Slide Deck 4 Flashcards
What are obligate intracellular bugs?
Stay inside (cells) when it is Really CHilly and COld. Rickettsia Chlamydia Coxiella
What are facultative intracellular bugs?
Some Nasty Bugs May Live FacultativeLY. Salmonella Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersinia pestis
Kid has cats, what happened, what bug? after you diagnose with serolgoy, how do you treat?
Patients present with bacillary angiomatosis. What is this, and why?
Cat scratch disease, caused by Bartonellosis henselae , flea transmitted or traumatically – most frequent of the Bartonellosis
leads to inflamed lymph node is shown
proliferation of endothelial cells, by NF-kB activation
patients present with little tumors that bleed on contact, comprised of endothelial cells “bacillary angiomatosis”
Azithromycin
What is verruga peruana?
the chronic delayed stage of infection by Bartonella bacilliformis.
It is a vasoproliferative manifestation of the infection characterized by 1–2 cm cutaneous nodules that are engorged with blood.
(Carrions disease: fever, headache, abdominal pain)
Endocarditis that doesn’t grow any bacteria?
Bartonella
The lone star tick bite spreads what? What are the symptoms, and what patients are most likelyaffected?
Ehrlichiosis
fever, red eyes (conjunctival injection), rash, fatigue, musle aches, nausea/vomiting/diarrhea
generally affects organ transplant and blood transfusion patients; it’s actually in 12% of people
What are these in your blood smears of monocytes? If they’re in the blood smears of granulocytes, then what is it an indicator for? How are these diseases transmitted?
Ehrlichiae! microcoloneis in monocytes are called morulae.
Morulae in granulocytes are an indicator for anaplasma, vector is Ixodes tick
MEGA berry
“Monocytes = Ehrlichiosis; Granulocytes = Anaplasmosis”
Between Anaplasmosis and Ehrlichiosis, which tick is responsible for which?
Ehrlichiosis: Lone Star
Anaplasmosis: Ixodes
What are the two groups of Rickettsia?
Typus group – includes prowazekii
Spotted fever group: includes typhii
Tick bite trasmission leads to fever, pain, systemic vasculitis: rash in 35-60%
What do you suspect, how do you diagnose? thereapy?
Rocky Mountain spotted fever (rickettsia)
Clinical–skin biopsy with NAAT
doxycycline
What causes epidemic typhus, and what does it look like? How do you treat it?
Rickettsia prowazekii
rash from trunk to extremities
can persist (Brill-Zinsser Disease)
tetracycline therapy
Which Rickettsial strain causes disease scrub typhus ? What does it follow?
Scrub typhus
Orienta tsutsugamushi
follows mite bite
infilitrate in lungs (pneumonia), headache, endocarditis (rare), fever, hepatitis, was around animals!
Coxiella burneti (no rash! Q fever!)
obligate intracellular
How does coxiella burneti infect humans?
Spores are contained in animal feces
Transmitted to humans via aerosol transmission
observed is a cell from anal area with lots of inclusion bodies. How is this grown on media? What type of stain do you have to use?
It can’t be. Chlamydia is an obligate intracellualr pathogen.
Giemsa stain
How does chlamydia enter cells, and what type secretion pathway?
It binds the outer membrane protein OMPc to glycosaminoglycans (GAGs), uses a type III secretion pathway.
What are the three forms of Chlamydia?
Chlamydia trachomatis, pneumoniae, psittaci (from birds)
What are the elementary and reticulate body of chlamydia?
Elementary body: smaller infectious form. Enters cell
Reticulate body: larger, replicative form. Replicates in cell.
For Chlamydia: Serovars D-K, what are the symptoms?
Women: vaginal discharge, dysuria, and pelvic inflammatory disease
Men: Urethral discharge, dysuria, testicular swelling
If you suspect Chlamydia, what do you do? If it is diagnosed, how do you treat?
diagnose with NAAT
but test for gonorrhea, bc it’s usually accompanied by that!
Macrolides, doxycycline
What is lymphogranuloma venereum, and what causes it? If you suspect it, what should you test for?
