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Clinical Bacteriology > (F) Lesson 14: Spirochetes, Chlamydia, Rickettsia, and Miscellaneous Bacteria (Part 1) > Flashcards

(F) Lesson 14: Spirochetes, Chlamydia, Rickettsia, and Miscellaneous Bacteria (Part 1) Flashcards

1
Q
  • -teles refers to Order
  • Family: Leptospiraceae
  • Genus: Leptospira
  • Familly: Spirochaetaceae
  • Genera: Borrelia and Treponema
A

Spirochaeteles

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2
Q

General Property

  • Difficult to G/S
  • Morphology is helically coiled
  • Long and slender
  • Oxygen Requirement: Anaerobes, Facultative microaerophilic
A

Spirochaeteles

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3
Q
  • Slender, flexuous, helically-shaped, unicellular bacteria
  • 0.1-0.5um wide and 5-20um long, with one or more complete turns in the helix
  • Producing a helix-shape
  • Contains a motility structure for movement: periplasmic flagella or axial fibrils, axial filaments, endoflagella, periplasmic fibrils
  • Usually used: periplasmic flagella and axial filaments
  • Produces a corkscrew-like motility
A

Spirochetes

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4
Q
  • The three genera under Spirochaeteles can be differentiated by the ____ and ____ it has.
A

Number of axial filaments and insertion disk

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5
Q

Identify the genera.

  • Arrangement: Tightly coiled
  • Axial Filament: 6 to 10
  • Insertion Disk: 1
A

Treponema

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6
Q

Identify the genera.

  • Arrangement: Thicker coiling
  • Axial Filament: 30 to 40
  • Insertion Disk: 2
A

Borrelia

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7
Q

Identify the genera.

  • Arrangement: Thicker coiling with hook ends
  • Axial Filament: 2
  • Insertion Disk: 3 to 5
A

Leptospira

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8
Q

The connection between axial filaments

A

Insertion disk

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9
Q

Has the most number of filaments

A

Borrelia

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10
Q

Has its characteristic hook ends

A

Leptospira

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11
Q
  • Aside from the number of insertion disks and axial filaments, it can also be differentiated by its method of ____ as well as the different ____ it can cause.
A

DIagnosis and diseases

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12
Q

Identify the genera.

Diagnosis: Serology
Disease: Syphilis, Bejel, Pinta, Yaws

A

Treponema

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13
Q

Identify the genera.

Diagnosis: Serology, Giemsa
Disease: Lyme Disease, Relapsing Fever

A

Borrelia

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14
Q

Identify the genera.

Diagnosis: Culture, Serology
Disease: Weil’s Disease or Infectious Jaundice

A

Leptospira

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15
Q
  • If serological assay is mentioned, the sample used will automatically be ____.
A

Serum

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16
Q
  • The serum will contain ____ against Treponema.
A

Antibodies

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17
Q
  • Borrelia, also known as ____, since it is mainly found in the blood through peripheral blood smear, which utilizes the Giemsa stain
A

Blood spirochete

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18
Q

Borrelia, also known as blood spirochete, since it is mainly found in the blood through peripheral blood smear, which utilizes the ____.

A

Giemsa stain

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19
Q
  • ____ is the only one that can be cultured.
A

Leptospira

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20
Q

The culture for Leptospira is (in vivo/in vitro) which uses artificial culture medium.

Not used for Treponema and Borrelia.

A

In vitro

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21
Q
  • These genera are commonly diagnosed using ____.
A

Serological assays

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22
Q
  • Difficult to visualize under a brightfield microscope due to its morphology and size
  • Microscope of choice: darkfield microscope or fluorescent microscope (can observe motility)
  • Spirals: Regular, angular with 4-14 per organism
  • Three periplasmic flagella were inserted into each end of the cell
  • Ends are pointed and covered with a sheath
  • Are motile with graceful flexuous movements in liquid
  • 4 genera pathogenic for humans
A

Treponema or Treponemes

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23
Q

Contains different specific subspecies wherein these subspecies are the ones that cause specific diseases.

A

Treponema pallidum

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24
Q

Identify the species.

