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Sterile site bugs
Microbiology
| Question | Answer |
|---|---|
| Intermittent septicemia | focus of infection is distal site |
| Continuous septicemia | mostly intravascular |
| Sterile body fluids: | Blood, CSF, peritoneal/ascitic, pleural, pericardial, joint/synovial, catheter urines |
| Vector-Borne (mite, flea, louse, tick) Febrile Syndromes | Bartonella, Ehrlichiosis*; Anaplasmosis*; Lyme Disease*; Babesiosis; Plague; Relapsing Fever; Rocky Mountain Spotted Fever *; Tularemia |
| most commonly acquired dz by blood trans) | Babesiosis |
| Sepsis/Shock Syndromes | Bacterial sepsis/septic shock; TSS, Staphylococcal or Streptococcal |
| Miscellaneous Systemic Febrile Syndromes | Kawasaki Syndrome; Rheumatic Fever |
| Infections that may present as febrile syndromes | Pyelonephritis; hepatitis |
| Systemic Febrile Syndromes: suspect in travelers | typhoid fever |
| Intracellular protozoa (sim to Plasmodium); geographic sim dist to Lyme dz; transfusion | Babesia |
| Co-infxn w/Lyme disease | Babesia |
| Aseptic Meningitis | Usually viral; negative bacterial culture; common but often not diagnosed |
| Bacterial Meningitis: ____ = significant factor in etiologic agent | Age |
| Bioterrorism list | Tularemia |
| Rare cause of meningitis (suspect in compromised immune function) | Fungal / Parasitic |
| Most common cause of Fungal / Parasitic meningitis | Cryptotoccal meningitis |
| Agents of Viral Encephalitis: | HSV-1; HIV; togavirus; rabies; flavivirus |
| Agents of Viral Meningitis (aseptic): | Enterovirus, ECHO, Coxsackie A & B, HSV-2 |
| Usually causes parotitis; 50% of patients have CNS involvement with 10% = symptomatic | Mumps Virus (Paramyxovirus group) |
| Bacterial Meningitis/Etiological Agents in Neonates: | Group B Strep (S agalactiae); Enterococci; Enterobacteriaceae; Listeria monocytogenes |
| Pathogens of Sterile Sites ; Common s/s = severe headache | Meningitis |
| Agents of Bacterial Meningitis in Infants (1-3 mos) | Strep. Pneumo; N. meningitidis; H. influenzae; Neonatal agents also possible |
| Agents of Bacterial Meningitis in Children (3 mos - 6 yrs) | Strep. pneumo (DRSP); N. meningitidis; H. influenzae |
| Agents of Bacterial Meningitis in Children/Adults (7-50 yrs) | Strep. pneumo (DRSP) (No. 1 cause); N. meningitidis; L. monocytogenes |
| Agents of Bacterial Meningitis in Adults > 50 yrs | Strep pneumo (DRSP) (mostly); rare: Enterobacteriaceae (P. aeruginosa; L. monocytogenes) |
| Agents of viral sepsis | No agents (blood is only a transport mechanism) |
| Bacterial Sepsis | Age = significant factor; bloodstream usually seeded from distant site |
| Sepsis in neonates: Agents | Group B Strep; E. coli; Enterobacter spp; Staph aureus; (> than 1 week old: add H. influenzae) |
| No. 1 cause of sepsis | Staph aureus |
| Etiologic agents of sepsis in children: | H. influenzae (less common now); S. pneumo; N. meningitidis; S. aureus |
| Etiologic agents of sepsis in adults (non-immunocompromised) | S. aureus (No.1 cause); viridans streptococci; Group A strep; E. coli; Salmonella; Enterococcus spp. |
| Etiologic agents of sepsis in Adults (neutropenic) | GN bacteria (Enterobacteriaceae inc. Pseudomonas); fungi (Candida, Aspergillus); Staph. aureus |
| Etiologic agents of sepsis in Adults (immunocompromised /asplenic) | [Asplenic susceptible to encapsulated organisms]; Staphylococcal spp. (coag neg); L. monocytogenes; (pregnant women; can cause spontaneous abortion); S. pneumoniae |
| Lyme Dz transmission occurs in what % of tick bites? | 10% of tick bites |
| predominant vector of Lyme dz/Borrelia | Ixodes tick |
| leading vector borne disease in US | Lyme Dz (Borrelia burgdorferi) |
| May-September incidence (arthropod borne dz) | Lyme Dz (Borrelia burgdorferi) |
| EM (erythema migrans)= pathognomonic rash for: | Lyme Dz (Borrelia burgdorferi) |
| Disease has three clinical stages with myriad symptoms | Lyme Dz (Borrelia burgdorferi) |
| DOC for Lyme Dz | Doxycycline |
| Etiologic agent of Ehrlichiosis | Ehrlichia chaffeensis |
| ~95% of cases occur April-September (arthropod borne dz) | Ehrlichiosis |
| Transmitted to humans via bite of lone star tick and is very common in southeast US | Ehrlichiosis |
| Fever, rash, and headache; pancytopenia/ thrombocytopenia is clue to diagnosis | Ehrlichiosis |
| Bigger rash than dermatophytes (> 5cm); less sharp, irreg borders but w/central clearing: bullseye pattern; Nontender, non itching | Lyme dz |
| Ixodes is vector | Lyme dz; anaplasmosis |
| clinical presentation very similar to HME | Anaplasma |
| Agent of anaplasmosis ( (HGA) | Anaplasma phagocytophilum (HGA = human granulocytic anaplasmosis) |
| Dz most commonly in New England states, north central US and specific sites in California; slightly more common than HME | Anaplasma |
| The Rickettsia | Genus of very small GNRs; obligate intracellular bacteria; were first thought to be viral (very small size & poor stainability) |
| Rickettsia pathogenic species are maintained in: | Animal & arthropod reservoirs |
| Rickettsia dz transmitted by: | Arthropod vectors, humans are accidental hosts |
| Rickettsial species: 3 groups: | Spotted Fever Group (SFG) (includes R. rickettsia); Typhus group; Scrub typhus group(geographic distribution important) |
| Strict intracellular parasite with multiplication in host cell cytoplasm | Rickettsia ricketsii |
| 5 states ( NC, SC, TN, AR, OK) account for > 50% of all cases annually | Rickettsia ricketsii |
| Agent of RMSF | Rickettsia ricketsii |
| most common rickettsial disease in USA | Rickettsia ricketsii |
| American dog tick is most common vector | Rickettsia ricketsii |
| RMSF morbidity/mortality | high mortality rate if treatment is delayed |
| Transovarian transmission: offspring of tick born infected (from mother) | Rickettsia |
| This dz parasitizes mono/macrophages | Ehrlichiosis |
| Black measles | RMSF (late stage dz assoc w petechial rash) |
| Acute onset of fever, diffuse rash, conjunctivitis, stomatitis, swollen erythematous hands and feet | Kawasaki’s Dz |
| Pts = 6 wks to 12 years; males greater than females | Kawasaki’s Dz |
| ? carpet cleaning | Kawasaki’s Dz |
| Tx for Kawasaki’s Dz | No specific treatment; watch for later cardiac abnormalities |
| Dreaded sequelae of Group A strept infxn | Acute Rheumatic Fever (ARF) |
| Follows only Group A Streptococcal pharyngitis | Acute Rheumatic Fever (ARF) |
| ASO titers (acute/convalescent) diagnostic | Acute Rheumatic Fever (ARF) |
Created by:
Abarnard
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