Who is at increased risk for zoonotic infection?
-people who handle animals
-persons exposed to arthropods
-people exposed to unprocessed food
-travelers
What is the typical presentation of someone with a zoonotic infection?
-Systemic febrile illness, unknown origin
-skin or soft tissue infection
-pneumonia
-encephalitis
Why is pneumonic plague bad news?
-rapidly progressive pneumonia
-high rates of transmission
What are the symptoms of ulceroglandular Tularemia?
-Ulcer at site of infection
-followed by swollen, painful lymph nodes
What are the symptoms of Glandular Tularemia?
-swollen painful lymph glands
*no development of ulcers
What are the symptoms of Oropharyngeal Tularemia?
-Tonsillitis
-vomiting & diarrhea
-maybe some gland swelling in neck
What are the symptoms of Oculoglandular Tularemia?
-pain, redness, swelling, and discharge of eyes
-dev. of an ulcer on inside of eyelid in some cases
What are the symptoms of Pneumonic Tularemia?
-sore throat & swelling of pulmonary lymph nodes
-sudden fever, chills, headache, myalgia, joint pain, dry cough , and progressive weakness
What are the symptoms of Typhoidal Tularemia?
-systemic illness (fever, chills, etc.) without site of infection or localized symptoms
-possibly fatal
What are the symptoms of septic Tularemia?
-systemic illness
-patient appears toxic
-may develop confusion and coma
-w/o Tx: shock, ARDS, organ failure
How do we distinguish an Ehrlichia infection from a Rickettsia infection?
-Ehrlichia invades WBC's, Rickettsia endothelial cells
-No rash in Ehrlichia
-Neutropenia more likely in Ehrlichia than Rickettsia
What organism causes Cat scratch fever?
-Bartonella henselae
What disease does Bartonella quintana cause?
-Trench fever
"homeless pt w/ a fever that lasts 4-5 days"
Bartonella quintana = trench fever
What disease does Brucella cause?
-Undulant fever
-Brucellosis ("the great imitator")
-osteomyelitis
What organs can Brucella suis damage?
-spleen
-Kidney
What is the frequent cause of brucella infection?
-ingestion of unpasteurized dairy products
single cells like "fine sand"
Brucella
Francisella tularensis is considered a _________ agent.
Bioterrorism
Describe the pathogenesis of tularemia.
-Painful ulcer at site of infection
-travels through ulcer to lymph nodes
-caseating granulomas at lymph nodes
What does pasturella cause?
-Cellulitis at location of cat/dog bite in first 24 hours
-osteomyelitis
"bipolar staining resembling safety pin"
Yersinia
"Rash starting on hands and feet, moving centrally"
Ricketsia ricketsii - Rocky mountain spotted fever
22 y/o woman from Mexico comes to ER with 4 weeks of fever, arthralgias. T 101, HR 95, BP 125/80, RR 20. No focal findings on exam. Admitted with unrevealing investigations. ID consulted for “Fever unknown origin” on day 5. As med student on service you ask “What kind of cheese do you like to eat?”
What is the causitive agent?
Brucella
43 y/o man comes to your office with 3 days of neck swelling and fever. Recently on hunting trip to eastern Oklahoma with lots of “bites”. T 101, HR 75, BP 110/75, RR 20. Has ulcerated lesion on neck with lymphadenopathy. You call the laboratory to tell them to be careful if the blood cultures turn positive because you suspect?
Francisella
A 39 year old man from Travis County, Texas, was hospitalized with a 1-day history of high fever, delirium, nausea, and vomiting. Although lymphadenopathy was not detected on the initial examination, a prominent axillary bubo was noted later. The patient recovered after treatment with multiple antibiotics, including gentamicin, doxycycline, ciprofloxacin, and levofloxacin. Before his illness, the patient had hunted rabbits in Lea County, New Mexico, and skinned the rabbit carcasses.
What was the causitive organism?
Yersinia pestis
44 y/o man brought to BT ER after being found outside bar. T 101, HR 130, BP 70/40, RR 35. Bite marks found on hands and arms. Admitted, started on broad-spec Abx. Lab calls 18 hrs after admission saying “Gram-negative rods are growing in his blood”
What is the causitive agent?
Pasteurella multicoda
31 y/o man comes to SLH ER with complaints of fever, malaise, severe headache for 3 days. Recent camping trip to Lake Of the Ozarks (Missouri). T 102, HR 110, BP 110/40, RR 20. Admitted, started on broad-spec Abx. Day 3 gets generalized rash.
What is the causative agent?
Rickettsia rickettsii
