Blood-Borne Bacterial Infections

Question 1

Bug, vector and rash pattern of Rocky Mountain Spotted Fever.

Answer 1

Rickettsia rickettsia

• wood tick
• rash starts on palms and soles and moves toward the torso

Question 2

Bug, vector, and rash pattern of Rickettsialpox.

Answer 2

Rickettsia akari

• mite
• papule at site of bite progressing to a vesicle, then after a week vesicles appear all over the body and become “crusty”

Question 3

Bug, vector, and rash pattern of Epidemic typhus.

Answer 3

Rickettsia prowazekii

• body louse
• rash forms on torso arms and legs, not palm, soles, or face

Question 4

Unique disease associated with Epidemic Typhus.

Answer 4

Brill Zinsser Disease

-recurrence of typhus years or decades later, more mild.

Question 5

Bug, vector, and rash pattern in Endemic Typhus.

Answer 5

Rickettsia typhi

• flea
• rash on chest and abdomen

Question 6

Bug, vector, and rash pattern in Scrub Typhus.

Answer 6

Orientia tsutsugamushi

• chigger
• scab at bite site followed by flat maculopapular rash

Question 7

How Ehrlichia infections differ from rickettsia infections?

Answer 7

Ehrlichia: infects WBCs
Rickettsia: infects RBCs

Question 8

What are the two Ehrlichia infections and how are they differentiated?

Answer 8

1. Human Monocyte Ehrlichiosis: morula seen on blood smear in monocytes
   - Ehrlichia chaffeensis
2. Human Anaplasmosis: morula seen on blood smear in granulocytes
   - Anaplasma phagocytophilum

Question 9

Describe the disease caused by B. burgdorferi.

Answer 9

Lyme Disease
Stage 1: bulls-eye rash at bite site
Stage 2: dissemination of microbe, fatigue, joint pain, muscle pain
Stage 3: chronic arthritis, encephalitis

Question 10

How is lyme disease diagnosed?

Answer 10

Two Tiered Testing
First Test: enzyme immunoassay or Immunofluorescence

Second Test:

• if symptoms have been present less than 30 days use IgM and IgG western blot
• if longer than 30 days just IgG western blot

Question 11

What vector and microbe causes endemic and then epidemic relapsing fevers?

Answer 11

Endemic: soft tick borne
-15 species of Borrelia

Epidemic: louse borne
-Borrelia recurrentis

Question 12

Way to diagnose B. recurrentis.

Answer 12

Microscopy of blood smear

-performs antigenic variation so serology cannot be used

Question 13

Mode of transmission of Leptospira interrogans.

Answer 13

Contact with contaminated animal urine

Question 14

How does Leptospira appear on microscopy.

Answer 14

Spirochete with “hooked” ends

Question 15

Major symptoms of Leptospirosis

Answer 15

Red Conjunctiva, photophobia

Question 16

Condition associated with Leptospira.

Answer 16

Weil Syndrome

-renal failure, hepatitis, jaundice, mental status change, hemorrhage

Question 17

Bug, vector, and symptoms of Trench Fever.

Answer 17

Bartonella quintana

• body louse
• bone pain in back and legs

Question 18

Bug, vector, and symptoms of Oroya Fever.

Answer 18

Bartonella bacilliformis

• sand fly
• anemia, blood filled skin nodules

Question 19

Bug, vector, and symptoms of Cat Scratch Disease

Answer 19

Bartonella hensaelae

• cat flea
• regional lymphadenopathy, fever
• bacillary angiomatosis