Pediulosis and the treponema (2) Flashcards
What are the three types of pediculosis?
- head
- body
- pubic
Who gets each of the three types of pediculosis?
- head - schoolkids - itchy behind ears
- homeless - itchy at night
- promiscuous people - itchy groin
How would you diagnose a case of pediculosis?
by eye, magnifying glass, microscope
-head and pubic nits are on hair, body is on clothes
What is the visual difference between the three types of pediculosis?
head and body = elongated
pubic = wide (crabs)
What is the treatment protocol for pediulosis?
TWO rounds of insecticide AND nit combing AND hot laundering
-check close contacts and inform them
-for pubic perform an STD panel
Why is treponema difficult to diagnose and treat?
can’t culture, can’t gram stain
How would you visualize treponema by microscopy?
darkfield - NO gram stain
-too small to see
What is the pathogenesis of treponema (syphillis)?
invades lymphatics and bloodstream right away
- virulence is based on immune evasion
- so there is low inflammation
- humans raise worthless antibodies
Compare and contrast the methods by which T. Pallidum, yaws, pinta are spread?
T. Pallidum - sexual contact, congenitally
yaws and pinta - direct contact
What are the four stages of syphillis?
- primary chancre
- secondary: body wide rashes, condylomata lata, patchy alopecia
- latent period
- tertiary: gummas, neurosyphillis, cardiac involvement
What are some complications of neurosyphillis?
- meningitis
- tabes dorsalis
- general paresis
- check for argyll robertson pupil
Is it a common occurence for a baby to die of congenital syphilis?
yes! 50% of newborns infected are killed
What are some complications of congenital syphillis?
- bone deformities
- interstitial keratitis
- progression to secondary and tertiary syphillis
What complicates the diagnosis of syphillis?
symptoms come and go
-need an accurate timeline of varied symptoms to diagnose
What are reagin (non-specific) antibody tests like VLDR, RPR used for?
disease in progress
efficacy of treatment
If specific antibodies to treponema are found, what does it tell you about the patient’s current state?
nothing
-just tells you they were exposed at some point
What does the histology of gummas show?
infiltrate rich in plasma cells
What is the treatment for any type of treponema?
PENICILLIN G
