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MICI Module 3 > Parasites, Mycology, Vector Borne, Public Health Infections > Flashcards

Parasites, Mycology, Vector Borne, Public Health Infections Flashcards

1
Q

What are characteristics of a vector borne illness

A

Transmission by live agents
Potential for rare transmission by other routes
Areas of endemicity restricted by vector
Control of vector may allow control of disease

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2
Q

What are some vector borne illnesses of concern in Nova Scotia

A

Lyme
Anaplasma found not diagnosed
Babesia found but not diagnosed

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3
Q

Describe ixodes scapularis

A

Vector often referred to as the black legged tick
Found in southern maritimes and southern Canada
Requires blood meal at each stage of maturation in females meaning females do most of the biting

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4
Q

Describe Lyme disease

A

First described in Lyme Connecticut
Caused by Borrelia Burgdorferi A GRAM NEGATIVE SPIROCHETE
transmitted by ixodes ticks

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5
Q

Describe the tick involvement in Lyme

A

Antigenic changes occur when a tick bites a host, 24-36 hours of attachment needed for transmission
Nymphs and adults are stages of tick involved in transmission

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6
Q

How does Lyme clinically present itself

A

Early localized disease (3-30 days post bite) = bullseye rash (erythema migrans) , flu like illness

Early disseminated disease = EM lesions, neurological or cardiac disease

Late disease = arthritis esp knee some neurological symptoms maybe

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7
Q

How is Lyme diagnosed

A

Early localized disease diagnosed clinically

Serology positive after a few weeks (IgM/IgG)

2 sub sequential rapid tests used more now but used to use enzyme immuno assay/western blot

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8
Q

How is Lyme treated

A

Prophylaxis (doxycycline)

Early disease: amoxicillin, doxycycline or cefuromine given for 3 weeks

Neurological disease (not palsy) = cefrtriaxone, penicillin or doxycycline for 28 days

Late Lyme may persist post treatment

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9
Q

Describe Babesiosis

A

An apicomplexa parasite related to malaria
Transmitted by ticks
Mice act as reservoir
24-36 hours of attachment for transmission
Lives in red blood cells within humans

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10
Q

What does Babesiosis do

A

Causes anemia, fever and hemolysis

More severe disease can occur if no spleen, old, v young or immunosuppressed

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11
Q

How is babesiosis diagnosed

A

Blood smear most common
Detection of parasite DNA by PCR if seen in blood (sensitive)
Serology for screening blood

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12
Q

How is Babesiosis treated

A

Antimicrobials are very effective

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13
Q

Describe anaplasma

A 
Grows inside phagocytes 
Transmitted by ixodes ticks 
GRAM NEGATIVE OBLIGATE INTRACELLULAR bacteria 
Occurs summer/early fall
Incidence of disease increases by age
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14
Q

Where does anaplasma infect

A

Granulocytes (pus cells) and grows in their cytoplasm

Must grow inside cells as it is unable to survive outside of cells due to being unable to produce peptidoglycan

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15
Q

What are symptoms of anaplasma

A

Fever, headache, muscle aches, malaise, cough, abdominal pain

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16
Q

How is anaplasma detected

A

NAAT for early illness although early illness rare
Inclusions in granulocytes

Serology mainly !

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17
Q

How is Anaplasma treated

A

Doxycycline for all ages and tick avoidance

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18
Q

Describe Q fever

A

Coxiella burnetii
SMALL GRAM NEGATIVE RODS INTRACELLULAR PATHOGENS

Large actively growing form and small dormant form

Pathogen of goats, sheep, cattle and cats

Transmitted by aerosols and rarely ticks

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19
Q

How does Q fever present

A 
Flu like with fever (common)
Pneumonia (common)
Hepatitis 
Chronic infection (endocarditis usually)
Pregnancy complications
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20
Q

How is Q fever diagnosed

A

Serology

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21
Q

How is Q fever treated?

