Bacterial Flashcards
2 countries with highest Leprosy
Brazil, India
2 rickettsia with higher mortality (40% UnTx)
RMSF
epidemic typhus
3 spirochetes
lepstospirosis, treponema, Borrelia
3 typhus types: disease, agent, vector
Epidemic- R. prowazekii- Louse
Scrub- O. tsutsu- Mites/chiggers
Murine- R. typhi- flea
acute watery diarrhea causes CCERN
rotovirus, norovirus, cholera, cryptosporidium, ETEC
African Tick Borne Fever- agent, vector, skin
R. africae
tick
eschar, often vesicular rash
Anthrax- agent, micro, bioterror, transmission, incubation max, Sx, Tx, special
Bacilius anthracis
gram pos rod
1
arerosol, contect, ingest
typical 1-7 d but pulmonary up to 43 day
95% cutaneous- painless eschar with edema and satellite vesicles, Do NOT debride
Inhalation- mortality up to 90%; Hemorrhagic mediastinal lymphadenitis (wide mediastinum)
GI- dysentery, ascites, sepsis (mortality > 50%)
Cipro (doxy, amp)- use 2 agents
Resistant to EtOH
Bacillary angiomatosis- agent, pt, Sx, Tx
B. henselae and B. Quintana
immunocompromised
vascular lesions, may ulcerate
doxy/macrolide
Bacillus anthracis- micro, portal (3), 2 findings, Dx (3), Tx, proph, mortality
gram pos rod
cutaneous (most), GI, inhalation
painless ulcer with lots edema and vesicles; widened mediastinum
culture, biopsy, serology
quinolone (multidrug)
doxy exposure prophylaxis for 60 days; PEP
20% UnTx cutaneous, 90% pulmonary
Bacterial diarrhea needing ABx
ETEC, EAEC, Shigella
Bartonella vectors
bacilliformis- sandfly
hensaleae- flea
quintana- louse
Bartonella- micro, 3 types, vectors and Sx
gram neg rod flagella intracellular
B. bacilloformis – bartonellosis (Oroyo, Verruga peruana- Carrion dz) in Andes, sand-fly; Tx chloramp + PCN
B. henselae- flea, cat scratch (zithro), bacillary angiomatosis (HIV), endocarditis (culture negative)
B. quintana- trench fever due louse (doxy), endocarditis, bacillary angiomatosis
Bartonellosis- agent, vector, 2 forms dz, Tx
B. Bacilliformis
sand fly
Oromo and Verruga peruana
Chloramphenicol and PCN
BCG partial protection against 3
TB, Bureli ulcer, leprosy
bejel- cause, Sx
endemic syphilis
ulcers of lips and oropharynx
Best culture source for S. typhi
bone marrow
Bioterror categories
A- airborne, sturdy, easily grown; e.g. anthrax, small pox, plague, tularemia, ebola, botulism (P. BATES)
B- moderately easy to produce, moderate Sx; e.g. Q-fever, brucellosis, ricin, glanders, meliodosis, typhus, staph, salmonella, shigella, E. coli O157:H7, cholera
C- more difficult to produce and distribute
Botulism- agent, micro, transmission, incubation max, Sx, Tx
Clostridium botulinum toxin
gram pos rod
aerosol, ingest
10 days max
Neuro- CN, descending paralysis, pupils fixed/dilated, autonomic dysfxn
Supportive, equine antitoxin
Brucellosis- micro, source, Dx, Tx
gram neg intracellular coccobacilli
dairy, meat, hunting/skin, inhalation
Cx- esp marrow or tissue
doxy, rifampin, bactrim
Brucellosis- source, Sx, Tx
animal milk, urine, afterbirth; labs (many farm animals)
Arthritic, Miscarriage. Orchitis. Heptatis, Peritonitis,
Meningitis, Endocarditis (most mortality)
PO doxy + rifampicin AND 2 wks streptomycin or gent
Bubonic plague- agent, frequency, Sx, Tx, prophylaxis
Yersinia pestis
90%
Bubos, LAD, fever, sepsis UnTx
streptomycin
doxy and cipro
bubos can be caused by (3)
Bubonic plague
Lymphgramuloma venereum
Chancroid
Campylobacter- kids in developing vs developed
developing may have multiple
