Bacterial meningitis

Neonates (less than 1 month old)

Streptococcus agalactiae (Group b streptococcus) Escherichia col

Children and adults

Streptococcus pneumoniae Neisseria meningitidis

Elderly (>60 yrs old)

Streptococcus pneumoniae Gram negative bacilli

Viral (aseptic) meningitis and encephalitis (90% of cases in patients under 30 years old)

Enteroviruses (70%; late summer and early fall) Arboviral meningoencephalitis (summer via tick or mosquito; West Nile virus, Eastern Equine Encephalitis virus, Western Equine Encephalitis virus, St. Louis Encephalitis virus, California group Encephalitis viruses, Powassan Encephalitis virus)- are the most common cause of episodic encephalitis in the US. Mumps (late winter and early spring) Herpes simplex virus (sporadic) HIV (sporadic) Rabies virus (rare)

Granulomatous Meningitis (Chronic meningitis)

Mycobacterium tuberculosis Cryptococcus neoformans

Spinal cord

Clostridium tetanus* Polio virus

Skin (Integument) Infections

There are a huge number of infectious diseases of this the largest organ of the human anatomy. Therefore, only the more common bacterial, viral and fungal microbes are mentioned here.

Common Bacterial Infections.

Staphylococcus aureus - impetigo, bullous impetigo, scalded skin syndrome, folliculitis, furuncles, carbuncles, cellulitis, myositis and toxic shock syndrome. Streptococcus pyogenes - impetigo, scarlet fever, erysipelas, necrotizing fasciitis, and streptococcal toxic shock syndrome. Propionibacterium acne - acne

Common Viral Infections.

Herpes Simplex 1 and 2 viruses- oral and genital herpes Papilloma viruses warts, genital warts, cervical dysplasia and cervical carcinoma Common childhood rashes (exanthems) are caused by o Coxsackie viruses and Echoviruses (enteroviral rashes), o Erythrovirus B19 (formerly Parvovirus B19; Erythema Infectiosum) o Human Herpes virus 6B (Exanthem subitum or Roseola) o Human Herpes Virus-7 (Exanthem subitum or Roseola) o Varicella-Zoster virus (Chickenpox) o Measles virus (Rubeola) o Rubella virus (Rubella).

Common Fungal Infections.

Malassezia furfur- Tinea versicolor The dermatophytes (Microsporum, Trichophyton and Epidermophyton) - Tinea pedis, Tinea corporis, Tinea capitis, Tinea manus and Tinea cruris. Candida albicans - intertrigo, perlche, folliculitis, paronchyia and onychomycosis.

Ear Infections
Otitis Media

Streptococcus pneumoniae Moraxella catarrhalis Haemophilus influenzae (nontypable)

Otitis externa

Pseudomonas aeruginosa* Staphylococcus aureus

Eye and Eyelid Infections

Anterior Blepharitis

Staphylococcus aureus or Staphylococcus epidermidis

Hordeola (stye)

Staphylococcus aureus

Periorbital (Preseptal) Cellulitis

Streptococcus pneumoniae in young children Staphylococcus aureus or Streptococcus pyogenes post-traumatic

Orbital (Postseptal) Cellulitis

Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae and Enterobacteriaceae

Dacryocystitis

Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Streptococcus pyogenes, and Pseudomonas aeruginosa

Conjunctivitis

Viral- Adenoviruses*, Herpes Simplex viruses types 1 and 2 (less common but more serious infection) Bacterial (pinkeye)- Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Pseudomonas aeruginosa, Neisseria gonorrhoeae and Neisseria meningitidis Chlamydial- Chlamydia trachomatis

Keratitis

Bacteria* o Gram positive bacteria (Streptococcus pneumoniae, Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus viridans, enterococci and Peptostreptococcus) are most frequently obtained with the most common of them being Staphylococcus aureus. o Gram positive bacilli that cause keratitis include Corynebacterium diphtheriae, Bacillus and Clostridium

Gram negative bacilli that cause keratitis include Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella pneumoniae, Serratia marcescens, Escherichia coli and Aeromonas hydrophila.Pseudomonas aeruginosa is one of the most destructive of the bacterial causes of keratitis. o Gram negative cocci or coccobacilli that cause keratitis include Neisseria gonorrhoeae, Neisseria meningitidis, Moraxella, Pasteurella multocida and Acinetobacter. o Ocular lymphogranuloma venereum is more serious than simple chlamydial conjunctivitis because corneal scars, conjunctival scars, and micropannus formation can occur (serotypes L1-L3 ofChlamydia trachomatis). Viruses o Herpes Simplex 1 and 2*- most common of viruses o Adenoviruses- epidemic keratoconjunctivitis o Varicella Zoster virus
o

Respiratory Tract Infections

Acute Rhinosinusitis

Usually caused by various respiratory viruses.

