View
231
Download
0
Category
Preview:
Citation preview
8/9/2019 Legionella Bordetella Haemophilus
1/48
1
PAMB 650 Medical MicrobiologyPAMB 650 Medical Microbiology
Lecture: 41Lecture: 41
Legionella Legionella ,, Bordetella Bordetella
andand Haemophilus Haemophilus
Gram Negative od! o" t#e e!$iratory %ractGram N
egative od! o" t#e e!$iratory %ract
8/9/2019 Legionella Bordetella Haemophilus
2/48
&rgani'ation o" Lecture&rgani'ation o" Lecture1(1( &vervie)&vervie)
*(*( &rgani!m! o" +linical m$ortance&rgani!m! o" +linical m$ortance
-(-( MicrobiologyMicrobiology
4(4( Public .ealt#Public .ealt#
5(5( Pat#ogenic Mec#ani!m!Pat#ogenic Mec#ani!m!6(6( +linical Pre!entation+linical Pre!entation
8/9/2019 Legionella Bordetella Haemophilus
3/48
LEGIONELLA LEGIONELLA
8/9/2019 Legionella Bordetella Haemophilus
4/48
LEGIONELLAE LEGIONELLAE
OverviewOverview /acultative intracellular $at#ogen/acultative intracellular $at#ogen Gram negative rodGram negative rod e uire! !$eciali'ed media to gro)e uire! !$eciali'ed media to gro) tain! $oorly )it# gram !taintain! $oorly )it# gram !tain %ran!mitted via contaminated aero!ol!%ran!mitted via contaminated aero!ol!
No $er!on to $er!on tran!mi!!ionNo $er!on to $er!on tran!mi!!ion
8/9/2019 Legionella Bordetella Haemophilus
5/48
** $ecie!$ecie! o" +linical m$ortanceo" +linical m$ortance Legionella Legionella
One genusOne genus 50 species50 species
of species implicated in human disease of species implicated in human disease Legionella pneumophila Legionella pneumophila
Causes ~ 90% of all cases of legionellosisCauses ~ 90% of all cases of legionellosis
Majority of all confirmed cases are caused y serogroups !"#Majority of all confirmed cases are caused y serogroups !"#
Legionella micdade Legionella micdade Most common afterMost common after L. pneumophila L. pneumophila
8/9/2019 Legionella Bordetella Haemophilus
6/48
Legionella micdadei Legionella micdadei
+aution:+aution: $his strain can stain ea&ly acid fast on primary$his strain can stain ea&ly acid fast on primary
isolation' ut loses this property hen gro n inisolation' ut loses this property hen gro n in(itro)(itro)
N&N& *+,-$.O/ 1.2 $O M3CO4-C$+*.-*+,-$.O/ 1.2 $O M3CO4-C$+*.-
8/9/2019 Legionella Bordetella Haemophilus
7/48
2ill not gro)2ill not gro) on !tandard #ee$ Blood Agaron !tandard #ee$ Blood Agar
Bu""ered +#arcoal 3ea!t tract Agar B+3 7Bu""ered +#arcoal 3ea!t tract A gar B+3 71(1( +y!teine+y!teine i! e!!ential "or gro)t#i! e!!ential "or gro)t#*(*( ronron i! e!!ential "or gro)t#i! e!!ential "or gro)t#
Gro)t# condition!:Gro)t# condition!:1(1( -5-5 00 ++*(*( -89 day!-89 day!
