Chlamydia and Rickettsia

Question 1

Do chlamydia and Rickettsia grow intra or extracellularly?

Answer 1

Obligate intracellular bacterial pathogens

Question 2

Are chlamydia and rickettsia gram positive or gram negative?

Answer 2

Gram negative

Question 3

Name the facultative intracellular bacteria:

Answer 3

Salmonella, shigella, legionella

Question 4

What are the three types of chlamydia and what do they cause?

Answer 4

chlamydophilia psittaci=parrot fever
chlamydophilia pneumoniae=pneumonia
chlamydia trachomatis=conjunctivitis

Question 5

Why are chlamydia and chlamydophilia obligate intracellular pathogens?

Answer 5

They cannot make ATP. They can only induce ATP synthesis in host cells

Question 6

What are the two stages of development of chlamydia?

Answer 6

Elementary bodies and reticulate bodies

Question 7

What are elementary bodies?

Answer 7

Small, non-replicating form of chlamydia with a rigid cell wall

Question 8

What are reticulate bodies?

Answer 8

Form of chlamydia that are larger, actively multiplying, and do not have a cell wall. They replicate through binary fission and are NOT infectious

Question 9

How is chlamydia psittaci contracted?

Answer 9

Inhalation of bird feces from contact with parrots, parakeets, and pigeons

Question 10

What are the symptoms of psittacosis?

Answer 10

Fever, headache, detected in blood/sputum. Occasionally can lead to interstitial pneumonia

Question 11

What kind of pneumoniae does C pneumoniae cause?

Answer 11

atypical pneumonia. No fever.

Question 12

What chronic condition is C pneumoniae linked to?

Answer 12

atherosclerosis

Question 13

What are the different serotypes of chlamydia trachomatis?

Answer 13

D-K, A-C, L1, L2, L3. Different serotypes cause different diseases.

Question 14

What do the D-K serotypes of C trachomatis cause?

Answer 14

non-gonococcal urethritis

Question 15

What is urethritis?

Answer 15

Irritation/inflammation of the urethra

Question 16

What percentage of pneumonias are caused by chlamydia pneumoniae?

Answer 16

10-20%

Question 17

What are the possible symptoms of C. trachomatis, serotypes D-K?

Answer 17

• Often asymptomatic
• Purulent discharge
• Infection of epididymis or fallopian tube
• Conjunctivitis, esp in neonates. Can spread to eye

Question 18

How do you test for chlamydia trachomatis serotypes D-K

Answer 18

Rapid PCR test

Question 19

How would you treat C. trachomatis serotypes D-K?

Answer 19

Single high dose of azithromycin

Treat both sexual partners

Question 20

What are the symptoms of a chlamydia trachomatis infection of the eye?

Answer 20

turned-in eyelashes, swollen eyelids, discharge, cloudy cornea

Question 21

How is chlamydia trachomatis (serotypes A,B, C) transmitted?

Answer 21

Mechanical from finger to eye or flies

Question 22

Where is chlamydia trachomatis (A, B, C) most prevalent?

Answer 22

Africa and Asia.

Question 23

What occurs with a chlamydia trachomatis A,B,C infection?

Answer 23

Corneal scarring from infolding of eyelashes. Trachoma is the world’s leading cause of preventable blindness

Question 24

How would you treat C. Trachoma?

Answer 24

Azithromycin

Question 25

What do the L1, L2, and L3 serotypes of chlamydia trachomatis cause?

Answer 25

Lymphogranuloma venereum. Starts with a painless papule turns into an ulcer. Sometimes progresses to disease of lymph nodes

Question 26

How do you treat chlamydia?

Answer 26

Tetracyclines. If compliance is an issue, administer a single high dose of azithromycin

Question 27

What are three methods to diagnose chlamydial infections?

Answer 27

1. Antibody titers 2. Fluorescent antibody assay 3. PCR

Question 28

How is C. psittaci transmitted?

Answer 28

respiratory route

Question 29

How is C. pneumoniae transmitted?

Answer 29

respiratory route

Question 30

What is a common vector for rickettsia?

