Systemic Spirochetes Flashcards
Discuss spirochetes in general
Spiral shaped organisms that exhibit corkscrew motility, don’t gram stain.
Discuss the three stages of syphillis in adults
1*= genital chancre (nonpainful)
2*= condyloma latum (warts), rash hands/feet, mucous patches in mouth
3*= neuro damage, damage to vasa vasorum (blood supply to aorta)--> damage to aorta→ ("tree bark"), Argyll Robertson pupils (can accommodate, can’t react to light), gumma formationDiscuss congenital symptoms of syphilis
Baby= saber shins, saddle nose, hutchinson’s teeth, mulberry molars, deafness, hydrops fetalis, death,
How do we diagnose Syphillis?
Dx: Dark field microscopy (direct visualization), lab blood test
- VDRL /RPR screening: non-treponium
- FTA-AB screening: treponium
Many false (+)
Silver stain needed to visualize, but note, can not be grown in culture, must be propagated in experimental animals
How do we teat syphillis?
Tx: PCN (may induce fevers/chills/HA)
Source for Leptosporosis
source: animal urine, contaminated water
How does Leptosporosis present?
Sx: Acute febrile illness with conjunctival suffusion that may progress to jaundice and renal failure (Weil’s disease) or meningitis.
Who is at risk for Leptosporosis?
At risk: Soldiers wading in water/streams during field exercises
Where do we find Lyme Disease?
Source: primarily in the NE, from ticks (ixodes scapularis type). Tick=vector. Most common arthropod-borne infection in the U.S. Nymph stage of the tick in the months of May - July is the most contagious.
Discuss the life cycle of Lyme Disease
Life cycle: White footed mouse= reservoir for larvae; white tailed deer = obligatory host for adult form (deer immune)
How do we diagnose Lyme Disease?
Dx: Wright stain, Giemsa stain, Synovial fluid if they have arthritis.
Discuss the stages of lyme disease and what symptoms present at each
Stage 1: bull’s eye rash (w/in a month of bite), flu-like sx (fever+chils) (Local spread of infection causing erythema migrans)
Stage 2: bilateral bell’s palsy, heart block caused by myocarditis, erythema migrans in other locations (from dissemination of bacteria, weeks to months later).
Stage 3: encephalopathy (memory problems, meningitis or other CNS sx), migratory polyarthritis starting w/ large joints (like knee), acrodermatitis all due to persistent long term survival
What is STARI?
STARI - Southern Tick-
Associated Rash Illness - Rash similar to that of lyme disease in people residing in southeastern and south-central states, associated with bite from a tick with a lone star on its back (Amblyomma americanum.
What happens with relapsing fever in Borrelia?
Sx: Relapsing fever - Caused by Borrelia, characterized by recurrent episodes of fever separated by asymptomatic intervals. Louse born = transmitted from person to person with no animal reservoir = epidemic form = Borrelia recurrentis. Tick borne = transmitted from animals to humans = endemic form = Borrelia hermsii.
How do we treat Lyme Disease?
Tx: Doxycycline (stage 1), Ceftriaxone (stage 3)
