Atypical Mycobacteria & M. leprae (4) Flashcards

1
Q

How are atypical mycobacteria aquired?

A

through the environment

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2
Q

Are atypical mycobacteria PPD + or -?

A

PPD -

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3
Q

Are atypical mucobacteria lethal in guinea pigs?

A

No, they are not

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4
Q

What are the Group 1 Atypicals?

A

Photochromogens

M. kansasii and M. marinum

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5
Q

What are the characteristics of group 1 atypicals?

A

Produces pigment in light and does not kill guinea pigs

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6
Q

Where is M. kansasii found?

A

midwest, texas, england

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7
Q

What disease does M. kansasii produce?

A

Some lung disease

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8
Q

Where is M. marinum found?

A

Fresh and salt water

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9
Q

Symptoms of M. marinum?

A

Forms “fish tank” granulomatous ulcerating lesions on abrasions exposed to swimming water or aquarium water

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10
Q

How is M. marinum treated?

A

Tetracycline

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11
Q

What are the group 2 atypicals?

A

Scotochromogens

M. scrofulaceum

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12
Q

What are the characteristics of the group 2 atypicals?

A

Produces pigment in the dark and does not kill guinea pigs

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13
Q

What illness does M. scrofulaceum produce?

A

Produces scrofula and is the most common PEDIATRIC cause of scrofula

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14
Q

What is the reservoir for M. scrofulaceum?

A

water

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15
Q

How is M. scrofulaceum treated?

A

Surgically removing the affected nodes

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16
Q

What are the group 3 atypicals?

A

Nonchromogens

M. avium and M. intracellulare

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17
Q

What are the characteristics of group 3 atypicals?

A

Do not produce pigment and does not kill guinea pigs

18
Q

What disease do M. avium and M. intraceullare produce?

A

Pulmonary disease indistinguishable from TB in severely immunocompromised patients

19
Q

What is the reservoir for M. avium and M. intracellulare?

A

Environmentally wide spread (soil and water)

20
Q

Treatment for M. avium and M. intracellulare?

A

Highly drug resistant!

Treat with a combo of clarithromycin and ethambutol, rifampin or cipro

21
Q

What are the group 4 atypicals?

A

Rapidly growing mycobacteria

M. fortuitum / M. chelonei

M. abscessus

M. smegmatis

22
Q

What are the characteristics of group 4 atypicals?

A

No pigment, does not kill guinea pigs

Culterable <1 week

23
Q

Who is generally susceptible to M. fortuitum / M. chelonei infections?

A

Immunosuppressed, people with prosthetic joints, indwelling catheters, puncture wounds

24
Q

How are M. fortuitum / M. chelonei infections treated?

A

Surgical excision, doxycycline, amikacin

25
Illnesses caused by M. abscessus?
Chronic lung infection, skin and bone infections as well
26
Where are M. fortuitum / M. chelonei, M. abscessus, M. smegmatis normally found?
M. fortuitum / M. chelonei- environment (soil and water) M. abscessus- environment (soil and water) M. smegmatis- normal flora under foreskin
27
Which group 4 atypical is highly Ab resistant?
M. abscessus
28
What disease does M. leprae cause?
Leprosy or Hansen's Disease
29
Reservoir for M. leprae?
Humans and armadillos
30
What is the growth rate for M. leprae?
14 day doubling time--> increadibly slow growing
31
What temperature does M. leprae prefer to grow at?
30C...so it sticks to the periphery of humans
32
The symptoms of M. leprae are caused by both the ________ and the __________.
the infection and the immune response
33
Mechanism of transmission for M. leprae?
Exact mechanism is unclear Requires prolonged contact with infectious case and contact with nasal secretions and skin lesion contact Rare zoonosis from animals is possible
34
Where does M. leprae replicate?
Skin histiocytes, endothelial cells, and Schwann nerve cells
35
Describe the tuberculoid form of Leprosy?
Big CMI response Few bacilli Asymmetric immunogenic peripheral nerve damage Lepromatin PPDGranulomas containing giant cels form +
36
Describe the Lepromatous form of leprosy?
Poort CMI response Large numbers of bacilli Symmetrical peripheral nerve damage from bacterial growth in schwann cells PPD - Foamy macrophages from
37
What are some sensory and motor function loss systems seen in leprosy?
Claw hand, foot drop, plantar insensitivity and clawed toes
38
Physical exam findings seen tubercloid leprosy?
Few sharply demarcated macules on butt, face or limbs Superficial nerves lesions can enlarge Asymmetric peripheral nerve damage--> neuropathic pain and muscle atrophy
39
Symptoms seen in lepromatous leprosy?
Extensive bilateral symmetric cutaneous macules Lesios have poorly defined borders and raised centers Eye infection is possible
40
T/F: Lepromin skin test is diagnostic of exposure to Leprosy
False...its used to determine patients ability to raise immune response
41
What will appear in a skin smear of both forms of leprosy?
Lepromatous: "foam cells" Tuberculoid: granulomatous cahnge with epithelial cells and lymphocytes
42
What is the treatment for leprosy?
Tuberculoid: Dapsone and rifampin for 2 years Lepromatous: Dapsone, rifampin and clofazimine for 2+ years Peds: prophylaxis w/ dapsone after exposure