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M & D > Ch 25: Circulatory and Lymphatic System infections > Flashcards

Ch 25: Circulatory and Lymphatic System infections Flashcards

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1
Q

Organs in the circulatory and lymphatic system

A

capillaries, capillaries, capillaries

Includes the circulatory system (blood) and lymphatic system (return of fluid from the tissues)

heart
arteries, capillaries, veins
lymphatic vessels
spleen
kidney
figures 25.2, 25.3, 25.4
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2
Q

Primary lympoid tissue

A

bone marrow which contains hematopoietic stem cells

thymus where T cells mature

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3
Q

Secondary lymphoid tissue

A

splees wherre filtration of the lymph fluid takes place

macrophage and DC for antigen presentation

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4
Q

lymph nodes

A

contain germinal centres for B cells and Ab produciton

also many macrophage and DC for antigen presentation

Lymph fluid enters through afferent lymphatic vessels

leaves through efferent lymph vessels

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5
Q

Circulatory system is nomally sterile

A

no normal flora, circulating microoganisms can occur

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6
Q

bacteremia

A

circulating bacteria in the bloodstream

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7
Q

septicemia

A

reproducing bacteria in the bloodstream

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8
Q

viremia

A

viruses circulating in the bloodstream

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9
Q

septic shock

A

low blood pressure, loss of blood volume, organ failure, death

release of IL-1 and TNF due to infection

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10
Q

Toxic shock syndrome

A

Staphylococcus aureus

similar condition due to streptococcus pyogenes

production fo a toxin which acts as a superantigen
=> activation of about 20% of T cells and excess production of cytokines

sudden onset, high fever, vomiting, diarrgea, myalgia, sudden blood pressure drop, later peeling of skin

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11
Q

Treatment of toxic shock syndrome

A

treatment of circulating bacteria

clindamycin, vancomycin, daptomycin

removal of infected tissue - debridement

vasopressors to increase blood pressure

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12
Q

Puerperal sepsis

A

puerperal fever, childbed fever

nosocomial infection after childbirth, UTI or surgical wound

mostly streptococcus pyogenes
=> also other strep species, staph aureus, gram negative enterics such as E. coli, klebsiella pneumoniae, proteus species
anaerobes such as bacteriodes

antibiotic treatment

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13
Q

Infectious arthritis

A

also called septic arthritis

inflammation of the joint capsules and fluid due to bacterial pathogen ( less frequently fungi or viruses)

usually due to bacteria in the circulatory system

  • hematogenous spread (bacteria spread though the circulatory system)
  • treatment by prolonged antibiotic therapy (hard to get rid of, 20-30+ days)
  • mortality 5-20%, 40% with permanent join damage
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14
Q

Osteomyelitis

culprits

A

inflammation of bone tissue by bacteria

staphylococcus aureus
mycobacterium tuberculosis
pseudomonas aeruginosa
strep spp.

childer most commonly infected through the blood stream

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15
Q

symptoms and treatment of osteomyelitis

A

fever, localized pain, swelling, soft tissue ulcers

spreads to joints and to bloodstream

broad spectrum antibiotics including vancomycin
=> implanted antibiotic beads

removal of infected bone

hyperbaric oxygen

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16
Q

Gas Gangrene

A

Due to anerobic condition in the tissue, lack of blood flow

clostridium perfringens, can be other anaerobes

expanding zone of necrotic tissues

pain, bad smell, gas bubbles, yellow discharge, tissue liquidification

usully need surgery or amputation

hyperbaric oxygen and antibiotics

50% fatality rate

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17
Q

Tularemia

A

caused by Francisella tularensis
=> zoonotic diseaase, reservoir are mammals like rabbits, muskrats and voles

spread through contact or vector
=> dog ticks (dermacentro variablis) and wood ticks (D> andersoni)

skin lesions (enter and leaave through cuts), fever and chills, swollen lymph nodes

