Section 7: Animal-Borne Diseases and Tick-Borne Diseases

Question 1

1. Diagnosis: Animal exposure + Jaundice + Renal
2. Test for above patient
3. Rx of above patient

Answer 1

1. Leptospirosis

Diagnosed with serology

Rx with ceftriaxone or penicillin

Question 2

Diagnosis: Hunter who touch a rabbit + ulcer at the site of contact + enlarged lymph nodes + conjuctivitis

Test and Rx of above patient

Answer 2

Tularemia

Diagnosed with serology

Rx with:

Doxycycline (oral)
 Ciprofloxacine (oral)
 Aminoglycoside (Streptomycin (IM), gentimicin (IM or IV))

Question 3

1. Diagnosis: Ate pork meat + CT scan of head showing thin-walled cysts that may be calcified
2. Rx of above patient

Answer 3

1. Cysticercosis
2. Rx with albendazole

Question 4

1. Diagnosis: Camping/hiking + Target-shaped rash
2. Name given to Target-shaped rash
3. Causative organism
4. Vector for causative organism
5. Test for above patient
6. Rx of above patient

Answer 4

1. Lyme disease
2. Erythema migrans
3. Borrelia burgdorferi
4. Ixodes genus (deer) tick
5. Serology for IgM
6. Oral doxycycline or amoxicillin

Question 5

List the long-term manifestations/complications of Lyme disease

Answer 5

Joint involvement (most common late manifestation)

Cardiac: the most common being AV conduction block/defect

Neurologic: the most common being 7th cranial nerve palsy (Bell’s palsy)

Question 6

Diagnosis of long term complications of Lyme disease

Answer 6

Serology:

IgM
 IgG
 ELISA
 Western blot
 PCR

Question 7

Lyme disease:

1. Rx of rash, joint or Bell’s palsy
2. Rx of CNS or cardiac involvement

Answer 7

1. Oral doxycycline or amoxicillin
2. IV ceftriaxone

Question 8

1. Apart from lyme disaese name two other tick-borne diseases tranmitted by Ixodes (deer) tick
2. What are the actual causative organisms for the diseases in 1
3. Method of diagnosis and findings
4. Rx modalities

Answer 8

1. a). Babesiosis; b). Ehrlichia
2. a). Babesia microti; b). Ehrlichia is GNB in the family of Anaplasmataceae
3. Peripheral blood smear or PCR: a). tetrads of intraerythrocytic ring forms; b). “morulae”, i.e. inclusion bodies in WBCs
4. a). Clindamycin and quinine; b). Doxycycline

Question 9

Features of babesiosis

Answer 9

Common in Northeast
Hemolytic anemia
Hemolytic anemia is severe in asplenic individuals

Question 10

Features of Ehrlichia

Answer 10

No rash
Elevated LFT (ALT and AST)
Thrombocytopenia
Leukopenia

Question 11

Rx of acute malaria

Answer 11

Quinine and doxycycline

Question 12

Prophylaxis for malaria

Answer 12

** Mefloquine** (weekly) or
Atovoquone/proguanil (Malarone, daily)
Daily doxycycline (NOT the best answer)

Question 13

Side effects of mefloquine

Answer 13

Neuropsychiatric side effects
Sinus bradycardia
QT elongation