Hanta virus pulmonary syndrome is caused by
Hanta virus
RNA virus, Caused by rodents, Causes recurrent
respiratory infection, Hemorrhagic fever with renal
failure
Inhalation of rodent urine and feces
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VIROLOGY
MICROBIOLOGY
RESPIRATORY SYNCITIAL VIRUS

Virus lacking hemagglutinin and neuraminidase but
have membrane fusion protein
RSV does NOT cause
RSV
Bronchitis
REOVIRUS
Virus composed of two distinct capsules enclosing
double stranded RNA
Segmented double stranded RNA is found in
Reovirus
Reovirus
RUBELLA
rd
3 day disease
8 years following URTI developed maculopapular rash
rd
on jaw spreading on to trunk which cleared on 3 day
without desquamation and tender postauricular and
suboccipial lymphadenopathy
Maculopapular rash on jaw cleared on 3rd day without
desquamation and tender postauricular and
suboccipital lymphadenopathy
Exanthema spreads from hairline to downwards and clears
as it spreads
Rubella causes
Multiple sites of narrowing of peripheral pulmonary
arteries
Forscheimer spots are seen in
Incubation period of rubella
Complications of Rubella
Uncommon clinical feature of Rubella
Most severely affected in Rubella infection
MC age group affected by rubella
Average incubation period of Rubella is equal to that of
Features of Congenital rubella
Congenital rubella syndrome is associated with
Multiple sites of narrowing of peripheral pulmonary artery
NOT true about congenital rubella
Risk of fetal damage in rubella is maximum if mother
gets infected in
Chance of transmission of rubella In 9 10 weeks
pregnancy
Rubella infected a mother at 10-14 weeks of Gestation,
Chances of congenital malformation
NOT true about rubella
Rubella
Rubella
Rubella
Rubella
Microphthalmia, Congenital cataract, Salt pepper
fundus
Rubella
Rubella, infectious mononucleosis, scarlet fever
2-3 weeks
Arthritis, Arthralgia, Encephalitis
Encephalitis
Unborn child
Women of child bearing age
Sleeping sickness
PDA, Deafness, Cataract
VSD, PDA
Rubella embryopathy
Infection after 16 weeks of gestation results in major
congenital defects
6-12 weeks of pregnancy
40%
5-10%
Incubation period more than 10 days
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VIROLOGY
MICROBIOLOGY
FALSE about rubella infection
Recommended vaccination strategy of rubella is to
vaccine first
Rose spots on soft palate

Women of 15-49 years
FEATURES OF HIV
Retrovirus
DNA form of retroviral genome
Retrovirus contain
HIV 1 and HIV 2
HTLV 1
HIV discovered in
AIDS
HIV belongs to
Retrovirus
Main HIV in India
MC subtype of HIV in India
HIV belongs to
HIV
HIV virus has
HIV is
HIV
Accessory proteins associated with HIV
Relation between HIV and CCR5 with
homozygous mutation in an individual is
Primary receptor for HIV
Receptors for HIV
Co receptor for HIV
T cell trophic HIV needs the following co receptor for
entry and fusion
Gp120 in HIV helps in
P17
Gp160
Genes present in HIV genome
Viral gene NOT associated with HIV
Gag encodes for
Reverse transcriptase endoded by
Tat encodes
HIV is inhibited by
Reverse transcriptase sequence in HIV
Reverse transcriptase
Unusual mode of replication is seen in
CCR 5 mutation in HIV is related to
NOT true about HIV
Isolation NOT needed for
HIV is common in
HIV commonly affects
NOT a target for initiation and maintenance of HIV
RNA dependent DNA polymerase

Provirus
Large terminal repeats
Lentivirus (Retrovirus)
Delta virus (Retrovirus)
1983
HTLV III E AII
Retrovirus
Thermolabile
HIV 1
C
Lentivirus
ssRNA
Single stranded RNA
Enveloped RNA
P24 early diagnosis, lysis of infected CD4, macrophage is
the reservoir for virus
Vpu, Vpx
Protective against HIV infection
CD4
CCR 5, CXCR 4
CCR 5
CXCR4
Virus attachment
Matrix protein
Envelop protein
Gag, pol and env
Tat
Core antigen
Pol
Transactivator protein
0.3% H2O2
RNA DNA - RNA
RNA dependent DNA polymerase
Retrovirus
High resistance to infection
Increased release of acid labile interferon
AIDS
Males than females
Helper cells
Neutrophil
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VIROLOGY
MICROBIOLOGY
infection
Seroconversion in HIV
Window period
Window period of AIDS
Window period in HIV
HIV antibodies show
CNS infection in HIV is caused by
MC site of lymphoma in AIDS patient
Most characteristic CNS lesion of HIV
MC CNS Neoplasm in HIV
Common late CNS complication of HIV
Most common in childhood AIDS
NOT a feature of CNS involvement in AIDS
NOT a cause of seizure in HIV patient
NOT found in CNS in case of AIDS
Most common vascular tumour in AIDS patient
In AIDS, lymphadenopathy is most often due to
Cardiovascular complication of HIV
NOT a cardiovascular complication of HIV
Malignancy associated with AIDS
Cancer NOT seen in AIDS
CMV retinitis in HIV when CD4 below
Cryptococcus neoformans infection in HIV
when CD4 below
Cotrimoxazole prophylaxis in AIDS in indicated
NOT a feature of AIDS
NOT an opportunistic infection of AIDS
NOT common in HIV infection
NOT seen in childhood AIDS
Body fluid having maximum HIV load
Diagnosis of AIDS according to WHO
4 weeks
Antibody is absent
3-12 weeks
Period between onset of infection and clinically
detectable level of antibodies
Antibody enhancement, bystander killing
Cryptococcus,Toxoplasma
CNS
Microglial nodule
Primary CNS Lymphoma
Dementia
Recurrent chest infection with typical
organisms
Vasculitis
PML
Inclusion bodies
Kaposi sarcoma
Non specific enlargement of lymphnode
Pericardial effusion, cardiac tamponade,
cardiomyopathy
Aortic aneurysm
Kaposi sarcoma, CNS lymphoma, Non hodgkins
lymphoma
Carcinoma Colon
50
200
Cryptosporidiosis
Toxocara uveitis
Rhizopus
Aspergillus
Kaposi sarcoma
Breastmilk
2 major signs and 1 minor sign
TRANSMISSION OF HIV
HIV
MC mode of HIV infection worldwide
Commonest transmission of HIV from mother to baby
Chance of acquiring HIV infection following needle prick
Percentage of risk of HIV transmission by needle stick
injuries
Transmission of AIDS in India in descending order
MC mode of HIV transmission from mother to child
Perinatal transmission of HIV
Male to female transmission is more common than

female to male transmission
Heterosexual
During delivery through vagina
0.3%
0.5 to 1%
Heterosexual, transplacental, homosexual
Perinatal
Cannot be diagnose by routine confirmatory test, Infant
rate transmission <50%, virus can be isolated from
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VIROLOGY
MICROBIOLOGY
Percentage of transplacental transmission of AIDS

Maximum risk of transmission of HIV
Intravenous drug abusers in HIV is a
NOT a high risk group for HIV transmission
NOT a method of transmission of HIV
Least common mode of HIV transmission
NOT an effective strategy to prevent mother to child
transmission of HIV
mothers milk
30-40%
Blood transfusion
High risk group
Healthcare workers
Intact skin
Homosexual
Vaginal cleansing before delivery
EPIDEMIOLOGY OF HIV
Epidemiology of AIDS
First country in South East Asian region to report AIDS

Maximum number of AIDS cases in India
From epidemiological point of view of AIDS which of the
following states in India put in group I (epidemiological
cases of HIV > 5%)
World AIDS day
Age group of highest number of AIDS cases in India
First case of AIDS reported in India
If prevalence of HIV is constantly >1% in pregnant
woman
Without any specific intervention of HIV positive
mother, from conception, term, preterm, after delivery,
lactation and non lactation, risk of transmission to child
NOT a OSHA guideline for needle stick injury
3 by 5 implementation by WHO in 2003
Achieve zero level transmission of HIV by
Seminal secretion are highly infectious than vaginal

secretion, Infectious in window period, Southern Africa
have 72% of total global burden, Children are rarely
affected
Thailand
Tamil nadu
Nagaland
December 1
30-44 years
1981
Generalised epidemic
15-30 %
Pre exposure prophylaxis

Providing treatment to 3 million sufferers by 2005
2010
MANIFESTATIONS OF AIDS
Cells infected by HIV virus
HIV commonly infects
HIV infection
HIV infection
HIV infection associated with
HIV in neonate
CD4+ T lymphocytes
CD4 cells
Following needle stick injury,infectivity is reduced by
administration of nucleoside analogues, P24 is used for
early diagnosis, Lysis of infected CD4 cells, Macrophage
is a reservoir for the virus
Caused by enveloped RNA virus, Rate of killing is
directly proportional to T4 molecules on cell surface,
Decreased delayed hypersensitivity activity reaction,
Gamma interferon is acid STABLE
Glandular fever like illness, Generalized
lymphadenopathy, Gonococcal septicemia, Presenile
dementia
Cannot be diagnosed accurately by current methods,
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VIROLOGY
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Characteristic finding in HIV in children

