Chlamydia, Legionella, And Mycoplasma

Front 1

major disease caused by Chlamydia trachomatis (5)

Back 1

1. trachoma - conjunctivitis that leads to blindness

2. Infection of the reproductive organs (STD)

3. Inclusion conjunctivitis (chlamydial and neonatal)

4. Neonatal Pneumonia

5. Reiter's syndrome

Front 2

basic clinical findings of Chlamydia trachomatis in:

1. trachoma

2. STD in men

3. STD in women

Back 2

1. conjunctivitis and/or keratitis

2. symptomatic 50% of time; urethritis, epididymidus, proctitis

3. usually asymptomatic; cervicitis, salpingitis, and eventually PID

Front 3

basic clinical findings of Chlamydia trachomatis in:

1. chlamydial inclusion conjunctivitis

2. neonatal inclusion conjunctivitis

3. Neonatal Pneumonia

4. Reiter's syndrome

Back 3

1. transfer from genitals to eyes (sup roomie)

2. transfer to neonate from birth canal = mucopurulent stuff in the eye

3. from birth canal; presents like pneumonia

4. autoimmune = arthritis; eye problems

Front 4

Types L1-L3 serovars of chlamydia trachomatis cause _____________, a sexually transmitted disease. i. Rare, but recent outbreaks in men who have sex with men and are HIV+

Back 4

lymphogranuloma venereum

Front 5

how is Chlamydia trachomatis transmitted

Back 5

Transmitted by close contact:

-sexual

- passage thru birth canal

-eye infections: finger-to-eye, fomite-to-eye, flies

Front 6

what populations are at risk of infection with Chlamydia trachomatis

Back 6

nonwhites

multiple sexual partners

<19 yo

poor socioeconomic status

single

non-barrier (or no) contraceptive use

Front 7

major disease caused by Chlamydophila pneumoniae

Back 7

URT and LRT in young adults

usually mild

Front 8

basic clinical findings of Chlamydophila pneumoniae

Back 8

atypical patchy pneumonia

bronchitis

siusitis

pharyngitis

persistant cough and malaise

Front 9

how is Chlamydophila pneumoniae transmitted

Back 9

aersol transmission from person-to-person

ubiquitous

e.g. community acquired pneumonia

Front 10

major disease caused by Chlamydophila psittaci

Back 10

Causes psittacosis aka ornithosis or parrot fever

Front 11

basic clinical findings of Chlamydophila psittaci

Back 11

1. headache, high fever, chills, malaise, myalgia

2. pulmonary symptoms: nonproductive cough, rales, consolidation

3. in severe cases, involvement of central nervous system and other organs; can be
fatal

Front 12

how is Chlamydophila psittaci transmitted

Back 12

transmitted from close contact with infected birds via aerosolized dust

Front 13

what populations are at risk of infection with Chlamydophila psittaci

Back 13

poultry workers

pet store workers

bird owners

veterinarians

Front 14

Basic structure of chlamydia

Back 14

Gram negative-like structure

intracellular parasite; uses host ATP

rigid cell wall but NO peptidoglycan

Front 15

Describe the biphasic life cycle of chlamydia

Back 15

1. Exists as elementary body (EB) outside of host cell = metabolically inactive spore-like structure = infectious form

2. EB attaches to epithelial cell, gets endocytosed, vacuoles containing EB fuse and the EBs become reticulate bodies (RB; aka replicative body).

Front 16

Why can't chlamydia be gram stained

Back 16

Because it exists intracellularly

Front 17

describe the significance of the different serovars of C. trachomatis.

Back 17

There are 19 of them and different serovars associated with different diseases.

Front 18

Do Chlamydia/Chlamydophila infections involve specific virulence factors

Back 18

no toxins or virulence factors

Front 19

Does the cell-mediated and humoral response to chlamydia result in protection from reinfection? does it result in complete clearance?

Back 19

no to both

Front 20

Clinical manifestations of Chlamydia/Chlamydophila appear to be due to ?

Back 20

Clinical manifestations appear to be due to immunopathogenesis.

Infection of epithelial cells results in release of cytokines and interferons that elicit infiltration by neutrophils, then lymphocytes, macrophages, plasma cells, and eosinophils. Repeated infections elicit stronger immune responses and tissue damage, fibrosis.

Front 21

How do you treat STDs and trachoma resulting from chlamydia?

How do you prevent chlamydia? prevention in infants?

Back 21

Treat with azithromycin

Prevent by treating infected patients and their partners

Infants can be treated with antibiotics to prevent disease

Front 22

basic structure and life cycle of Legionella pneumophila

Back 22

Gram-negative rod
Facultative intracellular parasite

Life cycle:

1. Entry via endocytosis
2. Phagosome does not fuse with lysosomes
3. Organism replicates in vacuole, produces cytotoxic enzymes

Front 23

Can you gram stain legionella?

Back 23

no, it grows intracellular

Front 24

describe where L. pneumophila is found and how it can be transmitted to humans; is
there person-to-person transmission?

Back 24

-grows in freshwater amoebae in nature
-grows in macrophages, monocytes, epithelial cells in human host
-grows in biofilms in human-made water systems

Infection occurs by inhalation of aersolized organisms; No person-to-person transmission or animal reservoir identified.

Front 25

what populations are at risk for more severe disease after exposure to L. pneumophila

Back 25

compromised pulmonary function

decreased cellular immunity

hospitalized patients

Front 26

2 diseases caused by L. pneumophila and the differences between them?

Back 26

Legionnaires’ Disease = more serious; abrupt onset; lobar pneumonia; higher mortality; lower attack rate; usually in people with comorbities

Pontiac Fever = mild flu like; shorter incubation; symptoms develop slowly; no respiratory symptoms/doesnt usually cause pneumonia; high attack rate

Front 27

How does L. pneumophila cause disease/damage?

Back 27

Replication within alveolar macrophages induces release of cytokines and chemokines, stimulating strong inflammatory response.

Organism produces variety of enzymes and exotoxins, including proteolytic enzymes, phosphatase, lipase, nucleases, hemolysin, cytotoxin.

LPS Endotoxin

Front 28

explain how mycoplasmas differ from other prokaryotes and how this affects susceptibility to certain antibiotics.

Back 28

No cell wall, contain sterols in cell membrane

antibiotics that target cell wall don't work

Front 29

describe how Mycoplasma pneumoniae is transmitted and who is most at risk for
disease.

Back 29

Transmitted by respiratory droplets

High risk for dorms, military barracks, classrooms

Front 30

list the 2 most common diseases and the symptoms caused by M. pneumoniae

Back 30

1. Tracheobronchitis = most common

2. Walking Pneumonia = Atypical pneumonia

Front 31

How does tracheobronchitis present?

Back 31

Low-grade fever, malaise, headache, non-productive cough; pharyngitis may also be present.

Front 32

How does atypical pneumonia present?

Back 32

Chest x-ray reveals patchy bronchopneumonia.

Front 33

Where does M. pneumoniae attach in the body?

Back 33

Attaches to cilia of respiratory epithleial cells = ciliastasis, and eventually destruction of cilia
and ciliated cells.

i.e. destroys mucociliary elevator = persistent cough

Front 34

Damage from M. pneumoniae is caused by

Back 34

Organism producing a variety of enzymes and exotoxins

Immune response

Front 35

In M. pneumoniae, autoantibodies are those produced against bacterial glycolipid antigens that cross react with red blood cells resulting in formation of ?

Is there lasting immunity to M. pneumonae?

Back 35

cold agglutinins

no lasting immunity