Planet of the Apes!

Human monkey pox comes from the Poxviridae family which belong to a group of viruses that includes the smallpox virus and the virus used in the smallpox vaccine, vaccinia. It was first found in 1958 in laboratory monkeys. Blood tests of other animals in Africa found that other types of animals also had monkeypox. Scientists then recovered the virus that causes monkeypox from an African squirrel. These types of squirrels might be the common host for the disease. Rats, mice, and rabbits can get monkeypox, too. Monkeypox was reported in humans for the first time in 1970. It is a rare viral disease that occurs mostly in central and western Africa. It was first reported in the United States in June of 2003. Most of these people got sick after having contact with pet prairie dogs that were sick with monkeypox. This was the first time that there has been an outbreak of monkeypox in the United States.

Other ways to transmit the virus are by person to person contact via respiratory droplets or body fluids. The signs and symptoms that occur are similar to smallpox but usually milder. About 12 days after people are infected with the virus, the person will develop a fever, headache, muscle aches, and backache. The person’s lymph nodes will swell and they will usually feel fatigued. About one to three days after the fever starts, the person will get a rash. This rash develops into raised bumps filled with fluid and often starts on the face and spreads, but it can start on other parts of the body too. The bumps go through several stages before they get crusty, scab over, and fall off. The illness usually lasts for 2 to 4 weeks. To differentiate the disease from smallpox, a cell culture and genome DNA restriction analysis should be performed. There is no specific treatment for monkeypox. In Africa, people who got the smallpox vaccine in the past had a lower risk of monkeypox. CDC has sent out guidelines explaining when smallpox vaccine should be used to protect against monkeypox.

Other fun ways to learn about poxviruses is a fun quiz I found!  Quiz Whiz!

Importance of finishing your antibiotics!

Antimicrobial resistance is when bacteria have developed a way of protecting themselves against antibiotics. Bacteria thrive on the mother nature motto “survival of the fittest.” These bacteria multiply very rapidly. By genetic mutation, bacteria may become resistant to an antimicrobial agent. As susceptible germs are killed by antimicrobial drugs, resistant microbes survive. The next time infection occurs the antimicrobial drug may not work if the germs are resistant. Bacteria are naturally susceptible to different types of antimicrobial drugs, however, particular bacteria develop resistance to the different types. Although all bacteria have the capability of potentially developing resistance. 

 

Not all antibiotics work in the same way. Some antibiotics kill bacteria and others just prevent bacterial growth. Different groups, or classes of antibiotics have different actions on bacteria. Some will interfere with the making of the bacterial cell wall. All bacteria have a cell wall that protects them from the outside environment and helps to contain the cell contents. When a bacteria multiplies it grows and divides into two. If the cell wall is damaged the bacterial cell will burst when it tries to multiply. Other antibiotics stop bacteria from making important chemicals they need to survive. They also interfere with the genetic material in a bacterial cell and cause it to stop the bacterial cell dividing into two and multiplying.

Because antibiotics act in different ways, but they also act on different bacteria. Some antibiotics will selectively target a few specific bacteria, these are known as narrow spectrum antibiotics. Others will target a wider range of bacteria, these are known as broad spectrum antibiotics. If a person has a bacterial infection is important to know which bacteria is causing it so the appropriate antibiotic can be prescribed. The best way to cause bacteria to become resistant to antibiotics is to under treat them. Bacteria multiply very rapidly, and as they multiply, random mistakes occur in their DNA which can make them resistant to antibiotics. The best way to keep this from happening is to take all the prescribed antibiotic doses on time. This will kill the bacteria rapidly and efficiently. When bacteria are under treated, some of them may have enough time to have these mistakes occur in their DNA. Then, when they multiply, they will no longer respond to the original antibiotic prescribed.

In order to prevent developing antimicrobial resistance, make sure to finish your prescriptions and follow your doctors orders!

End of Semester

Well everyone, it certainly has been an enjoyable semester studying various infectious diseases. I know I have learned a lot, and I hope that everyone has learned a lot from reading my blogs. This has been a very fun project to keep up with over the summer. It allowed for me to have fun with learning more about what I found interesting in the class. I feel like I have a better understanding and now will enjoy learning more about diseases. Now that the semester is over, I will be graduating and will discontinue my blog postings. I am moving to Nashville, TN for a job at Vanderbilt University Hospital. I look forward to my career as a Medical Technologist! :)

Bite Wound Case History

 This is a case history that I wrote during clinicals on a cat bite wound. I found it very interesting and thought I would share it again. Enjoy!!!

