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Microbiology > Treponema pallidum, borrelia and leptospira interrogans > Flashcards

Treponema pallidum, borrelia and leptospira interrogans Flashcards

1
Q

Give the four subspecies of Treponema pallidum

A

Treponema pallidum
Treponema pertenue
Treponema endemicum
Treponema carateum

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2
Q

What disease does Treponema pallidum cause?

A

Syphilis (worldwide)

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3
Q

What disease does Treponema pertenue cause?

A

Yaws

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4
Q

What disease does Treponema endemicum cause?

A

Endemic syphilis (Middle East and Central and South Africa)

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5
Q

What disease does Treponema carateum cause?

A

Pinta

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6
Q

What is the shape of Treponema spp?

A

Helically coiled, corkscrew shaped cells with 8-12 regular spirals

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7
Q

Are Treponema encapsulated?

A

No

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8
Q

Is Treponema motile?

A

Yes

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9
Q

Can Treponema form spores?

A

No

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10
Q

What can Treponema form instead of spores in the body

A

Cysts

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11
Q

How are Treponema different from other motile bacteria?

A

Endoflagella

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12
Q

Is Treponema gram positive or neegative?

A

It is gram negative

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13
Q

Is Treponema pallidum aerobic or anaerobic

A

Strict anaerobe

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14
Q

What staining method can be used to reveal Treponema from smears?

A

Silver impregnation methods

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15
Q

How can live Treponema be visualised?

A

Dark field microscopy

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16
Q

How difficult is it to culture Treponema pallidum?

A

It is fastidious, requiring very narrow pH and temperature ranges. It has not been successfully cultured in vitro

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17
Q

Describe the resistance of Treponema pallidum

A

It can not survive a long time in the environment. It is rapidly inactivated by mild heat, cold,
desiccation, and most disinfectants.
It is inactivated by contact with oxygen, distilled water, soap
T.pallidum is sensitive to arsenicals, mercurials, bismuth, common antiseptic agents and
antibiotics (penicillines).

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18
Q

How is Treponema pallidum transmitted?

A

Through sexual contact (venereal disease);
Through placenta (congenital syphilis);
Rarely with direct contact and with infected blood during transfusion

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19
Q

How long is the incubation period for syphilis?

A

Incubation period is about a month (10 - 90 days)

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20
Q

Give 4 stages in the clinical manifestation of infection with Treponema Pallidum

A

Primary syphilis
Secondary syphilis
Latent syphilis
Tertiary syphilis

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21
Q

How does primary syphilis begin?

A

The organisms penetrate mucous membranes or enter through the very tiny cuts on the skin.
Treponema multiplies in the site of entry causing formation of the primary specific lesion, named
“hard chancre”.

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22
Q

Describe the chancre of primary syphilis

A

Chancre is painless, circumscribed, indurated, superficially ulcerated lesion

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23
Q

What is the next stage of primary syphilis after formation of a chancre?

A

Treponema disseminates away from the site of initial entry to regional lymph nodes and
provokes their specific inflammation (syphilitic buboes).

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24
Q

Describe the changes in regional lymph nodes in primary syphilis

A

Lymph nodes are swollen, discrete,

indurated, and rubbery.

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25
Q

What is the normal progression of a chancre over time in primary syphilis?

A

The chancre heals spontaneously (!) in 10-40 days, leaving a thin scar

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26
Q

Roughly how long does primary syphilis last?

A

3 months

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27
Q

When does secondary syphilis set in?

A

3 months after primary syphilis

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28
Q

What causes the secondary lesions in syphilis?

A

The secondary lesions are due to dissemination through

the blood and wide-spread multiplication of the spirochetes.

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29
Q

How may secondary syphilis present?

A 
It may appear with:
ROSEOLAR RASHES
PAPULAR RASHES
MUCOUS PATCHES (broad, flat, erosive lesion of secondary syphilis that occurs on moist skin or mucous membranes and is often marked by a yellowish discharge)
CONDYLOMATA (anogenital warts).
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30
Q

In which stage of syphilis are patients most infective?