developed more inflammatory
Campylobacter- 2 main strains, micro, source, season, classic Sx, complication, Tx
C. jejuni (more industrialized) and C. coli
spiral neg rod with flagella
food (chicken), animal (no P2P)
more dry season
bloody stool, mimic appy
Guillian-Barre
ABx only IF high risk
highest identified travel diarrhea
fewer outbreaks in developing due to some immunity
can present as either watery or bloody diarrhea
shigella and campylobacter
Cat scratch disease- agent, Sx, Tx
B. henselae
papule, LAD may suppurate
zithro (doxy and gent if neuro or retino)
Cat scratch- agent, vector, Tx
B. henselae
flea
zithro
Cats assoc with- saliva (4), fecal (8), aerosol (1), direct (2)
saliva- bartonella, pasturella, rabies, tularemia
fecal- salmonella, campy, giardia, toxocara, echinococcus, toxoplasma, ancylostoma, dipylidium
aerosol- coxiella (Q)
direct- sporothrix, microsporum canis
Most common cause of necrotizing fasciitis
Group A BHS
Chancroid- agent, micro, Sx, Tx
H. ducreyi
gram neg rod
painful ulcer and bubos
zithro, roceph, cipro, erythro
Chancroid- agent, Sx, Tx (3)
Haemophilus ducreyi, gram neg rod
genital ulcer, bubos
zithro, EES, Cipro
Chlamydia- micro, tx, serovars
gram neg intracellular zithro, doxy
A-C -> blindness
D-K -> STD
L -> lymphogranuloma venereum
Cholera- agent, host, gram, source, Sx, Tx, Cx, prevention
Vibrio cholera, El Tor strain
man
gram neg bacilli with flagella
water, fish, shellfish, produce
Sx rice water diarrhea; rare fever or pain
Tx: hydration, optional ABx (doxy, TTC)
Cary-Blair, tellurite or bile salts
2 oral vaccines outside US
clofazine for leprosy- effect, SE
bacteriostatic
SE: transient blue skin, itch, constipation
Clostridia perfringens spores- diagnostic amt in stool, killed by
feces >106 spores per gram of stool
cooking
Clostridum tetani micro
Gram positive rod, drumstick appearance
Coxiella burnetii- micro, bio terror category, source, complications (3), Tx
Intracellular rod
Cat B
Animals- inhale, contact
Endocarditis, OB complications, persistent localized
Doxy, bactrim for preg, kids
Cryptosporidium- person
infants, immunocompromised
Cryptospridium- size, pt type, source, resistant, incubation, Sx, Dx, Tx
5 microns
Infants, immunocompromised
Fecal-oral: soil, food, water; autoinfective
RESISTANT chlorine
Both sexual and asexual reporduction
Incubation 1 wk
Sx: watery diarrhea, weight loss, abdominal pain, fever, N+V
Stool AFB/modified ZN stain, DFA, Ag test
Most Sx resolve in 10-14 d
Nitrazoxanide - reduces oocyst shedding
No swimming for 2 weeks after Sx resolved
Culture media for Francisella tularensis
Buffered Charcoal Yeast Extract (BCYE)
dapsone for leprosy- effect, SE (3)
bacteriostatic
check G6PD
SE: methemoglobinemia, neutropenia, neuropathy
dapsone special
check G6PD
diarrheal infections causing HUS
shigella (give ABx), EHEC (avoid ABx)
diarrheal infections NOT requiring ABx
salmonella, EHEC, yersinia
diphtheria transmission
P2P, droplet, rare fomite
Dogs assoc with saliva (3), fecal (7), aerosol (2)
saliva- rabies, pasturella, brucella
fecal- salmonella, campy, giardia, toxocara, ancylostoma, echinococcus, dipylidium caninum
Aerosol- bordetella, Coxiella (Q)
Donovanosis (granuloma inguinale)/ agent, micro, Tx
calymmatobacterium (Klebsiella) granulomatis
gram neg rod, intracellular, bipolar stain
beefy destructive ulcers (no LAD)
doxy
E. coli micro
gram neg rod fermenting lactose
EAEC Sx, Tx, more from..