Acute Bacterial Rhinosinusitis

Streptococcus pneumoniae Haemophilus influenzae (nontypable)

Common cold (Rhinitis)

Rhinoviruses* Coronaviruses

Pharyngitis

Adenovirus Herpes Simplex virus Epstein Barr Virus Coxsackie viruses Remember Streptococcus pyogenes (group A streptococcus is important because of the complications that can result (rheumatic fever).

Viral Croup

Parainfluenza virus

Influenza virus Respiratory syncytial virus (most common cause of bronchiolitis in children under 1 year of age).

Bacterial tracheitis

Staphylococcus aureus

Epiglottitis

Haemophilus influenzae type b (very rare now due to the Hib vaccine)

Bronchitis

Respiratory viruses that infect the upper respiratory tract: influenza viruses A and B, parainfluenza viruses, adenovirus, respiratory syncytial virus, herpes simplex virus, rhinovirus, coxsackievirus A and B, and echovirus. Mycoplasma pneumoniae Chlamydophila pneumoniae (TWAR agent)- 5% of cases Streptococcus pyogenes

Bronchiolitis

Respiratory Syncytial virus (RSV)

Pneumonia
Neonatal (0-1 month)

Escherichia coli Streptococcus agalactiae (group B streptococcus)

Infants (1-6 month)

Chlamydia trachomatis (afebrile pneumonia with staccato cough) RSV

Children (6month-5 year)

RSV Parainfluenza virus

Children (5-15 year)

Mycoplasma pneumoniae Influenza virus type A

Young Adults (16-30 yr)

Mycoplasma pneumoniae

Older Adults

Streptococcus pneumoniae* Haemophilus influenzae

Gastrointestinal tract infections

Infections of the Teeth

Dental caries- Streptococcus mutans Gingivitis/periodontal disease- is a polymicrobial process; Organisms commonly associated with these conditions: Eubacterium sp., Micromonas (Peptostreptococcus) micros, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus, Fusobacterium nucleatum, Prevotella intermedia, Capnocytophaga sp., Selenomonas sp., and spirochaetes.

Ludwigs Angina

Streptococcus, Bacteroides, Fusobacterium and/or Staphylococcus aureus

Infections of the Mouth and Tongue

Herpes Simplex viruses 1 and 2 (gingivostomatitis or cold sores) Candida albicans (oral candidiasis)

Angular Cheilitis

Candida albicans

Parotitis

Mumps virus- benign viral parotitis Staphylococcus aureus- acute bacterial parotitis

Esophagitis- usually only seen in immunocompromised patients

Candida albicans* Cytomegalovirus (CMV) Herpes Simplex Virus (HSV), Human Immunodeficiency virus (HIV), Varicella Zoster Virus (VZV)

Peptic Ulcer Disease

Helicobacter pylori

Intestinal Infections- Bacterial (can be inflammatory [blood and mucus small volume; fecal wbc's present] or noninflammatory [large volume watery stools; fecal wbc's NOT present]
Inflammatory ones

Campylobacter jejuni Escherichia coli (EIEC) Escherichia coli (EHEC) Salmonella typhimurium Salmonella typhi (get also fever and headache; sometimes no diarrhea) Shigella dysenteriae type 1 (lots of PMN's) Shigella sonnei/flexneri Yersinia enterocolitica Clostridium difficile (can be both inflammatory and non-inflammatory)

Non-inflammatory ones

Escherichia coli (EPEC) Escherichia coli (ETEC) Escherichia coli (EAEC) Vibrio cholerae Clostridium difficile (can be both inflammatory and non-inflammatory)

Parasitic infections of the intestine

Giardia lamblia* Entamoeba histolytica Cryptosporidium parvum Enterobius vermicularis Taenia saginata Taenia solium Hymenolepis nana Ascaris lumbricoides Necator americanus Strongyloides stercoralis

Viral Gastroenteritis

Rotavirus (winter infant diarrhea- most common in infants and children) Noroviruses* (winter vomiting disease- most common in industrialized countries) Norwalk virus (summer diarrhea) Adenoviruses Astroviruses

Food poisoning- intoxications

Staphylococcus aureus* Bacillus cereus Clostridium perfringens Clostridium botulinum

Viral Hepatitis- Infections of the Liver

Hepatitis A virus* Hepatitis C virus Hepatitis B virus

Infections of the Bones and Joints

Osteomyelitis

Staphylococcus aureus* Streptococcus sp. Members of the Enterobacteriaceae

Septic arthritis

Neisseria gonorrhoeae (most common in sexually active young adults) Staphylococcus aureus*

Infections of the Heart

Pericarditis

Viral pericarditis*- Enteroviruses [Coxsackieviruses (A and B) and Echovirus (type 8)] Purulent pericarditis- rare- Staphylococcus aureus, Streptococcus pneumoniae and other streptococci Chronic pericarditis- rare- Mycobacterium tuberculosis and various fungi (Candida sp.)