MicrobiologyMicrobiology
8/9/2019 Legionella Bordetella Haemophilus
8/48
+olony A$$earance:+olony A$$earance:
Ground gla!!Ground gla!! mall 18- mmmall 18- mm
8/9/2019 Legionella Bordetella Haemophilus
9/48
9
+ulture+ulture o"o" Legionella Legionella organi!m "romorgani!m "rom normallynormally!terile ti!!ue!terile ti!!ue
etection o"etection o" L. pneumophila L. pneumophila antigen in urineantigen in urine
eroconver!ioneroconver!ion : 4 "old or greater ri!e in !$eci"ic: 4 "old or greater ri!e in !$eci"ic
!erum antibody titer!erum antibody titer L. pneumophila L. pneumophila irect "luore!cent antibodyirect "luore!cent antibody /A7 !taining/A7 !taining
Laboratory iagno!i! o"Laboratory iagno!i! o"
Legionella Legionella
8/9/2019 Legionella Bordetella Haemophilus
10/48
10
Legionnaire!Legionnaire! di!ea!e8di!ea!e8
PublicPublic .ealt#.ealt#
isease " 6orld ideisease " 6orld ide poradicporadic +pidemic community"ac7uired pneumonia+pidemic community"ac7uired pneumonia
/osocomial infections /osocomial infections+8posure " 6ater" ased aerosols+8posure " 6ater" ased aerosols -ir conditioning cooling to ers-ir conditioning cooling to ers 6hirlpool spas6hirlpool spas auna or mister auna or mister
ur(i(al +n(ironmentur(i(al +n(ironment -moe ae-moe ae 4iofilms4iofilms
8/9/2019 Legionella Bordetella Haemophilus
11/48
11
Legionnaire;!Legionnaire;! di!ea!edi!ea!e ncubation $eriod *810 day!ncubation $eriod *810 day! $neumonia$neumonia 15895< mortality15895< mortality
eryt#romycineryt#romycin
Pontiac "everPontiac "ever ncubation $eriod 18* day!ncubation $eriod 18* day!
"lu8li=e"lu8li=e
milder no mortality7milder no mortality7 !el"8limiting!el"8limiting
** +linical Pre!entation!+linical Pre!entation!
8/9/2019 Legionella Bordetella Haemophilus
12/48
PA%.&G N &/PA%.&G N &/ LEGIONELLA LEGIONELLA
P#agocyto!i! into t#e monocyte!P#agocyto!i! into t#e monocyte!binding to com$lement rece$tor!binding to com$lement rece$tor!
n#ibition o" $#agoly!o!ome "u!ionn#ibition o" $#agoly!o!ome "u!ion e$lication )it#in t#e $#ago!omee$lication )it#in t#e $#ago!ome
Ly!i! o" t#e $#ago!ome lead! to a$o$to!i! andLy!i! o" t#e $#ago!ome lead! to a$o$to!i! and
relea!e o" t#e organi!mrelea!e o" t#e organi!m
%.1 cell! and /N8%.1 cell! and /N8 >>
http://medecinepharmacie.univ-fcomte.fr/bacterio_web/exa_microscopiques/bgn.htm8/9/2019 Legionella Bordetella Haemophilus
13/48
Bordetella Bordetella
http://medecinepharmacie.univ-fcomte.fr/bacterio_web/exa_microscopiques/bgn.htmhttp://medecinepharmacie.univ-fcomte.fr/bacterio_web/exa_microscopiques/bgn.htmhttp://medecinepharmacie.univ-fcomte.fr/bacterio_web/exa_microscopiques/bgn.htm8/9/2019 Legionella Bordetella Haemophilus
14/48
Bordetella pertussis Bordetella pertussis
trict aerobetrict aerobe
Gram negativeGram negative
mall +occobacillu! 8!ingly or in $air!mall +occobacillu! 8!ingly or in $air!
%ran!mi!!ion by aero!oli'ed dro$let!%ran!mi!!ion by aero!oli'ed dro$let!
Non8inva!iveNon8inva!ive
trictly #uman $at#ogentrictly #uman $at#ogen
8/9/2019 Legionella Bordetella Haemophilus
15/48
8/9/2019 Legionella Bordetella Haemophilus
16/48
B. pertussis B. pertussis mall, tran!$arent #emolytic colonie! onmall, tran!$arent #emolytic colonie! on
Bordet8Gengou mediumBordet8Gengou medium
8/9/2019 Legionella Bordetella Haemophilus
17/48
iagno!i!iagno!i!
Ba!ed on !ym$tom!Ba!ed on !ym$tom!
