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Microm 442 > Lecture 23 Chlamydia and Rickettsia > Flashcards

Lecture 23 Chlamydia and Rickettsia Flashcards

1
Q

Why is Chlamydia and rickettsia grouped together?

A
  • not genetically similar

- grouped because of unique lifestyle (obligate intracellular bacteria)

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2
Q

What are the three species of Chlamydia?

A
  • Chlamydia trachmomitis
  • Chlamydophila pneumoniae
  • Chlamydophila psittaci
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3
Q

What are some sx of contracting chlamydia Trachomatis?

A

-urogenital infections, ocular infections

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4
Q

What are some sx of C. Pneomoniae?

A

Respiratory tract infections

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5
Q

What are sx of C psittaci?

A

-Pneumonia, systemic infections (from birds)

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6
Q

What is the Elementary body of Chlamydia?

A
  • spore-like form (non-replicating)
  • ***infectious
  • stabilized by disulfide crosslinking of outermembrane proteins
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7
Q

What is the reticulate body of Chlamydia?

A
  • intracellular replicating form
  • divide within membrane-bound inclusion
  • osmotically unstable, cannot survive outside cell
  • ***non-infectious
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8
Q

What can be said of the genome of Chlamydia?

A
  • small chromosome
  • auxotrophic for several aa and nucleoside triphosphate (can produce limited ATP, encodes two translocases)
  • highly conserved endogenous plasmid required for full virulence
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9
Q

What virulence factor is expressed both in the EB and RB of chlamydia?

A

-Type III secretion system

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10
Q

what is the pathogenesis of EB chylamadia?

A
  • induces Epithelial cell internalization
  • pre-formed effector protein (TARP), secreted into target cell
  • TARP induces actin polymerization, phago of EB
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11
Q

What is the pathogenesis of Chlamydia?

A

secrete

  • Inc proteins: modify inclusion membrane
  • CPAF: Translocated proteases that degrade host and Chlamydia proteins
  • Anti-apoptotic factors secreted by chlamydia keep host alive until matures
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12
Q

What does the modification of chlamydia inclusion membrane do for the pathogen?

A
  • prevent lysosome fusion by blocking SNARE-mediated interactions
  • co-opt trans-golgi vesicles to camouflage growing inclusion
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13
Q

What is the immune response to C trachomatis (infects epithelial cells of conjuctiva, respiratory, GI, Urogenital)?

A
  • TH1 (interferon-y-associated) immune response
  • provokes a low level chronic inflammatory response
  • necrosis, cell proliferation, scar tissue formation
  • leads to disease
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14
Q

How are the servovars of C trachomatis determined?

A

-polymorphic outer membrane proteins, can associate servavors to diseases

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15
Q

What are diseases caused by C trachomatis?

A

-trachoma
-Urethritis/cervicitis
-perinatal infactions
inclusion of conjunctivitis
-Lymphogranuloma venereum

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16
Q

How do C Trachomitis servovars differ in release from epithelial cells?

A
  • some release apical to lumen (A-K)

- some release baolateral into lymph nodes (LGV)

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17
Q

What age group is more prone to C Trachomitis?

A

-20-24, more so in women

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18
Q

What are the sx of C trach urogenital infection in men?

A
  • Urethritis:
  • Dysuria and urethral discharge
  • More likely to be asymptomatic than gonorrhea
  • Epididymitis- frequently unilateral
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19
Q

What of some sx of urogenital infection in women by C trach?

A
  • dysuria, frequency

- absence of WBC in the urine

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20
Q

What are some sx of Cervicitis?

A
  • most women asymptomatic
  • Mucopurulent cervical discharge
  • Friability (easily induced bleeding)
  • Untreated infections persist for months
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21
Q

Whatare the Pelvic inflammatory diseases (PID)?

A
  • Endometritis (uterine lining)
  • Salpingitis (fallopian tubes)
  • Peritonitis (peritoneal cavity)
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22
Q

What some sx of PID?

A
  • discharge, bleeding, fever, abd tenderness, and pain.
  • Symptomatic PID can occurs in women with endocervical C trach infections
  • can result in scar tissue (tubal infertility, ectopic pregnancy, chronic pelvic pain)
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23
Q

What are some diseases caused by C trach Neonatal infections?

A
  • inclusion conjunctivitis

- Pneumonia

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24
Q

What are the sx of inclusion conjunctivitis?

A

-watery discharge becomes purulent, eylids swell, conjuctiva become red and thickened

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25
Q

How is C tach Dx?

A

-Nucleic acid amplification techniques (NAAT)
(High sensitivity, specific, urine or vaginal swab)

-Screenings (CDC recommended),
MSM (for urethral and reactal)

26
Q

How is Lymphogranuloma venereum (LGV) transmitted?

A
  • caused by serovors L 1-3
  • STD
  • lympotropic, meaning capable of regional and systematic dissemination
27
Q

What are the stages of LGV?

