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- 3. Order: Spirochaetales Family: Spirochaetaceae Genus: Treponema Borrelia Family: Leptospiraceae Genus: Leptospira Taxonomy
- 4. General Overview of Spirochaetales Gram-negative spirochetes Spirochete from Greek for “coiled hair” Extremely thin and can
- 5. Periplasmic Flagella Diagram
- 6. Tightly Coiled Spirochete
- 7. Cross-Section of Spirochete with Periplasmic Flagella NOTE: a.k.a., endoflagella, axial fibrils or axial filaments. (Outer sheath)
- 8. Spirochaetales Associated Human Diseases
- 10. Treponema spp.
- 11. Nonvenereal Treponemal Diseases Bejel, Yaws & Pinta Primitive tropical and subtropical regions Primarily in impoverished children
- 12. Treponema pallidum ssp. endemicum Bejel (a.k.a. endemic syphilis) Initial lesions: nondescript oral lesions Secondary lesions: oral
- 13. Treponema pallidum ssp. pertenue (May also see T. pertenue) Papillomatous Lesions of Yaws: painless nodules widely
- 14. Treponema carateum Pinta: primarily restricted to skin 1-3 week incubation period Initial lesions: small pruritic papules
- 16. Treponema pallidum ssp. pallidum
- 17. Venereal Treponemal Disease Syphilis Primarily sexually transmitted disease (STD) May be transmitted congenitally
- 18. Darkfield Microscopy of Treponema pallidum
- 19. Too thin to be seen with light microscopy in specimens stained with Gram stain or Giemsa
- 20. Epidemiology of T. pallidum Transmitted from direct sexual contact or from mother to fetus Not highly
- 21. Incidence of Syphilis in USA
- 22. Geographical Distribution of Syphilis in USA
- 23. Pathogenesis of T. pallidum Tissue destruction and lesions are primarily a consequence of patient’s immune response
- 24. Virulence Factors of T. pallidum Outer membrane proteins promote adherence Hyaluronidase may facilitate perivascular infiltration Antiphagocytic
- 25. Primary disease process involves invasion of mucus membranes, rapid multiplication & wide dissemination through perivascular lymphatics
- 26. Secondary disease 2-10 weeks after primary lesion Widely disseminated mucocutaneous rash Secondary lesions of the skin
- 27. Generalized Mucocutaneous Rash of Secondary Syphilis
- 28. Following secondary disease, host enters latent period First 4 years = early latent Subsequent period =
- 29. Tertiary syphilis characterized by localized granulomatous dermal lesions (gummas) in which few organisms are present Granulomas
- 30. Diagram of a Granuloma (a.k.a. gumma in skin or soft tissue) NOTE: ultimately a fibrin layer
- 31. Progression of Untreated Syphilis Tertiary Stage Late benign ?Gummas in skin and soft tissues
- 32. Congenital syphilis results from transplacental infection T. pallidum septicemia in the developing fetus and widespread dissemination
- 33. Comparison of Incidence of 1o & 2o Syphilis in Women and Congenital Syphilis
- 34. Prevention & Treatment of Syphilis Penicillin remains drug of choice WHO monitors treatment recommendations 7-10 days
- 35. Diagnostic Tests for Syphilis NOTE: Treponemal antigen tests indicate experience with a treponemal infection, but cross-react
- 36. Sensitivity & Specificity of Serologic Tests for Syphillis
- 37. Review Handout on Sensitivity & Specificity of Diagnostic Tests
- 38. Conditions Associated with False Positive Serological Tests for Syphillis
- 39. Effect of Treatment for Syphillis on Rapid Plasma Reagin Test Reactivity
- 41. Borrelia spp.
- 42. Giemsa Stain of Borrelia recurrentis in Blood Light Microscopy Phase Contrast Microscopy
- 43. Epidemiology of Borrelia Infections Borrelia recurrentis Borrelia spp. Borrelia burgdorferi Ixodes spp. Ornithodoros spp. Pediculus humanus
- 44. Borrelia recurrentis & other Borrelia spp.
