Zoonoses

Question 1

Erysipelothrix rhusiopathiae

Answer 1

pork, whales, nodular eruption that is localized

Question 2

Bartonella henselae

Answer 2

young cats
stellate abscess on biopsy
Warthin Starry stain
serology, PCR, DFA on pus

Question 3

Tuleremia

Answer 3

exposure to wild animals or their ticks

should be systemically ill with fever, malaise, chills

Question 4

Cat Scratch Disease

Answer 4

Bartonella henselae
acute suppurative lymphadenitis proximal to a bite, scratch or lick of a young cat; cats have chronic bacteremia but seem healthy
cat fleas may transmit between cats and humans

Question 5

Cat Scratch disease

Answer 5

papule, pustule at inoculation site, may be self-limited
encephalitis, stellate retinitis, uveititis are rare
macular star**

Question 6

Cat Scratch disease

Answer 6

10% drain spontaneously
if not, node aspiration improves pain, excludes Staph -
tx with azithromycin

Question 7

Bartonella

Answer 7

slow growing gram neg rod

Question 8

B henselae

Answer 8

cat scratch disease

peliosis

Question 9

B baciliformis

Answer 9

Andes, Peru, sand fly bite

Carrion’s disease

Question 10

B baciliformis

Answer 10

Oroya fever - acute, fever and anemia
later - verruga peruana (hemangioma-like nodules in skin and mucous membranes). tx with ciprofloxacin (oroya)
Azithromycin (VP)

Question 11

B quintana

Answer 11

Human body louse
Bacteremia in homeless, trench fever
endocarditis

Question 12

Bacillary angiomatosis (cutaneous)

Answer 12

B henselae or B quintana
Lesions bleed easily
vascular proliferation, plump endothelial cells, bacilli which make growth factor

Question 13

Bacillary peliosis

Answer 13

visceral involvement, B henselae 
hepatosplenic bacillar peliosis
fever, chills, hepatosplenomegaly
hypodense center with contrast-enhancing rim
US, MRI - masses
blood filled spaces, bacilli

Question 14

B quintana

Answer 14

Osteomyelitis. lytic

Question 15

B quintana

Answer 15

chronic bacteremia, endocarditis (culture negative)

Question 16

B quintana

Answer 16

human body lice; crowded, unsanitary conditions - trench fever in WWI
splenomegaly, fever, arthropathy and arthritis, leg pain, rash, weakness, thrombocytopenia

Question 17

B quintana

Answer 17

bacteremia, endocarditis in AIDS, homeless, alcoholics

Question 18

B henselae OR quintana

Answer 18

culture negative endocarditis
insidious onset
consider in homeless patients 
PCR should be positive
lower temp, fresh chocolate agar
if IgG > 800, highly suggestive

Question 19

Anthrax

Answer 19

*skin (95%), pruritic papule on skin exposed to goat hair, animal hides
Small vesicles around an ulcer with pain
edema
Mild systemic symptoms
Aerobic, encapsulated, sporulating gram positive rod on smear, culture
Tx with PCN, weaponized strains resistant to multiple abx
Inhalation, ingestion

Question 20

Tuleremia

Answer 20

highly infectious

gram negative coccobacillus

Question 21

Tuleremia

Answer 21

vectors - ticks, deerflies
direct inoculation - rabbits, squirrels
hunters skinning animals, farmer, veternatian
red tender local LN inoculation site
ulceroglandular > glandular > oculoglandular

Question 22

tuleremia

Answer 22

aerosolizing bunnies, lawnmowing, brush cutting,

pneumonia

Question 23

plague

Answer 23

Yersinia pestis 
NM, California, AZ, Colorado
rodent flea bite, prarie dogs
fever, nausea, swollen, painful nodes 
sepsis, PNA, can aerosolize

Question 24

yersinia pestis

Answer 24

gram negative coccobaccilus
bipolar-staining bacilis
safety pin appearance
lab hazard
streptomycin
**prairie dogs!

Question 25

plague

Answer 25

plaque is endemic in Mandagascar - consider plague!

also consider Marmot

Question 26

leptospirosis

Answer 26

spirochetes in the urine of infected host, able to survive in wet environment
ecotourism - hawaii, veterinarians, loggers, triatheletes, white water rafting, trapping, urine from cows pigs, dogs, raccoons, rats, mice

Question 27

leptospirosis

Answer 27

fever, myalgia, HA, aseptic meningitis
conjunctival suffusion, rash
jaundice, azotemia, pulm hemorrhage
serology, culture urine
doxy for outpatients, IV PCN inpatient, can get JH reaction

Question 28

brucellosis

Answer 28

• Exposure to non-USA dairy or meat, unpasteurized cheese, uncooked meat
• Slaughterhouse worker, meat packer, veterinarian
• Acute or indolent onset fever, aches
• Nodes, liver, spleen may be enlarged
• Later onset lesions in bone, liver,
  
  • Epididymo-orchitis, endocarditis
  • Sacroilitis, tenosynovitis, meningitis
  • ingestion
  • malodorous perspiration

Question 29

Q fever

Answer 29

Coxiella burnetti - tiny coccobacillus
spores survive in straw, manture, meat for months
acute pneumonia, fever, HA, hepatosplenomegaly
chronic endocarditis
granulomatous hepatitis with donut granulomas
tx with serology, diagnosis with doxy, levaquin

Question 30

Streptobacillus monofilomis

Answer 30

only bacteria that causes RBF in north america - fever, chills, myalgia, headache, vomiting, rash
- gram negative
contact with rodents carrying bacteria
- consumption of food, water contaminated with urine and droppings of rodents carrying bacteria
- PCN treatment

Question 31

Spirillum minus

Answer 31

Asia; fever, ulceration at bite site, lymphangitis, lymphadenopathy, rash
infected after contacts with rodents carrying bacteria - food or water contaminated with urine, droppings of rodents carrying bacteria