AIDS defining criteria
Major signs for AIDS case definition according to WHO
A patient with AIDS related complex is most likely

suffering from
Lesion associated with HIV
Oral ulcer in HIV patients commonly due to
MC genital lesion in HIV patient
Cutaneous manifestation of AIDS
MC psychological feature of AIDS
Painful articular syndrome is associated with
MC hematological manifestation of HIV
Diffuse infiltrative lymphocytosis syndrome (DILS) in
Fungal infection associated with AIDS patient
Meningitis due to cryptococcal meningitis occurs when
Oral candidiasis
Stage IV
NOT an AIDS defining illness
WHO stage IV does NOT include
NOT associated with HIV infection
CMV retinitis in HIV occurs when CD4 counts fall below
In HIV patient, complains of visual disturbance, fundal
examination shows bilateral renal exudates and
perivascular hemorrhages
MC causative agent of diarrhea in HIV patient
A patient with HIV has diarrhea with AFB positive
organism in stool
Diarrhea syndrome in AIDS children can be due to
NOT associated with persistent diarrhea in AIDS patient
Commonest helminthic infection in AIDS
NOT a common infection in HIV
Prophylactic therapy in P.carni infection in HIV if
Failure to thrive may be presentation, Transmission

vertically from mother
Recurrent chest infection
Generalized lymphadenopathy, Fever, weight loss and
fatigue, Pneumocystis carnii pneumonia,
Mycobacterium avium infection, Persistent diarrhea
Generalized lymphadenopathy, Prolonged fever more
than 1month, Chronic diarrhea > 1 month, Weight loss
> 10%
Opportunistic infection
Hairy leukoplakia
Candida
Herpes
Seborrhoic dermatitis
Depression
HIV
Anemia
HIV
Pneumocystis carnii, Penicilliuea marneffi, Candida,
Cryptococcus
CD4+ < 100/microliter
Stage III
Esophageal candidiasis, pneumocystis
carni pneumonia, wasting syndrome
Oropharyngeal candidiasis
Oral thrush
Hypogammaglobulinemia
50
Cytomegalovirus
Cryptosporidium
Mycobacterium avium intracellulare
Rotavirus, Cryptospora
Giardia, Cryptococcosis
Strongyloides
Aspergillosis
CD4 <200/microlitre
KAPOSIS SARCOMA
Kaposi sarcoma
Multifocal tumor of vascular origin in a patient of AIDS

Endemic kaposis sarcoma associated with
Virus associated with Kaposi sarcoma
Microscopically lesion similar to granulation tissue,

Dilated and irregular blood vessels with interspread
infiltrate of lymphocyte and plasma cells, Atypical blood
vessels have solid spindle cell appearance
Kaposis sarcoma
Lymphadenopathy
HHV 8
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VIROLOGY
MICROBIOLOGY
MC type of Kaposi sarcoma in African children
Kaposi sarcoma is tumour arising from
Tissue of origin of Kaposi sarcoma
MC site of Kaposi sarcoma
Kaposi sarcoma common in
Kaposis sarcoma associated with gut seen in
Multicentric castleman disease
Castleman disease
Most important in prognosis of castleman
disease
NOT true about Kaposi sarcoma
Lymphadenopathic type
Vascular tissue
Vascular
Skin
Lower limb
HIV
KSHV associated lymphoproliferative disorder, onion skin
appearance
Angiofollicular lymph node hyperplasia
IL 6
Occurs in AIDS patient only
DIAGNOSIS OF AIDS
Unlinked anonymous serological testing is
carried out in
Antenatal material in HIV diagnosis is of importance in
Full blown immunodeficiency syndrome is
Screening test for HIV
Marker of HIV infection in blood
Most sensitive test for test for diagnosis of AIDS in one
year old child
HIV can be detected and confirmed by
P24 antigen disappears from blood after
P24 antigen
Direct detection of HIV by
Sore throat, diarrhea, sexual contact 2 weeks before.
best investigation to rule out HIV
Best method for diagnosis of HIV in childhood
Compared to western blot, ELISA is
Characteristic western blot pattern in
AIDS
NOT a method of diagnosis of HIV infection in 2 month
old child
HIV
To prevent vertical transmission
High viral titres with low CD4 count
ELISA
Reverse transcriptase
HIV RNA PCR
Reverse transcriptase PCR
6-8 weeks of infection of HIV
High false positivity
P24 antigen capture assay, NASBA technique (isothermic)
P24 antigen assay
P24 antigen
More sensitive, Less specific
Absence of p24, loss of other activities
ELISA
TREATMENT OF AIDS
WHO stage I and II
WHO stage III and IV
Anti HIV never given as rechallenge once history of
allergic reaction to that drug in known
Nucleoside Reverse transcriptase Inhibitor
Abacavir is
Side effect of Abacavir
Abacavir hypersensitivity is associated with
Nucleoside reverse transcriptase inhibitor
Nucleoside reverse transcriptase inhibitior
ARV prophylaxis
ART
Abacavir
Abacavir
Guanosine analogue
Hypersensitivity
HLA-B57
Zalcitabine, Stavudine
Zidovudine, Didanosine
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VIROLOGY
MICROBIOLOGY
NOT a nucleoside reverse transcriptase inhibitor
Infant of HIV positive mother
Zidovudine in post exposure prophylaxis
Complication of zidovudine
Zidovudine causes
MC side effect of zidovudine
Main side effect of Zidovudine
Anti HIV drug known to cause myopathy
resembling mitochondrial myopathy with
ragged red fibers
NOT a side effect of zidovudine
Zidovudine is associated with
Resitance to zidovudine develops due to
Resistance to zidovudine develops due to
In ART, zidovudine should NOT be combined with
Maximum peripheral neuritis is caused by
Stavudine is
ART not causing peripheral neuropathy
Lamivudine is
Maximum risk of pancreatitis
Non nucleoside reverse transcriptase inhibitor
Nucleoside nucleotide reverse
transcriptase inhibitor
Side effects of efavirenz
Nevirapine
Nervirapine
Nevirapine is associated with
Tenofovir
Side effects of tenofovir

Not a NNRTI
Protease inhibitor
Protease inhibitors
Hypertriglyceridemia and Hypercholesterolemia seen in

Human Immunodeficiency Virus-1-Infected Treated
with
Protease inhibitors
Protease Inhibitor in treatment of HIV
Protease inhibitor having boosting effect
Protease inhibitor with maximum enzyme inhibition
Strongest inhibitor of CYP3A
Weakest CYP3A inhibitor
First licensed protease inhibitor
Protease inhibitor with least enzyme inhibition
Nevirapine
AZT therapy
Protects against acquiring HIV infection
Nausea, Vomiting, Steatosis, Anemia
Neutropenia
Anemia
Granulocytopenia
Zidovudine
Peripheral neuropathy
Increased MCV
Mutation at reverse transcriptase
Mutations at reverse transcriptase
Stavudine
Stavudine
Thymidine analogue
Lamivudine
Cytidine analogue
Didanosine
Efavirenz, nevirapine, delaviridine
Abacavir, tenofovir
Dysphoria
Non nucleoside reverse transcriptase inhibitor
Effective for repeated pregnancies also
Steven Johnson syndrome
Nucleotide reverse transcriptase inhibitor,
asthenia is a common side effect, indicated
in combination with other retroviral
agents
Acute renal failure
Lamivudine
Acts a substrate for p glycoprotein and action is
mediated by mdr 1 gene, Undergo hepatic oxidative
metabolism
Powerful enzyme inhibitors, cause hepatotoxicity, all
protease inhibitors are substrate for P glycoprotein
coded by MDR gene
Protease Inhibitors
Saquinavir, nelfinavir
Amprenavir
Ritonavir
Ritonavir
Ritonavir
Saquinavir
Saquinavir
Saquinavir
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MICROBIOLOGY
Basis of combining ritonavir with lopinavir
NOT a protease inhibitor
Ritonavir
Antiretroviral drug avoided in ATT with rifampicin
First protease inhibitor whose clinical efficacy is
demonstrated
First protease inhibitor used in combination
Non peptidic protease inhibitor
NOT a CYP3A inhibitor
Drug causing lipodystrophy
Side effects of saquinavir, lopinavir, ritonavir
Side effect of indinavir
Antiviral drug NOT causing dyslipidemia
Integrase inhibitor
Virus HIV intergrase inhibitor
Enfuvirtide
Enfuvirtide act at
Maraviroc
Side effects of maraviroc
Triple nucleoside regimen is recommended
for
Bone marrow depressive drug in AIDS treatment
Treatment of chorioretinitis in AIDS patient
Drug avoided with retroviral drugs
NOT useful for AIDS
Does NOT act against HIV 2
Triple ARV prophylaxis
IRIS
Immune reconstitution inflammatory
syndrome occurs how many days after
ART
CYP3A4 inhibition by ritonavir

Abacavir
Interacts with terfenadine, GI symptoms
Ritonavir
Ritonavir
Indinavir
Tipranavir, Darunavir
Saquinavir
Saquinavir
PR, QT prolongation
Nephrolithiasis
Atazanavir
Raltegavir
Raltegravir
Fusion inhibitor
Gp41
Entry inhibitor
Postural hypotension, allergic reaction
associated hepatotoxicity
Patients with HIV 2 infection
Dapsone, Cotrimoxazole, Ganciclovir
Ganciclovir, Cidofovir
Rifampicin
Famcicyclovir
Efavirenz
Lamivudine, Efavirenz, Tenofovir
Immune reconstitution inflammatory syndrome, seen in ART
given in tuberculosis patient
2 12 weeks
PREVENTION OF HIV
Universal precaution is applied to
Right method to discard dressing of HIV positive patient
A poverty striken mother suffering from active
tuberculosis delivers a baby. advice
HIV infection following needle stick infection reduced
by
HIV prophylaxis for rape victim
Post exposure prophylaxis of HIV blood infected needle
stick injury
For prevention of parent to child transmission of HIV,
the NACO recommendation is to give
Semen
Put in appropriate bag and send for incineration
Breast feeding and isoniazid administration
Nucleoside analogues
Combivir (zidovudine with lamivudine) 1
BD for 28 days
Zidovudine + Lamivudine + Indinavir for 4 weeks
Nevirapine 200 mg in active labour to mother and syrup
nevirapine 2mg/kg body weight to newborn within 24
hours of delivery
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MICROBIOLOGY
Dose of nevirapine during labor
Interventions to prevent mother to child transmission
of HIV
Vertical transmission of HIV to mother to child
prevented by
All are done to prevent maternal to fetal transmission
of HIV except
NOT a part of targeted intervention in preventive
strategy in spread of AIDS
200 mg
HAART, elective caesarean section, intrapartum
zidovudine
Cesarean section
Vaginal delivery
Providing ART
PRIONS AND SLOW VIRUS

