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Term 4: ID practice > Spirochetes > Flashcards

Spirochetes Flashcards

1
Q

What are the three genera of spirochetes?

A
  • Treponema
  • Borrelia
  • Leptospira
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2
Q

What organism causes syphilis?

A

-Treponema pallidum

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3
Q

Why can’t we see Treponema pallidum on light microscopy? What kind of microscopy is needed to see them?

A
  • they are too narrow
  • Need darkfield microscopy or EM
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4
Q

What is the outermost amorphous layer of Treponema pallidum?

A

-Glycosaminoglycans

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5
Q

What diagnostic tests do we use to detect Treponema pallidum?

A

Non-treponemal antibody tests:

  • VDRL (venereal disease research lab of CDC)
  • RPR (Rapid Plasma Reagin)

Treponemal antibody tests:

  • MHA-TP (MIcrohemagglutination antibody to T. pallidum)
  • EIA (Enzyme immunoassay)
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6
Q

Where does Treponema pallidum get phosphatidylcholine?

A
  • can’t make its own
  • takes it from mammalian host =cardiolipin
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7
Q

What tests detect cardolipin in Treponema pallidum?

A

=non-treponemal antibody tests

  • VDRL test (venereal disease research laboratory)
  • RPR (rapid plasma reagin test)
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8
Q

What is the epidemiology of Treponema pallidum?

A
  • Natural spread only among humans
  • Sexual transmission
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9
Q

What disease does Treponema pallidum cause?

A

Syphilis

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10
Q

What is weird about the flagella of spirochetes?

A

They are located underneath the outer membrane

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11
Q

What is the first sign of syphilis?

A

Primary syphilis = lesion called chancre

-incubation of 7-21 days before papule appears

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12
Q

Why is primary syphilis harder to detect in women and homosexual men?

A
  • chancre often in vaginal canal or rectum
  • syphilis usually diagnosed in second stage
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13
Q

What happens to the primary syphilis chancre without treatment?

A
  • Disappears in 3-4 weeks
  • reflects development of some immunity
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14
Q

What is secondary syphilis?

A
  • organisms have disseminated widely throughout body
  • Lesions appear all over skin, truck>extremitis and

**involves palms of the hands and soles of the feet”

-partial immunity prevents these lesions from turning into a chancre

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15
Q

What is seen in the CSF of patients with secondary syphilis?

A

-Treponemes

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16
Q

What kind of patient will develop early neurological symptoms of syphilis?

A

AIDS patient

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17
Q

What is latent syphilis?

A
  • organism is in body, but not causing any signs of disease
  • Occurs in absence of treatment of secondary syphilis
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18
Q

What are the three things that can happen once syphilis becomes latent?

A

1/3 eradicate disease

1/3 remain with latent disease; keep reactive RPR

1/3 develop tertiary syphilis

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19
Q

What are the three types of tertiary syphilis?

A
  • Benign
  • Cardiovascular
  • Neurologic
20
Q

What is benign tertiary syphilis?

A

-Gummas: large, immunologically mediated, granulomatous lesions of skin, liver testis, hard palate

***RARE

21
Q

What is cardiovascular tertiary syphilis?

A

-Aneurysm of ascending aorta due to invasion of vasa vasorum

*RARE

22
Q

What is neurologic tertiary syphilis?

A

Wide variety of sx’s

  • tabes dorsalis
  • strokes
  • dementia
  • paresis

*CSF is usually abnormal

23
Q

What is the most reliable diagnosis of primary syphilis?

A

-detection of treponemes in the canchre by darkfield exam

*difficult in secondary lesions

24
Q

What is the treatment for syphilis?

A

-Long acting penicillin b/c of slow dividing time

25
Q

What is the Jarisch-Herxheimer reaction?

A

-Treatment of syphilis with penicillin is followed in 4 hours by a fever that may be high and the worsening of lesions

26
Q

What organism causes Lyme disease?

A

-Borrelia burgdorferi

27
Q

What is the natural reservoir and vector of Borrelia burgdorferi?

A

Reservoir: White-footed mouse

Vector: hard tick (Ixodes)

28
Q

What are the tree stages of Lyme disease?

A

1) Localized infection

2) disseminated infection

3) Persistent destructive arthritis & cardiac disease

29
Q

What is stage 1 of Lyme disease?

A
  • localized infection
  • nonspecific generalized symptoms
  • Erythema migrans
30
Q

What is stage 2 of lyme disease?

A
  • disseminated infection (multiple smaller erythema migrans)
  • arthritis (large joints), carditis (heart block), neurologic disease (Bell’s Palsy)

“outbreak” of acute arthritis

31
Q

What is stage 3 of lyme disease?

A
  • Persistent destructive arthritis
  • cardiac disease
32
Q

What is the cause of leptospirosis?

A

-Leptospira

33
Q

Which species of Leptospira infects humans?

A

-interrogans

34
Q

What is the epidemiology of Leptospira?

A
  • Warm climates
  • rare in USA
  • infects mammals (rodents, dogs)
  • US soldiers in Panama

*work in or around bayous, contact with sewage or farm animals, presence of rats on property

35
Q

What is the clinical presentation of leptospirosis?

A
  • Non-specific febrile illness
  • muscle aches
  • fatal jaundice
  • renal failure
  • hemorrhage
36
Q

What is Weil’s disease?

A

-combined renal and liver failure seen in leptospirosis

37
Q

What is Tabes Dorsalis?

A
  • seen in tertiary syphilis
  • damage to posterior columns and dorsal roots of spinal cord
  • disrupts sensory perception
38
Q

What is general paresis of tertiary neurologic syphilis?

A

-progressive disease of the nerve cells in the brain leading to mental deterioration and psychiatric symptoms

39
Q

What disease is caused by Borrelia recurrentis?

A

-Relapsing fever

40
Q

“Tick/louse bites on campers sleeping in cabins in western U.S.”

A

Borrelia recurrentis or Borrelia hermsii= relapsing fever

41
Q

What is the reservoir and vector of Borrelia recurrentis?

A

Reservoir = human

Vector = louse

42
Q

What is the reservoir and vector of Borrelia hermsii?

A

Reservoir = rodents and small mammals

Vector = tick (humans infected incidentally)

43
Q

What is the clinical presentation of relapsing fever caused by B. recurrentis and B. hermsii?

A
  • Fever, headache, muscle pains (nonspecific)
  • persists for 4-10 days, then controlled by humoral response
  • recurrence of symptoms keeps occuring, milder each time
44
Q

Why is relapsing fever caused by B. recurrentis and B. hermsii able to relapse?

A

-organism changes its outer membrane proteins, escaping humoral immunity repeatedly

45
Q

What kind of heart block can be caused by Borrelia burgorferi?

A

Atrioventricular heart block

46
Q

What is the easiest way to prevent Lyme disease?

A

-if a tick bites you, take it off within 18-24 hours so it can’t puke on you

47
Q

How are humans typically infected with Leptospira interrogans?

A
  • swallowing water contaminated with animal urine
  • more common in tropical regions

Term 4: ID practice (22 decks)

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