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Flashcards in Spirochetes Deck (26):
1

What's special about spirochetes?

1) Too thin to visualize with light microscopy so use dark field microscopy
2) Corkscrew shape bc thin flexible cell wall
3) Periplasmic flagella

2

The 4 spirochetes?

1) Treponema pallidum
2) Borrelia burgdorferi
3) Borrelia recurrentis
4) Leptospira interrogans

3

How to distinguish between spirochetes?

Microaerophilic = Treponema and Borrelia
Aerobic = Leptospira interrogans

Sensitive to high temp - Treponema
Giemsa and silver stains - Borrelia

"Ice tong" appearance = Leptospira interrogans since you interrogate people with ice tongs

4

Treponema pallidum causes...

Primary syphilis
- Painless chancre

Secondary syphilis
- Condyloma lata, MC rash on palms and soles, hepatitis, meningitis

Tertiary syphilis
- Ascending aortic aneurysm, Tabes dorsalis, A-R pupils, gummas (granulomas of soft tissue and bone)

Congenital
- VIII deafness, Saber shins, Saddle nose, Hutchinson's incisors, mulberry molars

5

Treponema pallidum and what else causes rash on palms and soles?

1) Rocky mountain spotted fever (Richettsia)
2) Coxsackie virus

6

Organisms that cross placenta?

TORCHES.
Toxoplasmosis
Rubella
CMV
HIV, HSV
Syphilis

7

Treponema pallidum Dx

1) Dark microscopy shows motile corkscrew shaped bacterium

2) VDRL for anticardiolipin Abs

3) FTA-ABS for antitreponemal Abs

8

Treponema pallidum Tx

IV Penicillin (beta lactam which prevents transpeptidation and formation of PG CW).

9

Complications of Treponema palladium Tx

Jarisch-Herxheimer Rxn in which treponemal lysis leads to endotoxin-like factor release with fever, chills, myalgias

10

Borrelia burgdorferi causes...

Stage 1 Lyme - 10 days
- Erythema migrans (annular lesion)
- Flu like symptoms

Stage 2 Lyme - Weeks
- CNS - Bell's Palsy, Meningitis, Peripheral Neuropathy
- CV - AV block and Carditis
- Skin - Secondary annular lesions
- Joints - Myalgias and arthritis

Stage 3 Lyme - Mos-years
- CNS - Encephalitis
- Joints - Chronic arthritis
- Skin - Acrodermatitis chronicum atrophicans (inflammation, discoloration, sclerosis with wrinkling)

11

Borrelia burgdorferi transmitted by

Ixodes Scapularis

12

Most common vector borne diseases in the US

1) Lyme disease
2) RMSF
3) Tularemia

13

Borrelia burgdorferi Dx

1) Dark field microscopy
2) Serology

14

Borrelia burgdorferi Tx

1) Doxycycline if Stage 1
2) Ceftriaxone if later

15

Borrelia recurrentis causes

Relapsing fever with 5 days on and 8 days off, repeating 10 cycles

16

Borrelia recurrentis transmission

Louse

17

Borrelia recurrentis virulence factor

Antigenic variation of Variable Major Protein

18

Borrelia recurrentis diagnosis

Dark field microscopy, Serology, Wright and Giemsa staining

19

Borrelia recurrentis Tx

Penicillin, Tetracycline

20

Borrelia recurrentis complications of treatment

Jarish-Herxheimer Rxn:
Lysis of Treponeme --> endotoxin like factors released --> myalgias, fevers, chills

21

Leptospira interrogans shape

Ice tong shape 2/2 to periplasmic flagella

22

Leptospira interrogans transmission

Dogs, fish, rodents --> urine, H20, tissue to humans --> enters via mucosal abrasions

23

Leptospira interrogans causes...

Leptispirosis in 2 phases

Phase 1 - Leptospiremic phase
Photophobia and flu like symptoms

Phase 2 - Immune phase
Mild disease = Anicteric leptospirosis with aseptic meningitis
Sever disease = Weil's disease with kidney, liver damage and vasculitis

24

Leptospira interrogans Dx

Darkfield microscopy with organisms in blood Phase 1 and Urine Phase 2

Serology

25

Leptospira interrogans Tx

Penicillin, with doxy prophylaxis

26

Leptospira interrogans story?

Farmer with photophobia and elevated liver enzymes and kidney failure.