Gumma formation in the liver, skin, bone (gummas are painful swollen syphilitic granulomas)
Neurosyphilis can involve any part of the nervous system with personality change, emotional instability, hallucinations, memory loss, speech abnormalities
Atrophy fo the optic verve leads to blindness
Cardiovascular syphilis results from damage to the small arteries and the aortic walls (death from fatal rupture of vessels and heart failure)
A ring-shaped erosive gumma on the arm in late (tertiary syphilis)
Congenital syphilis A profuse nasal discharge that obstructs breathing Hutchinson's teeth Consequences: from mild to the extremes of spontaneous miscarriage or stillbirth Signs - nasal discharge , skin eruptions and loss, bone deformation, and nervous system abnormalities. In the late form - formation of Hutchinson's teeth
The laboratory diagnosis of congenital syphilis is based in the finding that the infant has a higher titer of antibody than has the mother.
Nonspecific serologic test. These tests involve the use of nontreponemal antigens. Cardiolipin extracts from beef heart react with antibodies in serum samples from patients with syphilis (Wasserman test).
False-positive reactions occurs in infections such as leprosy, hepatitis, and infectious mononucleosis and in autoimmune disease.
Specific serologic test. These tests involve the use of treponemal antigens and therefore are more specific (indirect hemagglutination assay, immunoenzyme test, immobilization test)
Microscopy of stained by Romanowsky-Giemsa smears of peripheral blood (the most useful method and very definitive evidence of relapsing fever)
Bacteriological method (rarely)
Serologic method (rarely)
Borrelia in blood smear Romanowsky-Giemsa staining
The main reservoir – small mammalians (mice), upon which the nymphs feed. Large mammalians (deer), are an obligatory host in the tick’s life cycle but are not an important reservoir of the Borrelia. There is no human-to-human spread
Reservoirs are rodents, domestic animals (horses, dogs, cattle, pigs)
Transmission . With contaminated water and food.
The illness is typically “biphasic ”:
Early, or leptospiremic, phase , the pathogen appears in the blood and cerebrospinal fluid. Symptoms: high fever, chills, headache, muscle aches, conjunctivitis, vomiting.
Second, “immune” phase , the leptospiras disappear from the blood because of the action of phagocytes, complement, and IgM antibodies. Symptoms: milder fever, headache due to aseptic meningitis, liver damage (jaundice) and impaired kidney function, anemia, and neurological disturbances.