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Pulm > Micro - Zoonoses (Yersinia pestis, Brucella, Coxiella burnetti) > Flashcards

Micro - Zoonoses (Yersinia pestis, Brucella, Coxiella burnetti) Flashcards

1
Q

How does Yersinia pestis look on gram stain?

A

Safety pin appearance; G- bacilli

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2
Q

Two forms of plague:

A
  1. Bubonic (lymph nodes)

2. Pneumonia (primary and secondary)

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3
Q

Only zoonose that can be transmitted human-to-human?

A

Primary plague pneumonia (inhalation)

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4
Q

How is bubonic plague transmitted?

A

Flea (that bites rodent = reservoir)

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5
Q

How is secondary plague transmitted?

A

Bubonic plague becomes septic, leading to pneumonia

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6
Q

How can you distinguish if pt has primary or secondary plague pneumonia?

A 
If septic (+ hx of flea bite) = secondary
If not septic (- hx of flea bite) = primary
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7
Q

What should you absolutely not treat plague with? Why?

A

B-lactam or macrolide - YP is resistant to these

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8
Q

What do you treat plague with?

A

Gentamicin + doxy

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9
Q

If someone has plague, what two things must be done?

A
  1. Isolate pt

2. Give doxy for 7 days to anyone exposed

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10
Q

Region affected by plague

A

New Mexico, SW US

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11
Q

Sx of bubonic plague

A

Swollen, painful lymph nodes especially in inguinal area (buboes = groin); ulcer at infection site; vomiting

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12
Q

How do you distinguish bubonic plague from tularemia?

A

Tularemia will have more prominent ulcer at infection site (so would anthrax)

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13
Q

Sx of septic plague

A

Rapid progression, petechiae, extreme DIC, vomiting and diarrhea, multiorgan system failure

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14
Q

Sx of pneumonic plague

A

WATERY/BLOODY SPUTUM (not really purulent)
Fever
Rapid progression

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15
Q

Virulence factors of Yersinia pestis

A
  1. Type three secretions (like Chlamydia) - paralyze phagocytes
  2. Fraction 1 (F1) - capsule antigen
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16
Q

How to dx Yersinia pestis

A
  1. Culture
  2. Rapid antigen test for F1
  3. RADT - urine dipstick for YP
  4. Gram stain - chubby safety pins
17
Q

Basis for serological testing of Yersinia pestis?

A

Abs to F1 antigen

18
Q

What media does YP grow on and why?

A

BAP and enteric media - it’s an enterobacteriacae

19
Q

How is primary plague transmitted?

A

Humans
Cats
Bioterrorism

20
Q

Plague doesn’t respond to:

A

B-lactams or macrolides!!

21
Q

Which form of plague is contagious?

A

Primary plague pneumonia

only zoonose transmitted by humans!!

22
Q

Reservoir for Brucella

A

Pigs, cows, goats, sheep

23
Q

How is Brucella transmitted?

A

Direct contact with infected animal or through UNPASTEURIZED CHEESE

24
Q

Virulence factors of Brucella

A

Obligate intracellular parasite of RES (bone marrow, liver, spleen); spreads via lymphatics

25
Q

Brucella is (G+, G-) (aerobic, anaerobic) (shape)

A

G- aerobic coccobacillus

26
Q

Which presentation should make you think of Brucella infection?

A

Chronic, remitting fever with night sweats in immigrant from Mexico or Mediterranean (bad milk there) or farm/vet/slaughterhouse worker

27
Q

Sx of Brucella

A
  1. Undulant fever = chronic, remitting fever with night sweats
  2. Long-term sequelae of endocarditis and hepatitis
  3. Localized infx in lower vertebra, liver, heart
  4. Can have an acute presentation with high fever and flu-like sx
28
Q

Characteristic lesion of Brucella

A

Granulomas in liver, bone

29
Q

Brucella often confused with:

A

TB

30
Q

Tx of Brucella

A

Long-term Abx

Control via pasteurization, vaccination of cattle, destruction of infected herds

31
Q

Coxiella burnetti is (G+, G-) (shape)

A

G- bacillus

32
Q

Virulence factors of Coxiella

A 
Obligate intracellular parasite
Replicates is phagolysosome
Endospore form (distributes several miles in wind)
33
Q

Sx of Q fever

A

Acute febrile illness

Atypical pneumonia when in spore form

34
Q

Long-term sequelae of Q fever

A

Granulomatous hepatitis, endocarditis

35
Q

Presentation of Q fever

A

Acute fever in someone who handles animal viscera, drank raw milk, tick bite

36
Q

Tx of Q fever

A

Mostly spontaneously resolves

Can give doxy

Pulm (33 decks)

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