1.03 MTB Step 3 - Animal-Borne Diseases (Part III)

Question 1

CHAGAS DISEASE

( AMERICAN TRYPANOSOMIASIS )

What should you look for in the patient’s history and how is Chagas Disease transmitted?

Answer 1

• Look for Travel to South America.
• Can also be spread by Blood Transfusion or Organ Transplantation.

Question 2

CHAGAS DISEASE

( AMERICAN TRYPANOSOMIASIS )

1. What are (4) Early-Stage signs/symptoms of Chagas Disease?
2. What are (3) Late-Stage signs/symptoms of Chagas Disease?

Answer 2

Early Stage presentation:

1. Fever
2. Lymphadenopathy
3. Headache
4. Local Swelling at Eye (which resolves)

Late Stage presentation (Decades later 30% develop):

1. Heart dysfunction
2. Esophagus dysfunction
3. Colon dysfunction

Question 3

CHAGAS DISEASE

( AMERICAN TRYPANOSOMIASIS )

How is Chagas Disease diagnosed?

Answer 3

Blood Smear

Organisms Visible

Question 4

CHAGAS DISEASE

( AMERICAN TRYPANOSOMIASIS )

What is the Treatment for Early-Stage Chagas Disease?

Answer 4

Benznidazole

or

Nifurtimox

Question 5

CHAGAS DISEASE

( AMERICAN TRYPANOSOMIASIS )

What are (3) disorders caused by Chagas Disease if left untreated?

Answer 5

Untreated disease Dilates Organs. Look for:

1. Dilated Cardiomyopathy
2. Esophageal Dysmotility
3. Colonic Dilation and Dysmotility

Question 6

ANTHRAX

How is Anthrax transmitted?

Answer 6

Exposure to Sheep, Cattle, Horses, and Goats

Question 7

ANTHRAX

1. What is the Clinical Presentation for Cutaneous Anthrax?
2. What is the Clinical Presentation for GI Anthrax?
3. What is the Clinical Presentation for Inhalational Anthrax?

Answer 7

1. Cutaneous: Painless, Black Eschar at site of contact; often self-limited
2. GI: Ulcerative Lesion gives Abdominal Pain, Vomiting, and Diarrhea; may perforate
3. Inhalational: Wide Mediastinum with Hemorrhagic Lymphadenitis and Pleural Effusion; can be rapidly fatal

Question 8

ANTHRAX

How is Anthrax diagnosed?

Answer 8

Culture

showing Gram-positive, Spore-forming, Boxcar-shaped, Encapsulated Rods

Question 9

ANTHRAX

What is the Treatment for Anthrax?

Answer 9

Quinolone

or

Doxycycline

Question 10

BARTONELLA​

What are (2) Diseases that can be caused by Bartonella?

Answer 10

1. Catscratch Disease (Bartonella henselae)
2. Endocarditis (Bartonella quintana)

Question 11

BARTONELLA

1. What is the Clinical Presentation for the disease caused by Bartonella henselae?
2. What is common in the patient’s history for the disease caused by Bartonella quintana?

Answer 11

1. Catscratch Disease (Bartonella henselae):
   
   • Enlarged, Tender regional Lymph Nodes
2. Endocarditis (Bartonella quintana):
   
   • Homeless, Flea bites

Question 12

BARTONELLA

1. How is Catscratch Disease (B. henselae) diagnosed?
2. How is Endocarditis caused by B. quintana diagnosed?

Answer 12

1. Clinically, supported by Serology.
2. Serology/PCR

Question 13

BARTONELLA

1. What is the Treatment for Catscratch Disease (B. henselae)?
2. What is the Treatment for Hepatosplenic Disease or Neuroretinitis, two disorders associated with Catscratch Disease?

Answer 13

1. Usually no treatment needed, but Azithromycin speeds resolution.
2. Definitely needs treatment with Doxycycline or Azithromycin and Rifampin

Question 14

BARTONELLA

1. What is the Empiric Treatment for Suspected Endocarditis caused by B. quintana?
2. What is the Treatment for Confirmed Endocarditis caused by B. quintana?

Answer 14

1. Ceftriaxone, Doxycycline, and Gentamicin.
2. Doxycycline and Gentamicin.