The Treponema: Syphilis, Yaws, Pinta Flashcards
What method must be performed to identify Treponema pallidum on standard microscopy?
Darkfield uscopy w/o gram stain
What is the culture procedure for T. pallidum?
Can’t be cultured
What makes T. pallidum so virulent?
Immune evasion and low inflammation
How is T. pallidum transmitted?
Sexually or congenitally
How are yaws and pinta passed?
Direct contact
Describe the immune reaction to T. pallidum.
Humans raise mostly useless Abs (reagin)
What are the four stages of syphillis?
Primary chancre, Secondary body-wide rashes (condylomata lata, and patchy alopecia), latent period, teriary (gummas, neurosyphilis, cardiac involvement
Describe the pupillary findings in neurosyphilis
One or both eyes fails to constrict in response to light while they both constrict in order to accommodate (Argyll-Robertson pupil
What are the effects of congenital syphilis?
(50%) Death, Bone deformities, interstitial keratitis, progress rapidly to Syx of secondary and tertiary syphilis
What is the major strategy for syphilis Dx?
Assemble accurate timecourse of the many varied Syx
What are the lab tests helpful for syphilis Dx?
Reagin (VDRL, RPR); Confirm with treponeme-specific Abs
What is the Tx for treponema?
Penicillin G
What are the mechanisms of transmission of T. pallidum?
Sexual contact, blood, transplacentally
What is the major virulence factor for T. pallidum?
Immune evasion
What is the lesion of primary syphilis?
Chancre
What are the typical lesions found in secondary syphilis?
Mucocutaneous lesions, condylomata lata, patchy alopecia
What complicates treatment of syphilis at the primary and secondary stage?
Lesions eventually go away so patients don’t present
Following secondary syphilis, what are the two possible routes of pathogenesis?
- Latent
- Teritary Syphilis
What are the typical lesions in a person with tertiary syphilis?
Gummatous lesions and cardiovascular syphilis
What are possible sequale of neurosyphilis?
- Syphilitic meningitis (early)
- Meningovascular syphilis
- Parenchymal neurosyphilis (Tabes dorsalis [Degeneration of nerves of dorsal column], General paresis)
What is the relationship b/w syphilis and HIV?
Ulcerations of syphilis facilitate HIV infection. HIV accelerates syphilis course due to immunosuppresion
What is the time span which tertiary syphilis can occur
3-10 years after infection
What congenital abnormalities are observed in a patient with congenital syphilis infection?
- Facial deformities (Hutchinson’s teeth, Mulberry molars)
- Bone and joint deformities
- Neuro (Tabes dorsalis, paresis)
What are the typical Dx issues and strategies for syphilis?
Problems:
Won’t culutre and two small to Gram stain
Strategy:
Darkfield uscopy/IF, CSF, Venereal Disease Research Lab (VDRL), Rapid Plasma Reagin (RPR), or ICE Syphilis recombinant antigen test
