Med Micro Block 3

KNOW THESE RESPIRATORY TRACT INFECTIONS

• Causes of Pharyngitis:
  • Adenovirus
  • Coxsackie A16
  • Streptococcus pyogenes (GAS)
  • Fusobacterium necrophorum
  • Arcanobacterium hemolyticum
  • Candida Albicans
  • Epstein-Barr virus (HHV-4)

• Cause of Diphtheria — Corynebacterium diphtheria

• Cause of Mumps — Mumps Virus

• Causes of Sinusitis & Otitis Media:
  • Streptococcus pneumoniae
  • Haemophilus influenza
  • Moraxella catarrhalis

• Causes of Allergic Rhinitis:
  • Rhizopus species
  • Mucor species

• Causes of Common Cold:
  • Rhinovirus
  • Coronavirus
  • Adenovirus

• Cause of Flu — Influenza Virus (NOT Hemophilus influenzae!)

• Cause of Epiglottitis — Haemophilus influenza type b

• Cause of Whooping Cough — Bordetella pertussis

• Cause of Croup — Parainfluenza Virus

• Cause of Bronchitis/Bronchiolitis — Respiratory Syncytial Virus

• Cause of Tuberculosis — Mycobacterium tuberculosis

• Causes of Typical Pneumonias:
  • Strep pneumo
  • Staph aureus
  • Pseudomonas
  • Burkholderia cepacia
  • Klebsiella
  • E Coli, Proteus
  • Serratia

• Causes of Atypical Pneumonias:
  • Chlamydophila pneumoniae
  • Mycoplasma pneumoniae
  • Legionella pneumonia

• Causes of Regional Pneumonias:
  • Histoplasma
  • Coccidioides
  • Blastomyces

• Causes of Occupational Pneumonias:
  • Bacillus anthracis
  • Coxiella burnetti
  • Chlamydophila psittaci
  • Francisella tularensis

• Causes of Opportunistic Pneumonias:
  • Aspergillus
  • Actinomyces israelii
  • Cytomegalovirus (CMV)
  • Nocardia asteroides
  • Pneumocystis carinii

• Causes of Parasitic Pneumonias:
  • Ascaris lumbridoides
  • Strongyloides stercoralis
  • Paragonimus westermani

• Other horrible respiratory infections to know:
  • Pneumonic Plague — Yersinia pestis
  • SARS — Coronavirus
  • Hantavirus Pulmonary Syndrome — Hantavirus

KNOW THESE URINARY TRACT INFECTIONS

• Causes of Non-STD Urethritis/Cystitis:
  • Staph sapro
  • E Coli
  • Proteus
  • Enterococcus fecalis
  • Pseudomonas

• Causes of STD Urethritis/Cervicitis:
  • Herpes simplex virus
  • Neisseria gonorrhea
  • Chlamydia trachomatis
  • Ureaplasma urealyticum
  • Trichomonas vaginalis

• Causes of Renal Stenosis:
  • BK Virus

• Causes of Vaginitis:
  • Trichomonas vaginalis
  • Candida albicans

• Causes of Bacterial Vaginosis (NOT Vaginitis) — Gardnerella

• Causes of Pelvic Inflammatory Disease:
  • Chlamydia trachomatis
  • Neisseria Gonorrhea

• Causes of Mucous Membrane Lesions
  • Treponema pallidum
  • Haemophilus ducreyi
  • Klebsiella granulomatis
  • Chlamydia trachomatis L1-L3
  • Herpes simplex virus
  • Human papilloma virus

