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64 Cards in this Set
- Front
- Back
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How long does a tick need to be engorged before it can transmit the disease and why?
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48-72 hrs. b/c this is the amount of time required for Borrelia Burgdorferi to crawl from the gut of the tick to the salivary gland
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What are the chances of acuiring lyme disease from a tick bite?
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1%
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What type of insect is a tick and how is it attracted?
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Exophilic and are attracted by feet hitting the ground or by CO2 emitted by a car stopped in the bush
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How large can a tick get during engorgement?
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Increase its wieght up to 120 fold
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What is Borrelia Burgdorferi?
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A two membrane spiral shaped bacterium that lives primarily as an extracellular pathogen
Flagella to stay motile |
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What ticks come from the Midwest/East and which from the West and how long do they live?
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Ixodes Scapularis= East/Midwest
Ixodes Pacificus=West 2 year life cycle |
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What are the symptoms of LD?
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Erythema Migrans=68%
Arthritis=33% Facial Palsy=8% Radiculopathy=4% Meningitis/encephalitis/heart block= 1% |
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What allows you to become reinfected after intial LD?
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The Spirochetes phenotype switches from OspA to OspC
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What is the difference between OspA and OspC?
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OspA is uniform across different isolates
OspC is highly variable hence no protection against previous infection |
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What Immunoglobin must you test for in LD?
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Test for IgG
IgM tells nothing |
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How long is the incubation period?
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7-10 days after the bite
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What is the hallmark of early localized LD?
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Erythema Migrans
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What is early disseminated LD characterized by?
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Multiple EM's
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What is late peristent LD characterized by?
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Arthritis, memory deficit, irritability
>8 Weeks |
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What can be caused by unterated LD?
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Muscoskeletal polyarthritis (60%)
Aseptic lymphocytic meningitis, palsy, vertigo (15%) A.V. conduction block (5%) |
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What is the surveilence criteria for LD?
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Rash must exceed >5 cm
Show expansion Persist >1 week |
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How would Dx LD?
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Clinical
ELISA or IFA; followed by Western Blot; followed by Serologic |
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What is the most fatal tick borne disease, what causes it and how to you treat it?
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Rocky Mountain Spotted Fever from Rickettsia Rickettsii; a gram (-)
Responds to Doxycycline Nationally notifiable disease |
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What are some common first sympotoms of RMSF?
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Rash starts at wrist and ankles, can lead to genital necrosis and ARDS
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What is the vector and main reservoir for R. Rickettsii
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The Tick
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What is the Triad features of RMSF?
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Fever, headache and rash with a history of tick exposure
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How do you Dx RMSF?
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Direct imminofluorescence
Serology (IFA) Lab results with raised LDH |
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What causes Ehrlichiosis (HME)?
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E. Chaffeenis by the lone star tick
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What causes Anaplasmosis (HGE)?
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E. phagocytophila or E. ewingii
Is life threatening |
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How might HGE and HME present?
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Rash, fever and conjunctivitis
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What is vector and what is the reservoir for HME and HGE?
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Tick is the vector and the white tailed deer is the reservoir
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What is the treatment for HME and HGE?
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Doxycycline or tetracycline
Rifampin can be used during pregnancy |
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How do you get Babesiosis?
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Natural host is the white footed mouse or deer from ticks.
May coexist with Lyme Borreliosis |
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What increase your chances of contracting Babesiosis?
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Having no spleen and immunosupression
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What are the clinical features of Babesiosis?
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Fever and Cold Shakes (rigors)
Same tick vector as lyme disease No spleen more suscitable |
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What should physicians consider when diagnosing Babesiosis?
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Pts with Lyme disese who experience prolonged symptoms after treatment need to be tested
Physicians should consider this differential when diagnosing Hemolytic Anemia of neonates, particulary among transfusion pts. |
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What causes Babesiosis?
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Babesia Microti
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What causes Rat Bite Fever, what are the symptoms and how do you treat it?
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Steptobacillus Moniliformis
Abrupt fever, chills, rash, asthritis and headache IV penicillin G followed by oral penicillin |
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What can cause Sepsis after a dog bite?
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Capnocytophaga Canimorsus, a Gram (-) bacteria
In pts that are asplenic or with heaptic disease |
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What is a common bacteria form Dog/Cat bites?