persistent diarrhea in kids and HIV
ABx
Latin America
EHEC- agent, reservoir, pathogenesis, sx, tx
enterohemorrhagic E. coli (e.g. O157:H7)
reservoir is primarily cattle
(Shiga-producing E. coli)
1-2 days of watery, then cramping and bloody diarrhea
Treatment: antimicrobials are NOT recommended, (increased risk of HUS)
EHEC- pathology, Sx, complication, Tx
shiga toxin
50% bloody, significant abd pain
HUS
supportive; NO ABx (increased risk HUS)
Ehrlichia- agents, vectors, target cells, Sx, Tx
E. chaffeensis and E. ewingii- deer and dog ticks
Anaplasma phagocytophilum- Ixodes
leukocytes
Flu, Rash, vomit, meningitis
doxy
EIEC- sx
bloody dysentery similar shigellosis
Entamoeba histolytica- agent, complication
protozoa
hepatic abscess
enteric fever is due to
salmonella typhi and paratyphi
Enteritis necroticans- agent, pt profile
Clostridium perfringens
malnutrition, diabetic, neutropenia
also known as pigbel
EPEC Sx
infant diarrhea
Epidemic typhus- agent, vector, skin, special
R. prowazekii
louse
No eschar
Brill-Zinsser recrudescence
Erythema nodosum leprosum (ENL)(type 2)- type, cause, Sx, timing, Tx
BL, LL (lepromatous types)
Immune complex with vasculitis (type III hypersensitvity),
Elevated TNF-alpha New papules/plaques/pustules and tender subq nodules neuritis, orchitis, iriditis, GN, HSM, LAD fever, flu-like before
diagnosis or even years after Tx
Tx: severe need thalidomide (or clofazimine per WHO) and prednisone
eschars can be caused by (5)
Anthrax
Staph
Tularemia
Scrub typhus
Rikettsial spotted
ETEC Sx, person, Tx
acute watery diarrhea
leading cause diarrhea in older kids and adults
ABx
ethambutol- effect, SE
disrupts cell wall vision
vision, hepatotoxic
feacal lactoferrin
more sensitive than leokocyte smear for inflammatory diarrhea
Flagellated bacteria (5) BCCCS
Bartonella, Clostridium, Campylobacter, Cholera, Salmonella
Flea borne rickettsia (3), other bacteria (2), parasite (2)
R. felis
R. typhi (murine)
Wolbachia piientis
B. henslae
Y. pestis
Parasite: Dipylidium caninum, tungiasis
Flea Rickettsiosis- agent, vector
R. felis
flea
Flinders Island fever- agent, vector
R. honei
tick
Gram beg coccobacilli
Yersina, Brucella
Gram neg cocci (1)
Neisseria
Gram negative coco bacilli resembling safety pin
Yersinia
Gram pos rod (CALC)
Clostridia, Anthrax, Listeria, Corynebacteria
helminth borne rickettsia (2)
Wolbachia
Neorickettsia
How long is anthrax proph needed?
