HACEK

Question 1

Bartonellosis

Answer 1

Oroya fever, Carrion’s disease

Acute febrile
severe anemia
Chronic cutaneous form

Question 2

End of severe anemia- stage in Bartonellosis ends with

Answer 2

development of humoral immunity

Question 3

Chronic stage (bartonellosis)

Answer 3

Verruga peruana

Angioproliferative

Question 4

Trench fever

Answer 4

5 days

B. quintana

homeless/poor sanitation/AIDS ptn

Question 5

Warthin Starry stain of lymph node - chains and clusters

Answer 5

B. henselae

Question 6

most common clinical human infection with Bartonella

Answer 6

Cat scratch disease (henselae)

Question 7

clinical sx of CSD

Answer 7

papule/pustule (3-10 days)

Regional ipsilateral lymph node enlargement (1-7 wks later)

Chronic regional adenopathy of LN draining site - typical presentation

Question 8

atypical CSD

Answer 8

Parinaud’s oculoglandular syndrome - Granulomatous conjunctivitis with lymphadenitis

Granulomatous hepatitis
Pneumonitis
Neurologic involvement
Encephalopathy, neuroretinitis
FUO

Question 9

Culture negative endocarditis

Answer 9

B quinta and hensalae

Question 10

Bacillary Angiomatosis

Answer 10

vascular proliferative form of infection due to Bartonella organisms (quintana and henselae)

organ transplant or who are immuno-competant
HIV ptn

Question 11

Bacillary angiomatosis affects

Answer 11

mucosal areas, bone, abdominal/GI

Question 12

hyperpigmented hyperkeratotic plaques, often overlying osseous defects

Answer 12

Bacillary Angiomatosis

Question 13

best way to diagnose B. hensalae, quintana

Answer 13

Serologic testing

- IgG, IgM

Question 14

Bartonella

tx

Answer 14

Choramphenicol

Question 15

typical CSD

tx

Answer 15

Azithromycin

Question 16

Bacillary angiomatosis

tx

Answer 16

Erythro/Azithro

Doxy

Question 17

HACEK organism

Answer 17

endocarditis

Question 18

H. flu and A. … grows on

Answer 18

blood and chocolate agar

POORLY on MacConkey’s

Question 19

H. flu and A. …

tx

Answer 19

3rd gen Cephalosporins

Question 20

found in respiratory tract of healthy humans

Answer 20

Cardiobacterium hominis

Question 21

enters blood through oropharyngx

Answer 21

C. hominis

Predisposing factors: heart disease, dental procedures/oral disease

Question 22

C. hominis

tx

Answer 22

PCN

Ceftriaxone daily iv or [Ampicillin with Genta 4 wks]

Question 23

Eats away (“corrodes”) the agar of a Petri dish

Answer 23

Eikenella corrodens

Question 24

Associated with human bite wounds

Fist-fight injury

Answer 24

Eikenella corrodens

Question 25

Associated with “sterile”/aseptic arthritis in children (it is really septic)

Answer 25

Kingella kingae

Question 26

Abscesses in brain, oropharynx, peritoneal cavity

Answer 26

Viridans Streptococcus

Angiosus

Question 27

Subacute bacterial endocariditis, neutropenic sepsis, pneumonia, meningitis

Answer 27

Viridans Streptococcus

Mitis

Question 28

Dental caries, endocarditis

Answer 28

Viridans Streptococcus

Mutans

Question 29

Bacteremia, endocarditis

Answer 29

Viridans Streptococcus

Question 30

Colon cancer (gallolyticus); meningitis (pasteurianus)

Answer 30

Viridans Streptococcus

Bovis

Question 31

Meningitis, bacteremia, streptococcal toxic shock syndrome

Answer 31

Viridans Streptococcus

S. suis

Question 32

Endocarditis, pancreatic abscess, otitis media, postpartum and postabortal sepsis

Answer 32

Viridans Streptococcus

Abiotrophia species

Question 33

Viridans Streptococcus

tx

Answer 33

PCN then add Aminoglycoside as needed based on MIC