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ID Boards > Zoonoses > Flashcards

Zoonoses Flashcards

1
Q

Hawaii (though WW)

kidney, liver, lung involvement

exposure to damp soil or water

late summer/early fall

A

lepto

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2
Q

image = conjunctival suffusion

AND/OR

calf and/or lumbar muscle tenderness

AND/OR

severe renal and hepatic dysfunction (total bili >> mild AST/ALT elevation)

A

consider lepto

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3
Q

Dx lepto

A

via microscopic agglutination test (MAT) - exposing serum samples w/ lepto Ags - detection of agglutination under dark field

  • 4-fold rise in acute/convalescent sera
  • _>_1:800 w/ sx = dx
  • _>_1:200 suggests recent or current infection
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4
Q

tx lepto

A

Severe: IV PCN G (CRO has = efficacy)

Mild: PO doxy or amox

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5
Q

RF/Buzz words for lepto

A

recreational: freshwater swimming, canoeing

natural calamities: flooding, increased rainfall

occupational or household exposure to rodents

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6
Q

Medically important spirochete infections

A

SwiRLL

  • Syphilis
  • Relapsing fever (Borrelia recurrentis)
  • Leptospirosis (leptospira)
  • Lyme disease
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7
Q

persons w/ HIV (CD4<200) or other immunosuppressed persons

neovascular proliferation - cutaneous nodules/masses (usually red/purple) that bleed profusely when incised

nodules in liver, spleen, bone, brain, GI tract

A

B henselae (also quintana) = bacillary angiomatosis

***Can look like KS in HIV pts

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8
Q

malodourous perspiration

A

brucella

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9
Q

anterosuperior step-like erosion of a (usually lumbar) vertebra

A

think of brucellosis

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10
Q

round pneumonia (coin-sized pulmonary infiltrate)

in the right epi setting

A

consider coxiella (Q fever)

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11
Q

painless, nonpurulent papule → vesicle → black eschar

significant induration

nonpitting edema >> size of wound

A

cutaneous anthrax

edema d/t edema factor produced by bacteria

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12
Q

prominent migratory arthritis/arthralgia + diffuse morbilliform/petechial rash (can involve palms/soles)

rodent exposure

A

rate-bite fever (specifically streptobacillus moniliformis)

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13
Q

rodent exposure

Asia

development of ulcer at inoculation site a/w regional LAD

ulcer becomes eschar

no arthritis/arthralgia

A

rat-bite fever (streptobacillus minus)

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14
Q

a/w exposure to sheep, goats, cattle, camels

papule → vesicle → granulomatous nodule over 4-6wks

(usually on finger)

A

Org

self-resolves

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15
Q

horses

A

rhodococcus

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16
Q

sacroiliitis

A

brucellosis

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17
Q

fever + jaundice

A

lepto

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18
Q

tender LN

A

bartonella

tularemia

plague

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19
Q

CN IE

  • homeless:
  • animal exposure:
A
  • homeless: B quintana
  • animal exp: Coxeilla
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20
Q

slaughterhouses, bets, parturient cats, sheep handlers, living downwind of sheep/cattle farms

A

Q fever

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21
Q

handling overseas animal hair, hides

A

anthrax

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22
Q

animal urine on intact skin: hiker, farmer, forestry, vet, swimming, rafting

A

lepto

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23
Q

eating unpasteurized cheese from overseas (including goat cheese)

A

brucellosis

24
Q

wild game or their ticks: handling, cleaning

muskrats, beavers, rabbits, squirrels

A

tularemia

25
Q

flea bites from rodents or outdoor cats in contact w/ wild rodents

A

Y pestis

26
Q

Acute PNA, fever, HA, HSM

chronic IE

granulomatous hepatitis - doughnut granulomas

exposure to cows, sheep, goats, cats, etc

A

Q fever

TX: doxy or levo or azithro. Chronic: doxy + hydroxychloroquine

27
Q

dx and tx of brucellosis

A
  • DX: BCx, serology
  • TX: doxy + rifampin or strep/gent (TMP/SMX in pregnancy, young children)
28
Q
  • Acute/indolent: fever, myalgias, HSM/LAD
  • Late: liver, epidymo-orchitis, endocarditis, meningitis, bone = asymmetric sacroiliitis, tenosynovitis
  • malorodous perspiration
  • exposures: non-USA dairy/meet (Greece, Turkey common), slaughterhouse worker, meat packer, vet
A

brucellosis

29
Q
  • fever, myalgia, HA (late - aseptic meningitis), conjunctival suffusion
  • severe: jaundice, azotemia, pulm hemorrhage
  • liver damage, leukocytosis
  • exposed intact skin to animal urine in water: vegetarians, farmers, loggers, triathletes, rafting
A

leptospirosis (a spirochete)