60 d
HUS- Sx (3), causes (3)
triad- thromobytopenia, micro hemolytic anemia, ARF
assoc shigella, EHEC, campy
HUS related to which infections
Shigella, EHEC, streptococcus in US
Incubation on bioterror A- highest, lowest
Anthrax 43 days
Tularemia 5 d
Infections mimicking appendicitis- 3 bacteria, 4 worms
Yersinia, TB, campylobacter
Pinworm, Ascaris, Angiostrongylus, Oesophagostomum
infections presenting as eschar
aspergillosis, anthrax, ecthyma gangrenosum, rickettsial, plague, Staph, Tularemia, Scrub typhus
intracellular bacteria (BBCCEFMORS)
Brucella, Burkholderia, Coxiella, Chlamydia, Ehrlichia, Francissella, MAC, Orientia, Rickettsia, Salmonella
invasive diarrhea causes (7) CEEESSTY
non-typhoidal salmonella, shigella, yersinia, campylobacter, EIEC, EHEC, entamoeba
Ioxides tick transmits (3) BELA
Anaplasma/ehrlichiosis, babesiosis and Lyme
Isoniazid- effect, SE
inhibit cell wall synthesis
hepatitis, neuropathy (take B6)
Japanese Spotted Fever- agent, vector
R. japonica
tick
Leprosy BB type- number, appearance, AFB, special
BB- Borderline
Multiple
mac, pap, plaque, dome, punched out Satellite lesions Less distinct borders asymmetric
AFB readily seen
common periph nerves
Leprosy BL type- number, appearance, AFB, special
BL- Borderline-lepromatous
Multiple
macules, papules, nodules Often symmetrical Smooth, shiny Borders may be ill defined
Sensation diminished or lost
Smear with many bacilli
Enlarged periph nerves
Leprosy BT type- number, appearance, anesthesia, AFB, special
BT- Borderline tuberculoid
Few to multiple
patches Vary size
Mod-marked anesthesia
Some AFB
Early neuropathy- may not resolve with Tx
Reversal reactions
Leprosy indeterminate type- number, appearance, anesthesia, AFB
one or few
hypopigmented, undefined edges
+/- anesthesia
rare AFB
Leprosy lesion number
Paucibacillary 1-5 (TT, BT)
Multibacillary > 5 (BB, BL, LL)
Leprosy LL type- number, appearance, AFB, special
LL- Lepromatous leprosy
Many lesions
macule, papule, nodule, infiltration, erythema, hyperpigment Symmetric
Anesthesia appears late Neuropathy late
erythema nodosum 50%, rare Lucio phenomena Ocular, nasal, testicular
Smears very positive
leprosy reaction 1 +2- name, hypersensitivity type, leprosy type, fever ?
1 vs 2
reversal vs erythema nodosum
type 4 vs type 3
borderline vs lepromatous
fever rare vs common
Leprosy TT type- number, appearance, anesthesia, AFB, special
tuberculoid- few lesions
large, flat, irreg, scaly, hypopig
asymmetric anesthesia (5% diag early before rash)
AFB rare
corneal denervation/lagopthalmos in 10% (unable close eyes)
Leprosy type having corneal denervation/lagopthalmos
tuberculoid
Leprosy type having erythema nodosum
lepromatous
Leprosy types- source, incubation, susceptibility, Sx, Dx
Human reservoir, 9 banded armadillo
Incubation up to 20 yrs
Only 3-5% of population susceptible
Rash with anesthesia 75% sensitive. Also congestion, leonine, Madurosis, ocular, erythema nodosum, nerve hypertrophy
skin fluid smear, nasal, skin Bx, nerve Bx -> AFB bunching into globi
leprosy: tuberculoid vs lepromatous
few vs many lesions
few vs many AFB
early vs late anesthesia
asymmetric vs symmetric
Leptospirosis- reservoir, entrance, micro, Sx, Tx
rodent reservior, affects mammals (human dead end )
urine, water/soil enter thru skin cute conjunctiva (rare ingest)
gram neg spirochete
? fever, HA, conjuntivitis, GI to Weil’s disease- liver and renal failure
Tx: doxy, zithro, PCN, ceftriaxone
Louse borne relapsing fever- agent, geo, Sx, special
Borrellia recurentis- sprochete
NE Africa
Fever, Bleed, Miscarriage, Myocarditis. Liver failure, Spleen rupture
Jarisch-Herxheimer (Acute worsening with Tx)
Louse borne rickettsia (1)
R. prowazekii (epidemic)
Lucio Phenomenon- type, cause, Sx, Tx
LL
Necrotizing vasculitis due to massive load bacteria
Diffuse shiny skin infiltration with Madurosis, Looks like burns, loss body hair, anemia, myxedema, bacterial sepsis -> toxic -> death
Tx- supportive, steroids, treat AFB
Lymphogranuloma venereum- agent, micro, Sx, Tx
C. trachomatis
gram neg intracellular
painless ulcer, bubos
doxy, zithro, TTC
MAC in HIV, Sx, CXR, Dx
fever, wt loss, LAD, HSM, cytopenias, LFTabnormalities.