3 day incubation

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18
Q

Tularemia dissemination

A

bacteria enters into lymphatic system though breaks in skin

ID50 = less than 50 cells needed to cause an infection (anything under 1000-100 in very contagious)

transport to regional lymph nodes

ingestion by macrophage

escape from lysosome and replication in macrophage cytoplasm

dissemination through circulatory system

formation of granulomas

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19
Q

Tularemia subspecies

A

also a pulmonary form from inhaling aerosols

there are two subspecies A and B

A is found only in North america and has a fatality rate of about 5%
=> 30-60% in repiratory cases

B is found in europe and asia and is `relatively benign

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20
Q

Brucellosis

A

Brucella abortus, B. canis, B. suis, B. melitensis

Gram-negative coccobacillus 0.6um long, 0.5 um wide

Facultatively intracellular

Aerobic but grow best in 5% CO2

Zoonotic infection, natural hosts dogs, cattle, reindeer, caribou, sheep and goat, pigs, deser wood rats

about 100 cases/ year in the us

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21
Q

Brucellosis Transmission

A

contact with contaminated animals, tools
airborne

consumption of contaminated meat or milk/ milk products (major route)

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22
Q

Brucellosis symptoms

Study These Flashcards
A

undulating fever, sweating, headache, malaise, fatigue, join pain and depression

23
Q

Brucellosis treatment

Study These Flashcards
A

Doxycyline and streptomycin for 6-8 weeks
=> doxycyclin and rifampin

about 15% of treated patient will relapse.

Herd animal vaccination and eradication programs have reducted or elimated brucellosis in North America

Wild animal reservoir bison and caribou

24
Q

Cat-scratch disease

Study These Flashcards
A

also called cat scratch fever

bartonella henselae

Gram-negative pleomorphic bacilus 0.3-0.6um wide and 1-1.7 um long. no capsule, fastidious, aerobic but groaw best with 5% Co2

