Infectious Diseases and Skin Infections Quiz
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Questions and Answers

Which of the following infections is primarily associated with animal exposure?

  • Impetigo
  • Folliculitis
  • Erysipeloid (correct)
  • Cellulitis
  • Which additional organism is commonly related to contaminated hot tubs in folliculitis cases?

  • Candidia spp.
  • P.aeruginosa (correct)
  • Corynebacterium spp.
  • S.aureus
  • What type of infection is characterized by a diffuse infection in deep epidermis tissue and subcutaneous tissues?

  • Carbuncles
  • Erysipelas
  • Cellulitis (correct)
  • Myonecrosis
  • Which of the following is a key bacterial cause of necrotizing fasciitis?

    <p>Group A streptococcus (B)</p> Signup and view all the answers

    Which type of infection could result from surgical wounds and commonly involves S.aureus?

    <p>Abscess (C)</p> Signup and view all the answers

    Which bacteria is primarily responsible for gas gangrene, a severe muscle infection?

    <p>C.perfringens (C)</p> Signup and view all the answers

    Which of the following organisms are considered normal flora of the skin?

    <p>S.epidermidis (C)</p> Signup and view all the answers

    What is the correct term for inflammation associated with pus formation in the skin?

    <p>Pyroderma (B)</p> Signup and view all the answers

    What is the most common microorganism associated with osteomyelitis?

    <p>Staphylococcus aureus (D)</p> Signup and view all the answers

    Which specimen collection technique is used for corneal scraping in cases of keratitis?

    <p>Special platinum spatula (B)</p> Signup and view all the answers

    In the context of external ear infections, what is commonly referred to as swimmer's ear?

    <p>Otitis externa (B)</p> Signup and view all the answers

    What type of bioterrorism event involves an immediate impact and early recognition of an event?

    <p>Overt (D)</p> Signup and view all the answers

    What culture media is commonly used for the diagnosis of malignant otitis externa?

    <p>Blood agar plate (BAP) (A)</p> Signup and view all the answers

    What form of bioterrorism relates to the use of microorganisms for fear rather than immediate physical harm?

    <p>Covert (A)</p> Signup and view all the answers

    Which organism is the most commonly associated risk factor for malignant otitis externa?

    <p>Pseudomonas aeruginosa (C)</p> Signup and view all the answers

    Which specimen is collected specifically for detecting endophthalmitis?

    <p>Eye chamber fluid (C)</p> Signup and view all the answers

    What is the primary characteristic of Brucella species in terms of transmission?

    <p>It is zoonotic, primarily from animals. (A)</p> Signup and view all the answers

    Which organism is primarily associated with causing diabetic foot ulcers?

    <p>Pseudomonas aeruginosa (C)</p> Signup and view all the answers

    Which of the following symptoms is NOT associated with Tularemia?

    <p>Profuse sweating (B)</p> Signup and view all the answers

    Which of the following organisms is most commonly involved in the formation of decubitus ulcers?

    <p>Staphylococcus aureus (A)</p> Signup and view all the answers

    What is the typical incubation period for Tularemia?

    <p>1 - 21 days (A)</p> Signup and view all the answers

    Which method of specimen collection is least desirable for anaerobic infections?

    <p>Swabs (B)</p> Signup and view all the answers

    Which laboratory identification feature characterizes the organism causing Tularemia?

    <p>Safety-pin appearance (D)</p> Signup and view all the answers

    What is the approximate mortality rate of untreated Tularemia?

    <p>30% (A)</p> Signup and view all the answers

    Which of the following stains can determine the quality of a specimen?

    <p>Gram stain (D)</p> Signup and view all the answers

    What is the characteristic colony appearance of Tularemia on sheep blood agar?

    <p>Nonhemolytic, fried egg colonies (D)</p> Signup and view all the answers

    What is the preferred culture medium for anaerobic cultures?

    <p>Anaerobic transport media (D)</p> Signup and view all the answers

    Which organism is associated with scalded skin syndrome?

    <p>Staphylococcus aureus (D)</p> Signup and view all the answers

    What is the role of fleas in relation to the Bubonic plague?

    <p>They can transmit the bacterium from rodents to humans. (A)</p> Signup and view all the answers

    What is the average duration of illness for untreated Tularemia?

    <p>Several weeks to months (C)</p> Signup and view all the answers

    Which of the following is a common manifestation of systemic infections in dermatology?

