Aerobic Fastidious Gram-Negative Bacilli

No.

Micro.

Disease

Meningitis

Haemophilus influenzae
Epiglottitis

H. ducreyi

Chancroid

Notes of
Disease
Similar to
other acute
bacterial
meningitis.
Suspected
epiglottitis is a
medical
emergency:
Prompt
recognition
and treatment
is critical.
Obstruction
of the airway
by the
inflamed
epiglottis.
Sometimes it
requires
tracheostomy
or endotracheal
intubation.
Sudden, with
fever, sore
throat,
hoarseness, an
often muffled
cough
Tripod
position.
Sexually
transmitted
infection
(STI).
More
common in
men.
Soft
chancre (in
contrast to
hard chancre
of syphilis):
Painful ulcer,
swelling and
tenderness.
Lymph nodes

Treatment

3rd generation
cephalosporins for
life-threatening
diseases
-lactam /lactamase inhibitor
Macrolides
TMP-SXT
Certain
fluoroquinolones

Prevention

Vaccination
against Hib:
Currently,
three
conjugate
vaccines are
available.
Postexposure
prophylaxis:
Rifampin.

Ceftriaxone or
Azithromycin
(single dose)

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Aerobic Fastidious Gram-Negative Bacilli

are enlarged
and painful.

Pasteurella

Local wound
infection (the most
common).
Pneumonia.
Systemic infection
(opportunistic).

Bordetella pertussis

Pertussis/Whoopin
g cough

Campylobacter

Enteritis

Penicillin
Cephalosporins,
macrolides,
tetracyclines, or
fluoroquinolones

IP: 7 10
(possible until
21 days)
Catarrhal
phase:
1 2 weeks.
Non-specific.
Paroxysmal
phase:
2 4 weeks.
Paroxysms
(sudden
attacks) of
cough:
+ Series of
uncontrollable
expirations -->
Gasping
inhalation,
whooping
sound.
Cyanosis.
Convalescent
phase:
Several
weeks to
months.
Finally, the
cough begins
to decrease.
Episodic
coughing may
reappear.

Macrolides:
Azithromycin in a
single dose for 5
days
Alternatives: TMPSXT
Supportive,
symptomatic.

Maybe the
most common

Antimicrobials:
NOT needed for

Initial
vaccines:
Killed wholecell pertussis
(included in
DTP
vaccines)
Current
vaccines:
Acellular
vaccines with
pertussis
antigens only:
Prn, FHA, PT.
Also included
in DTP
Postexposure
prophylaxis:
Antimicrobial
s for close
contacts of a
case.
Prevention
of pertussis in
infants:
Vaccination
of pregnant
women
during the
third trimester
and
reimmunizati
on in
subsequent
pregnancies
may be
necessary.

Page 2 of 4

Aerobic Fastidious Gram-Negative Bacilli

Helicobacter pylori

Gastritis.
Peptic ulcer
disease: Duodenal
ulcer.
Gastric cancer:
Adenocarcinoma.
MALT.
Legionnaires
disease

Legionella pneumophila
Pontiac fever

Brucella

Brucellosis

Francisella tularensis

Tularemia

cause of
bacterial
diarrhea
worldwide.
IP: ~3 days
(1 7 days)

Inflammatory
diarrhea:
Fever.
Lower
abdominal pain
that may be
severe.
Diarrhea.
Self-limited
after 3 to 5
days,

most cases
Options (3 days
treatment):
Fluoroquinolone
or
Macrolide

The most
common
chronic
bacterial
infection in
humans.

Triple therapy for

7 to 14 days:
Omeprazole,
Amoxicillin,
Clarithromycin.

Acute
pneumonia
similar to other
bacterial
pneumonias.
Self-limited
influenza-like
syndrome.
IP: 1 3
weeks.
Brucellosis is
a systemic
disease:
Malaise,
chills, sweats
in the evening.
High fever
>39.5C.
Undulant
fever.
Zoonosis
IP: 2 6 days
Tularemia:
Ulcero-

Macrolides
Fluoroquinolones
Tetracyclins
NOT require
antimicrobials.

Doxycycline +
gentamycin.
Doxycycline +
rifampin.

Aminoglycosides +
tetracyclines

Preexposure
prophylaxis
(vaccination):

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Aerobic Fastidious Gram-Negative Bacilli

glandular
tularemia: The
most common.
Pneumonic
tularemia:
Acquired by
inhalation:
+ Peribronchial
inflammation.
+ Pneumonitis.
Fever,
malaise,
headache, and
pain in the
involved
region and
regional lymph
nodes.

A live
attenuated
vaccine
exists.
Postexposure
prophylaxis:
Oral
ciprofloxacin
or
doxycycline.

Page 4 of 4