Miscellaneous Infections I (36) Flashcards

Dr. Erol

1
Q

What is tularemia? It is listed as a _____

A

a bacterial septicemia that infects many species

category A bioterrosim agent because of the potential for fatality, airborne dissemination, and societal disruption

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2
Q

What is the causative agent of tularemia?

A

francisella tularensis

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3
Q

What are the characteristics of francisella tularensis? It is an [intracellular/extracellular] pathogen

A

gram negative
intracellular - affects macrophages

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4
Q

What are the types of francisella tularensis?

A

f. tulararensis biovar tularensis (type A)

f. tularensis biovar holarctica (type B)

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5
Q

Contrast f. tulararensis biovar tularensis (type A) and f. tularensis biovar holarctica (type B)

A
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6
Q

Which biotype has reservoirs of rabbits, hared, ground squirrels, ticks?

A

f. tulararensis biovar tularensis (type A)

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7
Q

Who are the reservoirs for francisella tularensis?

A

mammals, ticks, and some birds
ticks and rabbits most important
rodent-mosquito cycle in Russia, Sweden

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8
Q

What is the infectious dose for francisella tularensis?

A

a select agent

small for inoculation or inhalation

large for oral

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9
Q

How is tularemia transmitted?

A

ticks - transovarial transmission

mosquito, flies

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10
Q

How is tularemia transmitted? Elaborate

A

direct: contact with tissues of rabbits or other infected mammals
- skinning, necropsy
- handling contaminated skins, paws
- bite wounds

ingestion: undercooked meat, contaminated water

aerosol

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11
Q

Explain tularemia aerosol transmission

A
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12
Q

T/F: Tularemia involves person to person transmission

A

FALSE

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13
Q

What is the pathogenesis of tularemia?

A

infection by arthropod bites, skin abrasions, inhalation or ingestion

enters macrophages

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14
Q

What kind of pathogen is tularemia?

A

a facultative intracellular pathogen
can enter macrophages by pseudopod loops and survive by inhibiting phagosome/lysosome fusion

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15
Q

Francisella pathogenicity island encodes _____

A

type IV secretion system (idk what this means)

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16
Q

What are effects of tularemia?

A

lymphadenitis - local or generalized

septicemia

17
Q

Where is tularemia only found?

A

northern hemisphere only

18
Q

T/F: Tularemia is notifiable

A

TRUE

19
Q

Contrast the sources of tularemia infection

A

endemic areas: ticks, rabbits

western: biting flies, ticks

20
Q

What are the forms of tularemia in humans?

A

uleceroglandular
glandular
oculoglandular
oropharyngeal
typhoidal
pulmonary

“only ugly people get on tinder”

21
Q

All forms of tularemia starts with ______

A

sudden fever
chills
headache
myalgia

22
Q

What is the ulceroglandular form of tularemia?

A

most common
ulcer and regional lymphadenopathy

23
Q

What is the second most common form of tularemia?

A

regional lymphadenopathy, no ulcer

24
Q

What is the oculo-glandular form of tularemia?

A

conjunctiva infected

25
Q

What is the oropharyngeal form of tularemia?

A
26
Q

Describe the typhoidal and pulmonary forms of human tularemia

A
27
Q

How do you diagnose tularemia?

A

culture and isolation - definitive
serology
PCR
immunofluorescent staining

28
Q

How do you treat tularemia? Drug of choice _____

A

antibiotic treatment - streptomycin

29
Q

Type ___ of tularemia has a higher case-fatality rate

A

type A

30
Q

What is tularemia disease in wildlife?

A

usually found dead
behave strangely

31
Q

What is tularemia in sheep?

A

outbreaks in enzootic areas - following severe winter
fever, weight loss, etc

32
Q

What is tularemia in equine, swine, and bovine?

A
33
Q

What is tularemia in cats and dogs?

A
34
Q

Upon necropsy of an animal with tularemia, what does it look like?

A

gray necrotic foci
lymph nodes, spleen, liver

35
Q

Necropsy of a horse liver in North America reveals gray necrotic foci. It experienced fever, depression, ataxia, stiffness, and lymph edema. Its spleen was also enlarged. What is the causative agent and disease?

A

tularemia
f. tularensis (biovar tularensis type A)

36
Q

How do you treat tularemia?

A

remove ticks as soon as possible

streptomycin

37
Q

How do you prevent and control tularemia?

A

laboratory precautions

live attenuated vaccine

38
Q

A 60-year-old woman was admitted to the hospital with a week history of sudden onset of cutaneous lesion on the second finger in her right hand, accompanied by fever, chills, headache and axillary lymphadenopathy. Initial antibiotic therapy with amoxicillin clavulanate was ineffective. The patient history includes recent handling of rabbits. What is the causative agent and disease?

A

tularemia - F. tularensis biovar tularensis (Type A)