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HemOnc > Bloodborne Bacterial Infections > Flashcards

Bloodborne Bacterial Infections Flashcards

1
Q

What are 3 obligate intracellular, small, gram - coccobacilli that don’t gram stain well and are transmitted via an arthropod vector?

A
  1. Rickettsia
  2. Erlichia
  3. Anaplasma
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2
Q

What are the general symptoms that rickettsia, ehrlichia, and anaplasma cause?

A

Fever, rash, and headache

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3
Q

How do you visualize rickettsia, erlichia, and anaplasma?

A

Giemsa stain (stain on a blood sample)

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4
Q

What type of testing is done to diagnose rickettsia, erlichia, and anaplasma?

A

Serology (antigens/antibodies, ect.)

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5
Q

What is given to treat rickettsia, erlichia, and anaplasma?

A

Doxycycline (ASAP)

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6
Q

What property of rickettsia is used in the Weil-Felix test?

A

That rickettsia can share antigen similarity to Proteus Vulgaris
-Add serum to P. Vulgaris antigens and look for aggulintation… this isn’t used because it’s not specific or sensitive

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7
Q

What transmits rocky mountain spotted fever?

A

TICK

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8
Q

What so tricky about the ticks that transmit rickettsia?

A

They can do things trans-ovarially… so the momma tick and give rickettsia to the baby tick, which makes it hard to control this disease

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9
Q

Where do you see Rickettsia?

A

Southeast US (APPALACHIAN TRAIL)

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10
Q

What seasons you you get Rickettsia in?

A

April to September

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11
Q

What kind of rash is seen in Rickettsia?

A

Petechial rash that stands OUT and moves IN

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12
Q

Where do rickettsia proliferate in a human what does this cause?

A

Endothelial lining of small blood vessels causes hemorrhages

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13
Q

What is done to diagnose rickettsia?

A

Microimmunifloouresence looking for antibodies

-IgM first, then IgG a bit later…look for BOTH

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14
Q

What is treatment for Rickettsia?

A

Doxycycline ASAP (even in kids)

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15
Q

What does Rickettsia akari cause?

A

Rickettsial pox

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16
Q

What is the arhtropod and reservoir for R. Akari?

A

Mite and mice

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17
Q

What happens to you with R. Akari?

A

Papule at site of bite that’s a vesicle…

-Then general symptoms plus photophobia and more vesicles–> SELF LIMITED

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18
Q

What causes epidemic typhus?

A

R. Prowazekii

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19
Q

What is the vector for R. Prowazekii?

A

Body lice (spread by fleas from flying squirrels)

-Poverty, war, natural distasters

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20
Q

What kind of rash does R. Prowazekii cause?

A

Small, pink macules on upper trunk and spreads out with NO rash on palms, soles, or face

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21
Q

This is the recurrence of typhus years to decades later, usually in a milder form

A

Brill-Zinsser Disease

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22
Q

What causes edemic typhus (murine typhus)?

A

Rickettsia typhi

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23
Q

What is the vector and reservoir for R. Typhi?

A

Flea and rodents

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24
Q

Where do you see R. Typhi?

A

Warm, humid –> US GULF COAST

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25
Q

What does Orientia Tsutsugamushi cause?

A

Scrub typhus

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26
Q

Where do you see scrub typhus?

A

Asia and SW pacific

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27
Q

What is the vector for scrub typhus?

A

Chiggers in soil/sand

mites on rodents

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28
Q

What is seen with scrub typhus?

A

Scab at bite with a flat maculopapular rash

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29
Q

Ehrlichiosis (an obligate intracellular bacteria) infects what?

A

WBC

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30
Q

What is the vector for ehrlichiosis?

A

TICK

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31
Q

When do you see ehrlichiosis?

A

April to October

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32
Q

Human monocytic erlichiosis (E. Chaffeensis) affects what?

A

Monocytes

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33
Q

Human anaplasmosis (Anaplasma phagocytophilum) affects what?

A

Granulocytes (eosinophils, basophils, neutrophils)

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34
Q

What lab values would be seen with an erlichiosis infection?

A

Leukopenia and thrombocytopenia

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35
Q

How do you diagnose Erlichiosis?

A

Geima/Wright stain- SEE MORULAE

-PCR or serology

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36
Q

Where does erlichiosis reproduce in the cell?

A

Phagosome

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37
Q

What’s a morula?

A

Clumbs of reproducing erlichiosis bugs in the membrane

38
Q

What side of the US gets erlichiosis?

A

EAST (midwest too)

39
Q

What causes Lyme disease?

A

Borrelia Burgdorferi

40
Q

What is the vector and reserboir for lyme disease?

A

Tick

White-footed mice or white-tailed deer

41
Q

What is treatment for Lyme Disease?

A

Doxy or amocillin

42
Q

Where do you see Lyme disease?

A

GREAT LAKES

43
Q

What’s the number 1 thing you think of with Lyme Disease?

A

BULLS-EYE RASH

Be careful for tricky shits that phrase it like concentric rings or something

44
Q

How many stages to Lyme disease?

A

3

45
Q

What’s stage 1 Lyme disease?

A

BULLS-EYE RASH and flu-like symptoms

46
Q

What is stage 2 Lyme disease?