A

The secondary stage as the spirochetes are present abundantly in the lesions

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31
Q

What is the natural progression of secondary syphilis?

A

Lasts 2-3 years

Lesions heal
spontaneously (!) but during first 4-5 years there may be relapses of rashes

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32
Q

How is latent syphilis diagnosed?

A

Serological tests

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33
Q

When does tertiary syphilis present?

A

Years to decades after secondary syphilis

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34
Q

How does tertiary syphilis present?

A

After several years tertiary syphilis
appears with cardiovascular lesions (aneurysms), chronic gummata and neurological
manifestation (tabes dorsalis or dementia)

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35
Q

What are gummas?

A

Highly destructive lesions (necrotizing granulomas ) that usually occur in skin and
bones but may also occur in other tissues. Gumma includes few treponemes

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36
Q

How well does the immune system deal with Treponema pallidum?

A

Immunity is weak, non-sterile, and cell-mediated. Antibodies which are formed during infection
are not protective

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37
Q

What is the significance of the antibodies produced during infection by Treponema pallidum?

A

Diagnostic significance

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38
Q

Can a person be reinfected with Treponema pallidum?

A

Yes (superinfection)

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39
Q

What is different about getting infected by Treponema pallidum a second time?

A

Due to ‘chancre immunity’ there are no primary signs

40
Q

What is the usual therapy of syphilis?

A

Prolonged penicillin preparations

41
Q

How can syphilis be diagnosed in a lab during the primary and secondary stages?

A

Microscopy with dark field microscopy of native smears or fluorescent antibody (immunofluorescence) test

42
Q

Can syphilis be diagnosed using serology?

A

Yes, 2-3 weeks after chancre appearance

43
Q

What group of borrelia species cause Lyme’s disease?

A

B.burgdorferi

44
Q

How can the size of Borrelia be described?

A

Large

45
Q

Are Borrelia motile?

A

Yes

46
Q

Describe the shape of Borrelia

A

3-8 wide, open coils

47
Q

Are Borrelia gram positive or negative?

A

Negative

48
Q

Are Borrelia aerobes or anaerobes?

A

Microaerobic - need oxygen but in lower concentration than atmosphere

49
Q

Can Borrelia be cultivateed?

A

Not into media but possible in chicken embryo or in rodents

50
Q

What diseases are Borrelia species primarily responsible for?

A

Relapsing fevers and Lyme’s disease

51
Q

How is Borrelia transmitted to humans?

A

Lice or ticks

52
Q

What species of Borrelia is responsible for the louse-borne/epidemic type of relapsing fever?

A

Borrelia recurrentis

53
Q

What is the reservoir host for Borrelia recurrentis?

A

Humans

54
Q

What is the reservoir for Borrelia species which cause the tick borne/endemic type of fever?

A

Rodents

55
Q

What is the vector for Borrelia bungdorferi?

A

Ticks

56
Q

What are the main reservoirs for Borrelia bungdorferi?

A

Rodents and deer

57
Q

What does Borrelia responsible for relapsing fever do once it has entered the body?

A

Enters the bloodstream and multiplies in the organs

58
Q

What is the body’s response to the presence of Borrelia recurrentis?

A

Mounting an immune response including a fever, lasting 3-5 days which destroys the bacteria in the blood

59
Q

Why does the fever relapse after an immune response destroys Borrelia recurrentis in the blood?

A

The pathogen has he ability to undergo multiple cyclic antigen variations so that once one strain is eliminated, another comes to dominate and infect the blood, triggering another immune response with new antibodies.

60
Q

How long is the afibrile period usually in relapsing fever?

A

4-10 days

61
Q

How can Borrelia recurrentis be diagnosed in a lab?

A

Microscopy of stained blood smears

62
Q

How can epidemic and endemic Borrelia strains be distinguished?

A

Injection into guinea pigs which are highly sensitive to animal Borrelia and less sensitive to human Borrelia

63
Q

What is the incubation period for Lyme’s disease?

A

3-30 days

64
Q

What are the 3 stages of Lyme’s disease?

A
  1. Localised infection
  2. Disseminated infection
  3. Persistent infection
65
Q

What happens during the localised infection stage of Lyme’s disease?

