Bacteria (and STIs) Flashcards
(182 cards)
1
Q
Treatment for Gonorrhea
A
Ceftriaxone/azithromycin
2
Q
Treatment for BV
A
Flagyl
3
Q
Treatment for chlamydia
A
doxycycline or azithro
4
Q
Treatment for chlamydia in pregnancy
A
azithromycin
5
Q
Treatment for epididymitis
A
Ceftriaxone + Doxycycline
6
Q
What causes cervicitis
A
Chlamydia Trachomatis, N gonorrhoeae, Mycoplasma Genitalium
7
Q
RUQ Pain sexually active women with fever, dyspareunia, vaginal discharge, dysuria, nausea/vomiting ; what are common pathogens
A
PID: Chlamydia Trachomatis, Neisseria Gonorrhea, Fusobacterium species, Mycobacterium Genitalia, Streptococcus Agalactiae)
8
Q
Treatment for PID
A
CTX + Doxy + Metronidazole
9
Q
typical etiologies of urethritis
A
Chlamydia trachomatis, neisseria gonorrhea, trichomoniasis, mycoplasma genitalium
10
Q
what is the most sensitive tool for detecting gonorrhea urethritis
A
gram stain of urethral secretion (however a lot of people dont do the gram stain anymore)
11
Q
Uncomplicated gonoccocal infection of cervix, urethra, rectum WITHOUT chlamydia
A
Ceftriaxone IM (if chlamydia not excluded, give doxy)
12
Q
Treatment of Mycoplasma genitalium
A
Check resistance; doxycycline and azithromycin
or Doxy and then moxifloxacin (can use this combo if there is no resistance testing avail)
13
Q
typical causes of proctitis
A
Gonorrhea, Chlamydia trachomatis (LGV and non-LGV strain-L1 L2 L3 ), HSV, CMV, Ameobiasis
14
Q
What is LGV
A
lymphogranuloma vernereum
Caused by chlmaydia trachomatis
Serovars L1, L2, L3
Endemic in areas of E. W Africa, India, SE Asia, Caribbean
Presentation: proctitis, LN swelling, genital ulcer
Treatment: Doxy
15
Q
Patient with migratory polyarthralgia and tenosynovitis and monoarticular purulent arthritis found to have tender encrotic acral pustules
A
Disseminated gonoccocal infection -
16
Q
What kind of bacteria is Cholera
A
Vibrio cholerae
Gram Negative Bacilli
Anaerobic
Motile and curved
17
Q
What is v. cholerae classified based on
A
Serogroup O1 and O139 (and other non O1s)
18
Q
Rice Water, fishy odor
A
Vibrio Cholerae
19
Q
How to treat cholera
A
Rehydration phase: lasts 2-4 hours
Maintenance phase: Lasts until diarrhea abates
20
Q
When can you discharge a cholera patient
A
If Oral Tolerance >1000mL/hr
If Urine Output >40mL/hR
If Stool Vlume <400cc/hr
21
Q
What are the preferred cholera abx
A
Tetracycline or Bactrim or Cipro or Azithro
22
Q
Does vaccinating against cholera protect you
A
Not against the O139 strain
23
Q
What are the vaccines for cholera
A
Give to mission workers (i.e. peace corps)
Give to endemic areas, esp school age children
Dukoral: Killed cell 2-3 doses Oral
Live Attenuated vax is also an option (Travelers, single dose)
24
Q
Typhoid fever in Asia mostly caused by
A
Salmonella Paratyphi A
25
Phase I of typhoid fever
Phase II of typhoid fever
Bacteremia: S typhy penetrates the TERMINAL ILEUM (Peyer patches)
Phase II: localization or complications-bowel perforation, GI bleeding, typhoid status, hepatitis
26
Patient had a fever at night more commonly, Diarrhea and constipation alternating, sleeping disorders, insomnia in adults, hypersomnia in children
Typhoid Fever
27
Rose spots, abdominal pain, dissociation pulse rate
Typhoid fever
28
How to diagnose typhoid fever
Widal Test, blood cultures
29
What are the side effects of previously used treatment for typhoid fever
chloramphenicol-side effects included are hematological side effects: Anemia, leukopenia, rarely bone marrow aplasia
30
First line current drug against typhoid fever
ceftriaxone-unless iraq or pakistan, then consider azithromycin, or meropenem
31
what is a serious complication of typhoid
perforation, usually after the 3 weeks of first symptoms-distal ileum usually
32
What does it mean to have a chronic carriage of S typhi or S paratyphi
Person who excretes S typhi in the bile and/or hte stools for more than 12 months
33
what is a risk of being a chronic carrier of s typhi
you shed in bile and stool x 12 months; you also develop hepatobiliary cancer
34
treatment of typhoid in a chronic carrier state
amoxicillin but has a high relapse rate if GB disease
Fluoroquinolone
35
What vaccines prevent typhoid fever
Ty 21a vaccine -3 doses (oral)
V poysaccharides vaccine
36
Patient with constant fever, HA, diarrhea followed by constipation and insomnia. Just back from India. Bradycardia and high temp.