    <p>Chickenpox/Shingles (C)</p> Signup and view all the answers

    What should be done to tissue before collection for optimal specimen quality?

    <p>Decontaminate the skin or mucous membrane (D)</p> Signup and view all the answers

    What is the reported cost of causing 50% casualties over a 1 sq/km area using anthrax?

    <p>$1 (A)</p> Signup and view all the answers

    Which of the following characteristics is NOT associated with anthrax as a bioterror agent?

    <p>High visibility odors (C)</p> Signup and view all the answers

    Which of the following statements is true regarding the delivery methods for biological agents?

    <p>Delivery can include aerosols and human vectors. (A)</p> Signup and view all the answers

    In the context of bioterrorism, what is the main reason for classifying agents into Categories A, B, and C?

    <p>Based on ease of dissemination and public health impact (D)</p> Signup and view all the answers

    Which level of the Laboratory Response Network (LRN) is responsible for confirmatory testing?

    <p>Reference Labs (C)</p> Signup and view all the answers

    What is a significant factor that affects the dispersion of biological agents like anthrax?

    <p>Weather conditions (C)</p> Signup and view all the answers

    Which biological agent is listed as Category A due to its potential for high mortality and social disruption?

    <p>Yersinia pestis (C)</p> Signup and view all the answers

    What type of laboratory is categorized as BSL4 and is involved in bioforensics?

    <p>National Labs (C)</p> Signup and view all the answers

    What is a common initial indication of a bioterrorism attack involving biological agents?

    <p>Human illness (C)</p> Signup and view all the answers

    Which delivery method is NOT typically associated with anthrax dissemination?

    <p>Synthetic biology creation (C)</p> Signup and view all the answers

    What is the mortality rate associated with gastrointestinal anthrax?

    <p>50% (B)</p> Signup and view all the answers

    Which form of anthrax is characterized by a skin lesion evolving into a black eschar?

    <p>Cutaneous anthrax (B)</p> Signup and view all the answers

    What is the primary method of transmission for Yersinia pestis in its pneumonic form?

    <p>Aerosolized droplets (A)</p> Signup and view all the answers

    What laboratory identification technique can indicate the presence of Bacillus anthracis?

    <p>Nonhemolytic, ground glass colonies on agar (C)</p> Signup and view all the answers

    Which symptom is NOT typically associated with inhalational anthrax?

    <p>Nausea and vomiting (B)</p> Signup and view all the answers

    Which type of anthrax has the highest mortality rate and is characterized by respiratory symptoms?

    <p>Inhalation anthrax (C)</p> Signup and view all the answers

    What is the primary vector for the transmission of plague?

    <p>Fleas (C)</p> Signup and view all the answers

    Which of the following specimens is NOT typically used for diagnosing inhalation anthrax?

    <p>Vesicles (A)</p> Signup and view all the answers

    What is the incubation period for gastrointestinal anthrax after ingestion of spores?

    <p>2-5 days (B)</p> Signup and view all the answers

    What type of anthrax is characterized by flu-like symptoms followed by severe respiratory failure?

    <p>Inhalation anthrax (C)</p> Signup and view all the answers

    Flashcards

    Pyroderma

    Infection of the skin, often caused by bacteria like staphylococcus and streptococcus. It can present as a blister-like lesion (impetigo) or a painful, swollen area (erysipelas).

    Folliculitis

    A skin infection that affects the hair follicles. It can range from a mild inflammation (folliculitis) to a deep, painful boil (furuncle) or even multiple boils connected together (carbuncle).

    Myonecrosis

    A serious bacterial infection deep within the muscles. It's often caused by Clostridium perfringens and can be life-threatening.

    Necrotizing Fasciitis

    An infection that affects the fascia, a layer of connective tissue that surrounds muscles and organs. It can spread quickly and be very dangerous. It's frequently caused by group A streptococcus or Staphylococcus aureus.

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    Epidermis

    The outermost layer of the skin, responsible for protection and acting as a barrier against pathogens.

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    Dermis

    Located beneath the epidermis, this is the thicker layer of skin that contains hair follicles, sweat glands, and blood vessels.

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    Abscess

    A collection of pus that forms in the skin or subcutaneous tissue. It's often a result of infection and may require drainage.

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    Soft Tissue Infections

    Infections involving the soft tissues, usually occurring after an injury, surgery, or burn. Common culprits include staph, strep, and anaerobes.

