Other Spirochetes Flashcards
Leptospira sp. Characteristics
- Obligate aerobes
- Growth conditions: 28-30°C, 7.2-7.6 pH
- Catalase +, oxidase +
- Simple growth media enriched with vitamins B2 & B12, long-chain fatty acids, ammonium salts
- Survive well in warm, humid environments
Leptospira infection
- Reservoir
- Environmental persistence
- Mode of transmission
- Risk factors
- Incubation period: 5-14 days (2-30)
- Period of communicability ~ 1 month - years
Leptospira Transmission
- Bacteria enters through broken skin or mucous membranes (conjunctiva)
- Occupational risk: working with infected animals or water/sewage/agricultural runoff
- Recreational activities in water
- Adventure sports
- Ecotourism
Leptospira Symptoms
- Flu-like
- Weil’s syndrome:
- jaundice
- kidney failure
- heart inflammation
- Meningitis
- Pulmonary hemorrhage & respiratory failure
Leptospira Diagnosis
- spirochetes in blood: days 1-7
- spirochetes in CSF & peritoneal fluid: days 4-10
- spirochetes in urine: days 7-?
- dark field microscopy
- culture: special media, 13 week incubation, low sensitivity
- MAT
- PCR
Leptospira Confirmed Diagnosis
PRESUMPTIVE
-Single high titer + acute febrile illness
-IgM + serology
CONFIRMED
-isolation of the organism
-amplification of leptospiral DNA from blood, urine, or other specimens
-demonstration of leptospires in tissues by -immunohistochemical staining
-4-fold rise in titer between acute & convalescent sera
Leptospira Treatment/Prevention
- antibiotics
- immunization
- rodent control
- sanitation
- protective clothing
Lyme disease Species
- Borrelia burgdorferi
- Borrelia afzelli
- Borrelia garinii
- Borrelia valaisiana
Lyme disease Signs & Symptoms
Acute illness: -Erythema migrans rash -Fever -Headache -Blurred vision Chronic illness: Secondary and Tertiary -Acrodematitis Chronica Atrophicans -Arthritis -Endocarditis -Neuroborreliosis -Other symptoms similar to chronic fatigue, ALS
Lyme disease Vectors
- Ixodes pacificus in California
- Ixodes scapularis (dammini) in eastern US
- other Ixodes in Europe, Japan, South America, Africa
Lyme disease Diagnosis
- Rash biopsy
- darkfield microscopy
- direct fluorescent antibody (DFA)
- polymerase chain reaction (PCR)
- Serology (blood tests)
- enzyme-linked immunosorbent assay (ELISA)
- indirect fluorescent assay (IFA)
- positives confirmed by Western blot
Lyme disease Treatment/Prevention
-Recommended antibiotics: doxycycline, amoxicillin, -cefuroxime
-Treatment for acute borreliosis: 10-21 days 100mg –doxy BID po
-Treatment for chronic borreliosis: not standardized
Prevention
-Highest risk activity: outdoor exposure
-Clothes, repellent
-Tick checks: within 36 hours
-Reduce tick/mouse/deer habitat around your home
-No human vaccine
-For your pets:
-Repellent
-Tick checks
-Vaccine for dogs
Tick-borne relapsing fever Species
- Borrelia hermsii
- Borrelia parkeri
- Borrelia turicatae
Tick-borne relapsing fever Symptoms
-ABRUPT OR ACUTE ONSET of fever, myalgias, arthralgias, chills, headache and fatigue, dry cough, neck pain, vomiting
-SEVERE CASES: dehydration, anorexia, rash, photophobia, anemia, shortness of breath, jaundice, pneumonia
-Incubation period
~ 7 days (2-18 days)
Tick-borne relapsing fever Diagnosis
- blood smear
- FA
- PCR
- serology
- culture
- animal inoculation
- Clinical diagnosis confirmed by serology (and PCR)
- Monoclonal ab for B hermsii
