182 - Rickettsial Diseases Flashcards
Rocky/Mediterranean spotted fever is caused by a __ born G(_), with a similar presentation in the first _ days.
5
The symptoms in the first 5 days include: 5
fever headache myalgia vomiting cough
3 days after infection _% of patients will develop __ and 6 days after- __
50
purpura
petechiae
__ involvement is very specific and appear after _ days in _% of patients
palms
5
40
The bitten area may develop into __
Tache noire
Pulmonal- non cardiogenic- __ may develop
edema
Hypo__ and hypo__ together with pre-renal azotemia are possible clinical complications in spotted fever
tension
volemia
Cardiac involvement with __ are possible clinical complications in spotted fever
arrhythmia
__ and __ are are possible CNS clinical complications in spotted fever
meningitis
encephalitis
__ and __ involvement with enzyme/bilirubin increase are possible clinical complications in spotted fever
renal failure
hepatic
Anemia and __ occur in up to __% in spotted fever.
myositis
30
Untreated Rocky fever may __ within - days if left untreated. __ and __ patients are in higher risk.
die
8-15
black
G6PD
only 3% of patients will have the typical triad in the first 3 days:
rash
fever
exposure to tick
Serological tests will become positive only - days after exposure
7-10
A good diagnostic tool is an __ biopsy of _ or _
immunohistologic
skin
PCR
What are the lab results we may see in spotted fever? 4
elevated CRP
elevated CPK
hypoalbuminemia
hyponatremia
What is the correct ABx for spotted fever?
doxycycline IV/PO- ASAP
What is the correct ABx for pregnant patients with spotted fever?
chloramphenicol
How long should you treat a spotted fever patient with ABx?
until the patient is fever free > _ days
Which pathogen causes Q fever?
coxiella Brunetti
What is the main vector for C. Brunetti?
cattle- via aerosol (during parturition)
unpasteurized mike
Incubation of Q fever may last - days
3-30
Q fever will initially have non specific flu like symptoms: 6
prolonged fever+ chills lethargy headache sweating nausea + vomiting diarrhea
Which patients are more exposed to IE due to Q fever? 3
immunocompromised
valvular disease
CRF
Which imaging test is the most suitable for diagnosing IE in patients with Q fever
TEE
What is the main diagnostic tool for Q fever?
serological tests
IgG >: for antigen phase I may suggest __ disease. In __ disease phase II is higher.
1:800
chronic
acute
What is the recommended ABx for treating acute Q fever?
doxycycline / quinolone
if pregnant - resprim (TMP/SMX)
What is the recommended ABx for treating chronic Q fever?
doxycycline + hydroxychloroquine - 18 months
or
rifampin + doxycycline/ciprofloxacin for 3 years
