J. Intracellular Bacteria

Front 1

What are the 3 main intracellular bacteria?

Back 1

1. Rickettsia
2. Chlamydiae
3. Mycoplasma

Front 2

What serves as the vector and reservoir for Rickettsiae?

Back 2

Arthropods (ticks and fleas)

Front 3

What is the typical clinical picture seen with Rickettsiae?

Back 3

-Rashes
-Fever
-Vasculitis

Front 4

What is the exception to the common clinical presentation with Rickettsiae?

Back 4

Coxiella burnetti does not caue fever and isn't carried by an insect.

Front 5

What are the 2 main illnesses that Chlamydiae are responsible for?

Back 5

-Ocular infections
-Long term genital infections

Front 6

What infection is Mycoplasma responsible for?

Back 6

Walking pneumonia

Front 7

What is the main thing to remember about the lifestyles of Chlamydia and Rickettsia?

Back 7

They are OBLIGATE intracellular organisms - can't grow without a host cell to support it.

Front 8

What are 6 obligate intracellular pathogens that are bacteria?

Back 8

CRECCM

Front 9

What is CRECCM?

Back 9

-Chlamydia
-Rickettsia
-Ehrlichia
-Chlamydophila
-Coxiella
-Mycobacterium leprae

Front 10

What defines facultative intracellular pathogens?

Back 10

They can be cultivated in the absence of host cells.

Front 11

What are 5 facultative intracellular pathogens?

Back 11

SLEMS

Front 12

What is SLEMS?

Back 12

-Shigella
-Legionella
-Ecoli
-M. tb
-Salmonella

Front 13

What type of lifestyle does Mycoplasma exhibit?

Back 13

Epicellular

Front 14

What does Epicellular mean?

Back 14

It is closely associated with host cells but can be cultivated away from host cells if appropriate additives are given.

Front 15

What are the 2 epicellular bugs?

Back 15

-Bartonella henselae
-Mycoplasma pneumoniae

Front 16

What happens to the genomes of bugs as they become more host-cell dependent?

Back 16

The genomes get smaller.

Front 17

Gram stain of Rickettsiae:

Back 17

Gram neg bacilli

Front 18

What type of infection do Rickettsiae cause?

Back 18

Zoonotic

Front 19

Vectors for transmitting Rickettsioses:

Back 19

Arthropods (ticks, mites, fleas, lice, chiggers)

Front 20

What species of Rickettsia causes:
RMSF
Epidemic typhus
Murine typhus
Scrub typhus

Back 20

RMSF = R. rickettsii
Epidemic typhus = R. prowazekii
Murine typhus = R. typhi
Scrub typhus = O. tsutsugamushi

Front 21

What transmits RMSF?
What transmits Epidemic typhus?
What transmits Murine typhus?
What transmits Scrub typhus?

Back 21

Ticks = RMSF
Human lice = Epidemic typhus
Fleas/rats = Murine typhus
Chiggers = Scrub typhus

Front 22

So the Rickettsiae are organized into what 2 groups?

Back 22

-Spotted fever types
-Typhus types

Front 23

What is the main Rickettsia organism that causes Spotted fever?

Back 23

R. rickettsii

Front 24

What is the main Rickettsia organism that causes Typhus?

Back 24

R. prowazekii (epidemic)

Front 25

What is the main Rickettsia organism that causes Murine typhus?

Back 25

R. typhi

Front 26

RMSF:
-Where is it mostly seen?
-When?
-In what patients?

Back 26

Atlantic states
April-September
Pediatrics

Front 27

What patients get a more severe form of RMSF?

Back 27

-Elderly
-Men
-African americans with G6PD deficiency

Front 28

How does Rickettsia rickettsii live within the tick population?

Back 28

By transmission from Momma ticks to baby ticks; transovarian transmission.

Front 29

Why does R. rickettsii cause a RASH?

Back 29

-Invades vascular smooth muscle
-Causes thrombosis
-Consumes platelets

Front 30

What Rickettsial disease is seen in patients that recently travelled in Africa and the Mediterranean?

