Chlamydia and Rickettsia Flashcards

1
Q

Chlamydiae

A
  • obligate intracellular parasites
  • C. trachomatis is primary pathogen
  • Elementary body (EB)
  • Reticulate body (RB)
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2
Q

Elementary body (EB)

A
  • infectious phase
  • major outer membrane protein (MOMP)
  • detected by monoclonal antibodies
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3
Q

Reticulate body (RB)

A
  • noninfectious phase

- replicative phase

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4
Q

Chlamydia trachomatis (infections)

A
  • urogenital
  • most common bacterial STI in US
  • Male: Nongonococcal urethritis (NGU), Prostatitis, Epididymitis
  • Female: cervicitis, endometritis, salpingitis, PID, Perihepatitis
  • Neonatal: conjunctivitis, nasopharyngeal infection, pneumonia, otitis media
  • Reiter syndrome
  • Lymphogranuloma venereum
  • Trachoma
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5
Q

Chlamydia trachomatis infections in males

A
  • Nongonococcal urethritis (NGU), Prostatitis, Epididymitis
  • urethral discharge, dysuria, hemospermia, conjunctivitis
  • usually asymptomatic
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6
Q

Chlamydia trachomatis infections in females

A
  • Cervicitis, endometritis, salpingitis, PID, perihepatitis, conjunctivitis
  • vaginal discharge, dysuria, pain bleeding
  • usually asymptomatic
  • infertility and sterility
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7
Q

Chlamydia trachomatis infections in neonates

A
  • conjunctivitis, nasopharyngeal infection, pneumonia
  • otitis media (less common)
  • erythromycin eyedrops at birth to take care of infections
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8
Q

Reiter Syndrome

A
  • caused by Chlamydia trachomatis

- urethritis, conjunctivitis, polyarthritis and mucocutanous lesions

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9
Q

Lymphogranuloma Venereum (L1, L2, L2a, L2b, L3)

A
  • caused by Chlamydia trachomatis
  • rapidly-healing genital or anal papule at inoculation site
  • buboes, fever, headache, myalgia
  • women often asymptomatic
  • presents as proctitis (from anal intercourse)
  • may become chronic
  • survive in mononuclear cells
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10
Q

Trachoma (A, B, Ba, C)

A
  • caused by Chlamydia trachomatis
  • chronic eye inflammation
  • may lead to blindness (not neonatal)
  • # 1 CAUSE OF PREVENTABLE BLINDNESS WORLDWIDE
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11
Q

Chlamydia trachomatis (virulence)

A
  • MOMP (17 serovars)
  • survive in macrophages
  • cause recurrent/persistent infections
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12
Q

Chlamydia trachomatis (transmission)

A
  • sexual contact
  • autoinoculation
  • vaginal delivery
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13
Q

Chlamydia trachomatis (detection/testing)

A
  • specimen on Dacron, rayon or calcium alginate swabs with plastic or metal shafts
  • need scraping specimen
  • first morning urine and vaginal swabs
  • antigen detection (ELISA, DFA)
  • McCoy culture
  • DNA probes
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14
Q

Results reporting

A
  • agree with OB/GYN test profiles
  • report tests performed and tests not performed
  • report unusual observations
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15
Q

Chlamydophila pneumoniae

A
  • formerly Chlamydia TWAR
  • 10% of world’s pneumonia
  • risk factor for Guillain-Barre
  • related to sarcoidosis, asthma and cardiovascular disease
  • endotoxin (LPS)
  • Life cycle: EB and RB
  • survive in macrophages or epithelial cells
  • causes recurrent or persistent infections
  • transmission via respiratory droplets
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16
Q

Chlamydia life cycle

A
  • Elementary bodies (EB) enter host cell and become reticulate bodies (RB)
  • host cell ruptures to produce new EB’s
17
Q

C. pneumoniae (infection)

A
  • Phase 1: sore throat, flulike after 1 week

- Phase 2: pneumonia and bronchitis

18
Q

C. pneumoniae (lab diagnosis)

A
  • specimens: sputum, bronchoalveolar lavage, nasopharyngeal aspirates, throat washings or swabs
  • serology tests (MIF)
19
Q

Chlamydophila psittaci

A
  • bird chlamydia
  • parakeets, turkey
  • PARROT FEVER (psittacosis)
  • pneumonia in humans
  • survive in macrophages or epithelial cells
  • bird-to-bird transmission
20
Q

Rickettsiae and Orienta

A
  • obligate intracellular bacteria (endothelial cells)
  • transmission via ticks
  • R. prowazekii transmitted by body lice
21
Q

R. rickettsii

A
  • ROCKY MOUNTAIN SPOTTED FEVER
  • transmitted via D. variabilis and D. andersoni ticks
  • flulike symptoms
  • rash spread over ankles, wrists, hands and soles of feet
  • NO RASH ON THE FACE
22
Q

Mediterranean spotted fever (Boutonneuse Fever)

A
  • ticks and dogs
  • rash over palms, soles of feet, body and ON THE FACE
  • taches noires (black spots at primary site of infection)
23
Q

R. typhi

A
  • endemic typhus (murine typhus)
  • oriental rat flea, cat flea
  • infection when flea defecates on skin and scratching infects the bite
24
Q

R. prowazekii

A
  • epidemic louse-borne typhus
  • known as BRILL-ZINSSER DISEASE
  • Human louse (Pediculus humanus)
  • Squirrel flea (Orchopeas howardii)
  • Squirrel louse (Neohaematopinus sciuriopteri)
  • areas of sanitation disruption
  • defecates in bite wound via scratching
  • rash over the body and FACE
25
Q

R. akari

A
  • mouse mite (Liponyssoides sanguineus)

- rash on face, trunk and extremities, but NOT ON PALMS OR SOLES

26
Q

Orientia tsutsugamushi

A
  • scrub typhus
  • chigger (Leptotrombidium deliensis)
  • reservoir: rat
  • tache noire at site of infection
  • rash not on palms, soles of feet or the face
27
Q

Anaplasmataceae

A

Ehrlichia, Anaplasma, Neorickettsia

28
Q

Ehrlichia

A
  • dogs infected with brown dog ticks
  • rickettsial-like inclusions IN MONOCYTES
  • Human ehrlichiosis: many asymptomatic
29
Q

Ehrlichia chaffeensis

A
  • Human monocytic ehrlichiosis (HME)
  • E. ewingii produces indistinguishable disease
  • Lone star tick (A. americanum)
30
Q

HME

A
  • many are asymptomatic
  • can have leukopenia, neutropenia, thrombocytopenia
  • elevated liver enzymes
  • severe complications possible
  • serology (IFA)
31
Q

Human Granulocytic Anaplasmosis

A
  • Anaplasma phagocytophilum
  • similar to HME
  • Ixodes scapularis and Ixodes pacificus
  • deer, rodents, horses, cattle, humans
32
Q

Coxiella burnetii

A
  • Q FEVER (Query fever)
  • potential bioterror agent
  • goats, cattle, sheep
  • influenza-like illness
  • serology (DFA, EIA)