Serotypes L1-L3 of chlamydia trachomatis, also STD
Women: vaginal discharge, dysuria, pelvic inflammatory disease
Men: urethral discharge, dysuria, testicular swelling
Test for HIV infection, >70% coinfection in MSM
Which form of clamydia causes scarring of the cornea? How is it transmitted?
This is the leading cause of infectious blindness
trachoma: serotypes ABC of chlamydia trachomatis
inturned eyelashes is why the scarring happens.
, follicular conjunctivitis
Direct contact between humans
If a person has pneumonia symptoms but not a high fever, this is atypical pneumonia. How do you treat?
Which chlamydia is associated?
Macrolides: azithromycin, erythromycin
Chlamydia pneuomniae
Inhalation of dried secretions from parrots results in
Chlamydia psittaci, which is a form of atypical pneumonia
_________ is the smallest free living extracellular bacteria . Diagnosis involves a positive ___ test.
Mycoplasma pneumonieaie. Cold agglutinins, IgM antibodies
What are the major symptoms that are associated with a reactivation of TB? What are the risk factors?
cough, chest pain, bloody sputum, weakness, weight loss, chills, low grade fever, night sweats
Risks: HIV infection, diabetes, alcohol, or drug abuse
What is the treatment for latent TB?
RIPE
Rifapentine and isoniazid for 3 months
or isoniazid for 9 months
requires patient compliance!
Where does tuberculosis divde?
organisms replicate in naive alveolar macrophages, killing the macrophages until cell mediated immunity.
Associated with caseating granuloma
How do you look at mycobacterium tuberculosis?
Need acid fast or Ziehl-Neelsen stain
It is a facultative intracellular organism
What do you see in this picture?
Ghon complex , which is calcified focus of infection and an associated lymph node, sign of primary pulmonary tuberculosis
PPD test, zone of induration of what threshold is a positive test? What does a positive mean?
10 mm
previous vaccination with BCG, Bacille Calmette Guerin (live attenuated), or infection
____ agar is used to culture M. tuberculosis. While it is the most sensitive, it is very slow (4-6 weeks)
Loewenstein-Jensen agar
Rapid, not sensitive way to diagnose M. tuberculosis in sputum?
Acid fast stain
What is miliary tuberculosis
Minimal immune response, so tiny “millet”-like granuloma
disseminating widespread tuberculosis
What happens if you swallow tuberculosis?
Pott’s disease: gets into the spine/bones
Who can be vaccinated against tuberculosis? What is the name of the vaccine? Does it work?
Bacillus Calmette Guerin (BCG)
only tuberculin negative individuals (newborns) can be vaccinated
it prevents severe tuberculosis 70% but not the more common forms/infection
What percentage of Tuberculosis patients progress to active disease? What is active disease?
Cough, chest pain, bloody sputum, weakness, weight loss, chills, low grade fever, night sweats
15%
What is the gram stain of Tb?
None!
What is Hansen’s disease? What proportion of the human population is resistant?
Mycobacterium leprae
95% of people are resistant
What are symptoms of leprosy? How do you daignose?
skin discoloration, numnbess in extremities (the bacteria prefers the cold)
won’t grow in vitro, you must do skin biopsy or staining
Differentiate between tuberculoid and lepromatous. What cell does this invade?
Tuberculoid: granuloma form, Th1 (strong immunity): fewer lesions
Lepromatous: humoral, Th2 (weak cell-mediated immunity): many lesions, leonine face (lose nasal septum, lose eyebrows
Invades the Schwann cell, so nerve symptoms
In what form of leprosy is the lepromin skin test positive?
Skin test is positive in tuberculoid, because it tests cell mediated immunity
Jaw trauma is associated with what bacteria? What is required before this bacteria can proliferate?
Actinomyces israelii, requires other infection and anaerobic condition
How is actinomyces diagnosed?
Detected because of production of sulfur granules
Between nocardia and actinomyces, which are around o2?
Nocardia is the obligate aerobe
Who does nocardia affect, and what do the symptoms look like?
affects the immunocompromised,
Madura foot, requires antibiotic therapy
pneumonia, brain abcesses
How do you treat nocardia? Actinomyces?
sulfonamides for nocardia, penicillin for actinomyces
