Bacterial Infections of Blood and Vasculature

Question 1

what type of bacteria are borrelia?

Answer 1

spirochetes

Question 2

what is the difference in appearance between treponema and borrelia?

Answer 2

borrelia are large enough to see with standard microscopy

Question 3

what organism causes lime disease? what is its vector?

Answer 3

b burgdorferi

vectored by deer ticks

Question 4

what is the downside of serology testing for b burgdorferi?

Answer 4

serology can confirm exposure but not disease and not promptly after infection?

Question 5

how much time does lyme take to transmit from the vector?

Answer 5

24 hours

Question 6

what are the three stages of lyme disease?

Answer 6

1) flu like with erythema migrans rash
2) musculoskeletal and/or neurologic symptoms
3) additional neurologic symptoms and arthralgias

Question 7

what is post lyme syndrome? what is it caused by?

Answer 7

lingering fatigue, joint pain and mental status changes. caused by damage, not lingering bacteria

Question 8

how is lyme disease treated?

Answer 8

with amoxicillin or doxycycline. give ceftriaxone if in child or pregnant woman. treat for 10-30 days only

Question 9

what vectors carry relapsing fever bacteria?

Answer 9

louse or tick borne.

louse are more severe but tick borne are most likely seen in the US

Question 10

what is relapsing fever?

Answer 10

high fevers with well periods in between.

Question 11

what two pathogens cause relapsing fever?

Answer 11

borrelia recurrentis (louse) and hermsii (soft ticks)

Question 12

what is the lifecycle of relapsing fever in the human body?

Answer 12

immediately enters the blood stream from the bite site. there is repeated rounds of bacteremia and clean up by neutralizing antibodies

Question 13

why can’t the immune system immediately terminate relapsing fever?

Answer 13

because there is antigenic variation by the spirochetes

Question 14

how is relapsing fever diagnosed?

Answer 14

by peripheral blood smear during febrile periods

Question 15

how is relapsing fevers treated?

Answer 15

with tetracyclines (doxycycline)

Question 16

how are relapsing fever and lyme disease avoided?

Answer 16

use protective clothing and deet. perform daily tick checks in at risk areas during the tick seasons

Question 17

what is the Jarisch Herxheimer reaction?

Answer 17

a reaction following the successful treatment of any spirochete infection. It is an endotoxin response resembling septicemia

Question 18

how are Rickettsia, Ehrlichia and Anaplasma transmitted? what shape are they?

Answer 18

transmitted through arthropod vectors

they are small cocci to short rods

Question 19

how are reckettsia, ehrlichia and anaplasma treated?

Answer 19

with tetracycline (doxycycline)

Question 20

what is a nuance of the life cycle of the rickettsia, erlichia and anaplasma?

Answer 20

they are obligate intracellular parasites that can only be grown in vitro in tissue culture

Question 21

how do the rickettsiae diseases present?

Answer 21

headache, fever and body aches. may also cause a rash or eschar

Question 22

what is the proper removal of a tick?

Answer 22

should be done with tweezers while wearing gloves. done promptly because bacteria take time to transmit

Question 23

what rickettsial disease has humans as the proper host? how does this differ from others?

Answer 23

epidemic typhus

other rickettsial diseases are accidental transmissions to humans by vectors

Question 24

where do rickettsia divide?

Answer 24

throughout the cell

Question 25

where do ehrlichia and anaplasma divide?

Answer 25

they form morulae in phagocytic vacuoles

Question 26

how are rickettsial bacteria identified?

Answer 26

all are difficult to stain and require microimmunofluorescent assay to visualize

Question 27

what treatment is used for rickettsial illnesses?

Answer 27

tetracyclines used for adults and children, but not for pregnant women. alternately treated with chloramphenicol (rickettsia) or fluoroquinolones (ehrlichia and anaplasma)