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==Actinomycetes== | ==Actinomycetes== | ||
===General=== | ===General=== | ||
*IUD needs to be removed if found on a pap test<ref name=Ref_WMSP446>{{Ref WMSP|446}}</ref> - see ''[[Gynecologic cytopathology#Actinomycetes|gynecologic cytopathology]]''. | *[[IUD]] needs to be removed if found on a pap test<ref name=Ref_WMSP446>{{Ref WMSP|446}}</ref> - see ''[[Gynecologic cytopathology#Actinomycetes|gynecologic cytopathology]]''. | ||
*Gram-positive branching rods. | *[[Gram]]-positive branching rods. | ||
*Common in the tonsils. | *Common in the tonsils. | ||
*Part of the large [[Actinobacteria]] group.<ref name=pmid17804669>{{Cite journal | last1 = Ventura | first1 = M. | last2 = Canchaya | first2 = C. | last3 = Tauch | first3 = A. | last4 = Chandra | first4 = G. | last5 = Fitzgerald | first5 = GF. | last6 = Chater | first6 = KF. | last7 = van Sinderen | first7 = D. | title = Genomics of Actinobacteria: tracing the evolutionary history of an ancient phylum. | journal = Microbiol Mol Biol Rev | volume = 71 | issue = 3 | pages = 495-548 | month = Sep | year = 2007 | doi = 10.1128/MMBR.00005-07 | PMID = 17804669 | PMC = 2168647}}</ref> | *Part of the large [[Actinobacteria]] group.<ref name=pmid17804669>{{Cite journal | last1 = Ventura | first1 = M. | last2 = Canchaya | first2 = C. | last3 = Tauch | first3 = A. | last4 = Chandra | first4 = G. | last5 = Fitzgerald | first5 = GF. | last6 = Chater | first6 = KF. | last7 = van Sinderen | first7 = D. | title = Genomics of Actinobacteria: tracing the evolutionary history of an ancient phylum. | journal = Microbiol Mol Biol Rev | volume = 71 | issue = 3 | pages = 495-548 | month = Sep | year = 2007 | doi = 10.1128/MMBR.00005-07 | PMID = 17804669 | PMC = 2168647}}</ref> | ||
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Notes: | Notes: | ||
*''Mycete'' = fungus; these organisms have a fungus-like appearance. | *''Mycete'' = fungus; these organisms have a fungus-like appearance. | ||
** Also called ''pseudomycosis''. | |||
===Gross=== | ===Gross=== | ||
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*Sulfur granule may be seen grossly - yellow.<ref name=medsc>URL: [http://pathmicro.med.sc.edu/mycology/mycology-2.htm http://pathmicro.med.sc.edu/mycology/mycology-2.htm]. Accessed on: 14 September 2011.</ref> | *Sulfur granule may be seen grossly - yellow.<ref name=medsc>URL: [http://pathmicro.med.sc.edu/mycology/mycology-2.htm http://pathmicro.med.sc.edu/mycology/mycology-2.htm]. Accessed on: 14 September 2011.</ref> | ||
Images: | ====Images==== | ||
<gallery> | |||
Image:Actinomyces_-_high_mag.jpg | Actinomyces - high mag. (WC) | |||
Image:Actinomyces_-_very_high_mag.jpg | Actinomyces - very high mag. (WC) | |||
File:Actinomycetes_CNS_HE.jpg | Purulent encephalitis with actinomyces in HE. (WC/jensflorian) | |||
File:Actinomycetes_CNS_grocott.jpg | Purulent encephalitis with actinomyces in Grocott. (WC/jensflorian) | |||
</gallery> | |||
*[http://pathology.class.kmu.edu.tw/ch05/Slide42.htm Actinobacteria (kmu.edu.tw)]. | *[http://pathology.class.kmu.edu.tw/ch05/Slide42.htm Actinobacteria (kmu.edu.tw)]. | ||
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*PAS +ve. | *PAS +ve. | ||
**May be confused with a fungus! | **May be confused with a fungus! | ||
*Grocott +ve. | |||
==Helicobacter pylori== | ==Helicobacter pylori== | ||
:See ''[[ | *Commonly abbreviated ''H. pylori'' or ''HP''. | ||
===General=== | |||
