Culture - Orgs

Question 1

Trench Fever

Answer 1

Caused by Bartonella quintana; common w/ poor sanitation (think homeless people)

-Causes 5 day fever w/ arthralgia and headache; spread by human body louse

Tx: Azithromycin

Question 2

Cat-scratch fever

Answer 2

Bartonella henslae

• Papule at 1-3 weeks; Regional lymphadenopathy of the regional draining site a week later w/ fever, malaise, and rash
• Resolves on it’s own
• Could also cause Parinauld’s oculoglandular syndrome, hepatitis, FUO, or encephalopathy

Tx: Azithromycin

Question 3

Bacillary angiomatosis

Answer 3

Caused by Bartonella henslae and quintana; cause large, raised red-purple lesions that can bleed when traumatized

• Can also causes jaundice, systemic infxn signs, lesions in the oral mucosa
• MUST DIFFERENTIATE from hemangiomas; best way to determine is probably thru serologic assay

IgM >1:16 or IgG>1:256

Question 4

HACEK orgs (culture neg)

Answer 4

HA- endo/pericarditis; tx. w/ ceftriaxone (3rd gen cephalosporin)

C- NF of respiratory tract; predilection for heart valves especially w/ heart disease or dental procedures; tx. w/ ceftriaxone

E- Assoc. w/ human bite wounds or fist-fight injury; can produce endocarditis or pneumonitis; tx. w/ cephalosporins or penicillin

K-Assoc. w/ septic arthritis and endocarditis

Question 5

Tx for S. viridans

Answer 5

Penicillin AND (if MIC is >.2) AGCs

Question 6

Oroya Fever; Carrion’s Disease

Answer 6

Caused by Bartonella bacilliformis; a small, pleomorphic GNR that produces an acute febrile illness alongside acute anemia

• Causes arthralgia, angina, seizures =» results in humoral immunity
• Spread by SA sandfly
• Chronic stage can produce benign, angioproliferative nodules that can persist for years after infxn
• Tx: Chloramphenicol (possibly fatal w/o)