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Spirochaetes

Spirochaetes. Presentation Outline. Morphology Organisms Diseases Leptospirosis Lyme disease Syphilis Tests. Spirochete Morphology. Gram negative cell wall often too small to see by light microscopy special stains Spiral morphology distinctive tight coils Motile

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Spirochaetes

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  1. Spirochaetes

  2. Presentation Outline • Morphology • Organisms • Diseases • Leptospirosis • Lyme disease • Syphilis • Tests

  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

  4. Spiral

  5. Spiral bacterium Spirillum volutans

  6. Spirochete

  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

  8. Spirochetes:Features • Chemoorganotropic • Range of oxygen requirements • Life style • Free living • host associated

  9. Spirochaete Motility Click on image

  10. Spirochetes: genera • Borrelia (lyme disease) • Brachyspira • Cristispira • Leptonema • Leptospira (Leptospirosis) • Serpulina • Spirochaeta • Treponema (Syphilis)

  11. Leptospirosis

  12. Leptospira biflexa • free living saprophyte in moist environments • motile, flagella • aerobic • can be grown in 2 weeks

  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

  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.

  15. Occupational exposure • farmers, slaughter house • workers, veterinarians.

  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

  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

  18. Borrelia Relapsing Fevers Lyme Disease

  19. Relapsing Fever • Borrelia recurrentis • Tick borne Relapsing fever • rodents are reservoir • soft shelled ticks • Louse borne Relapsing fever • humans are reservoir • body louse

  20. Borrelia • Easily seen in blood smear • Also confirmed by injecting mouse • blood stream teaming with Borrelia

  21. B.recurrentis • Tick borne relapsing fever is a zoonotic • Clinical evolution: relapsing fever • Serological tests not useful • treatment • tetracycline

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

  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.

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

  25. Lyme Disease: Serology • Immunofluorescence assay • Enzyme-linked immunoabsorbent assay (ELISA) • False positives • other spirochaetes • infectious mononucleosis • autoimmune disease

  26. Lyme Disease:Treatment • tetracycline or penicillin

  27. Syphilis

  28. Stages of Syphilis • Primary • Secondary • Tertiary

  29. Primary syphilis Chancre: painless blister at the site of contact Heals spontaneously even if untreated

  30. Syphilitic lesions of vulva

  31. Secondary Syphilis • Lesions of secondary syphilis are dispersed over the body • Lesions appear on the cooler parts of the body

  32. Secondary syphilis

  33. Syphilitic lesion on the cooler parts of the body

  34. Neuronal Syphilis • Treponemes have invaded the nerve and set up a lesion

  35. Syphilic lesions on bones

  36. Cardio Syphilis

  37. 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 Tests for Syphilis

  38. Performance Objectives Key terms, concepts short answers

  39. Key Terms

  40. Key Terms

  41. Key Organisms

  42. Key Concepts

  43. Epidemiology of ??? • Disease/bacterial factors • Transmission • Who is at risk • Geography/ season • Incidence • Modes of control

  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.

  45. The End

  46. Icteric leptospirosis • first stage: 3-7 days - septicemic • 10-30 days - immune • Cultures positive: blood, then CSF, then urine

  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

  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

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