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137 Cards in this Set
- Front
- Back
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Riccketsia infect what type of cell
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Endothelial
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This disease is caused by Ricketsia ricketsii
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Rocky mountain spotted fever
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Rickettsia ricketsiae is transmitted by _
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Rocky mountain wood tick or dog tick (wood tick)
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How is ricketsia ricketsiae spread
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Through ticks - passed transovarially
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Patient presents with abrupt onset of fever, chills, headache and myalgia 5 days duration. Physical exam reveals rash - patient states that it started on hands and feet and spreads inwards to trunk, rash initially was maculopapular but in the later stages became petechial and hemorrhagic
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Rocky Mountain Spotted fever
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Specific sensitive test for rocky mountain spotted fever
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IFA - 2,3 weeks after onset
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Treatment for rocky mountain spotted fever
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Tetracycline and chloramphenicol, doxycycline is preferred
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You suspect rocky mountain spotted fever - should you wait for diagnosis to start treatment
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Treatment decisions should be based on epigemiologic and clinical clues and should never be delayed while waiting for confirmation by laboratory results
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Rickettsia akari causes _
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Rickettsialpox
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How is rickettsia akari spread
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Urban infections - mice + people
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Vector for rickettsia akari (rickettsiapox)
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Mites and mice - transovarian transmission in mites
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Patient presents with high fever, chills, sore throat and other flu like symptoms. After 10 days he develops firm red papule
Diagnosis |
Rickettsialpox
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Diagnosis for rickettsialpox
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IFA
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Treatment for rickettsialpox
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Not warranted - self limited disease, tetracycline can spread recovery
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Rickettsia prowazekii causes _
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Epidemic typhus
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Epidemic typhus is transmitted by _
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Human body lice
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Primary reservoir for epidemic typhus
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Humans
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Does transovarian transmission occur in ricketsia prowazekii
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NO
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46 year old homeless male presents with maculopapular rash that develops on trunk and spreads to extremities (centrifugal spread). He recalls having flu like symptoms 8 days prior to the onset of rash
Disease + bug |
Epidemic typhus --> riketsia prowazekii
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Clinical course of this disease is similar to epidemic typhus but milder and faster recovery
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Brill Zinsser disease
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Primary test for epidemic typhus
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Serology
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Should you wait for diagnosis in treatment of epidemic typhus
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NO
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Treatment of epidemic typhus
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Tetracycline and chloramphenicol
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Prevention of epidemic typhus
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Vaccine in high risk population (killed typhus vaccine)
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Rickettsia typhic causes _
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Endemic (murine) typhus
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Vector and reservoir of endemic (murine) typhus
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Rat fleas, primary reservoir - rats
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Orientia (riketsia) tsutsugamushi causes _
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Scrub typhus
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Ricketsia tsutsugamushi is pread by _
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Chiggers (mite larvae), mite is both reservoir and vector, bacteria passed transovarially
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34 year old male presents with maculopapular rash (centrifugal spread) . History reveals appearance of eschar and flu like symptoms 3 days earlier
Disease and bug |
Scrub tyhus - Orientia (ricketsia) tsutsugamushi
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Treatment and diagnosis of scrub typhus
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Serology
Chloramphenicol and tetracycline |
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Which cell are infected by ehrlichia
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Mononuclear cells and granulocytes
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Human monocytic ehrlichiosis is caused by _
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Ehrlichia chafeensis
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Human granulocytic ehrlichiosis is caused by _
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Ehrlichia ewingii
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Human granulocytic anaplasmosis is caused by _
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Anaplasma phagocytophillum
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Inclusion body containing ehrlichia organisms
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Morula
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Ehrlichia is transmitted by _
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TICKS
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Which forms can you get ehrlichiosis from>
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Nymph and adults only - larvae are NOT INFECTED (transmission is not transovarian)
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Q fever is caused by _
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Coxiella burnetii
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Small gram negative organism that lives inside acidic lysosomes
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Coxiella burnetii
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How do you get infected with Q fever
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Through inhalation
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This organism is found in placenta and feces of infected livestock
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Coxiella burnetii
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Which cells are infected by Coxiella
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Monocytes
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Patient presents with flu like illness, myocarditis and hepatitis
Disease + bug |
Q fever - Coxiella burnetii
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Patient presents with endocarditis with negative cultures
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Q fever - Coxiella burnetii
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Bug causing trench fever
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Bartonella quintana
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Bug causing cat scratch disease
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Bartonella hensellae
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Bug causing oroya fever (Carrions disease)
