Bacterial zoonoses II

Question 1

What is the shape for borrelia?

Answer 1

Long spirochete

Question 2

What causes Lyme disease in the US?

Answer 2

Borrelia burgdorferi

Question 3

What is the main vector for Lyme disease?

Answer 3

Ixodes spp. (hard tick)

Question 4

What is the characteristic presentation of a borrelia burgdorferi bite / infection?

Answer 4

Bull’s eye rash

Question 5

What characterizes late infection of borrelia burgdorferi?

Answer 5

Arthritis - one or more joints, skin discoloration, neurologic complaints

Question 6

What is the treatment for early stage Lyme disease? Late stage?

Answer 6

1. Early stage - cefuroxime + doxycycline + amoxicillin 2. Late stage - ceftriaxone + doxycycline + amoxicillin

Question 7

What are the two types of relapsing fever?

Answer 7

Epidemic and endemic

Question 8

What is the cause of epidemic relapsing fever?

Answer 8

Borrelia recurrentis (louse-borne)

Question 9

What is the cause of endemic relapsing fever?

Answer 9

Borrelia hermsii (tick-borne)

Question 10

How does borrelia evade the immune system during relapsing fever infection?

Answer 10

Antigenic variation

Question 11

Is epidemic relapsing fever a zoonotic disease?

Answer 11

No - human to human

Question 12

What is the treatment for relapsing fever?

Answer 12

Tetracycline or erythromycin

Question 13

What is the gram stain for rickettsia?

Answer 13

Gram negative (weakly)

Question 14

What is the pathogenesis of rickettsia?

Answer 14

1. Organisms infect vascular epithelium of small blood vessels 2. Facilitate own entry into host cell 3. Escape vacuoles and enter cytoplasm 4. Limited ability to survive outside host cell

Question 15

How does rickettsia manifest in the skin?

Answer 15

Inflammation, thrombosis, erythrocyte leakage - rash or petechia

Question 16

How does rickettsia manifest in systemic disease?

Answer 16

Vascular lesions throughout body, dependent on virulence and tissue tropism of strain / species involved

Question 17

What are the vectors for rocky mountain spotted fever?

Answer 17

Dog tick, rocky mountain wood tick

Question 18

When are most cases of rocky mountain spotted fever reported?

Answer 18

Between April and September

Question 19

How does rocky mountain spotted fever present?

Answer 19

1. Fever 2. Rash 2-5 days after fever - small flat pink non-itchy spots on wrists, forearms, and ankles

Question 20

What type of spread is associated with rocky mountain spotted fever?

Answer 20

Centripetal

Question 21

What is the presentation of untreated rocky mountain spotted fever?

Answer 21

Disseminated intravascular coagulation, thrombocytopenia, pulmonary edema, renal failure, GI hemorrhage, shock

Question 22

What is the treatment for rocky mountain spotted fever?

Answer 22

Tetracycline (doxycycline)

Question 23

What is the gram stain for ehrlichia and anaplasma?

Answer 23

Gram negative (weakly)

Question 24

Ehrlichia and anaplasma primarily parasitize what cell types?

Answer 24

Monocytes and granulocytes

Question 25

What are morulae?

Answer 25

Colonies of ehrlichia / anaplasma inside vacuoles

Question 26

What causes human monocytic ehrlichiosis (HME)?

Answer 26

Ehrlichia chaffeensis

Question 27

What causes human gradulocytic ehrlichiosis (HGE)?

Answer 27

Anaplasma phagocytophilium

Question 28

What protects ehrlichia and anaplasma from humoral immune response?

Answer 28

Intracellular location

Question 29

What is the pathogenesis of ehrlichia / anaplasma infection?

Answer 29

Derailment of phagolysozome maturation

Question 30

What leads to resolution of ehrlichia / anaplasma infection?

Answer 30

INFy-mediated activation of macrophages

Question 31

What is the principle vector for human monocytic ehrlichiosis?

Answer 31

Lone Star Tick

Question 32

What is the principle vector for human granulocytic ehrlichiosis?

Answer 32

Ixodes tick

Question 33

Which is the treatment for ehrlichiosis?

Answer 33

Tetracycline (doxycycline)

Question 34

What is the gram stain for coxiella burnetii?

Answer 34

Gram negative

Question 35

Coxiella burnetii causes what disease?

Answer 35

Q fever

Question 36

Q fever is caused by what organism?

Answer 36

Coxiella burnetii

Question 37

What is the pathogenesis of coxiella burnetii?

Answer 37

Reside and replicate within fully acidified phagolysosomes of macrophages and monocytes (do not derail their formation)

Question 38

Which variant of coxiella burnetii can survive harsh condition, similar to a spore?

Answer 38

Small cell variant

Question 39

What is the treatment for Q fever?

Answer 39

Tetracycline (doxycycline)

Question 40

What is the gram stain for bartonella?

Answer 40

Gram negative

Question 41

What is the shape of bartonella?

Answer 41

Rod

Question 42

What causes trench fever?

Answer 42

Bartonella quintana

Question 43

What causes cat scratch fever?

Answer 43

Bartonella henselae

Question 44

How is trench fever transmitted?

Answer 44

Body louse - bacteria excreted via feces then rubbed into skin / wound by scratching the bite

Question 45

What is the treatment for trench fever?

Answer 45

Aminoglycoside (gentamicin) or macrolide (erythromycin)

Question 46

How is cat scratch fever transmitted?

Answer 46

Inoculation of flea feces into a cat scratch or bite

Question 47

What type of fever is associated with brucellosis?

Answer 47

Occurs daily, recurs in the evening, normal by morning, ends in a drenching sweat

Question 48

What type of fever is associated with borrelia?

Answer 48

Occurs every 7-10 days, lasts 7-10 days