A

Disseminated

MIGRATORY JOINT AND MUSCLE PAIN

47
Q

What is stage 3 Lyme disease?

A

CHRONIC

arthritis and encephalitis

48
Q

Do the ticks with borrelia burgdorferi do the whole trans-ovarial business?

A

NO

49
Q

When you diagnose Lyme disease what 2 options for your first test?

A

EIA or IFA looking for antibodies

50
Q

If your result in positive or equivocal what do you look at for a second test if

  • Signs/symptoms under 30
  • Signs/symptoms over 30
A
  • Under: IgM and IgG

- Over: IgG only (IgM no longer helpful son)

51
Q

What do you always need to consider in Lyme disease because the testing is so spotty?

A

SIGNS AND SYMPTOMS

52
Q

What are the 2 forms of Borellia or Relapsing Fever?

A
  1. Endemic (seen in US)

2. Epidemic (outbreak in isolated population)

53
Q

What is associated with endemia borellia?

A

RUSTIC LOG CABINS

-Soft ticks and rodents

54
Q

What causes the epidemic form of borellia?

A

Borellia Recurrentis

55
Q

What is the vector for endemic borellia recurrentis?

A

LOUSE -Human to Human

56
Q

Where do you see borrelia recurrentis?

A

Ethiopia, Rwanda, and Sudan

-DIRTY PLACES

57
Q

How do you diagnose borellia recurrentis?

A

Microscopy (no serology because of antigenic variation)

-You can see the little shits on a blood smear (spirochetes)

58
Q

What is treatment for borellia recurrentis?

A

Tetracyclines or penicillins

59
Q

How many relapses do you get with endemic relapsing fever due to antigenic variation?

A

10

60
Q

How many relapses do you get with epidemic relapsing fever due to antigenic variation?

A

1

61
Q

What is antigenic variation?

A

A VIRULENCE FACTOR

-Change proteins on cell curface)

62
Q

Why does epidemic relapsing fever have fewer relapses?

A

More readily recognized (cause its an epidemic) so it’s treated sooner, fewer felapses

63
Q

What does leptospira interrogan cause?

A

Leptospirosis

64
Q

Where is leptospira interrogans found?

A

Urine of dogs, rats, livestock, and wild animals

65
Q

How do you get leptospira?

A

Direct contact with urine…it penetrates cuts or scrapes in the skin
-Swimming or standing in contaminated water

66
Q

Where does leptospira invade?

A

Blood and CSF

67
Q

What are 2 unique symptoms to leptospira?

A

Red conjunctiva and photophobia

68
Q

What happens with the course of symptoms in leptospira?

A

They wane and reoccur

69
Q

Who is the classic leptospira patient?

A

A surfer in Hawaii (constantly urine contaminated water)

70
Q

What is the description of leptospira bug?

A

Shepards crook: It’s a spirochete with hooked ends

71
Q

How do you diagnose leptospira?

A

Microscopic agglutination test- Detect if antibodies in the patient’s serum can agglutinate leptospires (see if they clump)

72
Q

What do you use to treat leptospira?

A

IV penicillin or doxy

73
Q

What is Weil syndrome?

A

The sequela of leptospira including renal failure, hepatitis, jaundice, mental status changes, and hemorrhage

74
Q

Describe Bartonella?

A

It’s a gram - rod that is fastidious (meaning it’s hard to grow in the lab)

75
Q

What are the 3 species of Bartonella that we worry about?

A
  1. Bartonalla quintana
  2. Bartonella bacilliformis
  3. Bartonella Henselae
76
Q

What does bartonella quintana cause?

A

Trench fever

77
Q

Vector and reservoir for Trench fever?

A

Body louse and humans

-Associated with poor hygeiene

78
Q

What is a specific symptom for bartonall quintana?

A

severe bone pain in back and legs

SHIN FEVER

79
Q

How often do the symtpoms reoccur in Trench Fever?

A

5 day intervals

80
Q

What is given for Trench Fever?

A

Erythromycin or Doxy

81
Q

What does Bartonella bacilliformis cause?

A

Oroya fever or Carrion Disease

82
Q

What is the vector for oroya fever?

A

SAND FLY

-These get the disease from dead animals

83
Q

Where do you see Oroya Fever?

A

Peru, Ecudaor, Colombia

84
Q

What do Oroya Fever infect in us?

A

Our RBCs… leads to anemia, myalgia, arthralgia, and headache

85
Q

What happens in chronic disease with oroya fever?

A

1-2cm cutaneous nodules that are blood filled and last months to years

86
Q

What is the treatment for Oroya Fever?

A

Doxy or chloramphenicol

87
Q

What does B. Henselae cause?

A

Cat scratch disease- Don’t let the cats bite you or scratch you (CAT FLEAS)

88
Q

What does cat scratch disease cause?

A

Regional lymphadenopathy (BUBOS)

-BUBOS also seen with yersinia pestis in the groin

89
Q

So if a cat has B. Henselae and scratches you and you are normal what happen? If you are immunocompromised?

A
  • Cat scratch disease

- Bacillary angiomatosis

90
Q

What can bacillary angiomatosis be mixed up with?

A

Kaposi sarcoma (AIDS pts.)

HemOnc (8 decks)

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