S. Typhi
Tx: Ciprofloxacin if not resistant; or ceftriaxone, amoxicillin; or meropenem
37
10 year old boy from Lagunas in the Peruvian Amazon basin develops a large asymptomatic ulceration on hte right leg. Ulcer has undermined borders
Buruli Ulcer
Mycobacterium Ulcerans Infection
38
What are the endemic regions of buruli ulcer
West Africa, nigeria, Australia
39
Who is most likely to get buruli ulcer
people in poverty, 15 and under years old, stagnant waters
40
What is the pathogenesis of buruli ulcer
Polyketide toxin called mycolactone, cytotoxicity and immunosuppression can explain the extent of the ulcer
41
Describe category I, II, and III of Buruli Ulcer
I. Small, single lesion
II. Ulcerated and non-ulcerated plaque ; edematous form
III. Disseminated and mixed forms -osteitis, osteomyelitis, arthritis
42
how to diagnose buruli ulcer
direct exampintion, culture, skin biopsy, PCR (gold standard)
43
What would you find under microscope of buruli ulcer
Extensive fat necrosis-bluish dusty material in clumps in the areas of necrosis, minimal inflammatory infiltrate, abundant clumps of acid-fast bacilli
44
Treatment of buruli ulcer
Rifampin and streptomycin
Or rifampicin and clarithromycinPO
45
List common causes of bloody diarrhea
Shigella, Salmonella, Campylobacter, Yersinia, STEC or EHEC or VTEC, EIEC, C Diff, V Parahaemolyticus, E histolytica, Balantidium Coli
46
Incubation period of shigella
1-4 days
47
Watery diarrhea and tenesums that turns into bloody diarrhea in 1-2 days
shigella dysenteriae
48
What are common species and distributions of Shigella
S. Flexneri, S Boydii, S Dysenteriae Type 1
49
Describe shigella dysenteriae type 1
-Toxin?
-Epi?
-Transmission?
-Risk factors?
Produces cytotoxin (Shiga Toxin), causes an illness that is more severe, frequently fatal, resistance to antimicobials occur more frequently
-Outbreaks in Africa, South ASia, Central America
-Contaminated food/water, flies
-humans are the only reservoir
-Risk factors: Infants, adults>50yo, no breastfeeding, recovering from measles, malnourishments
-
-
50
Complications of Shigellosis
Abdominal: protein losing enteropathy, perforation, abscesses
Neuro: Seizures, headache, Toxin encephalopathy (ekiri)
Renal: HUS (s dysenteriae serotype1)
51
how do you diagnose shigella
isolate the organism from stool, serotype the isolate
52
Treatments for Mild shigella, Moderate/severe shella?
Mild: Furazolidone
mod-severe; Cipro, cefixime, ceftriaxone
53
What are the shigella vaccines
You can give a vaccine against 17 serotypes including S dysenteriae type 1, S flexneri, S sonnei
54
Most common species of shigella in developing countries
S flexneri, s sonnei
55
Guillan barre is associated with which gram negative bacteria
campylobacter jejuni/coli
56
Campy:
Human illness associated with what species?
Reservoir?
Most common time of life for infection?
Campylobacter Jejuni, Campylobacter Coli
Reservoir: Poultry, Pig
Infection common in the first year of life
57
How to dx cmapy
diagnosis; stool culture at 42 deg C
58
Tx of Campy
Erythromycin and azithromycin
59
Biggest risk factor of campy
Poultry
60
What is
61
If the child presents with blood diarrhea WITHOUT fever, antibiotics?