Most resistant to antiseptics
Prions are
Prions
Prion protein catalyse
Prions cause
Prions are made of
Human prions (Non Infectious) rich in
Prion associated diseases
Prion protein disease
Microscopic feature of prion disease
NOT a prion disease
MC Human Prion disease
Cruetzfeldt Jacob disease is caused by
60 year old man, progressive dementia of recent onset,
intermittent irregular jerky movements, periodic sharp
biphasic waves in EEG
Spongiform degeneration
Florid pattern
Secondary structure of prion protein in CJD
In CJ disease viruses are present in
Cruetzfeldt Jacob Disease IOC
T2W FLAIR in sporadic CJD
NOT true about Cruetzfeldt Jacob disease
NOT true about Prion disease
Mad cow disease is due to
Mad cow disease is due to
Human cannibalism is associated with
Defect in folding of protein
Kuru is associated with
Spongiform encephalopathy
Familial fatal insomnia associated with
Prions
Infectious proteins
Lack nucleic acids
Abnormal folding of protein
Misfolding of proteins
Protein only
-helix
Kuru, Scrapie, Cruetzfeldt Jacob disease, Fatal Familial
Insomnia
Caused by infectious protein, brain biopsy is diagnostic,
commonly manifests as dementia
Lack of inflammation
Alzheimers disease
Sporadic Cruetzfeldt Jacob Disease
Prion and Genetic factors
Cruetzfeldt Jacob disease
Vacuoles in neutrophil
Variant CJD
Beta sheets
Microglia
PRPsc
Cortical ribboning
Myoclonus rarely seen
Myoclonus is seen only in 10% of patients
Slow virus
Prions
Kuru
Kuru
Shivering
Prion virus
Prion disease
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MYCOLOGY
MICROBIOLOGY
MYCOLOGY
GENERAL FEATURES OF FUNGI
Fungi are
Sporangium contains
Yeast reproduce by
Rate of reproduction of yeast is
Types of fungi
Yeast like fungus

Tangled mass of hyphae
Barrel shaped spores
Sexual spores
Asexual spores of fungi
NOT an asexual spore
Thick walled resting spores formed by round shape and
thickening of hyphal segments is a feature of
Fungi without sexual cycle are classified as
Fungi of medical importance belong to
Does NOT show yeast like morphology
Dye most suitable for fungal demonstration in biopsy
PAS stains
Penicillium marneffi
Neurotrophic fungus
Endemic fungal infection is caused by
Antigen in Maple bark disease
Valley fever/Desert Rheumatism
In tissue, coccidiodes immitis produce
Treatment of coccidiomycosis
Side effects of amphotericin reduced by
NOT a fungal infection
Galactomannan antigen test for
Drug approved for fungal infection in febrile neutropenic
patients
Prevention of fungal infection in HIV
Posconazole
Eukaryotes
Sporangiospores
Budding
Slower than bacteria
Ascomyces eg Tinea, Basidiomyces eg
Cryptococcus, Deuteromyces (Fungi
imperfecti) no sexual spores
Candida, Geotrichum, Cryptococcus,
Penicillium marneffi
Mycelium
Coccidiodes
Ascospores
Arthrospores, Chlamydospores, Blastospores
Basidispore
Chlamydospore
Fungi imperfecti
Deuteromycetes
Aspergillus, Trichophyton
PAS
Glycogen, Lipid, fungal cell wall
Cause tuberculosis like disease, at 25* C
produces rose color pigment, at 37* C
produce yeast
Cryptococcus neoformans, Histoplasmosis, Candida,
Aspergillosis
Coccoides immitis, Blastomyces
Cryptosoma coricale
Coccidioidomycosis
Spherules and endospores
Amphotericin
Incorporating it in liposomal complex
Mycosis fungoides
Fungus
Itraconazole
Fluconazole/ Itraconazole
Approved for prophylaxis of aspergillosis and candidiasis in
high risk groups
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MYCOLOGY
MICROBIOLOGY
DIMORPHIC FUNGI
Feature of dimorphic fungi
Dimorphic fungi
At body temperature yeast, at 25* C mould

Candida, blastomyces, coccidioidomycosis,
sporotrichosis, histoplasma, philaspora, sporothrix
shenkii
Sprothrix shenkii
Sporotrichosis, Coccidioidomycosis, Blastomycosis
Cryptococcus neoformans, Phialospora, Aspergillus
niger
Cryptococcus neoformans
Dimorphic fungi
Dimorphic fungi
NOT a dimorphic fungi
NOT thermally dimorphic
DERMATOPHYTES
Dermatophytosis is caused by
Spreads from animal to man
Fungal culture slow growing colony, few small
microconidia
Black dot worm is caused by
NOT a subcutaneous mycosis
Organism that do NOT affect hair
Tinea capitis (endothrix) is caused by
Kerion is caused by
Favus is caused by
Tinea cruris is caused by
Tinea pedis is caused by
Characteristic feature of epidermophyton
floccosum
Tinea nigra is caused by
Pityriasis versicolor is caused by
Difficult to isolate from culture
Does NOT cause dermatophytosis in India
Hair perforation test is positive with
Trichophyton
T. verrucosum
Trichophyton
Trichophyton
Trichophyton rubrum
Epidermiphyton
T.tonsurans, T.violaceum
Dermatophytes
Trichophyton schenleinii
Epidermiphyton, Trichophyton
Epidermophyton floccosum
Clavate macroconidia
Exophiala Werneckii
Malassezia furfur
Malassezia furfur
Microsporum distortum
Trichophyton
CRYPTOCOCCUS
Trojan horse invaders
Serotype of Cryptococcus causing most infections

Cryptococcus
Cryptococcus
Cryptococcosis
Urease positive, 4 serotypes, superficial skin infection,
anticapsular antigen is detected in CSF, common in
immunocompromised, strongly positive mucicarmine
stain is usually diagnostic
A and D
Urease positive, inositol accumulation,
phenol oxidase and melanin production
Grows at 5* and 37* C, Has 4 serotypes
Capsular antigen is detected in CSF, Common in
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MYCOLOGY
MICROBIOLOGY
Cryptococcus neoformans produce

Eucalyptus camaldulensis is associated with
transmission of
Fungi that possess a capsule
Torulosis
Phagocytosis is inhibited by
Cryptococcus has predilection for
Cryptococcus neoformans has special affinity for
Cryptococcus is least likely to cause infection of
MC form of deep mycosis in India
Common organism causing meningitis in AIDS patient
Cryptococcal meningitis is common in
Pitted keratolysis
Soap bubble lesion in virchow robbin
perineural space of brain
NOT true about Cryptococcus neoformans
Latex agglutination test of the antigen in CSF helps in
diagnosis of
Maltese crossing in polarizing microscopy
Feature for identification of Cryptococcus neoformans
Capsule of Cryptococcus neoformans in CSF is best seen
by
immunocompromised patient, Strongly positive

mucicarmine stain of organism in tissue is diagnostic
Melanin
Cryptococcus
Cryptococcus
Cryptococcal infection of skin
Cryptococcal capsular material
Lung and meninges
CNS
Kidney
Cryptococcosis
Cryptococcus
Renal transplant patient
Micrococcus sedentarius (Cryptococcus)
Cryptococcus
Anticapsular antibody prevents recurrence
Cryptococcus
Hydrolyse urea
Indian ink preparation
CANDIDA
Predisposing factors for candida infection
Candida albicans infection is seen in
Candida is NOT frequently associated with
MC fungal infection in febrile neutropenia is
Fungal infection spread in infants by hand spread
HIV patient, indurated ulcer over tongue, growth in
cornmeal agar at 20*C, hyphae and growth in serum at
37*C showing budding yeast.
Pseudohyphae in culture
Germ tube is diagnostic for
Reynolde Braude phenomenon
Candida albicans
Candida glabrata
Pericae
Median rhomboid glossitis is caused by
Mucocutaneous candidiasis is associated
with
Bulls eye lesion in USG abdomen
Diabetes, OCP, Pregnancy

Myeloperoxide deficiency
IUCD user
Candida
C. parapsilosis
Candida albicans
Candida albicans
Candida albicans
Seen in candida albicans, formation of
germ tube
Candida shows mycelia and
chlamydospore on corn meal agar, present
in nomal feces
Only yeast form
Candidiasis
Candida albicans
Adrenal insufficiency
Candidiasis
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MYCOLOGY
MICROBIOLOGY
NOT true about candida
Czapek Dox media
Drug of choice in Systemic Candidiasis
Treatment of Oral and esophageal candidiasis
Treatment of mucocutaneous candidiasis in HIV
patients
Treatment of disseminated candidiasis
Blastomeres are seen in isolates

