Zoonotic Infections

Question 1

Brucella is a ____ intracellular pathogen that is shaped like a ____. It is gram ___.

Answer 1

Brucella is a facultative, intracellular pathogen that is shaped like a cocobaccilus. It is gram negative.

Question 2

If Brucella is phagocatysed by a professional phagocyte, what happens?

Answer 2

It doesn’t get killed. It inhibits the macrophage myeloperoxidase-peroxide system.

Question 3

What is the host response to Brucella?

Answer 3

It is a granulomatous response.

Question 4

How do you contract Brucellosis?

Answer 4

Direct contact, touching an infected animal, or eating unpasteurized cheese or milk that is contaminated.

Question 5

Brucellosis is most common in which country?

Answer 5

It is very common in the middle east, Pakistan, Iran.

Question 6

How can we control Brucella?

Answer 6

Pasteurize your milk and cheese. Education farmers, abattoir workers. Surveillance for infection in food animal herds and culling of infected animals. Vaccinate the animals!

Question 7

Tularemia is caused by:

Gram \_\_\_
Motile?
Aerobic/Anaerobic?
Shape?
Intracellular?

Answer 7

Franciscella tularensis (highly virulent!)
Tularemia is caused by:

Gram negative
Non-motile
Aerobic
Coccibacillus
Facultative Intracellular

Question 8

How is tularemia transmitted?

Answer 8

Via a fly or tick that bites a small mammal. Or from the mammal itself (from skinning or butchering). In particular, the mammal is a rabbit.

Question 9

How does Tularemia present?

Answer 9

It depends on how it enters your body. Most commonly, if it enters through the skin, you can get an ulceroglandular tularemia.

Question 10

How do you prevent tularemia?

Answer 10

Education of hunters and outdoorsman. There is also a vaccination.

Question 11

Q fever is caused by what?

Answer 11

Coxiella Brunetti

Question 12

C. Burnetii is acquired from ___ ___ __ ____ and is most prevalent in ___ and N. ____. In N. American, is it found in ____.

Often acquired during assisting with ____ or ___ contact.

It is transmitted via ___.

Many farmers or vets are at risk.

Answer 12

C. Burnetii is acquired from cattle, sheep, goats and cats. It is most prevalent in . Europe, and N. Australia, and N. America. In N. America, is it found in Nova Scotia.

Often acquired during assisting with birthing or placenta contact.

It is transmitted via aerosol transmission.

Many farmers or vets are at risk.

Question 13

A farmer comes to your clinic with flu-like illness, malaise, etc. A couple days she tells you that her sheep just gave birth. What is it?

Answer 13

Coxiella Burnetii –> Q fever

Question 14

KNOW THIS

There are not a lot of infections that cause pneumonia and hepatitis at the same time….but there is one. What is it?

Answer 14

Q fever - Coxiella burnetii

Question 15

What caused the black plague?

Answer 15

Yersinia pestis

Question 16

Yersinia petis is a small,
gram ___, coccobacillus. It shows a strong ___ staining. It is taken up and killed by ___. ___ cannot kill them. They use a ____ type of killing system. It is transmitted most commonly by what animal?

Answer 16

Yersinia petis is a small,
gram negative, coccobacillus. It shows a strong bipolar (safetypin) staining. It is taken up and killed by PMNs. Macrophages cannot kill them. They use a Type III secretion type of killing system which injects virulence factors into the host.
It is transmitted by rodents or their fleas.It can also be transmitted by prairie dogs and cats.

Question 17

Yersinia Pestis has an incubation period for about __ to __ days for pneumonia, and __ to __ days for bubonic or septicemia)

Answer 17

1-4

1-7

Question 18

A patient comes to you with sudden onset of fever, shortness of breath, hemoptysis, chest pain, and GI symptoms. He says that he was recently bit by a prairie dog.
What do you expect to see under the microscope and what does he have?

Answer 18

You’d expect to see g- coccobacilus that shows bipolar safety pin like staining. He has yersinia pestis

Question 19

How do you control Plague caused by Yersinia Pestis?

Answer 19

Rodent and flea control. Vaccine in development. Antibiotic prophylaxis of contacts or infected individuals or exposures.

Question 20

Cat Scratch Fever is caused by which bacteria?

Answer 20

Bartonella

Question 21

An immunocompetent patient comes to you with a papule on her hand, and enlarged lymph nodes in the axilla and groin (lymphadenitis). She says she recently adopted a stray kitten which scratched her. What type of stain would you do and what could she have?

