Cases in Medical Microbiology and Infectious Diseases. Melissa B. Miller

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Actinomyces spp. Anaerobic, Gram-positive bacilli Endogenous PID^a associated with intrauterine device usage Aerococcus spp. Catalase-negative, Gram-positive cocci Endogenous Community- or health care-associated UTI^b Bacteroides fragilis Anaerobic, Gram-negative bacillus Endogenous Pelvic abscess Chlamydia trachomatis Obligate intracellular pathogen (does not Gram stain) Direct sexual contact Urethritis, cervicitis, PID Enterobacter spp. Lactose-fermenting, Gram-negative bacilli Endogenous Community- or health care-associated UTI Enterococcus spp. Catalase-negative, Gram-positive cocci Endogenous Health care-associated UTI Escherichia coli Lactose-fermenting, Gram-negative bacillus Endogenous Community- or health care-associated UTI Haemophilus ducreyi Fastidious, pleiomorphic, Gram-negative bacillus Direct sexual contact Chancroid (painful genital ulcer) Klebsiella pneumoniae Lactose-fermenting, Gram-negative bacillus Endogenous Community- or health care-associated UTI Morganella morganii Lactose-nonfermenting, Gram-negative bacillus Endogenous Community- or health care-associated UTI Mycoplasma hominis Lacks a cell wall (does not Gram stain) Endogenous; direct sexual contact Pyelonephritis, PID Neisseria gonorrhoeae Gram-negative, intracellular diplococcus Direct sexual contact Urethritis, cervicitis, PID Proteus mirabilis Lactose-nonfermenting, swarming, Gram-negative bacillus Endogenous Community- or health care-associated UTI Pseudomonas aeruginosa Lactose-nonfermenting, Gram-negative bacillus Catheterization Health care-associated UTI Staphylococcus saprophyticus Catalase-positive, Gram-positive coccus Endogenous Community-associated UTI Treponema pallidum Spirochete (does not Gram stain) Direct sexual contact; vertical, mother to child Chancre (painless genital ulcer); primary, secondary, tertiary syphilis; neonatal syphilis Ureaplasma urealyticum Lacks a cell wall (does not Gram stain) Endogenous; direct sexual contact Urethritis, urethroprostatitis, epididymitis, chorioamnionitis Fungi Candida spp. Yeasts with pseudohyphae Endogenous Vaginitis, health care-associated UTI, balanitis Parasites Phthirus pubis Crab lice Direct sexual contact Pubic hair infestation Trichomonas vaginalis Protozoan Direct sexual contact Vaginitis Viruses Adenoviruses Nonenveloped DNA viruses Exogenous exposure Hemorrhagic cystitis Herpes simplex viruses (HSV-1 and -2) Enveloped DNA viruses Direct sexual contact; vertical, mother to child Recurrent genital ulcers, fetal/neonatal infections, encephalitis Human immunodeficiency viruses (HIV-1 and -2) Retroviruses Direct sexual contact; blood and body fluids; vertical, mother to child AIDS, neonatal infection, dementia Human papillomavirus Nonenveloped DNA virus Direct sexual contact Genital warts, cervical and anal carcinoma

^a PID, pelvic inflammatory disease.

^b UTI, urinary tract infection.

      CASE 1

The patient was a 19-year-old female with a history of a urinary tract infection (UTI) 4 months prior to admission for which she was treated with oral ampicillin without complications. Five

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