Presentation
What are the three possible clinical manifestations of infection with Bacillus anthracis?
Pulmonary, GI, or cutaneous
What is the vector for transmission of Yersinia pestis?
Fleas. This microbe is behind the Bubonic Plague.
This category of microbes has a special lipid-rich cell wall that distinguishes them from typical gram positive or gram negative microbes. They are very slow growing. Their special cell wall makes them “acid-fast staining.”
Mycobacteria
A 28y.o. F presents to urgent care for fever, chills, and headache. She recently returned from a two week trip to Florida. She applied insect repellent, but think she still got a few mosquito bites. On physical exam, she appears tired, but not acutely ill. She is febrile to 100.9F, vital signs are within normal limits otherwise. You suspect a viral syndrome. How would you treat her?
Supportive care (Hydration, rest, over the counter analgesia/anti-pyrectics)
Infection of this microbe is associated with squamous cell carcinoma of the bladder if left untreated.
Schistosoma haematobium
Which type of leprosy presents with leonine facies?
Lepromatous leprosy
This microbe is a protozoan that can infect a host via consumption of undercooked meat and can be passed to a fetus during pregnancy.
Toxoplamsa gondii
This microbe has actin rocket motility – a virulence factor that allows it to use actin to propel itself from cell to cell.
Listeria monocytogenes
What is the treatment for Stage 1 Lyme disease?
Doxycycline
What public health measure has helped to reduce the incidence of Brucellosis?
Vaccination of farm animals
A 62 y.o. F with a medical history notable for hypertension and osteoarthritis presents to her primary care doctor with a red, papular skin lesion to her left hand following a cat scratch to the same location. She also notes some fatigue and myalgias. On exam, she has left axillary lymphadenopathy. What microbe might be responsible for this presentation?
Bartonella henselae (Cat Scratch Fever)
What is the vector for transmission of Chaga’s Disease?
Reduviid bug (AKA Kissing Bug)
Name at least one of the virulence factors of Bacillus anthracis.
Edema Factor and Lethal Factor, both of which are AB toxins. It is also a spore-forming microbe, which allows it to survive through harsh environments.
What is the first line antibiotic for Bacillus anthracis?
Levofloxacin or Doxycycline
What congenital anomalies can Zika virus cause if a pregnant person is infected?
Microcephaly, hearing/vision loss, cerebral calcifications
What stage of Lyme disease involves cardiac manifestations (AV block, myocarditis)?
Second stage (early disseminated)
How is Francisella tularensis transmitted?
Via tick bite, deer flies, handling of infected animals, or inhalation of aerosols
This tick-borne illness enters red blood cells. Two of its hallmark manifestations are fever and hemolytic anemia.
Babesia
A 92 y.o. M with a history of Alzheimer’s disease, coronary artery disease, chronic lymphocytic leukemia, and osteoarthritis presents to the ED from his long term care facility for a change from baseline. According to staff, the patient has been less verbal and more drowsy than usual. He is unable to answer questions regarding any symptoms he is experiencing. Vital signs: 102.1F, 112 bpm, 101/74. You get a lumbar puncture. Gram stain of CSF shows the following. What is the most appropriate antibiotic for this patient?
Ampicillin
What species of Plasmodium can remain as hypnozoites in the liver, causing relapsing disease?
Vivax and ovale
A patient with a history of recent travel to sub-Saharan Africa presents with somnolence and confusion. Blood smear shows the following. What is the most likely diagnosis?
African Sleeping Sickness (microbe: Trypanasoma cruzii)
What is the vector for Leishmaniasis?
Sand fly
Ehrlichia chafeensis and Anaplasma spp are microbes that can cause illnesses that can have very similar presentations. Name one similarity and one difference between these two microbes. Your answer may include any aspect of the microbe (virulence factors, transmission, clinical presentation, treatment, etc.)
Similarities: Tick borne illness, generally non-specific symptoms (fatigue, headache), intracellular organism
Differences: Ehrlichia lives inside neutrophils, while Anaplasma lives inside of monocytes. Ehrlichia does not typically present with a rash, while Anaplasma does usually present with a rash.
An otherwise healthy 16F who volunteers at a cat shelter presents to urgent care following being bitten by a feral cat. Her vital signs are within normal limits. On exam, she has two puncture wounds to the dorsal aspect of her hand, which are oozing a very small amount of blood. There is no erythema, edema, or warmth of the surrounding skin. Should you give antibiotics, and if so, what antibiotic? Should you suture this wound? Why or why not?
Yes, give Amoxicillin/Clavulanate (AKA Augmentin).
No, do not suture.
How is Leishmaniasis typically diagnosed?
Visualization of amastigotes (Leishman-Donovan bodies) in tissue sample.