06 Gm Negative Zoonotic Bacilli

Bartonella Henselae

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• red pillow: gm negative

• starry night and silver color: Warthin-Starry stain, a silver stain

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• cat scratch fever

• bacillary angiomatosis

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• princess: Cat scratch fever occurs in immunocompetent patients (healthy young princess)

• scratched arm: Cat scratch fever transmitted by cat scratches

• balls around arm: Axillary lymphadenitis. Noncaseating granuloma

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• cane: Bacillary angiomatosis affects immunocompromised patients (HIV)

• scratched arm: Bacillary angiomatosis also transmitted by cat scratches.

• red dots: Raised red vascular lesions in bacillary angiomatosis

• mistaken for Kaposi but has neutrophils. Kaposi has lymphocytic infiltrate

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• bicycle: Doxycycline treatment for bacillary angiomatosis

• crows: Macrolides can be used to treat either disease

Brucella

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• red farm house: Gram negative

• Survive in macrophages, travel to different reticuloendothelial systems and causes enlargement

• open gate: Facultative intracellular organisms

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• cow and pig: Direct contact reservoirs: cow, pig

• milk bucket on ground: Ingestion of unpasteurized dairy products

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• farmer: Fever and anorexia, primary symptoms

• undulating hills: Undulant fever

• liver/spleen spots: Liver and splenic involvement/enlargement

• fish bone: chronic symptoms, Osteomyelitis

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• rifle: Rifampin used for adjunctive therapy, not for contact

• bicycle wheel: Doxycycline

Francisella Tularensis

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• red raddish: Gram negative, coccobacilli

• open cage: Facultative intracellular organism, recovery depends on cell mediated immunity

• Rabbits are main reservoir

• ticks from rabbit: Transmitted by dermacentor tick

• can also be aerosolized, as biological weapon

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• enters at site of ulcer, gets inside macrophages, travels through lymph nodes, to reticuloendothelial organs

• rabbit hole ulcerating: Painful ulcer at the site of infection

• rotting radish: Granulomas with caseating necrosis in reticuloendothelial organs (i.e. lymph nodes)

• mud pushing up: Regional lymphadenopathy

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• sai: Aminoglycosides for treatment

Pasteurella Multocida

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• cat: Catalase positive, spread by cat bites as well

• blue ring: Oxidase positive

• capsule: Capsule is important virulence factor

• sheep blood: Grows on 5% sheep agar

• safety pin: Demonstrates double staining, described as a "safety pin"

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• cat: cat bite

• dog bit: Transmitted by dog bites

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• red bite location: Cellulitis may occur within the first 24 hours

• fish bone: Infection may spread to bone and cause osteomyelitis

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• pencil: Empiric treatment is penicillin