Haemophilus Influenzae Overview

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Questions and Answers

The genus Haemophilus contains organisms that are small, gram-negative cocco-bacilli.

True (A)

What is the most common type of Haemophilus organism?

Haemophilus influenzae

All Haemophilus influenzae strains possess a capsule.

False (B)

What is the characteristic shape of Haemophilus influenzae?

<p>Gram-negative rod (coccobacillus)</p> Signup and view all the answers

Haemophilus influenzae is an obligate anaerobe.

<p>False (B)</p> Signup and view all the answers

What temperature range does Haemophilus influenzae prefer for growth?

<p>32-37 degrees Celsius</p> Signup and view all the answers

The capsule of Haemophilus influenzae is composed of protein.

<p>False (B)</p> Signup and view all the answers

Which of these serotypes for Haemophilus influenzae is considered the most virulent?

<p>Serotype b (B)</p> Signup and view all the answers

Haemophilus influenzae can enter the body through the gastrointestinal tract.

<p>False (B)</p> Signup and view all the answers

Which of the following is NOT a behavior associated with Haemophilus influenzae?

<p>Gastroenteritis (C)</p> Signup and view all the answers

What does Haemophilus influenzae produce that neutralizes respiratory mucosal IgA?

<p>IgA protease</p> Signup and view all the answers

Pili help Haemophilus influenzae attach to the respiratory mucosa.

<p>True (A)</p> Signup and view all the answers

What can occur after Haemophilus influenzae attaches to the respiratory mucosa and enters the bloodstream?

<p>Both Bacteremia and Meningitis (C)</p> Signup and view all the answers

The encapsulated forms of Haemophilus influenzae are responsible for the majority of severe infections.

<p>True (A)</p> Signup and view all the answers

Non-encapsulated forms of Haemophilus influenzae are commonly associated with which infections?

<p>Otitis media, sinusitis, and pneumonia</p> Signup and view all the answers

The peak incidence of Haemophilus influenzae infections is in children between the ages of 6 months and 6 years.

<p>True (A)</p> Signup and view all the answers

What are two key virulence factors associated with Haemophilus influenzae?

<p>Polysaccharide capsule and endotoxin</p> Signup and view all the answers

Symptoms of Haemophilus influenzae meningitis are similar to those caused by meningococcal and pneumococcal meningitis, but with a slower onset.

<p>False (B)</p> Signup and view all the answers

Otitis media and sinusitis caused by Haemophilus influenzae are characterized by a lack redness and swelling in the affected areas.

<p>False (B)</p> Signup and view all the answers

Epiglottitis, a serious infection of the epiglottis, commonly occurs in older adults.

<p>False (B)</p> Signup and view all the answers

Pneumonia caused by Haemophilus influenzae is most prevalent in healthy young adults.

<p>False (B)</p> Signup and view all the answers

What type of agar is used to cultivate Haemophilus influenzae?

<p>Chocolate agar (B)</p> Signup and view all the answers

What two factors are found in chocolate agar that Haemophilus influenzae requires for growth?

<p>Factor X (haematin) and Factor V (NAD)</p> Signup and view all the answers

All Haemophilus species require both Factor X and Factor V for growth.

<p>False (B)</p> Signup and view all the answers

What is the appearance of Haemophilus influenzae colonies on chocolate agar?

<p>Greyish-white, small, and mucoid</p> Signup and view all the answers

What test is used for definitive diagnosis of encapsulated Haemophilus influenzae?

<p>Quellung test</p> Signup and view all the answers

What drug is considered the first-line treatment for Haemophilus influenzae meningitis and other severe infections?

<p>Ceftriaxone</p> Signup and view all the answers

What is the typical treatment for Haemophilus influenzae otitis media and sinusitis?

<p>Co-amoxiclav</p> Signup and view all the answers

The Hib vaccine is a conjugated vaccine.

<p>True (A)</p> Signup and view all the answers

What is the recommended age range for the Hib vaccine?

<p>2-15 months</p> Signup and view all the answers

Conjugated vaccines are less effective than unconjugated vaccines.

