Degenerate bacteria

Rickettsia rickettsii virulence

OMPs - bind host cells, damage = blood vessels leak

disease of R. rickettsii

Rocky Mountain Spotted Fever
2-14d after tickbite - fever, HA, malaise
macular rash from extremities to trunk/chest - change to spotted/petechial form

identification of R. rickettsii

poor gram staining - Giemsa/Gimenez stain
MIF - detect OMP/LPS

R. akari epidemiology

transmitted by mites - biphasic
cosmopolitan distribution

disease of R. akari

papule to ulcer to eschar; high fever (dif. than anthrax)
systemic spread
in blood - high fever, HA, maculopapular rash to vesicles/crust

R. prowazekii epidemiology

louse-borne typhus
d/t crowding/unsanitary conditions

R. prowazekii disease

2-30d - high fever, HA, myalgia, petechial maculopapular rash
dx by MIF

R. typhi epidemiology

typhus, common in warm/humid areas
rodents = reservoir; vector = fleas

disease of R. typhi

7-14d incubation then onset fever, HA, chills, myalgia, nausea
rash to chest/abd

Orientia tsutsugamushi epidemiology

mites - chiggers/red mites

disease of orientiatsutsugamushi

6-18d - HA, fever, myalgia
macular to papular rash on trunk - centrifugal sp. to upper/lower extremities

ehrlichia chaffeensis

intracellular in monocytes
transmitted by ticks
flu-like - HA, fever, mailaise, myalgias, late-onset rash
leukopenia, thrombocytopenia, increased transaminases

ehrlichia ewingii

intracellular in granulocytes
transmitted by ticks
flu-like - fever, HA, myalgia
leukopenia, thrombocytopenia, increased transaminases

anaplasma phagocytophilum

intracellular in granulocytes (neutrophils, eosinophils, basophils)
transmitted by ticks
flulike - HA, fever, myalgia
leukopenia, thrombocytopenia, increased transaminases

coxiella burnetii epidemiology

SCV - spore-like, resistant & LCV
wool, dust, milk
from animals - contaminate soil - inhale airborne particles

diseases of coxiella burnetii

flu-like - fever, chills, fatigue, HA, myalgia, nausea
chronic Q fevers
SA endocarditis - valvular defect

identification of coxiella burnetii

serology/PCR of blood

chlamydia trachomotis characteristics

2 biovars- trachoma and lymphogranuloma venereum (LGV)
A,B,Ba,C = ocular trachoma
D-K = urogenital trachoma

epidemiology of chlamydia trachomotis

ocular trachoma - A-C; flies, dirty clothes, fingers; blindness
urogenital trachoma - D-K
LGV - chronic STD

virulence of chlamydia trachomotis

infection based on cell receptor
LGV serovars - blood infection; replicate in monocytes, dz d/t cell detruction/inflam. cytokines

disease of chlamydia trachomotis

- LGV - painless lesions on genitals; w/ fever, HA, myalgia; sw. inguinal LN; proctocolitis
- trachoma - follicular conjunctivitis/diffuse inflammation- blindness
- adult inclusion conjunctivitis - acute conjunctivitis; mucopurulent discharge, keratitis

identification of chlamydia trachomotis

intracellular, Giemsa stain = polymorphonuclear cells but NOT diplococci (dif. than gonorrheae)
gram neg.

chlamydia pneumoniae

person-person resp. secretions
dx by MIF
dz = sinusitis/pharyngitis, bronchitis, atypical pna; mild/persistant cough/malaise

chlamydia psittaci

bird reservoir
localized infiltration - inflam. cells, necrosis, hemorrhage
Parrot fever - resp. infection; asymptomatic to severe bronchopneumonia

mycoplasma pneumoniae epidemiology

school-age kids/YA
spread in friends/family/class

virulence of mycoplasma pneumoniae

adhesins - cilia
destroy cilia/epithelial cells
can't clear airways/LRT irritation - persistent cough

disease of mycoplasma pneumoniae

low fever, malaise, HA, dry/non-prod. cough
lymphocytes/plasma cells into bronchi cells into bronchi - PNA/atypical pna
patchy bronchopneumonia - CXR

identification of mycoplasma pneumoniae

strict aerobe - cx - slow growing x 4 weeks
cx = Eaton's agar - produce mulberry-shaped colonies

epidemiology of mycoplasmatales

pleomorphic rods; membrane contains sterols
in infants, increased in F/some pre-pubertal children retain - genital mycoplasmas

diseases of mycoplasmatales

M. genitalium - nongonoccal urethritis and PIDs
U. urealyticum - nongonoccal urethritis, pyelonephritis, stillbirth/premature - gr. on cx x 24hrs
M. hominis - pyelonephritis, postpartum fever, septicemia - gr. on cx x 2-4d