A
  • Primary stage: small ulcer on genitals, few, rapidly heals
  • secondary stage: inguinal lymphadenophathy, fever, HA, muscle pain, resolves after week w/ possible scars
  • Tertiary stage: Chronic procto-colitis, mimic inflammatory bowel diseases. Elephantiasis of genitalia can occur.
28
Q

What is the pathogenesis for trachoma disease?

A
  • by servovars A-C, not the same as genital
  • inital infection in ocular or nasopharyngeal cells
  • severity from repeated reinfections
29
Q

What is the sx of trachoma?

A
  • chronic follicular conjunctivitis
  • Progresses to thickening of eyelids, with papillary hypertrophy (bumps in eyelids), contraction of scarred tissue
  • Trichiasis- eyelashes turn in, scratch cornea
  • Ulceration and scarring of cornea, loss of vision
30
Q

Where is the highest prevalence of Trachoma?

A
  • sub-Saharan AFrica, SE Asia

- most active in children,

31
Q

How is trachoma transmitted?

A

eye and nasopharyngeal secretions in hands, flies fomites

32
Q

What is WHO’s plan for trachoma?

A 
-eliminate by 2020
SAFE:
*Surgery to correct Trichiasis
*Abx to treat infection 
*Facial cleanliness
*Environmental improvements (water sanitation)
33
Q

What abx are used to treat Trichoma?

A

azithromycin

34
Q

How is pneumonia transmitted?

A
  • Person-to-person, respiratory droplets
  • Most infections mild or asymptomatic
  • Clinically indistinguishable form other causes
35
Q

What types of cells does c pneumoniae infect?

A
  • wide range of cells that types may contribute to transport form the lungs to circulation
  • associated with atherosclerosis (plaque in arteries)
36
Q

How is psittacosis transmitted?

A

-Birds via inhalation (Psittacine birds or poultry)

37
Q

What are sx of psittacosis?

A

-ranges from mild fevrile to fatal pneumonia

38
Q

How is psittacosis prevented?

A

Quarantine and treatment of imported birds

39
Q

What animal population has Chlamydia devastated?

A
  • Koala population in AUS
  • Ocular and Urogenital infections
  • Solutions are culling and serine protease inhibitor
40
Q

What abx are sued for ocular and genital infections?

A
  • azithromycin
  • Doxycycline
  • erythromycin for neonatal
41
Q

What abx are used for PIDs?

A
  • Cephalosporin and doxycycline

- cannot heal scarring

42
Q

What abx are used for systematic infections?

A

-Doxycycline

43
Q

How is Chlamydia treated?

A

-abx, no vaccine

44
Q

What are the characteristics of Rickettsiales?

A
  • obligate intracellular

- Gram-negative bacteria

45
Q

How is Rickettsiales transmitted?

A

by arthropod vector

46
Q

What are some common manifestations of Rickettsiales?

A

-fever, rash, and HA

47
Q

What are the three groups of Rickettsiales?

A
  • Spotted fever group: R. rickettsii
  • Epidemic Typhus group: R. prowazekii
  • Ehrlichiaceae Family: E. chaffeensis, Anaplasma phagocytophilum
48
Q

How is Rocky Mountain Spotted fever transmitted?

A
  • American dog tick

- Rocky mountain wood tick

49
Q

What is the pathogenesis of Rickettsia rickettsii?

A
  • enter circulation through tick bite
  • attach to and invade vascular endothelial cells
  • small genome, capable of independent metambolism
  • intracellular motility and cell-to-cel spread via actin-based motility
  • injury to host cell results to increased vascular permeability
50
Q

What are some sx of Rocky Mountain Spotted fever?

A
  • fever, muscle pain, severe HA, nausea, vomiting
  • Maculopapular rash
  • Sever disease involves multiple organ systems
51
Q

How is Rickettsia rickettsii prevented?

A
  • avoidance and prompt removal of ticks

- transmission takes 24 hours

52
Q

What abx are given for Rickettsia rickettsii?

A

Doxycycline

53
Q

Which pathogen caused a Typhus epidemic?

A

R. prowazekii

54
Q

How is typhus transmitted?

A

Human body lice, infected louse feces transmits into skin through scratching.
In the US it was from fleas and lice of flying squirrels.

55
Q

What are the sx of typhus?

A
  • Fever, rigors, sever HA, macular rash, pneumonia, progression to delirium, coma, death
  • Pts remain latently infected after recovery and reactivation of disease may occur years later?
56
Q

What pathogens causes Ehrlichionosis?

A

Ehrlichia chaffeensis and Anaplasma phagocytophilium

57
Q

What is the pathogenesis of Erhlichiosis?

A
  • obligate intracellular
  • infect leukocytes
  • Replicate within inclusions
  • inhibit phago-lysosomal fusion
58
Q

How is Erhlichiosis transmitted?

A
  • Tick born:
  • Human monocytic erhlichiosis by lone star tick
  • human granulocytic anaplasmosis by deer tick
  • most cases in South Central US
59
Q

What are sx of Erhlichiosis?

A
  • clinically similar to Rocky Mountain Spotted fever, without the rash
  • Leukopenia, Thrombocytopenia
60
Q

How is Erhlichiosis treated?

A

Doxycycline

Microm 442 (16 decks)

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