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Body (CV and Lymphatic (Non-hemorrhagic fever diseases (Cat-scratch…

- - - - Yellow fever
        
        ssRNA flavivirus. Africa and South America, via Aedes aegypti mosquito. Causes capillary fragility, disrupts blood --> muscle pain, oral hemorrhage, nosebleed, vomiting, jaundice, liver/kidney damage. Significant mortality rates. Vaccine available.
      - Dengue fever
        
        ssRNA flavivirus. Aedes mosquito. "Breakbone fever": severe pain in muscles and joints. Endemic to SE Asia, India. Epidemics in South/Central America, Caribbean, Mexico. High morbidity, high mortality.
      - Chikungunya
        
        Alphavirus transmitted via Aedes albopictus. Sx similar to Dengue fever: severe joint pain and neurological sx that can last for years. May become endemic in US
      - Ebola and Marburg
        
        Filoviruses. Sx similar to yellow fever and dengue: virus causes capillary fragility and disruption of clotting. Patients bleed from orifices and mucus membranes, experience massive internal/external hemorrhage. Marburg mortality: 25%. Ebola mortality: 97%.
      - Lassa fever
        
        Arenavirus: Argentine hemorrhagic fever, Bolivian hemorrhagic fever, lymphocytic choriomeningitis. Found primarily in West Africa, some imported cases in UK.
        
        Hemorrhagic syndrome: chest pain, hemorrhaging, sore throat, abck pain, vomiting, diarrhea, encephalitis. Patients who recover suffer deafness. Spontaneous abortion in 95% cases.
  - - - Bartonella henslae: small gram-negative rod, fastidious, blood agar. Infection via claw/bite from cat. Present in over 40% of cats. Sx 1-2w after claw/bite: cluster of small papules at inoculation site, lymph nodes swell/pus-filled, 1/3 patients have high fever.
    - - Bartonella quintana: carried by lice, spread when lice feces enter bite wound. Mainly endemic in Europe, Africa, Asia. Urban trench fever: 33% homeless in SanFran carry lice with bacterium. Sx: 5-6 day fever, leg pains, macular rash. Endocarditis can develop
    - - Coxiella burnetii: small pleomorphic gram-negative organism. Intracellular parasite (endospore-like structure), transmitted by contact with infected animals.
    - - Ehrlichia chaffeensis (human monocytic ehrlichiosis), Anaplasma phagocytophilium (human granulocytic anaplasmosis). Both tick-borne (Ixodes tick), fever-producing. S/sx: acute febrile state, headache, muscle pain, rigors. Most patients recover rapidly with no lasting effects.
    - - Brucella: Gram-negative coccobacilli. Live in phagocytic cells to be carried to bloodstream --> lesions on liver, spleen, blood marrow, kidney. Bioterror agent of highest concern.
    - - Rickettsia rickettsii: transmitted via hard ticks. Mainly in SE/Eastern Seaboard of US, Canada, Central, South America. S/sx: chills, fever, headache, muscular pain. Distinctive spotted rash 2-4d after prodrome. If untreated, lesions merge and become necrotic. CV disruption, thrombosis, hemorrhage. 20% mortality untreated, 5-10% treated.
  - - - Acute sx: fever, anemia, abnormal heartbeat, sx of heart attack, abdominal/side pain. Caused by Staphylococcus aureus, Streptococcus pyogenes, S. pneumoniae, Neisseria gonorrhoae
      - Subacute sx: acute sx that are slower, less pronounced, along with enlarged spleen, clubbed fingers and toes Caused by Alpha-hemolytic streptococci
- - - - Herpes Simplex Virus
        
        Encephalitis in newborns born to HIV-positive moms. Also susceptible: older children, adults >50 (HSV-1)(reactivation of dormant HSV from trigeminal ganglion)
      - Arboviruses
        
        California Encephalitis
        
        California serotype virus. Children primary targets and have mild transient symptoms. Fatalities are rare. 2 strains, California and LaCrosse.
        California: occasionally in western US, little impact on humans. LaCrosse: widely in eastern US and Canada; prevalent cause of viral encephalitis in North America.
        
        Eastern Equine Encephalitis
        
        Endemic in eastern North America and Canada. Sporadic, but epidemics in humans and horses. Also present in caged birds. Vaccine available. 70% fatality. Likes rain.
        
