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Yersinia pestis
Southwest US
May October
Reservoir = prairie dogs and squirrels
Y. Pestis Cycle
Flea bites an infected rat
Y. pestis makes coagulase so the blood clots and the
flea cant swallow
Flea bites a human and spits up the clot with all the Y.
pestis in it
Y. pestis enters skin and travels via lymphatics to LN
Y. pestis is phagocytosed and replicates
INTRACELLULARLY and starts making I antigen
Host cell lyses and spills out Y. pestis, which is now
resistant to phagocytosis
What are the 3 different types of plague?
Bubonic plague
Fever + general symptoms + delirium
BUBO = super painful swollen LN
Necrosis of fingers/toes Black Death
Pneumonic plague
Y. pestis spreads from bubo to lung (via blood)
Form of plague that is super contagious between
people airborne cough/hemoptysis
Septicemia plague
Bacteria are in the blood but there
is no bubo (so its hard to recognize)
Yersinia enterocolitica
Infected via GI tract
Invades intestinal epithelial cells
Invasin, attachment invasion locus, YadA
Virulence/pathogenesis
Evade immune system (phagocytosis PLUS
complement): pYV
Invasion proteins
Siderophores
Y. Enterocolitica disease
Fever + RLQ pain (Peyers patches)
appendicitis? No
Fever + diarrhea for up to 3 weeks!
Usually in the winter chitterlings
during holiday parties
Seen in AA babies/kids who get it from the
hands of caregivers who were cooking pork
Blood transmission super bad, 50% die
Pasteurella multocida
Gram negative coccobacilli facultative anaerobes
If its pathogenic it has a capsule (antiphagocytic +
intracellular survival)
20% dog bites, 50% of cat bites, animal licking a
wound (lives in animal tonsils)
Inflammation of wound + lymphadenopathy + wound
discharge +/- fever cellulitis or subQ abscess
Osteomyelitis, arthritis
Francisella tularensis
Small, aerobic, gram negative,
coccobacilli
Catalase positive
Intracellular
Cell wall FA rich
FrancisellA
Francisella tularensis
Francis
Chocolate Rabbit
Thayer-martin,
Chocolate Media
Fatty Acids
Coccobacilli
Small, aerobic
Missouri, Arkansas,
Oklahoma
Francisella tularensis
Requires cysteine
Francisella, Pasteurella,
Legionella
FPL
The -ella's, or the girls
Girls are sissies
Girls really need cyses (kisses)
How is it transmitted?
Insect/tick bite
o Arthropod or insect vectors
Skinning/dressing animal
aerosoles
o Rabbits, hamsters, mice,
squirrels, beavers
o NO human to human
Farmers, vets, hunters, trappers, meat
handlers, lab workers (Men >30)
Francisella tularensis
Super aggressive and virulent!!!
Only need 10-50 organisms inhaled/ingested to
get sick (ingest 10^8)
Infected Organs
Infiltration by neutrophils, lymphocytes,
macrophages
Focal necrosis in bone marrow, node, lung, liver,
spleen
Granulomas develop and caseate (Looks like TB)
Symptoms
Abrupt fever, chills, anorexia, vomiting, diarrhea,
sore throat, cough
Can relapse/remit for 32 days
Pulse-temperature deficit in 42%
Tularemia Types
Ulcerogranular tularemia
Clinically, very Similar to bubonic plague
Plague lacks skin ulcer + less mortality
Pneumonic tularemia
Initial presentation dominated by pulmonary infection
Pharyngeal tularemia:
Contaminated food/water OropharynxExudative
pharyngitis w ulcers
Legionella pneumophila
Gram negative, aerobic,
non-spore forming
unencapsulated bacilli
Legionella pneumophila
French Legionnaire sitting at a campfire with his silver
helmet and iron sword - hes no sissy
Campfire Charcoal yeast extract
Sissy Cysteine (also, one of the ellas)
Iron Need iron for growth
Sources of Legionella?
River, lakes + Cooling tower aerosoles
Air conditioning systems
Cooling towers
Whirlpools
Growth in shower heads
Mist machines in supermarkets
Legionella pneumophila
Chlorine tolerant
Wide range of temperatures
Requires symbiotic microorganism like
amoeba to grow
Pathogenesis
Types of Legionella
Pontiac fever: Acute Flu-like illness, 1-2 days incubation
Headache, muscle aches, fatigue, fever, chills
Pontiac fever strikes suddenly and completely resolves in less
than one week (Without antibiotics)
Attack rate: >90%
Inhalation of endotoxin
GOOD LUCK!