Syphilis, Lyme Disease, Leptospirosis Flashcards
what are the bugs that cause syphilis, lyme disease, and leptospirosis
- Treponema pallidum – Syphilis
- Borrelia burgdorferi - Lyme disease
- Leptospira species - Leptospirosis
Common features to spirochetes –
how do you diagnose?
who are the hosts for each bug?
- Thin/spiral bacteria
- Difficult to Culture;
Dx -relies on serology
Zoonotic hosts that accidentally infect humans
except for Treponema for which Humans are the primary host
Treponema pallidum
- shape
- transmission
- progression of disease
- where does it tend to attack?
Spiral shaped
Human hosts
Transmitted via sexual contact
Not a linear course of the disease; “spontaneous cure vs progress”
Later stage complications include perivascular invasion;
Neurosyphilis and cardiovascular syphilis
what are the virulence factors of Treponema pallidum?
Adherence
Perivascular infiltrates (hyaluronidase)
Fibronectin coat prevents phagocytosis
what are the stages of syphilis and their symptoms?
how else can you get syphilis ?
Primary - painless genical ulcer (chancre)
Secondray - flu like symptoms but also characteristic rash on the palms of hands and soles of shoes
Tertiary – Chronic inflammation and granulomatous lesions leading to Neurosyphilis and cadriovascular syphilis
Congenital syphilis – fetal disease with latent manifesations or multiorgan malformations
diagnosis of syphilis
Serology:
- Nontreponemal tests: VDRL, RPR (sensitive but not specific for syphilis)
Treponemal Tests: FTA-ABS, TPPA, EIA
Treat of syphilis
PCN (little resistance)
Doxycyline
Ceftriaxone for CSF penetration
Borrelia burgdorferi
- what does it cause
- what stain is used for it?
- who is the vector? what is the reservoir
- where is it endemic to?
Lyme disease
Giemsa stain
Carried by Ixode Ticks; transmitted to humans via prolonged feeding of nymph and adult ticks on humans
Reservoirs: white foot mouse, white tailed deer
Endemic to NE USA and parts of the midwest
what are the disease stages of lyme disease and their characteristic features of each stage
Early localized Disease:
- erythema migrans “targetoid” rash
- malaise, fever, HA
Early disseminated disease: - multiple lesions; CN VII palsy (Bell's Palsy) Meningitis can cause Cardiac dysfunction such as 3rd degree heart block
late disseminated disease: weeks to months after infection; arthritis pains
Diagnosis of Lyme disease
the characterisitc rash is enough to begin treatment
Serology is the test of choice – but can have high false positive and possibly false negative in the early stage
Treatment of Lyme:
Doxycycline for early or disseminated disease
Ceftriaxone for CSF penetration
Leptospira species - shape - what does it cause - how does it transmit? -
- Leptospirosis
- spirochete
Worldwide distribution in animal carriers that excrete urine into the environment
- humans contract disease through breaches in skin while in contaminated waters
-
What are the three forms of the disease ?
Asymptomatic disease
Febrile illness
Severe disease:
- Stage 1 - septicemia;
- Stage 2 - Immunologic response:
Describe the servere disease form?
Septicemic Leptospirosis (5-7 days duration)
Fevers, myalgias
Vomiting, dairrhea
Conjunctival suffusion – boggy, thickened sclera
Immunologic response – (4-30 days duration) – disease caused by the immune response
Hepatic failure (jaundice) and Renal failure
Cardiac disease
Pulmonary hemorrhage
Meningitis
Diagnosis of Leptospirosis:
Clinical
Microscopic aggluntination test (MAT) – serology
Tissue biopsy – can see the spirochetes