*[[Gram stain|Gram]]-negative rods.<ref name=pmid21290743>{{Cite journal | last1 = Mobley | first1 = HLT. | last2 = Mendz | first2 = GL. | last3 = Hazell | first3 = SL. | last4 = Andersen | first4 = LP. | last5 = Wadström | first5 = T. | title = Basic Bacteriology and Culture | journal = | volume = | issue = | pages = | month = | year = | doi = | PMID = 21290743 | url = http://www.ncbi.nlm.nih.gov/books/NBK2444/}} </ref> | |||
*Causes [[gastritis]] - specifically [[Helicobacter gastritis]]. | |||
*Associated with [[peptic ulcer disease]], [[MALT lymphoma]] and [[gastric carcinoma]]. | |||
===Microscopy=== | |||
:See ''[[Helicobacter gastritis]]''. | |||
==Clostridium difficile== | ==Clostridium difficile== | ||
*Commonly ''C. difficile''. | *Commonly ''C. difficile''. | ||
*Classic cause of [[pseudomembranous colitis]]. | |||
===General=== | ===General=== | ||
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*Deletion of ''tcdC'' locus. | *Deletion of ''tcdC'' locus. | ||
*Resistant to fluoroquinolones (gatifloxacin and moxifloxacin). | *Resistant to fluoroquinolones (gatifloxacin and moxifloxacin). | ||
==Chlamydia trachomatis== | |||
*May be referred to as ''Chlamydia''. | |||
===General=== | |||
*Common. | |||
*May cause ''[[lymphogranuloma venereum]]''. | |||
Note: | |||
*Often co-exists with gonorrhea. | |||
===Microscopic=== | |||
*Variable. | |||
Lymphogranuloma venereum: | |||
*See: ''[[Cat-scratch disease]]''. | |||
==Mycobacterium tuberculosis== | |||
*Abbreviated ''TB''. | |||
===General=== | |||
*Causes ''tuberculosis''. | |||
*May mimic a malignancy. | |||
*Strong association with [[HIV]]. | |||
*TB has characteristics of Gram positive and Gram negative bacteria.<ref name=pmid12356459>{{Cite journal | last1 = Fu | first1 = LM. | last2 = Fu-Liu | first2 = CS. | title = Is Mycobacterium tuberculosis a closer relative to Gram-positive or Gram-negative bacterial pathogens? | journal = Tuberculosis (Edinb) | volume = 82 | issue = 2-3 | pages = 85-90 | month = | year = 2002 | doi = | PMID = 12356459 }}</ref> | |||
**Gram stain: subtle positive,<ref name=pmid22476652>{{Cite journal | last1 = Kawakami | first1 = S. | last2 = Kawamura | first2 = Y. | last3 = Nishiyama | first3 = K. | last4 = Hatanaka | first4 = H. | last5 = Fujisaki | first5 = R. | last6 = Ono | first6 = Y. | last7 = Miyazawa | first7 = Y. | last8 = Nishiya | first8 = H. | title = Case of Mycobacterium tuberculosis meningitis: Gram staining as a useful initial diagnostic clue for tuberculous meningitis. | journal = J Infect Chemother | volume = 18 | issue = 6 | pages = 931-6 | month = Dec | year = 2012 | doi = 10.1007/s10156-012-0382-y | PMID = 22476652 }}</ref> often weak positive/little staining.<ref name=pmid21327691>{{Cite journal | last1 = Atsukawa | first1 = Y. | last2 = Kawakami | first2 = S. | last3 = Asahara | first3 = M. | last4 = Ishigaki | first4 = S. | last5 = Tanaka | first5 = T. | last6 = Ono | first6 = Y. | last7 = Nishiya | first7 = H. | last8 = Fujisaki | first8 = R. | last9 = Koga | first9 = I. | title = The usefulness of changing focus during examination using Gram staining as initial diagnostic clue for infective tuberculosis. | journal = J Infect Chemother | volume = 17 | issue = 4 | pages = 571-4 | month = Aug | year = 2011 | doi = 10.1007/s10156-011-0216-3 | PMID = 21327691 }}</ref> | |||
**Genetically closer to Gram negative microorganism than Gram positive organisms - when the whole genome is considered.<ref name=pmid12143965>{{Cite journal | last1 = Fu | first1 = LM. | last2 = Fu-Liu | first2 = CS. | title = Genome comparison of Mycobacterium tuberculosis and other bacteria. | journal = OMICS | volume = 6 | issue = 2 | pages = 199-206 | month = | year = 2002 | doi = 10.1089/153623102760092797 | PMID = 12143965 }}</ref> | |||
====Clinical==== | |||
Classic features - pulmonary/systemic: | |||
*Cough. | |||
