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46 Cards in this Set
- Front
- Back
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What causes cat scratch disease, stellar retinitis, bacillary antiomatosis, meningo-encephalitis, and peliosis hepatica?
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Bartonella henselae (g - rod)
Dx with serology or g stain biopsy. |
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What diseases does the g - rod Bartonella henelae cause?
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cat scratch
stellar retinitis meningo-encephalitis bacillary angiomatosis |
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What is cat-scratch disease?
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slow progressive and chronic lympadenopothy with fever and/or malaise
caused by Bartonella henselae (g - rod) |
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What can cause a unilateral conjunctival granulation?
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Bartonella henselae - cat scratch disease
Dx with serology or biopsy (PCR or stain) |
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How do you confirm a diagnosis of cat scratch disease?
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serology assay
biopsy (stain or PCR) |
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What is the treatment for Bartonella henselae?
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in complicated cases Doxy (bacteriostatic Tetracycline derivative)
and Rifampin (Transcription bacteriocidal) or Gentamycin (Aminoglycoside) |
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What is Tularemia and what causes it?
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Phagocytic (monocyte) infection causing ulceroglandular, pnemonia, typhoidal, ocular (uncommon), and oropharyngeal infections.
Francisella tularemia |
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How is oropharyngeal infection from Francisella tularemia different from Bartonella hensulae?
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Tularemia gives you exudative tonsillitis and non red lymphadenopothy.
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How is pneumonic tularemia different from lobar and other pneumonias?
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Francisella causes substernal burning, nausea/vomiting, bilateral infiltrates, lung sounds...and Hx of animal contact.
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What gram negative pleomorphic intracellular bacteria can be inhaled, absorbed through unbroken skin, consumed, or enter the eye?
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Francisella tularemia
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Patient presents with an ulcerative lesion and swollen regional lymph nodes. How do you differentiate Francisella tularemia from Bartonella henselea?
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both are febrile, so take a good Hx, Francisella usually does have leukocytosis, and aspirate lymph node (use fluourescence, gram staining or PCR)
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Francisella tularemia and Bartonella hensulea are treated differently. How are they treated?
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Bartonella: Doxy and Rifamin (Transcription inhibitor)
Francisella: Streptomycin (Aminoglycoside) |
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What cells do the gram negative, Ehrlichiosis and Anaplasma inhabit?
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E. chaffeensis = monocytes and macrophages (mononuclear)
A. phagocytophilum and E. ewingii = PMN's and occ eosinophils (multinuclear) They form little vacuoles inside called morulae. |
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What intracellular gram negative bacteria form morulae?
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Ehrlichia (mononucleated) and Anaplasma (multinucleated)
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What are the signs and symptoms of Ehrlichia and Anaplasma?
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~ sometimes rash,
flu type symtoms (headache, malaise, myalgia, arthralgia, fever, diarrhea, vomiting) severe and needs hospitalization in 50% of people because they get leukopenia, thrombocytopenia, and elevated liver enzymes |
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A 45 year old patient presents with flu like symptoms. You run a blood panel and find leukopenia, thrombocytopenia, and elevated liver enzymes. What disease do you suspect and what tests can you provide next to confirm your DDx?
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Ehrlichia or Anaplasma (kids more likely to get RMSF, adults >40 get this)
CBC smear to look for mulberry shaped morulae PCR |
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How is Ehrlichiosis or Anaplasmosis treated?
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Doxycycline or another Tetracycline (protein translation inhibitors)
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How is Ehrlichiosis different from RMSF?
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The target/vulnerable population of RMSF is kids, the population for Ehrlichiosis is >40 y-o.
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How are Ehrlichiosis, Anaplasmosis, RMSF, Lymes, Tularemia, and Bartonella, Coxiella burnetii, and Brucella transmitted?
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Ehrlichiosis = ticks
Anaplasmosis = ticks RMSF = ticks Lymes = ticks Tularemia = direct, inhaled, tick Bartonella = scratch, ~flea bite Coxiella burnetti = unpasturized dairy or direct contact, especially with placenta Brucella = unpasturized dairy or direct contact |
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What is the cause of Q fever?
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Coxiella burnetti
g - intracellular in phagosomes of phagocytes |
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What are the symptoms of Q fever?
How often are individuals symptomatic? |
50% asymtomatic
flu-like (but the fever is quite high and 1-2 weeks) sore throat chest and abdominal pain non-productive cough pneumonia hepatitis endocarditis |
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A farmer presents with flu-like symptoms, abdominal and chest pain, non-productive cough, and a sore throat. What are your DDx? What tests do you run to determine the cause?
