S13C155 - zoonotic infections

Question 1

8 types of tickborne infections:

Answer 1

• rocky mountain spotted fever
• lyme dz
• ehrlichiosis
• anaplasmosis
• tickborne relapsing fever
• colorado tick fever
• tularemia
• babesiosis

Question 2

RMSF - rocky mtn fever

Answer 2

• high mortality, h/a, myalgias, malaise, LA, n/v/d, HSM, meningismus, myocarditis
• rash occurs 2-4d after fever (absent in 20% of people)
• fever, diarrhea
• Tx: doxycycline
• bug: rickettsia rickettsii

Question 3

Capnocytophaga

Answer 3

-bite from dog/cat
=fever, sepsis, endocarditis
-Tx: amox-clav (or clinda plus septra)

Question 4

Chlamydophila psittaci

Answer 4

• birds
• fever, pna, endocarditis, flulike
• sputum Cx
• doxy

Question 5

Leptospira

Answer 5

• birds, dogs, rodents
• fever, pna, conjunctivitis, LA
• Dx: darkfield microscopy
• Tx: doxy or pcn or amox

Question 6

Tularemia

Answer 6

• francisella spp, gm-
• rabbits, cats, wild animals
• fever, sepsis, meningitis, pna, hepatitis, rash
• ulceroglandular, glandular, typhoidal, pneumonic, oropharyngeal
• Dx: serology, ELISA, cx
• Tx: pip-taz or doxy or cipro

Question 7

Salmonella enterica

Answer 7

• turtles, dogs, cats
• fefver, sepsis, cellulitis, meningitis, endocarditis, septic arthritis
• Dx: blood cx
• Tx: cipro or azithro

Question 8

Yersinia Pestis

Answer 8

• dogs, cats, rodents
• plague
• Dx: blood dx
• Tx: doxy or cipro

Question 9

Babesiosis

Answer 9

-malarialike, protozoan parasites
-domestic mammals, rodents, deer
-malaise, h/a, rigors, abdo pain, dpn, dark urine, hepatomegaly, fever, petechiae, ecchymosis, rash, hemolytic anemia
-coastal
-labs: hemolysis, liver dysfxn, anemia, thrombocytopenia, renal failure
-dx: giemsa-stain blood smear, intraerythrocytic ring forms
tx: atovaquone plus azithro
or clinda plus quinine

Question 10

Colorado tick fever

Answer 10

• viral infxn
• deer, marmots, porcupines, >4000ft
• f/c, h/a, myalgias, n/v, photophobia, abdo pain, conjunctivitis, LA, HSM, stiff neck, retro-orbital pain, macular or petechial rash
• W/NW US
• supportive tx

Question 11

Lyme Disease

Answer 11

• borrelia burgdorferi
• deer, sheep, deer mice
• erythema migrans, meningitis, encephlaitis, neuropathy, heart
• 3 stages:
  1. erythema migrans (2-20d)
  2. borrelia dissemination, fever, neuropathy, arthritis, facial nerve palsy, annular derm lesions, myelitis, encephalitis
  3. tertiary stage: years later, chronic arthritis, myocarditis, subacute enchephalopathy
• atlantic central and north central US
• no risk if tick attached 72h attached, blood in tick, single 200mg doxy w/in 72h of bite can prevent dz

Question 12

Relapsing fever

Answer 12

• borrelia spp
• human body lice, wild rodents, humans
• f/c, h/a, myalgias, arthralgias, pain, n/v, HoTN, pruritic eschar at site of bite, episodic fevers
• tx: doxycycline

Question 13

West Nile virus encephalitis

Answer 13

• arbovirus
• flu-like illness
• vector: mosquito
• supportive tx

Question 14

Brucellosis

Answer 14

-tx: doxy for up to 6w

Question 15

Hantavirus

Answer 15

• deer mouse vector, foudn in feces, urine, saliva (bite or inhalation of dust)
• acute renal failure, thrombocytopenia, ocular abnormalities, flu-like, pulmonary edema, hypoxia, HoTN, tachycardia
• supportive care

Question 16

Causes of zoonotic meningitis:

Answer 16

-plague, listeriosis , brucellosis, tularemia, leptospirosis, lyme, q fever, psittacosis
=elevated opening pressure, protein and lymphocytes in CSF

Question 17

6 Zoonotic Causes of LRTI

Answer 17

• anthrax
• brucellosis
• psittacosis
• q fever
• pasteruellosis
• melioidosis
• rocky mtn spotted fever
• plague
• influenza
• hantavirus

Question 18

Anthrax

Answer 18

• bacillus anthracis
• imported hides, wool
• mediastinitis, resp fialure, vaccine available
• cutaneous anthrax: pruritic macule at inoculum site, ulcerates, then painless black eschar that falls off w/in 2w
• tx: cipro or doxy PLUS clinda

Question 19

Brucellosis

Answer 19

• unpasteurized dairy products or slaughterhouse workers
• brucella bacteria
• URTI Sx, lymph nodes on xr, granulomas
• tx: doxy

Question 20

Psittacosis

Answer 20

• c. psittaci
• birds, inhalation of dried feces or feather dust
• abrupt onset f/c, cephalgia, myalgia, malaise, atypical PNA
• tx: doxy

Question 21

Q fever

Answer 21

• c. burnetii
• ricketssial infxn, from farm animal urine/feces
• pulmonayr infiltrates, pericarditis, myocarditis, endocarditis, granulomatous hepatitis
• tx: doxy

Question 22

Pasteurellosis

Answer 22

• pasteurella multocida
• necrotizing cellulutis,
• animal bite
• bronchpneumonia, bronchitis
• tx: amox-clav or CTX

Question 23

Melioidosis

Answer 23

• abscesses plus pna

- tx: septra or doxy

Question 24

Hepatitis E

Answer 24

• virus, RNA
• waterborne, raw meat or wild animals, vertical transmission
• similar to HAV, jaundice, dark urine, elevated liver enzymes, abdo pain, n/v, fever
• tx: PCR, ELISA
• tx: supportive

Question 25

Chancriform bacterial zoonotic skin infxns

Answer 25

• usually livestock workers or vets

- tularemia, cat-scratch dz, listeriosis…

Question 26

Helminths

Answer 26

-tx; mebendazole

Question 27

Toxoplasmosis

Answer 27

• from ingesting pork/mutton, or from feces of cats or transplacentally
• transplacental infxn:retinochoroiditis, hydrocephalus, HSM, thrombocytopenia
• tx: pyrimethamine plus sulfadiazine plus folinic acid