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rare infections Flashcards

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1
Q

Bartonella - disease

A
  1. cat scratch disease

2. bacillary angiomatosis

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2
Q

cat scratch disease?

A

cutaneous lesion at the site of cat scratch/bute with regional lymphadenopathy with fever and malaise
GRANOULOMAS

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3
Q

cat scratch disease - clinical manifesrtation

A

papule at scratch/bite site
regional adenomapty
+/- fever

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4
Q

cat scratch disease - diagnosis + treatment

A

usually clinical
+/- serology
treatment: self limited, azythomycin

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5
Q

cat bite - management / microbiology

A
  1. copious irrigation + cleaning
  2. prophylactic augmentin
  3. tetanus as indicated (5 years)
  4. avoid closure
    - paster multocida, anaerobic
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6
Q

ixode tick is the vector of

A
  1. Borrelia burdorferi
  2. Anaplasma
  3. protozoa Babesia
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7
Q

early sign of Lyme disease - next step

A

oral doxacycline
no serology: serology only if nervous or Cardiac disease
clinical diagnosis

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8
Q

Lyme disease - stage 1 manifestation

A

1st month

  • erythema migrans
  • fatique / headache
  • myalgias, arthralgias
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9
Q

Lyme disease - stage 2 manifestation

A

early disseminated (weeks - months)

  • Multiple erythema migrans
  • Unilateral/bilateral CN palsy (CN 7)
  • Meningitis
  • Carditis (AV block)
  • Migratory arthralgias
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10
Q

Lyme disease - stage 3 manifestation

A

months to years

  • arthritis
  • encephalitis
  • periphearl neuropathy
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11
Q

treatment of early localized lyme in pregnant and lactating women

A

amoxicillin

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12
Q

prophylaxis criteria for lyme

A

must meet all 5

  1. attached tick in an adult or nymphal ixodes scapularis
  2. tick attached for 36 h or engorged
  3. prophyxis started within 72 hours of tick removal
  4. local infection rate 20% or more
  5. no condraindications to doxycycline (younger than age, pregnant, lactating)
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13
Q

how to remove a tick from the body

A

tweezers

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14
Q

Franciella tularencis - disease / transmission and source

A

Tularemia
ticks
rabbits, deer fly (handling of infected animals, aerosolization)

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15
Q

Tularemia - forms (and proportions)

A
  1. Ulcerroglandular form (80%)

2. typhoidal form (10-15%) (pneumonia and bacteremia)

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16
Q

Pasteruella multocida - disease / transmission and source

A
  1. Cellulitis
  2. Osteomyelitis
    animal bite, cat, dog
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17
Q

Yesrinia pestis - disease / source and transmission (and resevoirs)

A

PLAQUE

  1. fleas (rats and prairie are dogs reservoirs)
  2. contact with infected animals
  3. aerosol
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18
Q

Rickettsia rickettsi - disease / transmission and source

A

Rocky mountain spotted fever

Dermacentor (dog tick)

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19
Q

vector-borne illness - rash common and rash rare diseases

A

Rash rare: 1. Ehrlichiosis 2. Anaplasmosis 3. Q fever

Rash common: 1. Rocky Mountain spotted fever 2. Typhus

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20
Q

Rickettssia rickettsii - area (map)

A

despite its name –> occurs primarily in:

SOUTH ATLANTIC STATES (NORTH CAROLINA)

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21
Q

Rocky Mountain spotted fever - symptoms

Study These Flashcards
A

classic triad:

  1. headache
  2. fever
  3. rash (vasculitis)
22
Q

Rocky Mountain spotted fever - rash

Study These Flashcards
A

typically starts at wrists and ankles and then spreads to trunk, palms and soles

23
Q

Typhus is caused by

Study These Flashcards
A

Rickettssia typhi –> Endemic typhus

Rickettssia prowazekii –> epidemic typhis

24
Q

Rickettssia typhi - transmission and source

25
Rickettssia prowazekii - transmission and source
human body louse
26
typhus - rash
starts centrally and spreads out, SPARING palms and soles
27
Rocky Mountain spotted fever vs typus according to rash
Rocky Mountain spotted fever --> typically starts at wrists and ankles and then spreads to trunk, palms and soles Typhus --> starts centrally and spreads out, sparing palms and soles
28
vector-borne illness - rash rare diseases / caused by
1. Ehrlichiosis (Ehrlichia chaffensis) 2. Anaplasmosis (Anaplasma) 3. Q fever (Coxiella burnetii)
29
human monocytic ehrlichiosis - epidimiology
lone star tick | - southeastern south central US
30
Human momocytic ehrlichiosis - diagnosis
intracytoplasmic morulae in momnocytes | - PCR
31
human monocytic ehrlichiosis - clinical manfestation
flu like - neurologicc symptoms (conffusion) - rash is uncommon (less than 30% in adults) like Rocky mountain spotted fever without the sopots
32
human monocytic ehrlichiosis - labs
leukopenia + thrombocytopenia | - elevated liver enzymes + LDH
33
Humanmonocytic ehrlichiosis - treatment
empiric doxocycline while awaiting confirmatory testing
34
anaplasma vs Ehrlichia chaffensis according to cells
Mnemonic EMAN: Ehrlichia --> Monocytes Anaplsma --> granulocytosis
35
Q fever - transmission / presentation
spores inhaled as aerosol from cattle/sheep amniotic fluid | - presents as pneumornia, MCC of culture (-) endocarditis)
36
high risk wild animals for rabies ... (and next step)
bat, racoon, skunk, fox, coyote --> start prophylaxis if animal unavailable if available --> euthanize and test, start prophylaxis if test is (+)
37
low risk wild animals for rabies ... (and next step)
squirrel, chipmunk, mouse/rat, rabbit --> no prophylaxis
38
pet - rabies ... (and next step)
available for quarantine? NO: start prophylaxis yes: observe 10 days --> if healthy animal, no prophylaxis
39
livestock or unknown wild animal - rabies ... (and next step)
contact public health department
40
Rocket mountain spotted fecer - CSF
like viral mening
41
human bite - treatment
polymicrobial (aerobic and anaerobic) --> augmentin | + Tetanus vaccination
42
nocardia - duration of treatment
TMP-SXM for 6-12 months
43
vibrio vulnificus - epidimiology
gram (-) free living in marine environment ingestion (oysters) or wound infection risk with liver disease
44
vibrio vulnificus - manifestation
1. rapidly progressive (often less than 12h) 2. septicemia: septic shock, bullous lesions 3. cellulitis: hemorr bullae, necrotizing fascitis
45
vibrio vulnificus - diagnosis
blood + wound cultures
46
vibrio vulnificus - treatment
empiric in those with likely illness as highly fatal | IV ceftriaxone + doxycycline
47
Legionella - clinical clues
- fever (higher than 39) - Bradycardia relative to high fever - neurological symptoms (esp confusion) - GI symptoms (esp diarrhea) - Uneresponsive to beta lactam + aminoglycoside
48
Legionella - Labs
- low Na+ - hepatic dysfunction - hematuria + proteinuria - Sputum gram stain showing many neutrophils, but few or no organisms
49
legionella - diagnosis + treatment
diagnosis: urine antigen testing treatment: resp quinolone (fluoroquinolone) or newer macrolide
50
chronic slow growing non-tender mass near mandibular - after teeth extraction - organism , diagnosis, treatment
``` actinomyces RF: low immune, DM, malnutrition sulfur granules diagnosis: fine needle aspiration, culture for 2 weeks penicillin 2-6 months, surgery if severe ```

Infectious diseases (13 decks)

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