Relapsing Fever

Question 1

Borrelia Recurrentis

Answer 1

Epidemic Relapsing fever

Louse Vector

Question 2

Borrelia Spp.

Answer 2

Endemic relapsing fever

Tick vector

Question 3

Relapsing Fever Characteristic

Answer 3

Antigenic variation
antigenic switching
- VIp
-Vsp

Question 4

How does borrelia reoccur?

Answer 4

Interplay w/ immune system
VMP1
VMP2

Question 5

Endemic Relapsing Fever

Answer 5

B hermsii carried by ornithodoros hermsii

B parkeri carried by ornithodors parkeri

Question 6

Ornithodoros Hermsii

Answer 6

is a vector and reservoir
Transvarial passage
can live 15 years without feeding 
Reservoir Host- Rodents
Multiple feedings, immediate disease transfer

Question 7

Relapsing Fever Epidemiology

Answer 7

Peak season is outdoor season

Ticks nocturnal

Question 8

Borrlia Recurrentis Epidemia

Answer 8

Reservoir Humans
Vector Human Body Louse
No transvarial

Question 9

Infection process B recurrentis

Answer 9

Louse feed on sick human
ingests bug,
Louse evades the fever, and goes to new host

Question 10

B recurrentis epidemiology

Answer 10

Does not occur in us

overcrowding

Question 11

Borrelia Etiology

Answer 11

Gram neg
Larger than burdogoferi
gram or giemsa stains
EXTRACELLULAR
cultures BSK

Question 12

3 stages of relapsing fever

Answer 12

Primary spirochetemia
Latent
Secondary spirochetemia

Question 13

Primary Sprichetemia

Answer 13

Acute Onset
Ends abruptly
High fever
hepatosplenomegaly
CRISIS after first episode

Question 14

Latent Phase

Answer 14

Afebrile- replication

NO ISOLATION FROM BLLOD BECAUSE IN ORGANS

Question 15

Secondary Spirochetemia

Answer 15

antigenic variation relaps

eache relapse = ↓ severity and ↓ duration

Question 16

Fatalities of relapsing fever

Answer 16

Rare in endemic

40% in epidemic

Question 17

Immune response to relapsing fever

Answer 17

largely humoral
PMN phagocytosis
controlled when no longer evades system by switching
NO IMMUNITY TO REINFECTION

Question 18

Diagnosis Relapsing Fever

Answer 18

Directly or Gram prep from blood
lumbar puncture if meningitis
Culture, mouse inoculation or BSK medium

Question 19

Treatment and its complications

Answer 19

Doxycycline

Jarisch-Herxheimer response

Question 20

Leptospirosis

Answer 20

acute zoonotic, NO VECTOR
HAWAII
Hosts: renal tubule
passed by urination
RODENTS

Question 21

types of transmission of leptospirosis

Answer 21

Vertical and Horizontal

Question 22

Patterns of transmission

Answer 22

Epidemic
Endemic
Sporadic

Question 23

Leptospira interrogens

Answer 23

very thin tightly coiled

INTRACELLULAR PATHOGEN

Question 24

Lepto ETIOLOGY

Answer 24

gram neg structure, microscop not DIAGNOSTIC
Darkfield microscope
EMJH medium for growth
Aerobic organisms SLOW GROWING

Question 25

Lepto Characteristics

Answer 25

Sensitive to drying, disinfectants and acidic environments

Question 26

Lepto Pathogenesis

Answer 26

1. crossss mucous membranes
2. enters bloodstream and tissue
3. OMP and Factor H binding
   Target organs
   Kidneys, Liver, Heart

Question 27

Clinical Manifestations of Lepto

Answer 27

most infections subclinical
Two anicteric stages
1. septicemic
2. Immune

Question 28

Septicemic stage

Answer 28

last 4-7 days
abrupt in onset
flu symptom non specific
isolated from blood
fever recurs transitioning to second stage

Question 29

Immune stage

Answer 29

immune response to microbe
0-30 days
abs from blood
microbe isolated from URINE

Question 30

Specific organs of immune stage

Answer 30

1. aseptic meningitis, fever stiff neck, most important
2. Conjuctival suffusion
3. Renal symptoms

Question 31

Icteric stage Weil syndrome

Answer 31

Most sever form
MODS
•Renal dysfunction
•Hepatic necrosis
•Pulmonary dysfunction
•hemorrhagic diathesis

Question 32

When to consider Leptospirosis

Answer 32

Fl u like disease w/
Aseptic meningitis or
disproportionately myalgia

Question 33

Diagnosis Lepto

Answer 33

1.Clinical finding consistent
2.Patient History
• rats
contaminated water
other hosts
3. Culture Blood during septicemic stage
Urine during immune stage
4. PCR amplification
LEPTO CHECK
MAT

Question 34

Leptospirosis Treatment

Answer 34

Support

& Doxycycline