02 Gm positive bacilli

  • Air bellow : obligate aerobe
  • Large ships in chain: Large gram positive rods in chains
  • Leather armor with buckles: Protein capsule composed of poly-D-glutamic acid

  • Walnuts, like seeds: Spore forming
  • Sheep: "Wool sorters disease"- classically causes pulmonary infection in those who work with wool. Spores stay in wools for long time
  • Black ground and flame: Most common manifestation of infection is cutaneous black eschar
  • Large axe with blood: Pulmonary infection may lead to pulmonary hemorrhage
  • Ship with wide mast: Widened mediastinum on chest x-ray if pulmonary infection.

  • Shield with EF: Edema factor
  • viking tent: Edema factor acts by causing elevation in cAMP
  • LF shield: Lethal factor
  • Burning map: Map kinase, burned and turned into eschar. Lethal factor responsible for tissue necrosis

  • Pink flower: Flouroquinolone treatment
  • Bicycle: Tetracycline treatment
  • Viking reheating rice and vomiting: B.cereus classically causes vomiting after eating reheated rice.

Clostridium Tetani

  • purple color: gram positive
  • Walnuts: Spore forming
  • Gas mask: Obligate anaerobe

  • Pots of earth on ground: Spores found in soil
  • Nails: Endospores transmitted via puncture wound from rusty nail (construction zone)
  • Barbed wire: Endospores transmitted via puncture wound from barbed wire (construction zone)

  • Evil monkey smiling: Lock jaw symptoms and facial spasms (risus sardonicus (evil grin))
  • Monkey extend back: Opisthotonus, muscle spasms cause arched back

  • Orange syringe: Vaccine consists of deactivated toxin (same color orange), not the bacteria

  • Scissors on pulley: Tetanus toxin (not the organism) migrates to CNS via retrograde axonal transport
  • Snare trap: Tetanus toxin cleaves SNARE
  • G and G labs: Tetanus toxin cleaves SNARE preventing release of inhibitory neurotransmitters GABA and Glycine, inhibit inhibitors = uncontrolled firing
  • Wrench and saw: Tetanus toxin inhibits inhibitory neurotransmitter release from Renshaw cells in spinal cord

Clostridium Botulinum

  • violet color: gm +
  • mechanical nuts: Spore forming
  • gas mask: Obligate anaerobe

  • Canned robot shape: Transmitted by improperly canned, insufficient heating of home canned food, allow spore survival and heat production (family developing neuro symptoms)

  • Robots heads and torso going limp: Descending flaccid paralysis (Guillian Barre ascending) (multiple people with symptoms = botulism)
  • Only affects PNS, not CNS because can't cross BBB
  • Droopy robot eyelids: Ptosis

  • Oil: Infantile bolulism transmitted via honey ingestion
  • Baby robot flaccid: "Floppy baby"
  • Adults ingest spores directly ok because anaerobes outcompete in GI. Babies have low GI anaerobe flora

  • Ach power supply: Botulism toxin prevents acetylcholine release (excitatory) at neuromuscular junction
  • Scissor cutting: protease cutting SNARE

  • Adults symptoms by ingest toxins; baby symptoms by ingest spores

Clostridium Difficile

  • Gas mask: Obligate anaerobe
  • Walnuts: Spore forming

  • Apples: Exotoxin A
  • Brushing apple: Exotoxin A attaches to brush border
  • Chocolate syrup: Watery diarrhea
  • Shoe from chocolate syrup: Toxin detected in stool

  • Clean hand sign: Clindamycin: C. Diff infection after antibiotic use

  • B sign: Exotoxin B
  • Kid picking apart actins: Exotoxin B disrupts cytoskeleton by depolymerizing actin. Inactivates Rho regulatory protein. Loss of intracellular tight junction = cell rounding
  • Membrane on right: Pseudomembranous colitis

  • Tongue looking van: Oral vancomycin for treatment
  • metro train: IV metronidazole for treatment

Clostridium Perfringes

  • Gas mask: Obligate anaerobe
  • double fine zone: Double zone of hemolysis when plated in anaerobe environment

Anaerobic culture of Clostridium perfringens on blood agar. The characteristic double zone of clear beta-hemolysis around a colony is clearly seen (arrow).

