Spirochetes

Question 1

What is the Gram stain of spirochetes and do they have LPS? Flagella?

Answer 1

• Gram negative - do not have LPS, periplasmic flagella

Question 2

What is the method for viewing spirochetes

Answer 2

-Dark-field microscopy

Question 3

What are the 3 genera that are pathogenic to humans?

Answer 3

• Treponema, Borrelia, and leptospira

Question 4

What Treponeme causes endemic syphilis (bejel)? What causes yaws?

Answer 4

• T. pallidum endemicum

- T. pallidum pertenue

Question 5

What actually causes the tissue destruction in syphilis?

What is the only source its transmitted from?

Answer 5

• our immune response

- From humans only via sex, blood contact, or congenital

Question 6

Can syphilis spread by fomites?

What are the 3 phases of syphilis?

Answer 6

• No
• 1 - painless chancre
  2- Rash everywhere “copper colored rash”; “nickle and dime rash”
  3- Neurosyphilis - tabes dorsalis

Question 7

What can also occur in secondary and tertiary syphilis?

Answer 7

• 2: patchy alopecia “moth eaten”

- 3: gummas (granulomas), aneurysm and aortic endocarditis

Question 8

What do you see in early congenital syphilis vs late congenital syphilis?

Answer 8

• early: possible still birth, snuffles - highly infectious

- late: deafness, Hutchinson teeth, saber shins (curvature of long bones), saddle nose

Question 9

If syphilis is suspected what is the initial test to be done?

Answer 9

• Nontreponemal tests: measures IgG and IgM. Done because they are rapid- VDRL and RPR. Can get false positives

Question 10

What is confirmation of the non-treponemal test?

What is a problem with tests for syphilis?

Answer 10

• Treponemal tests: FTA-ABS, TP-PA, EIA

- Patients become positive in late first phase of syphilis.

Question 11

Where are Bejel found and what is there presentation?

Where are Yaws found and what is there presentation?

Answer 11

• Bejel found in A’s (Africa, Asia, Austraila) classically gummas of skin spread by contaminated eating utensils
• S. america, africa, asia presents with “cauliflower lesions” - direct contact

Question 12

Where is Pinta found and what is its presentation?

Answer 12

• Found in south and central america and presents with small pruitic papules on skin.

Question 13

What is the #1 vector born disease in the US?

Answer 13

• Borrelia burgdorferi - Lyme disease

Question 14

What is Borrelia burgdorferi transmitted by?

What is the first stage of lyme disease characteristic of?

Answer 14

• black-legged tick in the NE US

- Bull’s eye rash” - appears 3-30 days after bite

Question 15

What is characteristic of stage 2 lyme disease?

What is characteristic of stage 3 lyme disease?

Answer 15

• intermittent arthritis

- prolonged arthritis, encephalitis, fibromyalgia

Question 16

What would you do for diagnosis?

To be absolute one of the 2 criteria must be met?

Answer 16

• Ab titer (increase in IgM or IgG) followed by western blot for proteins
• (1) Erythema migrans (2) at least 1 late manifestation and positive lab confirmation

Question 17

What if somebody got something in a rustic log cabin in colorado?
What are the symptoms of relapsing fever?

Answer 17

• Relapsing fever - transmitted by B. hermsi; could be tick or louse borne (more severe though more rare).
• fluctuating fever/chills then drenching sweats

Question 18

When are organisms present in the relapsing fever patient?

What is diagnostic for relapsing fever?

Answer 18

• during the febrile period; then antibodies kill them during the afebrile period
• Dark-field microscopy of blood smears during febrile period, patients have a positive VDRL

Question 19

• What is obtained in Hawaii, transmitted through mouse urine, and contracted after swimming?
• First phase of this disease is a flu-like illness, what are the symptoms of the second phase?

Answer 19

• Leptospirosis from Leptospira interrogans.
• Sudden onset of headache, myalgia, chills, abdominal pain, and conjunctival suffusion. Can lead to Weil disease - renal failure, hepatic symptoms with jaundice.

Question 20

What is diagnostic for Leptospirosis?

Answer 20

• Dark-field microscopy (not reliable), serology most commonly used (MAT)