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CLS 1113 Introduction to Clinical Laboratory Practices. Unit 7 Serological Diagnosis of Infectious Diseases. Syphilis. Treponema pallidum (Spirochete) Helically coiled - “Cork-screw” motility Have no natural reservoir in the environment Must multiply within a living host

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Cls 1113 introduction to clinical laboratory practices

CLS 1113Introduction to Clinical Laboratory Practices

Unit 7

Serological Diagnosis of Infectious Diseases


Syphilis
Syphilis

  • Treponema pallidum (Spirochete)

    • Helically coiled - “Cork-screw” motility

    • Have no natural reservoir in the environment

    • Must multiply within a living host

    • Difficult to isolate in the laboratory

  • Transmission: sexual or congenital

  • >50,000 cases per year per your textbook

  • http://www.cdc.gov/nchstp/dstd/Fact_Sheets/Syphilis_Facts.htm



Syphilis1
Syphilis

  • T. pallidum

    • rapidly destroyed by heat, cold, and drying out.

    • Sexual transmission

    • 1/3 of individuals


Syphilis staging
Syphilis - Staging

  • Primary Stage

    • Initial lesion - chancre, develops from 10 – 90 days post infection. The lesion is painless.

    • The lesions usually occur on the external genitalia, can also appear on the cervix, vagina, inside the mouth and the rectum.


Syphilis2
Syphilis

  • Secondary Stage

    • If untreated, ¼ of cases will progress to the secondary stage.

    • The is characterized by the systemic dissemination of the organism.

      • Lymphadenopathy, malaise, fever, pharyngitis, skin rash, etc.

    • Skin lesions will last up to 8 weeks, but relapses can occur up to 4 years


Syphilis3
Syphilis

  • Latent Stage

    • Patients are non-infectious

    • Patients lack clinical symptoms

    • Occurs around 1 year post-infection


Syphilis4
Syphilis

  • Tertiary Stage

    • Usually occurs 10-30 years after the secondary stage

    • Patients exhibit neurological, cardiac and cutaneous involvement

      • Large skin lesions

      • Degeneration of the spinal cord

      • Mimics meningitis

      • Destruction of elastic tissue of the Aorta


Congenital syphilis
Congenital Syphilis

  • Syphilis passes from mother to child

    • Can occur starting at 18 weeks gestation

  • 2800 cases in 1990

    • http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5027a1.htm

  • 40% mortality rate

  • Bone, neural, and cutaneous abnormalities


Immune response
Immune Response

  • Primary Defense

    • Intact skin and mucous membranes

    • What is the primary defense against STD?

  • Secondary Defense

    • T cells, macrophages, and antibody production


Testing
Testing

  • Direct detection

    • Darkfield microscopy

    • Fluorescent Antibody Testing


Testing1
Testing

  • Non-Treponemal Serological Tests

    • Rapid Plasma Reagin (RPR) and Venereal Disease Research Laboratory (VDRL) Tests

    • Tests detect the presence of “reagin”, an antibody against cardiolipin (lipid molecule).

    • Reagin antibodies

      • IgG or IgM

      • Also found in other diseases

    • RPR-Antigen Suspension containing charcoal particles


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