Infectious Disease虫媒传染病课件.pptVIP

Vector-Borne Infectious Disease Danielle Kruger LYME’S DISEASE ETIOLOGY: ?????????????????????????????? ?????????????????????????????? Borrelia burgdorferi loosely coiled spirochete LYME’S DISEASE Vector: ?????????????????????????????? ?????????????????????????????? Ixodes scapularis: adult female, male, nymph, larva on cm scale Ixodid deer tick LYME’S DISEASE Reservoir: ?????????????????????????????? ?????????????????????????????? White-footed mouse White-tailed deer ?????????????????????????????? ?????????????????????????????? LYME’S DISEASE ?????????????????????????????? ?????????????????????????????? Localized rash: Erythema migrans 12-y/o girl presented to her PCP with a 6-cm circle of erythema with central clearing on the side of her neck. The patient lived in an area of Connecticut where Lyme disease is endemic. Diagnosed with erythema migrans and prescribed amoxicillin - after 20 days of antibiotic therapy, the rash had enlarged and contained multiple rings. Thought she had erythema migrans unresponsive to amoxicillin therapy. The eruption was mildly pruritic, and the patient had no constitutional symptoms. Seen in Pediatric ER We learn – her family applying a high-potency topical steroid to her neck prescribed for someone else KOH prep: fungal hyphae Fungal culture: Trichophyton Be cognizant of differentials: erythema migrans is rarely scaly and resolves rapidly with appropriate oral antibiotic therapy (amoxicillin or doxycycline). Tinea incognito - tinea infection modified by topical steroids; suppress local immune response allowing fungus to grow easily - bizarre appearance! LYME’S DISEASE ?????????????????????????????? ?????????????????????????????? ROCKY MOUNTAIN SPOTTED FEVER The most severe and most frequently reported rickettsial illness in the United States.? very small bacterium that must live inside the cells of its hosts Rickettsia rickettsii Microbe: Vector: Dermacentor tick (American dog