Zoonotic Infectections Flashcards

Question

Ehrliciosis • Treatment • mortality

Answer 1

**_HUMAN MONOCYTIC EHRLICHIOSIS – Ehrlichia chaffeesis_** _Structure_ Gram negative rod _Treatment_ Doxycycline _Mortality_ 1.8%

Answer 2

**_HUMAN MONOCYTIC EHRLICHIOSIS – Ehrlichia chaffeesis_** _Structure_ Gram negative rod _Key findings/Diagnosis_ Key: **Conjunctivitis + morulae in monocytes + southeast U.S.** DX: **Blood Smear + Serology** (NOT Weil-Felix)

Answer 3

**_ROCKY MOUNTAIN SPOTLESS FEVER – Anaplasma phagocytophilia_** _Structure_ Small gram-negative Rod (weak stain) _Transmission_ **Ixodes Blacklegged Ticks** _Replication Cycle_ Intracelluar Replication inside of *GRANULOCYTES*

Answer 4

**_ROCKY MOUNTAIN SPOTLESS FEVER – Anaplasma phagocytophilia_** _Structure_ Small gram-negative Rod (weak stain) _Disease Presentation_ **Flu-like symptoms ± (shocky symptoms) Dyspnea, Hemorrhage, Renal Failure, CNS problems** **\*\*Note the absence of rash**

Answer 5

**_ROCKY MOUNTAIN SPOTLESS FEVER – Anaplasma phagocytophilia_** _Structure_ Small gram-negative Rod (weak stain) _Epidemiology_ **East especially SOUTHEast + California** _Treatment_ Doxycycline

Answer 6

**_ROCKY MOUNTAIN SPOTLESS FEVER – Anaplasma phagocytophilia_** _Structure_ Small gram-negative Rod (weak stain) _Key findings/Diagnosis_ Dx: **MORULAE IN NEUTROPHILS = Pathognomonic**

Answer 7

**_Q-FEVER – Coxiella burnetii_** _Structure_ **Gram-negative bacillus** that is an **obligate intraceullular parasite** living in **MACROPHAGES**

Answer 8

**_Q-FEVER – Coxiella burnetii_** _Structure_ **Gram-negative bacillus** _Transmission_ Usually happens when humans handle **contaminated viscera (during birth) or drink raw milk. TICKS** also carry this pathogen.**Aerosolized SPORES** are also very infective. **EASILY transmitted** (very low infectious dose

Answer 9

**_Q-FEVER – Coxiella burnetii_** _Structure_ **Gram-negative bacillus** _Replication Cycle_ Obligate Intracellular – *MACROPHAGES* _Disease Presentation_ **30-50% of cases are asymptomatic**, others experience **2-4 weeks of ATYPICAL pneumonia with HIGH FEVER.** Sometimes the liver and heart are involved which can lead to **endocarditis or granulomatous hepatitis.**

Answer 10

**_Q-FEVER – Coxiella burnetii_** _Structure_ **Gram-negative bacillus** _Epidemiology_ Affect **GOATS** mainly, but also infects cattle, and sheep. Seen in almost **every country**. _Treatment_ **Doxycycline** can be used but **resolve spontaneously**

Answer 11

**_Q-FEVER – Coxiella burnetii_** _Structure_ **Gram-negative bacillus** _Mortality_ **Very low, below 2% , but 100% if left untreated** _Key findings/Diagnosis_ Granulomatous liver dz, or endocarditis, Unique Spore Transmission **Dx: SEROLOGICAL** - look for **increasing titers** to Coxiella b

Answer 12

Lyme Disease = Borrelia burgdoferi Relapsing Fever = Borrelia hersi/recurrentis Leptospirosis = Leptospira Interrogans

Answer 13

**_LYME DISEASE – Borrelia burgdoferi_** _Structure_ **Small** Spirochete only visible with Darkfield microscopy, Giemsa, or Silver Stain _Transmission_ Small Nymphal Stage Ticks (24-48 hrs of feeding required) East Coast and Midwest = **Ixodes scapularis** West Coast = **Ixodes pacificus** Small mammals =\> **White Footed Mouse**

Answer 14

**_LYME DISEASE – Borrelia burgdoferi_** _Structure_ **Small** Spirochete only visible with Darkfield microscopy, Giemsa, or Silver Stain _Disease Presentation_ Infection typically happens during the Summer Months _Pathogenic Mechanism_ No exotoxin or enzymes but Bites skin (*bulls eye rash*) = days =\> gets into blood (*arthralgia*) = weeks/months **=\> Heart, Joints (*arthritis*) , and CNS most affected (BILATEAL BELLS PALSY)**. **ANTIGENIC VARIATION** in outter surface proteins leads to PERSISTANT INFECTION.

