Zoonotic Diseases Flashcards
(155 cards)
1
Q
Rocky Mtn. Spotted Fever causative agent
A
Rickettsia rickettsii
2
Q
Vector of Rocky Mtn. Spotted Fever
A
dog tick
Rocky Mtn. wood tick
3
Q
Reservoir of Rocky Mtn. Spotted Fever
A
small woodland animals, domestic cats/dogs, deer
4
Q
Geographic distribution Rocky Mtn. Spotted Fever
A
North Atlantic & S. Central regions of US, N. America, C. America, S. America
5
Q
Peak incidence of Rocky Mtn. Spotted Fever
A
late spring and early summer
6
Q
Rocky Mtn. Spotted Fever clinical manifestations
A
Classic RMSF rash of centripetal inward spreading macular rash
- begins at wrists, forearm, and ankles
- spreads inward toward the trunk
- palms and soles involved in 80% of cases
7
Q
Rocky Mtn. Spotted Fever Severe disease
A
really messed up: effects skin, neuro, muscle, GI, cardiac, etc.
8
Q
Rocky Mtn. Spotted Fever diagnostics
A
Serology for R. rickettsia antibodies showing a 4 fold increase in IgG antibodies
Immunohistochemical detection of R. rickettsia in skin biopsy
PCR detection of ABs in eschar, blood, skin biopsy
9
Q
Rocky Mtn. Spotted Fever treatment
A
doxycycyline
chloramphenicol alternative when pregnant (monitor for pancytopenia)
- less adverse reactions/improved outcome with early treatment
- fever w/o rash common in elderly and African Americans
10
Q
Rocky Mtn. Spotted Fever prevention
A
avoid ticks and early removal of attached ticks
more severe infections in males, alcoholics, elderly, African Americans, immunocompromised, patients with G6PD deficiency
11
Q
centripetal rash
A
Rocky Mtn. Spotted Fever
12
Q
Lyme disease causative agent
A
Borrelia burdorferi (spirochete)
13
Q
Lyme disease reservoir
A
white footed mouse
14
Q
Lyme disease geographic distribution
A
Endemic areas: northeastern seaboard, midwest, west coast
15
Q
Lyme disease peak incidence
A
spring through fall and peak in summer
16
Q
Lyme disease description
A
tickborne spirochetal zoonosis that affects skin, joints, nervous system, and heart
17
Q
Lyme disease stages
A
early lyme stage
acute disseminated infection
late lyme disease
18
Q
Lyme disease early lyme stage
A
- erythema migrans bull’s eye rash
- constitutional sx
- HA
- GI sx: hepatitis, pharyngitis
19
Q
Lyme disease acute disseminated infection
A
- neurological manifestations: BILATERAL BELL PALSY
- cardiac manifestations: AV Block
20
Q
Lyme disease late lyme disease
A
- neurological: chronic encephalopathy, memory impairment, psychiatric disturbances, hypersomnolenece (just want to sleep alllllll the time)
- ARTHRITIS!!
21
Q
Lyme disease diagnostic teasting
A
Clinical dx: erythema migrans rash from endemic areas - treat empirically
serology: most important tests to cofirm clinical suspicion - ELISA during first month of illness & Western Blot
22
Q
Lyme disease treatment
A
Early localized dz:
- confined to skin: 10 days ABX
- spread beyond skin: extended tx to 20-30 days
- oral doxycycline for 21 days (not in pregnancy or kids <8yrs)
23
Q
Lyme disease treatment alternatives
A
amoxicillin
cefuroxime
24
Q
Lyme disease treatment for pregnancy and PCN allergy
A
erythromycin
25
Lyme disease treatment with complications
prolonged ABX tx 30-60 days
26
erythema migrans rash
Lyme disease
27
Tularemia causative agent
Francisella tularensis
28
Tularemia reservoir
furry "go get 'em" guys: rabbits, hares, squirrels, voles, prairie dogs
29
Tularemia vector
dog tick
Rocky Mtn. wood tick
long star tick
30
Tularemia geographic distribtuion
worldwide and primarily in N. hemisphere
31
Tularemia peak incidience
april through october and peak in June/July
32
Tularemia trasnmission
- handling infected animal tissues/fluids
- bites from infected arthropods
- direct contact
- inhalation of infective aerosols
33
Ulceroglandular/Glandular Tularemia
- MC form of tularemia
- cutaneous papule forms at site of bite/inoculation
- enlarged lymph nodes
- pustule suppurates and ulcerates
- eschar may form
- glandular tularemia: similare presentation w/o ulceration
34
Oculoglandular tularemia Tularemia
- occurs with inoculation into eye