A

Doxycycline and trimethoprim sulfamethoxazole

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22
Q

Who described Rocky Mountain spotted fever

A

Dr Howard Taylor Ricketts described the agent

Initially referred to as black measles

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23
Q

Describe Rocky Mountain spotted fever

A

Rickettsia rickettsii tiny gram negative intracellular bacteria

Infection in ticks- act as reservoir and vector (dog tick)
Infection transmitted between ticks by trans ovarian route (from birth) and sexually

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24
Q

How does Rocky Mountain Spotted Fever present

A

Flu like illness, headache, myalgia
Abdominal/joint pain, diarrhea, cutaneous gangrene

Rash 3-5 days post fever becoming raised and papular does not spare palms and soles

May be fatal is G6PD deficiency

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25
Q

How is Rocky Mountain spotted fever diagnosed

A

Low platelets, low sodium, liver enzymes increased, WBC normal

Diagnosis slow

Serological diagnosis using IFA

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26
Q

Describe tularaemia

A

Francisella Tularensis small GRAM NEGATIVe COCCOBACILLUS

Infection of wild hare/rabbit/rodents
Transmitted by ticks and biting flies
May also be acquired from handling dead carcasses or inhaling dust

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27
Q

How does Tularemia present

A

Papule at site of inoculation forms tender ulcer and scab
Painful lymphadenopathy, fever, headache, cough
Lasts several weeks
May progress to sepsis, pneumonia or meningitis

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28
Q

How is Tularemia diagnosed

A

Culture from blood or discharge

Immunofluoresce, PCR or serology after recovery

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29
Q

How is Tularemia treated

A

Streptomycin and doxycycline

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30
Q

What makes an infection of public health significance

A

Potential to rapidly spread
Associated with mortality and morbidity
Panic and concern
Can be controlled by strict guidelines

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31
Q

Describe West Nile Virus

A

Caused by member of the flavivirus genus (enveloped positive sense single stranded RNA virus); and arbovirus
Birds are natural hosts, transmitted by mosquitoes

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32
Q

How does West Nile virus present ?

A

Fever, aches, pains, malaise, 50% have a rash
Most severe progress to meningitis, encephalitis, paralysis or other neurological conditions
Can be passed vertically

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33
Q

How is West Nile virus detected

A

Diagnosis usually by serology either IgM or rising IgG titres

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34
Q

Describe encephalitis

A

Inflammation of brain tissue
Fever, headache, vomiting, confusion, coma or death
Arboviruses such as WNV can cause encephalitis
Diagnosed by serology

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35
Q

Describe Dengue

A

Member of flavivirus genus which is a positive sense single stranded RNA virus
Widely endemic in the tropic

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36
Q

What happens when reinfection of new Serotype of Dengue fever occurs

A

Reinfection with a new sero type may cause severe dengue hemorrhagic fever

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37
Q

How does Dengue present?

A

Usually minimal symptoms

2-7 days of high fever, myalgia, arthralgia (break bone fever), macular-papular rash

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38
Q

Describe dengue hemorrhagic fever

A

After initial phase of fever patient develops plasma leak and bleeding lasts about 1-2 days but very life threatening

Followed by convalescent phase and recovery may develop rash

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39
Q

How is dengue treated

A

Supportive treatment, fluid replacement and IV fluid volume support for hemorrhagic fever

Prevention most important

Vaccine available IF previously infected

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40
Q

Describe yellow fever

A

Flavivirus transmitted by aedes asgypti (mosquitos)
Usually in tropics, Africa and South America
Primarily monkey-mosquito with human spread

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41
Q

How does yellow fever present

A

3-6 day incubation
Fever, flu like illness with vomiting then recover
1/7 develop jaundice bleeding and shock (high risk of death)

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42
Q

How is yellow fever diagnosed

A

Serology most useful but can cross react with other flaviviruses

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43
Q

How is yellow fever treated

A

Supportive but avoid aspirin as it thins the blood

Prevention most important vaccine available

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44
Q

Describe Zika Virus

A

Flavivirus
RNA virus arbovirus group
Found in many popular winter destinations

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45
Q

How does Zika present

A

Relatively mild: fever, rash, conjunctivitis and muscle pain
Major risk is birth defects especially microcephaly or guillian barre syndrome