Answer 30

Arthropods

Question 31

Does rickettsia live intracellularly or extracellularly?

Answer 31

Intracellularly

Question 32

Describe the steps of pathogenesis in rickettsia

Answer 32

1. phagocytosis 2. slow growth 3. Lysis of cell

Question 33

Name the different types of rickettsia

Answer 33

Rickettsia prowazekii Rickettsia typhi Rickettsia rickettsii Rickettsia akari

Question 34

Describe the clincal symptoms of rickettsia prowazekii

Answer 34

1. Incubation period 2. Rash 3. fever

Question 35

How long is the rickettsia prowazekii incubation period?

Answer 35

10 days

Question 36

When does the rickettsia prowazekii rash show up?

Answer 36

4-7 days later

Question 37

What is the mode of transmission for RIckettsia prowazekii and typhi transmission?

Answer 37

Body lice. Can also be harbored in squirrels

Question 38

Typhus includes what types of rickettsia?

Answer 38

Rickettsia prowazekii and typhi

Question 39

How do you treat typhus?

Answer 39

tetracyclines

Question 40

How do you diagnose typhus?

Answer 40

PCR, antigen testing, elevated liver fxn tests

Question 41

What happens with R prowazekii resurfaces? What disease results?

Answer 41

Brill-Zinsser disease

Question 42

What are the symptoms of brill zinsser disease?

Answer 42

Similar to primary typhus (headache, rash, elevated liver enzymes

Question 43

What does rickettsia typhi cause?

Answer 43

Endemic murine typhus. Usually milder disease.

Question 44

What are the typical hosts for rickettsia typhi?

Answer 44

rats and ground squirrels

Question 45

What does rickettsia rickettsii cause?

Answer 45

Rocky mountain spotted fever

Question 46

What are the symptoms of Rocky Mountain Spotted Fever?

Answer 46

fever, headache, abdominal pain, vomiting. | Rash on hands/feet, spreading to trunk

Question 47

What type of life cycle does R. Rickettsii have? Describe it.

Answer 47

Trans ovarian transmission cycle - Infected tick lays eggs in adult - Adult harbors infected larvae - Infected larvae attach to rodent host - Larvae mature to nymphs then adult tick - Adult tick jumps on human host - cycle repeats

Question 48

What symptoms does Rickettsia akari cause?

Answer 48

Rickettsial pox. Primary skin lesion at site of bite then systemic disease. Chicken pox-like rash

Question 49

What is the mode of transmission for rickettsial pox?

Answer 49

Mouse mites

Question 50

How would you diagnose rickettsial diseases?

Answer 50

PCR test | Immunohistologic detection

Question 51

How would you treat rickettsial diseases?

Answer 51

Tetracycline

Question 52

What does coxiella burnetii cause?

Answer 52

Q fever

Question 53

What is the mode of transmission for Q fever?

Answer 53

inhalation of C. burnetii from placental tissue of carcasses

Question 54

What are the other vectors of Coxiella burnetii?

Answer 54

sheep, goats, cows, cats, ticks

Question 55

What are the symptoms of Q fever?

Answer 55

``` Interstitial pneumonia Fever Headache Elevated liver function tests If there is progression, leads to chronic disease ```

Question 56

How can you diagnose Q fever?

Answer 56

Serology testing for coxiella burnetii Immunofluorescence assay Immunohistochemical staining and DNA detection

Question 57

How do you treat Q fever?

Answer 57

Doxycycline | Quinolone antibiotics

Question 58

What is the disease transmission of ehrlichioses?

Answer 58

Ticks

Question 59

Is ehrlichiosis an intracellular or extracellular pathogen?

Answer 59

OBLIGATE intracellular pathogen

Question 60

What are the two types of ehrlichiosis?

Answer 60

Monocytic and granulocytic ehrlichiosis

Question 61

What are the symptoms of ehrlichioses?

Answer 61

Fever, lymphocytopenia, elevated liver function tests

Question 62

How do you treat ehrlichioses?

Answer 62

Tetracycline