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Bartonella bacilliformis
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These 2 bugs cause bacillary angiomatosis in immunocomromised
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Bartonella quintana and hensellae
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Vector for trench fever (B quintana)
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Human body lice
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Patient presents with flu like symptoms and SEVERE BONE PAIN in the tibia, neck and back. PE shows conjunctivitis, splenomegaly and tachycardia
Disease + bug Diagnosis Treatment |
Trench fever - Bartonella quintana
Culture on blood or chocolate agar OR PCR (preferred) Treatment - gentamicin +/- eryhtromycin |
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This disease is caused by Bartonella hensellae
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Cat scratch fever
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Patient presents with confusion, vision loss, prolonged fever, arthritis, atypical pneumonitis and abdominal pain. He recalls having enlarged lymph nodes several days ago
Bug + disease |
Cat scratch fever- Bartonella hensellae
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Treatment for cat scratch disease
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DOES NOT respond to antimicrobial therapy - supportive therapy, aspiration of lymp nodes for pain relief
TREAT IMMUNOCOMPROMISED WITH GENTAMICIN ( to prevent bacteremia) |
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Cutaneous papules caused by Bartonella species in AIDS patients
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Bacillary angiomatosis
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Treatment of bacillary angiomatosis
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Oral erythromycin, other oral antibiotics and anti TB medications (tetracycline, TMP SMX, rifampin)
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Which disease caused by Bartonella responds to antimicrobial therapy and which doesnt
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Cat scratch fever DOES NOT respond and bacillary angiomatosis RESPONDS
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Disease caused by bartonella bacilliformis
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Oroya fever (Carrions disease)
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This bug has polar flagella, adheres to and infects RBC's , TRANSMITTED BY SANDFLY
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Bartonella bacilliformis
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Giemsa stain of the sample shows rod shaped and slightly curved organisms that are adherent or inside of RBCs
Name bug and treatment |
Bartonella bacilliformis
Chloramphenicol or doxycycline for at least 1 week |
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This aerobic gram negative coccobacillus is non motile, non acid fast, has LPS, produces catalase, oxidase, urease and DOES NOT ferment glucose
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Brucella
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Which cells are infected with brucella
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Macrophages and neutrophils
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Brucella replicates in _
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ER of the host cell
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Patient presents with weakness, fatigue, malaise, depression, anorexia, PROFUSE SWEATS, chills
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Bordetella
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How do you diagnose Bordetella
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HISTORY is most important (exposure), serology is most common, ELISA and PCR are available, blood cultures but take 3-4 weeks
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Bone marrow is standard for diagnosis of this bug since reticuloendothelial system holds high concentration of the organism
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Bordetella
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Treatment for infection with Bordetella
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For adults and children over 8 years old --> doxycycline and rifampin or doxycycline and streptomycin (more effective in preventing relapse)
Children younger than 8 and pregnant women - rifampin and TMP SMX ( DO NOT GIVE DOXYCYCLINE TO PREGNANT WOMEN) |
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This disease is caused by Borrelia burgdorferi
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Lyme disease
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Spirochete transmitted by black legged tick, reservoirs are mice and deer, NOT transmitted transovarially
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Borrelia burgdorferi
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Patient presents with erythema migrans and flu like symptoms
Disease and which stage |
Lyme disease - stage 1
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Patient presents with intermittent arthritis, cranial nerve palsies, AV nodal block, severe malaise and fatigue
Disease and which stage |
Lyme disease - stage 2
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Patient presents with prolonged arthritis, chronic encephalitis, myelitis, and symptoms consistent with fibromyalgia
Disease and which stage |
Lyme disease stage 3
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CDC recommends this for diagnosis of Lyme disease
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AB titer followed by immunoblot
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Treatment of Lyme disease
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Doxycycline or amoxicillin, penicillin G for late stages
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Bug causing relapsing fever
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Borrelia recurrentis
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2 types of relapsing fever- which one is more common in US and which one is more severe
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Louse born and tick born
Tick born is more common in US and lice born is more severe |
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Why do people get better and get worse again with relapsign fever
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Get better because of antibodies but antigenic structure of spirochetes changes during infection
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Treatment of relapsing fever
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Tetracycline and erythromycin - erythromycin in children and pregnant women
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Obligate aerobic spirochetes with very fine spirals, tightly coiled body with hooked ends
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Leptospira interrogans
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Reservoir for leptospira
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Rodents - shed in urine
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Patient presents with sudden onset of headache, myalgia, chills, abdominal pain and conjunctival suffusion. he recalls having flu like illness week ago
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Leptospirosis
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Weils disease - hepatic smptoms with jaundice, no permanent damage is caused bY
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Leptospira interrogans
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Treatment for leptospirosis
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IV penicillin or doxycycline
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Infection with tularemia in winter is caused by _
Infection with tularemia in summer is caused by _ |
Rabbits
Ticks |
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Most common type of tularemia
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Ulceroglandular
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Media for francicella tularensis
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BCYE
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Drug of choice for treatment of tularemia
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Streptomycin
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Sexual reproduction of plasmodia occurs in _ , asexual in _
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Sexual in mosquito, asexual in humans
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Which species of plasmodium have hypnozoites
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P. vivax and P ovale