KNOW THESE WORD ASSOCIATIONS FOR UPPER RESPIRATORY INFECTIONS

• Non-exudative pharyngitis — ARDS, Adenovirus
• ARDS — Adenovirus
• Swimming pool — Adenovirus
• Pharyngoconjunctival fever — Adenovirus
• Military recruits — Adenovirus
• Herpangina — Coxsackie A16 — mouth blisters + fever + sore throat
• Pharyngitis with Petechial Hemorrhages on Pharynx — Strep pyogenes
• Pharyngitis with Fatigue and Splenomegaly — Mononucleosis — Epstein Barr Virus
• Pharyngitis with gingivitis — Fusobacterium
• Pharyngitis with Exanthem — Arcanobacterium
• Oral Thrush — Candida albicans
• Rheumatic Fever and Glomerulonephritis Sequelae — Strep pyogenes
• BBL PYR test positive — Strep pyogenes
• Bacitracin sensitive — Strep pyogenes
• Infects B cells — HHV-4 (Epstein-Barr virus) (remember HHV-6 Roseola infects B/T cells)
• Downey cells — Epstein-Barr virus — abnormal T cells that engulf the infected B cells
• Heterophile Positive — Epstein-Barr virus
• Jones Criteria — Rheumatic fever — criteria for diagnosis
• If Strep pyogenes not treated within ten days — Rheumatic Fever (Type II hypersensitivity)
• Fever, Rash, Carditis, Arthritis — Rheumatic fever
• Pharyngitis in young kids — Coxsackie
• Butyric Acid — Fusobacterium necrophorum
• Buttery odor — Fusobacterium necrophorum — pharyngitis
• Lemierre syndrome — Fusobacterium — pharyngitis breaks off, lodge in brain, ischemia.
• Neuraminidase — Thins the exudate — Arcanobacterium, Strep pneumo, Influenza virus
• Phospholipase D — Arcanobacterium haemolyticum — damages tissue by acting on sphingomyelin
• Diphteria — Corynebacterium diphtheriae
• Chinese Letter grouping — Corynebacterium diphtheriae
• Only harmful when gene carried by bacteriophage — Corynebacterium diphtheriae
• Iron-dependent transcription of toxin — Diphtheria toxin gene encoded by Corynebacteriophage
• Disease caused by toxin only — Diphtheria
• Pseudomembrane — Diphtheria — formed by exudate filled with neutrophils, obstructing breathing.
• Bull Neck — Diphtheria — Periglandular edema
• Perforation of Soft Palate — Corynebacterium diphtheria
• Gray-black colonies on Cysteine-Potassium Tellurite Medium — Corynebacterium diphtheria
• Black colonies on Cysteine-Potassium Tellurite Medium — Staph aureus
• F peplomer only — Respiratory Syncytial Virus (vs. mumps, measles, parainfluenza)
• Parotitis — Mumps — swelling of parotid glands
• Orchitis — Mumps — swelling of testes or ovaries
• Symptoms a lot like RSV — Mumps
• Hemadsorption positive — Mumps (because of H peplomer for hemagluttinin)
• Hemadsorption negative — RSV
• Otitis Media — Strep pneumo, H. influenza, Moraxella catarrhalis
• Most Common Cause of Otitis Media — Strep pneumo
• DNAse Positive — Moraxella catarrhalis (vs. Neisseria)
• Beta-lactamase positive — Moraxella (so penicillin-resistant)
• Inhalation of Sporangiospores — Rhizopus, Mucor
• Rotting fruit, Old bread — Rhizopus, Mucor
• Risk factor for Mucormycosis — Diabetic ketoacidosis