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46
Q

How is Zika transmitted

A

Mosquitoes but also sexual contact for 6 months after acute infection

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47
Q

How is Zika diagnosed

A

NAAT for first 14 days in serum or urine

Serology after 14 days

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48
Q

How is Zika treated

A

No treatment or vaccine mosquito avoidance and condoms best route

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49
Q

Describe the plague

A

Yersinia Pestis a member of enterobacteriaceae
Spread by fleas, natural hosts are rodents esp rats
High death rate

50
Q

What are the two types of the plague

A

Bubonic (flea transmitted)

Pneumonic (person to person transmitted)

51
Q

Describe bubonic plague symptoms

A

Painful enlarged lymph nodes (buboes) with headache, malaise, flu like illness progresses to sepsis and disseminated intravascular coagulation and death

52
Q

Describe pneumonic plague

A

Results in very aggressive pneumonia that progresses to sepsis and death

53
Q

How is plague diagnosed

A

Culture of blood, discharge of bubo, sputum

54
Q

How is the plague treated

A

Streptomycin or doxycycline

55
Q

Describe Ebola

A

Filoviruses cause life threatening Hemorrhagic fever

High mortality

56
Q

How is Ebola diagnosed

A

Detection of viral nucleic acid

57
Q

How is Ebola treated

A

Supportive

Canadian made vaccine also seems effective

58
Q

How does Ebola present

A

Headache, lack of energy, fever, sore throat, muscle ache: progresses to vomiting blood and diarrhea then bleeding from all orifices and internal bleeding

59
Q

Describe rabies

A

Caused by lyssa virus a negative single stranded RNA virus (looks like a bullet)
Transmitted from bite or scratch containing saliva from infected animal
1-2 month incubation period unless face affected

60
Q

What are symptoms of rabies

A

Pain at injury site, headache, Malaise, seizures, hallucinations, disorientation, coma and death as well as hydrophobia

61
Q

How is rabies prevented

A

Wash wound, rabies immune globulin, anti rabies vaccine (4 doses over 1 month)
Generally effective prior to symptoms

62
Q

Describe diphtheria

A

Occurs when immunization rates fall

Person to person transmission through droplets or skin contact

63
Q

How does diphtheria present

A

Pharyngitis with greyish membrane

Cutaneous in skin ulcers

64
Q

Describe tetanus

A

Caused by clostridium tetani anaerobic gram positive rods produces spores
Mediated by tetanus neurotoxin arising from wound infection
Toxins inhibit CNS inhibition of peripheral nerves at the spine

65
Q

How does tetanus present

A

Difficulty swallowing, right jaw muscles, prolonged muscular spasms

66
Q

How is tetanus treated

A

Wound cleaning, penicillin and tetanus antitoxin

67
Q

Describe neonatal tetanus

A

Can be deadly

Associated with contamination of the umbilical cord after birth

68
Q

What is a fungus

A 
Eukaryotic 
Larger and more complex that bacteria 
Has a cell wall 
Lack chlorophyll 
Reproduce sexually and asexually 
Biochemically distinct pathways
69
Q

What is present in a fungi cell wall

A

Ergosterol which is what antifungals usually target

70
Q

Describe yeast

A

Single cellsd
Elongate to form chains of cells (pseudohyphae)
Reproduce by budding to form daughter cells or blastospores
Some are commensal

71
Q

Describe moulds

A

Multicellular
Form tubular structures which may have cross walls or not
Many hyphae form a mycelium
Produce asexual spores

72
Q

What are dimorphism fungi

A

Fungi behaving as yeasts or moulds
Grow as mould at room temperature
Grow as yeast in elevated temperature
Geographically limited in distribution

73
Q

How do fungi cause disease

A

Growth on body surfaces
invasions of the body
Allergic reaction
Toxins upon ingestion

74
Q

What causes yeast infections

A

Candida albicans

Often commensal on mucus membranes in GI tract rapidly colonizes damaged skin

75
Q

Describe candida species

A

Candida means white
Gram negative
Commensal on skin, mucus membranes and in the environment