TX: doxy (outpt). IV PCN (inpt)

  • beware of Jarisch-Herxheimer reaction
30
Q

zoonotic endemic disease in Madagascar

Sept-April

A

plague (Y pestis)

31
Q

Dx and Tx

A

Y pestis

  • GN coccobacillus
  • safety-pin appearance
  • Tx: streptomycin >> doxy, cipro
32
Q
  • sepsis, PNA (hematogenous or aerosol)
  • fever, nausea, swollen/painful LN
  • crowded conditions
  • NM, CA, AZ, CO
  • rodent flea bites or prairie dogs
A

Y pestis

33
Q

Tx of tularemia

A

gentamycin (severe), FQ (mild)

ppx (bioterrorism): doxy

34
Q

Skin: pruritic papule on skin –> small vesicles around an ulcer +/- pain

edema

exposure to animal hides (goat, sheep)

A

cutaneous anthrax

aerobic, encapsulated, sporulating GP bacillus

tx w/ PCN

35
Q

Dx and tx of Bartonella IE

A
  • usually culture-negative
  • IgG>1:800 highly suggestive
  • PCR
  • TX: gent + doxy x6wks
36
Q
  • SM, F, arthropathy/arthritis
  • leg pains
  • rash
  • severe weakness
  • thrombocytopenia
  • BSI, IE (usually culture negative)
  • advanced HIV, homeless, EtOH
  • crowded, unsanitary conditions
A

B quintana (“trench fever” in WW1)

37
Q
  • F, C, HSM
  • CT: hypodense center +/- contrast enh rim
  • U/S, MRI: masses
  • Blood filled spaces
  • Warthin Starry stain - numerous bacilli
A

peliosis 2/2 B henselae

38
Q

pt w/ advanced stage HIV

A

bartonella osteo

39
Q

syndromes of bartonella in HIV pts

A
  • bacillary angiomatosis
  • bacillary peliosis
  • osteomyelitis (lytic)
  • chronic BSI/IE
40
Q

bacteremia/IE in homeless

trench fever

A

B quintana

41
Q
  • acute: fever + anemia
  • later: hemangioma-like nodules in skin/MM
  • Andes, Peru
  • sand fly bite
A

Oroya fever –> verruga peruana

d/t B bacilliformis

42
Q

Syndromes caused by B henselae

A
  • CSD
  • peliosis
  • bacillary angiomatosis (HIV)
43
Q

tx of CSD

A

lots resolve on their own

tx = azithromycin (a bit better than no RX)

44
Q
A

CSD LAD

  • stellate abscess - necrotic area w/ neutrophils surrounded by palisaiding histiocytes
  • Warthin Starry silver stain
45
Q
A

CSD

stellate retinitis, uveitis

*pic shows lipid exudates forming macular star

46
Q

stellate abscess (on bx)

Warthin Starry stain +

A

bartonella henselae

47
Q

Infections a/w purulent inguinal LN

A
  • bartonella henselae
  • tick-borne tularemia (“glandular”)
  • chancroid - w/ painful genital ulcer
  • S aureus
  • LGV (C trachomatis L1-3) - genital lesion usually inapparent

(NOT in syphilis or granuloma inguinale)

48
Q
  • several days HA, F/C, cough, myalgias
  • generalized LAD
  • generalized vesiculopustular rash - progressed in uniform manner (most prominent = trunk, palms, soles)
  • new pet prairie dog was ill
A

Monkeypox

49
Q

seals/whales (whaler)

also pork

A

Erysipelothrix rhusiopathiae

50
Q

rodents

A
  • leptospira
  • monkeypox
  • salmonella
  • spirillum minus
  • streptobacillus moniliformis
  • Y pestis
51
Q

rabbits

A

tularemia

52
Q

leeches

A

aeromonas hydrophila

53
Q

farm animals

A
  • B anthracis
  • brucella
  • coxiella
  • campy
  • E coli
  • Erysipelothris
  • Hep E
  • leptospira
  • salmonella
54
Q

dogs

A
  • campy
  • capnocytophaga
  • leptospira
  • pasteurella multocida
  • staph intermedius/pseudintermedius
55
Q

fish

A
  • E rhusiopathiae
  • M marinum
  • Strep iniae
  • vibrio
56
Q

cats

A
  • bartonella henselae
  • pasteruella multocida

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