<p>False (B)</p> Signup and view all the answers

What drug is given to close contacts of individuals with Haemophilus influenzae infections?

<p>Rifampicin</p> Signup and view all the answers

What is the most important causative agent for whooping cough?

<p>Bordetella pertussis</p> Signup and view all the answers

Bordetella pertussis is a large bacterium.

<p>False (B)</p> Signup and view all the answers

Bordetella pertussis is a gram-positive coccobacillus.

<p>False (B)</p> Signup and view all the answers

Bordetella pertussis is a strict anaerobe.

<p>False (B)</p> Signup and view all the answers

Bordetella pertussis easily survives for long periods outside the human respiratory tract.

<p>False (B)</p> Signup and view all the answers

Bordetella pertussis is oxidase and catalase negative.

<p>False (B)</p> Signup and view all the answers

What protein is found in the pili of Bordetella pertussis?

<p>Filamentous haemagglutinin (fha)</p> Signup and view all the answers

Bordetella pertussis is spread through direct contact.

<p>False (B)</p> Signup and view all the answers

Whooping cough is a highly contagious disease.

<p>True (A)</p> Signup and view all the answers

Whooping cough is primarily a disease of adults.

<p>False (B)</p> Signup and view all the answers

Bordetella pertussis does not directly invade cells.

<p>True (A)</p> Signup and view all the answers

What are the major virulence factors associated with Bordetella pertussis?

<p>Filamentous haemagglutinin, pertussis toxin, and tracheal cytotoxin</p> Signup and view all the answers

Pertussis toxin is a single antigen associated with tissue damage.

<p>True (A)</p> Signup and view all the answers

The B subunit of pertussis toxin binds to receptors and allows entry of the whole toxin.

<p>False (B)</p> Signup and view all the answers

The A subunit of pertussis toxin inhibits adenylate cyclase.

<p>False (B)</p> Signup and view all the answers

Adenylate cyclase can inhibit the bactericidal activity of phagocytes.

<p>True (A)</p> Signup and view all the answers

Tracheal cytotoxin is a component of the bacterial flagella.

<p>False (B)</p> Signup and view all the answers

Tracheal cytotoxin leads to an increase in nitric oxide production.

<p>True (A)</p> Signup and view all the answers

What is the type of inflammation affecting the upper respiratory tract that describes the early stage of whooping cough?

<p>Acute tracheobronchitis</p> Signup and view all the answers

The paroxysmal stage of whooping cough is characterized by a mild cough.

<p>False (B)</p> Signup and view all the answers

The convalescent stage of whooping cough typically resolves within a week.

<p>False (B)</p> Signup and view all the answers

Bordetella pertussis can be isolated from nasopharyngeal swabs.

<p>True (A)</p> Signup and view all the answers

Direct fluorescent-antibody staining is not a reliable method for diagnosing Bordetella pertussis.

<p>False (B)</p> Signup and view all the answers

Erythromycin is a common treatment for Bordetella pertussis.

<p>True (A)</p> Signup and view all the answers

Prevention of whooping cough is primarily achieved through use of anti-viral medications.

<p>False (B)</p> Signup and view all the answers

Flashcards

Haemophilus

A genus of bacteria known for its small, gram-negative, cocco-bacillary shape.

Haemophilus influenzae

The most common species of Haemophilus responsible for various infections.

Capsule (Haemophilus influenzae)

Capsular structure present in some strains of Haemophilus influenzae.

Capsulated Haemophilus influenzae

The presence of a capsule in Haemophilus influenzae.

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Non-capsulated Haemophilus influenzae

Haemophilus influenzae strains without a capsule.

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Serotypes of Haemophilus Influenzae

Distinct types of Haemophilus influenzae based on their capsule structure.

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Serotype b (Haemophilus influenzae)

The most virulent serotype of Haemophilus influenzae.

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Respiratory Tract Entry (Haemophilus influenzae)

The ability of Haemophilus influenzae to enter the body through the respiratory tract.

