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21 Cards in this Set
- Front
- Back
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Lyme disease
bact? host? |
Borrelia burgdorferi
Ioxes tick |
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How long is the life cycle of a tick
what do ticks repeatedly infect to maintain the endemic foci |
2 years
mice |
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Borrelia
How does it get from tick to human? how long does it take from activation to inoculation of host? |
Live in tick midgut, activated with blood meal --> travel to salivary glands --> tick bites human --> infection
55 hours |
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When a tick bites a human, what are 2 possible routes for spirochetes to spread
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1. on skin, outward from bite site --> erythema migrans
2. hematogenously |
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What accounts of the disease manifestations of borrelia infection
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Immune response
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Stage 1 symptoms of Lyme disease
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Erythema migrans = target lesion, annular, spreading
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Stage 2 symptoms of Lyme disease
3 |
CNS: peripheral neuropathy, facial palsy
Muscular: arthralgia CV: AV block indicates dissemination |
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Stage 3 symptoms of Lyme disease
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arthritis, can recur over years
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Diagnosis of Lyme disease
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1. travel to endemic areas
2. tick bite 3. characteristic lesion in patients |
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How do you treat
a. Lyme disease b. severe or refractory lyme disease |
a. doxycycline or amoxicillin
b. IV ceftriaxone or cefotaxime |
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What is post lyme disease syndrome
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muscle aches and fatigue after effective therapy
unknown why |
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Epidemic relapsing fever vs. endemic
a. cause b. place c. course |
Epidemic = body louse, N. Africa, can be lethal
Endemic = Ticks, North America, mild |
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Relapsing fever
a. pathogenesis |
High grade spirochetemia
Antigenic variation of "variable major (lipo) protein" (VMP) |
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Patient gets acute flue like symptoms +
-conjunctival suffusion -petechiae -hepatosplenomegaly -maybe CNS involvement -can cause death from myocarditis, shock, hepatic failure dx? treat? |
Relapsing fever
Tetracycline or erythromycin |
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Patient gets tetracycline for relapsing fever. Hours later, experiences fever, flushing, tachycardia, vasomotor instability.
What happened? |
Jarisch-Herxheimer reaction
Release of bacterial constituents --> cytokine release (TNFa) |
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Leptospirosis interrogans
Transmission |
indirect contact with urine of animals (rats)
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Type of leptospirosis
-flu-like -followed by aseptic meningitis -uveitis -rash -conjunctival suffusion |
anicteric form (late symptoms from immune complex vasculitis)
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Type of leptospirosis
-flu-like -hepatic and renal dysfunction -myocarditis -vascular collapse |
Icteric form (late symptoms from immune complex vasculitis)
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Patient with flue like symptoms gets a blood smear. You see an organism with a hook on the end
dx? |
leptosira
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Diagnosis of Leptospira
where can you culture early? (7-10 Days) where can you cultre late? |
early = blood
late = urine |
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Drug to prevent Leptospira in travelers to endemic areas
4 drugs to treat |
a. doxycycline (oral)
b. IV ampicillin, penicillin, ceftriaxone, tetracycline |