+ulture o" re!$iratory !ecretion! on Bordet8+ulture o" re!$iratory !ecretion! on Bordet8
GengouGengou mediummedium irect "luore!cent antibody te!tingirect "luore!cent antibody te!ting
P+ P+
lide agglutinationlide agglutination
8/9/2019 Legionella Bordetella Haemophilus
18/48
Public .ealt# A!$ect! o"Public .ealt# A!$ect! o" B. B.
pertussis ( pertussis ( Whooping oughWhooping ough ! !
8/9/2019 Legionella Bordetella Haemophilus
19/48
August 2, 2010
WHOOPING COUGH EPIDEMIC GROWS HEALTH OFFICIALS URGE VACCINATION AND TIMELY DIAGNOSIS
As of July 27, the number of illnesses from the disease this year hadclimbed to 2,174, a six-fold increase from the 49 illnesses re!orted for thesame !eriod last year" #n addition, a $an %iego &ounty infant has becomethe se'enth to die from !ertussis this year"
()he !ertussis e!idemic is a sobering and tragic reminder that diseaseslong thought controlled can return *ith a 'engeance,+ orton said" ( e can!rotect oursel'es and the most 'ulnerable in our community by getting'accinated today"+
8/9/2019 Legionella Bordetella Haemophilus
20/48
%uring January--June in &alifornia1". /9 of cases *ere among infants aged months
too young to be fully immuni3ed2"&hildren aged 7 to 9 years and 10 to / years
10"1 cases and 9" cases !er 100,000, res!ecti'ely"
f 4 case re!orts1"105 61 " !atients *ere hos!itali3ed,2" 6 2"9 *ere months"
"#ncidence among is!anic infants 649"/ cases !er 100,000 *as higher thanamong other racial8ethnic !o!ulations"4"5 deaths *ere re!orted, all in !re'iously healthy is!anic infants aged 2 monthsat disease onset none had recei'ed any !ertussis-containing 'accines"
)he incidence of !ertussis is cyclical, *ith !ea:s occurring e'ery --5 years in the
;nited $tates 6 2 " )he last !ea: *as in 2005, *hen a!!roximately 25,000 cases
*ere re!orted nationally"
Morbidity and Morta ity W!!" y R!#ort $ MMWR)
%& y '( )*+* , -'$)./01+2
http://www.cdc.gov/mmwr/http://www.cdc.gov/mmwr/http://www.cdc.gov/mmwr/http://www.cdc.gov/mmwr/http://www.cdc.gov/mmwr/8/9/2019 Legionella Bordetella Haemophilus
21/48
2ertussis -mong -dolescents and2ertussis -mong -dolescents and-dults-dults
isease often milder than in infants and childrenisease often milder than in infants and children .nfection may e asymptomatic' or may present.nfection may e asymptomatic' or may present
as classic pertussisas classic pertussis 2ersons ith mild disease may transmit the2ersons ith mild disease may transmit the
infectioninfection Older persons often source of infection forOlder persons often source of infection for
childrenchildren
8/9/2019 Legionella Bordetella Haemophilus
22/48
Pertu!!i!8 i!ea!ePertu!!i!8 i!ea!e
Primarily a to in8mediated di!ea!ePrimarily a to in8mediated di!ea!e
oto in! are controlled by central locu!oto in! are controlled by central locu! BvgA" BvgA" t)o8com$onent !ignal tran!duction !y!tem to !en!e t#et)o8com$onent !ignal tran!duction !y!tem to !en!e t#e
environment and regulate gene e $re!!ionenvironment and regulate gene e $re!!ion
8/9/2019 Legionella Bordetella Haemophilus
23/48
Pertu!!i!8 i!ea!ePertu!!i!8 i!ea!e
n"lammation inter"ere! )it# clearance o"n"lammation inter"ere! )it# clearance o"$ulmonary !ecretion!$ulmonary !ecretion! +oug# $rogre!!e! "rom mild catarr#al !tage7 to !ever+oug# $rogre!!e! "rom mild catarr#al !tage7 to !ever
$aro y!mal !tage7$aro y!mal !tage7
e!olve! !lo)lye!olve! !lo)ly
va!ion o" #o!t de"en!e!va!ion o" #o!t de"en!e! Pertu!!i! antigen! allo) eva!ion o" #o!t de"en!e!Pertu!!i! antigen! allo) eva!ion o" #o!t de"en!e!
