spirochetal infections

Question 0

what are the 7 spirochetal infections?

Answer 0

1. syphilis
2. yaws
3. bejel
4. pinta
5. Lyme disease
6. leptospirosis
7. relapsing fever

Question 1

3 genera of spirochetes? (inf’s all chronic or relapsing)

Answer 1

1. treponemia
2. borrelia
3. leptospira

Question 2

what are the treponema?

Answer 2

syphilus, yews, pinta, bejel

Question 3

what are the borrelia?

Answer 3

lyme dz, relapsing fever

Question 4

what are the leptospira?

Answer 4

leptospirosis

Question 5

syphilis

Answer 5

-caused by treponema pallidum, fragile, killed by soaps, drying, cold, antiseptics;;;spread by SEXUAL contact (there is congenital syphilis, mom-fetus).
3 stages:
1. classical lesion of primary syphilis: CHANCRE, which erodes to ulcer. shows luetic vasculitis (swell/prolif of endothelial cells–>vessel walls thicken)

2. 2ary syphilis: spirochete disseminates: mucous patches, LN, meninges (asx), stomach, liver lesions, OBLITERATIVE ENDOARTERITIS
   skin: 1. condylomata lata (exudative plaques in perineum, vulva/scrotum) (fLat papuLes, syphiLLis, Lata)
   
   2. follicular syphilids (papular lesions around hair follicles) – >loose hair
   3. numular syphilids (coin like lesion of face, perineum)

3rd deg syphilis: focal ischemic necrosis 2ary to OBLITERATIVE ENDOARTERITIS (underlying mech of many processes w.3rd syphilis)

1. ENDOARTERITIS OBLITERANS: obst vascular lesion --	 	>onion skin appearance
2. SYPHITIC AORTITIS: vasovasorum --> asc aorta -->  			aneurysms --> tree bark appearance
3. NEUROSYPHILIS: meningovascular syphilis, tabes 		 	dorsalis (dorsal column of SC, sensory to brain), general paresis (cerebral cortex)
4. benign tertiery syphilis: gumma

Question 6

yaws

-penicillin cures

Answer 6

tropical dz caused by t.pertenue, spread by SKIN CONTACT
-RF: kids and teens in impoverished tropical areas

-SX: starts with MOTHER YAW –> spread to lesions on other parts of skin: PAINFUL PAPILLOMAS ON FEET SOLES = CRAB YAW

Question 7

bejel

Answer 7

• aka endemic syphilis, T. pallidum, subspecies endemicum
• nonveneral, spread from infected body to breast, mouth-mouth, utensils to mouth
• GUMMAS OF SKIN, AIRWAY, BONE

Question 8

pinta

Answer 8

cause by t. carateum that spread by SKIN-SKIN inoculation

• all 3 stages are in skin, tend to merge: TROPICAL SKIN DZ
• prevalent in remote, arid, inland regions, river valleys

Question 9

LYME DZ; most common tick borne illness. Ab titers to DX

Answer 9

• caused by borelia burgdorferi thats from animal reservoir to DEER TICKS (ixodes ticks). MAY-JULY
• spreads in BLOODSTREAM;;; 3 stages:
  1. ERYTHEMA CHRONICUM MIGRANS (patch of maculopapular rash, annular appearance. fever, headache, fatigue)
  2. MSPAINS, CARDIAC, NEUROLOGIC ABN (facial nerve palsies)
  3. JOINTS (RHEUMATIOD ARTHRITIS), NEUROLOGIC MANIFESTATION (dementia, encephalomyelitis)

TX: PENICILLINS G, IV FOR STAGES 2+3

Question 10

leptospirosis

Answer 10

zoonosis, inc incidence in tropics.
-leptospira interogans from rats, water, mud
-penetrates abraded skin/mucous membrane
2 phases: 1. leptospiremic phase: blood, CSF. fever chills, headache, myalgias. Sx abates 1-2 wks later
2. immune phase: IgM. WEILDZ = ORGAN HEMORRHAGES. if severe: LIVER, KIDNEY FAILURE

Question 11

relapsing fever

TX: tetracyclines

Answer 11

endemic: rodents –> ticks –> humans
epidemic: BORRELIA RECURRENTIS in infected louse, which dislikes fever, will look for new host w/o fever. affects SPLEEN –> miliary microabscesses. LIVER –> IMMUNE CELLS, SPIROCHETES FREE IN SINUSOIDS,
SX: anthralgias, lethargy, fever, headache, myalgia. 1-2 weeks post ANTHROPOD bite–> HEPATOSPLENOMEGALY.
-in severe cases: start with rash, meningitis–> myocarditis, liver failure, coma