Micro - Tularemia

Question 1

The type of disease caused by Francisella tularensis depends upon:

Answer 1

Site of infection

Question 2

6 types of tularemia

Answer 2

1. Ulceroglandular
2. Glandular
3. Oculoglandular
4. Oropharyngeal
5. Pneumonic
6. Typhoidal

Question 3

Ways Francisella tularensis can spread

Answer 3

1. Inhalation (pneumonic)
2. Insect bites/Skin wounds (ulceroglandular)
3. Contaminated food/water (oropharyngeal)
4. Rubbing eyes after contact with infected animal (oculoglandular)
5. Contact with infected animal

Question 4

Francisella tularensis is (G+,G-), (aerobic, anaerobic) (shape)

Answer 4

G- aerobic coccobacillus

Question 5

Common vectors of tularemia

Answer 5

Rabbits, ticks, deer flies, rodents, arthropods

Question 6

Is tularemia spread human-to-human?

Answer 6

NO!

Question 7

Common sx of tularemia

Answer 7

Fever
Chills
HA
Exhaustion
Weakness
Joint/muscle pain

Question 8

Incubation period for tularemia

Answer 8

Can be hours to weeks

Question 9

Sx of pneumonic tularemia

Answer 9

CP, cough, dyspnea, sometimes bloody sputum but usually nonproductive

Question 10

Like anthrax, tularemia is a:

Answer 10

Category A biodefense agent

Question 11

3 virulence factors of Francisella tularensis

Answer 11

1. Capsule = inhibits complement
2. LPS is less immunogenic (remember: G-)
3. iglABCD transposon is highly mutagenic and improves survival in macrophages

Question 12

Most common form of tularemia

Answer 12

Ulceroglandular

Question 13

Sx ulceroglandular tularemia

Answer 13

Ulcer at site of infection
Swollen glands
Fever
Chills
HA
Exhaustion

Question 14

Sx of glandular tularemia

Answer 14

Ulceroglandular minus the ulcers.....
Swollen glands
Fever
Chills
Exhaustion
HA

Question 15

Sx oculoglandular tularemia

Answer 15

Eye redness, drainage, pain, swelling

Ulcer on inside of eyelid!!

Question 16

Sx oropharyngeal tularemia

Answer 16

Diarrhea
Vomiting
Sore throat
Fever

Question 17

Sx of pneumonic tularemia

Answer 17

CP
Dyspnea
Cough
Dry, unproductive cough (sometimes bloody)

Question 18

Who is susceptible to pneumonic tularemia?

Answer 18

Elderly

Pt with typhoidal tularemia

Question 19

Sx of typhoidal tularemia

Answer 19

Diarrhea
Vomiting
Pneumonia
High fever
Extreme exhaustion
Enlarged liver and spleen

Question 20

Where does tularemia live?

Answer 20

Water and soil (can survive in soil for weeks)

Question 21

Besides a bioterrorist act, how might someone get pneumonic tularemia?

Answer 21

Disturbing soil can cause it to become airborne; spread to lungs from another site of infection

Question 22

What can kill tularemia?

Answer 22

Heat and streptomycin + tetracycline

Question 23

4 ways to diagnose tularemia:

Answer 23

1. Culture (G- aerobic coccobacilli)
2. Serology (host is immune)
3. PCR from ulcer sample (F. tularensis DNA)
4. CXR (patchy infiltrates)

Question 24

How would you know tularemia came from natural source vs. bioterrorism?

Answer 24

If bioterrorism, could be in urban setting, healthy patients with acute severe RTI, no difference in susceptibility

Question 25

Tularemia may mess up the results of what two tests?

Answer 25

1. Febrile agglutinins

2. Infectious mononucleosis

Question 26

Plague v. anthrax v. tularemia: sputum

Answer 26

Plague = watery/bloody

Anthrax + tularemia = dry, non-productive

Question 27

Plague v. anthrax v. tularemia: CXR

Answer 27

Plague = acute bacterial pneumonia
Tularemia = patchy infiltrates
Anthrax = widened mediastinum