- ulcerated conjunctiva
- preauricular node enlargment
35
Oropharyngeal Tularemia
- ingestion of contaminated food/water
- stomatitis, exudative tonsillitis, pharyngitis
- lymphadenopathy of cervical or retropharyngeal nodes
36
Tularemia pneumonia
- inhalation of contaminated aersols or from bacterial spread from local site to lungs
- MUCH more serious and mortality rates of 30%
- AKA lawnmower tularemia
- ARDS
- PNA w/ hilar LAD, dry cough, SOB, chest pain
37
Tularemia other types
typhoidal (systemic with fever, chills, diarrhea) and tularemic sepsis
38
Tularemia tularemic sepsis
severe and often fatal
SIRS occurs with shock and DIC
patient is toxic appearing and may become comatose
39
Tularemia management
Streptomycin: IM BID x 10days
Gentamicin: IM/IV once a day for ten days
40
Tularemia need to know
painful preauricular lymphadenopathy is hallmark of oculoglandular Tularemia
- distingues if from cat scratch dz, TB, syphilis
41
Relapsing fever causative agent
Borrelia hermsii, B. parkeri, B. duttoni, B. miyamotoi
42
Relapsing fever vector
soft body ticks
43
Relapsing fever reservoir
humans
| rodents
44
Relapsing fever geographic distribution
Western US: incl. WA
45
Relapsing fever clinical manifestations
- Abrupt onset fever, chills, tachycardia, N/V, arthralgia, severe HA
- HSM
- Rashes: macular, papular petechial
- Recurs every 1-2 weeks with 3 to 10 relapses
46
Relapsing fever febrile episodes
- end with crisis collection of sx:
- Chill phase: very high fever (106) with delirium, agitation, tachycardia
- Flush phase: drenching diaphoresis, rapid decrease in body temp, transient hypotension
47
Relapsing fever diagnostics
- spirochetes in blood smear during fevers
- anti-borrelia antibody
- CSF abnormalities if meningeal involvement
48
Relapsing fever complications
iritis
uveitis
cranial nerve and neuropathies
49
Relapsing fever pregnancy complications
spontaneous abortion
premature birth
neonatal bath
50
Relapsing fever DDx
```
malaria
leptospirosis
meningococcemia
yellow fever
typhus
```
51
Relapsing fever tx
doxycycline
tetracycline
erythromycin
52
Dengue fever vector
mosquito
53
Dengue fever reservoir
human
| nonhuman primates
54
Dengue fever geographic distribution
tropical
| subtropical
55
Dengue fever clinical manifestations
- acute febrile illness
- rash
- retroorbital HA
- can progress to dengue hemorrhagic fever or dengue shock syndrome
- see saddleback pattern with subsequent infections
56
Dengue hemorrhagic fever phases
febrile
critical
recovery
57
tourniquet test
Dengue fever
58
Febrile phase of Dengue Hemorrhagic fever
fever, HA, easy bruising, epistaxis, positive tourniquet test
59
Critical phase of Dengue Hemorrhagic fever
- GI hemorrhage
- plasma leakage into chest/peritoneal cavities
- occurs after fever breaks
60
Recovery phase of Dengue Hemorrhagic fever
- white islands in a sea of red rash
| - pt begins to feel better
61
saddleback pattern
Dengue fever
62
white islands in a sea of red rash
Dengue fever
63
Dengue fever managment
- supportive
- acetaminophen
- no NSAIDs due to thrombocytopenia
- avoid mosquitoes
64
Zika causative agent
zika virus of flaviviridae family
65
Zika vector
Aedes aegypti, A. albopictus
66
Zika reservoir
human
| nonhuman primates
67
Zika distribution
tropical/subtropical regions
68
Zika clinical manifestations
- acute febrile mosquito-borne illness
- similar to and milder than dengue fever
- 80% are ASx or afflicted with mild disease
- microcephaly in pregnancy
69
Zika male effects
detected in semen up to 3-6 months after initial infection
70
Zika diagnosis
serological
71
Zika treatment
Supportive
| NSAIDs avoided until dengue ruled out
72
Zika prevention
- avoid mosquitos
- transmitted by sex, blood transfusions, vertically
- condoms for at least 8 weeks after return from Zika areas
73
Ebola Hemorrhagic Fever causative agent
Ebola virus from family filoviridae
74
Ebola Hemorrhagic Fever reservoir
fruit bats
75
Ebola Hemorrhagic Fever geographic distribution
W. & C. Africa
76
Ebola Hemorrhagic Fever transmission