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    What are the common causes of decubitus ulcers?

    Bacteria commonly found in the rectum causing bedsores or pressure sores.

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    What are the common causes of diabetic foot ulcers?

    Injuries take longer to heal due to impaired blood flow and immune response. Common causes include Staphylococcus aureus, Streptococci, Enterococci, Enterobacteriaceae, Pseudomonas aeruginosa, and anaerobes.

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    What are the common causes of nodular lymphangitis?

    Sporothrix schenckii, Nocardia spp., Actinomyces spp., and Mycobacteria are common causes of nodular lymphangitis, a skin infection characterized by swollen lymph nodes.

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    What are some bacteria that cause skin rashes?

    Bacterial infections that can cause skin rashes include Borrelia burgdorferi (erythema migrans), Treponema pallidum, Rickettsiae, Leptospira, and Mycobacterium leprae.

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    What bacterial toxins cause skin diseases?

    Staphylococcus aureus is the main culprit for staphylococcal scalded-skin syndrome and toxic shock syndrome. Streptococcus pyogenes causes scarlet fever. These are toxin mediated skin diseases.

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    What are the important steps in specimen collection?

    Proper specimen collection is vital for accurate diagnosis; avoid surface contamination, decontaminate skin or mucous membrane before collection, and prefer tissue and pus aspirates. Keep tissue moist to maintain viability.

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    What is the appropriate method for handling samples?

    Swabs are less desirable than tissue and pus aspirates. If using swabs, place them in transport medium and use anaerobic transport media for suspected anaerobic infections.

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    What are the common microscopic techniques used in microbiology?

    Gram staining can detect clinically significant organisms and evaluate specimen quality. Wet mount with KOH and calcofluor white is used for fungal infections. Acid-fast staining is performed for mycobacterial infections.

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    Conjunctivitis

    Inflammation of the conjunctiva, the clear membrane covering the white part of the eye and the inside of the eyelids.

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    Keratitis

    Inflammation of the cornea, the transparent front part of the eye. Usually caused by trauma, but various organisms can also be involved.

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    Endophthalmitis

    A serious and rare infection that infects the inner part of the eye, including the vitreous humor.

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    Osteomyelitis

    Infection of a bone or bone marrow. Staphylococcus aureus is the most common culprit.

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    Otitis externa

    An infection of the external ear canal, commonly caused by moisture and bacteria. Can be mild or severe, with 'swimmer's ear' as a familiar example.

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    Malignant otitis externa

    A severe, invasive form of otitis externa, often affecting patients with diabetes.

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    Bioterrorism

    The unlawful use or threatened use of microorganisms or toxins to harm people, animals, or plants. It aims to create fear and influence governments or societies.

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    Overt Bioterrorism

    A type of bioterrorism where the effects are immediate and recognized early on.

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    Bioterrorism Agent

    A biological agent that can be easily produced and used to cause harm. It is cost-effective and can be used to create panic in a population.

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    Anthrax

    A specific type of bioterrorism agent that can cause death. Often associated with the development of a fever.

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    Category A Bioterrorism Agents

    Biological agents that can be disseminated (spread) easily and cause significant health problems. They are ranked by their potential for public health impact and social disruption.

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    Laboratory Response Network (LRN)

    A network of laboratories established by the CDC that respond to biological and chemical threats. They test for potential dangers and report findings to authorities.

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    Reference Lab

    A type of laboratory in the LRN that specializes in confirmatory testing. They verify the initial findings of a potential threat to confirm its presence.

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    Biological Delivery Methods

    Biological delivery methods refer to the ways in which a biological agent is released or spread. These methods can vary from direct release to contamination.

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    Particle Size

    The size of biological particles, often in micrometers. Particles within a specific size range are ideal for spreading through air.

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    Weather Factors

    Weather conditions play a critical role in the spread of biological agents, affecting how successfully they can be released and dispersed.

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    National Labs

    A group of laboratories that specialize in the analysis and identification of biological agents. They are crucial for identifying a specific source or origin of a biological threat.

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    Person-to-person spread

    The spread of an infectious disease or agent from one person to another directly or indirectly.

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    Tularemia

    A zoonotic infection caused by the bacterium Francisella tularensis, commonly spread through contact with infected animals, ticks, or contaminated water.

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    How is Tularemia Transmitted?

