Serological and Molecular Detection of Spirochete Diseases Part 2

Loosely coiled spirochete that uses Outer surface proteins to allow attachment to mammalian cells. It is the causative agent for Lyme Disease

Borrelia burgdoferi

Media used for Borrelia burgdorferi

Barbour-Stoenner-Kelly

Borrelia

Reservoir:

Vector:

White-footed mouse (Peromyscus leucopus)

Ixodes sp.

Three Stages of Lyme Disease

Localized Rash Stage

Early Dissemination Stage

Late Dissemination Stage

Hallmark of infection with Borrelia burgdorferi is the appearance of

Erythema migrans

Erythema migrans expands to a ring-like erythema with partial clearing, calling it a

Bull’s eye rash

Stage of Borrelia where Hematogenous dissemination of the organism. it affects the skin, nervous system, heart, or joints.

Early Dissemination Stage

Most prevalent neurological sign associated with Lyme Disease

Facial Palsy

Stage that develops when Lyme Disease is left untreated. Occurs with patients with arthritis, peripheral neuropathy, and encephalomyelitis

Late Dissemination Stage

For Lab Diagnosis for Lyme Disease, it uses a ____________ approach for diagnosis. Testing should be done with the presence of clinical evidence

Two-Tiered Approach

Algorithm where patients are screened with EIA (ELISA) or IFA. A positive screening test is followed by Western Blot. Highly specific but low sensitivity in diagnosis of early Lyme disease

Standard Testing Algorithm

Algorithm that uses ELISA with purified Borrelia peptide antigens. A positive screening test is followed by another EIA/ELISA with a different method

Modified Two-Tiered Algorithm

Western blot for Borrelia burgdorferi

IgM =

IgG =

IgM = 2/3

IgG = 5/10

Thin, flexible, and tightly coiled spirochetes with hook-like ends. it resembles a chain of cocci

Leptospira spp.

It is a zoonotic infection that is transmitted through humans by exposure via mucous membranes, abrasions, and ingestion

Leptospirosis

Culture media for Leptospirosis

Fletcher

EMJH

Stuart Medium

Severe form of Leptospirosis which involves a severe systemic disease (kidneys and liver)

Weil’s Disease

Diagnosis of Leptospirosis

_________________ - Used in the first week of illness but is not recommended due to low sensitivity

_________________ - Most common method to diagnose leptospirosis

_________________ - Gold Standard for diagnosis of Leptospirosis, all positive screening tests must be confirmed by MAT

Darkfield Microscopy

Serology

Microscopic Agglutination Test