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Dermatological Block > Zoonoses > Flashcards

Zoonoses Flashcards

1
Q

Rickettsia properties

A

very short rods, obligate intracellular parasites, structurally similar to gram negatives, but gram stain work poorly

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2
Q

Rickettsia pathogenesis

A

typical lesion is a vasculitis; skin rash caused by edema and hemorrhages due to cutaneous vasculitis

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3
Q

Rickettsia rickettsii RMSF epidemiology

A

transmitted by ticks; usually in GA, NC, VA; reservoirs are ticks, dogs, rats; usually occurs in kids in summer; most common rickettsia infection

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4
Q

Rickettsia rickettsii clinical presentation

A

acute onset of nonspecific symptoms, muscle soreness (esp. calves), rash 2-6 days later, begins with macules that frequently progress to petechiae; rash starts at ankles and wrists, spreads to palms, soles, trunk; CNS issues can occur (delirium and coma); DIC, edema, circulatory collapse possible; 25% fatal if untreated

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5
Q

Rickettsia rickettsii diagnosis

A

H&P, confirmed by serology; Weil-Felix test - cross reacts antibodies to Proteus; IFA can be used

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6
Q

Rickettsia prowazekii (epidemic typhus) epidemiology

A

transmitted human to human by body lice feces, virtually absent in US

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7
Q

Rickettsia prowazekii (epidemic typhus) presentation

A

sudden onset of flulike symptoms 1-3wks post exposure; rash 5-9 days after symptom onset; rash starts on trunk and spreads to extremities, does not cover palms and soles; high mortality untreated; myocarditis and CNS involvement; death due to vascular collapse or bacterial pneumonia

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8
Q

Rickettsia prowazekii diagnosis

A

IFA and ELISA to visualize bug in infected tisse or to measure increased antibodies (4-fold titer increase between acute and convalescent is diagnostic)

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9
Q

Rickettsia typhi (endemic typhus) epidemiology

A

transmitted to humans by rat flea; small mammals are reservoirs

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10
Q

Rickettsia typhi presentation (endemic typhus)

A

less severe than epidemic but same symptoms with rash (50% of pts) starting on trunk and spreading to extremities 5-9 days post flulike symptom onset; rarely fatal if untreated

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11
Q

Rickettsia typhi diagnosis (endemic typhus)

A

symptomology combined with serology (ELISA)

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12
Q

Ehrlichia chaffeensis epidemiology

A

transmitted by Lone star deer tick; replicates in monocytes, inclusions are called morulae

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13
Q

Ehrlichia chaffeensis presentation

A

flulike symptoms with n/v/d and conjunctival injection; rash in kids (60%) and adults (30%); 2% fatality rate

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14
Q

Ehrlichia chaffeensis diagnosis

A

blood smear (murulae in monocytes), confirm with serology

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15
Q

Anaplasma phagocytophilia epidemiology

A

causes rocky mountain spotless fever; transmitted by Ixodes blacklegged ticks

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16
Q

Anaplasma phagocytophilia presentation

A

flulike symptoms, malaise, uncommonly rash (indicative of confection with burgdorgeri); severe cases: difficulty breathing, hemorrhage, renal failure, neuro issues; low mortality rate

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17
Q

Anaplasma phagocytoophilia diagnosis

A

blood smear, look for morulae in granulocytes

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18
Q

Coxiella burnetii (Q-fever) properties

A

gram negative bacillus that is an obligate intracellular parasite; infects cattle, sheep, and goats primarily

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19
Q

Coxiella burnetii (Q-fever) epidemiology

A

transmitted to humans that handle contaminated viscera or drink raw contaminated milk, or by tick; can be aerosolized if spore form; low incidence in all countries

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20
Q

Coxiella burnetii (Q-fever) pathogenesis

A

survives and replicates within macrophages, obligate intracellular parasite; extremely infectious; related to Legionella structurally

21
Q

Coxiella burnetii (Q-fever) presentation

A

about half are asymptomatic; acute febrile illness, can become pneumonic, sometimes has liver and heart involvement; long term chronic infections are uncommon but may cause endocarditis or granulomatous hepatitis which are always fatal untreated

22
Q

Coxiella burnetti (Q-fever) diagnosis

A

serological, looking for high or rising antibody titers

23
Q

Borrelia burgdorferi (Lyme) properties

A

flexible, motile spiochete (seen on dark field microscopy, Giemsa, silver stain), cultures of blood are usually negative, culture from tick is usually positive

24
Q

Borrelia burgdorgeri (lyme) epidemiology

A

transmitted by ticks (ixodes scapularis on East coast; Ixodes pacificus on west coast); main reservoir is white footed mouse; transmitted by nymph ticks during 24-48hr feed; mainly in NY, CT, PA, NJ

