Bacterial Infections, Part 4 (Chlamydial, Rickettsial) Flashcards
Chronic chlamydial infection that causes progressive scars of the conjunctiva and cornea?
Trachoma. -Leading cause of blindness due to follicular conjunctivitis.
Atypical pneumonia associated with myocarditis, reactive arthritis, meningoencephalitis, and Guillain-Barre syndrome?
Chlamydia pnuemoniae. -Uptodate says there is not much to distinguish the pulmonary process. These are some extra-pulmonary manifestations.
Genital ulceration and lymphadenopathy caused by Chlamydia trachomatis?
Lymphogranuloma venerum -Serovars L1-L3.
A 37-year-old animal worker presents with non-productive cough and fever. Physical exam reveals hepatomegaly. Which rickettsial disease may be present?
Coxiella burnetti. Q Fever -Flu-like symptoms -Pneumonia -Hepatitis
A 40-year-old woman presents with cough, fever, headache, and general malaise. She has generalized lymphadenopathy and a maculopapular rash on her abdomen. You notice several small eschars where the rash has developed. You learn she just returned from visiting relatives in Japan. Your differential’s must-not-miss should include?
Scrub typhus (R. tsutsugamuchi) -Spread by mites (chiggers). May be anywhere these are present. -Maculopapular rash starting on the trunk, may have small eschars. -Presentation similar to that of endemic typhus, may only distinguish with serology or biopsy (or incredible history taking skills specific to finding mites).
Rickettsial disease characterized by systemic vasculitis that is transmitted by infected lice?
Epidemic (Louse-born) typhus.
A 30-year-old woman presents with severe lower abdominal pain and pain on urination. Her and her husband have been unsuccessful in getting pregnant and she is concerned this is related. You immediately notice her conjunctivae look irritated.
Chlamydia trachomatis. -May cause reactive arthritis, conjunctivitis, urethritis, and pelvic inflammatory disease. -Serovars D-K: genital & neonatal infections
A 28-year-old adventurer presents with headache, fever, and a mucalopapular rash on his chest. Biopsy of legion reveals organisms within capillary enodthelium. He has just returned from filming a documentary about life on board a frigate. He spent most of his time in the hull with the cargo, and he noticed a lot of rats.
-Endemic (Murine) Typhus -Rat-flea-rat transmission -Maculopapular rash starts on trunk
Chlamydial trachomatis serotypes (3 “groups”)
-ABC: chronic infection, blindness -D-K: urethritis/PID, ectopic pregnancy, neonatal pnuemonia, conjunctivitis. -L1-L3: lymphogranuloma venerum
A 34-year-old woodsman is experiencing a severe headache, fever, and a small rash. The nonspecific findings get him sent home. 3 days later returns, as his rash and symptoms have gotten worse. You immediately notice a petechial rash over his ankles, wrists, palms, and soles. He is becoming confused and short of breath.
-Rocky Mountain Spotted Fever -Characteristic headache, fever, rash. -Petechial rash starts at the extremities. -Potentially fatal vasculitis.
Febrile illness caused by Coxiella burnetti?
Q Fever
A 50-year-old woman presents with a dry cough and shortness of breath for the last several days. X-ray shows diffuse infiltrates. Transbronchial aspirate reveals interstitial process. History reveals that she owns a parrot-breeding business.
Chlamydia psittaci (psittacosis). -Atypical, interstitial pneumonia -Birds. -Psittacosis, Parrots.