Candida albicans
Amphotericin
Fluconazole
Fluconazole
Amphotericin, azoles, echinocandins
PNEUMOCYSTIS JEROVECI
Pneumocystis carnii is a fungus because
Pneumocystis jiroveci
Tree in bud appearance in bone marrow transplant

recipient
Pneumocystitis carnii infection in HIV, if CD4 count
Pneumocystis jeroveci
Pneumocystis carnii diagnosed by
Prevention of pneumocystis jiroveci in HIV
Treatment of Pneumocystis carnii
Treatment of pneumocystis carnii
rRNA, mitochondrial protein gene sequence and

presence of thymidylate synthase, cell wall contains
glucans
May be associated with pneumatocele, diagnosed by
sputum examination, cause disease only in
immunocompromised host
Pneumocystis
<200
Diagnosis is by sputum microscopy
Silver nitrate staining (Methaneamine silver)
TMP/SMX
Cotrimoxazole
Pentamidine, dapsone, cotrimoxazole
BLASTOMYCOSIS
Blastomycosis
North American blastomycosis
Fungal infection resembling squamous cell
carcinoma
South American blastomycosis
European blastomycosis
Treatment of blastomyces dermatides
Yeast like fungus, dimorphic fungus, Commonly involves

lung and skin, Common in north America
Blastomyces dermatidis
Blastomyces dermatidis
(pseudoepitheliomatous hyperplasia)
Paracoccidioidomycosis
Cryptococcosis
Liposomal amphotericin B
HISTOPLASMOSIS
Histoplasma capsulatum infection is
commonly associated with
Histoplasma capsulatum
Histoplasma capsulatum
Histoplasmosis
Histoplasmosis
Bird and bat dropping, cave exploring

Thermal Dimorphic fungus
Non encapsulated
In early stage indistinguishable from TB
In earlier stage,it is indistinguishable from tuberculosis,
Common in AIDS patient, Bone marrow is involved,
Gomori methamine silver stain is used, Dimorphic
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MYCOLOGY
MICROBIOLOGY
Disseminated small nodules in chest with calcification

Clinical History of farmer, mimics Tuberculosis, Picture
of Organism given
Histoplasmosis is associated with
Microconidia as well as macroconidia is
associated with
Broncholithiasis is associated with
Methaneaamine silver is used to stain
Metheneamine silver is used to stain
Gold standard for diagnosis of histoplasmosis
fungus
Histoplasmosis
Histoplasmosis
Tuberculate macroconidia
Histoplasmosis
Healed histoplasmosis
Histoplasma
Cryptococcus, histoplasma, pneumocystis
Culture
ASPERGILLUS
Aspergillus
Dichomotous branching
Aflatoxin is produced by
Aspergillus niger produce
Most probable entry of aspergillus
MC aspergillus causing human infection
Malt worker lung is associated with
Common fungus causing corneal ulcer
MC etiological agent in paranasal sinus mycoses
Corneal sample revealed narrow angled septate
hyphae. Etiology is
Culture of periorbital pus showed branching septate
hyphae
Halo sign is characteristically seen in
Monad sign
Crescent sign of chest X ray
Drug of choice for aspergillus lung infection
Drug NOT used for Aspergillus infection
HEPA (high efficiency particulate filters are protective
against
Fumagillin is used for
Septate hyphae
Aspergillus
Aspergillus flavus
Oxalate
Lungs
Aspergillus fumigates
Aspergillus clavatus
Aspergillus, Fusarium
Aspergillus
Aspergillus
Aspergillus
Aspergillosis
Aspergilloma
Invasive aspergillosis
Amphotericin B
Fluconazole
Aspergillosis
Aspergillus fumigates, microsporidium
MUCOR
Mucor mycosis
Non septate hyphae with wide angle
branching
Ribbon like hyphae
Voriconazole NOT effective against
Voriconazole
Angioinvasion, Longterm desferioxamine therapy is a

predisposing factor, May lead to blindness
Mucor
Mucormycosis
Mucormycosis
Inhibits cortisol biosynthesis, active
against aspergillosis, available and
effective as oral and intravenous therapy
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PROTOZOA
MICROBIOLOGY
MADURELLA
Farmer multiple discharging sinus in leg not responding
to antibiotics
Madura foot
Madurella
Can erode bone, Slow growing
SPOROTRICHOSIS
Sporotrichosis
Pricking ulcer on finger with axillary lymphadenopathy
Series of ulcers in lower extremities in sub Himalayan
area is often caused by
Himachal Pradesh, series of ulcer in row in leg. cultured
on sabourads dextrose agar
Gardener, multiple vesicles on hand, along lymphatics
Asteroid bodies
Cigar shaped globi and asteroid bodies seen in
Definite diagnosis of sporotrichosis
Postassium iodide useful in treatment of
Sporothrix schenkii, spread along lymphatics, Potassium

iodide is the drug of choice
Sporothrix
Sporothrix schenckii
Sporotrichosis
Sporotrichosis
Culture
Sporotrichosis
CHROMOBLASTOMYCOSIS
Phaehyphomycosis
Chromoblastomycosis is caused by
Brown, spherical and septate bodies
Sclerotic bodies
Brown spherical septate bodies from pus
NOT a zoonotic disese
Any infection with pigmented mould

Cladosporium
Chromoblastomycosis
Chromoblastomycosis
Chromomycosis
Chromoblastomycosis
PROTOZOA
GENERAL FEATURES OF PROTOZOA
Protozoa belong to kingdom
Cyst phase is NOT seen in
Chief source of major parasitic diseases in
humans
Hematophagus trophozoite is
demonstrated by
Loefflers syndrome
Monera
Dientamoeba, E.gingivalis, trichomonas
Man
Stool test
Toxocara, strongyloides stercoralis, L.tryptophan
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PROTOZOA
MICROBIOLOGY
ENTAMOEBA HISTOLYTICA
Entamoeba histolytica
Entamoeba has
Entamoeba coli
Most important enzyme associated with
entamoeba histolytica
Entamoeba cyst has
Mature cyst of entamoeba
Entamoeba histolytica is antigenically
different from
Entamoeba which is NOT found in gut
Mature cyst of entamoeba histolytica
Trophozoite of entamoeba histolytica
Erythrophagocytosis is a feature of
Ingested erythrocytes seen only in
Main reservoir for Entamoeba histolytica
MC form of amoebiasis
Commonly affected by invasive amoebiasis
Characteristic shape of amoebic ulcer
Amoebic colitis
Amoebic colitis commonly occurs in
Teacher presents with profuse bloody diarrhea fever
104*, many children studying in the same school had
similar episodes
Intestinal amoeba can cause
MC extraintestinal site of amoebiasis
Seizures NOT commonly seen in
NOT a method of transmission of amoebiasis
Culture medium for Entamoeba histolytica
Pathogenic and non pathogenic strains of entamoeba
histolytica can be differentiated by
Invasive amoebiasis can be best diagnosed by
Amoebic lung abscess is diagnosed by
Diagnostic test for amoebic hepatitis
Amoebic liver abscess can be diagnosed by
Gastrointestinal bleed, ulcers in sigmoid, flask shaped
ulcer
Intraluminal amoebicide of choice
Treatment of luminal infection
Drug used for extraintestinal amoebiasis
Chloroquine is effective only in
Drug used against entamoeba histolytica
NOT a luminal amoebicide
Cysts are necessary for transmission of infection from

one host to other, Cysts are found in submucosa of the
lower intestinal wall
22 zymodenes (10 invasive and 12 non
invasive)
8 nuclei
Phosphoglucomutase
4 nuclei
Nuclear structure retains characteristics
of trophozoites
E.dispar
Entamoeba gingivalis
Nuclear structure retains characteristic of trophozoite
Show erythrophagocytosis
Man
Asymptomatic cyst passage
Young adult male of low socioeconomic status
Flask shaped
Caused by Entamobea histolytica, Flask shaped ulcers,
Caecum is the most common site
Caecum
Peritonitis
Liver
Amoebiasis
Vertical transmission
Boeck Drbohlav medium
Electrophoretic study of zymodenes
ELISA
Trophozoite in pus
Indirect hemagglutination test
Demonstrating trophozoites in pus
Intravenous metronidazole
Diloxanide furoate
Paromycin, Iodoquinol
Chloroquine
Hepatic amoebiasis
Emetine (derived from ipepac)
Ementine
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PROTOZOA
MICROBIOLOGY
AMOEBIC MENINGOENCEPHALITIS
Parasites causing encephalitis
Parasitic encephalitis is caused by
Most fatal amoebic encephalitis
Neuropathogenic amoeba
Brain eating amoeba
Primary amoebic encephalitis is caused by
30 year patient, features of acute meningoencephalitis.
CSF on wet mount microscopy revealed motile
unicellular organism
Humidifier fever by
Acute primary amoebic meningoencephalitis
Toxoplasma gondii, Angiostrongylus cantonensis.

Trypanosoma cruzi
Naegleria, Acanthamoeba, Balamuthia
Naegleria, Acanthomoeba
Acanthamoeba, Entamoeba, naegleria
Naegleria
Naegleria floweri
Naegleria fowleri
Naegleria floweri
Diagnosed by trophozoite in CSF
GIARDIA
Normal habitat of giardia
MC site of lodgement of giardia
Giardia lamblia
Giardia
Trophozoite of giardia
Trophozoite of giardia
Mature cyst of giardia has
Infection leading to Malabsorption
Diarrhea, stool in wet mount shows mobile protozoa
with pus and without RBC
Giardia
Digestion in intestinal mucosa is inhibited
by
Recurrent giardiasis associated with
String test for
Giardiasis is best diagnosed by
Drug used for giardiasis and amoebiasis
Drug used for giardiasis
Drug used for giardiasis
Duodenum and jejunum

Duodenum
Malabsorption commonly seen, Trophozoite form is
binucleate pear shaped, Diarrhea is seen
Jejunal wash fluid is diagnostic, Trophozoites and cyst
are seen in man
Flagellate, binucleated
Binucleated
Tennis racket shaped, non infectious,
motility resembles falling leaf
4 nuclei
Giardia
Giardiasis
Do not invade intestinal wall, no blood in
stool
Giardia
Common variable immunodeficiency
Giardia lamblia
Cyst and trophozoite in stool
Metronidazole
Furazolidone (MAO inhibitor)
Quinacrine (only drug approved for giardia)
LEISHMANIA
Amatigote forms are seen in
Leishmania
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PROTOZOA
MICROBIOLOGY
Amastigote
Amastigote
Promastigote
Glycoprotein in Leishmania promastigote
Leishmania is associated with
Leishmania use
Espundia
Mucous leishmaniasis
Leishmaniasis
Leishmaniasis is associated with
Napier aldehyde test is associated with