- dz of humans/primates with a very high mortality
- consumption of bushmeat
- human to human contact with bodily fluids
- contact with dead infected bodies
77
Ebola Hemorrhagic Fever clinical manifestations
Initial: flu-like then maculopapular rash
Severe: renal failure, DIC, hemorrhage
Hemorrhage: hematochezia, petechiae, ecchymosis, mucsal bleeding, hematemesis
78
Fruit bats
Ebola Hemorrhagic Fever
79
Ebola Hemorrhagic Fever diagnostics
- ELISA, IgM/IgG, PCR
80
Ebola Hemorrhagic Fever treatment
- supportive
| - experimental treatments and vaccines are being pursued
81
Mosquito-Borne encephalitis: Western Nile Virus vector
Culex spp. mosquito
82
Mosquito-Borne encephalitis: Western Nile Virus geographic distribution
worldwide
83
Mosquito-Borne encephalitis: Western Nile Virus manifestations
- ASx or flu-like
- transient maculopapular rash
- encephalitis in <1%
- may have polio-like acute flaccid paralysis
- mortality for neuroinvasive dz is 20%
- 50% of survivors of encephalitis have neurological sequelae
84
Mosquito-Borne encephalitis: Western Nile Virus treatment
supportive
85
Mosquito-Borne encephalitis: Western Equine Encephalitis vector
mosquito
86
Mosquito-Borne encephalitis: Western Equine Encephalitis geographic distribution
N. S. America: rural areas west of Mississippi
87
Mosquito-Borne encephalitis: Western Equine Encephalitis manifestations
- ASx or flu-like
| - Neuroinvasive in 0.1%
88
Mosquito-Borne encephalitis: Japanese Encephalitis vector
mosquito
89
Mosquito-Borne encephalitis: Japanese Encephalitis geographic distribution
Asia
| W. Pacific
90
Mosquito-Borne encephalitis: Japanese Encephalitis manifestations
- ASx or flu-like
| - <1% neuroinvasive
91
Mosquito-Borne encephalitis: Japanese Encephalitis treatment
Supportive
| VACCINE AVAILABLE
92
Mosquito-Borne encephalitis: Eastern Equine Encephalitis geographic distribution
N, C., S. America and Caribbean
93
Mosquito-Borne encephalitis: Eastern Equine Encephalitis manifestations
Most severe mosquito borne illness in US
Mortality from neuroinvasive cases is 30%
94
Hantavirus Pulmonary Syndrome transmission
inhalation of aerosolized virus from infected rodent excreta, saliva, urine
95
Hantavirus Pulmonary Syndrome Clinical manifestations phases
prodromal, cardiopulmonary, convalescent
96
Hantavirus Pulmonary Syndrome cardiopulmonary phase (lasts 24-48hrs)
severe dyspnea
cough
pulmonary edema
circulatory collapse
ventilation required
97
Hantavirus Pulmonary Syndrome convalescent phase
begins with onset of massive diuresis
98
Four corners area, Hanford, Tricities location
| West of mississippi
Hantavirus Pulmonary Syndrome
99
Hantavirus Pulmonary Syndrome management
Early tx in ICU for cardiopulmonary phase
Antiviral ribavirin may help some in early stages
100
Sin nombre virus
Hantavirus
101
Plague causative agent
yersinia pestis
102
Plague vector
rat flea
103
Plague reservoir
rats, mice, rodents, foxes, coyotes, wild cats
104
Plague geographic distribution
SW US, S. America, Africa, Asia
105
Plague: Bubonic plague
- MC form of dz
- lymphadenopahthy from replication (bubo)
- bubos ulcerate and open
- blood cots leading to arteriolar obstruction and acral gangrene: black death
106
Plague: Pneumonic plague
- inhale aerosolized Y. pestis bacilli
- hematogenous spread to pneumonia, hemoptysis, malaise, myalgias
- rapid decline 24 hrs from onset with DIC, circulatory shock, resp. failure
107
Plague: Speticmic Plague
sudden onset of febrile illness w/o bubo formation
rapid onset of hypotension and shock
very high mortality rate
108
Plague treatment
Streptomycin, Gentamicin
109
Rabies reservoir
all mammals - mostly common in bats, raccoons, skunks, foxes
MC worldwide cause of rabies: DOGS
110
Rabies infection
wound severity, wound location in relation to nerves, and relative distance from the brain decides the risk of infection
111
Rabies geographic distribution
worldwide
IN US: MCC by wild animals BATS and not dogs as they're vaccinated
112
Rabies general characteristics
Devastating, fatal viral encephalitis
