Section I

Organisms causing Upper respiratory tract infections

I. BATERIA: Streptococcus pyogenes H. influenzae type b C. diphteriae Streptococcus pneumonae Bordetella pertussiss Fusobacteria& Borrelia

DISEAESE: Pharyngitis & tonsillitis Epiglottitis- sinusitis- otitis media Diphteria

Sinusitis & otitis media

Whooping cough Vincents angina

Organisms causing Upper respiratory tract infections

II.

VIRUSES

Rhinoviruses Coronaviruses

Adenoviruses

Parainfluenza viruses Enteroviruses

DISEASES Common cold Common cold Acute febrile pharyngitis & Pharygoconjuctival fever

Organisms causing Lower respiratory tract infections(Pneumonia)

I.Bacteria -Strept. Pneumonae -Staph. Aureus -H. Influenzae -Moraxella catarrhalis -Mycobacterium tuberculosis(T.B) -Gram ve bacilli
-Primary atypical pneumonia: 1- Mycoplasma pneumonae 2Chlamydia(psittaci,tra chomatis,pneumonae) 3- Coxiella burnetti (Q fever) 4-Legionella pneumophila

Organisms causing Lower respiratory tract infections(Pneumonia)

II. VIRUSES - Influenza type A, B virus -Respiratory Syncytial virus -Parainfluenza virus - Adenovirus - SARS CoV III.FUNGI - Asperigillus fumigatus - Candida albicans -Pneumocystitis jiroveci

Streptococcus pneumoniae
Gram

positive capsulated diplococci.

Laboratory diagnosis of lobar pneumonia

Specimens :
Sputum (pneumonia ) CSF (meningitis) Blood (bacteremia)

Gram smear of sputum from a case of pneumonia

Culture

:on blood agar ,incubated aerobically for 24 hours.

 Gram

stained film:Gram positive diplococci

Tests used to differentiate

pneumococci ,Viridans streptococci

Streptococcus pneumoniae
Optochin

sensitivity test sensitive. Bile solubility test positive . Inulin fermentation positive. Viulence in mice positive.

Alpha haemolytic colonies of

Optochin

Streptococcus pneumoniae

sensitive.

Streptococcus pnuemoniae
Optochin

sensitive

Typing of Pneumococci
Capsular

swelling test: 83 serotypes . The type of pnuemococcus is determined by its reaction with type specific sera .

Questions:
What

are the diseases produced by Pneumococcus? How can you diffrentiate betweem Pneumococci & Strept. Viridans?

Corynebacteria

Non pathogenic i.e, diphtheroids Normal flora of URT

Pathogenic C.diphtheriae

Toxigenic

Non-Toxigenic

Laboratory diagnosis of Diphtheria:

Specimens:

Throat swab Gram stained smear It should be differentiated from other causes of pseudomembrane on the tonsils: a) Diphteria : Gram +ve bacilli ,clubbing, intracellular granules, chinese letter writings ve results are common

b) Vincents angina:large numbers of fusiform bacilli and Borrelia vincenti.

c) oral thruth: Gram positive oval bodies of Candida albicans

d) Acute tonsillitis: Gram positive cocci in chain

Neissers stain: to detect metachromatic granules.

Culture:
A)

Loefflers serum slope: Enriched medium to demostrate morphology of C.diphterae .3 parts serum+ one part glucose broth Sterilized by INSIPISSATION (70-80 C) for 2 hrs for 3 successive days

 Mc

leods tellurite plate: A selective medium for C.diphterae - Bood agar + potassium tellurite - Inhibitory substance: Potassium tellurite As it inhibits other org. allowing only growth of C. diphterae, appears as BLACK colonies - (reduces tellurite to black tellurium)

 Blood

agar plate: Strept.pyogenes ( acute tonsillitis)

Incubate & examine

Loefflers

slope:

serum

Gram stained film

Typical morphology

 Mc

leods tellurite plate:

BLACK colonies

 Blood

agar plate: Beta haemolytic Strept. if the case is: - acute tonsillitis or - Combinecinfection ( diphteria & tosillitis)

Toxigenicity test
A)

Elecks test:

b) ELISA: Toxin detection.

c) PCR : Toxin gene detection.

Laboratory diagnosis of suspected carriers:

Specimen :nose and throat Swabs Pottasium tellurite Loefflers serum slope Gram stained film &

Toxigenicity tests