NO Because of hte risk of HUS due to EHEC or STEC
62
watery or bloody diarrhea without fever,
STEC
63
Pathogen neonate PNA
Listeria
GBS
CMV
HSV
64
PNA children 0-3mo
Chlamydia
RSV
S pneumonia
S Aureas
65
3mo-5 years PNA
Adenovirus
S pneumo
H flu
Mycoplasma
RSV
66
5-15 years PNA complciation
chlamydia pneumo
S pneumo
Mycoplasma
TB
67
AFebrile, respiratory distress, neonate, CXR with e/o PNA. What is highest on ddx
chlamydia trachomatis
68
itchy vaginal discharge, yellow/green, strawberry cervix, pH >4.5, +whiff test, flagellated protozoa
trichomoniasis
69
Itchy, thick clumpy cottage cheese vaginal discharge, pH<4.5, pseudohyphae on KOH
candida
70
+whiff test vaginal discharge, clue cells
Bacterial vaginosis
Treatment: Metronidazole
71
Neutrophilic infiltrate with multiple acid fast bacilli
tuberculous chancre
72
Definition of Chancre
Superrficial ulceration and superficial granuloma with neutrophils or caseous necrosis
73
Definition of Scrofuloderma
Fistulous draining from underlying structure such as a lymph node, bone, or epididymis
74
fistula draining
scrofuloderma
75
what is the definition of a gumma
cold abscess as a result of hematogeneous spreading
76
Gumma: Bacilli likely seen
77
hematogeneous spread, apple jelly
lupus vulgaris, facial, Cutaneous TB
78
How do you treat a cutaneous TB
As a pulmonary TB
79
38 year old male from Cajamarca (northern highlands of Peru) complains of nasal obstruction, difficulty breathing
Russell bodies-rhinoscleroma on biopsy
Klebsiella Pneumonia sp Rhinoscleromatis
80
Patient with crusting, paleness, malodor, atrophy, Bluish discoloration, polypoid lesions, ulcerations. what is histology? what is treatment?
klebsiella pneumnoia rhinoscleromatis (rhinoscleroma)
Histology: large histiocytes with rods, mikulicz cells, russell bodies
Tx: prolonged administration of antibiotics such as tetracycline, quinolones, ceftriaxone from 6 weeks to 6 months
81
26yo HIV + not on HAART with 1 year history of ulcerated fungating masses on the glands and body of penis
Klebsiella Granulomatis, granuloma inguinal
82
What can cause autoamputation of penis in HIV2 ? What is the treatment
donovanosis, Tx: Azithromycin 1gm, then 500mg daily
83
The spontaneous appearance of abscesses primarily in the large muscles of hte limbs and trunk accompanied by systemic symptoms such as fever and localized pain
tropical pyomyositis (likely 2/2 staph, not MRSA)
Treatment with oxacillin
84
What are the 3 brucella species that cause most human disease
Brucella Melitensis -Goat, sheep
Brucella ABortus-cattle, water buffalo
Brucella Suis-Pig
85
What is the route of transmission for brucella melitensis?
Ingestion of unpasteurized dairy products, direct contact with animals and secretions, vets, lab personell
86
Night time fever, malaise, sweating, back pain, arthralgias, myalgias with hepatomegaly
Brucellosis
87
50 year old female with pain in the lumbar region involving 2 + vertebrae with lytic and blastic lesions
brucellar spondylitis
88
What is the pons sign?
Anterior upper angle erosion in the back-caused by brucella spondylitis
89
What are the most frequent brucellar arthritis locations
unilateral sacroilitis and peripheric mono-arthritis
90
Why do women have more severe brucella melitensis than men?
Iron deficiency: brucella rapidly grows under this condition and causes severe thrombocytopenia, arthritis
91
What is theh most common ocular manifestations with brucella
posterior uveitis
92
How do you diagnose brucella
Rose bengal test (agglutination), ELISA (less specific than TAT), PCR (expensive)
93
How do you treat brucella?
Doxycyline + Gentamycin
or Doxy + Rifampicin
94
How to treat children <7 years old for brucella?