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Asymptomatic Colonization (Haemophilus influenzae)

Haemophilus influenzae dwelling in the respiratory tract without causing symptoms.

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Infections (Haemophilus influenzae)

Infections caused by Haemophilus influenzae, such as sinusitis, otitis media, or pneumonia.

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IgA Protease (Haemophilus influenzae)

An enzyme produced by Haemophilus influenzae that breaks down IgA, a type of antibody in the respiratory system.

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Pilli (Haemophilus influenzae)

Hair-like structures on Haemophilus influenzae that help it attach to the respiratory mucosa.

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Bloodstream Entry (Haemophilus influenzae)

The ability of Haemophilus influenzae to spread from the respiratory tract to the bloodstream.

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Bacteremia (Haemophilus influenzae)

Infection of the bloodstream caused by Haemophilus influenzae.

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Meningitis (Haemophilus influenzae)

Inflammation of the membranes surrounding the brain and spinal cord caused by Haemophilus influenzae.

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Serotype b (Meningitis and Bacteremia)

Serotype b of Haemophilus influenzae is the most common cause of these diseases.

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Non-capsulated (Otitis Media, Sinusitis, Pneumonia)

Non-capsulated Haemophilus influenzae are commonly responsible for these infections.

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High Risk Age Group (Haemophilus influenzae)

The age group most vulnerable to Haemophilus influenzae infections.

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Peak Incidence Age (Haemophilus influenzae)

The peak age range for infections caused by Haemophilus influenzae.

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Virulence Factors (Haemophilus influenzae)

Factors that contribute to the virulence of Haemophilus influenzae.

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Polysaccharide Capsule (Haemophilus influenzae)

The outer layer of Haemophilus influenzae, contributing to its ability to cause disease.

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Endotoxin (Haemophilus influenzae)

A toxin released by Haemophilus influenzae that contributes to its disease-causing potential.

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Meningitis

Inflammation of the membranes surrounding the brain and spinal cord.

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Otitis Media

Infection and inflammation of the middle ear.

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Sinusitis

Infection and inflammation of the sinuses.

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Pneumonia

Infection of the lungs, often causing coughing, fever, and difficulty breathing.

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Septic Arthritis

Inflammation of the joints, often caused by an infection.

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Cellulitis

An infection of the skin and tissues beneath the skin.

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Sepsis

A serious condition characterized by widespread infection throughout the body.

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Epiglottitis

Inflammation of the epiglottis, a flap of tissue at the back of the throat.

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Gram Staining

A method of identifying Haemophilus influenzae using a microscope.

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Chocolate Agar

A type of culture medium used to grow Haemophilus influenzae.

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Factor X (Haematin)

A factor required for the growth of Haemophilus influenzae, found in chocolate agar.

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Factor V (NAD)

A factor required for the growth of Haemophilus influenzae, found in chocolate agar.

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Quellung Test

A test used to identify encapsulated Haemophilus influenzae by observing the capsule's swelling in the presence of specific antibodies.

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Ceftriaxone

A type of antibiotic used to treat serious Haemophilus influenzae infections, such as meningitis.

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Co-amoxiclav

A combination antibiotic used to treat Haemophilus influenzae infections, particularly otitis media and sinusitis.

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Vaccination (Haemophilus influenzae)

The use of vaccines to prevent Haemophilus influenzae infections.

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Hib Vaccine

A vaccine used to protect individuals from Haemophilus influenzae infections.

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Conjugated Vaccine (Hib)

A type of vaccine where the antigen (the part that triggers an immune response) is linked to a carrier protein to enhance its effectiveness.

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Rifampicin

An antibiotic that can be given to people who have been in close contact with someone infected with Haemophilus influenzae.

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Bordetella

A genus of bacteria that includes several species, with B. pertussis being the most important in causing whooping cough.

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Bordetella pertussis

The primary species of Bordetella responsible for causing whooping cough.

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Bordetella parapertussis, Bordetella bronchoseptica

Other species within the Bordetella genus that can cause respiratory infections, although less common than B. pertussis.

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B. pertussis Morphology

The size and shape of Bordetella pertussis bacteria.

