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Quiz 4 microbiology > The Black Plague (Yersinia Pestis) and others > Flashcards

The Black Plague (Yersinia Pestis) and others Flashcards

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1
Q

What is the cause of the black rash characteristic of the Black Plague?

A

Necrosis due to disseminated intravascular coagulation

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2
Q

What is the morphology of the Black Plague?

A

pleomorphic gram negative rods.

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3
Q

What are the metabolic properties of the Black Plague?

A 
glucose fermenter
Catalase positive
non lactose fermenter
oxidase negative
facultative anaerobe
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4
Q

Is yesenia pestis motile?

A

Non-motile

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5
Q

Describe the differences in transmission of bubonic plague vs pneumonic plague

A

Bubonic plague = flea to mammal
pneumonic plague = mammal to mammal

Note that pneumonic plague can be from sepsis and dissemination of untreated bubonic plague. This is secondary pneumonic plague.

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6
Q

Describe the three clinical features of the Black Plague

A
  1. bubonic plague: enlarged and tender lymph nodes, fever, chills
  2. pneumonic plague: pneumonia, chest pain, cough, watery/bloody sputum, rapid death from respiratory failure
  3. septicemic plague: abdominal pain, shock, bleeding into skin and other organs
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7
Q

Wayson or Giemsa stain of yesenia pestis shows:

A

safety pin appearance. Not viewed through standard gram staining

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8
Q

How do you diagnose Black Plague?

A
  1. culture on blood agar
  2. fluorescent antibody
  3. Rising antibody titer against F1 capsule
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9
Q

How would you treat the Black Plague?

A

streptomycin, tetracycline, chloramphenicol or sulfa drugs. There is a plague vaccine but it’s no longer available

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10
Q

Tularemia: How is it transmitted?

A
  1. Handling of infectious animal tissues
  2. Tick bites
  3. Ingestion of contaminated food, water, soil
  4. inhalation of aerosols from animals w disease
    NOT SPREAD FROM PERSON TO PERSON
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11
Q

What is the morphology of tularemia?

A

pleomorphic gram negative rod, slow grower

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12
Q

What medium can tularemia grow on?

A

cysteine glucose blood agar or chocolate agar. Can live at low temperatures within the environment

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13
Q

What is the infectious dose needed with tularemia?

A

10-50 organisms

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14
Q

Where does tularemia replicate?

A

Within macrophages, intracellularly

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15
Q

Pathogenesis of tularemia?

A

Look at powerpoint

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16
Q

What is the clinical presentation of tularemia?

A
  1. ulceroglandular tularemia
  2. typhoidal tularemia (bacteremia)
  3. tularemia pneumonia
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17
Q

What is the incubation period with tularemia?

A

3-5 days

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18
Q

What is the diagnosis for tularemia?

A
  1. Do not culture: can infect medical personnel
  2. serological diagnosis with 1:160 titer or 4x rise in agglutination
  3. direct antibody staining of bacteria
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19
Q

How do you treat tularemia?

A
  1. steptomycin, tetracycline, chloramphenicol. Maybe cipro

2. Doxycycline/cipro for prophylaxis

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20
Q

What is the morphology of brucellosis?

A

small, pleomorphic gram negative rod

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21
Q

What is the growth requirement of brucellosis?

A

10% CO2

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22
Q

What are the 3 major pathogenic sources of brucella?

A
  1. Brucella melitensis (unpasteurized goat/sheep cheese
  2. Brucella abortus (direct contact w/ cattle)
  3. Brucella suis (direct contact w/ pigs)
23
Q

Where else can brucella live, aside from mammals?

A

In the environment–dust/soil

24
Q

What is an important virulence factor of brucellosis?

A

LPS

25
Q

What are the clinical features of brucella?

A
  1. nonspecific cold-like symptoms
  2. fever
  3. enlarged lymph, liver, spleen
  4. osteomyelitis and endocarditis
26
Q

How do you diagnose brucella?

A

Isolation of the organism from blood/bone marrow

OR

Rise in antibody titer

27
Q

How do you treat brucella?

A

With doxycycline and rifampin

28
Q

Yersinia pestis: Is it aerobic or anaerobic?