Lym$#ocyto!i! $romoted but im$aired c#emota i!Lym$#ocyto!i! $romoted but im$aired c#emota i!
8/9/2019 Legionella Bordetella Haemophilus
24/48
Pertu!!i! Pat#ogene!i!Pertu!!i! Pat#ogene!i!
%)o8!tage $roce!! o" di!ea!e%)o8!tage $roce!! o" di!ea!e e!$iratory coloni'atione!$iratory coloni'ation
9810 day!9810 day!
N& !ym$tom!N& !ym$tom!
Po!itive culture! to)ard t#e end o" t#i! !tagePo!itive culture! to)ard t#e end o" t#i! !tage
%o in8mediated di!ea!e%o in8mediated di!ea!e
8/9/2019 Legionella Bordetella Haemophilus
25/48
+oloni'ation+oloni'ation
Attac#ment re uire! multi$le "actor!Attac#ment re uire! multi$le "actor!
Pertu!!i! %o inPertu!!i! %o in /ilamentou! #emagglutinin/ilamentou! #emagglutinin /imbriae/imbriae
8/9/2019 Legionella Bordetella Haemophilus
26/48
!)!) /ilamentou! #emagglutinin/ilamentou! #emagglutinina(a( ominant ad#e!inominant ad#e!inb(b( e uired "or trac#eal coloni'atione uired "or trac#eal coloni'ationc(c( .ig#ly immunogenic.ig#ly immunogenic
d(d( Primary com$onent o" acellular $ertu!!i! vaccine!Primary com$onent o" acellular $ertu!!i! vaccine! *(*( /imbriae/imbriae
a(a( e uired "or $er!i!tent trac#eal coloni'atione uired "or $er!i!tent trac#eal coloni'ation
b(b( +om$onent o" !ome acellular $ertu!!i! vaccine!+om$onent o" !ome acellular $ertu!!i! vaccine!c(c( e uired "or $rotective immunity to in"ectione uired "or $rotective immunity to in"ection
-dhesins-dhesins
8/9/2019 Legionella Bordetella Haemophilus
27/48
Bordetella pertussis Bordetella pertussis%o in!%o in!
??
// N% %&? N// N% %&? N
8/9/2019 Legionella Bordetella Haemophilus
28/48
y!temic e""ect! o" Pertu!!i! %o iny!temic e""ect! o" Pertu!!i! %o in
!)!) $ cell ,ymphocytosis ith mitogenicity$ cell ,ymphocytosis ith mitogenicity
:):) ;; insulin secretioninsulin secretion
) ;; .g+ production.g+ production
5)5) .mpaired phagocyte function.mpaired phagocyte function
#)#) - 2"ri osylates ? proteins- 2"ri osylates ? proteins
@)@) trong adju(anttrong adju(ant
A)A) 2rimary component of pertussis (accines2rimary component of pertussis (accines
8/9/2019 Legionella Bordetella Haemophilus
29/48
*( Adenylate cycla!e %o in*( Adenylate cycla!e %o in Calmodulin"acti(ated ithCalmodulin"acti(ated ith adenylate cyclase and hemolysinadenylate cyclase and hemolysin acti(ityacti(ity -cts as anti"inflammatory and antiphagocytic factor -cts as anti"inflammatory and antiphagocytic factor ecretedecreted in(asi(ein(asi(e to8into8in
calmodulin
B. pertussis
Adenylatecyclase toxin
8/9/2019 Legionella Bordetella Haemophilus
30/48
-(-( ermonecrotic to in N%7ermonecrotic to in N%7A(A( .eat8labile !ecreted to in.eat8labile !ecreted to inB(B( %ran!glutamina!e activity t#at act! on !mall G%Pa!e! o" t#e #o "amily%ran!glutamina!e activity t#at act! on !mall G%Pa!e! o" t#e #o "amily+(+( nduce! locali'ed necro!i!nduce! locali'ed necro!i!
