spirochetes Flashcards
Treponema pallidum
– syphilis (the Great Pox) The “treponeme” (thin thread) Humans – only natural host can't cultivate Staining – silver stain Darkfield microscopy Anaerobic Environmental sensitive Transmission: Venereal Transplacentally Surface proteins – very few Serology 2 types of tests comes along with Clamydia and Gonorrhea no exotoxins, only endotoxins
Borrelia burgdorferi
– Lyme disease
Giemsa stain, arthropod-borne
Borrelia burgdorferi
Large spirochetes–seen with light microscope
Endoflagella – highly motile
No apparent endotoxins or exotoxins
Can be cultured on bacteriological media (rich in serum)
Discovery – Lyme, Ct
Reservoir mice and beer
Vector Transmission – bite of infected tick
Usually in late spring or summer
Tick must remain attached for ~48 hr to transmit bacteria to host
Treponema denticola
– periodontal disease
morphology
growth
Coiled, spiral shaped morphology. The tips of the flagella are attached to poles
on either end of the spirochete and they wind around the body within the
periplasm (space between cell membrane and outer membrane) aka
endoflagellation. move in a corkscrew type fashion
They’re slow growers (especially pallidum) divide along their long axis/longitudinally. Some spirochetes are aerobic, but most are facultative. Treponema is anaerobic. Treponema have regularly spaced coils, the other spirochetes have irregular spacings among their spirals.
T. pallidum
virulence factors
1. OMPs ( on the end of the cell, hyalorinic acts) 2. Hyaluronidase 3. Fibronectin 4. Corkcrew motility
Syphilis stages
primary
secondary tertiary
Acquired syphilis
Transmission
Direct contact
Venereal – genital and extragenital (10%)
Touching primary or secondary lesions
primary syphilis
Hard chancre
properties:hard, painless, nice round margins
Oral chancre = oral diagnosis
Genital, oral, anal sites Intimate contact -entry Incubation period(3w) disappearance CMI Infectious? Yes
secondary
“THE GREAT IMITATOR”
Condylomata lata
Rash – generalized superficial lesions and systemic disease
Variability of clinical symptoms
Latency period (3-8 w)
Flu-like symptoms
Infectious? yes
Oral lesions
tertiary syphilis
Gummas – destructive granulomatous lesions
Latency period 15-30 years Especially -Cardiovascular syphilis -Neurosyphilis Other common sites bones, skin Infectious? no
Oral cavity
In tertiary syphilis, leukoplakia, ulceration and scarring may result and in the palate lead to perforation.
syphilis serology
- non specific antibodies=screening
Look for reagin!!!!! serum is mixed with cardiolipin. if serum has reagin—» positive result
flocculation tests: VRL, RPR are used to ID reagin
results: cheap, sensitive but not specific( can give false positive) - specific antibodies
Antitreponemal antibodies
-TPI
-FTA-ABS (Fluorescence microscopy)
These tests are more specific
More expensive
DARKFIELD MICROSCOPY CAN ALSO BE USED FOR DIAGNOSIS
tests results
Reagin tests
Titers decrease during recovery
So, can monitor ???
Antitreponemal tests
titers will stay high for life because you’ll always have those antibodies.
That won’t be useful for you for followup tests.
syphilis congenital
Congenital syphilis
Fetus infected –only after the 1st trimester
Oral manifestations
Hutchinson’s triad
Notched, peg-shaped teeth, deafness, impaired vision “mulberry” molars
Preventable
syphilis -oral aspects
Primary – hard chancre (oral ulcer)
Primary syphilis of the lip
Secondary - “mucous patches” = moist patches
Tertiary – gummas
Very destructive
Anywhere – hard palate most often; may perforate to nasal cavity
Other sites
immunity, treatment
Immunity - incomplete
Treatment
Acquired syphilis - penicillin – one large dose or doxycycline
Congenital – treat mother with penicillin – early
Antibiotic resistance??? No
Jarisch-Herxheimer Reaction – flu-like symptoms
Endotoxin shock cuz of the all endotoxins that are released during treatment
Control
Abstinence
Treat sex partners of syphilitic persons
Condoms help prevent transmission
