II-A. Systemic Bacteriology | 22. Treponema Flashcards
I. Treponema genus
1. What are the main features of Treponema genus?
Morphology: thin spirochete shaped bacteria
- Poorly visible on gram stain but has gram NEGATIVE envelope
- Outer membrane has endotoxin-like lipids
- countless apathogenic species (some of them might be present in the normal oral microbiota!)
I. Treponema genus
2. List important species of Treponema genus
- T. vincenti (might become pathogenic)
- T. pallidum (pathogenic species)
- T. carateum (pathogenic species)
I. Treponema genus
3. What are the subspecies of Treponema pallidum?
- T. pallidum subspecies pallidum => pathogen of syphilis
- T. pallidum subspecies endemicum => pathogen of endemic syphylis (bejel)
- T. pallidum subspecies pertenue => pathogen of framboesia (yaws)
I. Treponema genus
4. What are the subspecies of Treponema carateum?
pathogen of pinta
II. Treponema pallidum
1. What are the main features of Treponema pallidum?
- long, thin, spiral bacteria
- Gram-negative cell wall, but can NOT be stained by Gram (they are too thin!)
- motile (endoflagellar system)
- can not be cultured on media (only in rabbit testicles)
- 3 different subspecies
II. Treponema pallidum
2. What are the subspecies of Treponema pallidum?
- T. pallidum subspecies pallidum => pathogen of syphilis
- T. pallidum subspecies endemicum => pathogen of endemic syphylis (bejel)
- T. pallidum subspecies pertenue => pathogen of framboesia (yaws)
II. Treponema pallidum - Treponema pallidum sp. pallidum
5. What are the features of Treponema pallidum sp. pallidum?
invasive bacterium!
=> it is able to invade through mucous membranes / skin!
II. Treponema pallidum - Treponema pallidum sp. pallidum
6. What is the source of infection of Treponema pallidum sp. pallidum?
infected person (except in the 3rd stage of the disease)
II. Treponema pallidum - Treponema pallidum sp. pallidum
7. What is the route of transmission of Treponema pallidum sp. pallidum?
- direct contact (usually through sexual intercourse)
- transplacental (from mother to fetus)
- infected mother sill can infect her fetus even in the 3rd stage of the disease!
II. Treponema pallidum - Treponema pallidum sp. pallidum
8A. What is the disease caused by Treponema pallidum sp. pallidum?
syphilis (3-stage disease with a 10-90 days incubation period)
- Primary syphilis
- Secondary syphilis
- Thirdtertiarysyphilis
II. Treponema pallidum - Treponema pallidum sp. pallidum
8B. What happen in primary syphilis?
Neurological signs and symptoms might be present in any of the stages!
II. Treponema pallidum - Treponema pallidum sp. pallidum
8B1. What happen in secondary syphilis?
secondary syphilis: 2-12 weeks after the primary symptoms
- systemic symptoms (fever, chills, sore throat, headache)
- maculo-papulosus rash
- as the symptoms of the 2nd stage disappear, the patient usually becomes non-contagious
- after the 2nd stage the diseases progresses into latency
II. Treponema pallidum - Treponema pallidum sp. pallidum
8B2. What are the features of maculo-papulosus rash in secondary syphilis?
- infectious!
- might be presen on the palms and soles as well
+) often show collar-like peeling (Biett collarette)
II. Treponema pallidum - Treponema pallidum sp. pallidum
8B3. After the 2nd stage the syphilis progresses into latency
=> how?
Neurological signs and symptoms might be present in any of the stages!
II. Treponema pallidum - Treponema pallidum sp. pallidum
8C. What happen in tertiary syphilis?
Neurological signs and symptoms might be present in any of the stages!
II. Treponema pallidum - Treponema pallidum sp. pallidum
9A. What is congenital syphilis?
- Infected mother might infect her fetus through transplacentar infection
- There are early congenital syphilis and late congenital syphilis
II. Treponema pallidum - Treponema pallidum sp. pallidum
9B. What is early congenital syphilis?
early congenital syphilis (if the mother was infected recently)
- skin- and mucous membrane lesions of the newborn
- bone lesions of the new born
- hepatomegaly of the new born
II. Treponema pallidum - Treponema pallidum sp. pallidum
9C. What is late congenital syphilis?
Late congenital syphilis (if the mother has a chronic infection)
=> Hutchinson-triad
- bone- and dental lesions of the new born
- Deafness of the new born
- interstitial keratitis of the new born
II. Treponema pallidum - Treponema pallidum sp. pallidum
10A. How do we diagnose diseases caused by Treponema pallidum sp. pallidum?
II. Treponema pallidum - Treponema pallidum sp. pallidum
10B. How do we do sampling for diseases caused by Treponema pallidum sp. pallidum?
- Blood (for serology)
- If neurological symptoms are present: CSF and blood
II. Treponema pallidum - Treponema pallidum sp. pallidum
10C. How do we do laboratory for diseases caused by Treponema pallidum sp. pallidum?
- non-specific test: RPR (for follow-up, staging)
- specific tests: ELISA, TPPA (screening), immunoblot (for verification)
- PCR (from ulcer-sample – usually ain’t performed)
II. Treponema pallidum - Treponema pallidum sp. pallidum
10D. For the screening of asymptomatic patients, which samples do we use?
We use TPPA and ELISA from blood samples!
II. Treponema pallidum - Treponema pallidum sp. pallidum
10E. For the diagnosis of symptomatic / previously symptomatic patients, what do we use?
For the diagnosis of symptomatic / previously symptomatic patients we use RPR AND TPPA/ELISA from blood samples!
II. Treponema pallidum - Treponema pallidum sp. pallidum
11. What is the empirical therapy for diseases caused by Treponema pallidum sp. pallidum?
i.m. penicillin G
- Jarisch-Heixheimer reaction might develop (NSAID therapy helps to alleviate) => inflammation triggered by the decaying bacterium
II. Treponema pallidum - Treponema pallidum sp. pertenue
12. What are the features of Treponema pallidum sp. pertenue?
- pathogen of yaws (symptoms are quite similar to syphilis)
- usually present in the tropical region
- it is NOT an STI
II. Treponema pallidum - Treponema pallidum sp. pertenue
13. What are the features of Treponema pallidum sp. endemicum?
- pathogen of endemic syphilus (bejel)
- mainly present in the Middle East
- it is NOT an STI
II. Treponema pallidum - Treponema pallidum sp. pertenue
14. What are the features of Treponema carateum?
- pathogen of pinta
- mainly present in Central- and South America
=> it is NOT an STI
II. Treponema pallidum - Treponema pallidum sp. pertenue
15. What are the features of Treponema vincentii?
- long, thin, spiral bacteria
- Gram-negative cell wall, but can NOT be stained by Gram (they are too thin!)
- motile (endoflagellar system)
- might be present in the normal oral microbioty
- might lead to the fuso-spirochetosis (Plaut-Vincent angina) together with Fusobacteria (F. nucleatum)
+) painful, unilateral ulcerating tonsillitis
+) ulcerating gingivitis