F&"&i( A3 !t a 3 % 4io56!7 )**8 +9.:8+-;8+'0 doi:+*3+*'9,henoty!ic =odifications seen1"?eorgani3ation of
actin cytos:eletalfocal adhesionsstress fibers
2"Alterations in cell mor!hology
?ho
@%>
?ho
@%>
>olyaminated
% )
Bffectors
?ho
@)>
>olyaminated
&t#er %o in!:&t#er %o in!:
8/9/2019 Legionella Bordetella Haemophilus
31/48
4(4(
%rac#eal cytoto in%rac#eal cytoto in-)-) isaccharide"tetrapeptide monomeric y"product of peptidoglycan synthesisisaccharide"tetrapeptide monomeric y"product of peptidoglycan synthesis4) Causes damage to cilia' and loss of ciliated cells4) Causes damage to cilia' and loss of ciliated cellsC) .ncreased .,"! and nitric o8ide productionC) .ncreased .,"! and nitric o8ide production
5(5( %y$e !ecretion !y!tem%y$e !ecretion !y!tem-)-) -llo s-llo s Bordetella to translocate effector proteins directly into Bordetella to translocate effector proteins directly into host cellshost cells4)4) *e7uired for persistent tracheal coloni=ation*e7uired for persistent tracheal coloni=ationC)C) .nhi its host immune response.nhi its host immune response
)) .nduces necrotic cell death.nduces necrotic cell death
6(6( Li$o$oly!acc#aride LP 7Li$o$oly!acc#aride LP 7-)-) 2yrogenic2yrogenic4)4) MitogenicMitogenicC)C) -cti(ate and induce tumor necrosis factor production in macrophages-cti(ate and induce tumor necrosis factor production in macrophages
)) ,2 lac&s a repetiti(e O"antigenic structure,2 lac&s a repetiti(e O"antigenic structure
&t#er %o in!:&t#er %o in!:
8/9/2019 Legionella Bordetella Haemophilus
32/48
%reatment%reatment
ryt#romycinryt#romycin @accine@accine
=illed bacterial cell !u!$en!ion 8 %P vaccine=illed bacterial cell !u!$en!ion 8 %P vaccine @accine8 induced immunity )ane! a"ter "ive to@accine8 induced immunity )ane! a"ter "ive to
ten year!ten year! acellular vaccine! %aP7acellular vaccine! %aP7
Multicom$onent acellular vaccine!Multicom$onent acellular vaccine!
8/9/2019 Legionella Bordetella Haemophilus
33/48
.aemo$#ilu!.aemo$#ilu!
8/9/2019 Legionella Bordetella Haemophilus
34/48
&vervie)8 .aemo$#ilu!&vervie)8 .aemo$#ilu!
mallmall
Non8motileNon8motile
Gram8negative rod!Gram8negative rod! %ran!mitted via re!$iratory dro$let!, or%ran!mitted via re!$iratory dro$let!, or
direct contact )it# contaminated !ecretion!direct contact )it# contaminated !ecretion!
Normal "lora o" t#e #uman re!$iratoryNormal "lora o" t#e #uman re!$iratorytract and oral cavity(tract and oral cavity(
8/9/2019 Legionella Bordetella Haemophilus
35/48
Haemophilus Haemophilus !$ecie! o"!$ecie! o"clinical im$ortanceclinical im$ortance
1(1( H. in#luen$ae H. in#luen$ae88ty$e b i! an im$ortant #uman $at#ogenty$e b i! an im$ortant #uman $at#ogen
*(*( H. ducre%i H. ducre%i 88!e ually tran!mitted $at#ogen c#ancroid7!e ually tran!mitted $at#ogen c#ancroid7
-( &t#er-( &t#er Haemophilus Haemophilus are normal "loraare normal "lora88 H. parain#luen$ae & H. parain#luen$ae & $neumonia endocarditi!$neumonia endocarditi!
