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Mycobacterium Tuberculosis
: . acid-fast . . ) ( ) ( carbolfuchsin ) 59% + 3% ( HCL . . : , 01 3 , ) ( . , , . . ) - (, .
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. ; Mycobacterium tuberculosis: culture identification " .Rough: colony isn't smooth but rough like breadcrumbs .Tough: colony stuck to plate well, and tough to remove .Buff: buff is a color, a cream/coffee shade :Mycosides
: 1- : Mycolic acid . 2- : Mycoside Mycolic . glicolipid 3- : Cord factor mycoside mycolic acid . trehalose ( Cord Factor = 2 mycolic acid + disaccharide( trehalose , , . ) ( cord factor ) ( mitochondria ) ( TNF = cachectin . . 4 : Sulfatides mycosides Sulfates . , . sulfatides 5- : Wax D mycoside )
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( . : . , : 1- : ) ( . , , , . )( ) ( . 2- : , T helper , , . , . , . : PPD test
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) (Type IV ) PPD ; Purified Protein ( Derivative , . . PPD ) , ( , , 1-2 . ) ( 01 84 ) IV (, 5 . , , . * : BCG ) Bacillus Calmette ( Guerim . * : PPD , ) ,(anergic .... .
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, ) ( , 84 . : ) ( . , . : ) ( 03% ,5% , 5% . 01% . : : 1( , . 2( : , . . , :1- : 2- .
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1( : . . . ) ( . .PPD ) (. : ) ,(Ghon Focus ) (Ghon or Ranke 2( : ) ( . : : . . : : . , . , HIV 01% HIV ) ( .
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: 01% . %01: HIV . : 1- : , , . . ) ( . 2- : . 3- : , , ) . ( Scrofula 4- : ) ( ) ( sterile pyria 5- : skeletal ) ( . poots disease 6- : . 7- : CNS .
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8- ; Miliary Tuberculosis ) ( ) ( . , , . : , , . : 1- ) :( PPD skin test . 2- ) : ( chest X-ray ) Ghon ( focus . 3- : . http://www.health.nsw.gov.au/resources/publichealth/infectious/tb/pdf/fa ctsheet_ara.pdf Streptococcus pneumoniae
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: Pneumococcus 73 2Co 5 - 51% Lancefield . : polysaccharide capsule 48 , 1 02 3 . : . : Pneumonia Meningitis Otitis media . . ) (Stiff neck .
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: 1- . 2- . 3- ) (. 4- . : Chills high fevers chest pain with respiration .shortness of breath .pus .white consolidated . : . :Optochin ! Optochin . . . ) quellung (reaction . : Penicillin Erythromycin \ Trimethoprim/Sulfamethoxazole .Chloramphenicol
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.Vancomycin : ) (Pneumovax 52 . ) (Asplenic . 7 4 6B 9V 41 18C 19F 23F . 001% 3 6B 9V 41 19F 23F .
Streptococcus pyogenes
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A -Group A Beta Hemolytic Streptococci Streptococcus Pyogenes Lancefield A
. : 5-1 ) ( )1(. 1 01% 2 Co . : ) .(Carrier
: :C Rebecca Lancefield . A .C : . :M 08 Opsonization . T : R M : F : . : : : Heamolysins 1- -anti streptolysin o ) .(ASO test 2- .
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) Pyrogenic exotoxin :(Erythrogenic toxin Scarlet Fever . Superantigen T .Inflammatory Cytokines Streptococcal Toxic Shock .Syndrome ) Streptokinase Plasmin ( Hyaluronidase DNAases Anti-C5a Peptidase C5a NADase : . : - : . 1. : . 2. : . - : . . rheumatic fever . Post-streptococcal Glomerulonephritis
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. : 1- . 2- . 3- . 4- . 5- . : ASO .Anti-DNA : .
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Streptococcal Classification
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: Streptococcus 2 Co 3 : ) ( . . ) (. ) C (. Lancefield ) A B C D ... E .(S Lancefield . Lancefield . Lancefield . 03 5 . : Lancefield Lancefield A B .D Lancefield :
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.3/http://www.umanitoba.ca/science/microbiology/staff/cameron/graphics 47hemolysis2.jpg Enterococcus & Group D Streptococci
Group D Streptococci D
. . : Streptococcus bovis , Streptococcus equinus : 5,6% . : . : . : .
