- discharge, bleeding, fever, abd tenderness, and pain. - Symptomatic PID can occurs in women with endocervical C trach infections - can result in scar tissue (tubal infertility, ectopic pregnancy, chronic pelvic pain)

Lecture 23 Chlamydia and Rickettsia Flashcards by Richie Phan

Why is Chlamydia and rickettsia grouped together?

not genetically similar

- grouped because of unique lifestyle (obligate intracellular bacteria)

How well did you know this?

Not at all

Perfectly

What are the three species of Chlamydia?

Chlamydia trachmomitis
Chlamydophila pneumoniae
Chlamydophila psittaci

How well did you know this?

Not at all

Perfectly

What are some sx of contracting chlamydia Trachomatis?

-urogenital infections, ocular infections

How well did you know this?

Not at all

Perfectly

What are some sx of C. Pneomoniae?

Respiratory tract infections

How well did you know this?

Not at all

Perfectly

What are sx of C psittaci?

-Pneumonia, systemic infections (from birds)

How well did you know this?

Not at all

Perfectly

What is the Elementary body of Chlamydia?

spore-like form (non-replicating)
***infectious
stabilized by disulfide crosslinking of outermembrane proteins

How well did you know this?

Not at all

Perfectly

What is the reticulate body of Chlamydia?

intracellular replicating form
divide within membrane-bound inclusion
osmotically unstable, cannot survive outside cell
***non-infectious

How well did you know this?

Not at all

Perfectly

What can be said of the genome of Chlamydia?

small chromosome
auxotrophic for several aa and nucleoside triphosphate (can produce limited ATP, encodes two translocases)
highly conserved endogenous plasmid required for full virulence

How well did you know this?

Not at all

Perfectly

What virulence factor is expressed both in the EB and RB of chlamydia?

-Type III secretion system

How well did you know this?

Not at all

Perfectly

what is the pathogenesis of EB chylamadia?

induces Epithelial cell internalization
pre-formed effector protein (TARP), secreted into target cell
TARP induces actin polymerization, phago of EB

How well did you know this?

Not at all

Perfectly

What is the pathogenesis of Chlamydia?

secrete

Inc proteins: modify inclusion membrane
CPAF: Translocated proteases that degrade host and Chlamydia proteins
Anti-apoptotic factors secreted by chlamydia keep host alive until matures

How well did you know this?

Not at all

Perfectly

What does the modification of chlamydia inclusion membrane do for the pathogen?

prevent lysosome fusion by blocking SNARE-mediated interactions
co-opt trans-golgi vesicles to camouflage growing inclusion

How well did you know this?

Not at all

Perfectly

What is the immune response to C trachomatis (infects epithelial cells of conjuctiva, respiratory, GI, Urogenital)?

TH1 (interferon-y-associated) immune response
provokes a low level chronic inflammatory response
necrosis, cell proliferation, scar tissue formation
leads to disease

How well did you know this?

Not at all

Perfectly

How are the servovars of C trachomatis determined?

-polymorphic outer membrane proteins, can associate servavors to diseases

How well did you know this?

Not at all

Perfectly

What are diseases caused by C trachomatis?

-trachoma
-Urethritis/cervicitis
-perinatal infactions
inclusion of conjunctivitis
-Lymphogranuloma venereum

How well did you know this?

Not at all

Perfectly

How do C Trachomitis servovars differ in release from epithelial cells?

some release apical to lumen (A-K)

- some release baolateral into lymph nodes (LGV)

How well did you know this?

Not at all

Perfectly

What age group is more prone to C Trachomitis?

-20-24, more so in women

How well did you know this?

Not at all

Perfectly

What are the sx of C trach urogenital infection in men?

Urethritis:
Dysuria and urethral discharge
More likely to be asymptomatic than gonorrhea
Epididymitis- frequently unilateral

How well did you know this?

Not at all

Perfectly

What of some sx of urogenital infection in women by C trach?

dysuria, frequency

- absence of WBC in the urine

How well did you know this?

Not at all

Perfectly

What are some sx of Cervicitis?

most women asymptomatic
Mucopurulent cervical discharge
Friability (easily induced bleeding)
Untreated infections persist for months

How well did you know this?

Not at all

Perfectly

Whatare the Pelvic inflammatory diseases (PID)?

Endometritis (uterine lining)
Salpingitis (fallopian tubes)
Peritonitis (peritoneal cavity)

How well did you know this?

Not at all

Perfectly

What some sx of PID?

discharge, bleeding, fever, abd tenderness, and pain.
Symptomatic PID can occurs in women with endocervical C trach infections
can result in scar tissue (tubal infertility, ectopic pregnancy, chronic pelvic pain)

How well did you know this?

Not at all

Perfectly

What are some diseases caused by C trach Neonatal infections?

inclusion conjunctivitis

- Pneumonia

How well did you know this?

Not at all

Perfectly

What are the sx of inclusion conjunctivitis?

-watery discharge becomes purulent, eylids swell, conjuctiva become red and thickened

How well did you know this?