Venereal syphilis

A

Treponema pallidum subsp. pallidum

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25
Q

Identify the species.

Yaws

A

Treponema pallidum subsp. pertenue

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26
Q

Identify the species.

Endemic syphilis or Bejel

A

Treponema pallidum subsp. endemicum

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27
Q

Identify the species.

Pinta

A

Treponema carateum

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28
Q
  • Sexually transmitted diseases (STDs)
  • The main mode of transmission
A

Venereal

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29
Q
  • An infection of the skin and bones
A

Yaws

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30
Q
  • A disease of the skin and bones
A

Yaws

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31
Q
  • Disease of the skin, bones, and mucus
A

Bejel

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32
Q
  • An infection of the skin
A

Pinta

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33
Q
  • Discovered by Fritz Schaudin and Hoffman in 1905
  • Obligate intracellular pathogen
  • Not cultivable in agar medium
  • Can be cultured in vivo using rabbit’s epithelial cell
  • Causes venereal syphilis or sexually-transmitted syphilis
A

Treponema pallidum subsp. pallidum

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34
Q
  • Also called Great Pox DIsease, Antique disease, Halian disease, French disease
  • Aka Great Imitator since it imitates signs and symptoms of other diseases
A

Syphilis

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35
Q

Two theories on how syphilis spreads

A
  1. Pre-Columbian Theory or Old World Theory
  2. Columbian or New World Theory
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36
Q
  • States that syphilis was already present in Europe and the travels to America have caused its spread to the West
  • Europe to America
A

Pre-Columbian/Old World Theory

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37
Q
  • States that syphilis originated in America and was spread to Europe by Americans, specifically from Christopher Columbus’ crew who engaged in trades
  • America to Europe
A

Columbian/New World Theory

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38
Q

Familiarize yourself of the mode of transmission of syphilis.

A
  • Sexual contact with an infected individual
  • Direct blood transfusion
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39
Q

T or F: T. pallidum subsp. pallidum cannot cross the placenta

A

F (can cross)

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40
Q

T or F: T. pallidum is cold-sensitive, so they are destroyed after >72hrs (some 48) in storage.

A

T

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41
Q

Incubation time for Syphilis?

A

10 to 90 days (Average: 14 to 21 days)

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42
Q

What are the primary stages of syphilis?

A
  • Primary
  • Secondary
  • Latent
  • Tertiary
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43
Q
  • The first time you get infected with it
  • Characteristic lesion: chancre (hard chancre), painless, firm, smooth with regional lymphadenopathy and early invasion of blood
  • During this stage, there is active multiplication of the organism in the infected area, making it highly contagious
  • Healing: spontaneous (3-6 weeks)
A

Primary Syphilis

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44
Q

Primary Syphilis

T or F: The lesion contains plenty of bacteria.

A

T

45
Q

Primary Syphilis

  • ____ to observe the motility and its characteristics arrangement (tightly coiled with 4-14 spirals)
  • Using an aspirate of the lesion
  • (+) confirms primary-stage syphilis
A

Darkfield microscopy

46
Q

Primary Syphilis

  • (+) except during the early stages
  • Will only (+) 1-3 weeks after the appearance of hard chancre
  • Not recommended during the primary stage
A

Serologic Testing

47
Q
  • Weeks after the primary stage, which is usually missed out due to painless chancre
  • Appears if primary syphilis was not treated
  • Chancre heals leaving little to no scarring
  • Infections spreads from the genital area to the skin and mucus membrane resulting in the appearance of a characteristic lesion: condylomata lata usually seen on the palms of the hands and soles of the feet
  • If not treated, it proceeds or disseminates to other organs: liver, eyes, bones, CNS, mimicking different diseases affecting these organs
A

Secondary Syphilis

48
Q

What are the two diagnosis methods for secondary syphilis?

