f.

serologic tests TRILAMINAR cell membrane

LPS t
peptidoglycan
II::::::n
•
'

RICKETTSIA SPP same eager

•

.
.

-
light microscope
to
↳ resistance
antibiotics
↳ sulfonamide T growth

SPOTTED FEVER GROUP SCRUB TYPHUS TRADITIONAL

GROUP GROUP
RMSF Bouton neuse fever
Rickettsia POX

O " OEu 3 ,
Om
c )
'

s
✓

H ht h¥¥
f mi

gins Biphasic
m
to n
n c
,

:
"
m

tsutsugamnshi
-

Rickettsia rickettsia Orient a Rickettsia akari

Rickettsia conorii
centripetal tache noire tache noire : centrifugal Resevoir : Rodents

TICK BITE ticks lymphadenopathy v: Ailodermanyssus

↳ alcohol abuse
Reservoir : rodents
v:
reservoir : rodents
mites ( CHIGGER )
sanguine us mite

GROUP Q FEVER GROUP

TYPHUS
centripetal
① uqq pa photophobia ①
si÷gT
u

4) 4
rains
1 week 3 5 -

days
history of after onset after onset
'

etiipnmms in::#ment in .

Coxiella burnett i

finna
Rickettsia typhi
Resevoir :
sheep cattle goat
, ,

" ""

¥¥sms÷÷¥:n%
"
'
miiiiioiiiniiiiiiiaii :#nine :*.ae:O:*.
v: flea
V: human louse DOC Doxycycline
tongue )
-

( dry

Brill zinser disease centripetal phago lysosome

-

within
↳ recrudescence of
NO SKIN LESION ! ! !
epidemic typhus

ANA PLASMA GROUP

wlinphagosome ERLICH , AE &
"

O O
c- a
sunburn

↳
-
like

peking Funk'vement

HME HGA
• Chaffeensis Ana plasma phagocytophilum
canine
Ewinggi
• -

momlae
microscopy :
DOC -

tetracycline

→ serology !
 C- ) INDOLE no

0° capsule
( t ) nitrate , oxidase ,
catalase unease
00 ,

00 00
nutritive factors :

BRUCELLA
⑦ • amino acid
• vitamin
erythritol

(
:

•
salt
•
breast Human brucellosis
•
placenta
•
glucose
•
epididymis ↳ p ,ggµog,g ; blood culture agar ,
guy , , , , , , osyeoar , , mean
,

uterus gun,
.

t g W non hemolytic
☐ shiny
TRANSMISSION :
☐ brucellosis
Relapsing
Tmm convex

ME chronic brucellosis B. suis

I TO
-

All
Xp
'
droplet
transmission
ingestion of
milk

BbѥDPs
) ⑦BIPOLARstA-NNGCAg.PH?+andBaArP-
Doc : Aminoglycoside
ntamicin
safety pin
PESTIS :
appearance
(t ) INDOLE , catalase
0 ⑤
destroyed by neutrophil
.

☐
C- ) oxidase , unease
~ but supported by
yy yg

-
reproduction ) ¥96
YERSINIA monocyte (

ANTIGENIC STRUCTURES : Mac Conkey

Agar
LPS
•

↳ nonlaetose
Type 111 secretion system
Forming
•

-
bacterial
protein into host cell

•
V & W antigens
-

growth + virulence
•
PPCPI
coagulase
-
& fibrinolytic
•

pfra / PMT
-

protective covering
- allow survival of flea

Y entewwlitica & Y pseudo TB

=
YERSINIOSIS ""
tms

/
.
.

I
mainly 61T ↳ acute
-

→ :
yen , miosis 4x IgM rise

-
20% pharyngitis
pseudoappendicitis
"

cefsulodin-lrgasan-Novoviocinlc.IN )
-

agar syndrome
"

_ bull 's eye colonies • nausea

• ( actual ) •
vomiting
•
fever
•
pain
-

post -
infectious sequelae :

1. ARTHRITIS
2. ERYTHEMA NODOSUM
 ""

Ehling :YmYfIgb"Third
fretful
by MOA Ftreated
gained inflammation
.

Disinfectant new EM
transfusion
-

Detergent ( rare ) blood antibodies ( ELISA )

-

proteins
~
-
xzx

Lyme
BORRELIA - disease
Yee flipo
requires :
AND GENK STRUCTURES :
① B .

burgdorferi -

twisting & rotary

Amino Acids .C4B -

binding protein ↳ North america & Europe

② garinii
→
B
protein H
.

→ Fatty Acids .

ticks
→ Nucleic Acids .
suppressive complement ③ B .
afzelii → v : Ixodes

regulators
JARISH HERXHEIMERRXN
-

. outer surface protein ( B. burgdorferi

) skinless
wlin 24 hrs of treatment ( Em )
Erythema migrants
- .

05pA to F survival in
-

t
bacterial death U & host
tick
Chronica
t vector 's Aero dermatitis Atrophicans
ENDOTOXIN salivary glands
skin

/ ↳
Ospc -

. extremities
SPEUES :
,

Bs B.ba#ei STAGES : -

(
EARLY
③
EARLY LATE

ecmhibckyo
culture BSk H
①
WCAUZED
→ ② DISSEMINATED → LYME
-

multiple
mrajgfffrtoyyg
EM
Em
louse bone ( EPIDEMIC RE)
↳ HUMANS only
fever
chills Ab
Ag complex
-

headache NEUROLOGIC
Relapsing fever 1st week
( sudden onset of fever
Ct ) 1911196 (t ) IgG
L
3 -
todays incubation Doxycyline 78 weeks
-
-
false positive +1 -

IgM
Amoxicillin
① epidemic RF
le 8 weeks from
months
-

RF ( tick-borne) Cefuwxime onset

→
years
② endemic
hermsii Doxycyline ( 3rd gen Doxycyline
cephalosporin ( pen
-

B .
6 .