A

facultative aerobe

29
Q

Describe the epidemiology of urban plague:

A

rats die, their fleas seek new hosts–humans

30
Q

Describe the epidemiology of rural plague

A

SPoradic human cases related to residence in close proximity to infected rats and their fleas.

31
Q

Describe the modes of transmition of yersinia pestis within the US

A
  1. flea bite
  2. hand contact with infected mammal
  3. contact with domestic pets
32
Q

What are the important virulence factors for yersinia pestis?

A
  1. anti-phagocytic capsule with F1 antigen
  2. V and W antigens needed for survival within macrophages
  3. anti-phagocytic properties present at 37 degrees
33
Q

Is yersinia pestis an extracellular or intracellular pathogen?

A

Both. Persists within mammalian monocytes

34
Q

What are the clinical features of yersinia pestis?

A
  1. bubonic plague–fever, malaise and painful lymphadenopathy
  2. pneumonic plague (primary and secondary): fever, cough, and shortness of breath
  3. septicemic plague: no bubos, widespread dissemination via blood
35
Q

What are the worrisome complications of yersinia pestis?

A

DIC causing hemorrhage and necrosis

plague meningitis

36
Q

Is there a vaccine for the Black Plague?

A

Yes

37
Q

How do you diagnose the Black Plague?

A

aspirate the bubo, gram stain and culture. Confirm through fluorescent antibody

Blood culture–smear

Serology–4x rise in antibody to F1 capsule

38
Q

How do you treat the bubonic plague?

A
  1. Tetracycline/streptomycin/chloramphenicol for 10 days
39
Q

What is unique about the growth of tularemia in the environment?

A

Can stand cold temperatures–in water for up to 90 days!!!

40
Q

What is the infectious dose of tularemia?

A

5-10 organisms

41
Q

What are routes of infection for tularemia?

A
  1. rabbit: hand contact
  2. ticks/deer flies
  3. Handling of infected tissues, animal bite,
42
Q

Describe the pathogenesis of tularemia:

A
  1. Tick bite or wound contaminated with feces
  2. skin lesion, enter lymphatics, local lymphadenopathy
  3. bactermia with granuloma in spleen or liver
  4. Intracellular survial in monocytes
  5. Endotoxin plays role in systemic symptoms
43
Q

What are the clinical features of tularemia?

A
  1. abrupt onset of fever, chills, malaise
  2. ulceroglandular symptoms are common: skin ulcer and painful adenopathy
  3. Less common: bacteremia, pneumonia (10-15%)
44
Q

Mortality with treatment of tularemia:

A

1%

45
Q

How do you diagnose tularemia?

A
  1. fluorescent antibody staining of node biopsy

2. serology: 4x rise in titer

46
Q

How do you treat tularemia?

A

streptomycin 7-10 days OR tetracycline. Will have replaces from intracellular persistence

47
Q

Is there a vaccine for tularemia?

A

Yes, live attenuated

48
Q

How is brucella transmitted/

A

Commonly in unpasteurized cheese and milk

49
Q

What are the four major types of brucella? How is each transmitted?

A
  1. Brucella abortus: contaminated milk or tissue contact with cattle
  2. Brucella suis (swine): tissue contact, slaughterhouse workers
  3. Brucella melitensis (goats/sheep): unpasteurized milk, goat cheese
  4. Brucella canis: urine from dogs
50
Q

Describe the pathogenesis of brucella:

A
  1. infectious abortion in livestock
  2. disease of liver/spleen in humans
  3. Organisms ingested by PMN, multiply in monocytes, then form granulomas in liver, kidney, spleen, and marrow
51
Q

What are the clinical features of brucella?

A
  1. Fever of undetermined origin
  2. Fever, chills, myalgias, headache, arthralgias
  3. High risk of relapse from intracellular persistence
52
Q

What are more serious complications of brucella?

A
  1. osteomyelitis and endocarditis
53
Q

How do you diagnose brucella?

A
  1. occupational history
  2. blood culture: bacteremia common
  3. Serology: 4x titer increase
  4. Bone marrow biopsy
54
Q

How do you treat brucella?

A
  1. doxycycline plus rifampin for 6 weeks

Note that 25% relapse, but mortality is low arouund 1% to 2%

Quiz 4 microbiology (5 decks)

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