A
  • Darkfield Microscopy
  • Serology Testing
49
Q

Secondary Syphilis

  • Using lesions to observe motility and morphology
A

Darkfield Microscopy

50
Q

Secondary Syphilis

  • Always (+) at this stage, making it the best stage for serological testing
  • Uses serum which contains antibodies
  • Best used at the secondary stage
A

Serology Testing

51
Q
  • Absence of clinical symptoms with a positive serological test
  • In some cases, some individuals produce a (+) serological test even without signs and symptoms or lesions
A

Latent Syphilis

52
Q
  • It is either: untreated syphilis or treated syphilis, recurring
  • Can occur years (5-30) after syphilis
  • May include CNS, producing neurological abnormalities
  • Specimen of choice: CSF since it already involves the CNS
  • Signs and symptoms are mainly neurological
A

Tertiary (Late) Syphilis

53
Q
  • Paralysis, delusions, blindness, deafness, cardiovascular abnormalities, and the appearance of granulomatous lesions: ____ or ____, which are painful ulcers that enlarge and erupt
A

Gummas or Gummata

54
Q
  • The late syphilis also involves the ____ system
A

Cardiovascular

55
Q
  • Are sterile or contain few spirochetes, if any due to intense cellular immune response against the spirochete
A

Ulcers

56
Q

What are the main method of diagnosis of Tertiary Syphilis?

A

Serologic Testing

57
Q

Tertiary Syphilis

This method is not recommended for this stage since the lesions are sterile.

A

Darkfield Microscopy

58
Q
  • The baby acquires the said infection because of an infected mother
  • Syphilis may be passed from the infected mother to the fetus during primary, secondary, or latent stages, which may result in miscarriage or stillbirth.
  • Transfer usually occurs after the 4th month of pregnancy
  • Bone malformation, widespread skin rashes, meningitis or hepatosplenomegaly
  • Characteristic: notched teeth or Sabershins (Hutchinson’s Teeth)
A

Congenital Syphilis

59
Q

Paki-aral yung table about Syphilis sa transes.

A

Sensha n kau pagod n aq hehe

60
Q

Microscopic laboratory diagnosis of Syphilis methods.

Five (5)

A
  • Darkfield microscopy
  • Immunofluorescence
  • Levaditi Silver Impregnation
  • Animal Inoculation
  • Serological Testing
61
Q

Two types of Ab detection for Syphilis.

A
  • Non-treponemal Ab
  • Treponemal Ab
62
Q

Ab Detection for Syphilis

  • Nonspecific to T. pallidum subsp. pallidum or venereal syphilis
  • Only for screening
  • (+) is correlated with signs and symptoms since it is also produced by other diseases such as Systemic Lupus Erythematous (SLE), Rheumatoid Arthritis (RA), during pregnancy
  • Rapid Plasma Reagin (RPR) or Wasserman Ab
  • Venereal Disease Research Laboratory (VRDL)
A

Non-treponemal Ab

63
Q
  • Produced specifically during cases of venereal syphilis
  • Confirmatory Tests: Fluorescent Antibody Absorption Test (FTA-ABS)
  • Microhemagglutination Treponomal Test (MHT)
  • Treponema Pallidum Inhibition Test (TPI)
A

Treponemal Ab

64
Q

Drug of Choice for Syphilis?

A

Benzathine Penicillin G

65
Q

Alternative drug for Syphilis?

A

Tetracycline or Doxycline

66
Q

Syphilis

  • First DOC for syphilis by Paul Erlich
A

Salvarsan

67
Q

Syphilis

  • An adverse reaction to penicillin treatment, exhibiting: fever, body pain/malaise, vomiting, and headache
A

Jarisch-Herxheimer Syndrome

68
Q
  • The causative agent of Yaws
  • Chronic, non-venereal disease of the skin and bones
  • MOT: direct contact with open skin lesion
A

Treponema pallidum subsp. pertenue

69
Q

Identify the lesion for Treponema pallidum subsp. pertenue.

  • Appear 3-4 weeks after exposure, heals spontaneously and reappears as secondary lesions months later
A

Primary/Initial lesions

70
Q

Identify the lesion for Treponema pallidum subsp. pertenue.

  • Ulcerate, heals, and re-appear in crops for several years
A

Secondary lesions

71
Q

Identify the lesion for Treponema pallidum subsp. pertenue.