76
Q

What are examples of mucocutaneous yeast infections

A

Oral (thrush, stomatis, chelitis)
Vaginal
GI tract

77
Q

What is chelitis

A

Mucocutaneous yeast infection

Angular erosions on mouth with pustules

78
Q

What are skin and nail yeast infections

A

Intertrigo (damp areas)
Diaper rash (poor hygiene)
Nail frequent immersion in water

79
Q

What are dermatophytes

A

Closely related to keratolytic fungi
Minor trauma allows for initial infection
Occlusion allows for infection as well as moisture
Ringworm athletes foot or jock itch

80
Q

How do dermatophyte infections present and transmit

A

Red, scaly rash May have pustules

Transmitted via skin squames containing fomites (combs) rarely direct contact

81
Q

How are dermatophyte infections diagnosed

A

Skin scrapings, nail clippings, hair
Microscopy
Culture

Dermatophytes are not part of normal flora infection present if they are present

82
Q

Describe tinea versicolor

A

Superficial skin infection caused by Malassezia Furfur
Common cause of skin infection in healthy people
Flourishing on skin fatty acids

83
Q

How does tinea versicolor present

A

Manifests as hyper or hypo pigmented lesions with itching and occasional pustules

84
Q

How is tinea versicolour diagnosed

A

Clinically
Skin scrapings
Microscopy shows spaghetti and meatballs pattern
Cannnot culture as it only grows with oil supplement

85
Q

Describe invasive fungal infections

A

Divided into 2 groups

  1. Opportunistic (occur widely)
  2. Geographically defined
86
Q

What are examples of systemic yeast infections

A

UTI (catheter)
Endocarditis (prosthetic heart valves)
Septicaemia (immuno compromised)

87
Q

How are invasive yeast infections diagnosed

A 
Clinical suspicion 
Microscopy 
Culture (several days)
Antigen detection 
Imaging
88
Q

How are invasive yeast infections treated

A

FLYCONAZOLE

Superficial infections may be treated with nystatin

89
Q

Describe cryptococcus

A

Cryptococcus neoformans is an encapsulated yeast
Causes pneumonia can cause meningitis
Found in Vancouver less likely elsewhere in Canada

90
Q

Describe pneumocystis jirovecii

A

Non culturable yeast (no budding!!)
Causes pneumonia in immunosuppressed
Diagnosed by immuno fluorescence NAAT and silver stains

91
Q

Describe Aspergillus Spp.

A

Main mould that causes infection
Grows on rotting vegetation
Spores present in outdoor air
Immunosuppressed most at risk

92
Q

How does Aspergillus infections present

A

Allergies to spores leading to asthma
Bronchopulmonary aspergillosis
Fungal ball in cavities

93
Q

How is Aspergillus Infection diagnosed

A

Microscopic: KOH

Culture

94
Q

Describe Histoplasma Capsulatum

A

Dimorphic fungi
Found in central US
Infection occurs when spores inhaled and germinates in the lung
Only small proportion infected develop disease

95
Q

Describe parasites

A 
Eukaryotic 
Distinct from fungi 
No chlorophyll 
Single celled to multicellular 
Microscopic to macroscopic
96
Q

Describe Protozoa

A

Based on means of locomotion
Amoebae form cytoplasmic protrusions in order to love and change shape (pseudopodia)
Occur as trophizoites (active and growing) and cyst (environmentally protected)

97
Q

Describe entamoeba histolytica

A

An enteric amoeba
Ranges from asymptomatic to dysentery and liver disease
Transmitted fecal/oral
Identical non pathogenic species called entamoeba dispar

98
Q

Describe environmental amoebae

A

Found in natural surface water
Can cause corneal infection in contact lens wearers (chronic ulcers)
May cause amebic meningoencephalitis

99
Q

What are flagellates

A

Propelled by flagella
May occur in two forms: trophozites (active) cyst (dormant)
Rigid outer wall
May cause gut infection

100
Q

Describe Giardia

A

Enteric flagellate
Ranges from asymptomatic to acute or chronic diarrhea
Fecal oral or waterborne tranmission
Diagnosed by microscopy of stool