The patient presents to the doctor with a cat bite wound to the hand with a small amount of pus accumulating from the area. There is minimal localized swelling and pain. The patient is otherwise a healthy white female. A culture is taken from wound and plated onto 5% sheep blood agar, chocolate agar, and MacConkey agar; a gram stain is performed. The gram stain results showed small gram negative bacilli. There was growth on the 5% sheep blood agar and chocolate agar but no growth on MacConkey agar. [need more information on the actual investigation/workup] The final diagnosis was an infection of Pasteurella multocida. The patient did not experience some of the typical signs such as rapid development of pain, erythema, welling, cellulitis with or without a forming abscess, and purulent drainage at wound location. The patient was prescribed Augmentin and therapeutic advice of cleaning and irrigating the wound regularly until the wound healed. The prognosis for the patient was excellent as long as the medication was completed as prescribed.

 Pasteurella multocida are small gram negative bacilli that are present in normal animal flora and is the most frequently recovered Pasteurella species. This organism can be transmitted to humans during close contact, most often an animal scratch or bite. It is estimated to infect 20-50% of the 1 to 2 million Americans bitten or scratched by cats and dogs each year. The reservior of P. multocida includes the nasopharnyx and gastrointestinal tract of wild and domestic animals. It can also be found in the upper respiratory tract normal flora in humans who are animal handlers. The infection that can occur with P. multocida is often a soft tissue wound from an animal scratch or bite but it can cause more serious problems in patients who are immunocompromised. Other problems include respiratory tract infections, endocarditis, meningitis, brain absess, eye infections, sepsis, and bacteremia. The virulence factors caused by P. multocida are an endotoxin and antiphagocytic capsule. It is designated into groups A, B, D, E, and F then divided further into somatic serotypes 1 to 16. Most isolates of P. multocida fall into group A or D, and the toxin gene, toxA, is located in a conserved region of the P. multocida chromosome. The role however of the dermonecrotic toxin in human disease is unknown. These isolates are also known to produce lipases which can also be a virulent factor to this organism.

 Although there is no specific requirements for detection of Pasteurella multocida, a gram stain of the patient specimen would be the place to start. The gram stain would show small gram negative bacilli resembling a "safety-pin" under the microscope. Wright stains and Geimsa stains can also be performed to enhance the bipolar staining of the organism. On 5% sheep blood agar, the organism appears convex, smooth, shiny, gray, and nonhymolytic with a "musty" odor. On chocolate agar, the organism appears the same only slightly larger colonies. It does not grow on MacConkey agar because it does not ferment lactose. P. multiocida is also oxidase positive and sometimes can be a weak reaction. To compensate, the oxidase reagent can be flooded on the 5% sheep blood agar or chocolate agar the organism is growing best on and wait to observe the purple color indicating a positive reaction. This organism also produces acid but no gas from glucose, sucrose, and mannitol but not from maltose or lactose. A few other tests include catalase, indole, ornithine decarboxylase, urease and nitrate reduction. P. multocida is catalase, indole, and ornithine decardoxylase positive, urease negative, and reduces nitrates to nitrites.

An unusual characteristic of Pasteurella multocida is that most are susceptible to penicillin even though gram negative rods are intrinsically resistant to penicillin. Amoxicillin/clavulanate (a beta-lactamase inhibitor/penicillin) or Augmentin is the drug of choice for an animal bite wound to provide broad-spectrum coverage due to bite infections to be polymicrobial.

Fun link! So one of my favorite shows was Friends. I found this video and reminded me of Pheobe and her famous song "Smelly Cat." Listen to this Parody!

Camp jejuni, we hold you in our ....

The Facts about Campylobacter jejuni:

Where can you find it?

You can find it in animals such as chickens (poultry), birds, cattle and household pets including dogs and cats.

What are the suspecting symptoms?

The suspecting symptoms are diarrhea (which may contain blood or mucus), fever, stomach cramps, nausea and vomiting.

How can you catch it?

After the bacteria are taken in by mouth, it usually takes between two and five days before you become ill. To trace the cause of the illness, it is necessary to know where you were and what you ate and drank in the week before you became ill.

Prevention?

The single most important step especially poultry, and avoid cross-contamination via cutting boards and utensils of raw foods such as fresh produce.  Consuming unpasteurized dairy products such as milk and cheese is a known risk factor for Campylobacter infection and should be avoided to reduce the risk of exposure to foodborne pathogens.

The Laboratory:

What does it look like?

Campylobacter jejuni is a faint gram negative rod that is curved or seagull shaped with polar flagella.