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Enterococcus . : Enterococcus : Enterococcus faecalis ,Enterococcus durans : . . . 01 54 5.6 % .D . 06 03 . . . . . . Viridans Streptococcus
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Viridans Group Streptococci Streptococcus Salivaris S. Sanguis S. Mitis S. Intermedius S. Mutans
Oral Streptococci )( . : Sub-Acute Infective Endocarditis . heterogeneous .Lancefield
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Streptococcus Salivaris S. Sanguis S. Mitis S. Intermedius .S Mutans Oral Streptococci )( . : Sub-Acute Infective Endocarditis . heterogeneous .Lancefield : . . : :Dental Infections ) (S. Mutans . :Endocarditis ) subacute bacterial endocaritis (SBE ) ( low-grade fever fatigue anemia heart murmurs . acute infective endocarditis IV drug abuse
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.SBE Streptococcus pyogenes . Viridans Streptococci D Group D Streptococci .SBE
shaking chills high spiking fever . D Group D Streptococci .SBE
:Abscesses ) Streptococcus Intermedius group Streptococcus Intermedius S. Constellatus S. Anginosus microaerophilic . . .Bacteroides Fragilis : .CAT scan with contrast :Streptococcus InterMediUS IMmediately USses (asses) for ABSCESS .) Streptococcus agalactiae (Group B Strep
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: : . .
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. : 52% . : . Nursery . : .Irritability 1- : Meningitis Pneumonia Sepsis . : Pneumonia . : ) Stiff Neck (. : Lumbar .Puncture
. Escherichia Coli
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Listeria Monocytogenes B .Group B Strptococcus
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: : DNAase . . : . : * . * * . Micrococcus B
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: . . . ,Micrococcus luteus . : . . . . :Micrococcus roseus , Micrococcus varians
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1- . 2- . 3- ) (. 4- 5- 6- 7- ) ( . API Staph
Staphylococcus epidermidis , , . , . Glycolax . : - Continuous ambulatory peritoneal dialysis
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- . - . - - . Staphylococcus saprophyticus ) ( , )59%( ) ( . : . . . .DNAse staphylococcus saprophyticus .
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Staphylococci
Staphylococcus Gram positive ): Staphylococcus aureus subsp. anaerobius ) ( , 05% 02 : staphylococcus aureus staphylococcus epidermidis staphylococcus saprophyticus
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: , , . 1- : . 2- : , 2 H2O . 3- : ) ( . S.aureus coagulase positive . : ) ( ) (.
Neisseria
Neisseria , Neisseria flava , Neisseria mucosa
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Neisseria gonorrhoeae . Neisseria meningitidis
6- 1 31 A,B,C,X,Y,Z,29E,W-135,L,D,H,I,K A,B,C 531- Y, W 73 5 01% 2 Co : Nasopharynx carrier 5-02% .
1( Neisseria meningitidis
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09- 59% : . : . : 6- 42 01 02 : ) ( . . . : . : : ) (. Thayer-Martin VCN ) ( . VCN : :V :Vancomycin . :C: Colistin (Polimixin . :N: Nystatin 2 CO
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. : . : . . Sero-Group : . : . : A, C quadrivalent vaccine 531-A, C, Y, W . B C . . . 2( Neisseria gonorrhoeae Gonococcus Gonococcus 5 01% . : .
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Pili Pili . . : Gonorrhoea Venereal disease . . . : Purulent Discharge . : . : Ophthalmia Neonatorum .
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. : Vulvovaginitis urethritis anorectal . : Thayer-Martin VNC Selective medium . : . : . : : * Urethra . * ) (. : * endocervix . : :
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Transport Medium . : . . 3( : : 1 . 2 22 . 3 . 4- . 5 . :Neisseria flava Neisseria sicca Neisseria mucosa
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: . : * . * ) (. * . * 22 . * . * . staphylococcus aureus
:Morphology 5.0- 5.1
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1 4 42 . .capsule . : . catalase liquefy gelatin
. 51% . . : 1- : A Fc IgG . 2- : Coagulase . 3- : Hemolysins : , , , . 4- : Leukocidins . 5- : Pencillinase . 6- ) : ( PBP
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, . : 1-) Hyaluronidase ( : . 2- : Staphylokinase Streptokinase 3- : Lipase , . 4- : Protease . 5- :Deoxyribonuclease . : 1- :Enterotoxin . . . 2- Epidermolytic toxin or Exfoliatin :toxin Ritters disease
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) .(Staphylococcal Scalded Skin Syndrome SSSS 3- Toxic Shock Syndrome Toxin ) :(TSST diaphragm . : : , folliculitis abscess sutures intravascular catheters . : : septicaemia meningitis osteomylitis arthritis nephritis pneumonia empyema thrombophlebitis . .
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03% 05% . MRSA) Methicillin resistant Staphylococcus aueus (ORSA , ) (mecA-Gen ) ,Oxacillin .(Methicillin . : . : . .
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