        Western Equine Encephalitis
        
        Sporadically in western US and Canada. In horses and humans. Early summer, dangerous to infants and small children, fatality rate 3-7%.
        
        St. Louis Encephalitis
        
        Very common viral encephalitis. N and S America. Epidemics in US Midwest and South. Asymptomatic (50-100 cases). Peak activity in spring and summer.
    - - Toxoplasma gondii
        
        Flagellated parasite. Affects both birds and mammals. Primary reservoir is felines, wild and domestic. Asymptomatic with sore throat, lymph node enlargement, low grade fever. Immunocompromised may have chronic or subacute encephalitis. Worldwide distribution. Fetal and immunodeficient infection = death. More likely to display thrill-seeking behaviors and have slower reaction times*.
      - Measles virus
        
        Slow infection: symptoms appear years after initial measles episode. Caused by direct viral invasion of neural tissue.
      - Prions
        
        Gerstmann-Strussler-Scheinker disease
        
        Kuru
        
        Creutzfeldt-Jakob disease (CJD)
        
        Fatal familial insomnia
        
        Scrapie (sheep and goats)
        
        Bovine spongiform encephalopathy (BSE)
  - - - Listeria monocytogenes
        
        Gram-positive, bacilli to long filaments, palisade. No capsules or endospores, 1-4 flagella. Not fastidious, no virulence factors, just super survivors (temperature, salt, pH, bile). Intracellular parasite. Both adult and neonatal meningitis. Found in contaminated foods. Meningitis and septicemia in elderly, immunocompromised, fetuses, neonates --> premature abortion. Found in contaminated dairy, poultry, meat.
      - Cryptococcus neoformans
        
        Fungus, spherical to ovoid shape with large capsule. Transmitted via bird droppings (--> outside jobs e.g. agriculture, lawn-mowing, construction). Test with rapid antigen test. fast onset and acute in AIDS patients.
      - Haemophilus influenzae
        
        Gram-negative coccobacillus - one of most severe forms. "Hib" because serotype B. Vaccination reduced asymptomatic carriage rates, eliminated Hib in US.
      - Coccidioides immitis
        
        Fungus. 25C: white/brown mold, hyphae. 40C: parasitic, small spherule. Systemic infection, genetic susceptibility, natural reservoirs = Valley Fever.
      - Streptococcus pneumoniae
        
        Small gram-positive flattened coccus in end-to-end pairs. Polysaccharide capsule that protects against phagocytosis. Vaccines available. "Pneumococcus": majority of bacterial pneumonias, most frequent community-caused meningitis. No petechiae. Immunocompromised. Carriage rates >30%
      - Neisseria meningitidis
        
        Gram-negative diplococci, oxidase-positive, grows on chocolate agar/MTM; 25% all meningitis cases; spreads from nasal cavity. Endotoxin = WBC stimulator --> petechiae. Close quarters, late winter/early spring.
      - Viral
        
        Aseptic meningitis: no bacteria or fungi found in CSF (maybe WBC's). Majority children; enteroviruses. Resolve in 2 weeks. HSV-2, HIV can cause meningitis
    - - Streptococcus agalactiae
        
        Gram positive chain; Lancefield group B streptococci. 10-30% female genital tracts. Most frequent cause of neonatal meningitis
      - Escherichia coli
        
        K1 strain = 2nd most common cause of neonatal meningitis. Most common in premature babies. Poor prognosis: brain damage, 20% mortality rate. Transmitted via vaginal canal --> c-section birth
      - Cronobacter sakazakii
        
        Found in natural environment. Can survive dry conditions. Contaminated powdered infant formula, 40% mortality rate.
      - Listeria monocytogenes
        
        see above
    - - Naegleria fowleri
        
        Amoeba, small flask-shaped, single pseudopod. Rounded thick-walled uninucleate cyst, resistant to temperature extremes and mild chlorination --> infection (nose, olfactory nerve) from swimming in warm natural bodies of fresh water. Causes PAM. 1/128 cases have survived.
      - Acanthamoeba
        
        Amoeboid trophozoite, large, spiny pseudopods, double-walled cyst. Invades via broken skin, conjunctiva, lungs, urogenital epithelia. Cause GAM. Live longer but 2-3% survival rate.