Aldehyde test of Napier for
Indian kala azar
Kala azar is caused by

Meaning of kala azar
Visceral leishmaniasis is caused by
Oriental sore is caused by
Chiclero ulcer caused by
Visceral leishmanisis characterized by fever malise,
hepatosplenomegaly, Hyperpigmentation
Clinical history of person from Bihar with Biphasic fever
with Hepatosplenomegaly and Bone marrow aspirate
study Picture is given
Mucocutaneous leishmaniasis is caused by
Vector for Kala azar
Most important reservoir for leishmaniasis
More prevalent in india
Double rise of temperature within 24 hours
Most severely affected in Kala Azar
NOT an example for human dead end disease
Reservoir for Indian Kala azar
Kala azar is transmitted by
Transovarian transmission
Which DOES NOT cause brain lesion
Aldehyde test for
Aldehyde test in Kala azar positive after
Leishmanin test in NOT useful in
Montenegro skin test
rK 39
Medium for Leishmania
Tobies medium
Scheider liquid culture
Nucleus contains kinetoplast (multiplies copies of

mitochondrial DNA)
Without flagella
Flagellate, infective
Gp63
Abnormal T regulatory action
Trypnothione rather than glutathione
Leishmaniasis
Lesions around mouth and nose (Espundia)
Aldehyde test is NOT good for diagnosis, Co infection
with AIDS in now emerging, Indian leishmaniasis in non
zoonotic infection with man as sole reservoir, No drugs
for personal prophylaxis
Hyperalbuminemia, loss of protein and
fall in protein synthesis, reversal of
albumin globulin ratio
Raise in gamma globulin levels
Surveillance
Transmitted by bite of infected sandfly, Causative
parasite is cultivated in NNN medium, Disease is
endemic in Bihar, Man is the only reservoir in India
Leishmania donovani
Black fever
Leishmania donovani
Leishmania tropicalis
L.mexicanaum
L.tropica
Leishmaniasis
Leishmania brasiliensis
Sand fly
Case of post kala azar dermal leishmaniasis
Kala azar
Kala azar
Spleen
Leishmaniasis
Man
Phlebotomus argentipus
Phlebotomus
Leishmania
Leishmania
12 weeks
Indian leishmaniasis
Leishmanin test
Rapid test
NNN medium
Only for promastigote
For both promastigote and amastigote
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PROTOZOA
MICROBIOLOGY
Visceral leishmaniasis
NOT a lab test in Kala azar
Amphotericin used in treatment of
NOT used Leishmaniasis
Drug of choice for kala azar
Drug used for leishmaniasis
Only drug approved for visceral leishmaniasis
Treatment of cutaneous leishmaniasis
Treatment of mucous leishmaniasis
Treatment of L. guyanensis
Aminoglycoside used in treatment of
Kala azar
Kala azar is NOT responding to primary treatment. Now
the treatment should include
NOT used in treatment of visceral leishmaniasis
Prevention of leishmaniasis
Diagnosed by blood smear, Antimonials are useful

Immobilization test
Kala azar
Rifabutin
Sodium stibugluconate
Miltefosine
Liposomal amphotericin B
Pentavalent antimony
Pentavalent antimony
Pentamidine isethionate
Paromomycin
Amphotericin B
Hydroxychloroquine
Leishmanisation (inoculation of L.major Iran)
TRYPANOSOMA
Amphixenosis is seen in
Trypanosomiasis
East African trypanosomiasis
West African Trypanosomiasis
Acute disease is associated with
Poverty disease
Chagas disease
Chagas disease involve
Romana sign
Most commonly affected organ in Chagas
disease
Commonest cardiac defect in Chagas myocarditis
Vector for Chagas disease
Mega disease
Winter bottom sign (enlargement of nodes of posterior
cervical triangle) is seen in
NOT found in India
Diagnosis fo chagas disease
Xenodiagnosis is helpful in diagnosis of
Drug used for Chagas disease
Drug used for Trypanosomiasis
Treatment of East african trypanosomiasis with normal CSF
Treatment of East African trypanosomiasis with abnormal
CSF
Treatment of West African trypanosomiasis with normal CSF
Treatment of West African trypanosomiasis with abnormal
CSF
Side effect of suramin
Trypanosoma cruzi
Sleeping sickness
Rhodesience
Gambiense
High parasitemia
Chagas disease
Trypanosoma cruzi
Esophagus and colon
Unilateral painless edema of palpebral and periocular
region. Seen in chagas disease
Heart
RBBB
Reduvid bug
Chaga disease of GIT
Trypanosomiasis
Sleeping sickness
Microhematocrit tube containing acridine orange
Chagas disease
Nifurtimox, Benznidazole
Eflornithine, Melasoprol, Suramin (urea derivative),
Arsenical
Suramin
Melasoprol
Pentamidine
Eflornithine
Renal damage
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PROTOZOA
MICROBIOLOGY
TOXOPLASMA
Parasite affecting eye
Toxoplasmosis
Toxoplasmosis
Toxoplasmosis
Cerebral calcification and hydrocephalus in a newborn

A 2 years old child with head circumference of 55 cm is
likely to have intrauterine infection due to
Hydrocephalus and intracerebral calcification
Adult toxoplasmosis resemble
Macula is commonly involved in
Headlight in fog appearance, cracked mud
appearance
Trophozoite
Oocysts develop only in
Freshly passed oocyst
Oocyst of toxoplasma found in
Cat is the definite host for
Tachyzoites are seen in
Bradyzoites has
Route of transmission of Toxoplasma
Transmission of toxoplasmosis
Dissemination of toxoplasmosis via
Main route of transmission of toxoplasmosis
MC manifestation of acute toxoplasmosis
NOT true about toxoplasmosis
False about congenital toxoplamosis
Sabin Feldman reaction for
Goldmann Witmer coefficient for diagnosis of
Local cerebral lesion with ring on CT scan
Toxoplasmosis in fetus can be best diagnosed by
Prevention of toxoplasmosis in HIV
Drug of choice for treatment of toxoplasma infection in
st
1 trimester of pregnancy
Drug added to Pyrimethamine in treatment of
Toxoplasma gondii infection
Used in therapy of toxoplasmosis
Toxoplamosis is NOT treated by
Toxoplasmosis
Usually asymptomatic in adults, Anthroponotic disease,
Encephalitis is rare in immunocompetent individuals
Laboratory tests are useful for making diagnosis,
Infection is severe and progressive in
immunocompromised patients
Oocyst in freshly passed cats feces is NOT infective,
May spread by organ transplantation, Maternal
infection after 6 months has high risk of transmission
Toxoplasmosis
Toxoplasmosis
Toxoplasmosis
Infectious mononucleosis
Toxoplasmosis
Toxoplasmosis of eye
Asexual form, invades nucleated cells
Intestine of definite host
Non toxic
Cat
Toxoplasma gondii
Toxoplasma
Slowly multiplying round parasites
Blood
Ingestion of Bradyzoites
Blood
Oral
Cervical lymphadenopathy
IgG antibodies are diagnostic of congenital
toxoplasmosis
Avidity testing must be done to differentiate between
IgA and IgM
Toxoplasma
Ocular toxoplasmosis
Toxoplasmosis
IgM antibodies against Toxoplasma in fetus
TMP/SMX
Spiramycin
Clindamycin
Pyrimethamine
Erythromycin
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PROTOZOA
MICROBIOLOGY
BABESIOSIS
Obligate parasite of red blood cells
Babesiosis
Babesiosis is transmitted by
NOT an intestinal protozoa
Maltese crossing is characteristic of
NOT responsible for pulmonary
eosinophilia
Babesiosis is transmitted by
Treatment of mild babesiosis
Treatment of severe babesiosis
Atovoquone is used for
Babesiosis
Caused by Babesia microti, Resides in RBC
Tick (Isodex scapularis)
Babesia microti
Babesia microti
Babesia microti
Tick
Azithromycin
Clindamycin + Quinine
Toxoplasmosis, babesiosis
CRYPTOSPORIDIOSIS
Cryptosporidium parvum
Acid fast organism with oocyte of size 5 micron on stool
examination causing diarrhea in HIV positive patient
Treatment of cryptosporidiosis
Common opportunistic infection in AIDS, AFB positive