Answer 15

**_LYME DISEASE – Borrelia burgdoferi_** _Structure_ **Small** Spirochete only visible with Darkfield microscopy, Giemsa, or Silver Stain _Epidemiology_ **Summer in NY, CT, PA, NJ;** but may be present worldwide _Treatment_ Early – Doxycycline, tetracycline, amoxicillin Chronic – IV cephalosporins or Penicllin G

Answer 16

**_LYME DISEASE – Borrelia burgdoferi_** _Structure_ **Small** Spirochete only visible with Darkfield microscopy, Giemsa, or Silver Stain _Key findings/Diagnosi_ Dx: Cultures are Typically NEGATIVE so do.. **• ELISA (sensitive not specific, IgM, IgG) =\>** **WESTERN BLOT confirmation • PCR**

Answer 17

**_RELAPSING FEVER – Borrelia hernsii/recurrentis_** _Structure_ **Spirochete – ONLY ONE VISIBLE ON Light Micro** _Transmission_ **B. hernsii – Ioxdes tick B. recurrentis – Body Louse** **Rodents and Small animals =\> Reservoirs**

Answer 18

**_RELAPSING FEVER – Borrelia hernsii/recurrentis_** _Structure_ **Spirochete – ONLY ONE VISIBLE ON Light Micro** _Disease Presentation_ No associated skin rash (like with B. burgoderfori). **Fever for a week** then **recurs 2 weeks later**. This may occur up to **10 times.** _Pathogenic Mechanism_ **ANTIGENIC VARIATION** in Outer Surface Proteins is key to characteristic recurrent infections (no other virulence factors).

Answer 19

**_RELAPSING FEVER – Borrelia hernsii/recurrentis_** _Structure_ **Spirochete – ONLY ONE VISIBLE ON Light Micro** _Epidemiology_ Western U.S. predominantly, but is endemic almost everywhere _Treatment_ Doxycycline or Tetracycline _Mortality_

Answer 20

**_RELAPSING FEVER – Borrelia hernsii/recurrentis_** _Structure_ **Spirochete – ONLY ONE VISIBLE ON Light Micro** _Key findings/Diagnosis_ Dx: **Blood Smear with Spirochetes in Plasma**; Serology typically useless \*\*\*This is important b/c its the only spirochete you can see on LM\*\*\*

Answer 21

**_LEPTOSPIROSIS – Leptospira interrogans_** _Structure_ *Tightly Coiled* Spirochetes, not visible on Light Microscopy _Transmission_ **Mucosal or Cutaneous =\> No vector, Contaminated H2O** **Dogs =\> U.S. Reservoir** (other mammals may also carry)

Answer 22

**_LEPTOSPIROSIS – Leptospira interrogans_** _Structure_ *Tightly Coiled* Spirochetes, not visible on Light Microscopy _Disease Presentation (BIPHASIC)_ Patients come in with **flu-like symptoms and CONJUCTIVAL SUFFUSION** (eye redness and swelling with no exudate). The **infection clears** up **the comes back and is severe***: ASEPTIC MENIGITIS, LIVER DAMAGE, IMPAIRED KIDNEY FUNCTION (UREMIA; Weil’s Disease) and/or LUNG HEMMORHAGE*.