Presumptive ID?

If Campylobacter is suspected, it is grown on CAMPY agar in a microaerophilic environment at 42^oC. It is oxidase and catalase positive and under a wet prep, it shows darting motility.

Confirmatory ID?

For confirmation, a hippurate hydrolysis test will be positive for Campylobacter jejuni. To separate Campylobacter and Helicobacter, a urease test is performed which will be negative for Campylobacter. To speciate Campylobacter jejuni, it will be resistant to Cephalothin and sensitive to Nalidixic acid.

My Fun Memory Clue! --> Hope it helps!!!

At Camp jejuni, we will see purple hippos and pink seagulls darting into the foamy sea.

Funny song about bacteria and preventing some food-borne illnesses 

And can I get a hot tub?

Have you ever been curious as to what bacteria lurk in the warm waters of your hot tub? Well if not properly taken care of, there are quite a few that can cause you harm. For example, Mycoplasma, Legionella, and Pseudomonas are all bacteria that love to grow in a hot tub environment. Since this week we have learned about lower respiratory tract diseases, Legionella is a disease that not many people are aware of, and that’s why I have chosen to give you the 4-1-1 on this disease.

The bacteria got its name in 1976, when many people who went to a Philadelphia convention of the American Legion suffered from an outbreak of this disease, a type of pneumonia (lung infection). Although this type of bacteria was around before then, more illness from Legionnaires' disease is being detected now. Legionnaires' disease can have symptoms like many other forms of pneumonia, so it can be hard to diagnose at first. Signs of the disease can include: a high fever, chills, and a cough. Some people may also suffer from muscle aches and headaches. These symptoms usually begin 2 to 10 days after being exposed to the bacteria. A milder infection caused by the same type of Legionella bacteria is called Pontiac Fever. The symptoms of Pontiac Fever usually last for 2 to 5 days and may also include fever, headaches, and muscle aches; however, there is no pneumonia. Symptoms go away on their own without treatment and without causing further problems.

People get Legionnaires' disease when they breathe in a mist or vapor (small droplets of water in the air) that has been contaminated with the bacteria. One example might be from breathing in the steam from a hot tub that has not been properly cleaned and disinfected. 

Who is at risk for this disease? People at risk of getting sick from the bacteria are elderly people, as well as people who are current or former smokers, or those who have a chronic lung disease. People who have weak immune systems from diseases like cancer, diabetes, or kidney failure are also more likely to get sick from Legionella bacteria. People who take drugs to suppress (weaken) the immune system (like after a transplant operation or chemotherapy) are also at higher risk.

The laboratory criteria according to the CDC are:

• The isolation of Legionella from respiratory secretions, lung tissue, pleural fluid, or other normally sterile fluids, or 
• Demonstration of a fourfold or greater rise in the reciprocal immunofluorescence antibody (IFA) titer to greater than or equal to 128 against Legionella pneumophila serogroup 1 between paired acute- and convalescent-phase serum specimens, or   
• Detection of L. pneumophila serogroup 1 in respiratory secretions, lung tissue, or pleural fluid by direct fluorescent antibody testing, or   
• Demonstration of L. pneumophila serogroup 1 antigens in urine by enzyme-linked immunosorbent assay, etc.

I hope you have all learned a little more about Legionnaire's Disease!


Check out this House Spoof about Legionnaire's Disease!

Got Strep Throat???

Is it sore throat season already? Well, sore throats can occur year round. The primary cause of a sore throat, or pharyngitis, is a bacterium known as Streptococcus pyogenes. The primary infection of Streptococcus pyogenes is a strep throat or tonsillitis. A painful, red throat with white patches on your tonsils is characteristic of pharyngitis, otherwise known as strep throat.  It is usually accompanied by swollen lymph nodes, fever, and headache.  Occasionally nausea, vomiting, and abdominal pain also accompany it. The suppurative sequelae of the initial infection are sinusitis or otitis media. Other nonsuppurative sequelae of S. pyogenes are scarlet fever. The frequency of Streptococcus pyogenes for the general population is 15-35%. Streptococcus pyogenes is classified as Group A streptococcus. Group A streptococci typically have a capsule composed of hyaluronic acid and are beta-hemolytic, which is characteristic for Streptococcus pyogenes. Beta-hemolytic streptococci produce a toxin that forms a clear zone of hemolysis on blood agar, demonstrating its ability to destroy red blood cells.  This hemolysis is attributed to toxins formed by Group A streptococci called streptolysins.  Streptolysins can destroy not only red blood cells, but also the white blood cells responsible for fighting off bacteria and disease, as well as other body cells.

