10.12.18 Ehrilichiosis/Anaplasmosis Flashcards
What are bacteria diseases and vector?
Ehrlichiosis, Anaplasmosis
Tick
What are protozoa diseases and vectors?
Leishmaniasis, Trypanosomiasis
Sand fly, Tsetse fly/Reduvlid bug
Human diseases with an animal reservoir
Zoonoses
What is the cycle of vector-borne transmission?
- Infected host
- Intrinsic incubation period
- Infectious host
- Vector
- Extrinsic incubation perion
- Infectious vector
- Grace period
- Humans
Infects monocytes and causes human monocytic ehrlichioisis (HME)
Ehrlichia chafeensis
infects granulocytes and causes human granulocytic anaplasmosis (HGA)
Anaplasma phagocytophilum
Infect red blood cells and liver cells
Malaria species
Infects RBC
Babesia microti
Infects monocytes and macrophages
Trypanosoma species
Infect macrophages and reticuloendothelial cells
Leishmania species
Which obligate intracellular pathogen infects monocytes?
Ehrlichia
Which obligate intracellular pathogen infects neutrophils?
Anaplasma
What family do Ehrlichia and Anaplasma belong to?
Rickettsiae
infects endothelial cells and causes Rocky Mountain Spotted Fever
Rickettsia Rickettsii
Where does Ehrlichia chaffeensis infect, when, and what are the risk factors?
- Southeast to South central US
- Spring and Summer
- Hiking, Exposure to Wildlife
What is the vector, animal reservoir, and other routes of transmission for ehrlichia chaffeensis?
- Tick
- White tail deer, dogs, coyotes
- Maternal child, blood transfusion, contact with slaughtered deer
What would you see in blood smear with human monocytic ehrlichiosis?
Monocyte with characteristic morulae
How would you diagnose human monocytic ehrlichiosis?
- Indirect fluorescent antibody (IFA)
- Peripheral blood
- PCR
- Immunochemical staining in tissues
What does anaplasma phagocytophillium infect?
PMNs
Where does anaplasma phagocytophillium infect, when, and what are the risk factors
- Upper midwest and northeast US
- Spring and summer (can be all year)
- Hiking, Exposure to wildlife
Which bacteria has a high seroprevalence so its likely there are lots of asymptomatic transmission?
Anaplasma phagocytophillium
What is the vector, animal reservoir, and other routes of transmission for anaplasma phagocytophillium?
- Tick
- Deer, Rodents/small mammals
- Person-to-person, blood transfusion, Nosocomial
How would you diagnose human granulocytic anaplasmosis?
- Morulae in PMN
- PCR
- Serology
What are the clinical signs and symptoms of ehrlichioisis and anaplasmosis?
- Asymptomatic to chronic infection
- Typically acute febrile illness
Which bacteria is more life threatening?
Anaplasmosis
What is the treatment for ehrlichiois and anaplasmosis?
Use antibiotics early with suggestive clinical presentation
Specifically Doxycycline/Tetracycline because it can get inside cells
Motile, feeding, reproducing forms of protozoa
Throphozoites
Flagellated forms of protoazoa
-mastigotes
Sexual stages of protoazoa
- Merozoites
- Schizonts
- Gametes
- Oocysts
Where is Babesiosis (Babesia microti) found and what are risk factors?
Northeast and upper midwest
Hiking, Exposure to wildlife
What is the vector, animal reservoir, and routes of transmission for babesia microti?
Tick
White-footed mice
Blood transfusion, congenital (rare)
What are the clinical manifestations of babesiosis?
- Asymptomatic or flu like
- Dark urine/hemolytic anemia
- Life threatening in
1. Patients w/o spleen
2. Immunocompromised
3. Advanced age
How can you diagnose Babesia?
- Merozoite tetrad in blood smear (can be difficult to distinguish from plasmodium)
- Serology (IFA)
- PCR
What are two different types of Leishmaniasis?
- Visceral leishmaniasis
2. Cutaneous and mucocutaneous leishmaniasis
- Intracellular pathogens of the macrophage
- Sand fly insect vector
- Diverse group of protozoan parasites
Leishmaniases
What is the vector, animal reservoir, and other routes of transmission for Leishmaniasis?
Female sand flies
Small rodents/other mammals; human reservoir in some regions
Blood transfusion, IV Drug use, Needle sharing, Congenital
What are the clinical manifestations for leishmaniasis?
- Fever
- Weight loss
- Swelling of spleen and liver
- Anemia
- Fatality
- Post-kala-azar manifestations
How do you diagnose leishmaniasis?
- Bone marrow/splenic aspirate to detect amastigotes in macrophage
- Serology
What does each amastigote in Leishmania have?
- Nucleus
2. Kinetoplast- rod shaped
What is another term for African trypanosomiasis and what causes it?
Sleeping sickness
T. Brucei
What is another term for American trypanosomiasis
Chagas disease
T. Cruzi
What is the vector, animal reservoir, and other routes of transmission for chagas disease?
Reduviid bug- bites then poops
Aramadillos, raccoons, dogs, guinea pigs, rats
Blood transfusion, congenital
What are clinical manifestations for chagas disease?
Asymptomatic or flu like
Classic Romana’s sign- swelling of eyelids
May develop myocarditis; death due to cardiac pathology
How do you diagnose chagas disease?
- Blood smear to detect extracellular trypomastigotes in acute infection
- Bone marrow aspirate or muscle biopsy to detect intracellular amastigotes in chronic infection
- Serology
What is the vector for T. Brucei?
Tsetse fly