Unusual Organisms

transmission of Borrelia burgdorferi

bite of Ixodes tick

disease association of Borrelia burgdorferi

Lyme diseases (seasonal, north america)

GN spirochete, slow growing, microaerophilic, Barbour-stoenner-kelly medium

Borrelia burgdorferi

confirmatory testing for Borrelia burgdorferi

Standard two-tier test (STTT), EIA or IFA and western blot

prevention of Borrelia burgdorferi

prompt removal of tick

transmission of Borrelia recurrentis

person to person via human body louse in crowded and poor living conditions

disease association of Borrelia recurrentis

louse-Borne relapsing fever (LBRF) typically in Africa

prevention of Borrelia recurrentis

personal hygiene, wash clothes/bed linens in hot water (>130F)

Yaws disease with lesion on the face and distal extremities or syphilis like lesions, early stage granulomatous nodules that can disseminate in later stages

T. pallidum pertenue

demographic for T. pallidum pertenue

tropical climates and <15yrs old

Bejel, endemic sphylsis, ulcer in oral cavity of nasopharynx (ulcerative lesions on throat with papule on corners of mouth) with chance of progressing to serious destructive lesion

T. pallidum endemicum

transmission of T. pallidum endemicum

direct contact with infectious lesions

demographics of T. pallidum endemicum

hot and dry climates of those 2-15 yrs old

pinta disease with lesions beginning as scaling painless papule followed by erythematous rash (LIMITED TO SKIN INFECTION)

T. carateum

transmission of T. carateum

direct contact (rare through sexual contact) and often found in chimpanzee skin tissue

GN intracellular pathogen in endothelial cells and macrophages

Rickettsia rickettsii

disease association of Rickettsia rickettsii

Rocky Mountain spotted fever (can be deadly if not treated early with doxycycline)

transmission of Rickettsia rickettsii

bite of infected tick (American, brown dog, rock mountain wood) in seasonal times

best diagnosis of Rickettsia rickettsii

Serology IFA or NAAT

disease association and transmission of Rickettsia prowazekki

louse-borne typhus —> brill-zinsser disease via flea and lice transmission

disease association and transmission of Orienta tsutsugamushi

scrub typhus via flea and lice transmission

What are the 3 agents of typhus

O. tsutsugamushi, R. prowazekki, and R. rickettsii

Disease association of Leptospira interrogans

leptospirosis and is a biphasic illness

transmission of Leptospira interrogans

urine from infected animals contaminates water, outbreaks seen in natural disasters

diagnosis of Leptospira interrogans

MALDI-TOF and Serologically

disease associations with Bartonella henselae

Cat Scratch Disease with enlarged lymph nodes and pustules at site of scratch

transmission of Bartonella henselae

scratch from cats feces infected claws, cat is originally infected for a flea bites

disease association of Bartonella Quintana

Bartonellosis (trench fever) with lesions “bacillary angiomatosis”

transmission of Bartonella Quintana

infected human body louse spread person-to person via direct contact (or rare organ transplants)

demographics of Bartonella Quintana

immunocompromised HIV/AIDS and areas with poor sanitization

diagnosis of Bartonella species

Serological testing or PCR

Why is Bartonella species culture not ideal for diagnosis

they are fastidious and require a long incubation time (14days)

disease associations of Bartonella bacilliformis

Bartonellosis with (Oriya fever and verruca peruana)

transmission of Bartonella bacilliformis

via bite from infected sandfly primarily seen in Peru, Colombia, and Ecuador

disease association of Streptobacillus moniliformis and spirillum minus

Rat bite fever (RBF)

Which organisms cause Rat bite fever in the US and Europe

Streptobacillus moniliformis

Which organisms cause Rat bite fever in Asia

spirillum minus

transmission of Streptobacillus moniliformis and spirillum minus

via close contact with and infected rodent, contamination through direct contact or ingested food/drink

diagnosis of Streptobacillus moniliformis

culture isolation (blood, body fluids, or affected tissues) and real-time PCR

diagnosis of spirillum minus

Dark field microscopy, special stains, and visualization of spirochetes in lesions or blood

disease associations of coxiella burnetii

Q fever

transmission of coxiella burnetii

inhalation of contaminated aerosols from birthing fluids, placenta, feces, milk, or urine of infected animals

Diagnosis of coxiella burnetii

IFA is the gold standard and PCR in early stage

disease associations of Ehrlichia chaffeensis

Human monocytes Ehrlichiosis (HME)

transmission of Ehrlichia chaffeensis

tick borne(lone star tick) disease via tick saliva during feeding that infects monocytes

diagnosis of HME

PCR in the first week of illness and IFA, look for morale in monocytes

disease associate of anaplasma phagocytophilum

human granulocytic anaplasmosis (HGA)

transmission of anaplasma phagocytophilum

tick borne (black legged) and infects neutrophils

Diagnosis of HGA

PCR test in first week of illness, look for morulae in neutrophils

treatment of Ehrlichia and anaplasma

Doxycycline

disease associations of Chlamydia trachomatis

Chlamydia, LGV (lymphogranuloma venereum), and trachoma

transmission of Chlamydia trachomatis

sexually transmitted or contact with bodily fluids

diagnosis of Chlamydia trachomatis

PCR and antigen detection, culture isolation

disease associations of Chlamydophila psittaci

Psittacosis with dry cough and pneumonia evident on chest X-ray causing various complication if severe

transmission of Chlamydophila psittaci

inhalation of aerosolized bacteria following contact with poultry droppings or bird bites

disease associations of Chlamydophila pneumoniae

pneumonia, sinusitis, pharyngitis, acute respiratory disease, etc.. (biphasic illness)

transmission of Chlamydophila pneumoniae

via human secretions with outbreaks seen in schools, prison, military

What can Chlamydophila pneumoniae often resemble clinically

Mycoplasma pneumonia

disease associations of legionella pneumophila

Legionaire’s disease an Pontiac fever

transmission of legionella pneumophila

ubiquitous in water sources so spread via inhalation of aerosolized water (hotels, spas, cruise ships)

Diagnosis of legionella pneumophila

Culture is the gold standard with BCYE agar and urine antigen (EIA)

Colonial morphology of legionella pneumophila on BCYE agar

slow growing 3-5days, pearl drop colonies, ground glass

disease associations of mycoplasma pneumoniae

Walking pneumonia

transmission of mycoplasma pneumoniae

close person-to-person contact, typically infecting children and young adults

diagnosis of mycoplasma species

NAAT

Why is mycoplasma species difficult to detect via traditional methods

do not gram stain because they lack a cell wall, fastidious, and difficult to transfer colonies via loops

disease association of mycoplasma genitalium

Mgen, inflammation of urogenital tract and reproductive tissues

transmission of mycoplasma genitalium

sexually transmitted

disease association of mycoplasma hominis

post transplant infections, salpingitis, pyelonephritis, and PID (normal flora of urogenital tract)

disease association of Ureaplasma ureolyticum

urethritis in men (rarely symptomatic unless organisms load present)