lack of pulmonary symptoms and normal chest
isolation of the organism, most often from blood or bone marrow (granulomas)
main dource of leprosy
UnTx multibacillary
main source for new leprosy infections
untreated multibacillary in human
Mediterranean spotted fever- agent, vector, skin
R. coronii
tick
eschar
Melioidosis- agent, micro, bioterror, source, Sx, Tx, special
Burkholderia pseudomallei
gram neg intracellular, bipolar safety pin
3
saprophytic soil, water
abcess esp parotid, sepsis, pneumonia
IV ceftaz -> bactrim PO; may be 10 days before defervesce
may relapse up to 10 yrs
Mite borne rickettsia (2)
R. akari (rickettsial pox)
O. tsutsugamushi (scrub)
most common bacterial diarrhea in US
Campylobacter
most common causes of dysentery- 6 bacteria, 3 parasites
Shigella, Campy, EHEC, salmonella, C. dif, Yersinia
E. histolytica, Balantidium coli, schisto
most common infectious diarrhea in US? world?
norovirus, rotovirus
Murine typhus- agent, vector, skin, special
R. typhi
flea
NO ESCHAR
25% renal
Mycobacterium Avian Complex prophylaxis indication for HIV
CD4 count <50
Mycoplasma genitalium- micro, Tx
gram neg
zithro
Mycoplasma genitalium- micro, Tx
gram neg
zithro
Neisseria gonorrhea- agent, Tx
gram neg diplococcus
rocephin
neonatal tetanus Tx
diazepam
IG
TT if > 6 wks
Flagyl (alt pen, erythro)
quiet, dark
non-typhoidal salmonella enterica- source, micro, Sx, Tx
food- FO, P2P
gram neg rod with flagella- O somatic and H flagella antigens
GI, disseminated in kids, old, immunocompromised
NO Abx -> prolongs shedding
O. tsutsugamushi causes
scrub typhus
Oroya fever- agent, Sx, Tx
B. bacilliformis
fever, anemia, HSM, LAD, possible secondary infection
Cipro
Painless skin ulcer with surrounding edema
Anthrax
Pinta- cause, Sx
treponema
papules, plaques, depigmentation
Plague- micro, source/transmission, incubation max, Sx, Tx, prevention, high risk
Yersinia pestis, gram neg coccobacilli, bipolar stain
aerosol, contact, P2P
19 d max
pulmonary- V, D (30% bloody), abd pain, SOB, hemoptysis, shock, 100% fatal UnTx
Bubonic- more common, 50% fatal UnTx
streptomycin 1st, gent, Cipro, chloramphenicol
vaccine available, Cipro proph
high iron levels, e.g chronic hemolysis, sickle cell disease, or Beta thalassemia
Pneumonia with cavitary lesions- 4 bacteria, 1 worm
TB, S. aureus, Klebsiella, meliodosis, paragonimiasis
pyrazinamide- effect, SE
acidify -> disrupt cell mem; bacteriostatic for TB
hepatitis (esp with RIF), avoid in pregnant
Q fever- agent, sx, Tx
Coxiella burnetti (intracellular)
Flu, hepatitis, Pneumonia, Meningitis, Miscarriage, Chronic fatigue
doxy (add hydroxychloroquine for endocarditis)
Queensland TBF- agent, vector, skin
R. australis
tick
eschar, vesicular
R. africa causes… eschar?, complication
AfricanTBF
eshar may be tiny and hard to find
reactive arthritis
R. akari causes
Richettsial pox
R. australis
QuuenslandTBF
R. coronii causes
Mediteranean SF
R. felis causes
Flea rickettsiosis
R. honei causes
Flinders Island
R. japonica causes
Japanese Spotted Fever
R. prowazekii causes
epidemic typhus
R. rickettsia causes
RMSF
R. siberica causes
Siberian Tick Typhus
R. slovaca causes
Tick borne LAD
R. typhus causes
murine typhus
relationship between salmonella and schistosomiasis