88 H. aphrophilus & H. aphrophilus & $neumonia endocarditi!$neumonia endocarditi!
88 H. aeg%ptius & H. aeg%ptius & $in= eye $urulent con unctiviti!7$in= eye $urulent con unctiviti!7
8/9/2019 Legionella Bordetella Haemophilus
36/48
i""erentiation o" $ecie!i""erentiation o" $ecie!
H!7o y>i>H!7o y>i>? Y? Y
Gro@t6Gro@t6Fa5tor Fa5tor
8/9/2019 Legionella Bordetella Haemophilus
37/48
Public .ealt# A!$ect!8Public .ealt# A!$ect!8 H. in#luen$ae H. in#luen$ae
%y$ing ba!ed on ca$!ule $oly!acc#aride a%y$ing ba!ed on ca$!ule $oly!acc#aride a C " C "
Polyribo!e8ribitol $#o!$#ate P P7 ca$!ule ty$e b7Polyribo!e8ribitol $#o!$#ate P P7 ca$!ule ty$e b7
Nonenca$!ulated nonty$eable7 organi!m! are $artNonenca$!ulated nonty$eable7 organi!m! are $arto" normal "lora o" t#e re!$iratory tracto" normal "lora o" t#e re!$iratory tract
D5< o" inva!ive di!ea!e cau!ed by ty$e bD5< o" inva!ive di!ea!e cau!ed by ty$e b
8/9/2019 Legionella Bordetella Haemophilus
38/48
Public .ealt# A!$ect!Public .ealt# A!$ect!
H. in#luen$ae H. in#luen$ae ty$e b incidence #a! "allenty$e b incidence #a! "allenDD< $o!t8vaccineDD< $o!t8vaccine
Pre8immuni'ationPre8immuni'ation eroty$e b )a! t#e mo!t common inva!iveeroty$e b )a! t#e mo!t common inva!ive
!$ecie!!$ecie!
8/9/2019 Legionella Bordetella Haemophilus
39/48
Po!t8immuni'ationPo!t8immuni'ation Mo!t ca!e! in unvaccinated or incom$letelyMo!t ca!e! in unvaccinated or incom$letely
vaccinated c#ildren(vaccinated c#ildren(
Non8enca$!ulated and !eroty$e " are t#e mo!tNon8enca$!ulated and !eroty$e " are t#e mo!t
commoncommon
+#ildren 8 Pneumonia and meningiti! le!! common+#ildren 8 Pneumonia and meningiti! le!! common
Mo!t in"ection! E*F-7 are currently attributed toMo!t in"ection! E*F-7 are currently attributed tononty$eable !train!(nonty$eable !train!(
8/9/2019 Legionella Bordetella Haemophilus
40/48
i!ea!e cau!ed byi!ea!e cau!ed by H. in#luen$ae H. in#luen$ae "erot%pe ' "erot%pe '
&linical =icrobiology ?e'ie*s, A!ril 2000, !" 02- 17, Col" 1 , o" 2
8/9/2019 Legionella Bordetella Haemophilus
41/48
nva!ive i!ea!e! $o!t8immuni'ationnva!ive i!ea!e! $o!t8immuni'ation
e$tic art#riti!e$tic art#riti!
&!teomyeliti!&!teomyeliti!
+elluliti!+elluliti! Pericarditi!Pericarditi!
Pneumonia 8 mo!t "re uent i! !eroty$e " Pneumonia 8 mo!t "re uent i! !eroty$e "
&titi! media&titi! media "treptococcus pneumoniae "treptococcus pneumoniae and t#en non8ty$eable .iand t#en non8ty$eable .i
8/9/2019 Legionella Bordetella Haemophilus
42/48
Pat#ogenic Mec#ani!m!Pat#ogenic Mec#ani!m!
