Spirochaetes
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Spirochaetes

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This is a series of lectures on microbiology useful for undergraduate medical and paramedical students

This is a series of lectures on microbiology useful for undergraduate medical and paramedical students

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    Spirochaetes Spirochaetes Presentation Transcript

    • SPIROCHAETES Dr. Ashish Jawarkar M.D.
    • Spirochaetes   Spiro = flexible, motile Three families    Treponema – syphilis Borrelia – relapsing fever, Lyme disease Leptospira - leptospirosis
    • Treponema pallidum     regular spirals Cannot be seen by ordinary microscopy in wet films, cannot be stain by ordinary stains Can be seen under dark ground microscopy Can be stained by silver impregnation
    • Syphilis       Acquired by sexual contact Enter through abrasions Multiply at site of lesion Primary Secondary Tertiary
    • Primary syphilis      Hard chancre – at site of entry Usually on genitalia Covered by thick pus – rich in treponemes Regional lymphnodes swollen and rubbery Heals in 2 weeks – leaving a scar – without treatment
    • chancre
    • Secondary syphilis    1-3 months after chancre Rashes in oro pharynx, condylomata at mucocutaneous junctions Spirochetes are abundant in lesions
    • Condyloma acuminata
    • Latent syphilis   Following secondary syphilis, there is a latent period During this time, diagnosis is possible only by serological tests
    • Tertiary syphilis     Months to years after primary lesion Represents delayed hypersensitivity Organisms are not present in lesions Include aneurysms, gummata, neurological manifestations
    • aneurysm
    • gumma
    • Dementia paralytica
    • Lab diagnosis      Sample – serum from chancre, gumma Collected by scraping base/margin Highly infectious – handle with care Wet films examined under dark background DFA-TP – direct fluoroscent antibody test for Treponema pallidum
    • Serological tests  Non specific     VDRL (veneral disease research laboratory) RPR (rapid plasma reagin) TPI Specific    FTA-ABS TPHA EIA
    • VDRL    We use cardiolipin antigen obtained from bovine heart Look for antibodies in serum of patient Mix serum with antigen – look for agglutination under microscope
    • RPR – rapid plasma reagin test  Antigen is attached to carbon particles – can see agglutination with naked eye
    • False positive reactions       Leprosy Malaria Relapsing fever Infectious mononucleosis Hepatitis Tropical eosinophlia
    • FTA-ABS    Fluoroscent treponemal antibody absorption test Mix patients serum with artificial treponemes The artificial treponemes are immotile under dark field microscope
    • Treatmemt    Penicillin G injection single shot is sufficient in early cases Doxycycline Ceftriaxone in neurosyphilis
    • Borrelia     Transmitted to humans through skin Bite of lice or ticks B. recurrentis – relapsing fever B. burgdorferi – Lyme disease
    • Lyme disease
    • Leptospira   Lepto – thin Delicate spirochaetes with large number of closely wound spirals and characteristic hooked ends
    • L. Interrogans - leptospirosis
    • Selective media  EMJH MEDIUM – (Ellinghausen, Mc Cullough, Johnson, Harris)
    • Leptospirosis
    • Leptospirosis    Fever Jaundice Hepato renal damage (Weil’s disease)
    • Lab diagnosis   Demonstration of leptospira in urine Serological tests like sensitized erythrocyte lysis test complement fixation agglutination indirect immunofluorosence