- 45. Associated with poverty, crowding, and warfare Arthropod vectors Louse-borne borreliosis = Epidemic Relapsing Fever Transmitted person-to-person
- 46. Pathogenesis of Relapsing Fever Relapsing fever (a.k.a., tick fever, borreliosis, famine fever) Acute infection with 2-14
- 47. Clinical Progression of Relapsing Fever
- 48. Borrelia burgdorferi
- 49. Pathogenesis of Lyme Borreliosis Lyme disease characterized by three stages: Initially a unique skin lesion (erythema
- 50. Erythema chronicum migrans of Lyme Borreliosis Bullseye rash
- 51. Diagnosis of Lyme Borreliosis
- 52. Bacteria and Syndromes that Cause Cross-Reactions with Lyme Borreliosis Serological Tests
- 53. Lyme disease was recognized as a syndrome in 1975 with outbreak in Lyme, Connecticut Transmitted by
- 54. Incidence of Lyme Borreliosis in USA
- 56. Leptospira interrogans
- 57. Silver Stain of Leptospira interrogans serotype icterohaemorrhagiae Obligate aerobes Characteristic hooked ends (like a question mark,
- 58. Leptospirosis Clinical Syndromes Mild virus-like syndrome (Anicteric leptospirosis) Systemic with aseptic meningitis (Icteric leptospirosis) Overwhelming disease
- 59. Leptospirosis, also called Weil’s disease in humans Direct invasion and replication in tissues Characterized by an
- 60. Clinical Progression of Icteric (Weil’s Disease) and Anicteric Leptospirosis (pigmented part of eye)
- 61. Epidemiology of Leptospirosis Mainly a zoonotic disease Transmitted to humans from a variety of wild and
- 62. Comparison of Diagnostic Tests for Leptospirosis
- 64. REVIEW of Spirochaetales
- 65. General Overview of Spirochaetales Gram-negative spirochetes Spirochete from Greek for “coiled hair” Extremely thin and can
- 66. Periplasmic Flagella Diagram REVIEW
- 67. Spirochaetales Associated Human Diseases REVIEW
- 68. Review of Treponema
- 69. Summary of Treponema Infections REVIEW
- 70. Summary of Treponema Infections (cont.) REVIEW
- 71. Nonvenereal Treponemal Diseases Bejel, Yaws & Pinta Primitive tropical and subtropical regions Primarily in impoverished children
- 72. Review of Treponema pallidum ssp. pallidum
- 73. Too thin to be seen with light microscopy in specimens stained with Gram stain or Giemsa
- 74. Epidemiology of T. pallidum Transmitted from direct sexual contact or from mother to fetus Not highly
- 75. Pathogenesis of T. pallidum Tissue destruction and lesions are primarily a consequence of patient’s immune response
- 76. Virulence Factors of T. pallidum Outer membrane proteins promote adherence Hyaluronidase may facilitate perivascular infiltration Antiphagocytic
- 77. Primary disease process involves invasion of mucus membranes, rapid multiplication & wide dissemination through perivascular lymphatics
- 78. Secondary disease 2-10 weeks after primary lesion Widely disseminated mucocutaneous rash Secondary lesions of the skin
- 79. Following secondary disease, host enters latent period First 4 years = early latent Subsequent period =
- 80. Tertiary syphilis characterized by localized granulomatous dermal lesions (gummas) in which few organisms are present Granulomas
- 81. Diagram of a Granuloma (a.k.a. gumma in skin or soft tissue) NOTE: ultimately a fibrin layer
- 82. Progression of Untreated Syphilis Tertiary Stage Late benign ?Gummas in skin and soft tissues REVIEW
- 83. Progression of Untreated Syphilis REVIEW
- 84. Congenital syphilis results from transplacental infection T. pallidum septicemia in the developing fetus and widespread dissemination
- 85. Prevention & Treatment of Syphilis Penicillin remains drug of choice WHO monitors treatment recommendations 7-10 days
- 86. Diagnostic Tests for Syphilis NOTE: Treponemal antigen tests indicate experience with a treponemal infection, but cross-react
- 87. Review Handout on Sensitivity & Specificity of Diagnostic Tests
- 88. Analytic Performance of a Diagnostic Test REVIEW
- 89. Sensitivity = Measure of True Positive Rate (TPR) = No. of True Pos. = No. of
- 90. Review of Borrelia
- 91. Summary of Borellia Infections REVIEW
- 92. Summary of Borellia Infections (cont.) REVIEW
- 93. Epidemiology of Borrelia Infections Borrelia recurrentis Borrelia spp. Borrelia burgdorferi Ixodes spp. Ornithodoros spp. Pediculus humanus
- 94. Review of Borrelia recurrentis & other Borrelia spp.
- 95. Associated with poverty, crowding, and warfare Arthropod vectors Louse-borne borreliosis = Epidemic Relapsing Fever Transmitted person-to-person
- 96. Pathogenesis of Relapsing Fever Relapsing fever (a.k.a., tick fever, borreliosis, famine fever) Acute infection with 2-14
- 97. Review of Borrelia burgdorferi
- 98. Pathogenesis of Lyme Borreliosis Lyme disease characterized by three stages: Initially a unique skin lesion (erythema
- 99. Diagnosis of Lyme Borreliosis REVIEW
- 100. Lyme disease was recognized as a syndrome in 1975 with outbreak in Lyme, Connecticut Transmitted by
- 101. Review of Leptospira
- 102. Summary of Leptospira Infections REVIEW
- 103. Summary of Leptospira Infections (cont.) REVIEW
- 104. Leptospirosis Clinical Syndromes Mild virus-like syndrome (Anicteric leptospirosis) Systemic with aseptic meningitis (Icteric leptospirosis) Overwhelming disease
- 105. Leptospirosis, also called Weil’s disease in humans Direct invasion and replication in tissues Characterized by an
- 106. Epidemiology of Leptospirosis Mainly a zoonotic disease Transmitted to humans from a variety of wild and
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