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This bug derives energy solely from glucose - metabolize it faster than RBC, that is why patient presents with hypoglycemia and lactic acidosis
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Plasmodium
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Most common cause of death from malaria in immune people (Africa)
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Anemia
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Cause benign tertian malaria in 48 hour cycle
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P. vivax and P ovale
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Causes malignant tertian malaria in 36-48 hour cycle
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P falciparum
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Causes quartan malaria in 72 hour cycle
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P malriae
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This type of malaria is associated with lower density parasitemia (< 10000), milder anemia, reversible coma
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Cerebral malaria
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Most common cause of death from malaria in non immune people (outside Africa)
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Seizures
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Patient is passing black urine - what does he have
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Hemoglobinuria = blackwater fever, complication of renal failure in patients with malaria
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This type of blood smear identifies species of malaria
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Thin smear
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This type of blood smear is the concentration method to detect organisms
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Thick smear
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You see multiple parasites in one RBC on blood smear - which species
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P falciparum
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Blood smear shows enlarged RBC's, SCHUEFNER DOTS (TROPHOZOITES)- name bug
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P vivax
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Blood smear shows oval shaped RBC's with SCHUFNNERS DOTS, ragged cell wall - name bug
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P ovale
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Blood smear shows bar and band forms, rosette schizont
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P. malariae
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Blood smear shows ring form within RBC, crescent shaped (banana or sausage shaped) mature gametocytes
Name organism |
P falciparum
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Detoxified heme alters inflammatory mediator production in monocytes, allows malaria to progress
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Hemozoin
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Gives 100% protection from P vivax
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Duffy antigen deletion
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This drug is used in chloroquine resistant areas not for children or pregnant women
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MALARONE
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Drug of choice from malaria but high resistance pattern
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Chloroquine
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Cheap and effective drug from malaria, not for children or pregnant women
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Doxycycline
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Most effective drug from malaria, neurological side effects, also effects heart
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Mefloquine
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Anti relapse therapy for vivax and ovale (active vs HYPNOZOITES) not for children pregnant women or G6 PD defficient patients
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Primaquine
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Name drug that is NOT effective from P falciparum
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Primaquine
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This anti malaria drug makes you nuts
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Mefloquine
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This anti malarial drug is used for severe cases, toxic
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Quinine
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This drug is good for prevention of malaria
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Doxycycline
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This anti malarial drug is active against HYPNOZOITES, prevents relapses
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Primaquine
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You see maltese crosses and pear shaped piroplasm on blood smear
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Babesiosis
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Babesia microti is transferred by _
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Ticks
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This bugs severity is influenced by presence of co infections with Burrelia and anoplasma
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Babesia
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This bug causes retinochoroiditis and blindness
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Toxoplasma gondii
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T brucei gambiense causes _
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West African sleeping sickness
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Vector for trypanosoma
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Tsetse fly
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T brucei rhodoseinse causes _
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East African sleeping sickness
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Trypanosoma cruzi causes _
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Chagas disease
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Romana sign is the sign of _
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Chagas disease
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Most serious manifestation of infection by Trypanosoma cruzi
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Cardiomyopathy
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Hemoflaggelates causing Leishmania are transmitted by
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Sandflies
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Wuchereria bancrofti, brugia malayi and brugia timori cause _
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Lymphatic filariasis
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Onchocerca volvulus causes _
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River blindness
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B malayi causes _
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Pulmonary tropical eosinophilia
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Loa loa causes
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Severe infection with encephalitis, cardiomyopathy and kidney failure
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Most practical diagnostic procedure for diagnosis of filarial worms
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Identification of microfilariae by microscopy
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Schistosoma species invading bladder
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Schistosoma haematobium
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Schistosoma species invading bowel
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Schistosoma japanicum
Schistosoma mansoni |
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This bug causes cystitis and ureteritis with hematuria which can progress to bladder cancer
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Schistosoma hematobium
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These bugs can cause pulmonary hypertension
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Schistosoma japonicum or mansoni
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Reservoir for schistosomes
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Snails
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Drug of choice for Schistosome infections
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Praziquantel
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