Respiratory Tract Infections 9

Question 1

what pathogen causes melioidosis and what is the clinical manifestation

Answer 1

• caused by: Burkhoderia pseudomallei

- pneumonia (adults) + localized skin infection (kids)

Question 2

peridomestic settings such s barns, outbuildings and sheds are potential sites for transmission of ______

Answer 2

hantavirus pulmonary syndrome

Question 3

what is the typical presentation of ornithosis

Answer 3

• features of pneumonia (headaches, high fever chills myalgia, consolidation) PLUS CNS involvement and GI symptoms
• also patients tend to have hepatosplenomegaly and follicular kertoconjunctivitis

similar to legionella but look at exposure (contaminated water vs. birds; and won’t see hepatosplenomegaly in legionella)

Question 4

what is the initial presentation of someone with Hantavirus infection

Answer 4

• similar to viral gastroenteritis: fever, headache, myalgia, vomiting and diarrhea

Question 5

acute Q fever, looking at ________ against phase _____

Answer 5

IgG and IgM against phase II LPS

Question 6

ornithosis is a ______ disease caused by _____

Answer 6

zoonotic (also called parrot fever)

Chlamydophila psitacci

Question 7

what would you look for in diagnosis someone with melioidosis

Answer 7

• endemic region
• cornflower head morphology on Ashdown’s agar
• gram negative bacilli with bipolar staining

Question 8

unique biological features of chlamydophila psitacci:

Answer 8

• biphasic lifestyle: elementary bodies and reticulate bodies -
• cell wall does NOT contain peptidoglycan but instead contains MOMP (major outer membrane protein)

Question 9

what is the selective media for burkholderia pseudomallei from sputum and how is the presentation on that media described?

Answer 9

• Ashdown’s agar

- will see cornflower head morphology

Question 10

which bacteria does not have peptidoglycan in their cell wall, but instead has major outer membrane protein

Answer 10

chlamydophila sp.

Question 11

_________ are at high risk for getting infected by C. pstittaci

Answer 11

zookeepers and people dealing with birds

Question 12

______ is a primary risk for virus exposure of hantavirus

Answer 12

rodent infestation

Question 13

________ is a pathogen that shows phase variation

Answer 13

Coxiella burnetti

LPS is infections in the body but not infectious when grown on media

Question 14

describe the biology fo hantavirus

Answer 14

RNA virus, spherical, lipid envelope with two major glycoproteins

Question 15

cornflower head morphology on ________ agar is indicative of __________ infection

Answer 15

Ashdown’s;

Burkholderia pseudomallei

Question 16

describe the clinical phases of hantavirus

Answer 16

1. prodromal (3-5 days): represents viral gastroenteritis
2. cardiopulmonary (24-48 hours): dyspnea, dry cough, pulmonary edema, circulatory collapse
3. convalescent: dieresis and improvement of symptoms

Question 17

risk factors for melioidosis includes:

Answer 17

• diabetes
• excessive alcohol consumption
• chronic lung disease
• CF
• thalassemia

Question 18

what is the transmission method of hantavirus

Answer 18

inhalation of the air contaminated with the virus; airborne transmission

Question 19

what are examples of zoonotic diseases

Answer 19

• Q fever (coxiella burnetti)

- Ornithosis (Chlamydophila psitacci)

Question 20

_______ intracellular gram _____ bacteria = chlamydophila psitacci

Answer 20

obligate; gram NEGATIVE

Question 21

endemic regions of Burkholderia pseudomallei

Answer 21

• south asian (India, Thailand, Malaysia) SE Asia including China, and Northern Australia

Question 22

describe the biology of burkholderia pseudomallei

Answer 22

• gram NEGATIVE bacili, rod shaped
• motile
• bipolar staining
• aerobic
• facultative intracellular
• NON spore forming
• found in solid and fresh water in South Asia, SE asian and northern Australia

Question 23

What are the 3 main clinical presentations of Q fever?

Answer 23

• self limiting flu like illness
• pneumonia (North America)
• hepatitis (Europe)

Question 24

_____ is a lab investigation used for diagnosis of Hantavirus infection

Answer 24

RT-PCR or EILSA for IgM and IgG Abs against hantavirus

Question 25

reticulate bodies will convert back into elementary bodies _____ hours after initial penetration

Answer 25

18-24hours

Question 26

______ are natural reservoirs of someone with ornithosis

Answer 26

birds; caused by chlamydophila psittaci

Question 27

in someone with culture negative endocarditis, what serological testing are you going to be looking for in diagnosis?

Answer 27

• culture negative endocarditis is caused by chronic Q fever

- IgG’s against phase I LPS

Question 28

______ phase of the hantavirus infection correlates with the immune response

Answer 28

cardiopulmonary phase because there immune response causes increased permeability of capillaries resulting from the endothelial damage

Question 29

describe the biology of coxiella burnetti

Answer 29

• gram negative
• obligate intracellular
• transmission by inhalation
• cattle sheep and goats are important reservoirs

Question 30

primary reservoir for the Hantavirus is ______

Answer 30

rodents

Question 31

________ virus is the most common cause of hantavirus virus pulmonary syndrome (HPS)

Answer 31

Sin Nombre virus

Question 32

__________ can cause culture negative endocarditis. Risk groups for this include:

Answer 32

Chronic Q fever;

• pre existing heart defects
• pregnancy
• immunocompromised

Question 33

chylamydophila psitacci is spread via _______

Answer 33

inhalation of excreta, urine or respiratory droplets of birds

Question 34

the elementary body reorganizes into reticulate bodies in _______ after _________ hours after penetration

Answer 34

chlamydophila;

6-8 hours

Question 35

the predominant mode of transmission of burkholderia pseudomallei (melioidosis) is _______

Answer 35

percutaneous inoculation (broken skin) during exposure to wet soils or contaminated water

Question 36

describe the cardiopulmonary phase of hantavirus infection

Answer 36

• fluid moves from the intravascular space to extravascular –> edema
• SOB