Fungus-Like Bacteria

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1

Actinomycetes

fungus-like bacteria; growth and characteristics and clinical presentation mirror fungal infection: systemic, skin, hypersensitivity pneumonitis

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Actinomycetes

inhabit soil, normal flora, distributed worldwide prevalent in humid areas; penetrate wounds or abrasions in skin or are inhaled

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Actinomycetes

slow growers; paraffin media, buffered charcoal-yeast extract, Martin Lewis, modified Thayer Martin, Lowenstein-Jensen, columbie colistin-nalidixic acid agar for optimal recoery; plated to routine and selective media and incubated at 35 for 2-3 weeks

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Actinomycetes

anaerobic, identified by morphology, modified acid-fast, urease production, nitrate reduction, rhamanose-acid production, and opacification on Middle-Brook agar; hydrolyzes casein, xanthine, tyrosine, and gelatin; lysozyme sensitivity and PCR testing utilized

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elongated gram positive, some branching or sporing

Actinomyces gram stain

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dry or mucoid wrinkled colonies

Actinomyces growth

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mycolic acids

located in the cell wall of Actinomyces that makes is stain partially acid fast

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lysozyme sensitivity

enhanced growth in glycerol broth; growth interpreted as turbidity

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hydrolysis media

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demonstrates organisms ability to hydrolyze casein, xanthine, starch, and tyrosine, marked by clearing of the agar

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Actinomyces israelii

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most common Actinomyces bacteria that causes disease

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Nocardia

ubiquitous soil saprophytes inhaled or directly inoculated; cutaneous infection in immunocompetent

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N. asteroides

most common Nocardia infection; facultative intracellular pathogen; does not hydrolyze casein and tyrosine

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N. brasiliensis

most important Nocardia in tropical areas; cause majority of skin infections; hydrolyzes casein and tyrosine

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mycetoma (actinomycetoma)

chronic, localized painless and subcutaneous Nocardia brasiliensis infection

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Nocardiosis

may colonize respiratory tract; affects immunocompromised; pneumonia can disseminate-kidney, skin, GI, brain

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Nocardia species

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gram variable, modified acid fast bacilli positive, beaded; strictly aerobic; filamentous and branching; isolated on routine media within 4 days up to 2-4 weeks

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Nocardia

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colony morphology variable-crumbly, wrinkled and dry, mold-like; grey white or orangish tan; some beta hemolytic; distinct strong mildew odor

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Nocardia

biochemically resistant to lysozyme, hydrolyzes urea, reduces nitrates