salmonella can hide in schisto
Reversal reaction (type I)- types, Sx, Tx
BT, BB, BL (borderlines)
type IV hypersensitity, CMI acute neuritis Inflammation in old lesions- red, pain, swelling new lesions
Tx: prednisone 3-6 mos
Ricin- transmission, category, source, Sx
inhaled
Category B Toxin
castor bean seed
fever, cough, pulm edema, resp failure
Ricketsial infections with high mortality (2)
RMSF, epidemic typhus
Rickettsial diseases without eschar (4)
RMSF, murine typhus, epidemic typhus, tick borne LAD
Rickettsial pox- agent, vector, geo
R.akari
mite
S. Africa, Ukraine
rifampin for leprosy- effect, prednisone interaction, SE
bactericidal
reduce if prednisone needed (induces hypermetabolism)
SE: bone marrow suppression, red fluids, elevated LFT, interstitial nephritis
rifampin- effect, SE
block RNA pol
rash, multiple drug interactions
Rifaximin- treats _____ but not _____ because _______
watery diarrhea but not invasive because not absorbed
RMSF- agent, vector, skin
R. rickettsia
tick
no eschar, rash often purpuric (centripital- ext 1st) and after viral syndrome
Rose spot
shigella; invasive salmonella
blanching 2-4 mm papules on torso
rose spots
typhoid
Rotovirus claim to fame
leading cause diarrhea
Salmonella in HIV
high risk of invasive disease, 50% mortality rate, 40% rate of recurrent infection.
Salmonella typhi/paratyphi vs non-typhoidal salmonella
Salmonella typhi- prodrome weeks before GI
non-typhoidal- acute GI
Scrofula
TB in node, seen in 43%
Scrub typhus- agent, geo, vector, special Sx, Tx
O. tsutsugamushi
Asia, AUS
Chigger (immature mite)
50% eschar, ocular ingection, deafness
doxy, chloramphenicaol, macrolide
Shigella complications- 4 systems
GI: toxic megacolon, perforation
renal: HUS
Neuro: Sz
Rheum: Reiter’s syndrome (urethritis, conjunctivitis, arthritis)
Shigella 4 strains and their geo/situation
S. dysenteriae- developing, epidemics
S. flexneri- more in developing
S. boydii- Indian subcontinent
S. sonnei- more in developed, milder Sx
Shigella- fame, micro, pathology, source, Sx (GI, neuro), Tx
leading cause invasive diarrhea
anaerobic neg rod
serotype 1 has shiga toxin -> epidemics human (FO, P2P)
toxic megacolon, rectal prolapse, perforation, Sz, sepsis, encephalopathy, HUS (due to toxin)
Tx: antibiotics if severe only
Siberian typhus- agent, vector
R. siberica
tick
Smallpox- agent, transmission, incubation max, Sx, Tx, prevention
variola virus
aerosol, contact, P2P
19 days max
mucosal lesion followed next day by papular face rash- spreads centrifugal
Mortality due to response to infection
supportive
vaccine available
Streptomycin SE
Ototoxic, nephrotoxic, drug interactions, no pregnant
Syphilis- agent, micro, Tx
Treponema pallidum
gram neg spirochete
PCN
TB % pulmonary
85%
TB meds that are most bactericidal (2)
rifampin and INH
tetanus presentations (3)
Classic rigidity: jaw -> generalized
Local tetanus- muscle contraction around wound
Cephalic tetanus is rare, related to OM, involves paralysis of cranial nerves, especially facial area
third leading cause of infectious death
diarrhea
Typhoid- agent, host, HIV, incubation, Sx by week, Dx, Tx (2), vaccine effectiveness
Salmonella typhi
human carriers
HIV protective
