Trepodium Pallidus/Syphillis

Question 1

General Characteristics of Treponemes

Answer 1

o Are spirochetes
• Helical shaped, slender and long.
• Found in stomach of ruminants and termites
• Have a corkscrew like movement associated with periplasmic flagella.
• Cause few disease in humans, primarily
• Lyme disease
• Syphilis
• Large number in subgingival plaque, some associated with periodontal disease
• T. denticola

Question 2

Modes of T. Pallidium transmission

Answer 2

o T. Pallidium: causes syphilis
• Transmitted via sexual encounters and via the placenta.
o Encounter, entry, spread and multiplication

Question 3

How many stages are there with syphilis?

Answer 3

3

Question 4

First stage of syphilis characteristics

Answer 4

• Host WBC battle replicating spirochetes at site of initial inoculation, forming lesion
• Syphilitic chancre
o Increases risk of HIV infection 3-5 fold
• Painless, heal spontaneously but infection has already become systemic

Question 5

2nd stage; where does bacterium replicate

Answer 5

• bacterium replicates in lymph nodes, liver, joints, muscles, skin, and mucous membranes

Question 6

2nd stage, “great imitator”

Answer 6

• many symptoms, acts like a lot of other diseases

Question 7

2nd stage, where skin rashes/lesions can form?

Answer 7

• anywhere on body, even palms/soles of feet

Question 8

2nd stage, Jarisch Herxheimer reaction

Answer 8

• Treatment with penicillin can cause high fever and shock.

Question 9

2nd stage, Bacterium becomes latent

Answer 9

• Resolve with or without treatment. 2/3 of time bacterium remains latent for decades

Question 10

3rd stage, what mediates this stage

Answer 10

trepomenal antigens

Question 11

3rd stage, outcome

Answer 11

• destruction of host tissues due to inflammatory response/ vasculitis

Question 12

what are gummas?

Answer 12

• lesions consisting of few treponemes and inflammatory cells that destroy soft tissue and bone

Question 13

3rd stage, symptoms of CNS being affected

Answer 13

• ataxia, dimensia, loss of motor control, and general paresis

Question 14

Syphilis diagnosed

Answer 14

o Detect antibodies against the bacterium, not the bacterium itself necessarily
o Venereal diseases reference laboratory test (VDRL), Rapid Plasmia Reagin (RPR)
• Not very specific
• Confirm positive samples with treponeme specific test
o Fluorescent Treponemal Antibody test is treponeme specific

Question 15

Know how syphilis is treated

Answer 15

o Penicillin is used at all stages

• Less effective in tertiary because it cannot penetrate the CNS