Cefriaxone + Rifampin
DO NOT use tetracycline
95
31yo Man of tuscon, arizona returned from Colorado and started to have fever, deydration, nausea, vomiting. Went into septic shock with pneumonia, gram stain sputum showed gram neg rods
Yersinia Pestis (plague)
96
Country with the highest plague currently
Madagascar. Between 2000-2009, Congo, Madagascar, and Zambia
97
What does plague look like on staining
Gram negative bacillus with bipolar staining (closed safety pin)
98
What are the virulence factors of plague
1. YOPS (yersinia outer membrane-inhibits phagocytosis, downregulates pro-inflammatory cytoquines, induces cell death
2. F1 Antigen (Capsule): ANtiphagocytic
3. V Antigen: Survive and multiply in the macrophages
4. LPS endotoxin (Cell wall )
99
What are the reservoirs of plague
urban: Rat, sylvatic: squirrels, prairie dogs
100
How do you get the plague
Flea regurgitates infectious remnants from previous blood meal into bite wound
101
clinical manifestations of the bubonic plague
incubation period is 2-8 days, regional lymph nodes; sudden onset of fever and chills (high fever)
-Hepatosplenomegaly , thrombocytopenia, DIC
102
Septiemic plague clinical manifestations
bacteremia without a bubo, nausea, vomiting, diarrhea, delirium, coma, hemorrhage, shock
103
Pneumonic plague clinical manifestations
secondary (hematogenous), primary (inhalation-frothy blood tinged sputum)
Chest discomfort, cough, tachypnea, dyspneae, hemoptysis, respiratory distress
104
31yo M 3rd year resident with high fever, tachypnea, decreased breath soudns, in shock within 3 days; labs show DIC, elevated WBC . What is the orgnaism? diagnosis/ Tx
Yersinia Pestis (Plaque)
Can do F1 Ag (rapid Yersinia pestis test)
Tx: Streptomycin + chloramphenicol
105
What is the treatment for the plague
streptomycin, gentamicin, doxycycline, ciprofloxacin (treat at least 10-14 days or until 2 days after fever subsides)
106
How to prevent plague (chemoprevention) in someone exposed
7 days of Tetracycline (doxy)
107
What is the recommendation for healthcare workers taking care of those with the plague
droplet precautions for 8 hours while patient is on abx, wear surgical mask
108
Painless, superficial or deep, sharply demarcated, indurated, nonpurulent base genital ulcer
Treponema Pallidum (syphilis)
109
Superficial, painful genital vesicule, small, no induration
HSV
110
Deep, irregular, UNDERMINED edges, purulent, genital LAD
Chancroid: H. Ducreyi
111
List the Ulcerative STIs
112
What is the pathogenesis of HSV
Primary infection happens through inoculation/epithelial replication -->retrograde transport to sensory ganglia-->latency in the sensory neurons-->reactivation
113
incubation period of HSV?
Vesicular pustule time frame?
Wet ulcer time frame?
Dry Crusts time frame?
IP: 4 days
Vesicular: 0-6 days
Wet ulcer 6-12 days
Dry Crusts 12-20 days
114
What test do you NEED to use to accurately test for HSV
Glycoprotein gG test-NOT IgM !
115
When is testing for HSV actually useful
Recurrent or atypical genital sx or lesions with a negative HSV PCR previously, clinical diagnosis, 12 weeks after acquisition, partners are possible positive
NOT helpful for screening general population
116
Tx for HSV
Acyclovir, Famciclovir, Valacyclovir
117
How is HSV shed
genital mucosa-usually transmitted during asx genital shedding
118
What is monkey pox
orothopoxovirus
119
Classic presentation of monkey pox
Fevers/chills (prodrome), Rash including firm deep seated well circumscribed umbilicated lesions that srtart ont he face and spread. can be painful.
120
Monkey pox
121
How do you diagnose monkey pox
PCR-use CDC and state labs
122
What are the treatments for Mpox
Supportive care, Tecovirimat, Vaccination
123
Small fastidious gram negative rod with erythematous papule evolves into ulcer-typically 1-2cm
Chancroid: Hemophilus ducreyi
124
Tx for chancroid
Azithromycin or ceftriaxone
125
Lymphogranuloma Venereum: Organism, Clinical sx, Diagnosis, tx?
Chlamydia trachomatis, Proctitis among MSM, genital ulcer, inguinal lymph node/bubo; Diagnose with PCR; Treatment -doxy or azithro
126
What s granuloma inguinale
Klebsiella granulomatis (Gram negative Rod); Starts as firm papule that ulcerates, beefy red, non-tender ulcers; Dx with donovan bodies on biopsy; azithromycin is the tx of choice
127
LGV Proctitis treatmetn
doxycycline x 3 weeks
128
67yoM in HIV clinic for rash given dx of contact dermatitis. HIV well controlled CD4 633.
