- how a microbe acts, look like, and does is called ___. - looking for genetics involved is called___. - looking for antibody or antigen is called___.

phenotypic genotypic immunologic

Test #4 Microbiology Flashcards by Yonni Huggins

Diagnosis begins with specimen collection: (2)

asepsis

* correct sample

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Not sterile, doing things with as little contamination as possible.

*asepsis

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Using correct procedure to get right specimen.

ex:blood, urine

*correct sample

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This is done to see if there is anything growing in the blood.
-any growth at all needs to be reported

*blood culture

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disinfect with iodine or chlorhexidine
DONT re-palpitate
2 samples from 1 venipuncture
repeat 30 min later
of the 2 samples: 1 aerobe, 1 anaerobe

*blood culture

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clean catch(mid stream)
dirty catch
catheter
suprapubic catheter

*urine collection

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When you do not catch urine mid stream is called___.

*dirty catch

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When you go into abdominal wall and into the bladder to collect urine.
-anaerobic sample

*suprapubic catheter

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synovial (joint fluid, clear)
peritoneal, pericardial, pleural
cyst, abcess
CSF(cerebral spinal fluid, clear)
antiseptic/aseptic
needle aspiration (MD)
note appearance
most fluids collected by MD

*other fluids

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mucus from lower resp system
usually upon waking
avoid saliva
deep coughing(possible percussion)
suction catheter (Luken’s trap), used to avoid saliva, uncomfortable

*sputum

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-moistened transport swab(culturette-has enough fluid to support bacteria, but not let it grow)-avoid inside of the mouth

*throat swab

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-swab (surface), get pus on swab
-scrape (deeper, done on epithelial
-avoid surrounding skin, just want bacterial microbes
-

*wound culture

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A problem with wound cultures is:

*a lot of bacteria is anaerobic which makes it hard for culture to grow

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skin
nose: avoid inside of nostrils to get into nasal cavity
genital: STI’s
avoid surrounding surfaces

*other swabs

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main concern: environmental contamination(dont want other things to get in)
note appearance (consistancy, color)
note any abnormalities

*stool

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transport within 15 min or refrigerate
Dont refrigerate CSF(meningitis is sensitive to cold), vaginal/penile, specimens or anaerobes(b/c it causes O2)
label appropriately (name, what it is, diagnosis, what kind of test)

*all specimens

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After the lab has the specimen, its now time to:(4)

direct testing
cultivation
isolation
identification

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3 methods of microbial identification:

phenotypic
genotypic
immunologic

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how a microbe acts, look like, and does is called ___.
looking for genetics involved is called___.
looking for antibody or antigen is called___.

phenotypic
genotypic
immunologic

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morphology
physiological/biochemical characteristics(gas production, uses of different sugars)
chemical analysis(what lipids and proteins are part of the cell)
direct and indirect testing

*phenotypic

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what it looks like under a microscope is called___.
what a colony looked like under a plate is called___.
these are two types of morphology.

microscopic

* macroscopic

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staining(acid or gram)
colony morphology(what color is it, borders look like)
direct observation of specimen(looking at the tube for a weird appearance)

*phenotypic direct

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How things look after staining is called___.

*phenotypic direct

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selective/differential media
biochemical testing
other test
ex: phage typing, antimicrobial sensitivity test

*phenotypic indirect(how it acts)

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- genetic analysis: breaking down genetic code - no need to culture - fast - require specialized equipment, exspensive

*genotypic methods

- DNA analysis with genetic probes - rRNA analysis(everything has but same in same species) - PCR(great for a small sample, sending through a copier)

*genotypic

- pre made kits(all rapid test) ex:preg test - often easier than detecting the actual pathogen - serology:blood serum, can run on anything that has liquid - specificity and sensitivity - visualization and Ab-Ab intereactions - used all the time

*immunologic methods

How specific is the test, only recognizes the pathogen your looking for.

*specificity

Ability to detect small amounts of pathogens.

*sensitivity

- false positive test are called ___. | - false negative test are called___.