Answer 23

**_LEPTOSPIROSIS – Leptospira interrogans_** _Structure_ *Tightly Coiled* Spirochetes, not visible on Light Microscopy _Pathogenic Mechanism_ Bacteria spread from **skin to liver, kidney, lungs, and CNS. ANTIGENIC VARIATION** _Epidemiology_ **Urban poor, SWIMMERS, MINERS, AND FARMERS are at the highest risk**

Answer 24

**_LEPTOSPIROSIS – Leptospira interrogans_** _Structure_ *Tightly Coiled* Spirochetes, not visible on Light Microscopy _Treatment_ Penicillin G Prevention possible for animals: Vaccine _Key findings/Diagnosis_ Dx: **History, Clinical Signs, IgM titers, \*\*\*Culture is rarely possible**

Answer 25

Antigenic variation causes multi-phasic illness

Answer 26

**_Bartonella heneslae (Cat Scratch Disease)_** _Structure_ Small pleomorphic Rod (proteobacterium) _Transmission_ Cat Scratch/Bite (**NOT urine or feces – no risk)** No person-person transmission

Answer 27

**_Bartonella heneslae (Cat Scratch Disease)_** _Structure_ Small pleomorphic Rod (proteobacterium) _Disease Presentation_ Self-limiting in immunocompetent people. **Fever and papule at site of lesion with LAD on the side of the scratch.** Long course. **Endocarditis and Encephalitis** may develop rarely. **AIDS patients may get organ involvement.** _Treatment_ Typically no Tx. Needed, Doxycycline, Erythromycin, and Azithromycin is used for serous infection.

Answer 28

**_Bartonella heneslae (Cat Scratch Disease)_** _Structure_ Small pleomorphic Rod (proteobacterium) _Key findings/Diagnosis_ Key finding: Does not grow on routine agar Dx: **Serology, Warthin-Starry Silver Stain**

Answer 29

**_ANTHRAX – Bacillus anthracis_** _Structure:_ Large **gram-positive spore forming rod** with **sqaure ends**, frequently found in chains. **antiphagocytic capsule** is composed of **_d-glutamate_****.** _Transmission:_ Typically happens via **cutaneous** transmission with **animal products** but can also be transmitted from person to person via **aerosolized particles.** If ingested can cause **GI** illness too.

Answer 30

**_ANTHRAX – Bacillus anthracis_** _Structure:_ Large **gram-positive spore forming rod** with **sqaure ends**, frequently found in chains. **antiphagocytic capsule** is composed of **_d-glutamate_****.** _Replication Cycle:_ Exists in carriers as a **Facultative Intracellular** organism. **Spore forming** so may exist in **animal feces.**

Answer 31

**_ANTHRAX – Bacillus anthracis_** _Structure:_ Large **gram-positive spore forming rod** with **sqaure ends**, frequently found in chains. **antiphagocytic capsule** is composed of **_d-glutamate_****.** _Disease Presentation:_ **Most commonly** this is a **cutaneous infection**, but the **PULMONARY** infection is **most deadly.** **GI infections** are also extremely deadly. **Pneumonic Disease** typically sets in between **4-6** days (**spores** can sit in macs for up to **6wks**). Typically there is a **short prodromal period** (non-productive cough, sore throat, mild fever, myagia) **followed by severe illness** (tachycardia, hypoxia, sweating, chills, etc).

Answer 32

**_ANTHRAX – Bacillus anthracis_** _Structure:_ Large **gram-positive spore forming rod** with **sqaure ends**, frequently found in chains. **antiphagocytic capsule** is composed of **_d-glutamate_****.** _Pathogenic Mechanism:_ **capsule prevents direct recognition by phagocytes** (PAMPS are covered and can't be see by pattern recognition receptors), it also produces **several toxins.** **NOTE:** both capsule and toxin genes are coded for an **separate plasmids.**

Answer 33

**_ANTHRAX – Bacillus anthracis_** _Structure:_ Large **gram-positive spore forming rod** with **sqaure ends**, frequently found in chains. **antiphagocytic capsule** is composed of **_d-glutamate_****.** **Death** is caused by **blockage of pneumonic vessels** (leading to edema and death) or by **cytokine storm** causing **septic shock and death**

Answer 34

**_ANTHRAX – Bacillus anthracis_** _Structure:_ Large **gram-positive spore forming rod** with **sqaure ends**, frequently found in chains. **antiphagocytic capsule** is composed of **_d-glutamate_****.** _Epidemiology_ **Cattle and Sheep** carry this toxin **(consider wool and other animal products** made from these) _Treatment_ * *Prophylaxis - Ciprofloxacin 60 days** * *Severe Dz: Cipro + Penicillins, Vancomycin, or Rifampicin**