    Transmission of tularemia occurs through contact with infected animals, ticks, or contaminated water. It is NOT spread from person to person.

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    Incubation Period for Tularemia

    The incubation period for tularemia is typically 1-21 days, with an average of 3-5 days.

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    Duration of Tularemia Illness

    The duration of illness for tularemia can range from weeks to months, depending on the severity and type of infection.

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    Clinical Presentations of Tularemia

    Tularemia can cause a variety of clinical presentations, including pneumonic, glandular, and ulceroglandular forms, each with its own characteristic symptoms.

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    Tularemia Mortality

    Though treatable with antibiotics, untreated tularemia can have a mortality rate of 30%, particularly in the pneumonic form.

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    Brucellosis

    Brucellosis is a bacterial infection caused by Brucella species, primarily spread through contact with infected animals or their products. It is NOT spread from person to person.

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    Symptoms of Brucellosis

    Symptoms of brucellosis typically include fever, sweating, malaise, headache, and muscle/back pain. However, it is important to note that there is NO person-to-person transmission.

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    What is E. coli 0157:H7?

    A highly contagious bacterial infection causing food poisoning, characterized by abdominal cramps, bloody diarrhea, and fever. Spread through contaminated food or water. Requires enhancement in laboratory testing capacity at the CDC.

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    What is Category C of Biological Agents?

    This category of biological agents poses a potential risk to public health and national security. They are moderately easy to spread and may cause illness, but have a limited impact on the overall population. Enhancing CDC lab capacity is needed to respond effectively.

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    What is Anthrax?

    A serious bacterial infection caused by Bacillus anthracis, a gram-positive spore-forming bacterium.

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    What is Cutaneous Anthrax?

    The most common form of anthrax, characterized by a skin lesion developing over days from a papule to a black eschar. It is usually contracted through contact with infected animals or their products.

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    What is Gastrointestinal Anthrax?

    A rare but severe form of anthrax that occurs when spores are ingested, typically through contaminated meat. Symptoms include nausea, vomiting, bloody diarrhea, and abdominal pain.

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    What is Inhalation Anthrax?

    The most dangerous form of anthrax, caused by inhaling spores of Bacillus anthracis. Initial symptoms mimic a mild viral respiratory illness, followed by respiratory failure.

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    What is Plague?

    It is a bacterial infection caused by Yersinia pestis, a gram-negative coccobacillus. Known for its historical impact in the Black Death pandemic, it can be transmitted by fleas, direct contact with infected animals, or inhalation.

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    What is Bubonic Plague?

    A form of plague characterized by fever, headache, chills, and painful swollen lymph nodes called buboes.

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    What is Septicemic Plague?

    A form of plague that spreads through the bloodstream. Characterized by fever, chills, abdominal pain, and possibly necrotic changes in the skin ('black death')

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    What is Pneumonic Plague?

    A highly contagious and fatal form of plague caused by the inhalation of the bacteria. Characterized by fever, cough, and difficulty breathing.

