Treponema pallidum features
Gram-negative spirochete
Motile
Microaerophilic
Spirochete structure
“Gram-negative cytology
Flexible, peptidoglycan cell wall
Cell wall covered by an outer bilayered membrane”
T. pallidum disease
Syphillis
T. pallidum diagnosis
“Unable to observe with LM
Gram or Giemsa stain
Ab detection/serology most common method”
Five kinds of syphillis
“Primary
Secondary
Latent
Tertiary
Congenital”
Primary syphillis
“One or more painLESS skin lesions (chancres) at site of spirochete penetration
Inflammation”
Secondary syphillis
“Disseminated disease
Flulike syndrome
Prominent skin lesions (including palms and soles)
Condyloma lata”
Condyloma lata
Raised lesions that may occur in skin folds
Latent syphilis
“Asymptomatic period
Transmission possible from relapsing secondary lesions”
Tertiary syphilis
“Diffuse, chronic inflammation
Destruction of any tissue or organ
Granulomatous lesions (gummas)”
Congenital syphilis
“Transmission from mother to fetus
Presentation is similar to secondary syphilis in adult (rhinitis, maculopapular rash, late condyloma)
Teeth and bone malformation, blindness/deafness”
Microbes that can pass from mother to fetus
“ToRCHeS
Toxoplasma gondii
Rubella
CMV
HIV
HSV
Syphilis”
Syphilis serology
“Nontreponemal tests
Treponemal tests
Darkfield microscopy”
Nontreponemal test for syphilis serology
“Measures Ab against cardiolipin
Rapid plasma Reagin (RPR)
Venereal Disease Research Lab (VDRL)”
Treponemal test for syphilis serology
“Detect Ab specific to T. pallidum
FTA-ABS
MHA-TP”
Syphilis treatment and prevention
“Penicillin (doxycycline or azithromycin if allergic to penicillin)
Safe sex”
Most common cause of NGU
“Chlamydia
(Mycoplasma genitalium and Ureaplasma urealyticum thought to contribute)”
Mycoplasma and Ureaplasma features
“Smallest free-living bacteria
NO cell wall
Not stained with common methods
Pleomorphic
PM contains sterols
Extracellular”
M. genitalium
“NGU in males/PID in females
RESIST doxycycline, but azithromycin is effective”
M. hominis
“PID
Resists erythromycin, but doxycycline is effective”
Ureaplasma
Common cause of NGU in males, generally in those who are sexually active
Ureaplasma treatment
“Treated with doxycyline (also effective against Chlamydia)
If recurrent and doxycycline not helping, azithromycin or quinolones can be used”
Haemophilus features
“Gram-negative, pleomorphic, coccobacillus
Facultative anaerobe
Catalase +
Fastidious (require X factor = hemin and V factor = NAD)”
Haemophilis ducreyi symptoms
“Tender papule that becomes painful
Inguinal lymphadenopathy”
H. ducreyi diagnosis and treatment
“Syphilis and HIV must be excluded
Macrolide”
Klebsiella granulomatis disease
Donovanosis or Granuloma inguinale
K. granulomatis features
Gram-negative rod, intracellular, encapsulated
K. granulomatis symptoms
“Wartlike primary lesions
Lesions are painless, but easily bleed”
K. granulomatis diagnosis
“Rule out other causes
Presence of Donovan bodies”
K. granulomatis treatment
Prolonged use of tetracycline, sulfamethoxazole, gentamicin, ciprofloxacin, or erythromycin
Painful, non-indurated lesion with Hx of recent travel
Chancroid
Painless, indurated lesion, no travel Hx
Syphilis
Painless, wartlike, indurated lesion that bleeds easily with Hx of recent travel
Donovanosis