Syphilis (treponema pallidum)
Tx: Penicillin
129
What are the stages of syphilis
Exposure-->chancre (primary)-->rash/fever/neuro (secondary)-->.latent (no symptoms) (usually in the first year )
Then 30% can have latent for 5-50 years and then develop tertiary (gumma, cardiac, tabes dorsalis etc)
130
Treponema Pallidum
Classic chancre: Primary stage
RPR/VDRL (even if neg, and concerned about syphilis, treat)
131
Secondary stage of syphilis:
generalized rash: macular, papular, codyloma lata; 2-6 weeks
132
A 25 year old male presenting to outpatient clinic with disseminated crusted lesions, MSM +. RPR negative.
malignant syphilis. The patients' serum was diluted and RPR was positive. PROZONE -false negative response resulting from overwhelming Ab titers .
Tx: Benzathine penicillin prob for 3-4 weeks
133
DDx of disseminated rusted lesions in the tropics
Disseminated leish
Histo
Crypto
Lobomycosis
Chromoblastomycosis
Yaws (t. pallidum)
Pinta (no longer)
Disseminated varicella/zoster
Cutaneous TB
Leprosy
134
56yoF with HIV, anterior uveitis, tinnitus b/l, painless genital lesions, rash over palms and soles
treponema pallidum : syphillis
135
How do you define syphilis latent stage:
Positive treponemal serology , no sx
<1 year: early latent
>1 year: Late latent
2/3 persons with untreated syphilis remain in latent stage or life
136
Neurosyphilis clinical manifestations
meningovascular, meningitis, posterior column (tabes dorsalis)-ataxia, charcots joints, optic nerve defeneration
137
What are the tests for syphilis
Nontreponemal: VDRL and RPR (Ab to cardiolipin-lecithin-cholesterol antigen) Quantitative -use for treatment response
Treponemal tests: TP-PA, FTA-ABS (Qualitative)
EIA: Screening (high false positive)
138
Treatment of syphilis
Early syphilis tx: IM x1 BZN penicillin
Late latent IM x3 BZN penicillin
Neuro syph tx: Aqueous PCN x 2 weeks
139
10 month old female with vesicular skin lesions involving hands and palms. Nasal discharge +
Fever+. +saddle nose deficit.
Congenital syphilis: IM penicillin tx
140
Risk factors for neonatal sepsis
prematurity, low birth weight
141
What determines newborn immunity
immunoglobulins IgG for placenta; nuetrophils reserve is less than the adulr
142
common gram positives in neonatal sepsis
coag negative staph, GBS, enterococcus, s aurus
143
acute onset fever, chills pallor, jaundice. from ecuador. has hepatomegaly. increased reticulocytes
bartonella bacilloformis: Rx: Cipro/Azithro
144
macular star on fundoscopy
bartonella
145
abrupt onset fever, chills, myalgias, headache, meningeal symptoms after swimming in stagnant wate, conjunctival suffusion, very high bili
leptospirosis: Ceftriazone, penicillin
146
jaundice with ARDS after swimming with rodent contaminated water
leptospirosis: CTX, PCN
147
27 year old male with erythematous lesion developed aft over hte left thigh 3 weeks after closed trauma , multiple fistulas dark brown purulent material without granules. 11% eos. sulfur granules
Actinomycosis: sulfur granules (gram positive filamentous anaerobic bacteria) Tx: Penicillin
148
35yr old female with 10 year history of slow growing swelling on left foot, draining fistula with secretions containing white grains, ffrom ayachucho, rainforest
Actinomycetoma: Nocardia or Streptomyces or Actinomadura
Tx: Penicillin
149
gram positive bacilli on culture, skin lesions painless colorless blister
cutaneous anthrax: bacillus anthracis , penicillin therapy
150
fistula, white purulent exudate, osteomyelitis; what disease/ what is it associated with?
Botryomycosis caused by staph: HTLV association
Tx: Clindamycin and cipro
151
T2DM with BKA 7 days before, feeling unwell, difficulty swallowing. Couldn't open his mouth, drooling MUscles rigid, sweating profusely . What organism? What kind of org?
Clostridium Tetani (anaerobic gram-positive bacllus)
152
C tetani pathophys
Injury via spores-->Tetanospasmin travels to the spinal cord-->trismus, muscle spasm-->release of inhibitory neurotransmitters to te renshaw cell-->unopposed muscular contraction-->opisthotonos, risus sardonicus
153
DDx tetanus
strychnine poisoning, narcotic withdrawal, meningitis, rabies, hypocal tetany, NMS, stiff person
154
WHO definition of adult tetanus
Trismus (inability to open mouth) OR risus sardonicus (sustained spasm of the facial muscles) OR painful musclar contractions
155
How do you diagnose tetanus
CLINICAL! Spatula test-bite down and no gag
156
Incubation period of tetatnus? Period of onset of tetanus?
