 Welcome back to our meds smarter lecture series where we're taking a smarter approach to preparing future physician Before we get started if you'll take just a quick minute and click that like button and also Subscribe and turn the bell on so that you'll be notified when we post new videos Today we're going to continue on our subject of gram-positive bacteria specifically. We're going to start with streptococcus bovis some information about streptococcus bovis is that is a gram-positive cocci and Most importantly, it colonizes the gut. This is a common occurrence for it under normal circumstances. It's not pathologic However, if it gets into the blood then we have some problems that can be addressed First and foremost it can cause bacteremia when it gets into the blood. Also once it gets into the blood it could settle on areas of the heart and cause a Subacute endocarditis and finally we do have an association between streptococcus bovis and colon cancer So a way to remember that is if you have bovis in the blood you can have cancer in the colon Next we'll talk about intro cocci Intro cocci are a gram-positive cocci as you can see here the shape of the gram-positive They are typically going to be found alone or in small clusters They are catalase negative and PYR positive. They do have a variable Hemolysis meaning we can't classify it as alpha or beta or gamma hemolytic bacteria Enter a cocci specifically enter a cocci fecalis and fecium all are normal flora of the colon so Specifically here what we're seeing is that they are penicillin G resistant They do cause UTIs biliary tract infections and subacute endocarditis most of the time the subacute endocarditis presents itself after a GI or GU procedure you've probably often heard of VRE or Vencomycin resistant intro cocci. So this is intro cocci species that are resistant to the use of Vencomycin They have developed a resistance to The killing effects of Vencomycin so therefore we do see them quite often as a nosocomial infection that you can get in Hospital settings as you could expect because we do have that Resistance to Vencomycin enter a cocci are more resilient than streptococci That means in this case they can grow in a 6.5% sodium chloride and bile solution This is important to know and something that they can test you on on the USMLE So some things that maybe help you remember Intro cocci and some of the associations here is in this little chart. So intro is a good word root word for intestine Ficalis obviously we've heard of that is very as much associated with feces And then continuing strepto is gonna be meaning long twisted chains And then coccus is meaning berry So you can use those different Latin roots to help you understand what some of these specific bacteria involve Moving on we'll discuss bacillus anthracis Most common thing you've heard of bacillus anthracis is going to be anthrax So it is a gram positive now what type of a Bacteria is this is actually a spore forming rod The spore forming rod is where we get that anthrax toxin which is an exotoxin meaning it released from the bacteria And it consists of a protective antigen a lethal factor and an edema factor The bacillus anthracis also has a polypeptide capsule, which is a poly D glutamate capsule that helps protect it And you'll often see colonies that show a halo of projections Sometimes we call this the medusa head or a medusa head appearance if you can remember to any type of Greek mythology medusa head is the head of a Female with a bunch of snakes that are curling out of that head And that is kind of what you can expect to see from a bacillus anthracis colony So anthrax has been discussed quite a lot in the last 20 to 30 years regarding potential terroristic Use and what it is is a bacteria that causes these painless Papuels surrounded by vesicles and those will actually Continue on and grow and become ulcers that have a black eschar as you can see here in this picture That black eschar is painless and necrotic. So the tissue is dying in that area Now it is uncommon, but it could progress to bacteria and death The last thing we'll talk about today is pulmonary anthrax So we know that anthrax can manifest itself through cutaneous methods and it can also manifest Manifest itself through a pulmonary method. So what how do we get anthrax in our lungs? Well, we inhale the spores Typically, this is how animals and humans and everyone come in contact with these Spores is through inhalation and it's going to come from contamination from animal products or other animals typically We do know as I've mentioned already that it is a potent bioweapon. So we can see flu-like symptoms With these patients that have been exposed to anthrax in the inhalation form That will progress to fever pulmonary hemorrhage media stenitis and shock we also call this wool sorters disease because as There is contaminated animals sheep are very often found to have some of this bacillus anthracis in its wool and so people that are wool sorters or shepherds could become infected with pulmonary anthrax while they are around their sheep and Shearing the sheep especially There are several ways besides Inhalation that spores can get into the body The many ways are is through ingestion Inhalation or through skin cutaneous contact these symptoms that they present with are all going to be based upon how they enter into the body And as you can see here in this picture This is a x-ray a chest x-ray of a patient that has wool sorters disease or pulmonary anthrax And what you're seeing in these arrows is a widened media stynum So you can see the media stynum is quite large and then they do have pleural effusions commonly You can maybe see a little one down here in the left-hand side This one doesn't show a large effusion in this particular x-ray if you found this material helpful for your studying Please like and consider subscribing to the channel Also share this video so that more people can benefit from it like you have