Spirochetes Flashcards
Borrelia burgdorferi (Lyme disease)
lab tests
The bows and arrows of borrelia
Spirochete (Do not gram stain)
Helical and longer than Treponema
(the only spirochete that can be seen with microscope)
Wright and Giemsa stains can be used.
Borrelia burgdorferi (Lyme disease)
source
The bows and arrows of borrelia
Primarily in northeastern U.S.
Transmitted by ticks (Ixodes scapularis)
* Ixodes also transmits erliciosis (bacteria) and bubesiosis (protozoa)
Borrelia burgdorferi (Lyme disease)
life cycle
The bows and arrows of borrelia
- Mouse (main reservoir); Tick larvae
- Deer (obligatory host); Tick adult form
- Humans (incidental host); Tick is the vector
Borrelia burgdorferi (Lyme disease)
1st Stage
The bows and arrows of borrelia
Erythema chronic migrans “bulls eye” rash.
Sweating, feverish, flu-like illness.
Papule will form (Ixodes tick)
Borrelia burgdorferi (Lyme disease)
2nd Stage
The bows and arrows of borrelia
Heart block caused by myocarditis
Bilateral facial nerve Bell’s palsy
Borrelia burgdorferi (Lyme disease)
3rd Stage
The bows and arrows of borrelia
Joint pain and arthritis of large joints (like knees) that may move from joint to joint (Migratory polyarthritis).
Memory difficulty.
Lymphocytic meningitis.
Suttle encephalopathy.
Borrelia burgdorferi (Lyme disease)
treatment
The bows and arrows of borrelia
Stage 1: doxycycline
(child under 8 use amoxicillin)
Stage 2: ceftriaxone
Borrelia hermsii and duttonii
Endemic Relapsing Fever
The bows and arrows of borrelia
Endemic is caused by tick vs. Epidemic is caused by lice.
Most people who are infected develop sickness between five and 15 days after they are bitten.
Sudden fever, chills, headaches, muscle or joint aches, and nausea. A rash may also occur.
These symptoms usually continue for two to 9 days, then disappear. This cycle may continue for several weeks if the person is not treated
Treponema palladium (Syphilis)
lab tests
Pallidum Observatory
- Spirochete (Do not gram stain)
- Cannot be grown in culture (only in rabbit testes)
- Dark field microscopy is needed for direct visualization of the bacteria
- VDRL (Venereal Disease Research Lab) screening** test** (not specific)
- RPR (Rapid plasmin reagent) screening test (high incidence of false (+) due to cross antigenicity)
- FTA ABS is an antibody specific test to confirm a (+) screen. (fluorescent treponemal antibody absorption )
Treponema palladium (Syphilis)
Early stages (1º, 2º, early latent)
1º
(3-90 days after exposure)
Pallidum Observatory
Painless* genital chancre
* Syphilis locally invades small blood vessels causing ischemic necrosis, taking out nerves and making it painless.
Heals in 3-6 weeks
Treponema palladium (Syphilis)
Early stages (1º, 2º, early latent)
2º ( Systemic!)
(4-10 weeks after initial infection)
Pallidum Observatory
- Systemic maculopapular rash** that also occurs on the **palms and soles* of feet, weeks to months after infection.
- Condoloma Latta, a lot of bumps that are flat topped.
- Spirochetes can be visualized in the condoloma latta using dark field microscopy.
(* Only a few organisms cause rash on palms and soles of feet! )
Treponema palladium (Syphilis)
Condoloma Latta vs. Condoloma acuminata
Pallidum Observatory
Condoloma Latta is from 2º Syphilis.
- Bumbs that are flat topped.
Condoloma acuminata is from HPV
- Bumps are more wart like (rounded top)
Treponema palladium (Syphilis)
Late stages (3º, late latent)
3º
(3-15 years after initial infection)
Pallidum Observatory
- Formation of Gummas (soft growth with a firm necrotic center). Can be anywhere, including skin, organs, and bone.
- Aortitis → leading to an ascending pathologic aneurysm
- Destroys the vasovasorum (that supply blood to the aorta) → leading to tree barking on aorta (thick and wrinkled)
- Tabes Dorsalis
- Argyle Robertson
Treponema palladium (Syphilis)
Late stages (3º, late latent)
Tabes Dorsalis
Pallidum Observatory
Demyelination of nerves and posterior walls of the spinal cord.
Leads to loss of vibration sense, discriminating touch, and proprioception (can cause awkward gait).
Can also cause lancing pain and neurologic issues.
Treponema palladium (Syphilis)
Late stages (3º, late latent)
Argyle Robertson
Pallidum Observatory
AKA Prostitutes pupil
Pupils will accommodate distance… but…
Will not react to light!
Treponema palladium (Syphilis)
Congenital symptoms
Pallidum Observatory
* TORCHeS** infection!
- Saber shins (an anterior bowing of the tibia)
- Saddle shaped nose
- Hutchinson teeth (notched incisors)
- Mulberry molars (molars with several enamel outgrowths)
- Deafness
Treponema palladium (Syphilis)
treatment
Pallidum Observatory
Penicillin
If allergic, desensitize them and use penicillin!
Treponema palladium (Syphilis)
Jarisch Herschimer reaction
Pallidum Observatory
After treatment* for Syphilis (within an hour!)
Dying spirochetes release a bunch of cytokines that make people feel sick.
fever and chills
headache
* Indicates the tx is working!
Leptospirosis
lab tests
The Surfers Oasis
Spirochete (Do not gram stain).
The spirochete may be ? shaped.
Leptospirosis
source
The Surfers Oasis
Tropical regions.
Urine or Tissue of infected animals.
Water contaminated with animal urine.
Water sports or people who work with animals are common buzz words.
Leptospirosis
Mild form
(usually 5-7 days)
The Surfers Oasis
Flu-like symptoms (Fever, chills, muscle pain, etc)
Conjunctival suffusion (redness of the conjunctiva that resembles conjunctivitis, but it does not involve inflammatory exudates / pus)
Leptospirosis
Severe form
(Weil’s disease)
The Surfers Oasis
Leptospirosis travels in the blood stream and lymph and damage many organs.
Major symptoms include renal dysfunction and liver damage (_jaundice!_).
Can also cause abdominal pain, diarrhea, skin rash, and muscle pain.
