9-8 Rickettsia - Erlichia Flashcards
Rickettsiaceae Family Characteristics
- Size
- Gram Positive vs. Gram negative
- LPS and Peptidoglycan description
- Flagella?
- Which Stain do you use?
- Small (0.3 to 0.5 m)
- Gram negative
- LPS and Peptidoglycan present (but both minimal or no endotoxin activity)
- No flagella
- Best visualized with Giemsa stain of infected cells
A: Rickettsiaceae Division occurs through _____ ______ but is SLOW. They are ______ ______ PATHOGENS!
B: What do they require from their host? (4)
A: Rickettsiaceae Division occurs through [binary fission] but is SLOW. They are OBLIGATE INTRACELLULAR PATHOGENS!
B: They require host ATP / CoA / NAD+ / [amino acids]. After a while they can synthesize their own ATP
A: Pathogenesis of [Rickettsiaceae Family] (3)
B:
1st. Infection occurs by induction of an endocytic process that requires energy
2nd. Bacteria are initially present in membrane-bound vesicle (phagosome) but use [Phospholipase A] to enter cytoplasm
3rd: . Bacteria grow inside eukaryotic cells but location of replication varies
A: Locations of replicating bacteria vary
1. Where do [Coxiella and Ehrlichia] replicate?
- Where do [Rickettsia and Orientia] replicate?
B. Members of the genus Coxiella replicate in ________
- What does Coxiella growth require from this organelle?
- Coxiella has the ability to delay _____ fusion
A: Locations of the replicating bacteria vary
1. [Cytoplasmic vacuoles]: Coxiella and Ehrlichia
- Cytoplasm: [Rickettsia and Orientia] (they escape their initial vacuole using [phospholipase A] to enter Cytoplasm)
B. Members of the genus Coxiella replicate in Coxiella-containing vacuole (CCV)
a. Growth of Coxiella requires the low pH of this organelle
b. Coxiella delays lysosomal fusion
Which Rickettsiaceae have the ability to Spread intra- and inter-cellularly using actin polymerization? (2)
R. Rickettsii and R.Typhi Spread intra- and inter-cellularly using actin polymerization
A: [Rickettsia _______] can NOT UTILIZE [cytoplasmic projections] to move between cells like its cousins
B: What does this bacteria eventually do as a result?
C: Outside host cell, Rickettsiaceae family die quickly BUT _______ IS DIFFERENT SINCE IT IS RESISTANT TO _______! –> remains viable for years but _______ decreases as time outside host increases.
A: [Rickettsia Prowazekii] can NOT UTILIZE [cytoplasmic projections] to move between cells like its cousins
B: It just has to eventually grow until it lyses the eukaryotic cell.
C: Outside host cell, Rickettsiaceae family die quickly BUT COXIELLA IS DIFFERENT SINCE IT IS RESISTANT TO DRYING! –> remains viable for years but infectivity decreases as time outside host increases.
A: How does the [Rickettsiaceae Family] cause [Primary Vasculitis lesions] ? (3)
B: Where is [Primary Vasculitis lesion] more common? Where is MORE SERIOUS?
[Primary Vasculitis lesion]
a. Bacteria multiply in endothelial cells lining small blood vessels.
b. Endothelial Cells become swollen and necrotic
c. Thrombosis (clotting) of the vessel, leading to rupture and more necrosis —> [Primary Vasculitis lesion]
B: Skin but more serious in adrenal glands
List the general guidelines for [Rickettsiaceae Family] Tx (5)
Treatment:
1. Therapy should be instituted before seroconversion and is less effective if illness is dx later than 1st week
- Tetracycline and chloramphenicol are effective if treatment is started early given
orally and continued for 3-4 days after defervescence. - Sulfonamides enhance growth of Rickettsiae = contraindicated
- Abx do not free the body of rickettsiae, but they do suppress growth.
- Limited vaccines
Which 2 Rickettsia are in the Rocky Mountain Spotted Fever group?
B: Which is more dangerous
C: This more dangerous Rickettsia is maintained in the tick population by passage from tick to tick through
_______ _________. Small ______ and ______ may serve as a reservoir for tick infection
D: Incubation Period of this Rickettsia
Rocky Mountain Spotted Fever: Rickettsia rickettsii
Rickettsialpox: R. akari
dangerous = Rickettsia rickettsii
C: Maintained in the tick population by passage from tick to tick through transovarian transmission.
i. Small rodents and dogs may serve as a reservoir for tick infection
D: 2 to 6 days before sx onset, but may take more than 2 weeks
3 Ways to Diagnose Rickettsia rickettsii
- Positive results for [Immunoflurouescence Antibody]
Initial titer of 1:64 with 4-fold rise in antibody titer
(Antibody levels arise 2-3 weeks after onset) - Microimmunofluorescence (MIF)
- PCR with gene targets such as ompA, ompB
3 Ways to TREAT Rickettsia rickettsii
B: Which Tx is Rarely Used?
- [Doxycycline - Tetracycline]
- Chloramphenicol
- Fluoroquinolones (RARELY USED FOR THIS)
How do you Prevent [Rickettsia Rickettsii] Infection? (3)
Since there is no Vaccine,
1) Avoid Tick Contact and remove them frequently
2) These Ticks can live for 4 years without feeding
A: What bacteria causes Rickettsialpox? Describe the dz
B:
- What animal is the [Vector AND Reservoir] for this bacteria?
- Transovarian transmission?
- Where is it found? (4)
A: Spotted Fever group: Rickettsialpox
- Disease: Mild disease with a rash resembling that of varicella
- Cause: Rickettsia akari
B:
1. Vector AND Reservoir is [blood sucking mites from mice]
- Transovarian transmission occurs
- Found in [northern USA] / Russia / Africa / Korea
Describe The Clinical Manifestations of [Rickettsia Akari]
A: Phase 1 (3)
B: Phase 2- list sx -(6)
C: How does this resolve?
a. Phase 1
i. A firm red papule appears at the site of the bite
ii. Papule develops into deep-seated vesicle then black eschar
iii. Bacteria spread systemically
b. Phase 2
i. After 9-14 days, [high fever/sweats], severe headache, myalgia, photophobia
ii. A vesicular rash develops (small, blister like lesions filled with clear fluid).
C. Self-limiting after 1 week; no deaths have been reported
A: [Rickettsia Prowazekii] is transmitted by what 2 organisms?
B: Transovarian Transmission?
C: How is this bacteria transmitted?
D: 2 Reservoirs
(body LICE)
- Pediculus humanus corporis
- Pediculus humanus capitis
B: These Lice die 2-3 weeks = NO TRANSOVARIAN TRANSMISSION
C: [Rickettsia Prowazekii] remain viable in [lice feces], even when Lice are dead —> transmission occurs when human scratches [lice feces] into a Lice bite
D: Reservoirs = Humans and [Flying Squirrels]