* low specificity | * low sensitivity

- agglutination: whole cells/organisms, common for blood test - precipitation: Ag as soluble molecule - clumping:means positive - becoming obsolete, not reliable

*agglutination and precipitation

- prepare dilutions of patient serum - equal amount of Ag in each tube - highest dilution that still agglutinates=titer - diagnose disorders - determine immunology - can be misleading in diagnosing

*antibody titers

- antisera against cell surface features - identify specific strains of a certain bacteria - flagella, fimbria, LPS - ex: salmonella, e-coli

*serotyping

- separate proteins by lysing cell - separate proteins by eletrophoresis - proteins transferred to filter - label filter - compare to controls - very sensitive and specific - gold standard of immunologic test - confirming test for HIV

*western blot

Exposing to antibody looking for antigen

*label filter

- antibody labeled with fluorescent dye - direct testing-Ab-->slide with sample (looking for Ag) - indirect testing-Ab--> Fc region of Ab in human serum-->slide with sample (looking for antibody) - if it glows: antibody found antigen=positive

*immunofluorescence testing

- faster - more accurate - sensitive and specific - several types

*immunoassays

- Abs or Ags labeled with radioactive isotope - RIST,RAST - allergy testing, detection of hormones - automated

*radioimmunoassay

- looking for immunologic is called___. | - looking for allergens is called___.

* rist | * rast

- indicator Ab linked to some enzyme(horseradish) - indirect(antibody) or direct(antigen) - very commonly used test more, pre kits - have issues thats why conformation test are done

*ELISA

- detect microbe Abs in sera - known Ag absorbed to well - unknown pt Ab added - rinse - indicator Ab added - rinse - enzyme substrate added - color change(positive)

*indirect ELISA (looking for antibody)

- detect unknown Ags in sera - known Ab absorbed to well - unknown Ag added - enzyme linked Ab added - enzyme substrate added - color change(positive)

*direct ELISA(looking for antigen)

- skin - hair - nails - sweat and sebaceous glands

integument

Rash of the skin is called___. | Relates to fever, a lot of rashes are associated with is called___.

* exanthem | * febrile

- first line of defense - epidermis - dermis

*skin

- outer layer of skin, consist of: - stratum corneum - antimicrobial peptides - sebaceous glands - perspiration

*epidermis

Produce sebum or oil, normal bacteria eat oil and produce waste with low pH which kill off bad microbes.

*sebaceous glands

The part of the skin in touch with the outside world, has keratin that water proofs skin.

*stratum corneum

Short protein that have weak charge with antimicrobial properties.

*antimicrobial peptides

Sweat, has certain enzymes that makes hostile environment for microbes.

*perspiration

When epidermis separates from dermis.

*blister

Everywhere but more dense in some places, most in wrong place cause disease or certain strands

*normal skin microbes

- yeast - staphylococcus - streptococcus * these two live on skin - propionibacterium - corynebacterium - pseudomonas - janthinobacterium - --these are all ___.

*normal skin microbes

- s. aureus: disease all over, coagulase positive - s.epidermis: coagulase negative * both look the same under microscope

*staph

- flat to slightly raised colored bumps | - pathology: get into resp tract and spread out through blood

*maculopapular rash

- measles(rubeola) - rubella - fifth disease - roseola * all viruses that are treated the same way - scarlet fever These are examples of ___.

*maculopapular rashes

- cause: virus - signs/symptoms: * gets in resp tract, dry cough, sore throat, fever, headache, conjunctivitis * Koplik's spots: little leasions inside mouth * rash - rash spreads head-->body, and, last for a week

*measles(rubeola)

- highly transmissble: droplet, contact, direct - clinical dx or IgM ELISA - MMR vaccine - palliative tx, vitamin A

*measles (rubeola)

Alive intinuative, takes care of measles, mumps, and rubella

*MMR vaccine

Complications: - ear infection - get pneumonia - encephalitis - SSPE

*measles(rubeola)

Form of encephalitis, shows up in younger kids, causes conjunctivitis and muscular decline, by the time its recognized death is near, dosent appear until 7-10 years after infection.