• Allergic Rhinitis — Rhizopus and Mucor (allergic runny nose)
• Fatal Allergic Rhinitis — Rhinocerebral mucormycosis — Rhizopus and Mucor fungi. nasal mucosa –> orbits –> brain
• Branch at 90° — Mucor
• Rhizoids, no branching — Rhizopus
• No
• Rhizoids — Mucor
• Coenocytic hyphae (aseptate) — Rhizopus and Mucor
• Branch at 45° — Aspergillus
• Mycosel Agar — pathogenic fungi (i.e. rhizopus, mucor) because fo chloramphenicol and cyclohexamide
• Cold + Otitis media — Rhinovirus
• Cold + diarrhea — Coronavirus
• Cold + nothing else — Adenovirus
• Resistant to drying — Rhinovirus
• Cold in summer/fall — Rhinovirus
• Cold in winter/spring — Coronavirus
• Cold all year — Adenovirus
• Cold caused by enveloped virus — Coronavirus
• ssRNA replicates in nucleus — Influenza virus
• Segmented Genome — Influenza virus, Hantavirus
• HA and NA — Influenza (hemagglutinin and neuraminidase)
• Fever, Myalgia (NO CONGESTION) — Flu
• Tamiflu (Oseltamivir) — Treat Flu — Neuraminidase inhibitor for A and B Strains
• Flu vaccine that induces IgA, IgG, and Secretory IgA — Nasal-spray Flu (vs. Flu shot)
• Drift — point mutations — epidemics
• Shift — reassortment of genome — pandemics
• Epiglottitis — Hemophilus influenza b
• Thumb sign — Epiglottitis — Hemophilus influenza b
• Sulfonamide + trimethoprim — treatment for Hemophilus influenza
• Muffled Voice, Stridor, Drooling — Epiglottitis
• Whooping Cough — Bordetella pertussis
• Mucus Accumulates in airways –> uncontrollable cough — Whooping Cough
• Filamentous hemagglutinin — Bordetella pertussis — lets bacteria adhese to cell
• Toxin that causes Hypoglycemia, Lymphocytosis, Histamine Sensitivity — Pertussis Toxin
• Toxin that destroys cilia — Tracheal cytotoxin in Bordetella pertussis (Whooping cough)
• Catarrhal, Paroxysmal, Convalescent stages — Bordetella pertussis (Whooping cough)
• Charcoal-Cephalexin Blood Agar (CCBA) — Bordetella pertussis
• Bordet-Gengou Culture — Bordetella pertussis
• Regan-Lowe — Bordetella pertussis
• Nicotinic acid, charcoal, starch needed for culture — Bordetella pertussis (N support growth, C S remove fatty acids)
• AB Toxin — Diphtheria toxin, Pertussis toxin, Anthrax
• Croup — Parainfluenza virus
• Obstruction in Larynx — Croup – parainfluenza virus
• Raspy cough, voice — Croup – parainfluenza virus
• Seals Bark Cough — Croup – parainfluenza
• Steeple Sign — Croup – parainfluenza
• HAI Test — Hemagglutination Inhibition Test, for Mumps and Croup (because have H, F)
• Red Button — no agglutination, positive sign on HAI
• Croup Tent — Parainfluenza virus treatment, using humidification
• Bronchitis — RSV (Respiratory Syncytial Virus)
• Everyone infected by age 3 — RSV (Respiratory Syncytial Virus)
• Sloughing of cells plug bronchioles — Bronchitis – RSV
• Substernal Retractions — RSV, due to lower respiratory tract obstructions
• Bronchodilators, Ribavirin — Bronchitis – RSV
• Prophylaxis, Palviizumab — RSV prevention

