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Rickettsia, Coxiella, Ehrlichia, Bartonella
intracellular, fastidious Gram negative, aerobic rods
34
Medical
Graduate
10/16/2009

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Cards

Term
What is a clinical characteristic of Rickettsia?
Definition

typically cause fevers with a rash

Term
How is Rickettsia transmitted?
Definition
host is infected by an insect bite
Term

What is the pathogenesis of Rickettsia?

 

Definition
infection of vascular endothelium results in RBCs leaking from the vessels and causing a rash and petechial lesions; this same process in organs causes systemic symptoms
Term
What is the ideal way to diagnose Rickettsia and why is culture not used?
Definition
PCR; culture is difficult and hazardous
Term
What are good versus bad serologic tests for Rickettsia?
Definition

good: ELISA

bad: Weil-Felix agglutination tests (insensitive and non-specific)

Term
What organism causes Rocky Mountain Spotted Fever in the rest of the world?
Definition
Rickettsia conorri
Term
In what age group does Rocky Mountain Spotted Fever usually occur?
Definition
15 and younger
Term
What are the clinical manifestations of Rocky Mountain Spotted Fever?
Definition
  • incubation: 2-14 days
  • fever, headache, confusion, myalgia
  • rash by 2nd or 3rd day
    • appears on wrists and ankles, may spread to trunk
    • key if on PALMS AND SOLES
  • death in 25% w/o treatment
Term
What is important about diagnosing Rocky Mountain Spotty Fever?
Definition
must make clinical diagnosis- too late to treat if you wait for laboratory confirmation!
Term
What disease does Rickettsia akari cause and where is it most common?
Definition
Rickettsialpox, in NY and poorer sections of other large cities
Term
What causes scrub typhus and where is it most common?
Definition
Rickettsia tsutsugamushi, Asian and South Pacific
Term
In what disease are the vectors forever infected, and why?
Definition
rodent mites (Scrub typhus) remain infected forever by transovarian transmission
Term
What causes Louse-borne typhus fever?
Definition
Rickettsia prowazekii
Term
What are the symptoms of typhus fever?
Definition
fever, headache, confusion, myalgia, rash
Term
What are possible complications of typhus fever and what is called when it relapses?
Definition

- heart and CNS

- recrudescent typhus (Brill's disease)

Term

How long can Rickettsia remain dormant and where?

 

Definition
10-40 years, in reticuloendothelial cells
Term
What causes murine typhus?
Definition

Rickettsia typhi

 

Term
What is the difference between Murine typhus and Rickettsialpox?
Definition
Murine is carried in urban areas by a rat flea, rickettsialpox is carried in urban areas by the house mouse mite
Term
How is Coxiella burnetii different from other Rickettsiae in regards to mode of transmission and clinical presentation?
Definition
It is spread via aerosol, does not present with a rash
Term
Which rickettsial organism grows in placental tissue of sheep, goats, and cattle
Definition
Coxiella burnetii
Term
What people are most likely to contract Q fever?
Definition
researchers, vets, slaughter house workers, ranchers
Term
What is the incubation period and symptoms of Q-fever?
Definition

9-20 days

  • fever, chills, headache, no rash!
  • mild pneumonia
  • liver, abnormal LFTs
Term
What are some occasional complications of Q fever?
Definition
endocarditis, encephalitis, pericarditis
Term
What causes human monocytic ehrlichiosis?
Definition
Ehrlichia chaffeensis
Term
What are the symptoms of human monocytic ehrlichiosis?
Definition
fever, hypotension, confusion, renal failure, pancytopenia, GI hemorrhages, hepatocellular injury
Term
What is a morula inclusion in a mononuclear cell from the CSF indicative of?
Definition
Ehrlichia chaffeensis infection
Term
What organism causes human granulocytic anaplasmosis?
Definition
Anaplasma phagocytophilia
Term
What are symptoms of human granulocytic anaplasmosis?
Definition
fever, chills, headache, muscle ache, nausea, vomiting, elevated LFTs, decrease in platelet and WBC count
Term
What is the mortality rate for human granulocytic anaplasmosis and what does it result from?
Definition
5% mortality: kidney failure, meningitis
Term
What are symptoms of Trench fever?
Definition
fever, rash, bone pain, splenomegaly, can be mild to severe
Term
What causes urban trench fever and what is target population?
Definition
Bartonella quintana, disease of the homeless (esp. alcohol males)
Term
What are the symptoms of cat-scratch disease?
Definition
blister at site of inoculation in 3-10 days, lymph nodes swell and become tender, disappear in 2-6 months -> lifelong immunity
Term
What is the severe systemic variation of cat-scratch fever called and what population is most at risk?
Definition
Bacillary angiomatosis: AIDS patients
Term
How is cat-scratch fever commonly diagnosed?
Definition
antibody titer or PCR test (not culture)
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