*Fever. | |||
*Weight loss. | |||
CNS manifestations: | |||
*Tuberculoma (mass). | |||
*Meningitis. | |||
*Abscess. | |||
Tests: | |||
*PPD test, [[AKA]] Mantoux test, [[AKA]] TB skin test. | |||
Treatment: | |||
*Multiple drugs for a long time (months). | |||
**Commonly used drugs: isoniazid, rifampin, pyrazinamide, and ethambutol. | |||
===Gross=== | |||
====Ghon complex==== | |||
Consists of two components:<ref name=Ref_AoGP112>{{Ref AoGP|112}}</ref><ref>URL: [http://pathhsw5m54.ucsf.edu/case32/image324.html http://pathhsw5m54.ucsf.edu/case32/image324.html]. Accessed on: 27 February 2012.</ref> | |||
#Peripheral focus - subpleural, calcified. | |||
#Central focus - the hilar [[lymph node]] that drains the peripheral focus. | |||
Image: | |||
*[http://library.med.utah.edu/WebPath/LUNGHTML/LUNG034.html Ghon complex (utah.edu)]. | |||
===Microscopic=== | |||
Features: | |||
*Necrotizing [[granuloma]]s with rod-shaped bacteria. | |||
Note: | |||
*May be non-necrotizing. | |||
DDx: | |||
*[[Mycobacterium avium complex]]. | |||
*Other [[granuloma|granulomatous disease]]. | |||
Images: | |||
*[http://path.upmc.edu/cases/case186.html Tuberculosis - case 1 - several images (upmc.edu)]. | |||
*[http://path.upmc.edu/cases/case262/micro.html Tuberculosis - case 2 - several images (upmc.edu)]. | |||
*[http://path.upmc.edu/cases/case487.html Tuberculosis - case 3 - several images (upmc.edu)]. | |||
===Stains=== | |||
*[[Ziehl-Neelsen stain]] - red rod-shaped bacteria - '''key feature'''. | |||
**Very small - must use 40x objective. | |||
Image: | |||
*[http://commons.wikimedia.org/wiki/File:Mycobacterium_tuberculosis_Ziehl-Neelsen_stain_640.jpg Tuberculosis (CDC/WC)]. | |||
===Molecular=== | |||
*Can be diagnosed with PCR. | |||
==Mycobacterium leprae== | |||
===General=== | |||
*Causes ''leprosy''. | |||
Clinical: | |||
*Nerve damage -> injuries -> disability. | |||
===Microscopic=== | |||
Features: | |||
*[[Granuloma]]s with rod-shaped bacteria. | |||
===Stains=== | |||
*[[Fite stain]] - red rod-shaped bacteria - '''key feature'''. | |||
**Very small - must use 40x objective. | |||
Images: | |||
*[http://img.medscape.com/fullsize/migrated/576/467/smj576467.fig2.gif Leprosy (medscape.com)].<ref>URL: [http://www.medscape.com/viewarticle/576467_2 http://www.medscape.com/viewarticle/576467_2]. Accessed on: 2 January 2012.</ref> | |||
*[http://www.meddean.luc.edu/lumen/MedEd/orfpath/images/fig140x.jpg Leprosy (meddean.luc.edu)].<ref>URL: [http://www.meddean.luc.edu/lumen/MedEd/orfpath/bfsrinf.htm http://www.meddean.luc.edu/lumen/MedEd/orfpath/bfsrinf.htm]. Accessed on: 1 April 2012.</ref> | |||
==Mycobacterium avium complex== | |||
*Abbreviated ''[[MAC]]''. | |||
*Previously referred to as ''Mycobacterium avium-intracellulare'', abbreviated ''MAI''. | |||
===General=== | |||
*Refers to an infection with both:<ref name=pmid17428883>{{Cite journal | last1 = Turenne | first1 = CY. | last2 = Wallace | first2 = R. | last3 = Behr | first3 = MA. | title = Mycobacterium avium in the postgenomic era. | journal = Clin Microbiol Rev | volume = 20 | issue = 2 | pages = 205-29 | month = Apr | year = 2007 | doi = 10.1128/CMR.00036-06 | PMID = 17428883 | PMC = 1865596 | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1865596/?tool=pubmed }}</ref> | |||
**''Mycobacterium avium'' | |||
**''Mycobacterium intracellulare''. | |||
===Microscopic=== | |||
Features: | |||
*Small rod-shaped organisms - within histocytes. | |||
*+/-Granulomas. | |||
DDx: | |||
*[[Tuberculosis]]. | |||
*[[Whipple disease]] - esp. in the [[duodenum]]. | |||
===Stains=== | |||
*AFB +ve. | |||
Note: | |||