*SSPE

- virus - signs/symptoms: * post * congenital - clinical dx, IgM or IgG - MMR vaccine - palliative tx - mild 3 day rash - no complications

*rubella

You get after you were born, no big deal, rash for 3 days and fever.

*post rash

Born with rubella, crosses placenta, miscarraige, born early, potential blindness, and mental hadicaps.

*congenital

- cause: parvovirus B19 - signs/symptoms: * fever * rash starts around face and ends toward body and keeps reappearing for weeks. - very contagious by droplet or direct contact

*fifth disease

- clinical dx, may use IgM to rule our Rubella - palliative tx - confluent rash with "slap cheek" appearance - no vaccine

*fifth disease

- cause: HHV-6 or HHV-7 (human herpes virus) - signs/symptoms: * very high fever for 3 days - mildly contagious by droplets, resp tract - clinical dx

*roseola

- palliative care: keep fever down - rash after fever or no rash at all - complications: * trying to link to other diseases(MS)

*roseola

- cause: S.pyogenes with erythrogenic toxin(makes difference between sore throat and scarlet fever) - signs/symptoms: * secondary to sore throat * bumpy sand paper rash * strawberry tongue - transmission: droplet contact

*scarlet fever

- diagnosis: culture and rapid test - tx: antibiotics(penicillin) - rash thats bumpy and sand papery

*scarlet fever

- both causes: * impetigo * cellulitis - morphology differences: colony and micro - catalase test - toxins: * coagulase(staph) * others

* S(staph).aureus(clumps) | * S(strep).pyogenes(chains, gram positive)

Test that either fizzes or it doenst. - fizz for staph - no fizz for strep

*catalase test

- caused by: * staph:older kids/adults * strep:newborns - flaking, peeling, crusty lesions - transmission primarily by direct contact - oral cephalexin or topical meds - clinical dx, may culture - prevent with good hygiene

*impetigo

- caused by: strep or staph - infection of dermis and other tissues - pain, swelling, redness - parenteral implantation: scratch or improperly cared for med equipment - clinical dx - tx: cephalexin, penicillin, or surgery(cut out infected tissue) - prevent with good hygiene

*cellulitis

- caused by: staph or strep, flesh eating disease - type I(polymicrobial) or type II (monomicrobial) strep - superantigens(causes overwhelming response) - high mortality rate if left untreated, may have to get amputation - bacteria travel along fascia - tissue damage due to toxins

*necrotizing fascitis

3 other staph infections are:

* staphlococcal scalded skin syndrome(SSSS) * folliculitis * abscess

Big problem in newborns: - exfoliative toxin: causes skin to slough - bullous lesions: enormous lesions - desquamation: skin sloughs off

*staphylococcal scalded skin syndrome (SSSS)

In grown hair that gets infected.

*folliculitis

Pockets of infections that happen where ever. - furuncles: individual boils or abscess - carbuncles: one big boil or abscess

*abscess

- cause: HHV-3(varicella-zoster virus) - pustular rash: fluid lesions - HIGHLY transmissible by droplet contact or aerosolized lesion fluid - 10-20 day incubation

*chickenpox

- clinical dx - palliative care - centripetal rash, 4-7 days starts with limbs and moves to the center - live attenuated vaccine

*chickenpox

- cause: HHV-3 reactivates in nerves, hides in nervous system - very painful - thoracic and trigeminal nerves - live attenuated vaccine

*shingles

- causes: many (HPV) - also called: papillomas, verucas - common, flat, plantar - transmission for direct or indirect contact - usually harmless - many home tx or cryosurgery

*warts

- cause: protozoan leishmania - large pustular skin lesions - spread by female sand flies - mucocutaneous or systemic - endemic to equatorial regions

*leishmaniasis

- cause: contact with endospores of bacillus anthracis - large pustular lesions - fatal 20% of the time - tx: antibiotics (cepro)

*cutaneous anthrax

Big lesions with dead skin.