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    Study Notes

    Skin and Soft Tissue

    • Skin is composed of epidermis (outermost layer), dermis (containing hair follicles, sebaceous and sweat glands), subcutaneous layer (fat), fascia (fibrous tissue), and muscles.
    • Wound infections can be caused by trauma, obstruction of glands, or inflammation of hair follicles.
    • Infecting organisms can be endogenous (normal flora) or exogenous (outside the body).
    • Skill is needed to distinguish different colony types in mixed cultures.
    • Common skin flora includes staphylococci (S. epidermidis & S. aureus), diphtheroids (Corynebacterium), micrococci, streptococci (non-hemolytic), propionibacterium acnes, anaerobes, and yeast.
    • Dermatitis is skin inflammation caused by Candida spp., S. aureus, coliforms, Corynebacterium spp., and moulds (dermatophytes).
    • Pyoderma is inflammation with pus, including Impetigo (blister-like superficial skin infection caused by Group A strep and S. aureus), Erysipelas (superficial but painful infection caused by Group A strep or rarely S. aureus), and Anthrax (also caused by S. aureus rarely).
    • Erysipeloid is a superficial soft skin infection associated with animal products, hides, and meat caused by Erysipelothrix rhusiopathiae.
    • Cellulitis is a diffuse deep epidermis and subcutaneous tissue infection.
    • Folliculitis is an infected hair follicle, sometimes caused by P. aeruginosa (contaminated hot tubs).
    • Furuncles (boils) are deep hair follicle infections.
    • Carbuncles involve multiple hair follicles.
    • Abscesses are collections of pus in skin and subcutaneous tissues.
    • Soft tissue (wound) infections involve injured tissue (surgery, burns, bites) caused by many organisms including S. aureus, streptococci, and anaerobes.
    • Burn wounds are often caused by S. aureus and P. aeruginosa.
    • Animal bites can cause infection with Pasteurella multocida, Capnocytophaga canimorsus, S. aureus, or anaerobes. Human bites can cause infection from S. aureus or alpha-haemolytic streptococci.
    • Myonecrosis is a severe muscle infection caused by Clostridium perfringens.
    • Necrotizing fasciitis is a severe fascia infection caused by Group A strep and S. aureus.
    • Decubitus ulcers (bed sores) are caused by bacteria near the rectum (Enterobacteriaceae, Pseudomonas, and Enterococci).
    • Diabetic foot ulcers have slower-healing injuries, caused by S. aureus, streptococci, enterococci, Enterobacteriaceae, Pseudomonas aeruginosa, and anaerobes.
    • Nodular lymphangitis is caused by Sporothrix schenckii, Nocardia spp., Actinomyces spp., and Mycobacteria.
    • Systemic infections can cause dermatological manifestations, such as rashes from Borrelia burgdorferi (erythema migrans), T. pallidum, Rickettsiae, Leptospira, and Mycobacterium leprae.
    • Viral infections, such as measles, chickenpox/shingles (Varicella-Zoster Virus), Herpes Simplex Virus, and warts (HPV), can also manifest in the skin.
    • Toxin-mediated skin diseases include staphylococcal scalded-skin syndrome and toxic shock syndrome, both caused by S. aureus and S. pyogenes. Scarlett fever is caused by S. pyogenes.
    • Specimen collection and transport should avoid surface contamination, and skin or mucous membranes should be decontaminated. Tissue and pus aspirates are preferred specimens, and tissue should be kept moist.
    • Swabs are the least desirable specimens. When swabs are needed, they should be placed in transport media.
    • Anaerobic infection analysis uses anaerobic transport media.
    • Microscopic examination for infections uses gram staining, KOH, calcofluor white, or acid-fast staining to determine specimen quality and evaluate the presence of clinically relevant organisms.

    Other Topics

    • Cultures - Routine media (BAP, CHOC, MAC, PEA) vary based on setting, site, and suspected organisms. - Grow in 35°C in CO2. - Anaerobic cultures are necessary for closed wounds and abscesses. - Other cultures (Lowenstein-Jensen, Middlebrook, viral culture, Sabouraud's agar, eye, bone, BM, external ear) are used as well.

    • Eye - Conjunctivitis: inflammation of the conjunctiva, potentially due to neisserial or chlamydial infections (prevented with eye drops in newborns) or haemophilus influenzae aegyptius or S. pneumoniae. - Keratitis: inflammation of the cornea, often due to trauma. - Endophthalmitis (rare): inflammation of the eyeball's interior. - Specimens: conjunctiva (swab), cornea (scraping), eye chamber fluid. - Processing: gram stain and cultures (BAP, CHOC, enriched broth, MAC, anaBAP).

    • Osteomyelitis: infection of bone or bone marrow (most commonly caused by S. aureus) - Specimen collection: placed in enriched broth and pieces inoculated onto agar media (CHOC) - Bone marrow cultures are utilized only when Brucella or Mycobacteria are suspected, media choice depends on suspected organism.

    • External Ear - Otitis externa (swimmer's ear): ear canal infection due to moisture. - Malignant otitis externa: severe invasive infection, sometimes linked to diabetes, and often caused by P. aeruginosa. - Specimens: debris from ear canal, collected with swab, gram stain cultures on BAP, CHOC, MAC

    •  Bioterrorism - The unlawful use (or the threat) of microorganisms or toxins from living organisms to cause death or disease in humans, animals, or plants. Intended to intimidate and instill fear.  - Types include overt (immediate impact, early recognition) and covert (delayed response, recognized clinically). - History includes rye ergot (600 BC), WWI pathogens, Oregon salmonella, 2001 anthrax in the US. - Characteristics include low costliness, spread to large areas, and difficulty detecting. Common delivery methods include food/water, aircraft sprayers, vehicle sprayers, hand sprayers, and mail. - CDC developed the LRN (Laboratory Response Network) system in 1999 with sentinel labs (recognize, rule out, refer), reference labs (typing, confirmatory testing), and national labs (definitive characterization). - Categorization of potential bioterror threats (Category A, B, and C) depends on dissemination ease and impact (panic and social disruption).

