Zoonoses with Skin Manifestations

Question 1

Morphology of Rickettsia?

Answer 1

G- bacili

Question 2

Why can’t Rickettsia be cultured?

How is it diagnosed?

Answer 2

obligate, intracellular parasite

appearance, pt hx, confirmed with serology

Question 3

All rickettsia are sensitive to:

Answer 3

doxy

Question 4

Phyla of Rickettsia

Answer 4

Rickettsia
Ehrlichia
Coxiella

Question 5

Rickettsia symptoms

Answer 5

Fever-headache-rash

Question 6

Where do Rickettsia replicate? What does this cause?

Answer 6

• -in endothelial cells of small blood vessels

- -vasculitis

Question 7

2 diseases caused by rickettsia

Answer 7

RMSF

Epidemic typhus

Question 8

RMSF is transmitted by:

Answer 8

ticks

Question 9

Typical RMSF symptoms?

Answer 9

1. “Flu” with severe headache
2. Rash starts at ankles and wrists, spreads to palms, soles, trunk (***very characteristic!!!)
3. sore muscles, especially in calves

Question 10

RMSF can progress to:

Answer 10

Septicemia

DIC

Question 11

What test is used to diagnose RMSF?

Answer 11

immunofluorescent antigens

Question 12

What was the old test used to dx RMSF?

Explain it

Answer 12

Weil-Felix test

Non-specific test in which anti-rickettsial Abs cross-react with Proteus OX antigens

Question 13

R. prowazekii is likely transmitted:

Answer 13

human-to-human by body lice feces

maybe flying squirrels?

Question 14

R. prowazekii symptoms:

Answer 14

Rash similar to RMSF except spreads from trunks to extremities
Not found on palms or soles

Question 15

R. prowazekii has a (high/low) untreated mortality rate.

What are possible bad complications?

Answer 15

high mortality rate (10-60% untreated)

Myocarditis, CNS involvement

Question 16

Ehrlichia are “_____ ___-borne” diseases

Answer 16

Southern

tick

Question 17

Human monocytic ehrlichiosis (HME) is transmitted by:

Human granulocytic anaplasmosis is transmitted by:

Answer 17

Lone Star deer tick

Ixodes deer tick

Question 18

Human monocytic ehrlichiosis (HME) replicates in:

Answer 18

monocytes, within inclusions called morulae

Question 19

Human monocytic ehrlichiosis (HME) is diagnosed by:
Confirmed by:
treated with:

Answer 19

blood smear
serology
doxy

Question 20

Human granulocytic anaplasmosis is often called:

Why?

Answer 20

“Rocky Mtn Spotless Fever”

RMSF symptoms WITHOUT rash

Question 21

Human granulocytic anaplasmosis is diagnosed by:

Answer 21

Blood smear

look for morulae in granulocytes

Question 22

2 types of Spirochetes

Answer 22

Borrelia and Leptospira

Question 23

What disease is caused by Borrelia burgdorferi?

Answer 23

Lyme disease

Question 24

B. burgdorferi is transmitted by:

Answer 24

Ixodes deer tick nymph
(saliva)

Note: if you remove the tick in t get sick!

Question 25

Symptoms of early lyme disease:

Answer 25

1. Flu-like (milder than RMSF) | 2. Erythema chronicum migrans (**Usually!)

Question 26

Symptoms of secondary lyme disease:

Answer 26

Disseminated disease, weeks or months later 1. Arthritis 2. facial palsy 3. peripheral neuropathy

Question 27

Symptoms of chronic lyme disease:

Answer 27

``` Erosive arthritis (autoimmune; **esp bad in knees) Bell palsy ```

Question 28

Diagnosis of Lyme disease:

Answer 28

Step 1: ELISA (sensitive, false positives**) | Step 2: Must be confirmed by Western blot

Question 29

Treatment of Lyme disease Early: Chronic:

Answer 29

Early: doxy or amoxicillin Chronic: IV cephalosporins for extend time

Question 30

What is notable about Borrelia?

Answer 30

they undergo antigenic variation | change surface antigens, which causes a cyclical pattern of infection

Question 31

B. recurrentis is transmitted via: | B. hermsii is transmitted via:

Answer 31

louse (rare in US) | tick

Question 32

B. hermsii and B. recurrentis are endemic to:

Answer 32

high desert of Western US

Question 33

What are symptoms of B. hermsii and B. recurrentis infections?

Answer 33

1. Fever for a week, then recurs two weeks later (due to antigenic variation) 2. Skin rash uncommon

Question 34

How are B. hermsii and B. recurrentis diagnosed?

Answer 34

Blood smear | Serology to confirm

Question 35

How are B. hermsii and B. recurrentis treated?

Answer 35

doxy

Question 36

How is Leptospira interrogans transmitted?

Answer 36

urine contaminated water gets into cuts

Question 37

Symptoms of Leptospira interrogans?

Answer 37

1. Flu-like 2. Jaundice and renal damage (Weil’s disease) 3. Meningitis

Question 38

Diagnosis of Leptospira interrogans? | Treatment?

Answer 38

Serologic diagnosis Treat with penicillin Note: there's a vaccine for cattle and pets

Question 39

What causes Cat-Scratch disease?

Answer 39

Bartonella henselae

Question 40

Who is often infected with Cat-Scratch disease? | How does it present?

Answer 40

children | Swollen gland near site of scratch most will clear up on own in a couple of weeks

Question 41

How do you treat Cat-Scratch disease?

Answer 41

Erythromycin, but only for long-lasting infections