Other Bacteria

Question 1

Spirochetes

Answer 1

Blt (Borrelia, Leptospira, and Treponema)

Borrelia is big (need dark field microscopy for Treponema)

Question 2

Leptospira interrogans Transmission and Presentation

Answer 2

Found in water contaminated with animal urine

Causes leptospirosis: flu-like symptoms, jaundice, photophobia with conjunctival suffusion. Prevalent among surfers and in tropics

Weil disease: severe form with jaundice and azotemia from liver and kidney dysfunction; fever, hemorrhage, and anemia

Question 3

Lyme Disease Transmission and Treatment

Answer 3

Caused by Borrelia burgdorferi, which is transmitted by the tick Ixodes (also vector for Babesia). Natural reservoir is the mouse

Treatment: doxycycline, ceftriaxone

Question 4

Lyme Disease Presentation

Answer 4

Initially: erythema chronicum migrans, flu-like symptoms, +/- facial nerve palsy

Later: monoarthritis, migratory polyarthritis, AV nodal block, and neurologic symptoms (encephalopathy, facial nerve palsy, polyneuropathy)

FAKE: facial nerve palsy, arthritis, kardiac block, erythema migrans

Question 5

Syphilus Cause and Treatment

Answer 5

Caused by spirochete Treponema pallidum

Treatment: penicillin G

Question 6

Primary Syphilis Presentation

Answer 6

Localized disease presenting with painless chancre

Seen on dark field microscopy or VDRL/RPR serologic testing

Question 7

Secondary Syphilis Presentation

Answer 7

Disseminated disease with constituional symptoms, maculopapular rash (palms and soles), and condylomata lata

Question 8

Tertiary Syphilis Presentation

Answer 8

Gummas (chronic granulomas), aortitis, neurosyphilis, argyll robertson pupil (constricts with accommodation but is not reactive to light)

Signs: broad based ataxia, + romberg, charcot joint, stroke without hypertension

Question 9

Congenital Syphilis

Answer 9

Saber shins, saddle nose, CN VIII DEAFNESS, Hutchinson teeth, mulberry molars

Treat mother EARLY in pregnancy (placental transmission typically occurs after 1st trimester)

Question 10

VDRL false posititves

Answer 10

The test is sensititve but not specific=many false positives:

Viruses (mono, hepatitis), drugs, rheumatic fever, lupus and leprosy

Question 11

Jarisch-Herxheimer Reaction

Answer 11

Flu-like syndrome after antibiotics are started. Due to killed bacteria release pyrogens

Question 12

Gardnerella vaginalis Basic Info and Treatment

Answer 12

A pleomorphic, gram-variable rod that is involved in vaginosis, fishy smell, clue cells

Treatment: metronidazole or clindamycin