Mediterranean Mystery
This tiny, "sandy" insect is the primary vector for Leishmania
What is the Sandfly?
Francisella tularensis is often transmitted by contact with these long-eared mammals, giving it the nickname "Rabbit Fever.
What are Rabbits?
While Tularemia involves ticks and deer flies, Cat Scratch Disease is caused by this genus of bacteria.
What is Bartonella?
This "gold standard" diagnostic step for Visceral Leishmaniasis allows doctors to see amastigotes inside macrophages.
What is Bone Marrow Aspiration?
This drug is the treatment of choice for Leishmaniasis but requires a liposomal formulation to protect the kidneys.
What is Amphotericin B?
While cutaneous forms cause skin ulcers, this "visceral" form of the disease is also known by this Hindi name meaning "black fever."
What is Kala-azar?
This state, along with Arkansas, Oklahoma, and Kansas, makes up the high-incidence... ?
What is "Tularemia Belt."
This "bullseye" rash is the hallmark of Lyme Disease, distinguishing it from the ulcerative lesions of Tularemia.
What is Erythema Migrans?
Standard blood cultures for Tularemia often fail because the bacteria require this specific amino acid to grow.
What is Cysteine?
Mr. Ivette’s initial treatment failed partly because he stopped taking this medication due to "GI upset."
What is Doxycycline?
In visceral leishmaniasis, these two organs significantly enlarge due to the proliferation of infected macrophages.
What are the Liver and Spleen (Hepatomegaly and Splenomegaly)
Unlike the painless eschar of Anthrax, the ulceroglandular form of Tularemia is characterized by these two painful clinical findings.
What are painful skin ulcers and tender regional lymphadenopathy?
This staining method is used to visualize Bartonella (Silver stain) because it doesn't show up well on a standard Gram stain.
What is the Warthin-Starry stain?
A four-fold increase in these between the acute and convalescent phases confirms a Tularemia diagnosis.
What are Antibody Titers (Serology)?
This IV aminoglycoside is the bactericidal drug of choice for severe or systemic Tularemia.
What is Gentamicin?
These are the intracellular forms of the parasite found within macrophages, also known as L-D bodies
What are Amastigotes?
Because it takes as few as 10–50 organisms to cause disease, F. tularensis is classified as this level of "Select Agent."
What is a Tier 1 Select Agent?
Unlike Leishmaniasis, which is a parasite, Tularemia is caused by this type of "fastidious" organism.
What is a Gram-negative bacterium?
This term describes the drop in all three blood cell lines (WBC, Hgb, Platelets) seen in Pete’s Leishmaniasis case.
What is Pancytopenia?
Amphotericin B works by binding to this component of the parasite's cell membrane to create lethal pores.
What is Ergosterol?
This specific species of Leishmania is commonly found in the Mediterranean and was the culprit in Pete’s case.
What is Leishmania infantum
This imaging test is vital to rule out the most severe, inhalational form of the disease.
What is a Chest X-ray (to rule out Pneumonic Tularemia)?
This disease presents with a painless black eschar and significant surrounding edema, often confused with Tularemia.
What is Anthrax?
This molecular test is used to confirm the specific species of Leishmania by looking at its DNA.
What is PCR (Polymerase Chain Reaction)?
These two heavy-hitter antibiotics failed for Mr. Ivette because they cannot penetrate cells to kill intracellular, fastidious organisms.
What are Piperacillin-Tazobactam and Vancomycin?