Answer 21

You should do a Wharton-Starry SILVER stain.

Cat scratch fever from Bartonella.

Question 22

Which tick is responsible for causing Rocky Mountain Spotted Fever? Where is it most prevalent?

Answer 22

Dermacentor variabilis, the American dog tick. It is more prevaent in the SE U.S

Question 23

Ricketssia is a ___ intracellular. It is unable to produce __ and __. It is a gram ___ and its shape is ___.
What test do you use to diagnose Rickettsia? What stain do you use?
What is the main symptom that is causes?

Answer 23

Obligate. It is unable to produce NADH and AcH. It is weakly gram negative and it is shaped like a cocobaccilus.

Wheel-Felix agglutination test. You can use a Giemsa stain.

Small vessel vasculitis.

Question 24

A patient from N.C. comes to your clinic with fever (greater than 102), headache, myalgia, N/V and diarrhea. You notice small vessel vasculitis.
She said she recently went hiking in the woods. What might she have? How could you confirm?

What drug do you use?

Answer 24

She may have Rocky Mountain Spotted Fever caused by Ricketssiae. You should first do a gram stain wtih Giemsa, and then agglutination test with Wheel-Felix.

Use doxycycline

Question 25

____ infects vascular endothelium and smooth muscle. A person who gets this will have small vessel vasculitis.

Answer 25

RMSF (Rocky Mountain Spotted Fever)

Question 26

A patient comes to your clinic in June with a headache and a fever greater than 102. She has rashes as well. She said she was out hiking in the woods a few days before. What does she have and how can you treat her?

Answer 26

RMSF

Treat with Doxy for 5 days

Question 27

T/F: Ricketssiae can be a very systemic infection

Answer 27

True.

Question 28

Initial symptoms of RMSF are ___ greater than ___, ___ and ___.

Answer 28

Fever greater than 102, Headache, Myalgia

Question 29

___ ___ ____ is caused by the Lonestar tick (amblyomma americanum) and found in the ___ U.S. Another tick that can transmit erlichiosis is the __ tick, which can cause HGA. This is found in Nothern U.S. N.E, MInnesota, and Wiconsin,

Answer 29

Human mononucleosis
Erlichiosis
Ixodes Tick

Question 30

HME is caused by ehrlichia chaffeensis. It is an infection of ___ and ____. The other ehrlichia anaplasma infection is transmitted by the ___ tick and causes infection of ____. These cause big cytokine storms, which make the person sick.

Answer 30

HME is caused by ehrlichia chaffeensis. It is an infection of macrophages and monocytes. The other ehrlichia anaplasma infection is transmitted by the deer tick and causes infection of PMN granulocytes (HGA)

Question 31

A patient comes to you with either HME or HGA (Human monocytic ehrlichiosis or human granulocytic anaplasma phagocytophilium). How can you tell the difference?

Answer 31

In RMSF which causes HME, you see a rash.

Question 32

How do you treat RMSF and HME/HGA?

Answer 32

Doxycycline

Question 33

Ehrlichia chaffeensis primarily infects __ ___, We see this mostly in the ___ east of the U.S. while Anaplasma phagocytophilium infects ___ ___. We see this mostly in Northern U.S. and New England area.

Answer 33

Ehrlichia chaffeensis primarily infects mononuclear leukocytes, We see this mostly in the southeast of the U.S. while Anaplasma phagocytophilium infects PMN granulocytes. We see this mostly in Northern U.S. and New England area.

Question 34

___ can be used to treat almost ALL tick borne infections

Answer 34

Doxycycline

Question 35

Lyme Borreliosis:
Shape-
Transmitted by ___ tick.
At site of bite, you get ____ ___, which is a bull eyes rash.

Answer 35

Lyme Borreliosis:
Shape- spirochete
Transmitted by Ixodes tick.
At site of bite, you get erythema migrans, which is a bull eyes rash.

Question 36

How do you prevent Tick borne infections?

Answer 36

After you’d been oustide, check your body. Use tweezers to remove them. You can also use Permethrin spray.

Question 37

T/F: You can give prophylaxis where ticks are endemic.

Answer 37

True.

Question 38

Rabies is transmitted by ___ of an infected animal.

Answer 38

Saliva

Question 39

A patient comes to you concerned that he might have been bitten by a bat during his camping trip. He said that he woke up one morning with a bat flying over him. What do you do?

Answer 39

Give him a post exposure vaccination.

It us 99.9% fatal.