*eschar

- cause: dermatophytes(fungi) - cutaneous mycoses - tinea and based on body part - affects only non-living tissue - direct(human or animal) and indirect(fomites) contact or soil - tx: topical antifungals

*ringworm

- conjunctiva - cornea - first line of defenses: * mucus * tears(lysozyme): best defense of eye, lysozyme breaks down enzymes. - not much normal biota * S.aureus, S.epidermidis * corynebacterium

*eye

Membrane that covers whites of eye and back of eye lid.

*conjunctiva

Covers pupil of the eye.

*cornea

- cause: bacterial and viral - pinkeye(inflammed conjunctiva) - milky(bacterial) or watery(viral) exudate - transmission: direct, indirect, vertical - usually clinically diagnosed - tx: topical antibiotics - prevent with good hygiene

*conjunctivitis

Mucus and pus exudate(bacterial) is called___.

*mucopurulent

- invasion deeper into eye, involving cornea - cause: misdirected HSV-1 or 2 bacterial acanthamoeba - may lead to blindness - tx: topical antibiotic or oral antiviral

*keratitis

-neurons and neuroglia: main types of cells -brain and spinal cord -meninges Are all parts of the___.

*nervous system

- dura mater:outer most layer - arachnoid mater/subarachnoid space(CSF): spider webby - pia mater: in direct contact with spinal cord and brain

*meninges

- capillaries feed CNS - very few substances cross this barrier - immunologically privileged: reduced immune response - minimal phagocytosis and little to no inflammation

*blood brain barrier

Substances that can and cant cross the blood brain barrier: - yes: O2, water, sugars - no:antibodies, cells, large molecules

*blood brain barrier

Why doesnt the CNS mount an aggressive response to microbial invaders?

*closed compartments, heat and swelling, will cause brain damage

There is ___ normal flora in CNS.

*no

How do microbes enter?

* traumatic injury | * started as an infection some where else

- mening-itis: inflammation of meninges - life threatening - immediate problem: swelling - contagious

*meningtis

- sudden onset within a few days - severe headache * *** - VERY stiff neck - high fever - nausea/vomiting - confusing * **scream meningitis - seizures - tx: antibiotics

*bacterial meningitis

-cloudy, yellow/beige(done by lumbar puncture) -high pressure -elevated proteins -decreased glucose abundant WBC's including phagocytes

*CSF in bacterial meningitis

- neisseria menigitids - streptococcus pneumoniae - haemophilus influenzae * **throat infection starts, bacterial*** - listeria monocytogenes - cryptococcus neoformans(fungus)

*causative agents of meningitis

- cause: meningococcal/meningococcemia - gram negative diplococci - most serious of meningitis - verilance factor: capsule, pili, IgA protease

*neisseria menigitidis

- hemorrhage, vascular collapse, petechiae - spread by close contact(droplets) - young children, young adults, group living - tx: vaccine, prophylactic abx

*neisseria menigitidis

Pin point bleeding under skin is called ___.

*petechiae

- cause: pneumococal, gram positive diplococci - most common cause of community acquired - severe and acute - verulance factor: capsule

*streptococcus pneumoniae

- produces H2O and alpha hemolysin - spread by droplet contact - high risk: elderly and immunocompromised - tx: 2 vaccines, depends on age and health, IV abx

*streptococcus pneumoniae

- severe, acute - verulance factor: capsule - spread by droplet contact - not very common due to vaccine

*haemophilus influenzae

- cause: gram positive, multiple morphologies - food borne(meat and dairy) - intracellular, spreads one to the next - not fastidious(cold,heat,and salt) - mild or subclinical in healthy adults - can lead to septicemia

*listeria monocytogenes

- cause: fungus - spread through air and dust(bird droppings) - non-communicable - may be acute or chronic - highest rate among AIDS pts(fatal) - other risk: cancer, diabetes, steroid tx

*cryptococcus neoformans

- no fungus or bacteria in CSF(aseptic meningitis) - usually in children - usually enteroviruses - usually resolves in 1-2 weeks