Incubation period: <7 days
Symptoms day 7 trismus, dysphagia, back pain
Day 10: generalized spasms
Day >10 CVS HR >130, GI/Renal, Pyrexia >40deg C
157
What is modified Ablett Score
158
What are the two types of generalized tetanus
localized tetanus: rigidity, pain, weakness, increased deep tendon reflexes
Cephalic tetanus: Lower cranial nerve muscles, facial palsy, stiffness, trismus, pharyngeal spasms, largyngeal spasm, neck stiffness, paresis of IX, X, III
159
Treatment of Tetanus
minimize light and sound
benzos (use IV)
Chlorpromazine
Neuromuscular blockade with vec
Magnesium
VEntilation and early tracheostomy
160
Treatment of Tetanus
minimize light and sound
benzos (use IV)
Chlorpromazine
Neuromuscular blockade with vec
Magnesium
VEntilation and early tracheostomy
Antitoxin (TIG 500 IM/IV, Equine Antitoxin)
Abx: Metronidazole
B blocker, morphine, clonidine
161
7 day old child with fever, difficulty opening mouth, not opening mouth, sensitive to light, sound, touch. Orgnaism? Treatment? Prevention?
Clostridium Tetani
Tx: Abx-flagyl. anti toxin-TIG. Sedativie-phenobarb, chlorpromazine, anti-spastic-benzo; muscle relaxant-magnesium, quite dark stimulation
Prevention: mom vaccination-1st dose in 1st tri pregnancy, 2nd dose at least one moth later (3rd tri)
162
What is the global progress with maternal and neonatal elimination **TEST
Elimination is defined as <1 NNT case per 1000 live births every district per year
163
Definition of tetatnus
muscle stiffness spasms with or without cardiovascular instability + preserved consciousness
164
Patient with facial lesion, UMN lesion, after MVC
Cephalic tetanus
165
Definition of neonatal tetanus
normal ability to suck and cry during 2 days of life. Then could NOT suck normally between day 3 and 28 . Muscle stiffness and spasms (jerking)
166
Spread of Coxiella
aerosolization (>10km downwind), lambing, raw milk, tick bite
167
Incubation of Q fever
2-6; mostly asymptomatic, fever, pneumonia, hepatitis, HEADACHE *** ; mortality is very low IF treated
168
Pregnant woman with coxiella
TMP/SMX through pregnancy, be careful with staff who are coming into contact with placenta
169
20 year old malawian man-arrived in Italy from Malawi, 2 days of high fever, scratch marks on skin, CRP elevated
Borrelia Recurrentis infection
170
Louse Borne diseases (list 3)
Rickettsia Prowazekii
Bartonella Quintana
Borrelia
171
What is the vector for borrelia
pediculus humanus humanus
172
Louse borne relapsing fever incubation period (borrelia) and clinical picture
incubation period (4-17 days)
Sudden high fever, chills , HA, confusion, nightmares; jaundice, chest signs; can have relapses
173
severe complications of louse relapsing fevers
uterine bleeding, abortion, myocarditis, acute LVF, pulmonary edema, severe bleeding, splenic infarction and rupture , secondary bacterial infections
174
What is the jarisch-Herxheimer reaction , how do you prevent it
abx precipitation: CHILL (rigors) FLUSH (Vasodilation) AND RECOVERY in borrelia; treat with low dose procaine penicillin IM , then tetracycline
175
tx of louse borne relapsing fever
Tetracycline-->but high risk of JHR; or procaine penicillin but may have relapses
176
What is a tick borne relapsing fever caused by
borrelia duttonii//reservoir is ticks, humans, mammals
177
What are the differences between LBRF, TBRF?
178
single primary painless lesion , enlarges to exudatve papilloma or painless ulcer with local LAD
Yaws: T pallidum Pertenue (TPE)
179
What are features of treponematoses
Gram negative spirochetes, fragile (prefer body temp); infection via small skin abrasions/lacerations , cause chronic gramulomatous disease
180
secondary yaws
181
Yaws diagnosis
dark ground examination-like in syphilis
182
Endemic syphilis (bejel) -skin to skin, small painless papule/ulcer; angular stomatitis, gumma