incubation 10-20 d
Sx by week:
1: fever, abd pain, constipation, HA, cough
2: high fever with bradycardia, rose spots
3: weak, diarrhea
4: improve
Dx- blood Cx
Tx Cipro, azithro in Asia
75% vaccine effective
Tick borne LAD- agent, vector, skin, geo
R. slovaca
tick
NO rash, just LAD
Gulf Coast, Brazil, Uraguay
Tick borne relapsing fever- agent, geo, Sx
Borrelia
widespread, esp Africa
Epistaxis, Abdpain, Diarrhea, Cough, Splenomegaly, Neuro, Rash including petechiae
top 2 causes of infectious blindness in world
Oncho, chlamydia (toxocaria)
Treatment and proph for Yersinia pestis
Streptomycin, Doxy, cipro
Treatment for active pulmonary TB
INH + RIF x 6 mo WITH
ETH and PZA for 1st 2 mo
treatment for chronic Bartonella quintana (trench fever)
Doxycycline for 4 weeks plus gentamicin for the first 2 weeks
Treatment of Brucella
Rifampin and doxycycline for 6 weeks
treatment of Q fever
doxycline
Treatment severe erythema nodosum leprosum
Prednisone + thalidomide or clofazine
Trench fever- agent, vector, Tx
B. quintana
louse
doxy
trench fever agent, Sx, Tx
B. quintana
fever, myalgia, HA, conjunctivitis (95%), splenomegaly, shin bone pain
may be single or recurent episodes over 6 week
gent 2 weeks, doxy 4 wks overlap
Tropical Pyomyositis- cause, Sx, Tx
usually Staph aureus
muscle abscess
drainage and ABx
Tularemia bioterror- agent, micro, transmission, incubation max, Sx, mortality, Tx, Cx
Francisella tularensis (Gram neg intracellular)
aerosolized
5 days max
pneumonia
mortality 60% untreated
gent, cipro, doxy, chloramphenicol
yeast charcoal
Tx bloody diarrhea
Cipro
if no improve 48 h change to zithro
if Giardia change to tindazole
Tx MAC in HIV (3)
Clarithromycin, ethambutol, rifabutin
Tx multibacillary leprosy- daily/monthly, duration
daily dapsone + clofazine (self)
OR monthly rifampin + clofazine (supervised)
x 12 months or more
Tx paucibacillary leprosy, duration
daily dapsone + monthly rifampin (supervised) 6 months
typhoid vs non-typhoid salmonella- Sx, timing
non-typhoidal- acute enterocolitis, N+V, in days
Salmonella typhi- rare diarrhea (fever, Ha, pain), 2-3 weeks after infection
Verruga peruana- agent, Sx, Tx
B. bacilliformis
angioma-like nodules and ulcers -> resolve no scarring
rifampin or streptomycin can clear faster
Vibrio cholera- micro, pathology, source, Sx, Tx
curved neg rod with flagella
phage toxin affecting chloride secretion
water, fish, P2P
vomit, rice water stool (no fever) rehydration
Abx may reduce duration and shedding
Weils disease
Renal and liver failure seen with leptospirosis
Where MDR TB most prevalent
USSR
Where TB most prevalent
Africa (esp horn)> Asia
Which form of plague has P2P
pneumonic
Yaws- agent, sx, tx
treponema (not T. pallidum)
papule, ulcers, scabs, hyerkeratosis, late gummas
“mother yaw” painless and heals in months without scarring -> more wks to yrs later
Untreated can cause destructive lesions of the skin and bone (gummas)
Tx: penG x 1
Yersinosis- micro, source, Tx, complications
neg coccobacilli, safety pin bipolar stain, fermenting glucose
pork, surface water
supportive, ABx if septic (rocephin)
erythema nodosum, reactive arthritis
Yersinosis- agent, Sx (3)
Y. enterolittica
GI (DDx appy)
few rash and joint pain