B .
turicatae Amoxicillin

Recurrent fever
•
fever intervals : 4 -
14 days
1st : severe

latter : less frequent

END :
aisisphase →
posters Diagnosis
rigors ↳
⑧ specimen
BLOOD
diaphoresis
•
.

@ height of temp
T temp I temp g f
.
* .

T PR BP
fiemsal Wright (Silverstein
"
& t BP
•
hepato splenomegaly ( t ) spirochetes among RBC

• myocarditis a PCR : blood , CSF ,

tissue
bronchitis
•
pneumonia & •
CBC : t platelet
•
meningitis hemiplegia facial palsy , ,
normal It WBC

•
PCR : blood CSF
, ,
tissue

÷÷i
LBRF T ESR
TBRF

c'iii. Imf.nu:1?arP:Ieoutosis
-

' '
-

palsy
hematoma
bmi's ability
-

jaundice coffin PROLONGED

•
meningitis : Gallop
edema
-

CXR : pulmonary
cardiomegaly
 30% free FAS
MEMBRANE : 70% phospholipid
OUTER

§y
INNER
flagellum

LEPTOSPIRA
baEIlllllllt.fm
( x 18 )

Leptospirosis lnanukayami fever / cane

-
cutter fever

Weil 's / Rice field fever ( waterborne fever,

-

= Disease

JAUNDICE
Swamp fever (Mud fever
/ TRIAD L

yANlCTER€
RENA ftp.e-HEPANMEGALY
,
-

meningitis
22 species T IgM
Glo smkiennbmf.IT
'

f
pathogenic → Febrile
,
-
L .
interrog ans
conjunctiva episodes

borgpetersenii
'
L
ICTEMC
-

' -

kidney liver vascular

, ,

dysfunction
-

"
Pathogenesis pulmonary hemorrhage "" " is
.

: .
-

. "

t OT
o•?
" ""

Is :L!
gefrcysm.GE
incubation

Otg
Doxycycline

↳
→
days
-
a .su
-
infection Ampicillin
↳ soil -
I ✓ Amoxicillin

human LATER STAGE

biphasic
- - IV penicillin or

ISTTPHASET l2NDPHAsTI Ampicillin

DIAGNOSTIC
-
: -

fever myalgia
. ,
-
aseptic meningitis
specimen :
depends on poh headache T IgM
blood CSF tissue , urine -
conjunctival
Nephritis &
, ,
-

1st 10 DAYS - ↳ 1st week suffusion

•
Serology
upto
months
- muscle rigidity hepatitis recurrence
3
-
liver -9 kidney
-

MAT :
IgM ( IgG dysfunction
< current infection w/
> l : 800
single titer of

Leptospira
-
ELISA
• Molecular test : PCR

•
Culture :

-
Fletcher 's medium
-

EMJH medium
• DINGER 'S RING
( after I -2 weeks )
↳ if Wala → microscopy
dark field microscopy
NOT recommended
 TRYPANOSOMA TRYPANOSOMA
brucei cruzi LEISHMANIA sp
.

Dr KISSING BUG I Reduviid bug

VECTOR SAND FLY
Tse Tse fly feces into broken skin

INFECTIVE
metucyclictrypomastigote metucyclictnypomastigote Pwmastigote

DIAGNOSTIC Trypomastigote Thfpomastigote Amastigote

LIFE CYCLE T SIF =
stumpy form Epimastigote in bug 's midgut
Troms sialidase -
allows attachment
EVADING ( host cell tree .
)
MECHANISM
cmzipain -
cart release

Tc tox -

forms pores
cutaneous & Muwcutaneous
DIAGNOSIS microscopic :
lymph fluid microscopy leishmaniasis
microscopy
Antibody test f- definitive
-

per
-
ulcer margin
-

amasligole
visceral leishmaniasis
microscopy
-

disease cutaneous leishmaniasis

DISEASES Chagas
African sleeping sickness
( American sleeping sickness ) .
Dry ( chronic -

painless
• Romana 's sign :
⑧ -

disfiguring
stage ⑦ HEMOLYMPH ATC cha awe -4 acute exudates
.
gonna
-

Winterbottom sign Chiclets 's ulcer

trypanosoma chancre eel . Mexicana

• Ear ulcer
stage ② CNS
mnwculaneous leishmaniasis
- erosion of mucosal surfaces

visceral leishmaniasis ( KALA AZAR)

•
HYPER PIGMENTED skin lesion
•
L .
donovan i
•
61 si renal systems
1
stage Stage 2
WEST Penta midline Eflornithin
TREATMENT
or

Bentnidatohe
mnwcutaneousleishmaniasc.SE melarsopwl
GAMBIAN Sura min

ASTOR oral miltefosine

melarsoprol Nifurtimox
-

Sura min
Rhodesian -

N antimonyl Amphro B

visceral leishmaniasis
-

B
-

Ampho