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DT3- EXAM 1 > Cardiac Infections- IL- Mary (3)* > Flashcards

Cardiac Infections- IL- Mary (3)* Flashcards

1
Q

Bartonella:
Gram stain
Description
Motility

Growth Requirements

A

Gram (-)
curved, small, pleomorphic bacillus
Nonmotile

aerobic: fastidious growth requirements in prolonged humid atmosphere (6wks)

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2
Q

Bartonella Species

3 common +3 uncommon

A

Common:
B. bacilliformis, B. henselae, B. quintana

Uncommon:
B. elisabethae, B. clarridgeiae, B. grahmaii

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3
Q 
Oroya Fever/Carrion's disease:
Cause
Description of Disease
Incubation period
Severity of disease?
A

B. bacilliformis
Acute Febrile illness w/ severe anemia–>chronic cutaneous form
2-6wk incubation
High mortality rate w/o therapy

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4
Q

Oroya Fever insect vector

Locations (3)

A

Lutzonmyia sandfly

Peru/Ecuador/Columbia (ANDES MOUNTAINS)

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5
Q

Oroya Development of Acute Disease

A

Bite–>bacteria into RBC–> acute anemia

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6
Q

Symp of Mild Oroya Fever (5 systems)

What happens when these infections resolve?

A
  1. Myalgias/arthalgias
  2. Lymphadenopathy
  3. CNS: HA, mental change, seizures
  4. GI: anorexia, abd pain
  5. Heart: Angina
    ends w/ Humoral Immunity
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7
Q

Chronic Oroya Fever (mos-yrs)

A

Benign bloody nodules (1-2cm)
Heal on their own

Asymp bacteremia in 15% survivors (reservoir)

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8
Q

Trench Fever:
bacterial species
Insect Vector

A 
B. quintana
Pediculus humanus (body louse)
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9
Q 
Geographic Location of B. quintana
Populations infected(2)
A

Worldwide

  1. homeless (poor sanitation)
  2. AIDS
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10
Q

Trench Fever Signs/Symp (3)

A
  1. recurring FEVERS lasting 5 days (quintana=5)
  2. HA, myalgia
  3. Conjunctivitis
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11
Q

Cat Scratch Disease:

bacterial species

A

B. henselae

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12
Q

1 clinical human infection of Bartonella

A

Cat Scratch Disease

22,000 cases in USA (no higher incidence in vets)

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13
Q 
Cat Scratch Disease:
Cat Factoids (3)
A

stray cats > indoor cats; kittens > cats; cats are asymptomatic

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14
Q

Cat Scratch disease:

Transmission

A

cats–> fleas–>cats–>human (bite/scratch/flea)

flea–>human (not common)

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15
Q

Cat Scratch Disease :

Symptoms and timeline (4)

A

-papule/pustule (3-10d) lasting 1-3wk

-Regional ipsi LN enlargement (1-7wk)
+ F/Rash/malaise

  • Chronic regional draining adenopathy (lasts 2-4mos)
  • spontaneous resolution
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16
Q

Atypical Cat Scratch Disease (5)

A
  1. Parinaud’s oculoglandular syndrome
  2. Granulomatous hepatitis
  3. Pneumonitis
  4. Neuro: Encephalopathy/ neuroretinitis
  5. Fever of unknown origin (FUO)
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17
Q

Bartonella Endocarditis:
Culture (+) or (-)
Species (2)
symp (3)

A 
Culture (-)
B. quintana, B. hensalae
subacute presentation
1. Fever
2. embolic phenomena
3. valvular heart disease

“so symptoms are pretty much the same w/ all Infective endocarditis”

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18
Q

Bacillary Angiomatosis:
Species (2)
patient population (3)

A

B. quintana, B. hensalae

HIV/organ transplant/immunocompromised

19
Q

Bacillary Angiomatosis:
What do the lesions look like?
Where are the lesions typically found?
Symptoms (3)?

A
  1. Raised red/purple lesions (can bleed)–>like hemangioma
    or Hyperpigmented, hyperkeratotic plaques
  2. Lesions: oral/nasal/genital mucosa
  3. Bone Pain: Forearms/legs
  4. GI: Abd pain, N/V, Jaundice, GI bleed, anorexia
  5. Other: F/C, Malaise, Night Sweats
20
Q

Bartonellosis Diagnosis:

  1. Stains + organism that can be dx’ed this way?
  2. Is culture a good method for all manifestations of bartonellosis?
  3. What is the #1 way to dx b. henslae + b. quintana?
A
  1. Oroya Fever (bacilliformis): Giemsa stain
  2. Culture: Not for Cat Scratch Disease; ok for other manifestations of henslae/ quintana infection
  3. Serology: #1 method (IgG/IgM immunoassays)
    IgM >1:16 = recent infection
    IgG >1:256 = current/past infection
    Repeat 1-2wks later
21
Q

Treatment:

  1. Oroya Fever (B. bacilliformis)
  2. Cat Scratch Disease (B. henselae)
  3. Bacillary angiomatosis
A
  1. Oroya: Chloramphenicol (S. Am)
    Ciproflox, Doxy, Bactrim
  2. CSD lymphadenitis: Azithromycin
  3. Erythromycin/azithromycin or Doxy (8-10wk in HIV or endocarditis)
22
Q

Whats HACEK stand for?

