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27 Cards in this Set
- Front
- Back
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What is the morphology of bartonella?
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curved, small gram negative, aerobic, nonmotiel, pleomorphic bacillus
fastidious require prolonged incubation in humid atmosphere (6 weeks) |
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What are the common human pathogens of the Bartonella species?
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Bartonella bacilliformis
Bartonella henselae Bartonella quintana |
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B. Bacilliformis
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Causes Bartenellosis
"Oroya fever"/ "Carrion's Disease" 2-6 weeks incubation causes acute febrile illness with severe anemia High mortality without therapy |
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What is the transmission of B. Bacilliformis?
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the sandfly, Lutzomyia (peru, ecuador, columbia -- Andes Mountains)
bacteria enter RBC's - become fragile myalgias/arthralgias/headache also - angina, seisures, abdomical pain |
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What is the chronic form of Bacilliformis infection?
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Oroya fever
Chronic stage - verruga paruana has beningn nodules that self heal persistent bacteremia - resevior |
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B. Quintana
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Found worldwide
"trench fever" common in homeless population/poor sanitation common in AIDS patients |
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What is the transmission of B. Quintana?
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spread by the body louse, Pediculus humanus
self limiting disease fever/headache/conjunctivitus/myalgia |
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Bacillary Angiomatosis
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BA is a vascular proliferatibve form of Bartonella Quintana/Henselae
seen in patients with organ transplants or immunosupression raised red/purple lesoins that bleed when traumatized. Lesions in oral mucosa, nose, penis, anus bone pain fever, chills, malaise, night sweats, anorexia jaundice, GI bleeding |
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B. Henselae
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Cat Scratch Disease
Most common clinical human bartonella infection self limiting lymphadenitis (from cats or fleas) papule develops days after contact, can last 3 weeks - regional lymph node involvement can result in chronic lymphadenopathy (4 months) fever malaise, rash |
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Culture negative endocarditis
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B. Quintana/Hensalae
fever embolic phenomena, valvular heart disease |
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What are some other clinical scenarios with Bartonella?
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Parinaud's oculoglandular syndrome - conjuctivitis with lymphadenitis
granulomatous hepatitis pneumonitis Neuronitis - papilledema with macular exudates in eye FUO |
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How do you diagnose Bartonellosis?
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giemsa stained blood smears - bacilliformis for Oroya fever
cultures not recommmended for routine cases of CSD, but might be useful for abnormal/severe presentations serologic testing - B. hensalse/quintana PCR - pus |
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What are the interpretations of serological testing for quintana/hensalse?
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IgM > 1:16 - recent infection
IgG > 1: 256 past infection often repeated for confirmation |
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What is the treatment of B. Bacilliformis?
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chloramphenicol on SA
cipro, doxycycline, TM-sulfa |
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What is the treatment of CSD?
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debatable
Axithromycin for typical lymphadenitis |
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What is the treatment for Bacillary angiomatosis?
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erythromycin/azithromycin or doxycycline
in AIDS patients - treat for up to 12 weeks |
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What are the HACEK organisms? Where are they found?
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Haemophulus aprophilus
Actinobacillus actinomy. Cardiobacterium hominis Eikenella Corredens Kingella Kingae deep infections (need CO2) |
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Haemophilus/actinobacillus
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meningitis
brain abscess soft tissue infection parotitis septic arthritis osteomyelitis UTI Pnemonia/chest wall infection pericarditis endocarditis |
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How do you diagnose/treat Haemophilus/actinobacillus?
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diagnose: suspicion!, blood and chocolate agar, grows poorly on MacConkey's agar
treatment: third generation cephalosporins TMP/SMX fluoroquinolones tetracyclines aminoglycosides |
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Cardiobacterium hominis
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often cause endocarditis
non motile facultive anerobic small pleomorphic GNR fermentative/indole/oxidase positive can be found in healthy resp. tracts |
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cardiobacterion hominis
pathology |
slow onset of fever, enters blood through oropharyngx
heart disease/dental procedures/oral disease -> predisposeses to C. hominis |
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How do you treat C. Hominis infection?
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Penicillins
ceftriaxone |
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Eikenella corrodens
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corrodes agar on petri dish
associated with human bite wounds fist fight injury endocarditis, sinusitis, pnemonia, bran abscess, lung absecces penicillin, extended-spectrum cephalosporins, tetracyclines |
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Kingella kingae
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small, gram negative coccobacilli
human oropharrynx 'sterile" arthritis in childern pain and fever |
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viridans Streptococcus
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Anginosus - brain abscesses, oropharynx, peritoneal cavity
Mitis - subacture endocarditits, neutropenic sepsis, pnemonia Mutans - dental carries, endocarditis |
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viridans Streptococcus
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Salivarius - bactermia, endocarditis
Bovis - colon cancer, meningitis Ungrouped - streptococcal toxix shock syndrome nutrient variable streptococci - otitis media, postpartum and postabortal sepsis |
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How do you treat streptococcus?
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< .1 sensitive to penicillin
.2 - 2 penicillin/aminoglycoside > 2 aminoglycoside for long duration |