  • Can occur in the skins and bones leading to disfiguration of the face
A

Tertiary lesions

72
Q
  • The causative agent of Bejel
  • Endemic, non-venereal syphilis
  • MOT: Poor sanitation or personal hygiene
A

Treponema pallidum subsp. endemicum

73
Q

Identify the lesion for Treponema pallidum subsp. endemicum.

Oral cavity

A

Primary lesions

74
Q

Identify the lesion for Treponema pallidum subsp. endemicum.

Oral mucosa

A

Secondary lesions

75
Q

Identify the lesion for Treponema pallidum subsp. endemicum.

Widespread, in the skin, bones, nasopharynx.

A

Tertiary lesions

76
Q
  • The causative agent of Pinta (an ulcerative skin disease)
  • MOT: Direct contact with infective lesions
  • Skin lesions are flat red and become depigmented but do not ulcerate
  • Lesions remain confined to the skin, unlike Bejel and does not disseminate to the bones
A

Treponema carateum

77
Q
  • Loosely twisted, resembling a stretched spiral
  • MOT: Tick/Lice bite
  • Microaerphilic
  • Stains well with Giemsa or Wright’s Stain as blue
  • Seen in PBS
  • Produces 2 specific diseases: Relapsing fever and Lyme disease
A

Borrelia spp.

78
Q
  • Main sign of infection is intermittent fever
  • Agents: B. recurrentis, B. hermisii, and B. parkerii
A

Relapsing Fever

79
Q
  • Agent of Louse-Borne Relapsing Fever
  • Vector: Human Louse (Pediculus humanus subsp. humanus) or infected lice
  • Fever, muscle and bone pain, and confusion
  • A patient appears to have recovered 6 days after fever episodes only to relapse a few days or weeks later
  • Relapse is attributed to the ability of the organism to alter its antigenicity
A

Borrelia recurrentis

80
Q
  • Agent of Tick-Borne Relapsing Fever
  • Vector: Ornithodoros hermisii and Ornithodoros parkerii
  • Same signs and symptoms as Louse-Borne
A

Borrelia recurrentis

81
Q

Borrelia grows well on what type of media that can also be used for Borrelia burgdorferi?

A

Modified Kelly’s Medium or Barbour Stoenner-Kelly Medium (BSK-II)

82
Q
  • Preferred due to low number of organisms in the blood
  • Highly diagnostic if collected and performed during febrile episodes, during the highest peak of infection when the organism is found in the blood
  • Much better if (+) signs and symptoms of relapsing fever
A

Thick Blood Film

83
Q
  • Agent: B. BURGDORFERI
  • First epidemiologically investigated during an increased incidence of RA in children in Lyme and Old Lyme, Connecticut, USA in 1975
  • Most common arthropod-borne disease in the USA
  • Also infects the bone, hence its association with RA
A

Lyme Disease

84
Q

Match the vectors with the place.

  1. NE, E, NC, USA
  2. NW, USA
  3. EUR

A. Ixodes dammini
B. Ixodes pacificus
C. Ixodes ricinus

A
  1. A
  2. B
  3. C
85
Q
  • Characterized by these non-specific signs and symptoms mistaken for other diseases such as RA, SLE, and viral meningitis
  • Headache, low-grade fever, fatigue, and abdominal pain
A

Lyme Disease

86
Q

Identify the stage of Lyme Disease.

  • (+) Erythema chronicum migrans after tick bite
  • Bull’s eye skin lesion → dark red area surrounded by a clear area and then another red area
  • Unique to this stage of Lyme disease
A

Stage One

87
Q

Identify the stage of Lyme Disease.

  • Dissemination occurs through the blood and may affect several organs: bones, CNS, heart, liver
A

Stage Two

88
Q

Identify the stage of Lyme Disease.

  • Chronic stage with chronic neurological abnormalities, arthritis, and skin lesions
    Since it is widespread spread in the CNS and skin
A

Stage Three

89
Q

Used in the laboratory diagnosis of Lyme Disease but is not preferred since the yield of growth is very low.