Answer 35

**_ANTHRAX – Bacillus anthracis_** _Structure:_ Large **gram-positive spore forming rod** with **sqaure ends**, frequently found in chains. **antiphagocytic capsule** is composed of **_d-glutamate_****.** _Mortality_ 50%-70% mortality in pulmonary form even with proper tx. _Key Findings/Diagnosis_ * *CXR: Mediastinal Widening or pleural effusion** * *Dx: Culture or Test blood for Abs. or Toxins**

Answer 36

**_MELIOIDOSIS - Burkhoderia pseudomallei_** _Structure_ Small **ENCAPSULATED** **motile gram-negative rod** that is a**facultative intracellular bacterium** _Transmission_ Occurs via **Aerosolized bacteria after RAIN STORM (MOST COMMON ROUTE) =\> VERY TRANSMISSIBLE**. Direct contact can also lead to **cutaneous** infections. **Person-to-person transmission is possible with BODY FLUIDs.**

Answer 37

**_MELIOIDOSIS - Burkhoderia pseudomallei_** _Structure_ Small **ENCAPSULATED** **motile gram-negative rod** that is a**facultative intracellular bacterium** _Disease Presentation =\> **Whitmore's disease**_ Disease may present as **acute, subacute, or chronic.** Due to latency diseas symtoms of HIGH fever, muscle soreness, chest pain, cough (productive or non-prod.) **may present in 2-3 days or in years. Sepsis is very possible.**

Answer 38

**_MELIOIDOSIS - Burkhoderia pseudomallei_** _Structure_ Small **ENCAPSULATED** **motile gram-negative rod** that is a**facultative intracellular bacterium** _Pathogenic Mechanism_ Avoiding phagocytosis via its **anti-phagocytic capsule**, Burkholderia moves into **macrophages (hence granuloma formation)** and replicates. Once replicated it can spread via **1. lysing the host and releasing progeny 2. propelling itself via ACTIN network** into adjacent cells to avoid detection. It is also able to lay **latent for many years Vietanamese time-bomb.**

Answer 39

**_MELIOIDOSIS - Burkhoderia pseudomallei_** _Structure_ Small **ENCAPSULATED** **motile gram-negative rod** that is a**facultative intracellular bacterium** ``` _Epidemiology_ Southeast Asia (Thialand and N. Australia) found in rice, soil, and muddy H2O (**can live in H2O for a LONG time** - by inhabiting amoebas). Many farm animals can also harbor this infection. ```

Answer 40

**_MELIOIDOSIS - Burkhoderia pseudomallei_** _Structure_ Small **ENCAPSULATED** **motile gram-negative rod** that is a**facultative intracellular bacterium** _Treatment_ **Ceftazidime for at least 8 weeks, or 6 months if immunocompromised** (intrinsically **resistant Gentamicin and Colistin)** _Mortality_ **20-50% of cases result in sepsis or death**

Answer 41

**_MELIOIDOSIS - Burkhoderia pseudomallei_** _Structure_ Small **ENCAPSULATED** **motile gram-negative rod** that is a**facultative intracellular bacterium** _Key findings/Diagnosis_ CXR shows **UPPER lobe consolidation or Abscess with GRNAULOMAS** and may resemble MTB. **Dx: 2 steps - Isolate and culture AND look at antibodies in convelscent serum**

Answer 42

**_TULAREMIA – Fracicella tularensis_** _Structure_ **small pleomorphic Gram-negative rod, obligate intracellular** (w/ significant extracellular portion of life cycle), 2 type exist _Transmission_ **Ticks** are the most common vector of transmission and also mice and lice. Lives in **amoebas and survives a long time in H2O,** but can also be transmitted via **blood blood or ingestion. _VERY VERY Transmissible in aerosol. THINK DEAD RABBITS_**

Answer 43

**_TULAREMIA – Fracicella tularensis_** _Structure_ **small pleomorphic Gram-negative rod, obligate intracellular** (w/ significant extracellular portion of life cycle), 2 type exist _Pathogenic Mechanism_ **_LPS that cannot be recognized by TLR-4_**. It can **infect skin (lymph), GI, or eye and disseminate to the lungs** or it can go directly their depending on the mode of transmission.

