Learn: Spirochetes-- assignment #3

hard chancre

painless lesion in primary stage of syphilis that develops at the site of bacterial entry

gummas

soft, painless gummy noninfectious granular lesions-- seen in the tertiary stage of syphilis

Hutchinson triad

deafness, blindness, notched peg-shaped teeth

reagin

non-specific antibody to cardiolipin (antigen) that appears in serum, plasma, and CSF of individuals with treponemal infection

treponematoses

A group of related diseases (Bejel, yaws, Pinta) caused by the bacteria Treponema, which are non-venereal (not-sexual) and transmitted by skin contact (mainly-- children living with poor hygiene

leptospirosis

a disease of animals that can spread to humans

weil's disease

Severe form of leptospirosis; a combination of jaundice, kidney failure, and pulmonary hemorrhage

second phase leptospira

When does weil's disease usually manifest?

T. pallidum ssp pallidum

What causes syphilis?

T. pallidum ssp pertenue

What causes yaws?

T. carateum

What causes pinta

T. pallidum ssp endemicum

causes bejel

Treponema

Which genus of spirochetes causes:

- syphilis, yaws, pinta, and bejel?

Borrelia

Which genus of spirochetes causes:

- relapsing fever

- Lyme disease

B. recurrentis

causes relapsing fever

B. burgdorferi

causes lyme disease

Leptospira

Which genus of spirochetes causes:

- Leptospirosis

- Weil's disease

humans

T. pallidum ssp pallidum: Pathogenicity= EXCLUSIVE to _________

sexual, needles

T. pallidum ssp pallidum: Mode of transmission=

- ______ contact

- sharing of ______ by IV drug users

primary, treatment

T. pallidum ssp pallidum:

_________ Stage:

- hard chancre

- extremely infectious

- non-detectible in female genitalia

- symptoms disappear without __________

secondary, treatment

T. pallidum ssp pallidum:

__________ Stage:

- 2-12 weeks after primary lesion (systemic)

- flu-like symptoms

- rash hands/feet

- lose eyebrow patches

- liver- juandice

- may be mild and unnoticed

- symptoms disappear without __________

latent

T. pallidum ssp pallidum:

______ Stage:

- asymptomatic stage

- lasts 3-30 years

- no longer contagious, unless re- manifestation of secondary stage conditions

- 50% cases spontaneously cured or become latent, 50% develop tertiary syphilis with symptoms manifested 2-20 year later

tertiary

T. pallidum ssp pallidum:

_______ stage:

- usually noninfectious, 40% of untreated patients get here

- HALLMARK SYMPTOMS: gummas in skin, bones, liver, cardiovascular system, CNS

- CNS gummas: lead to paralysis, aphasia, seizure, stroke etc

- Cardio gummas: weaken major blood vessels// cause bulge and burst

congential syphilis

Happens when spirochetes cross the placenta after 3rd/4th month of pregnancy// cause mutlisystem disease

- could cause stillbirths, death after birth or child disease if untreated in mother

early

_________ congenital syphilis:

- similar to secondary syp

- infectious rash, hepatosphlenomegaly

- flat papules on anus and in skin folds

- inflammation of bone membrane (periostitis)

late

_________ congenital syphilis

- Hutchinson's triad

- poor bone formation (deformed maxilla)

- meningitis

- mental retardation

scraping and dark field microscopy

If a patient with T. pallidum has lesions then diagnostic testing would include _________

reagin

If a patient with T. pallidum is without lesions then diagnostic testing would include a serology test that detects ________ antibodies

reagin test

serology test that detects antibodies produced in response to cell damage caused by Treponema pallidum (syphilis)

(reaction to damaged cell, not scanning for actual bacteria)

specificity

Reagin based test do NOT have much __________, so all positive MUST be confirmed

RPR (Rapid Plasma Reagin)

Most common test used for screening syphilis (name of the serum test)

FTA-ABS

Syphilis positive screenings must be confirmed by ________ (example where spiroketes glow)

penicillin

What is the drug treatment for treponema pallidum?

pallidum

Prevention and control for T. ___________

- find, track, treat all sexual contacts of syphilis patient

- education about transmission

- pre-natal screening

yaws

Disease affects skin/bones-- cause disability/disfigurement

- raised sores

- soft nodule of tissue on face/arm/leg (granuloma)

- granulomas heal slow, may reoccur

- sores of soles of feet, disfigured nose

bejel

affects skin, bones and mucous membranes of mouth

- slimy patch on inside of mouth, blisters on trunk, arms and legs

- bone infection later (legs)

- Gummas on nose and roof of mouth

pinta

affects the skin, spanish for "painted"

- begin- flat redden rash on hands, feet, legs, arms

- after couple months, blue patches develop in same areas on both sides of body

- later- thickened skin develops

treponematoses

Because _______ and syphilis are similar, a person with any of the 3 will test positive for syphilis

penicillin, tetracycline

In treating one of the 3 of treponematoses, a single injection of _______ kills the bacteria, and ______ by mouth works well

tick, louse (lice)

B. recurrentis/ relapsing fever is

_____ borne via rodents OR

_____ borne via humans

relapsing fever

Disease Manifestaion:

- spirochete enter blood-- high fever, chills, severe headache and muscle pain for 3-7 days then abruptly ends

- recurs 4-14 days late (can happen several times)

Borrelia recurrentis

Diagnostic identification for _______

- direct stain (observe from blood sample)

- use special kelly medium

tetracycline

What is the drug for borrelia recurrentis?

prevent contact with ticks/lice

How to avoid relapsing fever?

burgdorferi

Transmission of borrelia ________ is mainly by ticks that are found in white footed mouse and white-tailed deer

lyme disease

Disease manifestations:

- 1-3 weeks after tick bite

- chills, fever, headache

- erythematous (red/inflammed) lesion with bulls eye appearance

burgdorferi

Laboratory diagnostic testing for borrelia __________:

- serologic--

- Indirect fluorescent antibody test (IFA)

- enzyme linked immunosorbent assay (ELISA)

- CONFIRMED with: immunoblot of specific proteins as bands on a gel

doxy, amoxicillin, penicillin

To treat Lyme Disease:

- Early stage: ______cycline or _________

- neurological stage: intravenous _______

leptospira

MODE of transmission for _________:

- contact with urine from infected animal (into a skin cut)

- contact with soil or water that has infected animal urine

first (anicteric leptospirosis)

______ phase leptospira:

- high fever, severe headache, muscle aches, vomiting, diarrhea

- leptospires in the blood

- no liver involvement

- self limiting, patients may recover for a time then become ill again

second (immune)

_________ phase leptospira:

- appearance of IgM antibody

- hallmark immune stage: icteric leptospirosis, aseptic meningitis

- weil's disease (jaundice, kidney failure, pulmonary hemorrhage)

- meninges infection, liver dysfunction

- leptospiras leave blood-- found in urine

blood, CSF, urine, serology

diagnostic testing for leptospirosis:

Week 1: test _______ and ______

Week 2: test _______

(diagnosis is usually by _______ )

serology

testing for antibodies in blood serum that would appear if your body is kicking ass against a certain bacteria

Doxycycline or penicillin

______ or ________ are the most common treatment for leptospira

- best if given EARLY. IV drip may be needed for severe symptoms