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Infection Medicine > Zoonoses > Flashcards

Zoonoses Flashcards

1
Q

What virus causes rabies?

A

Rhabdovirus

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2
Q

How is rabies transmitted?

A

Saliva or CNS tissue - bite of an infected animal

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3
Q

What is the incubation period of rabies?

A

2 weeks to several months

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4
Q

What are features of rabies?

A
  • Malaise, headache & fever, Progressing to mania, lethargy & coma
  • Over production of saliva & tears
  • Unable to swallow & ‘hydrophobia’
  • Death by respiratory failure
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5
Q

What are the prodromal features of rabies?

A
  • Headache
  • Malaise
  • Odd behaviour
  • Agiation
  • Fever
  • Itch around the bite
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6
Q

What is the mortality rate of untreated rabies?

A

100%

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7
Q

What syndromes can prodromal rabies progress to?

A
  • ‘Furious rabies’ - hyperactivity and terror, hydrophobia, aerophobia
  • ‘Paralytic rabies’ - flaccid paralysis in the bitten limb -> coma -> death
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8
Q

What neurological condition occurs due to rabies infection?

A

Encephalitis

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9
Q

How would you investigate someone with rabies?

A
  • Clinical picture + exposure
  • Viral PCR/CSF antibodies - late confirmation
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10
Q

How would you manage someone with rabies

A

Immediate post bite-prophylaxis

  • Soak/wash hand >15 mins
  • Human rabies immunoglobulin + Vaccinations
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11
Q

What organisms causes brucellosis?

A
  • B. Melitensis
  • B. Suis
  • B. Abortus
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12
Q

Which brucella species has the most virulence in man?

A

B. melitensis

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13
Q

What is the incubation period for brucellosis?

A

5-30 days

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14
Q

What are symptoms of brucellosis?

A
  • Fever
  • Anorexia
  • Sweats
  • Weight loss
  • Malaise
  • Localised infection - spetic arthritis, spondylitis, meningitis, endocarditis, orchitis
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15
Q

What are features of acute brucellosis?

A
  • High ‘undulant’ fever
  • Weakness, headaches
  • Drenching sweats
  • Splenomegaly
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16
Q

What are feautres of chronic brucellosis?

A
  • Flu-like symptoms/Malaise
  • Depression
  • Chronic arthritis
  • Endocarditis
  • Epididymo-orchitis
  • Rarely meningism
  • Splenomegaly
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17
Q

How would you investigate brucellosis?

A
  • Bloods - FBC, LFTs, Blood culture
  • CSF culture
  • Synovial fluid culture
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18
Q

How wouldyou treat brucellosis?

A
  • Long acting Doxycycline for 2-3 months + Rifampicin, or + intramuscular gentamycin for first week(s)
  • Consider Co-trimoxazole in CNS disease
19
Q

What is the causative organism of leptospirosis?

A

L. icterohaemorrhagica

20
Q

How is leptospirosis spread?

A

Contact with rat urine

21
Q

What is the incubation period of leptospirosis?

A

2-20 days

22
Q

How does leptospirosis present?

A
  • Abrupt fever
  • Myalgia/myositis
  • Cough
  • Chest pain +/- haemoptysis
  • Can have jaundice, meningitis, uveitis, and renal failure
23
Q

What is weil’s disease?

A

Leptospirosis illness - Triad of

  • AKI
  • Jaundice
  • Bleeding
24
Q

When should you think of leptospirosis as a cause of infeciton?

A

The farmer with protracted flu-symptoms is more likely to have leptospirosis than brucellosis

  • Fever in a cattle farmer
  • Exposure to water or rats
25
Q

How would you investigate for leptospirosis?

A
  • Bedside - ECG, urinalysis
  • Bloods - FBC, U+E’s, LFTs
  • Specific - ELISA serology, PCR, Culture
26
Q

How would you treat leptospirosis?

A
  • Abx
  • Mild - doxycycline
  • Severe - penicillin
27
Q

What is the causative organism for lyme disease?

A

Borrelia burgdorferi

28
Q

How is lyme disease spread?

A

Ixodes tick species

29
Q

What is usually the first sign of lyme disease?

A

Erythema migrans

30
Q

What is characteristic of the rash seen in lyme disease?

A

Circular - starts at the sight of bite

31
Q

What is the following?

A

Erythema migrans - target rash

32
Q

What are features of early lyme disease?

A
  • Erythema migrans
  • Pain/pruritis
  • Lymphadenopathy
  • Fever
  • Malaise
  • Headache
33
Q

What are features of early disseminated lyme disease (occuring weeks - months after bite)?

A
  • Lymphocytoma - Bluish-red plaque/nodule
  • Neuroborelliosis
  • Carditis
34
Q

Where should you check for lymphocytoma in lyme disease?

A
  • Earlobes
  • Nipples
  • Genitals
35
Q

What are the following?

A

Lymphocytomas - lyme disease

36
Q

What are features of neuroborelliosis?

A
  • Lymphocytic mengitis
  • Ataxia
  • Amnesia
  • Facial/cranial nerve palsies
  • Neuropathy
  • Encephalomyelitis
37
Q

What is the classic triad of features of neuroborelliosis?

A
  • Facial nerve palsy
  • Radicular pain
  • Lymphocyic meningitis
38
Q

What carditic disorders can occur in lyme’s disease?

A
  • 2nd/3rd degree HB
  • Myocarditis
39
Q

What are features of late disseminated lyme disease?

A
  • Acrodermatitis chronica atrophicans (ACA)
  • Lyme arthrtis
40
Q

What is acrodermatitis chronica atrophicans?

A

Red to bluish discolouration on the extensor surfaces of extremities, which ultimately becomes atrophic. Peripheral neuropathy is also common with this complication

41
Q

In what population does ACA (as a complication of lyme disease) occur in?

A

Europeans - due to B. afzelii

42
Q

How would you investigate someone with suspected lyme disease?

A
  • Clinical diagnosis - erythema migrans
  • Bedside - ECG
  • Bloods - Serology, ELISA
  • Other - LP and CSF culture
43
Q

How would you treat suspected lyme disease?

A
  • EM - doxycycline/amoxicillin/phenoxymethylpenicillin
  • Neuroborelliosis - IV ceftriaxone/IV Benpen/IV doxycycline

Infection Medicine (12 decks)

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