*viral meningitis

- cause: most often by s.agalactiae(mother's to be need to watch for) - meningitis is newborns - more common in premature babies - vertical transmission, usually during birth

*neonatal meningitis

- tetanus and botulism - both organsims: * gram positive rods(purple rods) * endospores * obligate anaerobes

*bacterial neurotoxins(exotoxin)

- cause: clostridium tetani - lockjaw - enters through puncture wound - release tetanospasmin

*tetanus

- spastic paralysis(jaw, back,arms,legs)-->resp muscles (causes death b/c muscles contract and cant relax) - treat with human TIG and antitoxin(if you know you have tetanus) - toxoid vaccines DTaP and TD

*tetanus

Looks like smile with tetanus b/c facial muscles contract.

*risus sardonias

- cause: clostridium botulinum - may enter through wound, more often food borne - improperly canned food - release botulinum toxin

*botulism

- flaccid paralysis(descending from muscles of the head) muscles wont contract - treat with antitoxin - treat with good food practices

*botulism

- cause: mostly viruses - initially- flu like symptoms - sever symptoms: nausea, confusion, seizures, personality changes, hallucinations - causes: * HSV * JC virus * arboviruses * toxoplasma gondii

*encephalitis

- encephalitis in newborns of infected mothers - poor prognosis - maternal screening - acyclovir tx - in adults: * reactivation of HSV-1 in trigeminal nerve * usually subacute

*herpes simplex virus 1 or 2

- common virus - problem in AIDS pts - progressive multifocal leukoencephalopathy: * virus attacks brain * cerebral demyelination * usually fatal

*JC virus

- causes: arthopod born viruses, spread by bugs - WEE, EEE, west nile - usually spread by mosquitoes - sever cases-->coma, convulsions and paralysis - no tx - prevent by controlling insect population

*arboviruses

- cause: spread by mosquitoes - an arbovirus - endemic to east coast of north america - mortality of 33-70% - sudden onset after 4-10 days - headache, tremor, high fever(seizures), vomiting, paralysis - palliative care - only prevention is avioding mosquitoes

*eastern equine encephalitis

- protozoan form of encephalitis - slow development of low grade symptoms or asymptomatic - stillbirth - often fatal in AIDS pts - primary reservoir: cats - fecal-oral or food transmission - prevent with hygeine

*toxoplasma gondii

spread by prions: proteinaceous infections particle, no DNA/RNA, not alive - vCID, kuru - spread by meat or other tissues(mad cow)

*transmissible spongiform encephalopathies

- long incubation, rapid progression, 1 year - when signs and symptoms start to show death is near - chronic and fatal - causes: dementia, uncontrollable muscle contractions, puts holes in the brain

*transmissible spongiform encephalopathies

- prions transforms host proteins-->plaques and spogiform damage - causes: dysesthesia(bad feelings), altered behavior, dementia, impaired senses, delirium(actually confused)

*creutzfeldt-Jakob disease

- spread through infected fluids, primarily nervous tissue - prions withstand heat (including autoclave), chemicals, radiation - no tx, death 1 year after diagnosis

*creutzfeldt-Jakob disease

- cause: enterovirus picornaviridae - enters and multiplies in oropharynx - food, water, fomite, fecal contaminated water - asymptomatic or mild general symptoms

*poliomyelitis

- non-paralytic or paralytic - long term effects, muscles waste away - tx: early vaccination - no tx, palliative care, pain management - iron lung

*poliomyelitis

- cause: rabies virus - causes fatal encephalitis - infection from animal bit es/scratches or droplet contact(inhalation) - anxiety, agitation, muscle spasm, convulsions

*rabies

- flu-like symptoms-->extreme thirst and difficult swallowing-->death - wild animals most common reservoirs - vaccines - clean debride, treat with IgG(antibody infused in wound), and vaccines - incubation 3 to 8 weeks

*rabies

- disease in meninges and brain - accidental amoeboid parasites - cause: naegleria fowleri(brain eating amoeba) * risk: swimming in water * burrows into nasal mucosa * primary amoebic meningoencephalitis * often to rapid to treat * carried as normal biota in many children

*meningoencephalitis

- heart and pericardium: protection around heart - blood vessels * arteries: away from heart * capillaries: exchange CO * veins: blood back to heart

*cardiovascular system

- lymph vessels: carry lymph | - lymph nodes

*lymphatic system

- leukocytes * phagocytes * lymphocytes - no normal biota in cardiovascular system

*defenses

Infections that are everywhere are called ___.

