Micro - Tularemia Flashcards
The type of disease caused by Francisella tularensis depends upon:
Site of infection
6 types of tularemia
- Ulceroglandular
- Glandular
- Oculoglandular
- Oropharyngeal
- Pneumonic
- Typhoidal
Ways Francisella tularensis can spread
- Inhalation (pneumonic)
- Insect bites/Skin wounds (ulceroglandular)
- Contaminated food/water (oropharyngeal)
- Rubbing eyes after contact with infected animal (oculoglandular)
- Contact with infected animal
Francisella tularensis is (G+,G-), (aerobic, anaerobic) (shape)
G- aerobic coccobacillus
Common vectors of tularemia
Rabbits, ticks, deer flies, rodents, arthropods
Is tularemia spread human-to-human?
NO!
Common sx of tularemia
Fever Chills HA Exhaustion Weakness Joint/muscle pain
Incubation period for tularemia
Can be hours to weeks
Sx of pneumonic tularemia
CP, cough, dyspnea, sometimes bloody sputum but usually nonproductive
Like anthrax, tularemia is a:
Category A biodefense agent
3 virulence factors of Francisella tularensis
- Capsule = inhibits complement
- LPS is less immunogenic (remember: G-)
- iglABCD transposon is highly mutagenic and improves survival in macrophages
Most common form of tularemia
Ulceroglandular
Sx ulceroglandular tularemia
Ulcer at site of infection Swollen glands Fever Chills HA Exhaustion
Sx of glandular tularemia
Ulceroglandular minus the ulcers..... Swollen glands Fever Chills Exhaustion HA
Sx oculoglandular tularemia
Eye redness, drainage, pain, swelling
Ulcer on inside of eyelid!!
Sx oropharyngeal tularemia
Diarrhea
Vomiting
Sore throat
Fever
Sx of pneumonic tularemia
CP
Dyspnea
Cough
Dry, unproductive cough (sometimes bloody)
Who is susceptible to pneumonic tularemia?
Elderly
Pt with typhoidal tularemia
Sx of typhoidal tularemia
Diarrhea Vomiting Pneumonia High fever Extreme exhaustion Enlarged liver and spleen
Where does tularemia live?
Water and soil (can survive in soil for weeks)
Besides a bioterrorist act, how might someone get pneumonic tularemia?
Disturbing soil can cause it to become airborne; spread to lungs from another site of infection
What can kill tularemia?
Heat and streptomycin + tetracycline
4 ways to diagnose tularemia:
- Culture (G- aerobic coccobacilli)
- Serology (host is immune)
- PCR from ulcer sample (F. tularensis DNA)
- CXR (patchy infiltrates)
How would you know tularemia came from natural source vs. bioterrorism?
If bioterrorism, could be in urban setting, healthy patients with acute severe RTI, no difference in susceptibility
Tularemia may mess up the results of what two tests?
- Febrile agglutinins
2. Infectious mononucleosis
Plague v. anthrax v. tularemia: sputum
Plague = watery/bloody
Anthrax + tularemia = dry, non-productive
Plague v. anthrax v. tularemia: CXR
Plague = acute bacterial pneumonia Tularemia = patchy infiltrates Anthrax = widened mediastinum
