A: Which Brucella species is MOST COMMON for Human infection and MOST VIRULENT
B: Which Brucella species is least common
A: [Brucella melitensis (from Sheep and Goats)] = MOST COMMON of human infections and most virulent.
B: Brucella canis (from dogs) = least common and generally laboratory acquired
A: Why are Lab workers at risk when working with Brucella?
B: List the populations at risk for Brucella Infection (4)
C: What category Bioterrorism is Brucella?
A: Laboratory workers inhale [Brucella Aerosols] which are dangerous
C: Brucella is a CATEGORY B INFECTIOUS AGENT!
2 Examples of Category C Bioterrosim Agents
B: What's the Criteria for this (3)
B: emerging pathogens that could be engineered for mass dissemination in the future because of
2. ease of production and dissemination; and
3. potential for major health impact
A: Brucella Pathogenesis (3 steps)
B: Where do the organisms actually replicate
C: What is the Host rxn to this
D: Natural recovery for the host depends on what?
1st: Organisms penetrate skin or mucous membranes
2nd: Phagocytosized by macrophages and monocytes
3rd: Carried to spleen, liver, bone marrow, lymph nodes and kidneys
B: Organisms multiply INSIDE macrophages in RE system and are able to live inside cells because they BLOCK PMN Degranulation
C: Host reaction is the formation of small granulomas
D: Recovery depends on [T-Cell Mediated Immunity] ONLY
A: What is [Erythritol predilection]?
B: What bacteria causes this?
Erythritol predilection explains why animals have abortions and sterility.
-MACs process Brucella antigens and present them to T cells which excrete lymphokines responsible for attracting cells to the area of infection---> Abortion.
A: Brucella Clinical Manifestations: (2)
B: What are the 3 Organomegaly's it causes
C: Bone-related Sx of Brucella (2)
D: Cardiovascular-related sx of Brucella
Brucella Clinical Manifestations:
1st: Initial = Nonspecific sx (Malaise/ weakness/ myalgias)
2nd:[GI sx] and [Intermittent Undulant Fever] caused by Brucella sequestering in granulomas of tissue and [bone marrow]
B: Also causes [Hepatomegaly / Splenomegaly / Lymphadenopathy]
C: [Osteolytic Lesions] and [Bone Sacroilitis]
D: [Brucella Endocarditis] --> may requires valve replacement
A: Brucella Diagnosis (2)
B: Brucella Characteristics
1. shape and gram stain
2. How does it physically look
3. Which Agar and what does it require?
1. Blood and [bone marrow] Cultures with EXTENDED incubation time
2. Elevated [Febrile Agglutinin Titer]
-gram negative coccobacilli
-appears like "fine sand"
-GROWS on Chocolate Agar but requires PROLONGED INCUBATION and enriched media
-Oral tetracyclines + [aminoglycosides-gentamycin/streptomycin]
C2: Relapse may occur becuz some Brucellosis can be chronic
Who are most at risk for [Francisella Tularensis] infection? (3)
2. People exposed to [Dermacenter Ticks]
3. Lab Workers (from inhaling infectious aerosol when dealing w/infected animal)
List the 6 Clinical Manifestations of [Francisella Tularensis]
"Francis FORCUT theTick b4 SYMPTOMS"
1. Fever and malaise 2-5 days after exposure
2. [Oropharyngeal Exudative Pharyngitis]
3. Regional Lymphadenopathy
4. Conjunctivitis (unilateral) after aersol/water exposure
5. Ulceroglandular Papule at bite site
6. Typhoidal Infection = HIGH MORTALITY = Fever/Wt loss/Prostration
[Francisella Tularensis] Diagnosis:
1. Which Stain.
1B: Special Requirements (3)?
2. Serologic Dx
• Culture requires [SulfHydryl] to grow -
•DOES NOT GROW ON ROUTINE MEDIA
2. Serologic Dx: acute and
convalescent agglutinin antibody titers
• Single serum may reflect previous exposure
A: Transmission for [Yersinia Pestis] (3) AKA ____
B: Lab Studies with pts infected with [Yersinia Pestis] (2)
Transmission for [Yersinia Pestis] (3) AKA PLAGUE
1. Flea Bite
2. Direct Contact w/infected tissue
3. INHALING infected aerosols or from pt with pulmonary dz
-WBC count between 10K to 20K
-normal Platelet or [low Platelet due to DIC]
[Bubonic Plague] Clinical Syndrome
1. What happens 1st
2. What happens 2nd
B: Mortality Rate
C: What Bacteria is this caused by?
1st: Bubo thts painful + Fever up to 1 week after bite
2nd: Lethargy with INTENSE BUBO PAIN hours after Bubo formation
B: 75% mortality if untreated
C: [YERSINIA PESTIS]
[Septicemic Black Plague] Clinical Syndrome
A: Sx (6)
B: Where does "Black Death" come from?
C: What is the fatality rate so high with [Septicemic Plague]
D: What Bacteria is this caused by?
Septicemic Black Plague
A: "PBS Did Favors Daily for Blacks "
-BLACK Hemorrhagic Splotches--> "BLACK Death"
B: [Black hemorrhagic splotches] gave rise to the name “Black Death”
C: 100% of pts. become septic with + blood cultures – Fatality rate high due to delay in Dx and Tx
D: [YERSENIA PESTIS]
[Pneumonic Plague] Clinical Syndrome
3. How do these pts become infectious
4. What happens, if untreated
5. What bacteria causes this
1. Plague bacillus reaches lungs by hematogenous spread or by inhalation of infectious aerosol from plague pt. with cough.
2.Initially: Fever, headache, malaise, confusion
2nd: Pts. develop cough, chest pain, hemoptysis.
3: Sputum usually purulent and contains [plague bacillus]
(Patient highly infectious)
4. Quickly followed by sepsis / death unless therapy initiated within one day following onset of symptoms
5. YERSINIA PESTIS
A: [Yersinia Pestis] Colonies grow slowly on ______ media and after 48 hrs can have a ______ or ______ appearance under stereoscope
B: [Yersinia Pestis] grow faster at ______ TEMPERATURES
C: MOTILE OR [NON-MOTILE]
D: What family?
A: [Yersinia Pestis] Colonies grow slowly on ORDINARY media and after 48 hrs can have a “fried egg” or “beaten copper” appearance under stereoscope
B: [Yersinia Pestis] grow faster at COLDER TEMPERATURES
A: Tx for [Yersinia Pestis] (2)
B: Alternative Tx (2)
C: INEFFECTIVE TX (2)
E: Vaccines available?
A: Tetra + Streptomycin
B: alternatives include gentamicin or chloramphenicol,
C: Penicillin's and cephalosporin's are not effective in treating plague
D: Chemoprophylaxis with tetracycline
E: Vaccines are available for high risk pt