04 Gm negative enteric bacilli
- O2 mask: Pneumonia
- bag of urine: Urinary tract infection
- Pills on ground: Multidrug resistant, treatment with carbapenem
- hospital room: nosocomial infections, thus multi drug resistance
- milk: Lactose fermenter
- pink milk cartoon: Pink on MacConkey Agar
Enterobacter cloacae
- enterodactyl
- flying: motile
Serratia marcescens
- triceratops
- charging with arm up: Motile
- red color: Produces red pigment on culture
- catalase positive
Klebsiella pneumoniae
- ankylosaurus with clubbed tail/ kleb tail
- mucous on back: polysaccharide capsule
- NH3 bottle spraying kleb: Urease positive
- all 4 feet: Immotile
- clear zone and thick capsule
- 3 A's: Alcoholics, abscesses, aspiration (started from aspiration)
- knocked over jar of currant jelly: "Currant" jelly sputum
- Xray: Cavitary lesion, may look like TB
- Liver abscess via ascending cholangitis
- The hallmark of Klebsiella pneumonia is a thick, mucoid, blood-tinged sputum (currant jelly sputum) and lung tissue necrosis with early abscess formation.
Salmonella
- macrophage cage: Facultative intracellular within macrophages
- fish tail floppy: Salmonella is motile
- lemon cut: Acid-labile
- black plate: H2S positive, black colonies on Hektoen Agar plate
- fish bone: Osteomyelitis
- capsule: vi Capsule, inhibit phagocytosis
- flower: Fluoroquinolones treatment (ie Cipro)
- syringe: Live attenuated vaccine
Enteritidis
- left chicken: The reservoir for Salmonella enteritidis is the chicken
- match: Inflammatory diarrhea
- syringe bulb: Type III secretion system
Typhi
- right: Salmonella typhi
- sickle: In Sickle Cell disease
- seagull: Salmonella typhi in the gallbladder of chronic carriers
- cook drape: Typhoid Mary
- drape: Rose colored macules
- Green pea: "Pea soup" diarrhea
Shigella
- standing on acid: Acid stable
- green shirt: Green colonies on Hektoen agar
- chained to stone: Immotile
- actin projectile: Use of actin filaments
- M: Invasion of M cells
- Flame all around: Inflammatory diarrhea
- Red stool: blood in stool
HUS:
- whip: Glomerular damage first
- plates: thrombosis with platelet, drop in platelet counts
- popped balloon: platelet aggregation lyse RBC, Red blood cell hemolysis
- young kid: HUS common in young children
- 60a timer: Toxin binds to 60S subunit of ribosomes
- syringe with bulb: Type III Secretion System
E. Coli
- cat: Catalase positive
- milk bottle: Lactose fermenter
- pink milk bottle: Pink on MacConkey Agar
- capsule with cake: Encapsulated
- K cake: K Antigen
- green drink holder: Green on EMB agar
- type III secretion
- milkshake with red strawberry: leading cause of sepsis via LPS
- hair bow: Fimbriae, pili like, cause for UTI
- UTI cup with #1: Most common cause of UTI
- neonate with helmet: Neonatal meningitis
- neonate points to cake: Only if it has K antigen
EHEC
- shiga toy: Shiga-like toxin can cause HUS
- Only $1.57: O157:H7 antigen is associated with outbreaks
- hamburger: Transmitted by eating undercooked meat
- ketchup on table and red stool: Bloody diarrhea
- sorbitol bottle: Does NOT ferment sorbitol
- balloon string: Damages endothelial cells in the glomerulus
- plates: Platelet aggregation follows and decrease in platelet count
- Popped balloon: Red blood cell hemolysis via the thrombosis
ETEC
- traveller truck: Traveler's diarrhea
- water truck: Transmitted via water
- LA: L = Labile, A = cAMP
- SG: S= Stable G = cGMP
- water truck: Watery diarrhea
Yersinia
Yersinia Enterolitica
- English terrier: yersinia enterolitica
- ice on window: Resistant to cold temperatures
- Safety pin: Bipolar staining, sometimes described as having a safety pin appearance
- glass capsule: Encapsulated
- poop in cage: Y. enterocolitica transmitted through puppy feces
- milk bottle: May be transmitted through contaminated milk products
- baby: Toddlers are commonly affected by Y. enterocolitica
- red stool: bloody stool
