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I&I STDs, CNS & Zoonotic Infections

Terms

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Rabies characteristics
Rhabdovirus
bullet shaped, affinity for neurons
bat rabies also replicates in epithelials
20-60 day incubation (may be up to 6 mo)
fever, anxiety & malaise
neurologic signs present 2-10 days after onset
Rabies presentation
treatment for rabies
Rabies Ig
antiserum around site of bite
characteristics of Plague
Yersinia Pestis
slow growing, G-
aerobic bacillus (safety pin)
bubonic
septicemic
pneumonic
plague presenting w/lump in arm or leg
Bubonic (bubo)
plague presenting w necrosis, spread through blood
Septicemic
most dangerous form of plague
Pneumonic
highly contagious
treatment for plague
streptomycin & doxycycline
characteristics of West Nile
Flavivirus, (env, ss, ico, RNA)
mosquito to bird (amplifying host)
human is secondary host (doesn't replicate in high titers)
presentation of West Nile
0.1% cases fatal
1% goes to CNS
20% show WN fever
most asymptomatic
Gonorrhea
Neisseria=G-, cocci
yellow purulent discharge in men
asymptomatic in women- peritonitis & infertility
diagnosis of gonorrhea
gram stain is sensitive & specific
treatment of gonorrhea
ceftriaxone
Chlamydia
obligate intracellular bacteria
G- envelope that lacks muramic acid
uses host ATP
not easily detected
treatment of chlamydia
tetracyclines
5 causes of genital ulcers
herpes
syphilis
chancroid
behcet's & reiter's are non-infectious
Syphilis
Treponema Pallidum
spirochete, motile, capsule-like outer coat
can NOT be cultured in lab
toxic to fetus
primary syphilis
chancre- painless, red, raised lesion
secondary syphilis
rash, condyloma lata
tertiary syphilis
benign- granulomatous lesions
CV
Neurosyphilis- tabes dorsalis
bacteria in meningitis
All are aerobes
S Pneumoniae (young adult & older), H Influenzae (vaccine), N Meningitidis (baby/kid), L Monocytogenes (immunocompromised)
G- usually from nosocomial
Staph usually from head trauma
diagnosis of meningitis
lumbar puncture
CSF w/monocytes, normal glucose & protein
viral meningitis- may culture virus but may not
CSF w/PMNs, LOW glucose, elevated protein
bacterial- probably culture bug
treatment for meningitis
cephalosporins-
large doses steroids for neuro sequelae

gentamycin does NOT cross BBB
Meningitis- mechanism of infection
respiratory infection, IL-1 attaches to meningeal blood vessels, PMNs attach & enter CNS
Brain Abscess- Mechanism of infection
in sinus after untreated sinus infection

or- travels in blood & lodges in small vessel
diagnosis for brain abscess
NO LUMBAR PUNCTURE
CT
presentation & bug of brain abscess
looks & acts like tumor
anaerobic bacteria
Cause of Encephalitis
usually virus
West Nile
Herpes

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