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Encapsulated (Bordetella pertussis)

Presence of a capsule in Bordetella pertussis bacteria.

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Obligate Aerobe (Bordetella pertussis)

Bordetella pertussis requires oxygen to survive and grow.

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Environmental Susceptibility (Bordetella pertussis)

The susceptibility of Bordetella pertussis to environmental changes and its short survival time outside the human respiratory tract.

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Oxidase and Catalase Positive (Bordetella pertussis)

Enzymes produced by Bordetella pertussis that indicate its presence.

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Pilli (Bordetella pertussis)

Hair-like structures on the surface of Bordetella pertussis bacteria.

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Filamentous Hemagglutinin (fha)

A protein found in the pilli of Bordetella pertussis, essential for its attachment to the respiratory tract.

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Spread (Bordetella pertussis)

The spread of Bordetella pertussis through droplets released from the infected person.

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Contagious (Bordetella pertussis)

The high infectivity of Bordetella pertussis, capable of infecting almost all susceptible individuals exposed to it.

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Strict Human Pathogen (Bordetella pertussis)

The restriction of Bordetella pertussis to human hosts for survival and growth.

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Primary Target (Bordetella pertussis)

The main population affected by Bordetella pertussis infections, primarily infants and young children.

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Attachment (Bordetella pertussis)

The attachment of Bordetella pertussis to the respiratory mucosa, facilitated by filamentous hemagglutinin (fha).

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Cilia Damage (Bordetella pertussis)

The damage caused by Bordetella pertussis to ciliated cells in the respiratory tract, leading to their eventual breakdown and removal.

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Non-invasive (Bordetella pertussis)

Bordetella pertussis does not invade cells or spread to deeper tissues, instead causing damage through toxins it produces.

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Pertussis Toxin (Bordetella pertussis)

A toxin produced by Bordetella pertussis, responsible for local tissue damage and inflammation in the respiratory tract.

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B Subunit (Pertussis Toxin)

The subunit of pertussis toxin that binds to target cells, allowing the toxin to enter the cell.

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A Subunit (Pertussis Toxin)

The subunit of pertussis toxin that activates adenylate cyclase within the host cell, leading to inhibition of phagocytosis.

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Extracellular Adenylate Cyclase (Bordetella pertussis)

An enzyme produced by Bordetella pertussis that can inhibit the activity of phagocytic cells, reducing their ability to fight infection.

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Tracheal Cytotoxin (Bordetella pertussis)

A fragment of the peptidoglycan of Bordetella pertussis that directly damages ciliated cells of the respiratory tract, contributing to whooping cough pathogenesis.

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Nitric Oxide (Bordetella pertussis)

A molecule involved in the immune response that can be released by inflammatory cells, like macrophages, in response to infection.

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Whooping Cough (Bordetella pertussis)

A serious respiratory infection caused by Bordetella pertussis, characterized by a distinctive coughing sound.

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Catarrhal Stage (Whooping Cough)

The initial phase of whooping cough, marked by mild upper respiratory tract symptoms.

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Paroxysmal Stage (Whooping Cough)

The phase of whooping cough characterized by severe coughing fits, extending to the lower respiratory tract.

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Convalescent Stage (Whooping Cough)

The final stage of whooping cough where the cough gradually lessens, although it may still persist for several months.

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Gram Staining (Bordetella pertussis)

A method used to identify Bordetella pertussis bacteria using a microscope.

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Bordett-Gengou Medium or Regan-Lowe

A culture medium specifically designed for growing Bordetella pertussis bacteria.

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Direct Fluorescent Antibody Staining (Bordetella pertussis)

Using fluorescent antibodies to identify Bordetella pertussis bacteria directly from nasopharyngeal specimens

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Polymerase Chain Reaction (Bordetella pertussis)

A laboratory test for detecting Bordetella pertussis DNA using polymerase chain reaction

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Erythromycin (Bordetella pertussis)

A type of antibiotic commonly used to treat Bordetella pertussis infections, reducing the bacterial load.

