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Pathology: Infectious disease section > Bacteria IV: Rickettsial diseases > Flashcards

Bacteria IV: Rickettsial diseases Flashcards

1
Q

intracellular vector-borne diseases

A
  • typhus (lice)
  • rocky mountain spotted fever (ticks)
  • Erlichiosis-> ticks
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2
Q

Extracellular vector-borne diseases

A 
lyme disease (ticks)
relapsing fever (lice or ticks)
plague (fleas)
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3
Q

what does rickettsia infect?

A

intracellular infection of endothelial cells with perivascular lymphocytic infiltrate (perivascular cuffing)

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4
Q

rickettsia characteristics

A

small, G-, obligate intercellular bacteria

  • ticks
  • dark, swollen, crusted lesion
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5
Q

how do you diagnose rickettsial disease?

A

immunostaining or serology or exposure to vector

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6
Q

where does rickettsia multiple?

A

small vessel endothelial

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7
Q

triad related to rickettsia diseases?

A

rash, fever, CNS manifestations (headache, seizures)

-small vessel vasculitis with microthrombi, ischemia and hemorrhage

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8
Q

what does the typhus group do to endothelial cells?

A

lysis

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9
Q

what does the spotted fever group do to endothelial cells?

A

spread cell to cell

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10
Q

does rickettsia have toxins?

A

No endotoxins, no exotoxins

  • LPS non-toxic
  • small vessel damage: thrombosis and hemorrhage
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11
Q

what are the first cells to come in for rickettsial diseases?

A

1st-> Natural killer cells-> produce gamma-interferon

2nd-> cytotoxic T cells mediated immune responses responsible for much of the tissue damage seen

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12
Q

clinical features from rickettsia

A

fever, rash, CNS symptoms

-severe cases: hypovolemic shock, DIC, pulmonary edema

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13
Q

treatment for rickettsia

A

doxycycline

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14
Q

typhus group of rickettsia

A

R. bellii

R. canadensis

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15
Q

other group of rickettsia

A

R. prowazekii

R. typhi

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16
Q

R. prowazekii: Epidemic typhus

A

head lice

  • centrifugal rash, CNS involvement (apathy, dullness, stupor, coma)
  • high fever, chills, cough, rash, severe muscle pain, sensitivity to light, delirium
17
Q

murine typhus

A

related syndrome to epidemic typhus

-high density population and poor hygiene

18
Q

clinical findings R. prowazekii: Epidemic typhus

A

mild rash, small hemorrhages

severe: gangrene of tips of fingers, nose, earlobes, scrotum, penis, vulva

19
Q

R. prowazekii: Epidemic typhus morphology

A

cuff of mononuclear inflammatory cells around vessels
ecchymotic hemorrhages of affected organs
microthrombi
no necrosis of vessels

20
Q

rocky mountain spotted fever group

A

R. rickettsia, tick bite
incubation time 7 days
-fever (high 2-3 weeks), N&V, headache, muscle pain

21
Q

when does the rash appear for rocky mountain spotted fever

A

day 6 of fever
extends over all body, INCLUDING palms, soles
-begins in periphery (palms wrists, soles)-> then to trunk, face and neck

22
Q

rocky mountain spotted fever morphology

A

perivascular mononuclear infiltrate
necrosis, fibrin extravasation and thrombosis of small blood vessels and arterioles
-severe cases-> foci of necrotic skin, fingers, toes, elbows, ears, scrotum

23
Q

what is the major death from rocky mountain spotted fever

A

noncardiogenic pulmonary edema

24
Q

Scrub typhus

A

Orienta (rickettsia tsutsugamushi)

  • rash transitory or absent
  • transmitted by mites
25
Q

Ehrilichiosis

A 
similar to RSMF
-rash rare
-(infects)Neutrophils or monocytes
-cytoplasmic inclusions-> shaped like mullberries
ticks
26
Q

Lyme disease (Borrelia burgdorferi)

A

tick of white tailed deer

-shift antigenic markers to avoid antibody production

27
Q

what is the primary stage of Lyme disease?

A

local infectio

-skin rash shows vasodilation with dense perivascular inflammatory infiltrates of mononuclear leukocytes

28
Q

what is the secondary stage of Lyme disease?

A

spread, Late (months)

  • bacteremia disseminates the spirochetes to many with focal necrosis, hemorrhages
  • joint disease
  • muscle pain, cardiac arrhythmias, meningitis, cranial nerve involvement
29
Q

what is the tertiary stage of Lyme disease?

A

multisystem chronic inflammation disease

  • local lesion progresses to bacteremia and chronic inflammatory lesions in distant organ
  • manifestations include chronic arthritis, polyneuropathy and encephalitis, skeletal muscle involvement
30
Q

what toll like receptor does LPS bind to in Lyme disease?

A

TLR2 of macrophages

31
Q

why does the bull’s eye (target) rash appear in lyme disease?

A

spreading erythematous margins and a blanching center

  • erythema chronicum migrans
  • fever and constitutional symptoms may occur at this point
32
Q

lyme disease pathogenesis

A

focal necrosis, hemorrhages and DIC
-rash shows vasodilation with dense perivascular inflammatory infiltrates of mononuclear leukocytes (lymphoplasmacytic cell infiltrate)

33
Q

how does lyme disease resemble rheumatoid arthritis

A

synovial hyperplasia
lymphocytes, plasma cells
proliferative arteritis

34
Q

relapsing fever (Borrelia recurrentis)

A

lice
1-2 week latent period, shaking, chills, fever, headache, fatigue
-successive attacks results from ability of organism to expressive new surface antigen

35
Q

Plague, Yersinia Pestis

A

G- bacillus

-Sylvatic cycle (organism cycle in rodents)

36
Q

Plague, Yersinia Pestis pathogenesis

A

rapid proliferation in lymphoid tissues

  • injection of YOP’s, yersinia outer proteins
  • inactivation molecules that regulate actin polymerization, inhibits secretion of inflammatory cytokines
  • necrosis of tissue and blood vessels
  • swelling of lymphoid tissue, striking leukocytosis, septicemia/DIC
37
Q

what constitutes minor plague symptoms?

A

lymphadenopathy and constitutional symptoms

38
Q

what constitutes bubonic plague symptoms?

A

prominent lymphadenopathy, most common

39
Q

what constitutes pneumonic plague symptoms?

A

hemorrhagic, necrotizing pneumonia primary or secondary to bubonic infections
-septicemia-> rapidly fatal

Pathology: Infectious disease section (11 decks)

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