*[[Fite stain]] considered the preferred stain for MAC.<ref name=pmid21327589>{{cite journal |authors=Ilyas S, Youssef D, Chaudhary H, Al-Abbadi MA |title=Myocbacterium-avium intracellulare associated inflammatory pseudotumor of the anterior nasal cavity |journal=Head Neck Pathol |volume=5 |issue=3 |pages=296–301 |date=September 2011 |pmid=21327589 |pmc=3173547 |doi=10.1007/s12105-011-0248-0 |url=}}</ref> | |||
==Coxiella burnetii== | |||
===General=== | |||
*Causes: Q fever. | |||
Features: | |||
*Intracellular bacterium. | |||
*Gram negative. | |||
Clinical: | |||
*Flu-like symptoms. | |||
===Microscopic=== | |||
Features: | |||
*Fibrin ring [[granuloma]]. | |||
**Epithelioid macrophages (i.e. a granuloma) surrounding a thin pink (fibrin) ring. | |||
DDx:<ref name=pmid11881318>{{cite journal |author=Tjwa M, De Hertogh G, Neuville B, Roskams T, Nevens F, Van Steenbergen W |title=Hepatic fibrin-ring granulomas in granulomatous hepatitis: report of four cases and review of the literature |journal=Acta Clin Belg |volume=56 |issue=6 |pages=341–8 |year=2001 |pmid=11881318 |doi= |url=}}</ref> | |||
*Infections (Coxiella burnetii, [[CMV]], [[EBV]] + others). | |||
*Drug reaction. | |||
*Malignancy (e.g. Hodgkin lymphoma<ref name=pmid8514044>{{cite journal |author=de Bayser L, Roblot P, Ramassamy A, Silvain C, Levillain P, Becq-Giraudon B |title=Hepatic fibrin-ring granulomas in giant cell arteritis |journal=Gastroenterology |volume=105 |issue=1 |pages=272–3 |year=1993 |month=July |pmid=8514044 |doi= |url=}}</ref>). | |||
Images: | |||
*[http://en.gooword.com/picture/864449/ FRG (gooword.com)]. | |||
==Bartonella henselae== | |||
===General=== | |||
Causative agent in: | |||
*[[Cat-scratch disease]]. | |||
*[[Bacillary angiomatosis]]. | |||
===Microscopic=== | |||
Features - ''bacillary angiomatosis'': | |||
*Similar to pyogenic granuloma - ''see [[pyogenic granuloma]]''. | |||
Features - ''[[cat-scratch disease]]'': | |||
*Stellate granulomas. | |||
===Stains=== | |||
*[[Warthin-Starry stain]] +ve. | |||
Image: | |||
*[http://commons.wikimedia.org/wiki/File:Blood_culture_negative_endocarditis.jpg Bartonella henselae (WC)]. | |||
==Lactobacillus== | |||
===General=== | |||
*Gram positive bacilli. | |||
*Normal vaginal flora. | |||
===Microscopic=== | |||
Features: | |||
*Slender bacilli. | |||
<gallery> | |||
Image:Lactobacillus_sp_01.png | Lactobacilli. (WC) | |||
</gallery> | |||
==Pseudomonas== | |||
===General=== | |||
*Gram-negative bacteria. | |||
*Common pathogenic ''Pseudomonas aeruginosa''. | |||
*Community-acquired [[bronchopneumonia]]. | |||
**May be seen under nail - causes green nails.<ref name=pmid23064921>{{Cite journal | last1 = Barankin | first1 = B. | last2 = Levy | first2 = J. | title = Dermacase. Can you identify this condition? Pseudomonas aeruginosa infection. | journal = Can Fam Physician | volume = 58 | issue = 10 | pages = 1103-4 | month = Oct | year = 2012 | doi = | PMID = 23064921 }}</ref><ref>{{Cite journal | last1 = Hengge | first1 = UR. | last2 = Bardeli | first2 = V. | title = Images in clinical medicine. Green nails. | journal = N Engl J Med | volume = 360 | issue = 11 | pages = 1125 | month = Mar | year = 2009 | doi = 10.1056/NEJMicm0706497 | PMID = 19279344 }}</ref> | |||
===Gross=== | |||
*Green [[nail]]. | |||
Images: | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470509/figure/f1-0581103/ Green nail (nih.gov)].<ref name=pmid23064921/> | |||
==Sarcina== | |||
{{Main|Sarcina}} | |||
==See also== | ==See also== | ||
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==References== | ==References== | ||
{{Reflist}} | {{Reflist|2}} | ||
[[Category:Microorganisms]] | [[Category:Microorganisms]] |
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