Microbiology 15 - Zoonoses

Question 1

What are the key features of campylobacter food poisoning?

Answer 1

Diarrhoea

Bloating

Cramps

Question 2

What are the key features of salmonella infection?

Answer 2

Diarrhoea

Vomiting

Fever (enteric fever - S typhi and paratyphi)

Question 3

How can salmonella food poisoning be treated?

Answer 3

Supportive

Ciprofloxacin or Azithromycin

Question 4

Which types of salmonella must always be treated, and with which can you wait to see if they will need treatment?

Answer 4

S. typhi/ paratyphi = always treat
Other types = watchful waiting

Question 5

Bartonella is a zoonotic infection from which animal?

Answer 5

Kittens - transmission by scratches, bites, licks of open wounds, flea

Question 6

What diseases can be caused by bartonella henselae?

Answer 6

Cat scratch disease/ baciliary angiomatosis (if immunocompromised)

Question 7

What are the signs and symptoms of cat scratch disease?

Answer 7

macule at site → pustular

regional adenopathy

systemic sx

NOTE: can present fairly similarly to TB/lymphoma - always consider Bartonella in a young person with fever, weight loss and night sweats who has been in recent contact with a cat

Question 8

How should cat scratch disease be treated?

Answer 8

Erythromycin + doxycycline

Question 9

What are the signs of baciliary angiomatosis?

Answer 9

Skin papules

Disseminated multi-organ and vasculature involvement

bursting of blood vessels in various organs and tissues

whacky LFTs

Question 10

What is the treatment for bacillary angiomatosis?

Answer 10

wash hands after handling cats, use flea control

Erythromycin Doxycycline

Add Rifampicin

Question 11

Toxoplasmosis is a zoonotic infection from which animal?

Answer 11

cats and sheep

Question 12

How is toxoplasmosis treated?

Answer 12

Pregnancy - spiramycin

Non-pregnancy - pyrimethamine and sulfadiazine

Question 13

What is the risk with toxoplasmosis infection in the immunocompromised?

Answer 13

That it will be reactivated, leading to progressive visual/ hearing/ motor/ cognitive impairment and seizures

Question 14

What is the risk with toxoplasmosis infection in pregnancy?

Answer 14

Still birth

Question 15

Where in the world is brucellosis most likely found?

Answer 15

Middle East - in cattle and goats

Question 16

What are the symptoms of brucellosis?

Answer 16

FLAWS

Back pain

Orchitis

Focal abscesses (psoas, liver, balls etc.)

Question 17

What is the management for Brucellosis?

Answer 17

6 weeks

Doxycycline; and

Gentamycin; or rifampicin

Question 18

What are the symptoms of Q fever?

Answer 18

Fever ‘Flu-like’ illness

Pneumonia

Hepatitis

Endocarditis

Focal abscesses (para-vertebral/discitis, etc.)

Question 19

What is the causative organism in Q fever?

Answer 19

Coxiella burnetti

Question 20

How is coxiella burnetti transmitted to humans?

Answer 20

Aerosolisation/inhalation of secretions, waste, or milk of infected animals

Unpasteurised milk

Question 21

What is the treatment for Q fever?

Answer 21

Doxycycline

(Hydroxychloroquine)

Question 22

Recall some examples of VHF

Answer 22

Ebola (bats)

Lassa (rats)

Marburg (bats)

CCHF (ticks) - CCHF = Crimean Congo Haemorrhagic Fever

Question 23

What are the causative organisms in rabies?

Answer 23

Lyssa viruses

Question 24

What are the signs and symptoms of rabies?

Answer 24

Seizures

Excessive salivation

Fever

Agitation

Confusion

Headache

Question 25

What are the causative organissm in rat bite fever?

Answer 25

Streptobacillus moniliformis or Spirillum minus)

Question 26

What are the symptoms of rat bite fever?

Answer 26

comes on 2-10 days after bite 1st: fevers, polyarthralgia, maculopapular → purpuric rash 2nd: endocarditis

Question 27

Hantovirus is transmitted to humans via contact with which type of animal?

Answer 27

Rats

Question 28

How can rite bite fever and hantovirus be differentiated clinically?

Answer 28

Rat bite fever = polyarthralgia Hantovirus = myalgia

Question 29

What investigations can be used to detect toxoplasmosis?

Answer 29

Sabin Feldman Dye test

Question 30

How is viral haemorrhagic fever transmitted?

Answer 30

Contact with fluids of infected

Question 31

What is the clinical presentation of viral haemorrhagic fever?

Answer 31

Fever Myalgia ‘Flu-like’ illness Bleeding - thrombocytopoenia

Question 32

What is the management for Lyssa fever?

Answer 32

Immunoglobulin (only given if direct exposure to saliva likely and no pre-exposure to vaccine) Post exposure vaccine

Question 33

what investigations would you do in rat bite fever?

Answer 33

Looks like septic arthritis Joint fluid microscopy/culture Blood culture

Question 34

What is the management for rat bite fever?

Answer 34

Penicillin

Question 35

What is the first investigation to order in Brucellosis?

Answer 35

blood culture