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Derm Micro > Rickettsia and Related Microbes > Flashcards

Rickettsia and Related Microbes Flashcards

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Dermatology Board Prep flashcards
1
Q

What is the general information about Rickettsia?

A

Gram negative rods, obligate intracellular bacteria

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2
Q

Can Rickettsia be cultured on agar media?

A

Nope

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3
Q

<p>

| What are the 3 phyla of Rickettsia and related microbes?</p>

A

<p>

| Rickettsia (vector-borne), Ehrlichia (vector), Coxiella (non vector-borne)</p>

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4
Q

In general, how is the diagnosis of a Rickettsia organism made?

A

Pt presentation and history (travel/exposure), confirm with serology

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5
Q

What drug are the Rickettsia and others responsive to?

A

Doxycycline

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6
Q

What is the classic presentation of Rickettsia?

A

Fever, Headache, Rash

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7
Q

Where do Rickettsia replicated? In which Cells? What does this cause?

A

In cytoplasm of endothelial and muscle cells of small blood vessels, hemorrhage and edema, dz is vasculitis leading to rash and headache

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8
Q

What is responsible for Rocky Mountain Spotted Fever?

A

R. Rickettsia

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9
Q

How is R. Rickettsia transmitted?

A

Various ticks (microbes replicate in salivary gland). So it is seasonal, when ticks are active

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10
Q

Where is the highest incidence of R. Rickettsia?

A

NC, SC, AR, MO, OK, TN (endemic in TN)

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11
Q

What are initial symptoms of R. Rickettsia?

A

FLS with severe headache followed by rash, also, significant muscle tenderness (calf)

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12
Q

Where is the rash of RMSF?

A

Spreads from ankles and wrists to soles, palms, and trunk

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13
Q

What happens when the rash of RMSF spreads?

A

Infection becomes systemic…septicemia… DIC

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14
Q

How is the Dx of RSMF made?

A

Initially made on presnetation and Hx, nonspecific Weil-Felix serologic test measures x-reactivity of Anti-rickettsial Ab’s to Proteus OX strains; must confirm by comparison of acute and convalescent sera. Indirect fluorescent Ab assay now used mostly

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15
Q

How many people die of RSMF if untreated? What is Tx?

A

1 in 4; Doxy within first week; septicemia often mistreated with beta-lactams which doesnt work

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16
Q

How do you prevent RMSF?

A

Use DEET to avoid tick bites or remove tick within 4 hours of bite

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17
Q

What does R. prowazekii cause?

A

Epidemic typhus; dz associated with wars and poverty

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18
Q

Is R. Prowazekii a zoonosis?

A

nope

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19
Q

How is Epidemic Typhus transferred?

A

Human to human via body lice

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20
Q

Epidemic typhus is similar to RMSF, so how do you distinguish them?

A

It spreads from trunk to extremities instead of the other way around

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21
Q

What are the two bugs classified as Ehrlichia?

A

E. Chaffeensis (HME) and Anaplasma phagocytophilia (HGA)

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22
Q

How are HME and HGA transmitted?

A

Ticks, but not the same as RMSF geography

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23
Q

What cell does R. Chaffeensis replicate in?

A

Monocytes

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24
Q

What cell does A. phagocytophilia replicate in?

A

Granulocytes

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25
Q

Replicating microbes from inclusion bodies in monocytes/granulocytes from HMA/HGA are called what?

A

Morulae

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26
Q

What are the symptoms of HME/HGA?

A

generally more mild than RMSF; FLS’s, and rash is less common

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27
Q

Do HMA/HGA bugs have a Weil-Felix reaction?

A

No

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28
Q

How is E. Chaffeensis transmitted?

A

Lone star deer tick

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29
Q

How is the diagnosis of E. Chaffeensis made?

A

Wright/Giemsa stain of blood smear shows morulae in monocytes and serology

30
Q

How do you treat both E. Chaffeensis and A. Phagocytophilia?

A

Doxy

31
Q

What is the nickname for the dz caused by A. Phago?