    - Anthrax (Bacillus anthracis) - Gram-positive, spore-forming bacillus. - Three forms of anthrax in humans: cutaneous, gastrointestinal, inhalation. - Cutaneous anthrax is most common, characterized by a skin lesion evolving to an eschar. - Gastrointestinal anthrax causes nausea, vomiting, bloody diarrhea, and significant mortality. - Inhalation anthrax begins with flu-like symptoms, leading to respiratory failure and sometimes meningitis. - Specimens: sputum, blood, stool, eschars, environmental samples. - Lab identification: gram stain (GPR spores), aerobic growth, nonhemolytic colonies, medusa-head colonies, catalase-positive, nonmotile.

    • Plague (Yersinia pestis) - Distribution: highest in western states. Animal reservoir: prairie dog, deer mice, ground squirrels. - Transmission: inhalation, direct contact, fleas.  - Clinical presentations include: bubonic (infected lymph nodes), septicemic (bloodborne organisms), necrotic changes, and pneumonic (aerosol, deadliest). - Specimens: bubo, lymph node aspirate, blood, sputum, bronchial washings, environmental, fleas, powder. - Lab identification: gram-negative bacilli, sometimes safety-pin appearance, slow growth (approx 2 days), nonhemolytic, fried egg colonies. nonmotile, Oxidase, urea and indole negative.

    • Tularemia (Francisella tularensis) - Zoonotic infection spread through animals, including ticks and deer flies. - No person-to-person transmission. - Low to moderate mortality.  - Clinical presentations include: glandular (adenopathy w/or w/out lesion), ulceroglandular (ulcer with adenopathy), oculoglandular (purulent conjunctivitis), typhoidal (sometimes presenting with flu-like features), and septicemia. - Specimens for lab: blood, tissue, lesion aspirate/swab, sputum, serum, environmental samples. - Lab ID: pleomorphic, small gram-negative rod, slow growth, grows on SBA, CHOC, and MTM buffered charcoal yeast-extract, nonmotile, catalase, oxidase, urea negative, BSL-2/3.

    • Brucellosis (Brucella species) - Transmission is mainly through unpasteurized dairy products, direct skin contact with animals or contaminated aerosols. - Clinical symptoms include fever, profuse sweating, malaise, and muscle/back pain. - Low mortality rate (<5%).  - Specimens: blood/bone marrow, serum, tissue, spleen, liver, abscesses, environmental/evidentiary samples. - Lab ID: slow growth, aerobic growth on BAP and CHOC, some strains grow on MAC, nonmotile, catalase, and oxidase, urea, positive.

    • Burkholderia species (B. mallei/B. pseudomallei) - Transmission: direct contact with animals/occupational hazard. - Incubation period: 1 day - 2 weeks. - Clinical presentation: cutaneous, systemic, pneumonia. - Specimens: blood, bone marrow, sputum, bronchial alveolar lavage, abscess material, urine, serum. - Lab ID: growth after ~ 48 hours in CO2, larger nonpigmented colonies, becoming wrinkled.

    • Q Fever (Coxiella burnetii) - Acquired through inhalation or contact with infected animals. - Characteristic spore-like bodies are found. - Clinical presentation: flu-like symptoms with pneumonia, hepatitis. - Mortality: around 2%. - Specimens for laboratory testing: blood, serum, body fluids, visceral tissue, biopsies, autopsies. Store at 4°C and use isolation and direct detection at reference labs.

    • Botulism (Clostridium botulinum) - Neuroparalytic illness caused by a potent toxin. Seven types of botulinum toxin exist. - Types A, B, E, and F primarily affect humans, C and D birds and mammals, and Type G is undetermined. - Clinical symptoms can vary depending on source but include rapid progressive paralysis, double vision, and in severe cases, respiratory failure. - Infection can originate from food, wounds, or intentional release (bioterrorism). - Specimens for lab identification include serum, gastric contents, stool, food samples, autopsy specimens.

    • Ricin

      • Derived from castor bean waste.  
      • Various forms (powder, mist, pellet).
      • Delivery methods primarily via inhalation.
      • Highly stable substance.

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