cyst
Cryptosporidium
Nitrazoxanide
ISOSPORA
In HIV patient with malabsorption, fever, chronic
diarrhea, with acid positive organism. what is the
causative organism
Autofluorescence
Isospora
Isospora
CYCLOSPORA
25 year male diarrhea 6 month. acid fast with 12
micrometer diameter
Treatment of isospora and cyclospora
Cyclospora
Trimethoprim and Sulphamethoxazole
BALANTIDIUM COLI
Largest intestinal protozoa
Bigger size
Ciliated large intestine pathogen
Drug used for Balantidiasis
Balantidium coli
Balantidium coli
Balantidium coli
Tetracycline
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PROTOZOA
MICROBIOLOGY
FEATURES OF PLASMODIUM
JSB stain is used for
Stage of Falciparum NOT seen in peripheral blood
smear
Schuffners dot in malaria is due to
Schuffners dot is associated with
Malarial pigment is mainly formed by
Exoerythrocytic Schizogony
Radical cure is required form malaria caused by
Enlarged erythrocytes
Plasmodium falciparum cause
Plasmodium falciparum infection in man is
characterized by
Incubation period for Plasmodium
falciparum
Plasmodium with shortest incubation period
Black water fever
Only ring and gamete forms are found in
Banana shaped gametocyte
Maurers dots
NOT seen in plasmodium falciparum
malaria
Accole forms are seen in
Complications of malaria is common with
Cerebral malaria is caused by
Parasitemia is highest in
Multiple ring and double chromatin dots
Persistent exoerythrocytic cycle is absent in
Post transfusion malaria is caused by
Plasmodium malariae affects
Band RBC are seen in
Organ NOT affected by plasmodium falciparum
35 year male, sudden onset of high grade fever, on
malarial slide examination all stages of parasites seen
with schizonts of 20 microns size with 14 to 20
merozoites per cell and yellow brown pigment
Plasmodium vivax attacks
Senescent RBC mainly attacked by
Older RBCs are preferred by
Reticulocytes are preferred by
Duffy blood group antigen negativity confers protection
against infection by
Size of RBC are enlarged in
Fimbriated RBCs are seen in
Infective stage of mosquito in case of plasmodium vivax
Incubation period of plasmodium vivax
Fever every third day is associated with
Plasmodium
Schizont
Pigment released from breakdown of hemoglobin
Plasmodium vivax and ovale
Hemoglobin
P.vivax, P.ovale, P.malariae
Vivax and ovale
Vivax and ovale malaria
Thrombocytopenia, hemolysis, hematemesis, DIC
Multiple infection of erythrocytes seen
12 days
Plasmodium falciparum
Schizont
Falciparum malaria
Falciparum malaria
Plasmodium malariae
Older cells
Plasmodium malariae
Liver
Plasmodium vivax
Young RBC
Quartan malaria
Plasmodium malariae
Plasmodium ovale and vivax
Plasmodium vivax
Plasmodium vivax infection
Plasmodium ovale
Gametocyte
10 14 days
Plasmodium vivax
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PROTOZOA
MICROBIOLOGY
Stages seen in peripheral smear of falciparum malaria
Band shaped trophozoites are seen in
Nephrotic syndrome is caused by
Fever every 4th day is associated with
NOT seen in falciparum malaria
Monkey malaria of human is caused by
Gametocytes, accole form and ring form

Plasmodium malariae
Plasmodium malariae
Plasmodium malariae
Schizonts
Plasmodium knowlesi
FEATURES OF MALARIA
Cycle of malarial parasite is in sequence of
Infective form for mosquito in plasmodium
Gametocytes
Period between blood meal and laying of

egg
Gonadotrophic cycle in anopheles
Man is NOT dead end host in
Secondary host for malaria
Infective form of Malaria in vertebrate host
Mosquito injects in to man
Infectious stage of Malaria
Stage of malarial parasite transmitted to man
Among various species of mosquitoes belonging to
anopheles genus, one that is highly anthrophilic and
transmits even at low density
Malaria transmitted by
Anopheles transmitting malaria in urban area
Prolonged parasitism in malaria is due to
Persistence of malaria infection is due to
Malaria resistance is seen in
Malaria relapse is due to
Recurrence in malaria
Recrudescence in malaria
Contribute to Resurgence of malaria
Factor NOT responsible for resurgence of malaria
NOT true about severe malaria
Chronic complication of malaria
Pathogenesis of cerebral malaria
Feature of Malaria
Malarial parasites are easily detected if blood films are
taken and examined
Gametocytic stage
Gametozoites
Appear in blood 4-5 days after the appearance of
asexual parasite, in vivax infection, 10-12 days in
falciparum, in early stage of infection, density may
exceed 1000 per cu mm of blood
Gonotrophic cycle
Time between blood meal and laying of
eggs. 48 hours
Malaria
Man
Sporozoite
Sporozoites
Sporozoites
Sporozoite
Anopheles fluvitalis
Female anopheles mosquito

Stephensi, dirus
Antigenic variation
Intracellular persistency
Thalassemia, sickle cell anaemia, G6PD deficiency
Hypnozoites
Hypnozoites
Appearance of gametocytes again
Drug resistance in parasite, drug resistance in vector,
antigenic variations in parasite
Use of bed nets
Hematocrit more than 15
Splenomegaly, nephrotic syndrome
Cytoadhesion, sequestration of cerebral vessels by RBC
Thick smear is used to diagnose parasite
One hour after the height of paroxysm
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PROTOZOA
MICROBIOLOGY
EPIDEMIOLOGY OF MALARIA
Epidemiology of malaria
Most sensitive index of recent transmission of malaria
in a community
Most sensitive index for recent
transmission of malaria
Best indicator for malaria prevalence in a community
API
Annual Parasite Incidence
Infective form of malarial parasite through blood
transfusion
Peak of fever in malaria coincide with the successive
broods of
Plasmodium ovale in India has been reported from
NOT a malarial parasite in India
Antimalaria month
If API>2, vector is resistant to DDT, malathion spray
should be done
Malathion is used once
Goal reduction in morbidity and mortality due to
malaria in 2010
Mosquito acts as definite host

Infant parasite rate
Infant parasite rate
Spleen rate
Annual parasite incidence
Confirmed cases during one year
1000
Population Under Surveillance
Trophozoite
Merozoite into blood stream
Gujarat, Orissa
Ovale (but now reported in india)
June
3 round of malathion every 3 months
3 months
50% reduction
DIAGNOSIS OF MALARIA
Jaswanth singh Bhattacharya stain and
field stain for
Blood smear in malaria used to identify
Detected by antigen detection test for falciparum
malaria
Fluorescent antibody test for diagnosis of falciparum
Malaria
Type of parasite
Histidine rich protein II
Immunochromatographic test, Detects aldolase
antigens, Detects LDH antigen, Detects histidine rich
protein II, detection of glutamate dehydrogenase
antigen
TREATMENT OF MALARIA
Chemoprophylaxis for Malaria is given
NOT used for prophylaxis of malaria

Pyronaridine is
Best associated with lumefantrine
Drug of choice for malaria in pregnancy
Bulls eye maculopathy
Long term use of chloroquine
Workers for short period in endemic area, travelers

from non endemic to endemic area, pregnant woman in
high endemic area
Doxycycline
Antimalarial
Antimalarial
Chloroquine
Chloroquine
Lichenoid eruptions,visual deterioration,T wave change
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PROTOZOA
MICROBIOLOGY
Side effects of chloroquine

Antimalarial of choice in chloroquine resistant pregnant
woman
Treatment for drug resistance in malaria
Quinidine acts mainly on
Can cause hypoglycemia in a patient of severe cerebral
malaria on treatment
Resistant falciparum malaria in the pediatric age group
is treated by
In chloroquine resistant zone the presumptive
treatment of malaria to be given is
Antimalarial which is a slow acting schizonticide
Presumptive treatment of malaria in a chloroquine
resistant area
Drug of choice in chloroquine resistant pregnant
woman in 1st trimester
Prophylaxis of chloroquine resistant malaria
Treatment of Multidrug resistant Plasmodium
falciparum
Food enhances the rate and absorption of
Drug that be given simultaneously or with
in 3 weeks of mefloquine
Antimalarial causing neuropsychiatric adverse reaction
Treatment of choice for severe falciparum malaria
Drug of choice in severe complicated falciparum malaria
NOT an accepted regimen
Drawback of artesunate
Tissue schizonticide preventing relapse of vivax malaria
Radical cure of malaria is done with
In high risk areas, the radical treatment for plasmodium
vivax infection after microscopic confirmation is
administration of tablets primaquine in the daily dosage
of
Used for radical cure of malaria
Contraindicated in pregnancy
Prophylaxis of malaria in an area with P.vivax
Person wants to visit a malaria endemic of low level
chloroquine resistant falciparum malaria
Safe for use in pregnancy
Antimalarial effective in pre erythrocyte phase in liver
Malrone
Prophylaxis of chloroquine, mefloquine resistant malaria
Prophylaxis for malaria
Marked reduction in asexual parasitemia in 48 hours
without complete clearance in 7 days
Synthetic cocktail vaccine SPf66 has shown potential for
protection against
in ECG
Hypotensive shock, retinopathy
Quinine
Quinine
Trophozoite stage
Quinine
Clindamycin
Sulphadoxine + pyrimethamine
Pyrimethamine
Sulphalene and pyrimethamine
Pyrimethamine
Mefloquine
Mefloquine
Mefloquine
Halofantrine
Mefloquine
Intravenous artesunate
Artesunate
Artesunate + quinine
Rapid recrudescence of malaria
Primaquine
Primaquine
0.25 mg/kg body weight
Primaquine
Primaquine
Primaquine
Proguanil + chloroquine
Proguanil
Proguanil
Atovoquone + Proguanil
Atovoquone/proguanil
1-2 weeks before travel
Type 2 resistance
Falciparum malaria
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HELMINTHS
MICROBIOLOGY
HELMINTHS
GENERAL FEATURES OF HELMINTH
Nematodes are differentiated from other worms by
Cestode (tapeworm)
Most anterior segment of tapeworm
Helminthic infection resembling Crohns disease
Dwarf tapeworm
Smallest tapeworm
Hymenolepis nana
Egg containing polar filaments arising
from either end of embropore
Organisms with filariform larva as infective agent
Heterophyes heterophyes is an
Transmission of biliary flukes, intestinal flukes and
paragonimus westermani
Dew itch/Ground itch produced due to larva of
Eggs concentrated in saturated salt
solution
Float in saturated salt solution
Does NOT float in saturated salt solution
Eggs having hexacanth embryo
7 year boy intermittent abdominal cramps, loose stools
on stool examination ova of size 100 micrometre. NOT a
cause
African eye worm
Calabar swelling is caused by
Lizard skin
Observation of worm under conjunctiva and Calabar
swellings is diagnostic for
Raccoon ascaris
Helminth found in mesentry
Visceral larva migrans caused by
Visceral larval migrans is treated by
Drug of choice for Cutaneous larva migrans
Small intestine helminth
Larva found in stool in
Parasites penetrate through skin and enter into body
Parasites causing lung infection
Pigs are reservoir for
Fish act as intermediate host in
Post saline purge is used in
Intermediate host for Paragonimus
Absent fragmentation, Separate sexes, Cylindrical body,