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Vaccination (Bordetella pertussis)

Protection against Bordetella pertussis infections through vaccination.

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Study Notes

Haemophilus Influenzae

  • Haemophilus organisms are small gram-negative coccobacilli
  • Haemophilus influenzae is the most common type
  • Some strains have a capsule
  • It is a gram-negative rod (coccobacillus)
  • Facultative anaerobe, grows best in CO2-enriched media
  • Temperature requirements 32-37 degrees Celsius
  • Has a polysaccharide capsule
  • Non-capsulated forms also exist
  • Six serotypes (a, b, c, d, e, f)
  • Serotype b is the most virulent type
  • Enters the body via the respiratory tract
  • Two types of behaviours: asymptomatic colonization and infections (e.g., sinusitis, otitis media, pneumonia)
  • Produces IgA protease which neutralizes respiratory mucosal IgA
  • Pili help in attachment to respiratory mucosa
  • Can enter the bloodstream and cause bacteremia and meningitis
  • 95% of encapsulated forms (type b) responsible for these diseases
  • Non-capsulated forms cause otitis media, sinusitis, and pneumonia
  • Children 6 months to 6 years are most prone to infection
  • Peak incidence is 6 months to 1 year
  • Virulence factors are the polysaccharide capsule and endotoxin
  • Meningitis similar to meningococcal and pneumococcal, but onset of symptoms including drowsiness is rapid
  • Otitis media and sinusitis cause pain, redness, and bulging of the tympanic membrane
  • Other complications include septic arthritis, cellulitis, sepsis, and rarely epiglottitis in young children. Pneumonia in elderly, especially those with chronic respiratory disease
  • Diagnosed by Gram staining and grown on chocolate agar (enriched with factors X and V)
  • Colonies are greyish-white, small, and mucoid
  • Definitive diagnosis with Quellung test

Bordetella Pertussis

  • The genus Bordetella contains seven species
  • Bordetella pertussis is the causative agent of whooping cough
  • Other important species include Bordetella parapertussis and Bordetella bronchiseptica
  • A tiny (0.5 to 1.0 µm), gram-negative cocco-bacillary rod
  • Encapsulated
  • Obligate aerobe
  • Very susceptible to environmental changes, survives a short time outside the human respiratory tract
  • Oxidase and catalase positive
  • Pili of cell wall contain filamentous haemagglutinin (fha)
  • Spreads via droplets produced by patients in the early stages of illness
  • Highly contagious, infecting 80-100% of exposed susceptible persons
  • Strict human pathogen, primarily a disease of infants and children
  • Attaches to respiratory mucosa with filamentous haemagglutinin (fha)
  • Bacteria immobilize cilia and progressively destroy ciliated cells
  • Doesn't directly invade or spread to deeper tissues, but produces toxins:
    • Pertussis toxin (exotoxin): single antigen, causes local tissue damage associated with inflammation
      • B subunit binds to cell receptors, "unlocks" cell entry of A subunit
      • A subunit activates adenylate cyclase, inhibiting phagocytosis
    • Extra-cytoplasmic adenylate cyclase; the enzyme inhibits phagocytic cells
    • Tracheal cytotoxin is a bacterial peptidoglycan fragment that damages ciliated cells
  • Tracheal cytotoxin and endotoxin cause nitric oxide to kill ciliated epithelial cells
  • Whooping cough is an acute tracheobronchitis, starts with mild upper respiratory symptoms, followed by severe paroxysmal cough, lasting 1-4 weeks
  • Occurs in three distinct stages:
    • Catarrhal stage: mild upper respiratory infection
    • Paroxysmal stage: extends to lower respiratory tract, severe cough
    • Convalescent stage: less severe cough, may persist months
  • Diagnosed by Gram staining, isolating from nasopharyngeal swabs during paroxysmal stage, using Bordet-Gengou or Regan-Lowe medium for culture, and direct fluorescent-antibody staining or polymerase chain reaction
  • Treated with erythromycin to reduce organisms in the throat and decrease risk of complications
  • Prevented by vaccination

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