The identification of Streptococcus pyogenes is to make a presumptive decision based on the gram stain and colony morphology. After, a PYR test can easily be performed. If the test is positive, it can be presumptively identified as Streptococcus pyogenes. Further tests such as a Bacitracin disk are performed where the expected results are to be sensitive to the organism. A quick test that can be performed in a clinic setting rather than the clinical laboratory is the Quick Vue Dipstick Strep A Test. It is a rapid lateral-flow immunoassay where the extracted antigen attaches to the antibody to the step A colored particles. The complex then migrates through the membrane and attaches the antibody to the strep A where the test line will produce a pink to purple color. On the control line, the complex reacts with the antibody, or protein A, to produce a blue color. To report a positive test, it must be reported as “Positive for Group A Streptococcus antigen.” To report a negative test, it must be reported as “Negative for Group A Streptococcus antigen.” For an invalid report, it must be reported as “Invalid Group A Streptococcus antigen test result. Possible interfering substance present. Please submit another sample if clinically indicated.” The advantages to this assay are that it has good specificity where the patient can be treated sooner, and it is faster than a culture. The disadvantages to this assay are that it has lower sensitivity than a culture and it does not detect other infections due to other groups of streptococci.

According to a CDC report dated April 3, 2008, approximately 9,000-11,500 cases of invasive GAS disease (3.2-3.9 per 100,000 population) occur each year in the United States. More than 10 million noninvasive GAS infections (primarily throat and superficial skin infections) occur annually. The best way to avoid strep throat is to avoid close contact with someone who is already infected with strep. It may also be helpful to reduce stress, get plenty of rest, and fortify your body's natural defenses. Frequent hand washing can help prevent infection as well.

Found a pretty tough quiz that include some questions from my blog but also from our respiratory tract infection lectures. Check it out!!!

Respiratory Infection Quiz!

Cat Scratch Fever

How many people have a household cat as a pet? Yes, I am referring to that cute little kitty that is all curled up next to you. They might look friendly at first, but then something “rubs” them the wrong way. Next thing you know you’re grabbing your arm and screaming, “Ouch!” There is now a slight scratch that is throbbing with pain. A quick clean up and a band-aid is all the normal human being does to solve the problem. Little do you know, there could be a much more severe consequence.

Cat-scratch fever, or cat-scratch disease, is caused by Bartonella henselae, which is a normal flora of the cat’s saliva. B. henselae is also associated with bacteremia and endocarditis. Symptoms usually do not show for a few days following the incident. Once the symptoms start, however, they can last for a couple weeks. Symptoms of cat scratch fever include pain and swelling of the lymph nodes, general discomfort and body aches, and loss of appetite. Many times, cat scratch fever is never diagnosed. The symptoms are sometimes mild and not severe enough to warrant treatment. Cat scratch fever is not a very common disease. According to the U.S. Centers for Disease Control and Prevention, there are about 25,000 cases in the United States each year. However, there are likely many more cases that go undiagnosed or unreported.

In order to isolate this organism, the Isolator system is used for blood culture. It is plated out to fresh chocolate or 5% blood agar (rabbit or horse). The plates should be incubated at 35⁰C in CO₂ for up to 30 days. Bartonella henselae is a weak staining, gram-negative rod that stains better with a Gimenez. It appears irregular in shape, raised, whitish, and rough (cauliflower) like. The organism is catalase and oxidase negative as well as negative for all carbohydrates. The presumptive identification is based on colony growth after seven days with characteristic colony morphology, wet prep, catalase, and oxidase reactions. 

I hope everyone has learned a little more about what to expect from the adorable kitty curled up by your side. Just remember for next time that if you get a scratch that does not appear normal, you might want to see your doctor for a possible infection of Bartonella henselae.

 Check out this song!!!

 

A little about me :)

Hey everyone! My name is Destiny and I am a graduate student in the Clinical Laboratory Sciences program at the University of Alabama at Birmingham (UAB). I have an undergraduate Bachelor's of Science degree in Physical Sciences/Chemistry from Auburn Montgomery (AUM). I am originally from Swansea, IL and moved to Montgomery, AL to attend AUM on a basketball scholarship. After finishing my basketball career and graduating, I applied for the CLS program, was accepted, and moved to Birmingham. I will be graduating this August and looking forward to starting my career as a Medical Technologist. This summer I am taking a course titled Infectious Diseases.  Every week I will be writing a blog about something interesting I learn about. Please log on every week to read a new blog entry on my exciting laboratory studies!