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Pasteurella Multocida
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What are common pathogens from human bites?
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Eikenella Corrodens
S. Aureus Sterptococci |
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What does Bacillus Anthracis cause, what are the virulence factors, how does it work, and what is the incubation period?
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Causes Anthrax with its spores which can remain viable for 60 yrs "box car" apperance.
Is pathogenic b/c of the 2 extra DNA molecules, incubates for 2 D - 8 W Virulence factors are the PROTECTIVE ANTIGEN and lethal factor which causes the release of TNF-A and IL-1B |
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What is Cutaneuos Anthrax?
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Malignant pustule with a Eschar "cigareete burn" lesion which is painless, depressed, small crusted nectrotic, center is black
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What is characteristic of Gastrointestinal Anthrax?
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Abdominal pain, rebound tenderness and bloody diarrhea
From insufficiently cooked meat from infected animals |
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What is characteristic of Inhalational Anthrax?
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Spores are transfered to lings and then mediastinal lympth nodes
Then turn into vegitative cells and release their deadly cargo |
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What type of disesae is Inhalational Anthrax?
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Biphastic illness
Initial phase: fever, malaise, chest tightness, comiting, chills, ab pain Fulminant Phase: Sudden fever, hemorrage, pleural effusion, cyanisis, necrosis and septic shock |
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What is the pathogenic evidence in Advanced Inhalational Anthrax?
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Mediastinal Widening in a previously healthy pt. due to massive lymphadenopathy with overwhemling "flu like" sympotoms
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What is the primary complication in Inhalational Anthrax?
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50% develop hemorrhagic meningitis "cardinal cap"
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What is the treatment for Anthrax?
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Ciprofloxacin IV or BID orally.
Amoxicillin can be used in children |
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How does the Vaccine for Anthrax work?
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Recommened for ages 18-65 and is administered at 0,2,4,6,12,18 weeks followed by yearly boosters
PEP vaccine can be given on day zero with treatment |
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How is infection control done for Anthrax?
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NO person to person transmission
Standard barrier precautions requires bisafety level II |
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What causes the plague?
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Yersinia Pestis bacteria
Gram (-) rods with a "safety pin" apperance Uses fleas as their vector |
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What are the clinical features of the plague?
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Necrotizing rash, purpuric skin lesions and gangrene
Mortality is 100% in untreated septicemic form |
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How can you Dx the plague?
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Made from lymph hode aspirate, sputum, broncial washes and blood
Y. Pestis has a "safety pin" appearance |
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How is the plague treated?
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Streptomycin, gentamicin, tetracycline, doxycycline, and fluoroquinolones
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What is the common most zoonotic infection worlwide?
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Human Brucellosis
Transmitted by ingestion of undercooked delicacies, liver and spleen, and unpasteurized dairy products |
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What are the clinical features of Brucellosis?
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Intermittent spiking fever, rigor and perfuse sweating
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What is the most common reported lab-associated infection?
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Brucellosis
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What is the Dx for Brucellosis?
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Bone marrow culture is the gold standard
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What is the treatment for Brucellosis?
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Tetracycline, Doxycycline, rifampin, streptomcin
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What is most commonly related to Q fever?
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Most frequent organism in blood-culture-negative endocarditis
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How does Q fever transmit and what are the reservoir hosts?
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By inhalation, contact with infected blood/placenta of animals and ingestion of raw milk
Reservoir hosts: carrle, goats or sheep |
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What is the prominant clinical feature of Q fever?
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Infective endocarditis
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What is a key Dx feature for Q fever?
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Unexplained elevated hepatic enzymes
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What is the treatment for Q fever?
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Doxycycline and FQ if pt. developes meningitis
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How is Bartonellosis most commonly transmitted?
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"Cat Scratch Fever" hence is usually caused by a cat scratch, children are the most suscitable
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What is the treatment for Bartonellosis?
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Macrolides
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What is a hallmark diagnostic sign for Leptospirosis?
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Flu like sympotoms and Conjunctivitis, followed by meningitis
Patients with a H/O recreational freshwater sports, occurs often after street flooding |
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What is the treatment for Leptospirosis?
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Penicillin or tetracycline/doxycycline
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