Not at all

Perfectly

How is C tach Dx?

-Nucleic acid amplification techniques (NAAT) (High sensitivity, specific, urine or vaginal swab) -Screenings (CDC recommended), MSM (for urethral and reactal)

How is Lymphogranuloma venereum (LGV) transmitted?

- caused by serovors L 1-3 - STD - lympotropic, meaning capable of regional and systematic dissemination

What are the stages of LGV?

- Primary stage: small ulcer on genitals, few, rapidly heals - secondary stage: inguinal lymphadenophathy, fever, HA, muscle pain, resolves after week w/ possible scars - Tertiary stage: Chronic procto-colitis, mimic inflammatory bowel diseases. Elephantiasis of genitalia can occur.

What is the pathogenesis for trachoma disease?

- by servovars A-C, not the same as genital - inital infection in ocular or nasopharyngeal cells - severity from repeated reinfections

What is the sx of trachoma?

- chronic follicular conjunctivitis - Progresses to thickening of eyelids, with papillary hypertrophy (bumps in eyelids), contraction of scarred tissue - Trichiasis- eyelashes turn in, scratch cornea - Ulceration and scarring of cornea, loss of vision

Where is the highest prevalence of Trachoma?

- sub-Saharan AFrica, SE Asia | - most active in children,

How is trachoma transmitted?

eye and nasopharyngeal secretions in hands, flies fomites

What is WHO's plan for trachoma?

``` -eliminate by 2020 SAFE: *Surgery to correct Trichiasis *Abx to treat infection *Facial cleanliness *Environmental improvements (water sanitation) ```

What abx are used to treat Trichoma?

azithromycin

How is pneumonia transmitted?

- Person-to-person, respiratory droplets - Most infections mild or asymptomatic - Clinically indistinguishable form other causes

What types of cells does c pneumoniae infect?

- wide range of cells that types may contribute to transport form the lungs to circulation - associated with atherosclerosis (plaque in arteries)

How is psittacosis transmitted?

-Birds via inhalation (Psittacine birds or poultry)

What are sx of psittacosis?

-ranges from mild fevrile to fatal pneumonia

How is psittacosis prevented?

Quarantine and treatment of imported birds

What animal population has Chlamydia devastated?

- Koala population in AUS - Ocular and Urogenital infections - Solutions are culling and serine protease inhibitor

What abx are sued for ocular and genital infections?

- azithromycin - Doxycycline - erythromycin for neonatal

What abx are used for PIDs?

- Cephalosporin and doxycycline | - cannot heal scarring

What abx are used for systematic infections?

-Doxycycline

How is Chlamydia treated?

-abx, no vaccine

What are the characteristics of Rickettsiales?

- obligate intracellular | - Gram-negative bacteria

How is Rickettsiales transmitted?

by arthropod vector

What are some common manifestations of Rickettsiales?

-fever, rash, and HA

What are the three groups of Rickettsiales?

- Spotted fever group: R. rickettsii - Epidemic Typhus group: R. prowazekii - Ehrlichiaceae Family: E. chaffeensis, Anaplasma phagocytophilum

How is Rocky Mountain Spotted fever transmitted?

- American dog tick | - Rocky mountain wood tick

What is the pathogenesis of Rickettsia rickettsii?

- enter circulation through tick bite - attach to and invade vascular endothelial cells - small genome, capable of independent metambolism - intracellular motility and cell-to-cel spread via actin-based motility - injury to host cell results to increased vascular permeability

What are some sx of Rocky Mountain Spotted fever?

- fever, muscle pain, severe HA, nausea, vomiting - Maculopapular rash - Sever disease involves multiple organ systems

How is Rickettsia rickettsii prevented?

- avoidance and prompt removal of ticks | - transmission takes 24 hours

What abx are given for Rickettsia rickettsii?

Doxycycline

Which pathogen caused a Typhus epidemic?

R. prowazekii

How is typhus transmitted?

Human body lice, infected louse feces transmits into skin through scratching. In the US it was from fleas and lice of flying squirrels.

What are the sx of typhus?

- Fever, rigors, sever HA, macular rash, pneumonia, progression to delirium, coma, death - Pts remain latently infected after recovery and reactivation of disease may occur years later?

What pathogens causes Ehrlichionosis?

Ehrlichia chaffeensis and Anaplasma phagocytophilium

What is the pathogenesis of Erhlichiosis?

- obligate intracellular - infect leukocytes - Replicate within inclusions - inhibit phago-lysosomal fusion

How is Erhlichiosis transmitted?

- Tick born: * Human monocytic erhlichiosis by lone star tick * human granulocytic anaplasmosis by deer tick - most cases in South Central US

What are sx of Erhlichiosis?

- clinically similar to Rocky Mountain Spotted fever, without the rash - Leukopenia, Thrombocytopenia

How is Erhlichiosis treated?

Doxycycline

Lecture 23 Chlamydia and Rickettsia Flashcards

(60 cards)