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Microbiology (bacteria) > Plague, Tularemia, Brucellosis > Flashcards

Plague, Tularemia, Brucellosis Flashcards

1
Q

what is the cause of plague?

A

Yersinia pestis (Y. pestis)

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2
Q

shape and gram stain of Y. pestis?

A
  • large rod-shaped or coccobacillus

- gram negative

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3
Q

Y. pestis metabolism

A
  • aerobe or facultative aerobe

- non-lactose fermenter

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4
Q

how is Y. pestis transmitted?

A

1 - flea to mammal (bubonic). Flea regurgitates in bite site, organisms enter lympathics and cause regional adenitis (bubo).
2 - mammal to mammal (pneumonic). respiratory droplets.

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5
Q

urban vs. rural plague

A

urban was through rats and accounted for major human outbreaks. rural is sporadic and in developing countries mostly. caused by flea bite, contact with indigenous rodent, or domestic pet.

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6
Q

Y. pestis extracellular pathogens

A
  • anti-phagocytic capsule (F1)
  • V and W antigens for survival in macrophage
  • anti-phagocytic properties dependent on human 37C temperature
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7
Q

Y. pestis intracellular properties

A
  • persistence within mammalian monocytes
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8
Q

Y. pestis toxins

A
  • LPS endotoxin

- exotoxin

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9
Q

clinical features of bubonic plague

A
  • fever
  • malaise
  • painful lymphadenopathy
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10
Q

clinical features of pneumonic plague

A
  • fever
  • cough
  • shortness of breath
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11
Q

clinical features of septicemic plague

A
  • no bubo

- dissemination via blood

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12
Q

plague complications

A
  • DIC
  • skin hemorrhages (black death)
  • meningitis
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13
Q

plague immunity?

A
  • antibodies develop over time

- military vaccine used in Vietnam against bubonic plague

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14
Q

plague diagnosis

A
  • bubo aspirate: gram and culture positive confirmed by fluorescent antibody microscopy
  • blood culture: positive
  • serology: rise in antibody to F1 capsule with hemagglutination test
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15
Q

plague treatment

A
  • 10 days streptomycin or tetracycline or chloramphenicol
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16
Q

what causes Tularemia?

A

F. tularensis

17
Q

shape and grain stain of F. tularensis

A

small unencapsulated pleomorphic gram negative

18
Q

metabolism of F. tularensis

A
  • aerobic slow grower

- requires cysteine, glucose or thioglycolate

19
Q

F. tularensis infectious dose?

A

5-10 organisms

20
Q

F. tularensis routes of human infection

A
  • rabbit: contact
  • arthropod: ticks, deer flies
  • infected tissues, animal bite, etc.
21
Q

F. tularensis pathogenesis

A
  • tick bite
  • skin lesion
  • enter lymphatics, local lymphadenopathy
  • bacteremia follows, granuloma formation (spleen and liver)
  • intracellular survival in monocytes
  • endotoxin has role in symptoms
22
Q

F. tularensis clinical features

A
  • similar to plague
  • abrupt onset fever, chills, malaise
  • syndromes (see other card)
23
Q

F. tularensis specific syndromes

A
  • ulceroglandular: most common, skin ulcer and painful adenopathy
  • typhoidal (bacteremia)
  • pneumonia
24
Q

F. tularensis diagnosis

A
  • fluorescent antibody staining of node biopsy

- serologic: 4X titer increase or single titer greater than 1:160 at 2 weeks

25
Q

F. tularensis treatment

A
  • either streptomycin 7-10 days or tetracycline 14 days
26
Q

Brucella gram stain and morphology

A
  • pleomorphic

- gram negative

27
Q

brucella metabolism

A
  • slow grower

- requires CO2 for optimal growth

28
Q

Brucella species

A
  • B. abortus (cattle), milk or meat
  • B. suis (swine), meat, airborne, slaughterhouse
  • B. melitensis (goat, sheep), milk, cheese
  • B. canis (dog), urine
29
Q

brucella pathogenesis

A
  • infectious abortion in huffed animals
  • infects reticuloendothelial system in humans
  • neutrophils - multiply in monocytes - granulomas in liver, kidney, spleen, bone marrow
30
Q

brucella clinical features

A
  • systemic and non-focal (FUO)
  • fever, chills, myalgias, headache, arthralgias
  • intracellular survival prolongs initial symptoms
31
Q

brucella complications

A
  • osteomyelitis

- endocarditis

32
Q

brucella diagnosis

A
  • occupational history
  • blood culture
  • serologic: 4X titer increase
  • bone marrow biopsy in difficult FUO cases
33
Q

brucella treatment

A

doxycycline and rifampin for 6 weeks

34
Q

prevention of brucella

A
  • vaccination of calves
  • herd testing
  • physical barriers

Microbiology (bacteria) (16 decks)

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