GIT is formed completely
Progressively elongating chain of proglottids (Strobilia),
length can be upto 1000 2000 proglottids
Scolex
Anisakiasis
Hymenolepis nana
Hymenolepis nana
No intermediate host
Hymenolepis nana
Hookworm, Strongyloides
Intestinal fluke
Metacercaria, ingestion by fish
Strongyloides stercoralis, Ankylostoma, Necatar
Trichuris, H. nana, E.granularis
Fertilized eggs of ascaris, Larva of strongyloides,
Trichuris trichura, H.nana
Clonorchis sinensis
Taenia solium, Taenia saginata, Hymenolepis nana
Opisthorcis viverrani
Loa loa
Loa Loa
Loa loa
Loiasis
Baylisascarias procyonis
Mansonella
Toxocara canis
Thiabendazole
Thiabendazole
Ascaris, Ankylostoma, Necatar
Ankylostoma, Necatar, Strongyloides
Ankylostoma, Strongyloides, Necatar
Paragonimus westermani, Echinococcus granulosus and
Echinococcus multilocularis
Taenia solium, Trichinella spiralis
Diphyllobothrium latum, Clonorchis sinensis
Niclosamide and T.solium infection
Fish
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HELMINTHS
MICROBIOLOGY
westermani
Man snail crab man cycle in
Paragonimus westermani is NOT seen in
Treatment of lung fluke
Nitrazoxanide is appoved for
Mechanism of action of Nitrazoxanide
Paragonimus westermani
Jammu and Kashmir
Praziquantel
Cryptosporidium
Interferes with pyruvate ferredoxin dependent electron
transfer reaction
CLONORCHIS
Parasite passing through three hosts
Intermediate host for clonorchis sinensis
Organism causing bile duct obstruction
Biliary obstruction
Helminthiasis is caused by
Cholangiocarcinoma is caused by
A traveler present with conjugated hyperbilirubinemia
and on investigation, an egg was found in his biliary
tract
Ingestion of raw fish leads to gall bladder cancer due to
Liver is the target organ for
Clonorchis sinensis
Fish
Clonorchis sinensis, Ascaris, Fasciola
Clonorchis
Clonorchiasis
Clonorchis sinensis
Clonorchis sinensis
Clonorchis sinensis
Clonorchis sinensis
DIPHYLLOBOTHRIUM LATUM
Diphyllobothrium Latum Infection is caused by ingestion
of
Human diphyllobothriasis results from
consuming infected
Second intermediate host for
diphyllobothrium latum
Megaloblastic anemia is caused by
Plerocercoid Larva
Fresh water fish
Fresh water fish
Diphyllobothrium latum
FASCIOLA HEPATICA
Man invertebrate host cycle is seen in
Treatment of biliary fluke
Fasciola hepatica
Praziquantel, Triclabendazole
FASCIOLOPSIS BUSKI
Largest trematode infecting man
NOT an inhabitant of liver
Drug used for fasciolopsis hepatica
F. buski
F.buski
Bithinol
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HELMINTHS
MICROBIOLOGY
ASCARIS
Source of infection of Ascaris lumbricoides in man
Associated with normal hemoglobin and
hemocrit
Does NOT cause malabsorption
Ascaris lumbricoides cause deficiency of
Medusa head colony on X ray
Drug of choice for ascariasis
Round worm infection best treated with
Mechanism of action of albendazole
Causes flaccid paralysis of ascariasis
Drug of choice in worm colic due to ascariasis
Adult dose of bephenium hydroxynaphthoate in the
form of single dose
Vegetables contaminated with eggs containing larval

forms
Ascaris
Ascariasis
Vitamin A
Round worm infestation
Albendazole
Albendazole
Binds to beta tubulin and inhibits polymerization
Piperazine
Mebendazole
5 gm
TAENIA SOLIUM
Longest worm
Man is both intermediate and definite
host for
On microscopic examination, eggs are seen, but on
saturation with salt solution no eggs are seen. the eggs
are likely to be of
Larval form of Taenia referred to
Consumption of uncooked pork is likely to cause
Commonest parasite of CNS in India
Cysticercus cellulose seen in
Cysticercosis is caused by larva of
Autoinfection is a mode of transmission in
Most likely to be invaded by Cysticercus
Comma shaped calcification in X ray
Treatment of taenia solium
Drug of choice for tapeworm infection
Tenia solim
Taenia solium
Taenia solium
Cysticercus
Tenea solium
Cysticercosis
Taenia solium
Taenia solium
Cysticercosis
Muscle
Cysticercosis
Praziquantel
Praziquantel
NEUROCYSTICERCOSIS
MC central nervous system parasitic infection
Neurocysticercosis is caused by
Neurocysticercosis
Multiple cystic lesion with calcified borders and

contrast enhancement in CT scan
MC Site of Neurocysticercosis
MC manifestation of Neurocysticercosis
Neurocysticercosis
Taenia solium
Acquired by eating contaminated vegetables, Caused by
regurgitation of larva, Acquired by orofecal route,
Acquired by eating pork
Neurocysticercosis
nd
rd
Brain Parenchyma, 2 Subcutaneous tissue, 3 Eye

New onset Partial Seizures
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HELMINTHS
MICROBIOLOGY
35 year old male presented with 15 day history of
proptosis in right eye and pain on eye movement. There
is difficulty in moving upwards and downwards. CT scan
showed cystic lesion with a hyperdense opacity within
it, located in the superior oblique muscle
Cysticercosis is associated with
Investigation for Neurocysticercosis
Oedema in CT absent in which stage of
Neurocysticercosis?
Diagnosis of cysticercosis
Drug of choice for Neurocysticercosis
Neurocysticercosis
Treatment of Neurocysticercosis
Treatment of neurocysticercosis
Drug of choice for neurocysticercosis
NOT used in treatment of neurocysticercosis
Cysticercosis cellulosae
Cigar shaped soft tissue calcification

CT scan
Calcified nodular stage
Immunoblast assay using lentil lectin purified glycoprotein
Albendazole
Albendazole superior to praziquantel
Praziquantel, albendazole, flubendazole
Albendazole and praziquantel
Albendazole
Niclosamide, Ivermectin
TAENIA SAGINATA
Longest worm
Ova of t.saginata and t.solium
Intermediate host for taenia saginata
Man is NOT dead end in
Drug of choice for Taenia saginata
Dose of niclosamide in tenia saginata infection in
children
Taenia saginata
Can NOT be differenriated
Cow
Taeniasis
Niclosamide
40 mg/kg single dose
ECHINOCOCCUS
Special feature of echinococcus among cestodes
Tinea echinococcus causes
Hydatid cyst of liver is caused by
Hydatid cyst is caused by
Transmitted by egg ingestion
Intermediate host for Hydatid disease
Vital layer of hydatid cyst
Only living part of Hydatid cyst
Fluid filling hydatid cyst is secreted by
Hydatid cyst commonly occur in
Hydatid cyst of lung common in
Dropping water lilly sign is seen in
Signs of hydatid cyst
Sensitivity of casoni test
Hydatid cyst
ARE-C5 in countercurrent mechanism
NOT a scolicidal agent
Both intermediate and definite host are animals

Hydatid cyst
Echinococcus granulosus and Echinococcus
multilocularis
Echinococcus granulosus
Hydatidosis
Man
Germinal layer
Germinal epithelium
Germinal layer
Liver
Lower lobe
Liver
Cart wheel appearance, cyst in cyst sign,
floating membrane sign
90%
ELISA, Casoni test, False positive reaction in CFT
Hydatidosis
0.5 % Silver nitrate
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HELMINTHS
MICROBIOLOGY
Used in hydatid disease
Infection resembling malignancy
Albendazole
Echinococcus multilocularis
FEATURES OF FILARIASIS
Filiariasis is endemic in
Percentage of persons examined showing microfilaria in
blood or disease manifestation or both
Organism commonly causing genital filariasis in most
parts of Bihar and Eastern UP
Hydrocele and edema of foot occur in
Wuchereria bacrofti
Types of microfilaria
Non sheathed microfilaria
Sheathed microfilaria
Wuchereria bancrofti
Sheathed microfilaria with nuclei upto tail tip
Microfilaria with sheath and two nuclei at the end
Nuclei in brugia malayi
MC nematode in south india
Brugia malayi
Brugia malayi is common in

NOT true about Brugia malayi
Tail tip of microfilaria free from nuclei
Clinical incubation period of filariasis
Lymphatic filariasis is NOT caused by
Filariasis
Stage of filariasis in which microfilaria are seen in
peripheral blood
Meyer Kouvenaor syndrome
Meyer Kouvenaor body
River blindness is caused by
Subcutaneous itchy nodules over left iliac crest, firm,
non tender and mobile. skin scraping contain
Subcutaneous nodules are diagnostic of skin snip which
is taken in
Sowdah
Onchocerciasis is associated with
Adult worm of O.volvulus is found in
Skin snip for
UP, Bihar, Gujarat

