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Pulmonary Microbiology > Tularemia > Flashcards

Tularemia Flashcards

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1
Q

Describe the characteristics of Francisella tularensis? What disease does it cause?

A

Francisella tularensis is:
1. anaerobic 2. gram-negative 3. non-motile and 4. non-sporing 5. coccobacillus.
It is the causative agent of TULAREMIA

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2
Q

How is Tularemia frequently spread? How else can it spread?

A
  1. Tularemia is frequently spread by direct contact with rabbits (hence it’s called rabbit fever).
    2&3. However, it can also be spread by other animals, typically rodents, and by arthropods.
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3
Q

What are the 6 different forms that Tularemia occurs in?

A
  1. typhoidal
  2. pneumonic
  3. oculoglandular
  4. oropharyngeal
  5. ulceroglandular
  6. glandular
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4
Q

Why is Dx of tularemia difficult?

A

B/c the disease mimics many other illnesses.

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5
Q

Pathogenesis of tularemia varies greatly dependin on what?

A

depending on the mode of infection

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6
Q

What is the incubation period of tularemia?

A

about 3-5 days, but it can take as long as two weeks for symptoms to appear

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7
Q

What are the symptoms of tularemia?

A

They vary based on the mode of infection, but generally include:
1. fever 2. chills 3. joint and muscle pain 4. headache 5. weakness and 6. sometimes pneumonia

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8
Q

What are the symptoms of people who develop pneumonic tularemia?

A

They experience:

1. chest pain 2. bloody sputum, and 3. difficulty breathing

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9
Q

How is tularemia treated? Is it curable?

A

The disease is effectively cure by antibiotic treatment

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10
Q

How is tularemia spread? (4)

A
  1. thru bites of ticks (wood, dog, and lonestar types) and deer flies
  2. thru contact w/ contaminated water, blood, or tissue while handling carcasses of infected animals (skinning or dressing animals)
  3. thru eating insufficiently cooked meat of infected animals
  4. thru inhalation of dust from contaminated soil, hay, or grain
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11
Q

The virulence of the tularemia organism lends itself to potential use as what?

A

as a biological weapon (it’s a Category A biodefense agent)

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12
Q

What are some characteristics of Francisella tularensis that help it survive the innate immune response and the killing mechanisms and phagosomes of alveolar macrophages? (3)

A

a. LPS has reduced immunostimulatory property
b. The bacterial CAPSULE plays a role in resistance to complement
c. A number of protein products have been found to be important for survival in macrophages

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13
Q

What is the incubation period of tularemia? How long does it take people exposed to it to become sick?

A

Most people exposed to tularemia who become sick generally do so w/in 2 to 10 days, but incubation can take as little as a few hours or as long as 3 weeks

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14
Q

What are the 6 types of tularemia?

A

There are six types of tularemia, each with its own set of symptoms:

  1. Ulceroglandular
  2. Glandular
  3. Oculoglandular
  4. Oropharyngeal
  5. Pneumonic
  6. Typhoidal
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15
Q

What is by far the most common form/type of tularemia? What are its signs and symptoms?

A 
Ulceroglandular Tularemia
Signs/Symptoms:
1. A skin ulcer that forms at the site of infection (usually an insect or animal bite)
2. Swollen and painful lymph glands
3. Fever
4. Chills
5. Headache
6. Exhaustion
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16
Q

What are the signs/symptoms of people with glandular tularemia?

A

They are the same as those for ulceroglandular, except NO SKIN ULCERS

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17
Q

What does oculoglandular tularemia affect? What can it cause?

A

It affects the eyes and may cause:

  1. Eye pain
  2. Eye redness
  3. Eye swelling and discharge
  4. An ulcer on the inside of the eyelid
18
Q

What is oropharyngeal tularemia caused by? What does it affect?

A

It is usually caused by eating poorly cooked wild animal meat or drinking contaminated water. This form affects the digestive tract.

19
Q

What are the signs/symptoms of oropharyngeal tularemia?

A
  1. fever 2. sore throat 3. vomiting 4. diarrhea
20
Q

In what individuals is pneumonic tularemia more common?

