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Derm Rheum > Micro of Zoonotic Skin Infections - Miller > Flashcards

Micro of Zoonotic Skin Infections - Miller Flashcards

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Dermatology Board Prep flashcards
1
Q

Common symptoms of all zoonotic bacterial infections?

A

Flu like symptoms (myalgias, fever, malaise)

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2
Q

Morphology/gram stain of Rickettsia, Ehrlichia, and Coxiella? Do they gram stain well?

A

Short gram negative rods; all obligate intracellular parasites that express LPS. Do not gram stain well

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3
Q

Common pathogenesis of all Rickettsial microbes?

A

Vasculitis of the endothelial layer, causes a cutaneous rash. LPS mediates the fever/petichae

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4
Q

What organism causes RMSF?

A

Rickettsia Rickettsii

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5
Q

Vector that commonly transmits RMSF?

A

Dog ticks

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6
Q

What seasons and where are you most likely to get RMSF?

A

Spring and summer months; Georgia, North Carolina, and Virginia are the most common

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7
Q

Presentation of RMSF?

A

Typical flu like symptoms; muscle soreness in the CALVES; rash that STARTS AT THE ANKLES/WRISTS and proceeds proximally (this is pathognomonic); palms and soles are commonly involved (also specific for RMSF)

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8
Q

Severe complications of RMSF if untreated?

A

CNS change leading to delirium and coma; DIC with circulatory collapse

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9
Q

What test do you use to diagnose RMSF?

A

Weil-Felix Test

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10
Q

How does the Weil-Felix test work?

A

Uses antigens derived from Proteus; for some reason Rickettsial specific antibodies cross react with the antigens

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11
Q

What organism causes Epidemic Typhus?

A

Rickettsia Prowazekii (epidemic and Prowazekii both have “P’s”)

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12
Q

Presentation of epidemic typhus?

A

flu-like symptoms for 1-3 weeks; rash that spreads from the TRUNK–>distally to extremities (KNOW THIS); palms and soles are not involved with rash (KNOW THIS TOO)

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13
Q

Criteria for diagnosis of epidemic typhus?

A

When antibodies specific to Rickettsia Prowazekii increase 4x between acute-phase and convalescent serum

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14
Q

What causes Endemic typhus?

A

Rickettsia typhi

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15
Q

What vector transmits endemic typhus?

A

Fleas

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16
Q

Presentation of endemic typhus?

A

Significantly less severe disease that epidemic typhus

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17
Q

What 2 bugs cause Southern tick-borne disease?

A

Ehrlichia chaffeensis and Anaplasma phagocytophilia

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18
Q

What tick transmits anaplasmosis?

A

Ixodes ticks

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19
Q

What tick transmits ehrlichiosis?

A

Lone star deer tick (fucking Texas)

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20
Q

What is the specific name for the disease caused by Ehrlichiosis chaffeensis?

A

Human monocytic ehrlichiosis

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21
Q

Where specifically in the body does ehrlichiosis infect/replicate?

A

Monocytes; they’re obligate intracellular parasites

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22
Q

Diagnosis of ehrlichiosis?

A

Blood smear looking for morulae in circulating monoctyes

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23
Q

Unique symptoms to Ehrilichiosis?

A

N/V/D, cough, and CONJUNCTIVITIS

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24
Q

What disease does anaplasma phagocytophilia cause?

A

Human granulocytic anaplasmosis; “Rocky Mountain Spotless Fever”

25
Q

Why is human ganulocytic anaplasmosis referred to as Rocky Mountain Spotless Fever?

A

Because rash is uncommon

26
Q

What does it indicate if there is a rash present in Rocky Mountain Spotless Fever?

A

Most likely coinfection with Borrelia Burgdorferi

27
Q

Diagnosis of Anaplasma phagocytophilia

A

Blood smear looking for mourlae in NEUTROPHILS

28
Q

Severe complications seen in Anaplasma phagocytophilia?

A

Renal failure and hemorrhage, respiratory compromise, CNS issues

29
Q

Morphology of Coxiella Burnetti?

