Uncommon Bacterial Pathogens Flashcards

1
Q

What 3 pathogens are on the “A” list of biological weapons?

A
Bacillus anthracis (Anthrax)
Yersinia pestis (Plague)
Francisella tularensis (Tularemia)
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2
Q

What is the morphology of Bacillus anthracis

A

Gram positive, spore forming rod

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3
Q

How is Bacillus anthracis transmitted?

A

Herbivores
Humans get it from contact with or ingestion of contaminated animal products
NO person to person transmission of inhalational anthrax

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4
Q

What are the virulence factors of Bacillus anthracis?

A

Poly-D-glutamic acid capsule

Tripartite toxin

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5
Q

What are the three proteins of the anthrax tripartite toxin?

A
Protective antigen (PA)
Lethal factor (LF)
Edema factor (EF)
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6
Q

What are clinical cutaneous features of anthrax?

A

Painless ulcer with black eschar and surrounding edema

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7
Q

What are clinical gastrointestinal features of anthrax?

A

Lesions in oropharynx and GI tract like the cutaneous form (echars)
‘thumb print” in haustra due to edema of bowel

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8
Q

What are clinical inhalational features of anthrax?

A

Inhale spores, taken up by macrophages to mediastinum
Early symptoms: widened mediastinum, pleural effusions
Terminal symptoms: fever, hemorrhagic mediastinitis, bacteremia, sepsis

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9
Q

What is the treatment for anthrax?

A

Fluoroquinolone + clindamycin or rifampin

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10
Q

What is the morphology of Yersinia pestis?

A

Gram negative bacilli

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11
Q

How is Yersinia pestis transmitted?

A

Natural hosts are rodents

Transmitted by rodent flea

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12
Q

What are the virulence factors of Yersinia pestis?

A

Type III secretion system

Fibrinolysin (allows spread through soft tissues and systemic disease instead of just cutaneous)

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13
Q

What are the 3 clinical forms of Yersinia pestis and their presentation?

A

Bubonic - large swollen lymph node (bubo), sudden onset headache, malaise, myalgia, fever

Pneumonic - aerosol and person to person transmission! pneumonia progresses rapidly to respiratory failure

Septicemic - end result of bubonic or pneumonic, death if untreated

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14
Q

What is treatment of Yersinia pestis?

A

Gentamicin or fluoroquinolones

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15
Q

How is Tularemia transmitted?

A

Rabbits/hares in winter, ticks in summer

NO person to person transmission

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16
Q

What are major clinical presentations of Tularemia?

A

Ulceroglandular - ulcer with regional adenopathy

Pneumonic - inhalation or secondary to bacteremia

17
Q

What is treatment of Tularemia?

A

Gentamicin or fluoroquinolones

18
Q

What is the morphology of Tularemia?

A

Gram negative coccobacillus

19
Q

What is the morphology of Listeria monocytogenes?

A

Motile Gram positive rod
- Shows mushroom cloud in soft agar
Facultative anerobe, Beta hemolytic

20
Q

What is the pathogenesis of Listeria monocytogenes?

A

Uses internalin to invade cells
Escapes phagosome using lysteriolysin
Usurps actin (ActA nucleates on one pole, propels through cytoplasm)
Protrudes through cell membrane, engulfed by neighboring cell

21
Q

What is key to clearing a Listeria infection?

A

Cell mediated immunity (T cells)

22
Q

What groups of people are most susceptible to Listeria infection?

A

Immunocompromised individuals

Pregnant women and neonates

23
Q

What is the most common clinical manifestation in non-pregnancy associated Listeria?

A

Meningitis!!!

Leading cause of meningitis in immunocompromised hosts

24
Q

What is the treatment for Listeria?

A

Penicillin, ampicillin

CEPHALOSPORINS are INEFFECTIVE

25
Q

How is Bartonella transmitted?

A

Primarily by cats, fleas

26
Q

What diseases does Bartonella cause and what are the clinical features?

A

Cat Scratch disease
- Unilateral adenopathy

Bacillary angiomatosis
- Neovascular proliferation of skin seen in HIV patients

27
Q

What is the clinical presentation of Brucella?

A

Prolonged febrile illness