1 Spirochaetes 3 16 2018 2 Presentation Outline ä

1 Spirochaetes 3/16/2018

2 Presentation Outline ä Morphology ä Organisms ä Diseases ä Leptospirosis ä Lyme disease ä Syphilis ä Tests 3/16/2018

3 Spirochete Morphology ä Gram negative cell wall ä often too small to see by light microscopy ä special stains ä Spiral morphology ä distinctive tight coils ä Motile ä Periplasmic flagella 3/16/2018

4 Spiral 3/16/2018

5 Spiral bacterium Spirillum volutans 3/16/2018

6 Spirochete 3/16/2018

7 Axial Filament ä Between cell wall and cytoplasmic membrane ä Attached at either end of cell ä Overlap in the centre ä constrict at overlap ä pulls ends together 3/16/2018

8 Spirochetes: Features ä Chemoorganotropic ä Range of oxygen requirements ä Life style ä Free living ä host associated 3/16/2018

9 Spirochaete Motility Click on image 3/16/2018

10 Spirochetes: genera ä Borrelia (lyme disease) ä Brachyspira ä Cristispira ä Leptonema ä Leptospira (Leptospirosis) ä Serpulina ä Spirochaeta ä Treponema (Syphilis) 3/16/2018

11 Leptospirosis 3/16/2018

12 Leptospira biflexa ä free living saprophyte in moist environments ä motile, flagella ä ä aerobic can be grown in 2 weeks 3/16/2018

13 Leptospirosis ä Leptospira interrogans ä Zoonosis of wild & domestic animals ä acquired from urine of infected animals ä Dogs, rodents ä Portal of entry ä broken skin or mucosa ä Bacteremia 3/16/2018

14 L. interrogans ä Carried by wild and domestic animals ä source of human infection ä Streams, rivers, moist soil ä contaminated by animal urine ä Person to person very rare. 3/16/2018

15 Occupational exposure ä farmers, slaughter house ä workers, veterinarians. 3/16/2018

16 L. interrogans ä mild flu like febrile illness ä Weil’s disease ä renal and hepatic failure ä vasculitis ä meningitis ä myocarditis ä death ä Penetrate all organs including CNS ä Enter through small cuts 3/16/2018

17 Leptospirosis ä Febrile illness not clinically distinctive ä Acute phase ä Leptospiremic phase ä incubation 7 -14 days ä fever, headache, muscle pain nausea ä Immune phase ä found in urine ä meningitis 3/16/2018

18 Borrelia Relapsing Fevers Lyme Disease 3/16/2018

19 Relapsing Fever ä Borrelia recurrentis ä Tick borne Relapsing fever ä rodents are reservoir ä soft shelled ticks ä Louse borne Relapsing fever ä humans are reservoir ä body louse 3/16/2018

20 Borrelia ä Easily seen in blood smear ä Also confirmed by injecting mouse ä blood stream teaming with Borrelia 3/16/2018

21 B. recurrentis ä Tick borne relapsing fever is a zoonotic ä Clinical evolution: relapsing fever ä Serological tests not useful ä treatment ä tetracycline 3/16/2018

22 Lyme Disease ä Lyme, Conneticut USA - spring/fall ä Borrelia burgdorfii ä reservoir rodents, pets, deer ä vector hard shelled ticks ä Bite: incubation 3 -30 days 3/16/2018

23 Lyme Disease: Early Signs ä Erythema chronicum migrans ä Erythematous skin lesion ä small macule or papule - enlarges to 68 mm. ä Malaise, severe fatigue, headache, fever, chills, ä chronic neurologic, cardiac rheumatic manifestations. 3/16/2018

24 Lyme Disease: Complications ä 1 month or more ä myalgia, lymphadenopathy ä Up to 2 years ä meningitis, encephalitis, peripheral nerve neuropathy. ä Cardiac disfunction, myopericarditis. 3/16/2018

25 Lyme Disease: Serology ä Immunofluorescence assay ä Enzyme-linked immunoabsorbent assay (ELISA) ä False positives ä other spirochaetes ä infectious mononucleosis ä autoimmune disease 3/16/2018

26 Lyme Disease: Treatment ä tetracycline or penicillin 3/16/2018

27 Syphilis 3/16/2018

28 Stages of Syphilis ä Primary ä Secondary ä Tertiary 3/16/2018

29 Primary syphilis Chancre: painless blister at the site of contact Heals spontaneously even if untreated 3/16/2018

30 Syphilitic lesions of vulva 3/16/2018

31 Secondary Syphilis ä Lesions of secondary syphilis are dispersed over the body ä Lesions appear on the cooler parts of the body 3/16/2018

32 Secondary syphilis 3/16/2018

33 Syphilitic lesion on the cooler parts of the body 3/16/2018

34 Neuronal Syphilis ä Treponemes have invaded the nerve and set up a lesion 3/16/2018

35 Syphilic lesions on bones 3/16/2018

36 Cardio Syphilis 3/16/2018

37 Tests for Syphilis ä Break down products of infected cells ä cardiolipin ä VDRL, Wasserman ä Simple, well documented ä cross reactive eg TB ä presumtive test ä Treponemal antigens ä more expensive ä more specific ä confirmatory test 3/16/2018

38 Performance Objectives Key terms, concepts short answers 3/16/2018

39 Key Terms 3/16/2018

40 Key Terms 3/16/2018

41 Key Organisms 3/16/2018

42 Key Concepts 3/16/2018

43 Epidemiology of ? ? ? ä Disease/bacterial factors ä Transmission ä Who is at risk ä Geography/ season ä Incidence ä Modes of control 3/16/2018

44 Short Answers ä Construct a table of the virulence factors associated with ? ? ? and the biological activity of each ä Use a series of no more than four diagrams to describe the mechanism of ? ? ? activity ä Describe the clinical manifestions ? ? ? ä Construct a table listing the common ? ? ? species and the associated human diseases. 3/16/2018

45 The End 3/16/2018

46 Icteric leptospirosis ä first stage: 3 -7 days - septicemic 10 -30 days - immune ä Cultures positive: blood, then CSF, then urine ä 3/16/2018

47 Icteric leptospirosis ä Jaundice, hemorrhage, renal failure, myocarditis ä Anicteric described ä Best in CSF, blood, and urine culture -- 1 st week ä Lab test -- slide agglutination ä Doxycycline - treatment ä Prevention: rodent control 3/16/2018

48 So What ä Know importance ä #1 communicable disease growing fast ä Know how it is spread ä Sexual intercourse ä skin-skin contact ä Know the symptoms ä Syphilis can be identified and cured 3/16/2018