101
Q

Describe Trichinoniasis

A

Flagellate infection
Causes vaginitis
Sexual transmission usually from males
Diagnosed by microscopy of discharge or culture
Non pathogenic found in oral cavity and gut

102
Q

Describe Trypanosomiasis

Africa

A 
Found in AFRICA
Systemic flagellate infection
Sleeping sickness (fever encephalitis) 
Transmitted by TSE TSE fly 
Detection: parasites on blood smears and serology
103
Q

Describe trypanosomiasis (South America)

A

Chagas’ disease (cardiac complications)
Transmitted by Reduvid Bug
Detected by parasites stained on blood smears and serology

104
Q

Describe Leishmaniasis

A

Systemic Flagellate

Present as cutaneous ulcers or visceral infiltration and Hepatosplenomegaly (enlarged liver and spleen)

105
Q

Describe Apicomplexa

A

Mature forms non motile
Complex life cycles
Attach
Cause malaria

106
Q

Describe Malaria

A 
Apicomplexa 
Plasmodium Spp. 
episodic fevers and anaemia 
Transmitted by mosquito bites 
Detected by parasites stained on blood film
107
Q

Describe Cryptosporidium spp

A

An enteric apicomplexa
Watery diarrhea (chronic in immunosuppressed)
Fecal oral, waterborne, zoonosis tranmission
Detection by microscopy of stool using acid fast stain or detection of antigen in stool using EIA

108
Q

Describe cyclospora

A

Looks like cryptosporidium but 2X bigger
Watery diarrhea
Fecal oral route especially in tropics
Detection by microscopy

109
Q

Describe toxoplasma Gondi

A

Apicomplexa causing systemic disease
Mostly asymptomatic unless pregnant (fetal malformation)
Transmitted by poorly cooked meat and cat stool
Detected by serology

110
Q

Describe Helminths Platyheminths

A

Bigger organisms

Flatworms

111
Q

Describe cestodes

A 
Tapeworms
Ribbon like and segmented 
Largest is 10m 
Hermaphordite (ovaries and testes) 
No digestive system 
Adult attaches to gut using scolex (hooks or suckers) 
Larval forms in tissues (cysts)
112
Q

Describe the life cycle of Cestodes

A

Definitive host gut contains adult worm
Environment where ova are consumed by intermediate host in whose tissue the larval stage develops
When intermediate host is eaten by definitive host adult worm develops in gut and later produces ova

113
Q

Describe taenia saginata and taenia solium

A

Beef and pork tapeworm
Principle cestode pathogen
Abdominal discomfort
Transmitted by larval forms ingested in food
Detected by identification of ova or adult segments in stool

114
Q

Describe Cysticercosis

A

T. Solium larvae
Cysts throughout the body including brain
Transmitted by ingested ova
Detected by serology, X-ray, ultrasound etc

115
Q

Describe Trematodes

A

Flukes (kinda like flatworms)
Leaf shaped, hermaphrodite, primative gut, suckers for attachment
Definitive host life cycle
Ova (environment) consumed by intemredjate host and ova becomes larva

116
Q

Describe schistosomiasis

A

Effects of inflammation, hematuria (blood in urine)
Transmitted by penetration of skin in fresh water
Detected by ova in stool/urine

117
Q

Describe Nematodes

A 
Roundworms 
Big enough to be seen 
Separate sexes 
Some are adapted to attach to gut wall 
Cause abdominal discomfort and pain 
Fecal oral tranmission 
Detected by microscopy and identification of adult worms
118
Q

Describe hookworms

A

Cause chronic blood loss
Transmitted by larvae penetrating Skin
Detected by identification of ova or larvae in stool

119
Q

Describe filariasis nematode in tissues

A

Filaria block lymph channels
Causes fevers, elephantiasis, swelling or deformity of limbs and genitalia

Tranmitted by mosquitos
Detection- parasite larvae (microfilaria) stained on blood film

120
Q

Describe Ectoparasites

A

Colonize the body vs micro predators that bite only
Insects (6 legs) fleas, lice, bedbugs
Arachnida (8 legs) ticks and mites

Vectors of disease and cosmetic

MICI Module 3 (3 decks)

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