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MYCOPLASMA, RICKETTSIA, CHLAMYDIA AND CHLAMYDOPHILA - Coggle Diagram

- - - - Ureaplasma 尿漿菌
        
        Ureaplasma
        urealyticum
        
        Respiratory tract, GU tract
      - Haemobartonella
      - Eperythrozoon
      - Mycoplasma 黴漿菌
        
        Mycoplasma
        pneumoniae
        
        Respiratory tract, GU tract
        
        致病機轉
        
        P1 adhesin protein
        
        superantigen
        
        一部分Mycoplasma 有 lipoproteins
        
        流
        
        inhalation of aerosolized droplet and nasal
        secretions
        
        Strict human pathogen
        
        Worldwide disease
        
        no seasonal incidence
        
        all population, esp. children
        
        not reportable disease
        
        病
        
        多為asymptomatic carriage
        
        Tracheobronchitis
        
        Low grade fever
        
        dry, non productive cough,2 to 3 weeks
        
        Atypical pneumonia (or walking pneumonia)
        
        Secondary complications
        
        Otitis media
        
        Erythema multiforme (Stevens Johnson syndrome)
        
        診
        
        clinical recognition of syndrome
        
        no cell wall
        
        Culture
        
        is a strict aerobe
        
        serum (provides sterols)
        
        Mulberry shaped
        
        PCR :<3:
        
        治
        
        Erythromycin
        
        Tetracycline
        
        Newer fluoroquinolones
        
        Gatifloxacin and moxifloxacin
        
        防
        
        難呀
        
        spread by close contact.
        
        are typically infectious for a prolonged period
        
        Vaccine: the protective immunity conferred by infection has
        been low
        
        Mycoplasma
        hominis
        
        GU tract
        
        Mycoplasma
        genitalium
        
        Respiratory tract
        
        Other
        Mycoplasma species and Ureaplasma
        
        流
        
        Infants, particularly females: M. hominis, M. ginitalium , and Ureaplasma species
        
        病
        
        M. ginitalium can cause nongonococcal urethritis(NGU)
        
        Ureaplasma urealyticum can cause NGU & and spontaneous abortion or premature birth
        
        M. hominis can cause postpartum fever
- - - - :person_with_blond_hair: :dog2: Ehrlichia chaffeensis=>病名human monocytic ehrlichiosis
      - :dog2: :person_with_blond_hair:Ehrlichia ewingii=>病名canine&human granulocytic ehrlichiosis
    - - :horse: :person_with_blond_hair: :rat: :dromedary_camel:Anaplasma phagocytophilum=>病名human (granulocytic) anaplasmosis
    - - 進入host cell後，remain in the phagocytic vacuole
        
        Prevent lysosome fusion
        
        morulae
      - 兩型態
        
        Small elementary bodies
        
        Larger reticulate bodies
      - Giemsa or Wright stains :eyeglasses:
      - Replicates in phagosome
    - - Initiates inflammatory response
    - - Apr~Oct(跟Rickettsia rickettsii一樣耶)
    - - :person_with_blond_hair: :dog2: Human Monocytic ehrlichiosis
        
        Infect blood monocytes and mononuclear phagocytes
        
        Incubation period: 1 to 2 weeks
        
        Flulike illness : high fever, headache, and myalgia to leukopenia,
        thrombocytopenia, and elevated serum transaminases develop
        
        A late onset rash develops in 30% to 40% patients
        
        :skull: 2-3%
      - :dog2: :person_with_blond_hair:canine&human granulocytic ehrlichiosis
        
        Fever, headache, and myalgia to leukopenia, thrombocytopenia,
        and elevated serum transaminases develop
      - :horse: :person_with_blond_hair: :rat: :dromedary_camel: human anaplasmosis
        
        Granulocytes (neutrophils, eosinophils, basophils)
        
        Incubation period: 5 to 10 days
        
        Flulike illness , gastrointestinal symptoms (fewer than half),
        leukopenia , thrombocytopenia, and serum transaminase elevation
        
