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BLOODSTREAM AND CARDIOVASCULAR SYSTEM INFECTIONS

brucellosis<br>rickettsial infections

Shakira2
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BLOODSTREAM AND CARDIOVASCULAR SYSTEM INFECTIONS

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  1. MRS. SHAKIRA ANSARY ASSISTANT PROFESSOR MBBS PHASE II

  2. Topics to be covered Brucellosis Rickettsial infections

  3. BRUCELLA Gram negative coccobacilli 0.5-0.7*0.6-1.5 Non motile Non capsulated Non sporing Non acid fast Intracellular parasite Zoonotic disease Mediterranean fever, Malta fever, undulant/remittent fever, Cyprus fever

  4. Family Brucellaceae

  5. Antigenic structure Antigenic determinants- A & M Variable amounts in various species B.abortus: A:M=20:1 B.melitensis: A:M= 1:20 B.suis: A:M= 2:1 Antigenic cross-reaction

  6. Virulence factors LPS- O-PS Inhibit fusion of phagosome, lysosome Replication in phagosome Intracellular bacterial growth

  7. 3 major species- B.melitensis, B.abortus, B.suis Refractoriness to chemotherapy Co-exist with antibodies

  8. Transmission Incubation period 10- 30 days Prolonged Spread Predilection to placenta (erythritol) • Wound • Conjuctiva • Inhalation • ingestion

  9. Immunity

  10. Clinical features 3 types of human infection Latent infection- only serological and clinical evidence. Acute or subacute brucellosis Chronic brucellosis

  11. Acute Brucellosis B.melitensis Prolonged bacterimia & irregular fever Muscular & articular pain, asthmatic attacks, nocturnal sweating, chills, anorexia, nervous irritability. Thrombocytopenic perpura causes thrombocytopenia Complications.

  12. Chronic brucellosis State of hypersensitivity Low grade infection with periodic exacerbations PUO Joint pain, lassitude, periodic pyrexia Often non bacteremic Granuloma formation

  13. Clinical manifestations

  14. Laboratory diagnosis

  15. Blood/Bonemarrow culture • Capnophilic • 37 C • pH 6.6-7.4 • Agar containing erythritol • Castaneda Method of blood culture

  16. Automated blood culture systems- Bac T/ALERT, Vitec, MALDI ToF 48-72 hrs

  17. ELISA • IgG, IgM • SAT 160 or more • False negative • False positive

  18. Diagnosis in animals

  19. Prophylaxis Checking dairy products vaccine

  20. Treatment

  21. Scrub typhus Chigger borne typhus Orientia tsutsugamushi/R.orientalis Acute febrile infectious illness All Indian states Vector borne disease- trombiculid mites of Leptitrombidiumdelinsis

  22. Transmission & Spread

  23. Clinical features

  24. Laboratory diagnosis Biosafety class III cabinets • Direct microscopy- blood & tissue samples. • Giemsa/Macchiavello • Immunoflurescence • Immunoenzyme • Immunohistochemical • Culture- cell & tissue culture on Vero or MRC-5 • Serological tests- • Immunoassays • Weil-Felix reaction • Molecular- PCR

  25. Specific test- IgM ELISA Non specific test- Weil-Felix test (heterophile agglutination test using Proteus strains)

  26. Treatment

  27. Other rickettsial infections of bloodstream

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