A 
Haemophilus aprophilus
Actinobacillus actinomycetemcomitans
Cardiobacterium hominis
Eikenella corrodens
Kingella kingae

*H. aprophilus + Actinobacillus are group into Aggregatibacter

23
Q

HACEK growth pattern

A

slow growing, fastidious (CO2 atmosphere)

Deep infections

24
Q

Non-Cardio H + A manifestations (5)

A
  1. Meningitis/Brain Abscess
  2. Soft Tissue Infection, Parotitis
  3. Septic Arthritis, Osteomyelitis
  4. UTI
  5. Pneumonia
25
Q

Cardio H + A manifestations (3)

H, A are endogenously found where?

A
  1. Empyema + Chest Wall Infection
  2. Pericarditis
  3. Endocarditis

*Flora of Mouth –>periodontitis

26
Q

H + A:
Diagnosis/Culture
Treatment

A

Dx: blood/chocolate agar

Tx:

  • # 1 = 3rd gen Ceph
  • Bactrim, Fluoroquinolones, Tetracyclines, Aminoglyc.
27
Q 
Cardiobacter:
Gram stain
Description
Motile?
Aerobic/Anaerobic
Growth
A 
Gram (-)
small pleomorphic rod
non-motile
facultative anaerobic
fermentative, indole, and oxidase (+)
1-2wk in broth -or- enhanced CO2/humidity on agar
28
Q

Where can Cardiobacter be found in healthy humans?

Predisposing factors to C. hominid infection (2)?

A

respiratory tract (low virulence)

1. heart disease
2. dental procedures/oral disease
bacteria enters blood through oropharynx

29
Q

Symptoms of C. hominis endocarditis

A

slow onset w/ Fever + Malaise

30
Q

Treatment of C. hominis

A

Penicillins (Ceftriaxone, ampicillin w/ gentamicin)

31
Q

Eikenella Corrodens:

Transmission (2)

A

“corrodes” agar

  1. Human Bite Wounds
  2. Fist-Fight Injury
32
Q

Eikenella manifestations (4)

Treatment

A
  1. brain abscesses
  2. sinusitis
  3. pneumonia/ lung abscess
  4. endocarditis

Tx: Penicillin (extendend cephalosporins, tetracyclines)

symptoms: “Brad Sucker Punched Egleton” –>b/c Eikenella is transmitted by fighting

33
Q

Kingella Kingae:
Gram Stain
Description
Endogenously found where on humans?

A

Gram (-)
small coccobacilli
human oropharynx

34
Q

Kingella in children

Treatment

A

“sterile”/aseptic arthritis (but actually septic) w/ Pain, F

Tx: children generally recover, abx similar to Eikenella (Penicillin)

35
Q

Strep species causing:

abscess in brain, oropharynx, peritoneal cavity

A

S. anginosus
S. constellatus
S. intermedius

“ANGIe is CONSTantly INTERrupting about abscess in the brain, oropharynx and peritoneal cavity. Idiot”

36
Q

Strep species causing:

Subacute bacterial endocarditis, neutropenic sepsis, penumonia, meningitis

A

S. mitis
S. pneumoniae
S. oralis

37
Q

Strep Species causing:

Dental caries, endocarditis

A

S. mutans
S. sobrinus

“Mutans mutates your teeth into cavities”

38
Q

Strep Species Causing:

bacteremia, endocarditis

A

S. Salivarius

“Sail BAC to my heart (ENDOCARDITIS)”

39
Q

Strep species causing:

colon cancer, meningitis

A

Strep Bovis (S. gallolyticus, S. pasteurianus)

“if Strep bovis, be sure to look at their bowels”

40
Q

Strep species causing:

Meningitis, bacteremia, strep toxic shock syndrome

A

S. suis

“I’m SUper SHOCKed MEN eat BACon”

41
Q

Nutrient variable Strep species causing:

endocarditis, pancreatic abscess, otitis media, postpartum + postabortal sepsis

A

Abiotrophia

42
Q

hemolysis of Strep viridans

treatment

A

alpha (partial) hemolytic

Tx: penicillin (bacteriostatic) +/- aminoglycoside

43
Q

Strep species that cause endocarditis (6)

A

1 strep viridans (alpha hemolytic)

  1. Mitis
  2. Mutans (also dental caries)
  3. Salivarius
  4. Abiotropia
  5. Bovis (also colon cancer)

DT3- EXAM 1 (26 decks)

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