Microbiology part 1

To remember the relevant medical microbial producers of urease, remember:

"Urease PUNCH"

Proteus mirabilis
Ureaplasma urealyticum
Nocardia asteroides
Cryptococcus neoformans
Helicobacter pylori

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Actinomyces israelii vs Nocardia asteroides- both are gram +, and form long, branching hyphae, which is characteristic.

So what differentiates them? Actinomyces is anaerobic, colonizes mouth and vagina normally, and causes abscesses that drain with sulfur granules.  Nocardia is aerobic, lives in water and soil, and causes cutaneous (through trauma), respiratory, or disseminated (e.g. brain/meningeal, kidney) involvement. Only the cutaneous problems are seen in immunocompetent people.

Treatments: SNAP

SMX/TMP - Nocardia
Actinomyces - Penicillin G

Actinomyces israelii: There is a lot of sand in Israel. The yellow sulfur granules look like sand.

Nocardia asteroides: Asteroids are foreign to Earth, just like this bacteria is foreign to the human body (not grown in normal flora)