Bacteriology 3 Flashcards
Spirochetes
morphology
BLT species
microscopy
spiral shaped bacteria with axial filaments
Borrelia, Leptospira, Treponema
Borrelia - analine dye
Treponema - Dark Field microscopy
Borrelia burgdorferi - Lyme Disease
tranmission & reservoir region Stage 1 Stage 2 - FACE Stage 3
tx
ixodes tick (anaplasma & babesia), mouse reservoir NE USA
Stage 1 - early localized
- erythema migrans (bulls eye)
- flu like sx
Stage 2 - early disseminated
F - facial nerve palsy/Bell's b/l
A - arthritis, transient & migratory myalgias
C - Cardiac block
E - erythema migrans ("bull's eye")
- CN VII palsy - Bell's palsy
Stage 3 - late disseminated
- chronic arthritis
- encephalopathy
tx: doxycycline
preg women & children - amoxicillin & cefuroxime
Leptospira interrogans morphology found where? Leptospirosis Weil Disease
hook shaped ends
water contaminated with animal urine
Leptospirosis p/w surfers & tropics
- flu like sx
- myalgias of calves
- jaundice
- photophobia w/ conjunctival suffusion (erythema w/o exudate)
Weil Disease - Icterohemorrhagic leptospirosis
- fever
- hemorrhage & anemia
- severe jaundice & azotemia (kidney & liver dysfunction)
Syphilis
Treponema pallidum
Primary Syphilis
painless chancre - localized dx
VDRL + in ~80%
Secondary Syphilis +/- latent syphilis
VDRL/RPR?
disseminated disease p/w
- constitutional sx
- LAD
- patchy hair loss
- maculopapular rash (palms & soles)
- condylomata lata (white warts on genitals)
VDRL/RPR nonspecific
FTA-ABS to confirm
Latent syphilis (+ serology w/o sx) may follow
Tertiary Syphilis
Neurosyphilis test?
p/w
- Gummas
- Aortitis (vaso vasorum degeneration, storke/dissection w/o HTN)
- neurosyphilis w/ tabes dorsalis (p/w +romberg sign)
- Argyll Robertson pupil (accomodates but doesn’t react)
- Charcot joint
test spinal fluid with VDRL/RPR, FTA-ABS, PCR
Congenital Syphilis
when does transmission occure
P/w Facial Abnl - rhagades (linear scars at the angle of the mouth) - snuffles (nasal d/c) - saddle nose - notched teeth (Hutchison) - mulberry molars - short maxilla - saber shins - CN VIII deafness
transmission across placenta after 1st trimester
False Positive VDRL
Positive VDRL P - Pregnancy V - viral dx (EBV, hepatits) D - Drugs R - Rheumatic fever L - Lupus & Leprosy
detects nonspecific ab to beef cardiolipin
Jarisch-Herxheimer reaction
flu-like syndromes
2/2 killed bacteria usually spirochetes releasing toxins
Gardnerella vaginalis Morphology p/w dx tx
pleomophic gram variable rod
p/w BV (grey d/c, nonpainful, fishy smell) a/w sexual activity NOT STI
Clue cells - vaginal epithelial cells covered in G. vaginalis
positive amine KOH whiff test
Clindamycin or metronidazole
Chlamydiae
Pathogenesis
Obligate intracellular (can't make ATP) 2 forms cause mucosal infections: - elementary bodies - endocytosis into cell to form into reticulate body - reticulate body replicated in cell via fission & reorganizes into elementary bodies
Chlamydia trachomatis
Chlamydia pneumoniae & Chlamydophila psittaci
dx
tx
Reactive arthritis,
nongonococcal urethritis & PID
neonatal and follicular adult conjunctivitis
atypical PNA; psittaci has avian reservoir
PCR, NAAT
reticulate bodies seen on stain
Azithromycin (one time dose for mucosal infxn)
Or doxycycline
Chlamydia trachomatis serotypes
A,B,C
D-K
L1,L2,L3 (tx)
A,B,C
Africa, Blindness, Chronic Infxn (follicular conjunctivitis)
D-K
urethritis/PID
neonatal PNA (staccato cough) w/ eosinphilia
neonatal conjunctivitis 1-2wk s/p birth
L1, L2, L3
Lymphogranuloma venereum
= small, painless on genitals –> swollen, painless inguinal LNs that ulcerate (buboes)
tx doxycycline
RIckettsial Disease & Vector Bourne Illness Rash Common - Rickettsia rickettsii - Rickettsia typhi - Rickettsia prowazekii Rash Rare - Ehrlichia - Anaplasma - Coxiella burnetii
tx
RMSF Typhus Ehrlichiosis Anaplasmosis Q fever
tx - doxycycline
preg - chloramphenicol
Rickettsia rickettsii
Vector
Region
p/w
Rocky Mountain Spotted Fever
tick
South Atlantic, esp North Carolina
Triad: Fever, H/A, Rash (writs & ankles –> trunk, palms, soles)
Rickettsia typhi
vector
p/w
fleas, endemic
p/w rash centrally –>spreads; spares palms & soles
Rickettsia prowazekii
human body louse, epidemic
p/w rash centrally –> spreads; spares palms & soles
Ehrlichia
Vector
microscopy
tick
monocytes w/ morulae (mulberry like inclusions in cytoplasm)
Anaplasmosis
tick
granulocytes w/ morulae
Coxiella burnetii - Q fever
transmission
p/w
no arthropod vector
spores inhaled as endospores from cattle/sheep amniotic fluid
PNA, Cx neg endocarditis
Mycoplasma pneumoniae morphology p/w labs growth medium tx
pleomorphic, no gram stain (no cell wall)
membrane contains sterols
walking PNA, usually <30 yrs, military recruits and prisons
cold agglutinins (IgM)
Eaton agar
macrolides, doxycycline, or fluoroquinolone
