(55) Spirochete

Negative

Treponema pallidum

Outer membrane: protein mediates host cell surface adherence
Hyaluronidase: expressond and secretion may promote perivascular invasion
Fibronectin: coating protects cells from phagocytosis
Immune response to bacterial presence responsible for tissue damage associated with lesions

sexually transmitted disease which occurs worldwide
-Direct sexual contact
-acquired as a congenital infection in utero or by tainted blood transfusion

NO

skin lesions referred to as chancres appear at inoculation site.
Initial papule develops into a painless ulcer followed by painless regional lymphadenopathy.
Bacterial & immune cells present in large numbers. Bacteria are disseminated through blood and lymphatic systems while lesion heals.

characterized by dissemination with generalized mucocutaneous rash
Flulike symptoms with lymphadenopathy
Highly infections like the primary lesion
resolves spontaneously into a latent disease

Chronic inflammation of any tissue in the body
Characterized by granulomatous lesions referred to as gummas
High frequency of neurosyphilis even with early stage therapy in AIDS patients

NO

cannot be visualized using light microscopy of stained preps due to their thin morphology, so must use DARKFIELD or fluorescence microscopy

spirochetes have axial filaments that can be up to 20 micrometers long

Fibronectin: coating protects cells from phagocytosis

Three: primary, secondary, and tertiary

Chancers appears at the inoculation site

NO, if syphilis is the only bacteria present then the lesion will be painless

yes, the bacteria are disseminated though the blood and lymphatic system while lesion heals

dissemination with generalized mucocutaneous rash with flu-like symptoms and lymphadenopathy
-this is highly infectious

Tertiary phase of syphilis

Neurosyphilis

organism is extremely labile with regard to both chemical and physical agents

Direct fluorescent antibody test is specific for pathogenic treponemes.
Bacteria is stained with fluorescein labeled specfic antibodies
Examined using flucescence in microscopy
fresh samples are not required as nonmotile cells are also stained

Nontreponemal test
Treponemal test

detection of serum antibodies specific for T. pallidum
more sensitive than nontreponemal test
include indirect fluorescent antibody, microtiter agglutination, and enzyme immunoassay test

Penicillin

detection of IgG and IgM antibodies in serum directed against lipid from damaged lesion cells
based on degree of flocculation of cardiolipin antigen by patient serum

Borrelia burgdorferi

Borrelia recurrentis

arthropods which result in a bacteremia

microaerophilic

complement mediated lysis of bacteria occurs upon specific humoral immune response to bacteria that are free in the blood

surviving bacteria sequestered within internal tissues then alter their surface exposed serotype specific proteins by gene rearrangement, thereby becoming serologically novel. Multiple immune responses resulting in repeated febrile and nonfebrile cycles due to antigenic variation ensue

fever is due at least in part to the release of outer membrane lipopolysaccharide

exposure via infected tick bite results in erythema migrans after up to 30 day incubation period.

small macule or papule enlarges to at least 5 cm with red, flat border and a clear center
erythema, vesicle formation, and central necrosis ensues accompanied by flu-like symptoms and adenopathy. Early symptoms subside in about 4 weeks

in absence of treatment, hematogenous dissemination occurs within days to weeks. Systemic symptoms include flu-like symptoms, arthralgia, myalgia, erythematous skin lesions with cardiac and neurologic involvement

immunologic response to bacterium

B. recurrentis utilizes humans as reservoir and the body louse as vector.
Epidemics occur during periods of unsanitary conditions involving crowded human populations
Restricted to geographically

zoonotic by virtue of the facts of rodents, small mammals, and soft ticks serve as reservoirs by multiple Borrelia spp. capable of causing disease
Soft shell ticks act as vectors and transmit bacterium through bite wounds
Occurs worldwide

B. burgdorferis is the etiologic agent of the recently recognized disease which is now the most frequently diagnosed vector born disease in the U.S.
Primary reservoris are the white tailed deer and white footed mouse with hard shelled ticks serving as vector

Can be confirmed by Western blotting
-false positives can occur with syphilis patients
* must confirm patient history and symptomology

pathogenic and nonpathogenic leptospires
typical spirochete morphology with one or two hooked ends
only two periplasmic flagella
can be cultivated in vitro at 28-30 C with certain fatty acids, cofactors, and ammonium salt supplementation

bacteria typically enter thru mucous membranes or compromised skin, then migrate to potentially all host tissues through circulatory system and CSF

humoral immune response results in clearance of bacteria

rapid multiplication within various tissues
Immunologic reactions can cause post clearance meningitis and glomerulonephritis

Weil's disease may result in as high as 15% mortality due to hepatic and renal involvement with vascular complications

incidental host then contracted infection via contaminated water and exposure to reservoir animals

NO
microscopy is unreliable due to thin cellular morphology and paucity of labeled antibody preparations

the most sensitive and specific serologic procedure is the microscopic agglutination test using live leptospires and patient serum