WORD ASSOCIATIONS FOR LOWER RESPIRATORY INFECTIONS (PNEUMONIA)

• Quorum Sensing — Strep pneumo (so it can integrate antibiotic resistance genes)
• Lobar pneumonia — Strep pneumo (affect lobes, not whole lung)
• Thin Sputum — due to neuraminidase — strep pneumo, h. influenza
• Congestion –> Red hepatization –> Gray hepatization –> Resolution — Strep pneumo
• Typical Pneumonia — extracellular
• Atypical Pneumonia — intracellular
• Panton-Valentine Leukocidin (PVL) — Staph aureus (pore formation in host cell –> necrotizing pneumonia) from phage.
• Necrotizing pneumonia — Staph aureus
• Bilateral Bronchopneumonia — Pseudomonas
• Proteins A, S, F — Staph aureus (S and F are superantigens)
• Pus in naturally-existing cavity — Empyema (vs. Abscess, which is pus in a newly-formed cavity)
• Empyema — Staph aureus
• Sticky sputum — pseudomonas (due to biofilm)
• Pneumonia in COPD or CF patients — Pseudomonas, Burkholderia
• Pseudomonas-like pneumonia with NO PIGMENT — Burkholderia
• API Strips — lab test used to differentiate Gram negative bacilli
• Don’t use bacteriocidal due to exotoxins (can lead to shock) — E. Coli
• R-plasmids (Resistance plasmids) — Klebsiella pneumoniae, Serratia marcescens
• Red Pigment — Serratia
• Large Polysaccharide capsule — Klebsiella
• Currant Jelly Sputum — Klebsiella, thick, blood mucus due to large polysaccharide capsule
• Pneumonia in homeless, alcoholics, diabetics — Klebsiella
• Indole negative — Klebsiella (vs. E. coli)
• Bulging Fissure sign on chest x-ray (Lobar consolidation) — Klebsiella
• Pneumonia with non-motile bacteria — Klebsiella
• Pneumonia with very flagellated bacteria — Proteus
• Urease-positive pneumonia — Proteus (remember nocardia is urease-positive pustule). causes kidney stones
• Concentric rings of colonization — Proteus (spreads, due to swarming flagella)
• DNAse, Lipase, Gelatinase — Serratia
• Lactose-nonfermentor
• s — Pseudomonas, Salmonella, Proteus
• Atypical pneumonia in young adults (<40) — Mycoplasma pneumoniae Atypical pneumonia in middle aged adults or smokers — Legionella pneumophila Atypical pneumonia in elderly — Chlamydophila pneumoniae Requires iron and cysteine for growth — Legionella Infects alveolar macrophages/monocytes — Legionella pneumophila Reservoir in amebas — Legionella Pontiac Fever — Legionella (most get pontiac, some get legionnaire’s disease) — just fever, no pneumonia Atypical pneumonia with watery diarrhea — Legionnaire’s disease — Legionella Walking Pneumonia — Mycoplasma pneumoniae Atypical pneumonia + Rhonchi + Reynaud’s phenomenon — Mycoplasma (due to cold agglutination) Fried-Egg or Mulberry appearance — Mycoplasma pneumoniae Atypical Pneumonia + ciliostasis — Mycoplasma pneumoniae (due to P1 adhesin) P1 adhesion — Mycoplasma pneumoniae (causes ciliostasis) Cold agglutination in Serology — Mycoplasma Cell Wall-less Bacteria — Mycoplasma (NOT Mycobacteria, which as acid-fast cell wall) Requires cholesterol supplement on agar — Mycoplasma Massive bilateral infiltrates in Chest Xray — Chlamydophila (pneumoniae and psittaci) Buffered Charcoal Yest Extract Agar (BCYE) — Legionella (needs iron and cysteine for growth) Parrots — Chlamydophila psittaci — causes atypical pneumonia (because intracellular) Paired sera — Chlamydophila, Francisella, SARS Coronavirus Amino acid-based capsule (vs. polysaccharide) — Bacillus anthracis (poly-D-glutamyl capsule) — lets it evade phagocytosis Woolsorter’s Disease — Inhalation Antrax (vs. Eschar) — atypical pneumonia, widened mediastinum, spores go to lymph nodes –> lymphadenitis
• Widened mediastinum — Bacillus anthracis (Inhalation Anthrax/Woolsorter’s Disease)
• Only Gram negative with Spores — Coxiella burnetti
• Phase variation — Coxiella burnetti (Phase 1 infectious), Brucella
• Q fever — Coxiella burnetti — from sheep/cattle — atypical pneumonia, granuloma in liver (see large liver in xray)
• Weil-Felix Test Negative — Coxiella burnetti (agglutination negative)
• Ohio River, Mississippi River Valey — Histoplasma
• Southwest US, Central and South America — Coccidiodes immitis
• East of Mississippi river — Blastomyces dermatitidis
• Spores in Bat guano in soil — Histoplasma
• Macro/microconidia (spores on ground) –> Yeast (infectious intracellular) — Histoplasma
• Arthrospores (spores on ground) –> Spherules (infectious intracelluluar) — Coccidiodes
• Conidiophores (spores in air at room temp) –> Yeast (infectious EXTRACELLULAR at body temp) — Blastomyces
• Coin lesion, Caseating — Tuberculosis, Histoplasma (look like TB, so differentiate by looking for yeast in alveolar macrophages)