A

Modified Kelly’s Medium or Barbour Stoenner-Kelly Medium (BSK-II)

90
Q

Four (4) immunoserological Tests to demonstrate antibodies (proteins) against Lyme Disease.

A
  1. Fluorescent immunoassay
  2. Indirect immunofluorescence
  3. Enzyme-Linked Immunoassay
  4. Western Blot → gold standard, like in HIV
91
Q
  • Aerobic
  • Differentiates it from the first two
  • Morphology: Tightly twisted with one or both ends into a hook
A

Leptospira

92
Q

Two important members of leptospira?

A
  1. Leptospira biflexa
  2. Leptospira interrogans
93
Q

Leptospira spp.

  • Non-pathogenic, found in soil and water
A

Leptospira biflexa

94
Q
  • Causes human and animal leptospirosis
  • Very important human pathogen
  • Very common in the PH due to infected water systems
  • Primarily parasitic on vertebrates other than humans such as rodents, cattle, dogs, cats, raccoons, and bats.
  • Sheds the organism in urine (why it easily spreads)
  • MOT: Direct contact with urine of animals carrying the organism OR indirect contact through close contact with contaminated soil and water
A

Leptospira interrogans

95
Q

Leptospira spp.

  • Involves 3 main organs: kidney, liver, CNS
  • First to be affected is the kidney, especially if not treated immediately
  • In the PH, it is spread by infected rodents that urinate everywhere
A

Leptospirosis

96
Q

Leptospirosis

  • Infectious can be mild or severe accompanied by myalgia, nausea, vomiting, fever, headache, and chills
A

Acute phase

97
Q

Leptospirosis

  • Follows the acute phase
  • Associated with Ab production and elimination of the organism
  • Patient may recover 2-3 weeks after
  • Requires complete treatment, otherwise, it might spread to the kidneys, liver, and CNS
A

Immune phase

98
Q

Match the serovarities.

  1. Weil’s Syndrome
  2. Infectious jaundice
  3. Fort Bragg/Pretibial Fever
  4. Seven Day Fever
  5. Marsch Fever
  6. Swine Herd Disease

A. L. interrogans SEROVAR mitis/Pomona
B. L. interrogans SEROVAR grippotyphosa
C. L. interrogans SEROVAR hebdomanis
D. L. interrogans SEROVAR autumnalis
E. L. interrogans SEROVAR icterohaemorrhagiae
F. L. interrogans SEROVAR canicola

A
  1. E
  2. F
  3. D
  4. C
  5. B
  6. A
99
Q

T or F: L. interrogans SEROVAR canicola can spread in the liver.

A

T

100
Q

T or F: SEROVAR icterohaemorrhagiae and canicola are important in humans.

A

T

101
Q

Laboratory Diagnosis for Leptospira spp.

  • Culture media of choice
  • Incubated in the dark for 4-6 weeks at RT (25-300C)
  • Leptospires grows 1-3cm below the agar surface and may form linear disk of growth and is examined under darkfield microscopy
  • (+) spiral w/ hooked ends
A

Fletcher’s or Stuart’s Medium or Ellinghausen-McCullough-Johnson-Harris (EMJH) Medium

102
Q

Specimen

  • 1st 10 days
  • CSF, blood, and tissues during early bacteremic phase
A

Acute Phase

103
Q

Specimen Used

  • Urine → requires alkalinization if cannot be cultured immediately
A

Immune Phase

104
Q

Direct Detection of Leptospiral Antigens

  • From clinical specimens
A
  • ELISA
  • RIA
  • Immunogenic capture
105
Q

Direct Detection of Leptospiral Antigens

  • From infected tissue samples
A
  • Immunofluorescence
  • Immunohistochemistry
106
Q

Serological Methods (Leptospira)

What are the four serological methods?

A
  • Macroscopic Agglutination Test (MAT)
  • Microscopic Agglutination Test (MIT)
  • Hemagglutination assay
  • Enzyme Immunoassay (EIA)
107
Q

Serological Methods

  • Used for screening
A

Macroscopic Agglutination Test

108
Q

Serological Methods

  • Used for confirmatory
A

Microscopic Agglutination Test

Clinical Bacteriology (33 decks)

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