  • Walnut and pots : Spores found in soil
  • Private fell of motorcycle: Infection associated with motorcycle accidents and other major trauma
  • Private: Infection associated with deep penetrating military wounds

  • Slow sign in puddle: May cause slow onset diarrhea; spores have to germinate first before cause diarrhea, not preformed
  • Gas from motor cycle: Causes "gas gangrene", causes crepitus when palpate. Metabolizes carbohydrates, producing the gas.

  • alpha flag on bob pins: Alpha-toxin, lecithinase (phospholipase), disrupts cell membrane function
  • tomatoes on ground smashed: Alpha-toxin also has hemolytic activity

  • Pencil: Penicillin treatment

Cornyebacteria diptheria

  • purple hue: gram positive
  • Guy playing with toys, zig zag lines: Metachromatic granules (red and blue). Club shaped rods in V or Y formation

  • Guy with bow tie playing elongating piano: ADP ribosylation of elongation factor 2, inhibits protein synthesis, cell death, pseudomembrane

  • Candy with plastic wrap: Pseudomembrane on throat and tonsils
  • Bull: Bull neck
  • Heart shaped cape block bull: Cardiotoxic effects: myocarditis, arrhythimia, heart block
  • Guy eating sausages shaped like nerves: Demyelination causes nerve deficits starting in posterior oropharynx
  • Fibrinous exudate → systemic circulation → cortical neurons: This is the route that diphtheria toxin takes from the pseudomembranous exudate it forms in the pharynx to the bloodstream and subsequently to cardiac and cerebral cortical tissues.

  • Droplets from bull's mouth: Transmitted by respiratory droplets

  • Tele screen: Plated on Tellurite agar
  • Kid watching and laughing: "Plated on Loeffler's medium"
  • Bull licking: Elek's test, differentiate toxin variant

  • Syringes: Inactivated pertussis toxoid vaccine, IgG

  • Treatment: administer IVIG

Listeria monocytonegenes

  • Cat: Catalase positive
  • Falling tree: Tumbling motility
  • Beta bulb: Beta hemolytic
  • Actin rocket half in and out: Facultative anaerobic bacterium
  • Ice on window: Motile with flagella at 30 degrees and below
  • Actin rocket: At body temperature, motile by actin polymerization, or "actin rockets"

  • Pregnant woman: May be acquired transvaginallypregnant women may be advised not to eat soft cheese
  • Milk: Transmitted from dairy products
  • Cheese: Transmitted by consumption of certain of cheeses
  • Santa: Infection also prevalent in elderly population
  • Baby with helmet: Common cause of neonatal meningitis

  • Amplifier: Treatment with ampicillin

Actinomyces israeli

  • gas mask: Obligate anaerobe, nocardia is aerobe
  • Tree branching, violet wrap: Gram positive filamentous rod
  • Yellow rocks: Yellow sulfur granules

  • Canal draining: Formation of sinus tracts. Draining sinus tract
  • Jaw wrap: Infection associated with jaw trauma

  • Pencil: Treat with penicillin

Nocardia

  • NH3 spray bottle: Urease positive
  • Branching tree: Gram-positive branching filamentous rod. - Similar to actinomyces
  • air bellow: Obligate aerobe
  • Cow boy cloth with tails: Mycolic acids with two tails
  • cat: Catalase positive, pts with CGD at increased risk
  • Fast drawing of gun: Partially acid fast, carbo fuscia stain

  • Cactus pot broken: Found in soil

  • Cane: Immunocompromised especially affected

  • Coughing: Pneumonia like symptoms
  • Bullet hitting chest: Associated with cavitary lesions in lung
  • Bullet leaving hole in hat: Brain abscess formation
  • Cow print with red around: Cutaneous symptomsindurated lesions and inflammatory reaction

  • Rotten eggs: Treat with sulfonamides