• Typical Regional Pneumonia — Blastomyces
• Broad-Based Budding Yeast — Blastomyces
• Regional Pneumonia affecting pregnant women — Coccidiodes (spherule grow faster with estradiol)
• Regional Pneumonia affecting more men — Blastomyces
• Valley Fever/Desert Rheumatism — Coccidiodes immitis (Coccidiodomycosis)
• Tricks body in thinking it is intracellular, so it brings in T-cell response, leading to granuloma — Coccidiodes immitis
• Pneumonia with Erythema multiforme and erythema nodosum and Flu-like symptoms — Coccidiodes immitis
• Pneumonia that disseminates to the skin and CNS (deadly) — Coccidiodes immitis, Nocardia asteroides
• Pneumocystic carinii pneumonia (PCP) — Pneumocystis jiroveci
• Extracellular but present as Atypical Pneumonia — Pneumocystis jiroveci (because exudate too thick to cough up)
• Kill alveolar epithelial cells — Pneumocystis jiroveci
• Popular among AIDS patients — Pneumocystis jiroveci
• Foamy Exudate — Pneumocystis jiroveci — due to serous exudate + dead epithelial + PMN
• Bronchoalveolar Lavage — Pneumocystis jiroveci — to wash out all that dead epithelial cells, thick exudate
• Cup-shaped organism — Pneumocystis jiroveci
• Ground-glass appearance — Pneumocystis jiroveci
• Won’t grow on agar, so use Calcofluor white stain — Pneumocystis jiroveci
• Mycelium — Aspergillus
• Neutrophil deficient patients get it — Aspergillus
• Fungus balls — Aspergillus
• Air Crescent sign — show invasion of aspergillus in lung
• Fungal invasion of cavity left by TB — Aspergilloma
• Farmer’s Lung — Actinomyces israelii
• Purulent Sputum (pus) — Actinomyces israelii
• Opportunistic pneumonia that Typical — Actinomyces israelii
• Pneumonia that is unable to invade healthy cells, so stays opportunistic — Actinomyces israelii
• Abcesses in lung — Actinomyces israelii (like carbuncle in lung!), Nocardia asteroides
• Urease Positive — Nocardia (braziliensis and asteroides), Mycoplasma (Ureaplasma), Proteus. (Remember UR NO MY PRO)
• Kinyoun acid-fast stain — Nocardia asteroides
• Owl’s eye appearance — CMV
• Ganciclovir — CMV
• SARS — Coronavirus (usually in common cold)
• Bind to ACE 2 receptors — SARS Coronavirus
• nps1 — SARS Coronavirus — bind ribosome, interfering with mRNA translation
• Plague — Yersinia pestis
• Requires Amino Acids for growth — Yersinia pestis
• Plague via respiratory droplets — Pneumonic Plague (Yersinia pestis) — bloody sputum, productive cough, 90% mortality
• Plague via fleas — Bubonic plague (Yersinia pestis) — painful swollen lymph nodes (buboes), bacteremia can lead to pneumonic plague, 75% mortality
• Plague with bloody sputum — Primary Pneumonic Plague (no progression from bubonic plague)
• Plague without palpable lymphadenopathy — Septicemic Plague
• Type III Secretion system — Yersinia pestis (like syringe)
• YOPs — Yersinia Outer Protein — cause apoptosis of host cell
• Plasminogen activator protease — Yersinia
• Field Mouse droppings (aerosolized) — Hantavirus
• Four Corners Region — Hantavirus
• Kill Native Americans — Hantavirus — Nonproductive cough, tachypnea, tachycardia, pulmonary edema, respiratory failure, death within days.
• Parasitic Pneumonias — Ascaris lumbricoides, Strongyloides stercoralis, Paragonimus westermani (ASK STRONG WESTERNERS)
• Parasitic pneumonia via fecal-oral — Ascaris
• Parasitic pneumonia via direct skin penetration — Strongyloides (Threadworm)
• Parasitic pneumonia via eating raw crustaceans — Paragonimus westermani
• See trails under skin — Strongyloides
• Loeffler’s Syndrome — pneumonia-causing worms — migrate through lungs, causing eosinophils to accumulate in lungs.
• Worms appear in sputum but NOT IN STOOL — Strongyloides (vs. others, where appear BOTH in sputum and stool)
• Lung Fluke — Paragonimus westermani
• Slow growing, intracellular, obligate aerobe — tuberculosis
• Niacin produced — tuberculosis
• Potts Disease — TB — infects vertebral disc –> collapse
• Scrofula — TB — swollen cervical lymph nodes in neck
• Lowenstein-Jensen media — Mycobacterium
• Positive PPD 5mm — immunocompromised, recent contact with TB
• Positive PPD 10mm — high prevalence countries, ppl in high-risk settings, IV-drug user, children under 4
• Positive PPD 15mm — healthy ppl with no known risk factors
• INH-SPIRE — drugs for TB — Isoniazid (INH) with B6 to prevent INH toxicity, Streptomycin, Pyrazinamide, (INH), rifampin, ethambutol
• DOT — Directly Observed Therapy — a way to make sure TB patients are adhe
• ring to treatment so TB won’t develop resistance
• MDR-TB — multi-drug resistant TB… so treat with fluoroquinolone, kanamycin
• XDR -TB — extremely drug resistant TB.

