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Flashcards in Fever & Lymphadenopathy Deck (14):
1

Mononucleosis syndrome

 

 Herpesviruses,enveloped dsDNA

 Children and young adults

 Transmission by respiratory secretions

 Usually due to EBV: >2/3 cases  Clinical presentation

 Fever,Malaise,Lymphadenopathy:Cervical,submandibular, axillary, inguinal, Painful exudative pharyngitis

 Hepatosplenomegaly- Filtration and clearance of pathogens; Enlarged with some infection

2

Mononucleosis syndrome

 Labs

Downey cells

 Heterophile-positive (Monospot) - EBV

 Latex agglutination assay using ‘other’ species RBCs as the substrate

 IgM cross-reaction

3

Mononucleosis syndrome complications 

Splenic rupture- Rare, Limit contact sports

4

ACUTE RETROVIRAL SYNDROME sx

 Symptoms occur 2-4 weeks following infection

 Fever

 Fatigue

 Myalgia

 Rash

 Headache

 Pharyngitis

 Also mucocutaneous ulcers

 Usually painful, mimics HSV

 May represent co-infection (syphilis)

5

ACUTE RETROVIRAL SYNDROME lab testing

 HIV RNA viral load

 >1 million copies/mL

 Positive 5-15 days after

infection

 Sensitive 4th generation combination antigen/antibody test

 + p24 antigen

 Becomes positive ~1 week after viremia is detected (15-20 days after infection)

 HIV IgM

 Becomes positive 45-60 days

following infection

 Followed by WB

 Western blot usually negative or indeterminate (35-50 days) early on

6

TOXOPLASMA GONDII cd

 HIV,CD4<100

 Encephalitis

 Chorioretinitis

 Pneumonitis

7

FRANCISELLA TULARENSIS

 “rabbit fever,” “ulceroglandular disease,” “Perinaud’s disease”

 Small gram negative coccobacillus

 Risks

Exposure to infected animal tissue

 Skinning rabbits

Lawn-mower

8

LYMPHOGRANULOMA VENEREUM (LGV)

Chlamydiatrachomatis (SerogroupsL1,L2,L3)

 Rare, associated with outbreaks, mainly among MSM, HIV+

 Primary infection

Genital ulcer or a mucosal inflammatory reaction at the site of inoculation

 The incubation period is 3 to 12 days

 These lesions spontaneously heal within a few days.

 Secondary infection

2-6 weeks later and is related to local direct extension of the infection to regional lymph nodes (ie, inguinal and/or femoral nodes)

Extensive painful lymphadenitis

9

HISTOPLASMA CAPSULATUM

 Mold form in the environment

 Inhaled

 Engulfed by macrophages 

 Disseminate

 Yeast form in host tissue

 Soil

Bat/bird droppings

10

Lymphadenopathy related to Histoplasma 

Mediastinal & hilar lymphadenopathy

11

COCCIDIOIDES IMMITIS

Characteristics/ where found 

 Mold in nature

 Yeast in tissue

 Spherule with endospores

Deserts of southwestern US

 Arizona, New Mexico,Texas

 Central & South America

 Mexico

12

COCCIDIOIDES IMMITIS

 Clinical disease

 Pneumonia

 Valley fever

 Desert rheumatism

 Fatigue

 Arthralgia

 Skin: E. nodosum

13

PARACOCCIDIOIDES Microscopy

“mariner’s wheel”,“pilot’s wheel”

14

PARACOCCIDIOIDES characteristics 

 Central & South America

 Mold in nature

 Inhalation

 Dissemination  Granulomas

 Yeast in tissue

 Clinical manifestation

 Pneumonia

 Lymphadenopathy

Draining fistulas