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1 Spirochaetes 5/24/2017 2 Presentation Outline Morphology Organisms Diseases Leptospirosis Lyme disease Syphilis Tests 5/24/2017 3 Spirochete Morphology Gram negative cell wall often too small to see by light microscopy special stains Spiral morphology distinctive tight coils Motile Periplasmic flagella 5/24/2017 4 Spiral 5/24/2017 5 Spiral bacterium Spirillum volutans 5/24/2017 6 Spirochete 5/24/2017 7 Axial Filament Between cell wall and cytoplasmic membrane Attached at either end of cell Overlap in the centre constrict at overlap pulls ends together 5/24/2017 8 Spirochetes:Features Chemoorganotropic Range of oxygen requirements Life style Free living host associated 5/24/2017 9 Spirochaete Motility Click on image 5/24/2017 10 Spirochetes: genera Borrelia (lyme disease) Brachyspira Cristispira Leptonema Leptospira (Leptospirosis) Serpulina Spirochaeta Treponema (Syphilis) 5/24/2017 11 Leptospirosis 5/24/2017 12 Leptospira biflexa free living saprophyte in moist environments motile, flagella aerobic can be grown in 2 weeks 5/24/2017 13 Leptospirosis Leptospira interrogans Zoonosis of wild & domestic animals acquired from urine of infected animals Dogs, rodents Portal of entry broken skin or mucosa Bacteremia 5/24/2017 14 L. interrogans Carried by wild and domestic animals source of human infection Streams, rivers, moist soil contaminated by animal urine Person to person very rare. 5/24/2017 15 Occupational exposure farmers, slaughter house workers, veterinarians. 5/24/2017 16 L. interrogans mild flu like febrile illness Weil’s disease renal and hepatic failure vasculitis meningitis myocarditis death Penetrate all organs including CNS Enter through small cuts 5/24/2017 17 Leptospirosis Febrile illness not clinically distinctive Acute phase Leptospiremic phase incubation 7 -14 days fever, headache, muscle pain nausea Immune phase found in urine meningitis 5/24/2017 18 Borrelia Relapsing Fevers Lyme Disease 5/24/2017 19 Relapsing Fever Borrelia recurrentis Tick borne Relapsing fever rodents are reservoir soft shelled ticks Louse borne Relapsing fever humans are reservoir body louse 5/24/2017 20 Borrelia Easily seen in blood smear Also confirmed by injecting mouse blood stream teaming with Borrelia 5/24/2017 21 B.recurrentis Tick borne relapsing fever is a zoonotic Clinical evolution: relapsing fever Serological tests not useful treatment tetracycline 5/24/2017 22 Lyme Disease Lyme, Conneticut USA spring/fall Borrelia burgdorfii reservoir rodents, pets, deer vector hard shelled ticks Bite: incubation 3-30 days 5/24/2017 23 Lyme Disease: Early Signs Erythema chronicum migrans Erythematous skin lesion small macule or papule - enlarges to 68 mm. Malaise, severe fatigue, headache, fever, chills, chronic neurologic, cardiac rheumatic manifestations. 5/24/2017 24 Lyme Disease: Complications 1 month or more myalgia, lymphadenopathy Up to 2 years meningitis, encephalitis, peripheral nerve neuropathy. Cardiac disfunction, myopericarditis. 5/24/2017 25 Lyme Disease: Serology Immunofluorescence assay Enzyme-linked immunoabsorbent assay (ELISA) False positives other spirochaetes infectious mononucleosis autoimmune disease 5/24/2017 26 Lyme Disease:Treatment tetracycline or penicillin 5/24/2017 27 Syphilis 5/24/2017 28 Stages of Syphilis Primary Secondary Tertiary 5/24/2017 29 Primary syphilis Chancre: painless blister at the site of contact Heals spontaneously even if untreated 5/24/2017 30 Syphilitic lesions of vulva 5/24/2017 31 Secondary Syphilis Lesions of secondary syphilis are dispersed over the body Lesions appear on the cooler parts of the body 5/24/2017 32 Secondary syphilis 5/24/2017 33 Syphilitic lesion on the cooler parts of the body 5/24/2017 34 Neuronal Syphilis Treponemes have invaded the nerve and set up a lesion 5/24/2017 35 Syphilic lesions on bones 5/24/2017 36 Cardio Syphilis 5/24/2017 37 Tests for Syphilis Break down products of infected cells cardiolipin VDRL, Wasserman Simple, well documented cross reactive eg TB presumtive test Treponemal antigens more expensive more specific confirmatory test 5/24/2017 38 Performance Objectives Key terms, concepts short answers 5/24/2017 39 Key Terms 5/24/2017 40 Key Terms 5/24/2017 41 Key Organisms 5/24/2017 42 Key Concepts 5/24/2017 43 Epidemiology of ??? Disease/bacterial factors Transmission Who is at risk Geography/ season Incidence Modes of control 5/24/2017 44 Short Answers Construct a table of the virulence factors associated with ??? and the biological activity of each Use a series of no more than four diagrams to describe the mechanism of ??? activity Describe the clinical manifestions ??? Construct a table listing the common ??? species and the associated human diseases. 5/24/2017 45 The End 5/24/2017 46 Icteric leptospirosis first stage: 3-7 days - septicemic 10-30 days - immune Cultures positive: blood, then CSF, then urine 5/24/2017 47 Icteric leptospirosis Jaundice, hemorrhage, renal failure, myocarditis Anicteric described Best in CSF, blood, and urine culture -- 1st week Lab test -- slide agglutination Doxycycline - treatment Prevention: rodent control 5/24/2017 48 So What Know importance #1 communicable disease growing fast Know how it is spread Sexual intercourse skin-skin contact Know the symptoms Syphilis can be identified and cured 5/24/2017