H. in#luen$ae H. in#luen$ae Anti$#agocyticAnti$#agocytic $oly!acc#aride ca$!ule$oly!acc#aride ca$!ule i! t#ei! t#e
ma or $at#ogene!i! "actorma or $at#ogene!i! "actor
Li$o$oly!acc#aride li$id A com$onent "rom t#eLi$o$oly!acc#aride li$id A com$onent "rom t#ecell )all ma or role in non ca$!ule !train!7cell )all ma or role in non ca$!ule !train!7
All virulent !train! $roduceAll virulent !train! $roduce neuraminida!eneuraminida!e andandanan gA $rotea!egA $rotea!e
No e oto in!No e oto in!
http://medinfo.ufl.edu/year2/mmid/bms5300/images/d7128.jpg8/9/2019 Legionella Bordetella Haemophilus
43/48
.ib con ugate vaccine P P ca$!ule7.ib con ugate vaccine P P ca$!ule7
%#e .ib con ugate vaccine doe! not $rotect%#e .ib con ugate vaccine doe! not $rotectagain!t nonty$eable !train!(again!t nonty$eable !train!(
Per!on! at ri!= "or inva!ivePer!on! at ri!= "or inva!ive H in#luen$ae H in#luen$ae di!ea!edi!ea!e A!$leniaA!$lenia
mmunocom$romi!edmmunocom$romi!ed
Pat#ogene!i! .o!t /actor!Pat#ogene!i! .o!t /actor!
8/9/2019 Legionella Bordetella Haemophilus
44/48
Public .ealt# A!$ect o" ot#erPublic .ealt# A!$ect o" ot#er Haemophilus Haemophilus !train!!train!
H. ducre%i H. ducre%i e ually tran!mitted di!ea!e 8 c#ancroide ually tran!mitted di!ea!e 8 c#ancroid
H. in#luen$ae H. in#luen$ae biogrou$biogrou$ aeg%ptiusaeg%ptius Bra'ilian Pur$uric /everBra'ilian Pur$uric /ever
H. aeg%ptius H. aeg%ptius
HH
$in= eyeI $urulent con unctiviti!7$in= eyeI $urulent con unctiviti!7
H. aphrophilus H. aphrophilus $neumonia$neumonia n"ective endocarditi!n"ective endocarditi!
8/9/2019 Legionella Bordetella Haemophilus
45/48
Haemophilus Haemophilus in#luen$aein#luen$ae biogrou$biogrou$ aeg%ptiusaeg%ptius
Bra'ilian $ur$uric "ever in c#ildrenBra'ilian $ur$uric "ever in c#ildren
.ig# "ever.ig# "ever eat# )it#in 4J #our!eat# )it#in 4J #our!
8/9/2019 Legionella Bordetella Haemophilus
46/48
Case StudyCase Study HistoryHistory
13 year old white male13 year old white male fully vaccinatedfully vaccinated cold-like symptoms and persistentcold-like symptoms and persistent
cough- 10 days durationcough- 10 days duration 2 weeks later2 weeks later
progressive coughing spells withprogressive coughing spells withinspiratory whoopinspiratory whoop
posttussive vomitingposttussive vomiting
8/9/2019 Legionella Bordetella Haemophilus
47/48
Case StudyCase Study
%e!t!%e!t! Na!o$#aryngeal !)ab!Na!o$#aryngeal !)ab!
Bordet8GengouBordet8Gengou mediummedium
Blood !am$le! "or !erologyBlood !am$le! "or !erology $o!itive gM and gA antibodie!$o!itive gM and gA antibodie!
%reatment%reatment
a'it#romycina'it#romycin
8/9/2019 Legionella Bordetella Haemophilus
48/48
Case StudyCase Study
HistoryHistory 4 month old white female4 month old white female 1 day history1 day history
10310300
fever, lethargy, irritability, stiff neckfever, lethargy, irritability, stiff neck TestsTests
Cerebral spinal uid cultureCerebral spinal uid culture !o@itale?8enric#ed!o@itale?8enric#ed c#ocolate agarc#ocolate a gar
Recommended