        The pathology relate to macrophage activation
  - - - 分群
        
        Spotted fever group
        
        Rickettsia rickettsii
        
        病名
        
        Rocky Mountain spotted fever
        
        Incubation Period: 7 days
        
        致病機轉
        
        Pathogenesis: The replication of bacteria in endothelial cells
        
        subsequent damage to the cells and leakage of the blood vessels
        
        Loss of plasma into tissues
        
        Hypovolemia
        
        Hypoproteinemia
        
        Reduction of perfusion of various organs and organ failure
        
        outer membrane protein A, OmpA
        
        為了 adhesion
        
        The host immune responses: CD8
        
        The host immune responses: CD8 T cells and antibody response to outer membrane proteins
        
        流
        
        The principal reservoir and vector
        
        hard ticks
        
        2 more items...
        
        Apr~Oct
        
        病
        
        High fever, chills, headache, myalgias
        
        rash:Centripetal spread
        
        :skull: 20-40%
        
        診
        
        Giemsa or Gimenez stains :eyeglasses:
        
        Direct fluorescent antibody (DFA)
        
        Microimmunofluorescence (MIF) detects Abs directed against
        
        治
        
        Doxycycline
        
        Rickettsia akari
        
        病名
        
        Rickettsial pox
        
        第一期:被咬後的一周
        
        1 more item...
        
        流
        
        城市，mites
        
        Typhus group
        
        Rickettsia prowazekii
        
        病名
        
        Epidemic typhus louse borne typhus 流行性斑疹傷寒
        
        Principal vector: human body louse
        
        Sporadic disease : flying squirrels and squirrel fleas
        
        Primary reservoir: Human，People living in crowded area
        
        Brill Zinsser disease 巨濾泡性淋巴腺瘤
        
        :skull: 20-40%
        
        病
        
        Incubation period: 8days
        
        Initiation: nonspecific symptoms within 1 to 3 days
        
        1 more item...
        
        治
        
        Doxycycline
        
        Inactivated vaccine is available
        
        Rickettsia typhi
        
        病名
        
        Endemic (murine ) typhus
        
        Incubation period: 7-14days
        
        Primary reservoir: Rodents
        
        Principal vector: rat flea美國是Cat flea
        
        病
        
        petechial 瘀點出血點 or macular rash 斑疹 develops
        
        Rash is typically restricted to the chest and abdomen
        
        防治:困難
        
        Scrub typhus group
        
        Orientia
        tsutsugamushi
        
        病名
        
        Scrub typhus恙蟲熱
        
        Incubation period: 10-12 days
        
        Vectors: mites= chiggers , red mites
        
        Reservoir: mites
        
        :skull: 15%
        
        病
        
        Incubation period: 6 to 18 days:Severe headache, fever, and myalgias
        
        A macular to papular rash
        
        1 more item...
        
        治
        
        Tetracycline
        
        Doxycycline
        
        Chloramphenicol
      - 簡介
        
        Aerobic, obligate intracellular parasites (by :arrow_up: phagocytosis)
        
        Lysis of the phagosome membrane by phospholipase
        
        Release into the cytoplasm
        
        Giemsa or Gimenez stains :eyeglasses:
        
        Structure similar to gram negative bacilli with minimal PPDGCN & LPS
        
        binary fission
        
        Continually released from cells
        
        Orientia and the spotted fever group of Rickettsia
        
        Accumulates in the cell cytoplasm until the cell membranes
        lyse , signaling cell death and bacterial release
        
        The typhus group of Rickettsia The R. prowazekii
        
        Carbohydrate metabolism, lipid biosynthesis, nuclear acid, synthesis, amino acid synthesis
        
        The bacteria are able to produce ATP by the TCA cycle, or they can use the host cell ATP
        
        Antibiotics sensitive
        
        源:節肢動物傳播: tick mite louse flea
  - - - Coxiella
        burnetii
        
        病
        
        Q fever
        
        症
        
        急: atypical pneumonia
        
        慢:subacute endocarditis, hepatitis, pulmonary disease, and infection of pregnant women. Subacute endocarditis.
        
