South America Flashcards
Bartonella organism type
Gram negative intracellular bacteria
Cause of zoonotic infections
3 types of Bartonella most related to human infections
Bartonella Henselae
Bartonella Quntana
Bartonella Bacilliformis
What is Trench Fever?
b. quintana
5 day fever
First reported Europe soldiers
Transmitted by human body louse
Associated with endocarditis
What is Oroya fever?
b. bacilliformis
Also known as Carrion disease
Railway line Lima to Oriya
Common mountainous Peru/SA
Orya fever and verruca peruana same disease
What is cat scratch disease?
b. henselae
Most common bartonella infection
Cutaneous manifestation - vesicular, erythematous and papular phase
Lymhadenopathy
Occasional ocular neuropathy
Stages of Bartonella bacciliformis disease?
Acute phase - Oriya fever
Chronic phase - eruptive cutaneous lesions that appear 2-8 weeks after acute phase
Treatment of bartonella?
CSD - can be managed symptomatically without supportively (if local signs only) but one off abz (eg Azithro) limits symptoms
Trench fever - doxy
Oroya fever - cipro
Verrugana peruana - azitrho
Abx vary - ( azithro, cipro, gent, co trimox and rifampicin)
Diagnosis of bartonella?
Serology or PCR
Difficult to culture - need long isolation times
Chronic bartonella
Chronic eye problems
Bone marrow effects - bone pain
Classic symptom of pain soles of feet in morning - damaged blood vessels on soles
Anaemia
Neurological symptoms
3 important bartonella, mode of acquisition and disease
Valley fever
N America deserts/SA
Cocci immitis and cocci posadasii
Inhalation spores
Fever + cough
Erythema nods/multiforme possible
Dx - antibodies or culture
CXR - hilar adenopathy, infiltrates, cavitation
Paracoccidiodomycosis
Farmers - tobacco/coffee crops
Inhalation spores
Lung - main target, mucosal involvement possible
Resp Symtpoms
Mickey Mouse/pilots wheel on micro with KOH
Treat - co-trimoxazoel or itraconoazole
Histoplasmosis
Histo capitulum
Inhalation
Damp soil/guano
Caves
Acute pulmonary and disseminated possible
Culture = slow, urinary antigen test
Tx: Lip amp B or itraconazole
Bolivian Hemorrhagic fever
Large vessel mouse - vector, virus shed in excretion
Human to human possible
Fever headache malaise
Haemorrgaic features - mucosal bleeding/petchia
Can develop severe haemorrhagic/neurological fealtures
Responds to Ribavirin
Death in 25%