25
Q

Lyme disease pathogenesis

A

spreads from the bites site though surrounding skin, disseminates in blood causing bacteremia and infects heart, joint, and CNS; antigenic variation of its OPSs to adapt for survival within various hosts

26
Q

Acute lyme disease presentation

A

erythema chronic migrans (bulls eye rash), rash is painless and non-puritic; flulike symptoms; arthralgia without arthtitis

27
Q

Subacute lyme disease presentation

A

cardiac and neurologic involvement; myocarditis forming heart block, acute aseptic meningitis, bilateral facial nerve palsy, Bell palsy, other cranial neuropathies

28
Q

Chronic lyme disease presentation

A

arthritis of large joints primarily (likely autoimmune) and chronic progressive CNS disease

29
Q

Lyme disease diagnosis

A

ELISA (sensitive, false positives), confirmed by Western blot, PCR also available

30
Q

Borrelia spp. Relapsing fever epidemiology

A

transmitted by Ixodes tick and body louse; most endemic in high desert of Western US; rodents and small mammals are reservoir

31
Q

Relapsing fever pathogenesis

A

antigenic variation of OPS is responsible for relapsing disease

32
Q

Relapsing fever (Borrelia) presentation

A

fever for a week, then recurs two weeks later; cycle can repeat up to 10 times; skin rash is uncommon

33
Q

Relapsing Fever (Borrelia) diagnosis

A

blood smear - see spirochetes; serology can be confirmatory but usually not needed

34
Q

Leptospirosis properties

A

tightly coiled, fine spirochetes; not stained with dyes; sometimes visible via dark field microscopy

35
Q

Leptospirosis epidemiology

A

dogs are primary reservoir in US; bugs are shed in urine which contaminates water and soil; transmission is through consumption or touching of contaminated products; infection can occur via mucosal or cutaneous routes

36
Q

Leptospirosis pathogenesis

A

bacteria spread from infection site and eventually disseminate via bacteremia to other organs; bugs have antigenic variation causing relapsing symptoms

37
Q

Leptospirosis presentation

A

early disease has none specific fever, chills, HA, conjunctival suffusion, followed by short period without symptoms; last phase is characterized by aseptic meningitis, jaundice, uremia, Weil’s disease, lung hemorrhage

38
Q

Leptospirosis diagnosis

A

history of possible exposure, suggestive clinical signs, rise in IgM antibody titers, isolation form blood and urine (unreliable)

39
Q

Bartonella heneslae (Cat Scratch Disease) properties

A

small, pleomorphic gram negative rod; fastidious organism that will not grow on normal blood agar and requires specialized medium

40
Q

Bartonella heneslae (Cat Scratch Disease) epidemiology

A

cat scratches or bites is primary transmission route; normal oral flora of cat; mostly seen in children

41
Q

Bartonella heneslae (Cat Scratch Disease) pathogenesis

A

low virulence pathogen; usually self limiting in immunocompetent patients

42
Q

Bartonella heneslae (Cat Scratch Disease) presentation

A

fever and tender LAD on same side as scratch; papule at site of scratch may precede LAD; long disease course that resolves without antibiotics; rarely endocarditis or encephalitis can develop

43
Q

Bartonella heneslae (Cat Scratch Disease) in AIDS

A

bacillary angiomatosis can occur in skin and visceral organs; path will distinguish it from Kaposi

44
Q

Bartonella heneslae (Cat Scratch Disease) diagnosis

A

serological usually; can see rods in biopsy tissue using Warthrin-Starry silver stain

45
Q

Bacillus anthracis cutaneous clinical findings

A

incubation period of 2-12days; at site of inoculation a painless papule develops with surrounding edematous inflammation and subsequent blistering; a painless necrotic center develops within a few hours; symptoms include fever, dizziness, heart palpitations; w/o treatment will develop lymphangitis and sepsis

46
Q

Burkholderia pseudomallei (meliodosis or Whitmore’s disease) Cutaneous

A

cutaneous infection occurs through contact of abrasions with contaminated soil or water; more common in Asia; most commonly pneumonic disease that can mimic TB

47
Q

Francisella tularensis cutaneous

A

skin infections cause the ulceroglandular presentation of disease (skin lesions with bubo-like LAD), 1-3% mortality w/o treatment; transmitted by tick and contact with animal blood; can disseminate to lungs and cause pneumonic disease

48
Q

Yersinia pestis cutaneous

A

bubonic plague begins with pain and swelling of lymph nodes near site of flea bite, followed by dissemination to lymph nodes which become enlarged and very tender, also disseminates to other organs. Fatal in 50% of cases

Dermatological Block (6 decks)

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