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DDx:
Pneumonia Tularemia Strep throat Q fever heart problems Tests: X-ray of chest ~ positive for pneumonia Serology of phase I and II Coxiella burnetti antibodies ~ High phase I and present phase II --> endocarditis heart exam ~ endocarditis strep throat rapid antigen tests and culture were negative |
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What is the microbiology of Coxiella burnetti and how is it treated?
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Q fever is g - intracellular especially in macrophages
Treat with doxycycline |
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What is Malta fever?
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Undulant Fever or Brucellosis
daily nighttime fever with drenching sweats, weakness, headache, backache, malaise |
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What is Brucellosis?
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Undulant or Malta fever
daily evening-nighttime fever with drenching sweat, headache, backache, weakness, malaise |
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Where does Brucellosis, undulant, or Malta fever come from?
Where does Q fever or coxiella burnetti come from? |
unpasturized dairy or direct animal contact
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What g - bacterial multiply in macrophages what make granulomas in the liver and spleen?
Periodic release of these is ~like Malaria. |
brucellosis/Malta fever/undulant fever
B. melitensis > B. suis > B. abortus |
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What is the treatment for Malta/undulant fever or Brucellosis?
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Tetracycline AND Gentamycin (aminogycoside)
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What cell type do these pathogens inhabit?
F. tularemia Bartonella henselae Ehrlichia chaffeensis Anaplasma Brucella Coxiella burnetii Think of their route of entry. |
F. tularmemia - monocytes
B. henselae - macrophages Ehrlichia chaffeensis - monocytes Anaplasma - PMN's Brucella - Mac's and PMN's Coxiella burnetii - Mac's |
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Which of the following is a category A biological weapon?
Coxiella burnetii B. henselae Brucella F. tularemia Anaplamsa Ehrlichia chaffeensis |
Francisella tularemia is very easily absorbed especially through the lungs or skin. Many more organisms are needed to infect the digestive system.
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4 types of malaria?
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P. falciparum - worst
P. vivax - #1 P. malaria - quaternary P. ovalae - rare, teritary |
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Kinds of malaria that store in the liver?
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P. vivax and ovalae
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What malaria-like parasite (RBC invading, not WBC invading bacteria) do ticks transfer in the US?
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Babesia microti
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Babesiosis effects on CBC.
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Increased abnormal WBC's
hemolytic anemia (break because they are now inflexible in capillaries) thrombocytopenia Lymes disease Maltese cross on smear |
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What is the name of the sexual form of a parasite?
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gametocyte
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The causing agent of bacillary angiomatosis?
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Bartonella henselae (cat-scratch) and Bartonella quintana
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What are the signs of bacillary angiomatosis?
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1-100 lesions (cutaneous or subq)
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What is the pathogenesis of bacillary angiomatosis?
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bacteria are phagocytosed and transported to the lymph nodes
the immunocompromised body can not contain it after spread, endothelial cells are infected infected endothelial cells produce MCP-1 and are now angiogenic Macrophages are attracted and produce VEGF |
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What is the cause of relapsing fever?
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Borellia species
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In which of the tick borne diseases is inoculation nearly immediate?
Ehrlichia Anaplasma Babesia Borellia |
Borellia sp.
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What bacteria is known for changing it's protein coat as a disguise?
micro of those organisms |
Borellia sp.
g - spirochetes, intracellular to endothelial cells |
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What diseases (2) are associated with Jarisch-Herxheimer reactions with treatment?
Hint: both relapse What are the symptoms? |
Borellia Relapsing Fever and syphilis
presser response (apprehension, diaphoresis/fever, tachycardia, tachypnea) followed by hypotension This response is probably due to endotoxin release |
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What is the pathogenesis of the Hantavirus/Sin Nombre virus?
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inhaled from feces -->
multiplication in endothelial cells causing prodrome (fever/chills, headache, dizzy, nausea/vomiting)--> damage causes plasma leakage to lungs --> infiltration and platelet levels drop causes cardiopulmonary phase (cough, tachypnea, dyspnea rales, tachycardia) --> |
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How frequent is Relapsing Fever?
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7-10 d
Borrellia from ticks or lice. Endemic, tick-borne, is the only concern over last 80 years |
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What is the cause of endemic relapsing fever?
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Borellia hermsii
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What cells does Borellia hermsii, the cause of relapsing fever, inhabit?
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endothelial, therefore treatment can lead to Jerisch-Herxheimer rxn
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