Other Zoonotic or Vector-born Bacterial Diseases

Question 1

Francisella tularensis: Gram +/-? shape? where does it grow? what is the vector?

Answer 1

A small gram negative coccobacilli. Facultative intracellular in macrophages.

Vector: hard tick, arthropods, or rabbit.

Question 2

What are the four types of infections tularemia can cause?

Answer 2

1. Ulceroglandular: primary infection of skin
2. Oculoglandular: contaminated eye
3. Pneumonic: aerosol transmission (30% fatality rate)
4. Typhoidal: ingestion of organism: systems similar to typhoid fever

Question 3

How do you diagnose tularemia? Lab results to look for?

Answer 3

• 4x fold rise in serology
• culture (alert lab!)
• grow on BCYE or chocolate agar
• confirm with slid agglutination test

Question 4

Which states are most suspicious for Tularemia?

Answer 4

Arkansas, Missouri, Kansas, Oklahoma (highest number case of rabbit hunting)

Question 5

What is Brucellae sp: where does it live when it infects us, where do we usually get it from?

Answer 5

• in humans, it is a facultative intracellular parasite of the RES
• Shed in milk: get it in unpasteurized milk or direct contact with animals. Results in UNDULANT FEVER - usual fever/chills/ns, but NO enlargement of RES

NO VECTOR

Question 6

What does Bartonella quintana cause? How is it transmitted?

Answer 6

Classic Trench Fever - by body louse (in immunocompetent pt)

Can cause Bacillary angiomatosis or endocarditis in immunocompromised.

Question 7

What does Bartonella bacilliformis cause? Where is this usually seen?

Answer 7

Carrions disease of the Andes
first Oroya fever (hemolytic anemia)
then Verruga peruana

Question 8

What does Bartonella henselae cause?

Answer 8

Immunocompetent: cat scratch disease: inflammation.

Immunocompromised: bacillary angiomatosis and endothelial colonization

Question 9

Rickettsia: Gram stain? extracellular/intracellular? shape? stain? Unique feature?

Answer 9

Obligate intracellular Gram 0 coccobacilli.

Stain with Giemsa stain

utilizes actin polymerization

Question 10

What is the general disease caused by Ricketsia?

Answer 10

VASCULITIS: due to proliferation of the organism in the ENDOTHELIAL lining in small arteries, veins, capillaries. Results in skin rash, fever, severe headache, malaise, prostration, and enlargement of spleen/liver.

Question 11

What does Rickettsia rickettsii cause? What is the vector?

Answer 11

Rocky Mountain Spotted Fever

Tick borne: dog tick Rhipicephalus sanguineus

Question 12

What does Rickettsia a kara cause? What is the vector?

Answer 12

Rickettsial pox: Mite borne. Causes pox like chicken pox, with an eschar at the bite.

Question 13

What does Rickettsia prowazekii cause? What is the vector? when do you usually see these cases?

Answer 13

Epidemic typhus. Lice born - see them during war times

Question 14

What does orientia tsutsugamsushi cause? What is the vector?

Answer 14

Scrub typhus. Chigger/red mites borne.

Question 15

What does Rickettsia typhi cause? What is the vector?

Answer 15

endemic or murine typhus. Flea borne rodent vector

Question 16

Ehrlichia and anaplasma: where do they live?

Answer 16

obligate intracellular bacteria that survive in the cytoplasm vacuoles of hematopoetic cells.

Question 17

Anaplamsa phagocytophilum: what does it infect? How is it transmitted?

Answer 17

infects granulocytes (neutrophils). Transmitted by the Ixodes scapulars - can also be co-transmitted with Lyme disease Borrellia burgdorferi

Question 18

Coxiella Burnetii: what disease does it cause? How is it usually transmitted?

Answer 18

Q fever - atypical pneumonia. Through contact with cattle, goats, sheep, ticks.

Question 19

A 65 year old man is undergoing chemotherapy for Hodgkin’s lymphoma. Vaccination against which one of the following viruses is CONTRAINDICATED for use in his immediate household contacts?

a. Hep A virus
b. Hep B virus
c. HPV
d. Rabies virus
e. Varicella zoster virus

Answer 19

varicella zoster virus

Question 20

Lassa Fever - how is it transmitted?

What type of virus is it? RNA/DNA. ss, +/-

Answer 20

Through multimammate rate (mastomys) urine and feces

causes hemorrhagic fevers with non-specific symptoms and conjunctivitis

This is an arena virus (Sandy appearing), contains 2 strands of AMBISENSE RNA: +/-, S and L.

Question 21

Hantavirus what type of virus is it? RNA/DNA, how many parts? What can it cause? What about in mexico?

Answer 21

enveloped ssRNA virus
3 negative sense RNA segments L, M, S.

transmitted through rodent urine and feces
Causes hemorrhagic fevers

Can also cause Hemorrhagic fever with renal symptoms (HFRS) and Hantavirus pulmonary syndrome (HPS) - sin hombre hanta virus.

Question 22

Which one of the arbovirus is the ONLY one that is dsDNA and is not enveloped? (all other arboviruses are enveloped ssRNA)

Answer 22

Reoviridae

Question 23

A 24 year old man presents to your northeastern New Mexico clinic with unexplained fever, myalgia, and what appears to be acute respiratory distress syndrome (ARDS). He informs you that he spent the prior Saturday cleaning out his garden shed. The patient has not traveled outside the area for the past 3 months. The viral agent MOST LIKELY causing the infection is a

a. arenavirus
b. bunyavirus
c. coronavirus
d. filovirus
e. flavivirus

Answer 23

bunyavirus

Question 24

An obstetrician examines a pregnant patient who was exposed to rubella virus in the 16th week of pregnancy. The patient does not remember getting a rubella vaccination. The BEST course of action is to IMMEDIATELY

a. administer rubella immune globulin
b. administer rubella vaccine
c. order a rubella antibody titer to determine immune status
d. reassure her that rubella is not a problem until after the 30th week
e. suggest termination of the pregnancy

Answer 24

c. order a rubella antibody titer to determine immune status