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Term 4: ID practice > Bordetella & Neisseria > Flashcards

Bordetella & Neisseria Flashcards

1
Q

What is the clinical presentation of Whooping Cough

A
  • cold w/o fever
  • coughing with a whoop (deep breath)
  • Difficulty breathing
  • emesis for 2-3 weeks
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2
Q

What bug are we thinking with Forceful cough and blood vessel rupture in eyes of child?

A

Bordetella pertussis

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3
Q

Who is at most risk for death by pertussis?

A

-Babies who are not vaccinated at that age

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4
Q

What lab technique is used to diagnose Bordetella pertussis?

A

PCR

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5
Q

What is the medium of choice for growing bordetella?

A

Regan Lowe agar = charcoal agar w/ 10% horse blood (grows slowly)

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6
Q

How does B. pertussis cause disease?

A
  • Bacteria are inhaled and colonize ciliated epithelium
  • injects exotoxin
  • Tracheal cytotoxin kills ciliated epithelium
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7
Q

What are the exotoxins produced by B. pertussis?

A

-Pertussis Toxin (PT) = inhibits neutrophil migration

-Adenylate Cyclase Toxin (CyaA) = inhibits phagocytosis

-Tracheal cytotoxin = killes ciliated epithelium

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8
Q

How does Pertussis toxin work?

A
  • A-B exotoxin (like diphtheria)
  • Damage to respiratory cells.
  • Inhibits migration of lymphocytes and macrophages to areas of infection.
  • Causes lymphocytosis.
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9
Q

How does Adenylate Cyclase Toxin produced by bordetella pertussis work?

A

Enters neutrophils and catalyzes the excessive production of cAMP which intoxicates the cells such that phagocytosis is compromised.

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10
Q

How do we diagnose pertussis?

A
  • Swab from nasopharynx, cultured onto special media (required by CDC)
  • PCR is better
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11
Q

What are the microbiological features of Neisseria?

A
  • Gm (-)
  • Diplococci
  • intracellular
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12
Q

What is the culture media preferred for Neisseria?

A

-Chocolate agar

(requires Thayer Martin VCN = Vancomycin, Colistin, Nystatin)

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13
Q

What are the virulence factors of neisseria?

A
  • Pili
  • Polysaccharide capsule
  • LOS (endotoxin)
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14
Q

What diseases are caused by Neisseria meningitidis?

A
  • Sporadic & epidemic meiningitis
  • meningococcemia

**Waterhouse-Friderichesen syndrome

-Rare: bacteremia, pneumonia, septic arthritis

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15
Q

How do we diagnose Neisseria meningitidis?

A

-gram stain of CSF

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16
Q

What neonatal infections are we worried about with Neisseria gonorrhoeae?

A
  • Conjunctivitis (causes blindness)
  • soft tissue abscesses
  • arthritis
  • bacteremia/sepsis
17
Q

What are the microbiological features of Bordetella pertussis?

A
  • Gm (-)
  • rod
18
Q

What allows Bordetella pertussis to attach to ciliated epithelial cells of the upper respiratory tract?

A

-Filamentous hemagglutinin (FHA)

=a pili rod that extends from surface to bind ciliated epithelial cells

19
Q

What does tracheal cytotoxin produced by Bordetella pertussis do?

A

-kills ciliated epithelial cells

20
Q

What does DTaP stand for?

A
  • vaccine
  • Diphtheria, Tetanus, acellular Pertussis
21
Q

What is the only Gm (-) pathogenic cocci?

A

Neisseria (meningitidis & gonorrhoeae)

22
Q

“Petechial rash & meningitis”

A

-Neisseria meningitidis

23
Q

What is the treatment for Bordetella pertussis?

A
  • No antitoxin available
  • Early macrolides may limit severity
  • New vaccine has purified and inactivated proteins/toxin (only lasts 4-5 years)
24
Q

Which, caused by Neisseria meningitidis, is more deadly? Meningococcemia with meningitis or meningococcemia without meningitis?

A

-Meningococcemia without meningitis

25
Q

Who is at most risk for developing meningitis caused by Neisseria meningitidis?

A

1) infants aged 6 mo to 2 years
2) Army recruits
3) College freshmen

26
Q

What is Waterhouse-Friderichsen syndrome, and what organism causes it?

A

-sever outcome of meningococcemia =acute hemorrhagic destruction of adrenal glands

27
Q

What serotypes of Neisseria meningitidis does the MPSV4 vaccine protect against?

A
  • A, C, Y, W135
  • does NOT protect against B
28
Q

What is the pathogenesis of Neisseria meningitidis?

A
  • Enters respiratory tract
  • colonizes nasopharynx
  • invades epithelium
  • travels to choroid plexus, causing meningitis
29
Q

What diseases are caused by Neisseria gonorrhorea in BOTH men and women?

A
  • Gonococcal bacteremia
  • Septic arthritis
30
Q

What diseases are caused by Neisseria gonorrhorea in women?

A
  • Pelvic inlammatory disease
  • vaginitis, urethritis, etc.
  • Tenosynovitis
31
Q

What are the complications of pelvic inflammatory disease in women?

A
  • Sterility
  • Ectopic pregnancy
  • Peritonitis
  • Peri-hepatitis (Fitz-Hugh-Curtis syndrome)
  • abscesses
32
Q

Does Neisseria gonorrhea have a capsule?

A

no

33
Q

“Fitz-Hugh-Curtis syndrome”

A

Neisseria gonorrhea

=peri-hepatitis

Term 4: ID practice (22 decks)

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