Flashcards in Lecture 12 Deck (58):
Types of spirochetes
treponema, borrelia, leptospira
What is a causitive organism for syphilis
What does treponema pallidum look like?
thin walled flexible spiral roda with axial filaments which causes undulating movements
Is treponema pallidum grown in a culture?
NO- not grown in culture media/in cell culture
Transmission of Treponema pallidum
through intimate contact of skin and mucous membranes
Is treponema pallidum transmitted to fetus?
YES- through the placenta
How is Treponema pallidum related to the world?
world wide in distribution, increasing incidence, notifiable disease
Path of transmission of treponema pallidum
no toxins or enzymes produced. Not very invassive, not much inflammation
While treponema run a chronic course if not treated?
How many stages of treponema pallidum>
Primary stage of treponema pallidum
organism multiply at site of infection- 2-10 weeks after inoculation, pt develops painless ulcer on genitals- heals spontaneously
Secondary stage of treponema pallidum
1-3 months later, pt develops papular rashed in palms and soles - verrucae like growth of skin + mucous membranes in genitals
what are condyloma lata rich in?
WHat is condyloma lata?
verrucae like growth on skin and mucous membranes of genitals
Will the secondary stage heal on its own?
Part portion of people in second stage progress to third stage?
latent stage of 2nd stage
symptoms occur 2-3 years later
Tertiary stage of syphilius
granuloma formation on skin and bones, CNS manifestation, tabes dorsailes, CVS lesions
What is tabes dorsal is?
pt will have abnormal sensation in coordination of walking and loss of knee jerk
Define CVS lesions
aortitis and aneurism formation of ascending aorta
Organism transmitted through placenta and can cause this disease in children
features of congenital syphilis
depressed nose, notched teeth, interstitial keratits, nerve deafness
3 features of congenital syphilis are known as what...?
rapid plasma reagin test- nonspecific antibodies (reagin) bind cardiolipin (Ag) and reagin is a mixture of IgG &IgM
WHen will the RPR test be positive and when will it be negative?
Positive in primary and secondary stages
Negative after treatment
When do you have false positives in RPR?
occurs in leprosy, Hep B/infectious mononucleosis
When do you have false negatives in RPR?
if Abs are in too high concentration and no flocculation can result
Specific Serological Tests are what?
immuno fluorescent or haemaglutinin tests
Treatment for syphilis
Pen G- single dose- affords total cure
for pts allergic to Penicillin, take TC/Erythromycin for prolonged period
What happens in the treatment of secondary syphilis with Penicillin ?
Because bacteria is so high, you will have a rxn- fever, chill, myalgia flu like symptoms because of all the dead bacteria - Jerish Herxheimer rxn
Prevention for Syphilis
condoms, - individuals and contact person should be treated
Where does Leptospira grow?
in bacteria media containing serum
What are reservoirs for leptospira?
mainly rats, rodents, domestic livestock, US dogs- animal urine contaminate the soil and water
How can you contact leptospira?
wimming in contaminated water, consuming contaminated food or drinks (common in sewage), human infection occurs through skin and mucous membrane or ingestion
What does leptospira affect?
any organ!- liver (jaundice), kidney (uremia), lung (hemorrhage), CNS (meningitis)- first it produces fever and later attaches organ
clinical manifestations in leptospira
biphasic- fever, chills, severe headache- disappear then re appear after a week with all systemic manifestations
What is the multi organ failure phase called?
Treatment for leptospira
Penicillin G (no resistance) / doxycycline
What does Borrelia burgdorferi cause?
causes lyme disease
What medium can you see lyme disease on?
motile spirochetes can be seen with Geirmsa stain and can be grown
Main reservoir of lyme disease?
small mammals like white footed mouse, deer transmission among animals by tick bite
What states is lyme disease common in?
NY, CT, Penn, NJ
What is the most common vector borne disease in US?
How long does the nymph have to feed on the skin to produce infection of lyme disease?
What parts of the body are affected by lyme disease?
heart, joints, CNS
How many stages of lyme disease?
Stage 1 of lyme disease
circular red rash at site- clear white center described as Bull's Eye- accompanied with flu like symptoms
Stage 2 of lyme disease
Occurs weeks or months later - cardiac and neurological involvement in this stage, cerebral palsy
Stage 3 of lyme disease
Arthritis of large joints (knee), chronic progressive CNS disease follows
lab diagnosis of lyme disease
culture not done, serological exam for IgM Ab or raising IgG Ab by ELISA test
Treatment of lyme disease
severe form- Pen G/Ceftrioxone
Prevention of lyme disease
protective clothing, insect repellent, examination of skin for ticks, vaccine available
How is Borrellia recurrent is transmitted?
from person to person by human body louse
What does Borrellia recurrentis produce?
relapsing fever, chills, headache, multiorgan dysfunction
What happens to the antigens of this organism during infection?
Ags of this organism undergo variations and cause relapse 3-10 times- each attack terminates with rising Ab
Diagnosis of Borrellia recurrentis
large spirochete in peripheral smear
Treatment of Borrellia recurrentis