A

It is more common in:

a. the elderly
b. people with typhoidal tularemia

21
Q

What are the signs/symptoms of pneumonic tularemia?

A

Signs and symptoms typical of pneumonia:

  1. cough
  2. chest pain
  3. difficulty breathing
  4. other forms of tularemia also can spread to the lungs
22
Q

What is the rare and serious form of tularemia?

A

Typhoidal tularemia

23
Q

What are the signs/symptoms of typhoidal tularemia?

A
  1. high fever
  2. extreme exhaustion
  3. vomiting and diarrhea
  4. enlarged spleen
  5. enlarged liver
  6. pneumonia
24
Q

What is an important fact about tularemia epidemiology/transmission? (KNOW THIS)

A

Tularemia doesn’t occur naturally in humans and isn’t known to pass from person to person.

25
Q

Where does tularemia occur? Why?

A

It occurs worldwide, especially in RURAL areas, b/c many mammals, birds, insects, and fish are infected with F. tularensis.

26
Q

How long can F. tularensis live? Where can it live?

A

F tularensis can live for weeks in soil, water, or dead animals

27
Q

What are the several routes/modes of transmission of tularemia?

A
  1. Insect bites
  2. Exposure to sick or dead animals
  3. Airborne bacteria
  4. Contaminated food or water
28
Q

Why is the route/mode of transmission of tularemia important?

A

How you get the disease (the mode of transmission) usually determines the TYPE and SEVERITY of symptoms

29
Q

Although a number of insects carry tularemia, what two are most likely to transmit the disease to humans?

A

Ticks and Deerflies

30
Q

Tick bites cause a large number of cases of what type of tularemia?

A

Ulceroglandular tularemia

31
Q

Ulceroglandular tularemia can also form through what two ways?

A

(both via exposure to sick or dead animals)

  1. It can result from handling or being bitten by an infected animal, most often a rabbit or hare.
  2. Bacteria can enter the skin thru small cuts and abrasions or bites, and an ulcer forms at the wound site
32
Q

What can cause oculoglandular tularemia?

A

Rubbing your eyes after touching an infected animal (exposure to sick or dead animals)

33
Q

How can F tularensis in the soil become airborne? What form of tularemia can inhaling F. tularensis lead to? What other workers are at risk of airborne infection?

A

Bacteria in the soil can become airborne during gardening, construction, or other activities that disturb the earth.
Inhaling it can lead to pneumonic tularemia.
Laboratory workers who work with tularemia are at risk of airborne infection.

34
Q

What is the most uncommon mode of tularemia transmission? What type of tularemia and its associated signs and symptoms does this mode lead to?

A

Eating undercooked meat of an infected animal or drinking contaminated water.
The signs include vomiting, diarrhea and other digestive problems (oropharyngeal tularemia)

35
Q

Why is well-cooked meat (at least 160F or 71C) usually safe to eat?

A

Heat kills F. tularensis

36
Q

What are the diagnostic tests used to Dx tularemia?

A
  1. Blood culture for F. tularensis
  2. Blood test measuring the body’s immune response to infection (Serology for tularemia)
  3. CXR
  4. PCR test of a sample from an ulcer
  5. Look at chart in the handout
37
Q

Tularemia affects the results of what tests?

A

It affects the results of febrile agglutinins and some tests for infectious mono.

38
Q

What is the DDx for Tularemia?

A
  1. Any infectious skin agent causing a skin lesion
  2. Tickborne infections (RMSF, Babesiosis)
  3. Bacterial Septicemias
  4. Flu, flu-like viral infections
  5. Acute causes of pneuomonia, especially common causes of atypical pneumonia
  6. Plague
  7. Q fever
  8. Anthrax
39
Q

What is the goal of treatment of Tularemia?

A

to cure the infection with antibiotics

40
Q

What drugs are commonly used to treat tularemia infections?

A

Streptomycin and Tetracycline

41
Q

In the treatment of tularemia, what is an alternative therapy to streptomycin?

A

gentamicin

42
Q

While tetracycline and chloramphenicol can be used alone to treat tularemia, why are they not considered a first-line treatment?

A

they have a high relapse rate

Pulmonary Microbiology (4 decks)

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