Gram indeterminate Sketchy Copy Flashcards
Chlamydia Trachomatis, Pneumonia, and Psittaci
lab tests
The pirates of Calam Island
gram indeterminate (does not gram stain)
use Giemsa stain or NAAT test (aka PCR)
obligate intracellular (cannot create its own ATP, like ricketsia)
Lacks muramic acid in the cell wall.
Elementary and Reticulate bodies.
Chlamydia Trachomatis, Pneumonia, and Psittaci
Elementary vs. Reticulate bodies.
The pirates of Calam Island
Elementary bodies:
1st stage of life cycle outside of cell. The infectious form! Elementary enters the eukaryotic cell and is taken up by phagosomes.
Reticulate bodies:
Dividing form! Reticular replicates to form inclusion bodies seen under microscope in cells when infected.
*After bacteria replicate with its host cells, they leave the cell and become elementary stage again
Chlamydia Trachomatis
3 main groups of C. Trachomatis
The pirates of Calam Island
3 main groups of C. Trachomatis
- A-C → Blindness
- D-K → STI
- L1-L3 → Lymphogranuloma venereum
* “Can’t see, Can’t pee, Can’t climb a tree” (Reiter’s syndrome)
Chlamydia Trachomatis
Blindness group of C. Trachomatis
The pirates of Calam Island
C. trachomatis A-C → Blindness
Trachoma is the leading cause of blindness in the world!
Transmission is usually from hand to eye contact, but can also be from fomites (objects like clothes or phones)
* mnemonic “A-_C (see) with your eyes_”
Chlamydia Trachomatis
STI group of C. Trachomatis
The pirates of Calam Island
C. trachomatis D-K → STI
- Most common bacterial STI in the U.S.
- Watery discharge (vs. Gonorrhea with mucoprulent).
- Can lead to PID w/o symptoms or ectopic pregnancies.
- If mother has it during delivery can lead to neonatal conjunctivitis and pneumonia. Presents in 1-2 weeks (vs. Gonorrhea in 2-4 days) as possible staccato cough (short sudden bursts with breath inbetween) or conjunctivitis.
Chlamydia Trachomatis
LGV group of C. Trachomatis
The pirates of Calam Island
C. trachomatis L1-L3 → LGV (Lymphogranuloma Venerum)
(also is an STI)
- Starts with painless genetial ulcer (similar to syphilis)
- Presents as tender lymphadenopathy with draining lymph nodes.
Chlamydia Trachomatis
Reiter’s syndrome
The pirates of Calam Island
Reiter’s syndrome Triad
- Cant see (Conjunctivitis)
- Can’t pee (Urethritis)
- Can’t climb a tree (Arthritis)
* Reactive arthritis due to cross reaction of antibodies fighting chlamydia hitting the knee or sacroiliac joint.
Chlamydia Trachomatis, Pneumonia, and Psittaci
treatment
The pirates of Calam Island
Macrolides - Azithromycin
Tetracycline - Doxycycline
* also tx for Co-infection of Chlamydia and Gonorrhea with cephtriaxone
Chlamydophila Pneumonia
signs and symptoms
The pirates of Calam Island
Walking atypical pneumonia - 1 single lobe
More commoin in the elderly.
Hoarsness and Dry cough
Diagnosis by Complement Fixation and ELISA
Chlamydia Psittaci
signs and symptoms
The pirates of Calam Island
Transmitted by birds and bird droppings: Pstitacosis.
Causes Atypical Pneumonia with Hepatitis
Diagnosis by Complement Fixation and ELISA
Mycoplasma pneumonia
lab tests
Walking on thin ice
gram indeterminate (does not gram stain, no cell walls)
Cholesterol in the membrane (sterols help stabilize cell membrane and allow flexability)
Grown on Eatons agar (“dont eat on ice”; takes >1 week so not often used)
Patchy infiltrates on XRAY (Walking pneumonia, XRAYs appears much worse then pt does clinically)
Test for IgM cold agglutination
Mycoplasma pneumonia
signs and symptoms
Walking on thin ice
Walking pneumonia
Young adults (<30 years old)
Crowded areas (military recuits etc)
IgM molecules that agglutinate red blood cells in cold temperatures → lysis of RBC’s (1-2 weeks into infection)
Mycoplasma pneumonia
treatment
Walking on thin ice
Macrolides - Zpack (azithromycin)
Rickets species (Rickettsia Prowazekii, Rickettsii)
lab tests
Rickettsia tennis
gram indeterminate coccobacillary (gram - but does not gram stain well aka Pleomorphic).
obligate intracellular (cannot produce its own NAD+ and CoA, needed for bacterial growth and replication).
Weil Felix agglutination test for rickettsia infections .
Endothelial hyperplasia due to endothelial colonization.
Rickets species (Rickettsia Prowazekii, Rickettsii)
shared signs and symptoms
Rickettsia tennis
Prodromal headache (varying intensity, often accompanied by sensitivity to light or sound, distorted vision, and flashes of light in vision) and fever in early ricketssia.
Vasculitis (Inflammation and destruction).
Rash
Rickets species (Rickettsia Prowazekii, Rickettsii)
DDX and Treatment
Rickettsia tennis
Direct Immunofluorescence - Determination of Species : Prowazekii/ Rickettsii
Doxycycline
If pregnant Chloramphenicol
Supportive care with vascular collapse
Rickettsia Prowazekii
signs and symptoms
Pro Boot Camp
- “Patchy” rash starts on trunk and moves out towards extremities.
- * Rash spares the hands, feet, and head.
- Myalgia and arthralgia
- Pneumonia
- Encephalitis with dizziness and confusion
- Can cause COMA if really serious
- Unremitting headache
Rickettsia Prowazekii
source
Pro Boot Camp
Spread by lice.
Lice feed on blood, and defecate near feeding sites. The scratching of lice feces is what infects pts.
Close contact allows human to human spread (military recuits and POWS)
R. Prowazekii is called epidemic typhus: widespread outbreak
(vs. R. typhi which is an endemic typhus that is localized)
Rickettsia Rickettsii
signs and symptoms
Rickett’s Rock Climbing Competition** in the **Dermacenter Arena
- Incubation period of 2-14 days for “maculopapular” rash
- Rash starts on ankles and wrists then moves centrally.
- Headache, severe fever, myalgia
Rickettsia Rickettsii
source
Rickett’s Rock Climbing Competition** in the **Dermacenter Arena
“Rocky Mountain Spotted Fever”
Dermacenter Tick transmission through direct bitting.
Coxiella Brunetii
Treatment
Curly Q the Ram
Self Limiting
Doxycyclin
Possible Prevention to Vetrinarians - Acellular Vaccine
Coxiella Brunetii
Diagnosis
Curly Q the Ram
Giemsa Stain
Serology - IF / ELISA
Coxiella Brunetii
Clinical Features
Curly Q the Ram
Headache, Fever, Pneumonia and Hepatitis
Could complicate to endocarditis in Immunocomprimised Patients/Previous heart Problems
NO RASH - ddx from Rickettsia
Coxiella Brunetii
Pathogenesis
Curly Q the Ram
- Transmitted by Inhalation from Animal Feces or Placenta (Delivary in Farm), Also from Unpasteurized Milk
- Survival and Replication slowly in Phagsome of Macrophages and Monocytes by altering the signaling pathways - IL10 from Chronic Inflamation
Coxiella Brunetii
General and Biochemical Features
Curly Q the Ram
Gram Negative Poorly Stains
Pleomorphic Shape
Spore- “Like” Survival in Animal Feces
Obligate Intracellular (in Phagosome)