A

Gram-negative bacillus; obligate intracellular parasite

30
Q

Primary carriers of Coxiella burnetti?

A

Sheep, Cattle, Goats

31
Q

2 common ways Q- fever (coxiella burnetti) is contracted?

A

Ingestion of contaminated dairy products; contact with contamintated animal viscera (usually birthing of livestock)–> veternarians and farmers at risk

32
Q

ID50 of Coxiella?

A

Less than 50; one of the most infectious human pathogens

33
Q

Typical coure of Q-fever? What about more severe disease?

A

cutaneous disease with acute febrile illness with atypical PNA lasting 2-4 weeks; most serious disease causes endocarditis and granulomatous hepatitis

34
Q

Describe spirochetes

A

Very flexible, highly motile; have a unique cork-screw-like appearance

35
Q

What 2 species of spirochetes are we concerned with?

A

Borrelia and Leptospira interrogans

36
Q

What disase does borrelia burgdoferi cause?

A

Lyme Disease

37
Q

Vector for lyme disease (borrelia)

A

Ixodes tick

38
Q

Where and when would you get Lyme disease?

A

Summer months; Northeastern states and Wisconsin

39
Q

Diagnosis of borrelia?

A

Stain with Giesma or silver stain

40
Q

Why is it important that the nymphal stage tick more commonly causes Lyme disease?

A

They’re tiny so people don’t notice them until they’ve been munching on them for a while

41
Q

Generalized pathogenesis of Borrelia?

A

Bugs disseminate from the orignal vector bite through surrounding skin and into bloodstream; ensuing bacteremia allows dissemination to heart, the joints, CNS

42
Q

Describe the 3 stages of disase in Lyme disease

A

Stage 1) Erythema chronicum migrans (charactersitic bullseye rash)

Stage 2) Cardiac and neurologic symptoms; Myocarditis with heart block; BILAT FACIAL NERVE PALSY (pathognomonic

Stage 3) development of arthritis in large joints like the knees and shoudlers

43
Q

Picture of erythema chronicum migrans

A
44
Q

Diagnosis of borrelia burgdorferi

A

Serology using ELISAs to measure IgM/IgG specific for Borrelia; confirm with a Western Blot for any + ELISA

45
Q

What 2 species cause relapsing fever? What is their vector and where are they found?

A

Borrelia hermsii and Borrelia recurrentis; small rodents and endemic in the Western US

46
Q

Clinical presentation of relapsing fever?

A

Fever that lasts for weeks, resolves, and reccurs with this continuing over 10 times

47
Q

What do leptospira interrogans look like?

A

Tightly coiled spirochetes

48
Q

What is the primary resovoir in the US for leptospira?

A

Dogs

49
Q

Other common way to contract leptospira besides canine contact?

A

Consumption of contaminated water or swimming in contaminated water

50
Q

Early symptoms of Leptospirosis?

A

Flu-like symptoms with conjuncitivits

51
Q

Severe disease symptoms seen in Leptospirosis?

A

Liver damage (jaundice), Kidney dysfunction (uremia), Lung hemorrhage, Aspetic meningitis

52
Q

What causes cat scratch disease?

A

Bartonella Heneslae

53
Q

Where is bartonella found in the cat?

A

Normal oral flora

54
Q

What 2 ways can you get catch scratch disease from a cat?

A

Scratches or bites; NOT from fecal matter

55
Q

Clinical presentation of cat scratch disease?

A

Fever, tender/enlarged lymph nodes on the same side as the bite. Papule may occur at the bite site. Relatively benign disease

56
Q

Cat scratch disease in AIDS pts?

A

Bacillary angiomas may form on the skin and visceral organs

57
Q

Diagnosis of bartonella heneslae?

A

Warthin-Starry stain

58
Q

What disease must you r/o in a patient with bacillary angiomomatosis?

A

Kaposi Sarcoma (most common malignancy in AIDS pt)

Derm Rheum (39 decks)

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