*systemic infections

- viruses in blood:___ - fungi in blood:___ - bacteria in blood:___

* viremia * fungemia * bacteremia

Fungi or bacteria in blood that multiply rapidly, typically bacterial, can lead to septic shock.

*septicemia(sepsis)

When you blood pressure bottoms out is called___.

*septic shock

- cause: protozoans-p.falciparum, p.vivax( both have a resistance to tx)p.ovale, p.malariae - dx by blood smear or serology(immune type test) - spread by mosquitoes(female) - 10-16 day imcubation - malaise, nausea - cycle fever, chills, and sweating(b/c RBC's get ruptured) - hemolytic anemia, organ enlargement/rupture in liver and spleen

*malaria

- endemic to equatorial regions - prevention: physical and chemoprophylactic (give quinine before traveling) - tx: quinine, chloroquinolone

*malaria

- retrovirus affecting T-cells, cd4 cells - transmission: blood or sexual contact, vertical - test: ELIZE, western blot - T cell count below 200=AIDS

*HIV/AIDS

- ADI's, aids defining illnesses - tx but no cure - prevention: take meds, safe sex

*HIV/AIDS

ADI, its a cancer 3 or more ADi's you are considered having AIDS

*kaposi's sarcoma

-antiretroviral therapy -protease inhibitors: given to expecting mothers -transcriptase inhibitors -fusion inhibitors Are drugs for tx ___.

*HIV

- inner lining of the heart - acute or subacute - inflammation of endocardium(valves) - sign/symptoms: * fever * joint pain/swelling * anemia-->fatigue-->weakness * janeway leasions * oslers nodes - towards tips of fingers and toes * clubbed fingers and toes due to lack of O2

*endocarditis

- bacterial challenge in bloodstream: - colonize valves - create emboli and bacteria - causes: s.aureus, s.pyogenes, s.pneumoniae, n.gonorrhea - usually parenteral transmission - tx: antibiotics or surgery

*acute endocarditis

- cause: alpha hemolytic strep, s.mutans - preceded by damage or malformation of heart valves - cuts and lacerations introduce bacteria to bloodstream - vegetations on heart vavles, bacteria growing in clumps - prophylactic antibiotics, give to pts with heart murmurs before dental work

*sub-acute endocarditis

- bacteria or fungi actively multiplying in blood - fever, chills, low bp, altered mental state - gram neg vs gram pos - result of infections elsewhere or parental introduction - blood culture - tx: get blood pressure back up and control infection - gets mistaking for UTI

*septicemia

- cause: yersinia pestis - gram neg rod with capsule - 3 types: - pneumonic - bubonic: lymph nodes infected - septicemic - very low infectious dose, few as 3 bacteria can make you sick

*plague

- biologic vector(flees), droplet contact, bodily fluids - fever, headache, nausea, weakness, enlarged inguinal lymph nodes - death in 2-4 days if left untretaed - tx: streptomycin, gentamicin

*plaque

- cause: francisella tularensis - rabbit fever - gram neg intracellular pathogen(stain pink) - biologic vector, droplets, fluids, airborne - low infectious dose, 10 cells to get sick

*tularemia

- fever, swollen lymph nodes, portal of entry issues - vaccine for high risk individuals - can get by mowing over animal in lawn - tx:streptomycin, gentimicin

*tularemia

- cause: borrellia burgdorferi(spirochete) - vector: ticks - erythema migrans rash(bulls eye rash) in 70% of cases

