Zoonotic skin infections Flashcards

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1
Q

General initial presentation of zoonotic infections

A

Flu-like symptoms

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2
Q

What is the microbiological structure of Rickettsia

A

Gram negative Bacilli, obligate intracellular parasites

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3
Q

What is significant about htem being obligate intracellular parasites?

A

It is damn near impossible to grow them in lab culture

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4
Q

If you can’t culture rickettsia, how do you diagnose it?

A

Diagnosis is by appearanceand pt history, confirmed by serology

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5
Q

All Rickettsia are sensitive to:

A

Doxycycline

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6
Q

True Rickettsia infection features what

A

The Rickettsia Triumvirate
Fever
Headache
Rash

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7
Q

Rickettsia replicate where?

A

Endothelial cells of small blood vessels

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8
Q

This replication in Endothelial cells ultimatley causes

A

vasculitis

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9
Q

Rocky Mountain spotted fever occurs in large part where?

A

East of the mississippi river (not in the rocky mtns at all.

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10
Q

First symptom of RMSF

A

flu like headache

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11
Q

Rash comes on a few days later and has what pattern?

A

Starts on the ankles and the wrists, moves radially from there (to the palms, soles, trunk)

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12
Q

Muscle soreness (especially calves)

A

RMSF

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13
Q

Major complications in RMSF

A

Septicemia, DIC

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14
Q

Diagnosis of RMSF

A

Immunoflourescence assay. IF antigens against rickettsiae

Used to be Weil Felix Test. Anti-rickettsiae antibodies cross-react with Proteus OX antigens. MUST BE confirmed by 4x rise in titers

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15
Q

Treatment for RMSF

A

Doxy….25% mortality if untreated

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16
Q

How is Rickettsiae prowazekii spread?

A

Lice who contain the organism, bite you defacate in the bite spot, the bite spot itches and you scrath it thus working the feces into the bite. You then have the organism inside you

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17
Q

Do we see R Porwazekii in the US

A

Nah….seen in regions of extreme poverty

EPIDEMIC TYPHUS

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18
Q

Rash pattern

A

Spreads from trunks to extremities

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19
Q

complications from R Prowazekii

A

myocarditis, CNS involvement

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20
Q

R. Typhii?

A

Causes endemic typhus

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21
Q

Where is R Typhii endemic in US?

A

Southern Texas, Southern Cal, Hawaii

Transmitted by the rat flea

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22
Q

Endemic typhus is much less severe than epidemic typhus

A

true

23
Q

Ehrlichia

A

southern tick borne illness, 1,400 cases per year

24
Q

Erlichia Chafeensis is also referred to as

A

Human monocytic ehrlichiosis

25
Q

E. Chafeensis is spread by what>

A

Lonestar deer tick

26
Q

E chafeensis replicates in?

A

Monocytes

27
Q

Diagnosis of E. Chafeensis

A

blood smear, confirm with serology, treat with Doxy

28
Q

E. Chafeensis in monocytes are called

A

morulae…know this

29
Q

Anaplasma phagocytophilia is also called?

A

Human granulocytic anaplasmosis

30
Q

HGA is usually called

A

rocky mountain spotless fever

31
Q

HGA lives inside

A

granulocytes…also called a morulae,

32
Q

Spirochetes

A

spiral shaped, usualy too thin to gram stain, the two we need to know are Borrelia and Leptospira

33
Q

Borrelia undergo?

A

antigenic variation

34
Q

Borrelia burgdorferi

A

Lyme disease causative agent

35
Q

B Burgdorferi presentation

A

flu like, milder than RMSF

36
Q

How long do you have to remove the deer tick before infection

A

24 hours , In RMSF- 4 hours

37
Q

What is the rash pattern in lyme disease

A

Bulls eye rash (erythema chronicum migrans)

38
Q

Early LD

A

flu-like

39
Q

Secondary LD

A

disseminated disease, weeks or months later, arthritis, facial palsy, peripheral neuropathy

40
Q

chronic LD

A

erosive arthritis (really terrible knees), bells palsy

41
Q

Lyme disease DX

A

ELISA (this can give false positives), must to a Western Blot afterwards

42
Q

Treatment of early LD

A

doxy

43
Q

chronic

A

cephalosporins

44
Q

Relapsing fever is caused by

A

Borrelia hermsii and borreli recurrentis

45
Q

Borrelia hermsii is spread by

A

tick

46
Q

B recurrentis

A

louse

47
Q

Clinical presentation of Relapsing fever

A

fever for a week, two weeks off, fever again

48
Q

How do these bacteria cause recurrent fever?

A

antigenic variation

49
Q

DX of relapsing fever

A

blood smear, serology to confirm

50
Q

Leptospira interegans

A

urine contaminated water gets into cuts

51
Q

Symptoms of leptospirosis

A

flu like, renal damage, jaundice,

52
Q

dx or leptospirosis

A

serological, treat with penicillin, Vaccinate cattle and pets

53
Q

Bartonella Henselae

A

Cat scratch

54
Q

clinical presentation

A

swollen gland near scratch site…most will clear up in a couple weeks, treat with erythromycin