07 Mycobacterium

  • Mycobacterium cowboy: acid-fast gunslinger
  • Fuschin color: Carbol fuchin stain
  • tassels: Mycolic acids
  • lowenstein general store: TB grows on Lowenstein-Jenses medium
  • air bellow: Obligate aerobe

  • latent
  • miliary and systemic, multiorgan failure
  • reactivation

  • Primary TB: infects middle or lower lobe of lung
  • Primary TB: Hilar lymph node calcification
  • cactus with holes in middle lobe and hilar involvement, gun complex: Ghon complex: Hilar lymphadenopathy + peripheral granulomatous lesion in middle or lower lung lobe

  • Proliferates in macrophages
  • cord: cord factor (serpentine shaped) secreting TNF-a to activate macrophages and walled off in granuloma
  • spur and clouds: Sulfatides (spurs), phagosome and lysosome unable to fuse
  • broken down carts: Necrotic macrophages, caseating granulomas

  • sleeping kid: Latent infection common after primary infection kids
  • sleeping kid with sac: Fibrosis
  • shovel: Positive PPD test

  • BCG vaccine can cause a false positive skin test

  • Millet seeds everywhere: Miliary TB
  • cow skull: Miliary TB can be lethal

  • TNF guy bound: neurtralized TNF > reactivation
  • Reactivation with TNF alpha inhibitors
  • guy coughing blood and sweating at night: Symptoms of reactivation: cough, hemoptysis, night sweats
  • wasting from TNF alpha
  • 2nd cactus: Reactivated TB: affects upper lung lobes

  • bullet in hat: CNS involvement with cavitary lesion or tuberculoma
  • pots damaged: Pott's disease, multiple vertebrae affected, demineralization of bone, soft tissue swelling

  • RIPE: Rifampin, isoniozid, pyrazinamide, ethambutol
  • Rifampin and isoniazid for prophylaxis

Mycobacterium Leprosy

aka Hansen's disease.

  • tassles: Mycolic acids
  • Mycobacterium cowboy: Acid-fast gunslinger
  • gun: Carbol fuchsin stain

  • armadillo jail and armadillo: Armadillo is main reservoir in United States
  • Winter scene: Thrives in cool temperatures: predilection for extremities

  • tuberculoid
  • lepromatous

  • Jail cell 1: Tuberculoid leprosy: Th1 response with cell mediated immunity
  • Jail: Tuberculoid leprosy: able to contain bacteria within macrophages
  • bald head: Tuberculoid leprosy: well-demarcated, hairless, hypoesthetic skin lesion
  • rifle and deputy: Treatment: Rifampin/dapsone

  • shovel in dirt: Tuberculoid leprosy: positive Lepromin skin test, good cell mediated response

  • Jail 2: Lepromatous leprosy: bacteria unable to be contained by macrophages
  • prisoner laughing: Lepromatous leprosy: Th2 mediated humoral response
  • touching hands: lepromatous human to human transmission
  • lion's face mask: Lepromatous leprosy: leonine facies
  • gloves: Lepromatous leprosy: symmetric glove and stocking neuropathy
  • skin lesions on arm/legs: Lepromatous leprosy: poorly demarcated raised lesions on extensor surfaces of extremities
  • clothe: Treatment: Clofazimine along with rifampin/dapsone