Answer 44

**_TULAREMIA – Fracicella tularensis_** _Structure_ **small pleomorphic Gram-negative rod, obligate intracellular** (w/ significant extracellular portion of life cycle), 2 type exist _Epidemiology_ 2 types - **_type A - A_**_merican strain_ - **more virulent**, type B - Europe - less virulent. Most cases are in **Arkansas, Missouri, and Massachusetts.** _Treatment_ * *Streptomycin (resistance not an issue)** * *Live VACCINE is available to military personnel**

Answer 45

**_TULAREMIA – Fracicella tularensis_** _Structure_ **small pleomorphic Gram-negative rod, obligate intracellular** (w/ significant extracellular portion of life cycle), 2 type exist _Mortality_ **1-3% mortality rate** without treatment, **survivors have lifelong immunity** _Key findings/Diagnosis_ CXR: Spotted infiltrates or Lobular, pleural exudation possible **Severe Conjunctivitis, BUBO-LIKE LYMPHADENOPATHY** (in surrounding regions) **Dx: Serology**

Answer 46

**_PLAGUE – Yersina pestis_** _Structure_ **small encapsulated gram-negative rod** (lost upon passage in vitro) that lives **intracellularly** (in macs) and exibits **bipolar staining to resemble a SAFETY PIN** _Transmission_ **INSANELY transmissible (1-10 bugs). RATS AND PRAIRIE DOGS carry and FLEAS bite them and then bite people to transmit. AEROSOLIZED particles are also transmissible (most virulent).**

Answer 47

**_PLAGUE – Yersina pestis_** _Structure_ **small encapsulated gram-negative rod** (lost upon passage in vitro) that lives **intracellularly** (in macs) and exibits **bipolar staining to resemble a SAFETY PIN** _Disease Presentation_ **Lymph nodes** where the Flea bit get **very swollen** and people get**SEVERE flu-like symptoms**, and collapse is commonly seen.**Nodes continue to enlarge and Septic Shock and pneumonia (via septic emboli) are they typical killers.**

Answer 48

**_PLAGUE – Yersina pestis_** _Structure_ **small encapsulated gram-negative rod** (lost upon passage in vitro) that lives **intracellularly** (in macs) and exibits **bipolar staining to resemble a SAFETY PIN** _Pathogenic Mechanism_ **Fleas bite and the infection spreads to lymph nodes** causing buboes to form (bubonic plague). Typically the infection becomes **bacteremic due to protection from the** **¹****polysaccharide protein capsule**and hematogenous spread to many organs occurs. ²**LPS (ENDOTOXIN may aid in this spread.****³****V and W proteins also allow this guy to live and grow in macrophages.****⁴****Yersinia outer proteins (Yops) are injected (type III secretion) into host cells to inhibit phagocytosis and cytokine production.** ⁵Also produces **exotoxin which cause DIC an hemorrhage.** Disease may affect the lungs regardless of how it was introduced.

Answer 49

**_PLAGUE – Yersina pestis_** _Structure_ **small encapsulated gram-negative rod** (lost upon passage in vitro) that lives **intracellularly** (in macs) and exibits **bipolar staining to resemble a SAFETY PIN** _Epidemiology_ **99.9% of cases occur in Southeast Asia** - found in rodents everywhere _Treatment_ * *TREAT IMMEDIATELY with Streptomycin or Tetracycline** * *Vaccines are available for military for bubonic form only**

Answer 50

**_PLAGUE – Yersina pestis_** _Structure_ **small encapsulated gram-negative rod** (lost upon passage in vitro) that lives **intracellularly** (in macs) and exibits **bipolar staining to resemble a SAFETY PIN** _Mortality_ **50% (bubonic), 100% (pneumonic) without tx.** _Key findings/Diagnosis_ BULBULAR Lymphadenopathy, Dx: **Giemsa or Wayson stains** will show safety pin appearance, **Serology** can also be used. `

Zoonotic Infectections Flashcards

(74 cards)