Filarial endemicity rate
Body is long and slender, Terminal nuclei absent
Long and thick type I, short and thick
type II, long and thin type III - infective
Mf.malayi
W. bancrofti, Loa loa, B. malayi
Terminal nuclei absent
Brugia malayi
Brugia
Blurred and difficult to count
Brugia malayi
Intermediate host in India are Mansoni, Nuclei are
blurred and so counting is difficult, Adult worm is found
in lymphatic system, Enveloped sheath, Nocturnal
periodicity
Bihar and eastern UP
Smooth curved in stain preparation
Mf.ozzardi
8-16 months
Dirofilaria imitis
Man is definite host, Caused by Wuchereria bancrofti,
Involves lymphatic system, DEC is used in treatment
Early lymphangitis stage
Occult filariasis
Filariasis
Onchocerca volvulus
Onchocerca volvulus
Onchocerciasis
Localized onchodermatitis in onchocerciasis
Papular eruption, snowflake opacities in eye, hanging groin
lymphnodes
Subcutaneous tissue
Onchocerca volvolus, Mansonella
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HELMINTHS
MICROBIOLOGY
MANAGEMENT OF FILARIASIS
Filaria dance sign is seen with
Method used to detect low density
microfilaria
Microfilaria does NOT multiple in
Drug of choice for Filariasis
Difference between action of DEC and ivermectin in
case of scrotal filariasis
DEC is most effective against
Currently given regimen for bancroftian filariasis
Dose of DEC in mass prophylaxis of filariasis in India
DEC mediated salt for mass treatment in lymphatic
filariasis was shown to be safe, cheap and effective in
Mass chemotherapy is used in
Target year for elimination of filariasis
Ultrasonography
Xenodiagnosis, membrane filter
concertration method
Humans
Diethylcarbamazine
DEC acts on adults, Ivermectin on microfilaria
Microfilariae
DEC 6 mg/kg/day for 12 days
6 mg/kg for 2 days
Lakshadweep Islands
Filariasis
2015
ENTEROBIUS
Seatworm
MC presenting symptom of threadworm infection
Autoinfection is seen in
Nematode residing in caecum and appendix
Eggs causing intense pruritis in perianal skin
Does NOT pass through lung
Cellophane test for
Feces examination NOT useful in diagnosing
Enterobius
Abdominal pain
Enterobius
Enterobius vermicularis
Enterobius
TRICHINELLA
Viviparous
Trichinella
Larvae found in muscle
Larvae found in muscle in
Trichinellosis
MC muscle group involved in Trichinella spiralis infection
Viviparous
Does NOT enter human body via skin
NOT a neuroparasite
Parasite causing myocarditis
Muscle biopsy is indicated in
Treatment of trichinella spiralis infection
Trichinella spiralis
Larva rest in nurse cell
Trichinella spiralis, Taenia saginata,
echinococcus
Ova encysted in muscle with hyalinised capsule, associated
with splinter hemorrhage and subconjunctival hemorrhage
Extraocular muscles
Trichinella
Albendazole, glucocorticoids
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HELMINTHS
MICROBIOLOGY
GUINEA WORM
Dragon / serpent worm
Dracunculiasis
Definite host of guinea worm
Dracunculus medinensis is transmitted by
Dracunculiasis is more common in
Guinea worm infection is common in workers of
Comma shaped calcification in tissue
Guinea worm infection
Drug preventing transmission of
dracunculiasis
Concentration of abate used in killing
Cyclops
Dracunculiasis
Parasite does NOT enter the body by skin penetration
Dracunculiasis
Infection through ingestion of water
containing cyclops
Man
Cyclops
Rajasthan
Step wells
Guinea worm
Metronidazole
No drug
1 mg/L
Eradicated in India, limited to tropical and subtropical
region, no animal reservoir
Dracunculus
STRONGYLOIDES
Stronglyoidosis is associated with
Infection associated with colitis
Unique feature of strongyloides stercoralis
Larva currens is seen in
Autoinfection seen with
NOT transmitted by fecooral route
Does NOT transmitted through egg
NOT a water borne disease
Diagnostic feature of uncomplicated strongloidiasis
Enterotest for
Treatment of strongyloidiasis
Immunodeficiency
Strongyloides
Replicate in human host
Strogyloides stercoralis
Strongyloides
Strongyloides stercoralis
Strongyloides
Strongyloidosis
Rhabditidiform larva
Strongyloidosis
Ivermectin
SCHISTOSOMA
Cercaria
Natural habitat of Schistosoma
NOT a cestode
Redia stage is NOT seen in
Painless terminal hematuria is associated
with
Katayama fever is caused by
Swimmers itch is associated with
Transmission of Schistosomiasis
Liver manifestations of schistosoma hematobium
Mature schistosomal larvae

Veins of urinary bladder, portal and pelvic veins, vesical
plexus
Schistosoma
Schistosoma
Schistosoma hematobium
Schistosoma
Cercaria from snail by skin penetration
Symmers clay pipe stem fibrosis (Periportal)
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HELMINTHS
MICROBIOLOGY
Helminth entering skin by penetration
Investigation contraindicated in children
coming with hematuria due to
Peripheral smear is NOT useful in
Cercarial dermatitis is caused by
Pipestem cirrhosis
Swimmers itch is associated with
Rectal snip for
Egg with lateral spine
Schistosoma japonicum resides in
Jacksonian epilepsy may be caused by
Egg of schistosoma japonicum
Parasitic infection is transmitted by direct penetration
of larva
Urinary bladder calcification radiologically which
resemble fetal head in pelvis
Hematuria, renal calculi, calcifications in the wall of
bladder and small contracted bladder
Quantification of infection in Schistosoma hematobium
Metrifonate is effective against
Drug of choice for schistosomiasis
Drug used for schistosoma hematobium
Drug used for Schistosoma mansoni
Cystoscopy
Schistosoma mansoni
Schistosoma mansoni eggs incite a fibrotic
response in portal vein
S.japonicum, S.mansoni
Schistosoma mansoni
S.mansoni
Splenic vein
Schistosoma japonicum
Small hook like spine
Schistosomiasis
Schistosomiasis
Schistosomiasis
Nuclear pore filter
Schistosomiasis
Praziquantel
Metrifonate
Oxamniquine
TRICHURIS
Trichuris trichura
Trichuris trichura maintains its position
in the intestinal tract by
Trichuris trichura resides in
Lemon shaped eggs
Eggs look like football with bumbs on each
end
Man is the only host in
Trichuris trichura infection is associated
with
Rectal prolapse is associated with
Infection does NOT affect eye
Sputum examination is NOT useful in diagnosis of
Does NOT pass through human lung
No filariform stage, no invasion so

eosinophil count is increased
Anchorage with its anterior portion
Caecum
Trichuris trichura
Trichuris trichura
Trichuris trichura
Chronic dysentery, abdominal pain, rectal
prolapsed in children
Trichuris trichura (whip worm)
Trichuris
Trichuris trichura
Trichuris trichura
HOOKWORM
Old world hookworm
Ancylostoma enters human body by
Ancylostoma
Penetration of skin
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HELMINTHS
MICROBIOLOGY
Habitat of ancylostoma
Major cause of cutaneous larva migrans
Creeping eruptions commonly seen in
Anclyostoma cause
Anemia, skin rash in in a child
Average blood loss associated with hook
worm
Ground itch
Does NOT cause biliary tract obstruction
Transmammary transplacental transmission is reported
in
Chandlers index used for
Warm load in community is measured by
Chandlers index
Chandlers index water containing 200-250 eggs should
be considered
Nematode present in jejunal mucosa
Drug of choice for hookworm infection
Jejunum
Ancylostoma brasiliensis
Ancylostoma brasiliensis, Ancylostoma carinum
Asymptomatic infection
Hook worm
0.2 ml/day
Hook worm
Ancylostoma duodenale
Anclyostoma duodenale
Ancylostoma duodenale
Chandlers Index
No of hookworms per gram of stool
Dangerous
Necatar americanus
Albendazole
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MICROBIOLOGY

CULTURE AND STERILISATION

CULTURE AND STERILISATION

GENERAL FEATURES OF TETANUS ........................................................................................................................... 26

CULTURE AND STERILISATION

CULTURE AND STERILISATION

CULTURE AND STERILISATION

CULTURE AND STERILISATION

CULTURE AND STERILISATION

KEY TO THIS DOCUMENT

CULTURE AND STERILISATION

CULTURE AND STERILISATION

Absence of pathogenic microbes

CULTURE AND STERILISATION

Autoclaving at 120*C for 15 mins

Hypochlorites are bactericidal and inactivated by

No complex with proteins

GRAM POSITIVE AND GRAM NEGATIVE ORGANISMS

Associated with protein F

LIGAND AND HOST RECEPTORS FOR MICROORGANISMS

Lytic phase of bacteriophage is an

Bacterial drug resistance in tuberculosis is via

Taking up soluble DNA fragments across their cell wall,

Drug resistance most commonly transmitted by

BIOTERRORISM AND VESICANTS

Category C bioterrorism agents

Anthrax, Botulism, plague, small pox, tularemia, viral

Craiges tube differentiates

Mitochondria always absent, Divide by binary fission

Diarrhea type of Bacillus cereus

Verotoxin of E.coli, Shigella toxin,

Superinfection is common with

Staphylococcal food poisoning, Clostridia, Shigella,

Important virulent factor in

30% of population is healthy nasal carriers,

MRSA resistance primarily mediated by

Staphylococcus hemolyticus, Staphylococcus

DISEASES CAUSED BY STAPHYLOCOCCUS

Epidermolysin, TSS toxin

STAPHYLOCOCCAL FOOD POISONING

Incubation period of Staphylococcal food Poisoning

Optimal temperature for formation of toxin 37* C,

C carbohydrate antigen is same

Streptococcus causing dental caries

Viridans group, pneumococci

DISEASES CAUSED BY STREPTOCOCCUS

Streptolysin O, Erythrogenic toxin, Hyaluronidase

CROSS SENSITIVITY OF STREPTOCOCCAL ANTIGEN

Beta hemolytic bacteria resistant to vancomycin,

Common species are enterococcus fecalis and

Differentiation of pneumococci from other alpha

Gram positive cocci in pairs, catalase negative bile

GENERAL FEATURES OF NEISSERIA

Gram negative cocci

Kidney shaped, non capsulated, ferment

Kidney shaped organism

Exclusive human pathogen, Some strains may cause

Treatment of meningococcal infection

Lens shaped, capsulated, ferments both

GENERAL FEATURES OF CLOSTRIDIA

Cl. Welchi, Cl. Septicum

Cl.perfringes, Cl.septicum, Cl.novyi, Cl.histolyticum,

Gram positive, Produce heat resistant spores, NO man