*lyme disease

3 stages: - 1st stage: fatigue, fever, muscle aches, joint pain - 2nd stage: cardiovascular and neurologic problems, facial palsy may be permanent - 3rd stage: sever arthritis that is permananet

*lyme disease

- changes surface antigens to avoid immune system - testing is difficult: indirect ELISA, looks for antibodies but can give a lot of false negatives - vaccine: none - 3-4 weeks of doxycycline if caught early

*lyme disease

- cause: epstein-barr virus, determines if you are going to get the disease or not - 90% of population: time matters, mostly happens in adolescent years - direct oral contact or saliva - long incubation: takes 1 to 2 months to show symptoms

*infectious mononucleosis

- symptoms: sore throat, high fever, lypmhadenopathy, leukocytosis(WBC's spike), hepato/splenmegaly, FATIGUE is long term - supportive care: rest, get fever - can be a chronic infection

*infectious mononucleosis

Enlargement of the liver and spleen, the spleen may rupture.

*hepato/splenmegaly

___ is an onco virus that can lead to cancer.

*EBV

- cause: RNA virus - spread by: biological vectors - symptoms: high fever, internal hemorrhage - disruption of clotting, increased capillary fragility - supportive care - types: yellow fever, dengue fever, chikungunya, ebola/marburg, lassa fever - called orphan diseases

*hemorrhagic fevers

- cause: dengue fever virus - often called breakbone fever b/c of pain in bones - biologic vector: female mosquitoe

*dengue fever

- zoonotic disease: carried by non human primates - endemic to SE Asia and India, epidemics on South/central America, Texas, Florida - vaccine in testing - supportive care

*dengue fever

- high fever - no capillary fragility - cause: bacterial - tx with antibiotics - pretty common

*nonhemorrhagic fevers

-brucellosis -Q fever -cat-scratch disease -rocky mountain fever -septicemic anthrax Are all ____ fevers.

*nonhemorrhagic fevers

- cause: brucella - gram negative coccobacilli - zoonotic disease: farm animals - live inside phagocytic cells

*brucellosis

- direct contact, airborne - through damage skin or mucus membranes - undulating fever(up and down), lesions on organs(kidney and liver), muscle aches - dx by gram gran stain, distinctive looking

*brucellosis

- cause: bartonella henselae - fever due to endotoxin(gram negative) - fastidious, but not obligate intracellular parasite, does best living inside the cell but doesnt have to

*cat-scratch disease

- cat scratch or bite 40% of cats - small clusters of papules at bite - prevent: clean cat scratches - tx: azithromycin

*cat-scratch disease

- cause: coxiella burnetti - small, sporulating, gram negative, pleomorphic, coccobacilli - most common is airborne, food borne, direct contact - lungs, skin, conjunctiva, respiratory, GI

*Q fever

- sudden onset of fever, chills, headache, muscle ache, rash(maybe) - high risk: farm workers, meat cutters, vets, lab, raw milk - severe cases: doxycycline is very effective - shed through feces, and birthing of farm animals

*Q fever

- cause: rickettsia rickettsii - biologic vector: ticks - sypmtoms: fever, chills, muscle pain, headache, measles-like rash

*rocky mountain spotted fever

- cardiovascular disruptions: thrombosis or hemorrhage, low blood pressure - neurologic effects: coma, seizures - PCR test - tx and prevent like lyme disease: doxycycline - fatal: 20% untreated, 5-10% treated - prevent getting bit by ticks

*rocky mountain spotted fever

- cause: bacillus anthracis - virulence factors: 3 exotoxins, hemolysins(big concern), capsule - spread by contact, inhalation and ingestion - possible outcome of all forms of anthrax, get from another form of anthrax - site specific+headache, fever, malaise

*septicemic anthrax (in blood)

- bleeding from intestine, mucous membranes, orifices, any opening to the human body - must suspect anthrax-->culture, Ab testing (gets sent away) - vaccine for high risk - tx: antibiotics(doxycycline) - high mortality rate

*septicemic anthrax (in blood)