- right abdomen toddler : Infection can mimic appendicitis symptoms
Yersinia Pestis
- Pink color: Gram negative organism
- Rodents in cage: Prairie dogs main reservoir in United States
- flea sign: Transmitted by flea bites
- sai: Streptomycin (with tetracycline) for treatment
- mouse wheel: Tetracyclines (with streptomycin) for treatment
- syringe bulb: Yops (yersinia outer protein) secreted via type III secretion systems, stops phagocytosis
- guy with buboes: Characteristic buboes form on skin
- Uncontrolled spread can cause organ abscess, cutaneous hemorrhage, and tissue necrosis
- killed vaccine sign: Killed vaccine can be used to prevent transmission
Campylobacteria Jejuni
- curved moustache: Curved/spiral gram negative rod
- flame: Grows at 42 degrees C
- chicken roasted: Poultry reservoir. Can be transmitted from domestic animals (pet dog)
- ring: Oxidase positive
- red stool: Causes bloody diarrhea
- bear cub invading cooler: Invasive, bacteremia, sepsis
- slapping knee: Reactive arthritis, seronegative
- bear playing with sausages: Guillain-Barre syndrome - Ascending paralysis
Vibrio
- blue ring: Oxidase positive
- comma mustache: Comma shaped
- red boat: Gram negative
- lemon sliced: Acid labile because grows on alkaline media
- base camp map: Grows on alkaline media
- boat attached: Fimbrae attachment, does not invade
- Base camp map: Increases cAMP
- Gs bottle: Toxin activates Gs pathway and cAMP, increase water secretion
- bathroom: Fecal-oral transmission
- rice farms: Rice water stools
- water: Watery diarrhea
- general drinking water: Oral rehydration therapy
- Vibrio vulnificus/parahemolyticus: oysters on plate, contaminated sea food
Helicobacter
- ammonium bottle: Urease positive, splits urea into ammonia and CO2, reduce acidity for invasion (urease breath test)
- helicopter blade: Motile, spins around with flagellum
- curved mustache: Curved/spiral gram negative rod
- blue ring: Oxidase positivex
- silver headphones: silver stain
- catalase positive
- bullet holes and duodenum letters: Duodenal ulcers
- crab: Increased risk of gastric adenocarcinoma
- pile of tissues with mucous: Mucosa associated lymphoid tissues (MALT)
- gasoline pump: Proton Pump Inhibitor (PPI)
- ammo box: Amoxicillin
- keep clear crows: Clarithomycin
Pseudomonas
- cat: Catalase positive
- red bathtub: Gram negative rod
- blue ring: Oxidase positive
- glass capsule: Encapsulated
- grapes on table: Produces fruity grape odor
- air bellow: Obligate aerobe
- water in red tub: Thrives in aquatic environment
- blue/green residue: Produces blue-green pigment (from pyocyanin and pyoverdin)
- motile
- type 3 secretion
- Nurse coughing and pouring Cl water: Nosocomial pneumonia and respiratory failure in cystic fibrosis patients due to Cl mutation
- fish bone next to candy and mortar: Osteomyelitis in diabetics (traumatic injury) and IV drug users (directly introduce via needles)
- maid on fire: Infection associated with burn patients
- chamber pot: Nosocomial urinary tract infections
- Hot tub folliculitis: red, itching, pustular folliculitis association with hot tub
- dog with black spot: Ecthyma gangrenosum - black necrotic lesions on skin (from toxins)
- Maid listening with trumpet outside ear: Otitis externa. Swimmer's ear
- Guy wearing green with bow: Toxin inactivates EF-2 by ribosylation (Same mechanism as Diphtheria toxin)
- Piper: Piperacillin for treatment
- flower: Fluoroquinolones, great for UTI
- sai: Aminoglycosides, good with tetracycline
Proteus mirabilis
- red: gm negative
- NH3: Urease positive, makes ammonium/CO2, alkaline environment, responsible for struvite stones precipation
- octopus: Swarming motility when plated
- Fish all around: Fishy odor
- horn of stag: Forms staghorn calculi in renal stones
- Stone in hand: Alkaline environment can cause struvite stone production
- Guy urinating: May cause UTI
Links to this note
- Eggs: Treat with sulfonamides