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'''Bacteria''' are single celled [[microorganisms]], without a nucleus (prokaryotes), that can cause lots of morbidity and mortality.  They are not infrequently seen by pathologists.
'''Bacteria''' are single celled [[microorganisms]], without a nucleus (prokaryotes), that can cause lots of morbidity and mortality.  They are not infrequently seen by pathologists.
==Actinobacteria==
===General===
*A very large group of bacteria.
It includes:<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>
*Actinomycetes.
*Corynebacterium.
*Mycobacterium.
*Nocardia.
*Streptomyces.
==Actinomycetes==
===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]]''.
*[[Gram]]-positive branching rods.
*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>
Notes:
*''Mycete'' = fungus; these organisms have a fungus-like appearance.
** Also called ''pseudomycosis''.
===Gross===
*Yellow granules.<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>
===Microscopic===
Features:<ref>URL: [http://pathology.class.kmu.edu.tw/ch05/Slide42.htm http://pathology.class.kmu.edu.tw/ch05/Slide42.htm ]. Accessed on: 14 September 2011.</ref><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>
*Branching rods.
*Typically form pink/purple granules ("sulfur granule") that is surrounded by inflammatory cells (lymphocytes or neutrophils).
DDx:
*Nocardia.
Notes:
*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====
<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)].
===Stains===
*Gram +ve.
*AFB -ve.
**Nocardia +ve.
*PAS +ve.
**May be confused with a fungus!
*Grocott +ve.


==Helicobacter pylori==
==Helicobacter pylori==
:See ''[[Stomach]]''.
*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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