Back 30

Boutonneuse fever

Front 31

What Rickettsial disease resembles chickenpox? What is the species that causes it?

Back 31

Rickettsialpos - R. akari

Front 32

What is the Rickettsial disease that was significant during war times? What is the causative species?

Back 32

Epidemic typhus - R. prowazekii

Front 33

What is the vector for R. prowazekii? How does it live in it?

Back 33

Vector = Human lice
-doesn't live in lice
-they just transmit it

Front 34

For what disease is increased risk associated with poor golf scores, strategies for retrieving lost golf balls, and the use of insect repellent?

Back 34

Ehrlichiosis

Front 35

What disease is Ehrlichiosis similar to?

Back 35

Mono

Front 36

What are the steps in Rickettsia pathogenis? (5)

Back 36

1. Enter skin via tickbite
2. Spread thru bloodstream
3. Infect endothelium
4. Rickettsial attachment induces phagocytosis into EC's
5. Escape from phagosome

Front 37

What is the pneumonic for the 5 steps in the Rickettsial lifecycle?

Back 37

ESIRE
-Enter
-Spread
-Infect endothelium
-Rickettsial attachment
-Escape phagosome

Front 38

What happens after the rickettsia escape the phagosome in endothelial cells?

Back 38

They replicate WITHIN endothelial cells and cause a rash.

Front 39

Which type of Rickettsial disease do you see lots of pathology and cytotoxicity in?

Back 39

RMSF - R. rickettsii

Front 40

Which type of Rickettsial disease do you see little pathology and cytotoxicity in?

Back 40

Epidemic Typhus - R. prowazekii

Front 41

What IS R. prowazekii able to do better than R. rickettsii?

Back 41

Replicate intracellulary in MASSIVE quantities before lysing the host cell.

Front 42

If R. rickettsii is NOT able to replicate intracellularly as much, how is it so cytotoxic?

Back 42

When it does leave, the bugs spread RAPIDLY to involve many other cells.

Front 43

What are the 3 main features of Rickettsial disease pathology?

Back 43

-Multifocal Endothelial injury
-Edema
-Low blood volume

Front 44

What people are at risk for Rickettsial disease?

Back 44

People exposed to ticks, mites, lice, and fleas

Front 45

What are the 2 main differences in the pathology of Ehrlichiosis compared to Rickettsial?

Back 45

-No phagolysosomal fusion at all
-Targets all WBCs, not ECs

Front 46

Where does Ehrlichia multiply in WBCs?

Back 46

Within the Phagosome, before any phagolysosomal fusion might have occurred.

Front 47

Does phagolysosomal fusion occur in Rickettsial disease?

Back 47

No; but the Rickettsial species break out of the phagosomes and aren't involved in preventing phagolysosomal fusion.

Front 48

Where does replication occur for
-Rickettsiae
-Ehrlichia

Back 48

Rickettsiae = cytoplasm
Ehrlichia = phagosome

Front 49

What happens after Ehrlichia replicate in the phagosome?

Back 49

Phagosomal and Cell lysis

Front 50

What is the main way to diagnose a Rickettsial infection versus Ehrlichia?

Back 50

-History/exposure to ticks
-Rash present only in Rickettsial disease

Front 51

How is Rickettsia treated?

Back 51

-Empirically with later lab confirmation

Front 52

What are the 2 main diagnostic tests for Rickettsial disease?

Back 52

-Flourescent antibody
-PCR

Front 53

Where is the site of rash seen in RMSF?

Back 53

Palmar/solar rash

Front 54

3 diseases where you see a palmar/solar rash:

Back 54

-RMSF
-Syphilis
-Leprosy

Front 55

How does the rash in epidemic typhus compare to that in RMSF?

Back 55

Epidemic typhus: centrifugal (spreads from trunk outward)

RMSF: centripetal spread (inward)

Front 56

What is Brill Zinsser disease?

Back 56

Recrudescent epidemic typhus that occurs decades after the initial infection.