06 Gm negative zoonotic bacilli

  • red pillow: gm negative
  • starry night and silver color: Warthin-Starry stain, a silver stain

  • cat scratch fever
  • bacillary angiomatosis

  • princess: Cat scratch fever occurs in immunocompetent patients (healthy young princess)
  • scratched arm: Cat scratch fever transmitted by cat scratches
  • balls around arm: Axillary lymphadenitis. Noncaseating granuloma

  • cane: Bacillary angiomatosis affects immunocompromised patients (HIV)
  • scratched arm: Bacillary angiomatosis also transmitted by cat scratches.
  • red dots: Raised red vascular lesions in bacillary angiomatosis
  • mistaken for Kaposi but has neutrophils. Kaposi has lymphocytic infiltrate

  • bicycle: Doxycycline treatment for bacillary angiomatosis
  • crows: Macrolides can be used to treat either disease

Brucella

  • red farm house: Gram negative
  • Survive in macrophages, travel to different reticuloendothelial systems and causes enlargement
  • open gate: Facultative intracellular organisms

  • cow and pig: Direct contact reservoirs: cow, pig
  • milk bucket on ground: Ingestion of unpasteurized dairy products

  • farmer: Fever and anorexia, primary symptoms
  • undulating hills: Undulant fever
  • liver/spleen spots: Liver and splenic involvement/enlargement
  • fish bone: chronic symptoms, Osteomyelitis

  • rifle: Rifampin used for adjunctive therapy, not for contact
  • bicycle wheel: Doxycycline

Francisella Tularensis

  • red raddish: Gram negative, coccobacilli
  • open cage: Facultative intracellular organism, recovery depends on cell mediated immunity
  • Rabbits are main reservoir
  • ticks from rabbit: Transmitted by dermacentor tick
  • can also be aerosolized, as biological weapon

  • enters at site of ulcer, gets inside macrophages, travels through lymph nodes, to reticuloendothelial organs
  • rabbit hole ulcerating: Painful ulcer at the site of infection
  • rotting radish: Granulomas with caseating necrosis in reticuloendothelial organs (i.e. lymph nodes)
  • mud pushing up: Regional lymphadenopathy

  • sai: Aminoglycosides for treatment

Pasteurella Multocida

  • cat: Catalase positive, spread by cat bites as well
  • blue ring: Oxidase positive
  • capsule: Capsule is important virulence factor
  • sheep blood: Grows on 5% sheep agar
  • safety pin: Demonstrates double staining, described as a "safety pin"

  • cat: cat bite
  • dog bit: Transmitted by dog bites

  • red bite location: Cellulitis may occur within the first 24 hours
  • fish bone: Infection may spread to bone and cause osteomyelitis

  • pencil: Empiric treatment is penicillin