WORD ASSOCIATIONS FOR URINARY TRACT INFECTIONS

• Lack urgency or increased frequency to urinate — Urethritis
• Has urgency or increased frequency to urinate — Cystitis, pyelonephritis
• No discharge in urine — Cystitis
• Has discharge in urine — Urethritis
• Infected kidney — Pyelonephritis — increased urgency/frequency to urinate, nephrolithiasis (kidney stone), FEVER
• White blood cell in urine — pyuria
• H and P Fimbrae — E. Coli
• Fimbrae that contributes to Cystitis — H Fimbrae (HC PP)
• Fimbrae that contributes to Pyelonephritis — P Fimbrae (HC PP)
• Most common cause of UTI — E. Coli
• Coagulase negative Staph — Staph saprophyticus
• Non-mannitol fermenter Staph — Staph saprophyticus (so colorless on MSA)
• Urethritis due to overgrowht — Staph sapro (all others autoinoculation or sexual contact)
• Honeymoon Syndrome — Acute Urethral Syndrome due to Staph sapro with low bacterial count <10^5 Novabiocin resistant — Staph sapro Staghorn calculus on X-ray — Proteus, because it has urease, causing kidney stone Urethritis + Kidney Stone — Proteus, Ureaplasma (aka Mycoplasma), because both have urease. Renal Stenosis — BK Virus (“RSBK”) Renal Transplant, Immunocompromised are risk factors — BK Virus — Renal Stenosis BKAN — BK-associated nephropathy Tubulointerstitial nephritis (space between renal tubules) — BK Virus Fitz-Hugh-Curtis Syndrome — Neisseria gonorrhea or Chlamydia trachomatis –> fallopian tube –> liver –> Acute perihepatitis.
• Violin String adhesion — Fitz-Hugh-Curtis Syndrome — between liver and peritonium.
• Thick, green discharge cervicitis — Gonococcal Cervicitis — Neisseria gonorrhea
• Thin discharge cervicitis — Nongonococcal Cervicitis — Chlamydia trachomatis D-K
• Cell-Wall Less urethritis — Ureaplasma (aka Mycoplasma)
• A8 Agar — Ureaplasma (aka Mycoplasma) — MnSO4 on agar + Urease –> Golden Brown Pigment
• Golden Brown Pigment — Ureaplasma
• Acyclovir — Herpes Simplex Virus (Gancyclovir is for CMV)
• Protozoan Vaginitis — Trichomonas vaginalis
• Fungal Vaginitis — Candida albicans
• Bacterial Vaginosis (BV) — Gardnerella vaginalis
• Vaginitis STD — Trichomonas vaginalis
• Vaginitis due to overgrowth — Candida, Gardnerella
• Strawberry Cervix — Trichomonas — petechial hemorrhage on cervix
• Frothy Green-Yellow Discharge — Trichomonas vaginalis
• Basic Vaginal conditions increase growth — Trichomonas vaginalis
• “Baked Bread” odor — Candida albicans (vaginitis)
• “Cottage Cheese” discharge — Candida albicans (vaginitis)
• “Milk-like” vaginal discharge (THIN DISCHARGE) — Gardnerella vaginalis (Bacterial vaginosis)
• “Fishy Odor” in Whiff test — Gardnerella — KOH liberates amine-like odor
• Clue Cells — Gardnerella — bacteria adhering to epithelial cell surface is clue for diagnosis.
• Serovars D through K — Chlamydia trachomatis that causes urinary tract infections
• Serovars L1-L3 — Chlamydia trachomatis that causes genital mucous membrane lesions
• Capnophile — Need CO2 — Hemophilus ducreyi
• PAINFUL ragged ulcers on genitals — Hemophilus ducreyi — Chancroid (“Do Cry”)
• Chancroid — Hemophilus ducreyi — PAINFUL (“Do Cry”)
• PAINLESS soft ulcer on genitals — Chlamydia trachomatis L1-L3
• Lymphogranuloma venereum — Chlamydia trachomatis L1-L3 — inguinal lymphadenopathy
• Groove sign — Chlamydia trachomatis L1-L3 — parallel lesions in groin
• Granuloma venereum — Klebsiella granulomatis — red, painless ulcers on genitals
• Donovan Bodies — Klebsiella granulomatis
• Syphilis — Treponema pallidum
• Lack surface antigens — Treponema pallidum — so very stealthy
• Gummas — Treponema pallidum — granulomatous lesions all over body caused by immune reaction, TERTIARY STAGE of syphilis
• Aortitis — cardiovascular syphilis
• Condyloma lata — Treponema pallidum — SECONDARY STAGE of syphilis (smooth, moist, flat lesions all over body)
• Rash on palms of hands and feet — Treponema pallidum
• tabes dorsalis — neurosyphilis — can’t coordinate walking.