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45 Cards in this Set

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***Brucellosis***
***Brucellosis***
How are humans infected w/ Brucellosis? (3)
1. contact with animals
2. ingestion of contaminated milk or dairy products
3. lab workers
A fear of Brucellosis exists b/c it may be:
used as a BIOTERRORISM agent
Characteristics of Brucella (3):
1. small coccobacilliary gram-neg rods
2. slow-growing
3. oxidase, catalase, and urease* positive
Most common form of Brucella?
B. melitensis
Pathogenesis of Brucella:
How does it enter the body?

What forms?
penetrates skin or mucous membranes --> into macs --> to RE system where it mulptiples

forms small granulomas
How long after exposure do Brucellosis symptoms appear?
2-8 weeks after exposure
What does the fever assoc w/ Brucellosis look like?*
intermittent/cyclical**
(i.e. undulating fevers)
Most common advanced dz manifestations of Brucellosis?
1. GI symptoms - 70%
2. osteolytic lesions or joint effusions - 20-60%
3. respiratory symptoms - 25%
Less common disease maninfestations of Brucellosis:
CNS
CV (endocarditis)
GU tract (orchitis, renal granulomas)
ocular (endophthalmitis from hematogenous dissemination)
Diagnosis of Brucella:
1. bone marrow or infected tissue cultures
2. serology: single titer >1:80*
Which types of Brucella are more and less virulent?
more virulent: smooth colony type w/ capsule

less virulent: rough colony type w/o capsule
Treatment of Brucella:
drugs?
relapses?
control?
Doxycycline and rifampin (WHO criteria)

relapses in 10%

control: immunize livestock
***Plague***
***Plague***
Transmission of plague? (3)
1. flea bite
2. direct contact w/ infected tissues
3. inhalation of infected aerosols (i.e. bioterrorism)
Plague epidemics used to occur in:
8-12 year cycles
Where is the U.S. is there an endemic focus of plague?
Western/SW U.S.
What is a sylvatic infection? Why is it relevant to the plague?
sylvatic infection: rodents are infected

this is how plague spread in U.S. (thru San Franin 1900)
Types of plague:
1. Bubonic
2. Septicemic
3. Pneumonic
4. Unclassified
What is the agent that causes plague?
Yersinia pestis
What animal has been the source of 15 human cases of plague since 1977 in Western U.S.?
cats
What animal has been the source of 15 human cases of plague since 1977 in Western U.S.?
cats
Yersinia is a member of what bacterial family?

Some characteristics?
Enterobacteriaceae

oxidase negative, non-motile
What is the appearance of Yersinia on bipolar staining?**
"safety pins"**
Pathogenesis of Plague:
flea bites human and pass Yersinia on --> Yersinia moves to lymph nodes and multiply --> necrosis and swelling --> BUBO (blsiters at site of infection; can be cultured)
Virulence factors of Yersinia:
resist phagocytic killing: antiphagocytic protein capsule and plasminogen activator gene (degrades complement and fibrin clots)
Sign of plague that gave it the name "Black Death":
terminal cyanosis
How do people with Bubonic plague present?
sudden onset of fever and painful bubo 2-7 days after bite

75% mortality of untreated
How do patients with Septicemic plague present?
100% of pts w/ septicemic plague have positive blood cultures**

present with high fever, delirium, seizure in kids, septic shock; black hemorrhagic splotches = "Black Death"
Describe Pneumonic Plague:
plague bacillus to lungs --> purulent sputum w/ plague bacillus (highly infectious) --> sepsis an death unless therapy started in 1 day!
Big concern w/ Yersinia?
may be a BIOTERRORISM agent!**
Who should a doctor suspect of having plague?
a febrile patient recently exposed to rodents or other mammals in epidemic areas of world
Treatment of Plague:
Streptomycin; need to treat immediately (don't wait for susceptibility tests)
***Tularemia***
***Tularemia***
How do humans get Tularemia?

What is the classic patient who gets it?

Where found?
animal contact, bites from deer flies or ticks

most patients are men (hunters)

Arkansas, Oklahoma, Missouri
What domestic animals are associated w/ Tularemia and why?
domestic cat that has caught an infected animal (i.e. rabbit)
"Classic" people who may get Tularemia:
hunters
lab workers
people exposed to ticks
What bacteria causes Tularemia?

What do they look like?

What do they need for growth?
Fransicella tularensis

very small gram-neg coccobacilli; strict aerobe

growth: sulfhydryl compounds (extended incubation time)
Clinical manifestations of tularemia:
1. initial: fever, chills, malaise 2-5 days after exposure

2. Ulceroglandular infections: papule at site becomes necrotic and ulcerates (rabbit assoc cases involve fingers and hands)

3. Oculoglandular: unilat painful conjunctivitis

4. Typhoidal infection: fever, weight loss, prostration (highest mortality)

5. Pneumonic infection
6. Glandualr form: adenopathy
7. Oropharyngeal form
Key term to associate with Tularemia:**
Rabbits!!!**
***Pasturellosis***
***Pasturellosis***
Pasturellosis is assoc w/ what animals?**
Dogs and cats**
Where is Pasteurella usually found?
normal respiratory and GI flora in cats and dogs

P. multocida --> cats
P. canis --> dogs
Key growth features of Pasteurella multocida and canis:
1. indole positive*, oxidase positive, nonmotile, bipolar GNRs
2. does NOT grow on MacConkey agar (grows on blood and chocolate agar)*
DOC for Pasteurella:
penicillin