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Pulmonary Micro > Atypical Pneumonia - Chlamydia, Legionella, and Mycoplasma > Flashcards

Atypical Pneumonia - Chlamydia, Legionella, and Mycoplasma Flashcards

1
Q

What is unique about Chlamydia’s life cycle?

A

It’s biphasic w/ two functionally and morphologically distinct forms

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2
Q

What is chlamydia’s life cycle?

A

Elementary body (EB) enters cells - inhibits phagolysosomal fusion and becomes a reticulate body (RB). –> RB forms daughter EBs and they are released from the cells

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3
Q

T or F. Chlamydia is an obligate intracellular parasite.

A

true - depends on host cell to provide numerous compounds

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4
Q

Why is chlamydia not classified as a gram negative bacteria?

A

b/w the EB doesn’t have a peptidoglycan and muramic acid but peptidogylcan is involved in the cell cycle at some point

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5
Q

What type of organism is Legionella?

A

gram negative rods, aerobic, nonencapsulated, facultative IC pathogens

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6
Q

Describe mycoplasma!

A

the smallest free-living organism and lacks a cell wall. nutritional requirement for a sterol is unique among prokaryotes

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7
Q

What is the major component of M. pneumonaie infection?

A

immunopathology. mycoplasma doesn’t enter nor penetrate the host cells. Instead it uses its lipoproteins to interact w/ TLRs on macrophages to produce cytokines

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8
Q

What are the virulence factors for chlamydia?

A

Proteins involved in the Type 3 secretion system: Tarp, Pkn5, CopN, inclusion membrane proteins, lipoproteins (CdsJ)

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9
Q

Where does Leiongella pneuophila replicate?

A

in alveolar macrophages after inhalation

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10
Q

What is an important virulence determinant of L. pneumophila?

A

avoidance of phagosome-lysosome fusion in phagocytic cells

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11
Q

How does legionella support bacterial replication?

A

bacterial proteins alter the vesicle traffic and a specialized vacuole forms that resembles the ER of the host.

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12
Q

What do the virulence factors for Mycoplasma do?

A

production of bacterial, polarized, adhesin complex

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13
Q

What diseases does Chlamydia cause?

A
  1. Psittacosis (parrot fever)
  2. Pneumonia
  3. Ocular, respiratory, and genital tract infections
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14
Q

Tell me about psittacosis!

A

caused by C. psittaci; birds = reservoir; spread by inhaling organisms in dried bird feces

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15
Q

What percentage does Chlamydia pneumonaie account for CAP?

A

6-10%

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16
Q

What other disease has C. pneumonaie infection been associated w/?

A

coronary heart disease

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17
Q

What does Chlamydia Trachomatis cause?

A

ocular, respiratory, and genital tract infections

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18
Q

What is the reservoir for chlamydia trachomatis?.

A

humans

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19
Q

What cells do chlamydia trachomatis infect?

A

squamocolumnar cells of mucous membranes

20
Q

What is trachoma caused by and what it is?

A

immunotypes A-C and it’s an infection of the conjunctiva and the world’s leading preventable cause of blindness

21
Q

What immunotypes of C. trachomatis cause genital tract infections?

A

D-K, some of these serotypes are associated w/ cervical squamous cell carcinoma

22
Q

What is the most common sexually transmitted pathogen in industralized countries?

A

chlamydia trachomatis

23
Q

How can neonatal pneumonia and neonatal inclusion conjuctivits be prevented?

A

erythromycin eye drops at birth

24
Q

What is an unique problem of C. trachomatis infections?

A

50-70% in women are clinically silent

25
Q

Who are at risk for Legionnaires’ disease?

A

elderly, ICP, heavy smokers, alcoholics, and other w/ compromised lungs. Males are over twice as susceptible as females

26
Q

What is Pontiac fever?

A

milder illness caused by L. pneumophila. Attacks 95% of those exposed indiscriminately and causes flu-like symptoms

27
Q

What diseases does Mycoplasma cause?

A
  1. primary atypical pneumonia - mild respiratory infections characterized by sore throat and pharyngitis
  2. nonspecific urethritis caused by ureaplasma urealyticum
  3. postpartum fever and pelvic inflammatory disease caused by M. hominis
28
Q

What are the symptoms of C. pneumoniae?

A

most have relatively mild respiratory illness, symptoms of bronchitis or pneumonia. Scant sputum, prominent cough, history of hoarseness, headache, fever in early days, sinus percussion tenderness, rales and rhonchi

29
Q

What are the symptoms of Legionnaires disease?

A

high fever, chills, cough, muscle aches and headaches. Symptoms usually begin 2-14 days after being exposed to bacteria

30
Q

What are the symptoms of Pontiac Fever?

A

fever, headache, muscle aches, but no pneumonia. symptoms go away on their own

31
Q

Tell me about mycoplasmal pneumonia?!

A

gradual and insidious onset of several days to weeks. Presents w/ fever, malaise, persistent dry cough, headache, chills, scratchy sore throat, sore chest, tracheal tenderness, pleuritic chest pain

32
Q

How is chlamydiae transmitted?

A

attach to outer membrane of susceptible host cells and produce cytoplasmic inclusions which then release the matured inclusions to infect adjacent cells.

33
Q

How are the various chlamydia strains transmitted?

A

Pneumoniae - human to human
Psittaci - birds to humans via respiratory route through direct contact or aerosolization
Trachomatis - transmitted to infant when it passes through infected birth canal

34
Q

How do people get Legionnaire’s disease?

A

when they breathe in mist or vapor that has been contaminated w/ the bacteria. it is NOT transmitted from person to person

35
Q

What age group is mycoplasmal pneumonia most common in?

A

the first 2 decades of your life, highest rate of individuals aged 5-20 years, rare in kids less than 5

36
Q

What time of the year does M. pneumoniae cause as many as 50% of the pneumonias?

A

summer

37
Q

What is the incubation period of mycoplasmal pneumonia?

A

3 weeks in contrast to that of influenza and other viral pneumonias which generally average a few days

38
Q

Where are epidemics of mycoplasmal pneumonia seen?

A

every 4-8 years in the general population and tend to be more frequent w/in close populations such as military and prison populations

39
Q

How is chlamydia Dxed?

A

IgM titer exceeding 1:16 or a 4-fold increase in IgG by MIF, PCR

40
Q

How is Legionnaire’s Disease Dxed?

A

CXR for pneumonia, urinary antigen test, culture,

41
Q

How is mycoplasma Dxed?

A

lab test are of limited benefit b/c they tend to be nonspecific or within the normal range.

42
Q

When does one administer treatment for chlamydia?

A

when mixed infections with other organisms are present – in 60% of cases, treat empirically

43
Q

What is the drug of choice for chlamydia?

A

doxy but not in kids less than 9 and pregos. Treat for 10-14 days

44
Q

What other drugs can be given for chlamydia?

A

erthyromycin, macrolides (arithromycin and clarithroymycin)

45
Q

What are the treatments for Legionella?

A
  1. respiratory tract quinolones (floxacins)
  2. macrolides
    ones used most frequently = levofloxacin and azithromycin
46
Q

When should mycoplasmal pneumonia be considered a possible etiology?

A

pt who presents with 3 weeks of more of a steadily progressive cough

47
Q

What drugs can be used for prophylaxis in households in which pts have underlying conditions predisposed to sever mycoplasmal infection. eg SCD or antibody deficiencies

A

macrolide o doxycycline

Pulmonary Micro (19 decks)

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