Myocarditis

Enteroviruses (Coxsackievirus B is the most common)*

Endocarditis
Native valve- Streptococcus sp. (60-80%, viridans streptococci (3040%), Streptococcus bovis (10%), Enterococci (S. faecalis and S.

faecium; 5-18%) and Staphylococci (20-35%, usuallyStaphylococcus aureus) Intravenous drug users- Staphylococcus aureus (50%) and gramnegative bacilli (15%; Pseudomonas aeruginosa is most the common gram-negative). Prosthetic valve infections
o

Early (within 2 months of surgery) - Staphylococcus (50%; coagulase positive and coagulase negative), gram-negative aerobic bacilli (20%) and fungi (5%). Late (more than 2 months post surgery) - viridans Streptococcus sp. (35%), coagulase negative staphylococci (20%), and Staphylococcus aureus (10%).

Rheumatic Heart Disease

Streptococcus pyogenes

Hematopoietic/Lymphoreticular Infections
Infections of the Lymphocytes

Acquired Immunodeficiency Syndrome (HIV/AIDS)- T-lymphocytes Infectious Mononucleosis- B-lymphocytes Cytomegalovirus Infections- T-lymphocytes and macrophages

Infections of the Phagocytic Cells

Cat-scratch disease Bartonella henselae Tularemia Francisella tularensis Ehrlichiosis/Anaplasmosis - Ehrlichia chaffeensis, Ehrlichia ewingii and Anaplasma phagocytophilum Q fever- Coxiella burnetii Brucellosis- Brucella sp. Plague- Yersinia pestis

Infection of the Erythrocytes

Babesia- Babesia microti Malaria- Plasmodium sp.

Infection of the Endothelial Cells

Bacillary Angiomatosis/Hepatica peliosis- Bartonella henselae or Bartonella quintana Endemic relapsing fever- Borrelia sp. (15 different species; B. hermsii, B. parkeri) Epidemic Hemorrhagic fever- Sin Nombre virus (Hantavirus- hantavirus pulmonary syndrome) Rocky Mountain Spotted Fever- Rickettsia rickettsii

Bacterial Sepsis
Neonates

E.coli* Streptococcus agalactiae (group b strep.)

Adults (Systemic Inflammatory Response Syndrome, Sepsis, Septic Shock)

Most are due to bacterial infections. 50% due to Gram negative bacteria; 50% due to Gram positive bacteria. It depends on the location of the site of the initial infection. Most common sites of infection leading to sepsis are lungs, abdomen, and urinary tract (ex. urinary tract think Escherichia coli; community acquired pneumonia think Streptococcus pneumoniae).

Infections of the Genitourinary Tract

Cystitis and Pyelonephritis

Escherichia coli*

Acute bacterial Prostatitis

Escherichia coli*

Vaginitis

Bacterial Vaginosis* (BV) due to Gardnerella vaginalis, Mycoplasma hominis and various anaerobic bacteria including Mobiluncus sp., and Prevotella sp. Candida albicans Trichomonas vaginalis

Sexually Transmitted Infections (STIs) of the Genitourinary Tract

Genital Ulcerative Diseases

Genital Herpes- HSV-2* (80%), HSV-1 (20%) Syphilis- Treponema pallidum Chancroid- Haemophilus ducreyi Granuloma Inguinale- Klebsiella granulomatis (formerly Calymmatobacterium granulomatis) Lymphogranuloma Venereum- Chlamydia trachomatis

Urethritis

Chlamydia trachomatis* Neisseria gonorrhoeae

Cervicitis

Chlamydia trachomatis* Neisseria gonorrhoeae

Other STIs
Acute Pelvic Inflammatory Disease

Chlamydia trachomatis* Neisseria gonorrhoeae

Genital Warts

Human Papilloma virus (HPV types 6 and 11 most common for wart-like lesions; HPV types 16 and 18 most common for with cervical dysplasia and carcinoma.)

Epididymitis

Sexually active men aged <35 years- Chlamydia trachomatis or Neisseria gonorrhoeae Men >35 years of age- gram-negative enteric bacteria

Ectoparasitic Infections
Scabies

Sarcoptes scabiei var hominis

Pediculosis

Pediculus humanus capitis (head louse) Pediculus humanus corporis (body louse) Pthirus pubis (pubic louse)