Contracted in a scratch or bite from infected saliva
Corneal transplant
113
Rabies clinical manifestations
- Once Sx present, invariably fatal
- pain, pruritis, or paresthesias at bite/scratch
- prodromal
- hydrophobia: foam at mouth
- coma and death
114
Rabies types
furious rabies
| paralytic rabies
115
Furious Rabies
- MC
- hyperactivity
- disorientation
- aggressive, bizarre behavior
- excessive salivation
Acting like a crazed animal
116
Paralytic Rabies
- lethargic
- loss of coordination
- confusion
- stupor
- ascending paralysis
117
Rabies diagnosis
Negri bodies histologically
118
Rabies treatment (post-exposure)
- clean wound with soap/water
- wild animals: capture if can, destroy, and lab histology preformed
- healthy animal in an endemic area: capture and quarantined for ten days
119
Rabies treatment (post-exposure) hospital management
passive immunization: rabies immunoglobulin into wound and glute
active immunization: administer anti-rabies vaccine 3x IM
120
DOG
Rabies
121
Cat Scratch Disease: causative agent
Bartonella henselae
122
Cat Scratch Disease: vector
cat flea
123
Cat Scratch Disease reservoir
cat
| kittens more likely to carry bacteria
124
Cat Scratch Disease transmission
cat is infected and then infects a human
125
Cat Scratch Disease clinical manifestations
- small papular/nodular lesion
- linear papules/nodules
- Rare/severe: meningitis, osteomyelitis, endocarditis
- parinauds oculoglandular
- HIV/AIDS can get peliosis hepatitis or bacillary angiomatosis
126
Parinaud's oculoglandular syndrome of Cat Scratch Disease
granulomatous conjunctivitis with preauricular lymphadenopathy
127
Cat Scratch Disease treatment
azithromycin
128
Pateurella multocida: gram stain
gram negative encapsulated rod
causes infections in wounds related to dogs/cats
129
Pateurella multocida pathogenesis/epidemiology
normal flora of most animals
transmission is through bite
don't suture the wound close as is an anaerobe
130
Pateurella multocida clinical manifestations
- rapidly spreading cellulitis at site of bite
- complicate to osteomyelitis
- cat bites esp. problematic due to sharp needle teeth
131
cellulitis
Pateurella multocida
132
Pateurella multocida management
amoxicillin-clavulanate
133
Chagas disease causative agent
Trypanosoma cruzi
134
myocarditis
Chagas disease
135
Chagas disease vector
reduviid/kissing/assassin bug
136
Chagas disease reservoir
opossums, raccoons, armadillos, rodents
137
Chagas disease geographic area
endemia in mexico, C./S. America, southern states
138
Chagas disease transmission
tropical parasitic zoonoitc infection in feces of vectors
also via blood transfusion, congenitally, organ transplantation, consumption of contaminated food/water
139
Chagas disease acute manifestations
- often mild/ASx
- chagoma: localized erythema/edema where parasite entered
- romana sign: painless palepbral edema and conjunctivitis
140
costa rica
Chagas disease
141
Chagas disease intermediate/chronic phase
may last years to decades before chronic phase
142
Chagas disease chronic
```
1/3 of pts
dilated cardiomyopathy
megaesophagus
achalasia
megacolon
neuritis
```
143
new parrot
| pet store owner
psittacosis
144
Psittacosis causative agents
chlamydia psittaci
145
Psittacosis reservoir
birds
146
Psittacosis transmission
inhaled aerosolized feces of birds
147
Psittacosis clinical manifestations
```
Severe HA
Pneumonia
Photophobia
HSM
hepatitis
DIC
```
148
severe HA with pneumonia
Psittacosis
149
Psittacosis diagnostics
CXR: lower lobe consolidation
Mild leukocytosis with left shift
Elevated AB titers
Increased LFTs
150
Psittacosis treatment
doxycycline
tetracycline
rapid improvement w/in 24 hrs of ABX
pregnant: azithromycin
151
Brucellosis resevoir
```
sheep
swine
cattle
dogs
bison
```
152
Brucellosis distribution
worldwide
153
Brucellosis transmission
raw milk
| unpasteurized cheese
154
Brucellosis clinical manifestations
- Bone and joint involvement
- Chronic disease >1 yr
- May relapse/reoccur w/o proper ABX tx
155
Brucellosis treatment
ciprofloxacin + doxycycline or ciprofloxacin + rifampin