        型態
        
        兩型態
        
        Large cell variants
        
        Small cell variants
        
        型態轉變
        
        Phase I: LPS intact; is able to prevent lysosomal fusion
        
        Phase II: LPS lost outermost O antigen sugars
        
        Intracellular multiplication in phagolysosome.The acidic
        environment activates the bacterial metabolic machinery
        
        流
        
        Can survive in soil and milk for months to years
        
        Reservoirs: mammals, birds, and ticks
        
        contact with infected animals or acquired through
        inhalation , or possible from consumption of contaminated milk.
        
        無季節性
        
        診
        
        Serology is the most commonly used test
        
        Detection of antibody response to phase I and phase II
        antigens is test for choice.
        
        治
        
        Doxycycline
        
        Phase I antigen vaccines are protective and safe
- - - - Primarily human pathogen
        
        oculogenital disease
        
        infant pneumonia
      - 包含體有碘染色的肝醣
      - Two biovars associated with human disease
        
        Trachoma 砂眼
        
        Lymphogranuloma venereum (LGV) 性病淋巴肉芽腫
        或花柳性淋巴肉芽腫
      - 受感染的細胞種類
        
        cuboidal
        
        nonciliated columnar
        
        epithelial cells
        
        transitional
      - 毒力
        
        Prevents fusion of phagosome with cellular lysosomes
        
        repeated infections，and the host inflammatory response
      - 流
        
        sexually transmitted
        
        Ocular trachoma全世界
        
        LGV :black_flag: :crossed_flags: :flag-ar:
        
        C. trachomatis L1, L2, L2a, L2b, and L3害的
        
        A painless ulcer develops
        
        接下來
        
        inflammation and swelling of lymph nodes draining the area (the second stage; buboes)
        
        Proctitis is common in women with LGV
        
        Trachoma Trachoma ( Biovars A, B, Ba, and C)
        
        Adult inclusion conjunctivitis ( Biovars A, B, Ba, D to K) 做 :<3:
        
        Neonatal conjunctivitis:Exposed at birth
        
        Infant pneumonia
        
        Urogenital infections ( Serotypes: D to K)asymptomatic nfections common in women (80%)
        
        Approximately 35% to 50% of cases of nongonococcal urethritis
      - 診
        
        Nucleic acid amplification
        
        Iodine strain
      - 治
        
        Treat LGV with doxycycline for 21 days
        
        Treat ocular or genital infections with azithromycin or
        doxycycline for 7 days
        
        Treat newborn conjunctivitis or pneumonia with erythromycin
        
        Safe sex practices
  - - - Primarily human pathogen
        
        bronchitis
        
        pneumonia
      - 台灣首分離成功
      - Only a single serotype (TWAR, TW 183 and AR 39)
      - 病
        
        呼吸道
        
        Bronchitis, pneumonia, sinusitis
        
        asymptomatic or mild persistent cough and malaise
        
        do not require hospitalization
        
        Atherosclerosis
        
        可以在endothelial cells of the coronary artery , and macrophages內生長
        
        流
        
        Person to person by respiratory secretions
        
        診
        
        困難
      - 治
        
        Macrolides (erythromycin, azithromycin , clarithromycin
        
        Tetracyclines (tetracycline, doxycycline
        
        Levofloxacin
    - - Primarily animal pathogen
        
        Pneumonia(psittacosis)
      - Ornithosis 飼鳥病
      - 病
        
        呼吸道
        
        Focal necrosis in liver and spleen
        
        Bacteria spread to the reticuloendothelial cells of liver and spleen
      - 流
        
        Inhalation of dried bird excrement, urine, or respiratory secretions
        
        psittacine birds
      - 診
        
        serologic findings
        
        MIF test
      - 治鳥
        
        Tetracyclines or macrolides
        
        Person to person transmission occurs rarely , so isolation of the
        patient and prophylactic treatment of contacts不必要
        
        Such control can be achieved by treating birds with
        chlortetracycline HCl for 45 days
  - - - elementary bodies, EBs
        
        Resistant to many harsh
        environmental factors
      - reticulate bodies, RBs