A

There appears an expanding annular skin lesion (erythema migrans).

66
Q

What happens during the disseminated infection stage of Lyme’s disease?

A

Fever
Myalgia
Arthralgia
Lymphadenopathy.

67
Q

When do the symptoms of the persistent infection stage of Lyme’s disease arise?

A

Arises in months or years after the disseminated stage

68
Q

What happens during the localised infection stage of Lyme’s disease?

A

Chronic arthritis
Polyneuropathy
Acrodermatitis
Encephalopathy

69
Q

How can laboratory diagnosis of Borrelia burgdorferi be done?

A

Serology

Microscopy in the site of entry during the first stage

70
Q

What are the prophylactic methods that should be used to avoid Borrelia infections?

A

Avoid the vectors
Cover skin with clothing in tick habitats
Use tick repellent in tick habitats
Periodic skin inspection and tick removal
Avoid endemic areas

71
Q

What is the treatment for Borrelia?

A

Borrelia are sensitive to penicillins, tetracyclines, newer macrolides and cephalosporins.

72
Q

Describe the shape of Leptospira interrogans

A

Slender
Tightly coiled
Flexible
Hooked ends that create an S or C shape

73
Q

Is Leptospira interrogans encapsulated?

A

No

74
Q

Is Leptospira interrogans motile?

A

Yes

75
Q

Is Leptospira interrogans spore forming?

A

No

76
Q

Is Leptospira interrogans Gram positive or negative?

A

Negative

77
Q

How can Leptospira interrogans be visualised?

A

Dark field microscopy

Visualisation in tissue by silver impregnation methods

78
Q

Can Leptospira interrogans be easily cultured?

A

Yes they are far from fastidious

79
Q

Is Leptospira interrogans sensitive to heat?

A

Yes

80
Q

Is Leptospira interrogans sensitive to acid?

A

Yes, killed by stomach acid in 30mins

81
Q

Is it easy to kill Leptospira interrogans with disinfectants?

A

Yes

82
Q

How is the survivability of Leptospira interrogans in water?

A

L.interrogans can survive into clean water for some days and can multiply in the environmental water at summer.

83
Q

How long can soil remain infective if it is contaminated with urine containing Leptospira interrogans

A

Urine-contaminated soil can remain infective for as long as 14 days.

84
Q

What are the main reservoirs of Leptospira interrogans?

A

Rodents
Domestic animals
A range of hosts worldwide

85
Q

How is Leptospira interrogans transmitted?

A

Direct or indirect contact with urine containing virulent leptospires.
Leptospires from urine-contaminated environments, such as water and soil, enter the host through the mucous membranes and through small breaks in the skin.

86
Q

How long is the incubation period of Leptospira interrogans?

A

About 10 days (3-25)

87
Q

Where does Leptospira interrogans go after entering the body?

A

Through the blood it reaches the organs, most commonly the CNS, kidneys and liver

88
Q

What are the symptoms during onset of infection with Leptospira interrogans?

A 
Abrupt fever
Severe headache
Muscle pain
Nausea
Jaundice in severe cases
89
Q

How long does the initial phase of leptospira interrogans infection last?

A

7 days

90
Q

What takes place after the initial phase of infection by Leptospira interrogans?

A

Leptospires are rapidly eliminated from all host tissues except the brain, eyes, and kidneys.

91
Q

What is the most notable feature of severe leptospirosis?

A

Progressive impairment of hepatic and

renal function

92
Q

How is the immunity after leptospirosis?

A

It is primarily humoral (antibody - mediated)
Type-specific
Long-lasting (may persist for years).
Cell-mediated immunity is not protective.
Due to a lot of serotypes immunity in general is weak

93
Q

Can microscopy be used to diagnose leptospirosis?

A

Yes

94
Q

Where can samples be taken from for microscopy of Leptospirosis interrogans?

A

Blood (first 8-10 days)
Urine (from second week)
CSF

95
Q

Is culture used to diagnose leptospirosis?

A

No, too slow

96
Q

is serology used to diagnose leptospirosis?

A

Yes

Microbiology (5 decks)

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