A

Rocky Mountain SpotLESS fever because rash is so rare

32
Q

How is A. Phago transmitted?

A

Ixodes deer tick

33
Q

How is Dx of A. Phago made?

A

Wright/Giemsa stain of blood smear shows morular in granulocytes + serology

34
Q

What is the shape of Borrelia?

A

Spirochetes

35
Q

How can spirochetes of Borrelia be seen?

A

Wright/Giemsa stain

36
Q

What characteristic plays a role in relapsing fever of Borrelia?

A

Antigenic variation

37
Q

What is the causative agent of Lyme Dz?

A

B. Burgdorferi

38
Q

How is LD transmitted to humans?

A

Via ixodes deer tick nymph which is extremely small and hard to detect

39
Q

How can one prevent LD?

A

Remove tick within 24 hours

40
Q

True or False, LD is the most common tickborne dz in the US?

A

True

41
Q

Where is LD endemic?

A

New England, Mid Atlantic states, Upper midwest, also in TN

42
Q

What are the early LD symptoms?

A

FLS usually milder than RMSF, classic bulls eye rash at site of tick bite called erythema chronicum migrans (not always seen)

43
Q

What are the secondary LD symptoms (disseminated)

A

Arthritis, facial palsy, peripheral neuropathy. Occurs weeks or months after initial infection

44
Q

How is the Dx of LD made?

A

2 step serological testing: ELISA + Western Blot. PCR based NAATs now available

45
Q

What is the Tx for early LD?

A

Doxy or Amoxicillin

46
Q

What is the Tx for chronic Ld?

A

IV Cephalosporins for extended periods

47
Q

What are the causative agents of Relapsing Fever?

A

B. Hermsii and B. Revurrentis

48
Q

How is B. Hermsii transmitted?

A

Tick

49
Q

How is B. Recurrentis transmitted?

A

Louse

50
Q

Where is B Hermsii endemic?

A

HIgh, dry areas of Western US

51
Q

Is B. recurrentis common or rare in the US?

A

Rare

52
Q

What are the symptoms of Relapsing Fever?

A

Recurrent fever that is on one week, off two, rash uncommon

53
Q

How can one see B. Hermsii or Recurrentis?

A

Wright/Giemsa stain of blood smear

54
Q

What is needed to confirm Dx of relapsing fever?

A

Serology

55
Q

What is the tx for relapsing fever?

A

Doxy

56
Q

What is the causative agent of Leptospirosis?

A

Leptospira Interrogans

57
Q

What are the L. Interrogans?

A

Spirochetes

58
Q

How is L. Interrogans transmitted?

A

Through water contaminated with animal urine usually through a break in the skin

59
Q

Does L. Interrogans cause skin lesions?

A

Lol, no

60
Q

What can L. Interrogans cause?

A

FLS, Weil’s Dz (jaundice + renal damage), meningitis

61
Q

How is the Dx of interrogans made?

A

Serology

62
Q

What is the Tx for Leptosporosis?

A

Penicillin

63
Q

What has reduced the incidence of Leptosporosis in humans?

A

Vaccination of cattle and household pets

64
Q

What dz does Bartonella henselae cause?

A

Cat Scratch Dz

65
Q

What is the reservoir of B. Henselae?

A

Cats (but they’re not affected)

66
Q

What patient population is B. Heneselae seen in?

A

Children

67
Q

What symptoms are seen with Cat Scratch Dz?

A

Swollen LN’s near site of scratch, adults can also have FLS, can lead to severe disseminated Dz involving CNS in ICP’s

68
Q

How is the diagnosis of Cat Scratch Dz made?

A

Presentation and Hx of scratch or bite

69
Q

What is the treatment for Cat Scratch? Tx for long lasting infections?

A

Most infections clear on their own in two weeks; Erythro for longer infections

70
Q

What other bugs can cause skin lesions or swollen glands?

A

Anthrax (Eschar); Plague (Bubo in groin or axilla); Tularemia (Ulcer)

Derm Micro (7 decks)

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