grows on blood agar but takes 5-45 days for colonies to grow

25
Transmission of cat-scratch fever
transmission by catt bite or scratch => up to 40% of domestic cats are infected => spread between them by fleas Local pus filled nodule 1-3 weeks after infection B. henselae can infect rbc and disseminate also infect endothelial cells
26
B. henselae migration to the lymph nodes
may infect macrophages and other immune cells (no granuloma) fever, chills, fatigue, swollen and painful lymph nodes in immunocompromised patients may proceed to bacillary angiomatosis which are tumors in organs due to proliferation of blood vessels
27
Trench fever
caused by bartonella quintana, transmitted by the human louse human reservoir but has been found in cats, dogs, and fleas and ticks
28
Carrions diseaase
caused by bartonella bacilliformis characterized by acute hemolytic bacteriemia human reservoir
29
Other bartonella species
HAVE BEEN FOUND ISOLATED FROM squirrels, mice, fox, cattle and sea otters other bartonella species (there are 22) have been implicated in human diseases
30
Bubonic plauge
yersinia pestis Gram negative, non-motile bacillus, faculatatively anerobic, negative to most biochemical tests, slow grower`
31
Mammalian hosts of y pesits
mormots, gerbils, ground squirrels and prarie dogs blat rats, and norwegian rats
32
Y pestis transmision by fleas
fleas bite infected host, bacteria multiply and block the proventriculus, fleas starve and bite, blood mixed with blockage and is regurgitated into the bite wound
33
Vector transmission of bubonic plauge
epidemics of plauge spread thorugh natural hosts, fleas leave natural host and find new host often a different host including people spread to people by flea bite (vector transmission, bubonic plauge) bacteria spread to circulatory system (septcemic plauge) and to lungs Aerosol transmission (pneumonic plauge)
34
Transmission cycles of Y. pestis
Sylvatic cycle in natural hosts in non-urban areas, transmission through fleas Urban cycle between rats through fleas transmission from either source to humans with human to human transmission through fleas and aerosols
35
Y pestis symptoms
2-6 day incubation abrupt fever and chills, headache, inflammation of regional lypmh nodes, painful, leads to swelling, hemorrhaging Swollen lymph nodes particularly in the groin and armpits- buboes if modes into septicemic plague then DIC (disseminated intravascular coafulation occurs)
36
Y pestis DIC= disseminated intravascular coagulation
DIC leads to blockafe of capillaries and small blood vessels, necrosis of tissue => blackening of toes and fingers Septic shock, organ failure, respirator distress
37
mortality rates of plauge
50% IN BUBONIC 100 in septicemic 100% in 2 days with pneumonic (all above without antibiotic treatment)
38
Pneumonic plague
1-3 day incubation chill followed by fever, productive cough (bloody or watery), pneumonia, shortness of breath, ulceration, caviation of lungs antibiotic treatment => streptomycin (still sensitive) => doxycline/ ciprofloxacin (levofloxacin) => chloramphenicol
39
Typhus
epidemic typhus caused by Rickettsia prowazekii and transmitted by human louse Pediculus humanus associated with war and civic disruptions mortality rates of up to 40% Gram negative, very pleomorphic cells obligately intracellular, cannot synthesize amino acids, no glycolysis
40
Lyme diseas (emergin disease?)
LYME BORRELIOSIS => Borrelia burgdoferi the most common tick-born disease in north america and europe named after an outbreak of apparently rheumatoid arthritis in children around the town of old lyme, connecticut in 1975 most cases were characterised by an annular skin rash preceding the arthritis by a month subsequent investigation of ticks from the area revealed a spirochete which was immunologically cross-reactive with the affected childrens's serum
41
Primary stage of lyme disease
distinctive sign is erythema migrans (EM) the bulls eye rash at the site of the tick bite => 10% do not have RM arthralfia, myalgia, fever, severe fatigue and regional lymphadenopathy are also common bacteria may spread quickly through the blood (hematogenous dissemination) and secondary EMs appear in the skin
42
Lyme disease Secondary stage
neurological abnormalities meningoradiculitis (bannwarth syndrome), inflammation of the meninges and spinal nerve roots pain and paresis, facial palsy meningitis ``` borrelial carditis (8% of patients) distruvance of heart beat ``` dizziness, palpitations
43
Lyme disease tertiary stage
asymmetric olifoarticlar arthirits (60% of patients) one-sided arthritis of the major joints, usually the knees and elbows episodes last days to weeks,may resolve or reoccur
44
Rare neurolofical complications of lyme disease tertiary stage chroncally progressive meningoencephalitis
chroncally progressive meningoencephalitis which is irreversible CNS damage
45
Rare neurolofical complications of lyme disease tertiary stage cerbral vasculitis
cerbral vasculitis whihc is a destructive inflammation of the blood vessel accomplnied by a lyphocytic infiltrate
46
Rare neurolofical complications of lyme disease tertiary stage subacute encephalopathy
subacute encephalopathy whihc causes memory loss, lack of concentrationa and personality changes
47
Post-Lyme disorder
patients with well diagnosed lyme disease who, after receiving adequate antibiotic therapy suffer: nonspecific fatigue sleep disorders headaches memory disorders joint and muscle pain
48
post lymantibiotic refractory lyme arthritis
arthritis persists after 1 or more antibiotic treatments
49
treament of lyme disease
oral doxycline except for children and pregnant woman then amoxicillin 14-28 days for lyme neurological disease and severe cardiac complications parenteral ceftriaxone, cefotaxime or penicillin G
50
Vectors of Lyme disease
ticks of the genus ixodes are usual vectors ixodes scapularis (blacklegged tick) is the most common N american vector
51
Vector biology of lyme disease | egg to larva
ticks have 4 life stages egg, larva, mypmh, adult generally eggs are not infected, the larvae acquire B. burgorferi after feeding on an infected host for the larvae hosts are small mammals such as the white-footed mouse peromyscus leucopus
52
Vector biology of lyme disease mymphs to adult
nymphs move from host to host life stage which most commonly transmits the disease to humans adult ticks move to larger hosts such as deer take a final blood meal and lay eggs adults can transmit B. burgorferi to their hosts do not usually pass on the bacterium to the eggs
53
lyme disease in europe
borrelia afzelii and borrelia garinii in eurpoe bullseye rash first noted in Sweden in 1909, Borrelia observed in 1948

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