Baffling bacterial infections

In its beginning the malady is easier to cure but difficult to detect, but later it becomes easy to detect but difficult to cure.

Niccolo Machiavelli (1469-1527) On tuberculosis

Bacterial infections can present diagnostic brainteasers, and a high index of suspicion is needed to pinpoint the diagnosis. Many are rarely encountered, thus making diagnosis more difficult yet demanding vigilance and clinical flexibility. The list includes:

• tuberculosis

• infective endocarditis

• the zoonoses, e.g. brucellosis, Lyme disease

• clostridial infections o tetanus o gas gangrene o puerperal infection o botulism

• hidden suppuration o abscess o osteomyelitis

• mycoplasma infections o atypical pneumonia

• Chlamydia infections o psittacosis o non-specific arthritis o pelvic inflammatory disease o trachoma o atypical pneumonia

• legionnaires' disease

Chlamydia and rickettsial organisms have been confirmed as being small bacterial organisms.

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