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syphilis ppt(microbiology)

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  1. 1. The generaTreponema belong to the “spirochetes”. Treponemes are relatively short, slender spirochetes with fine spirals and pointed ends. Treponemes cause following diseases:- Veneral syphilis – Tpallidum Endemic syphilis –Tpallidum Yaws - Tpertenue Pinta - Tcarateum
  2. 2. Treponema pallidum. Described in 1905 by Schaudinn and Hoffman, Hamburg.
  3. 3. sexual; maternal-fetal, blood transfusion and rarely by other means of both transmitting and getting infected with HIV. Morphology:  It is a thin, delicate, actively motile spirochete with tapering ends & about 10µm long & 0.1 – 0.2µm wide.
  4. 4. It can be seen on fresh primary or secondary lesions by darkfield microscopy or fluorescent antibody techniques. Have axial filaments, which are otherwise similar to bacterial flagella. Filaments enable movement of bacterium by rotating in place.
  5. 5. It can be stained by silver impregnation methods. Fontana’s method is useful fir staining films & Levaditis method for tissue sections.
  6. 6. Penetration: T. pallidum enters the body via skin and mucous membranes through abrasions during sexual contact. Also transmitted transplacentally. Dissemination: Travels via the lymphatic system to regional lymph nodes and then throughout the body via the blood stream. Invasion of the CNS can occur during any stage of syphilis.
  7. 7.  The bacteria multiply at the initial entry site forming a chancre, which is painless, avascular, ulcerated lesion and most frequently on the external genitalia, but it may occur on the cervix, perianal area, in the mouth or anal canal.
  8. 8. BY three means :-  Person to person via vaginal, anal, or oral sex through direct contact with a syphilis chancre. Person to person during foreplay, even when there is no penetrative sex (much less common). Pregnant mother with syphilis to fetus.
  9. 9. Classification: Veneral syphilis Occurs by: STDS Non-veneral Occurs extra genitally. Congenital Occurs from infected mother to foetus.
  10. 10. Congenital syphilis usually occurs following vertical transmission ofT. pallidum from the infected mother to the fetus in utero, but neonates may also be infected during passage through the infected birth canal at delivery.
  11. 11. The clinical manifestations falls into 3 stages:-
  12. 12. The primary lesion in syphilis is formation of chancre at site of entry of spirochete. The chancre covered by thick, glairy exudate rich in spirochetes. Regional lymph nodes are swollen, discrete, rubbery & non-tender. Pennile chancre
  13. 13. Chancre heals within 10 – 40 days without treatment leaving a thin scar. In highly infected persons multiple chancres are seen.
  14. 14. Patient is most infectious during this stage. It sets in 1-3 months after chancers between the patient is asymptomatic. Secondary lesion due to wide spread & multiplication of spirochetes & their dissemination through the blood. Roseolar & papular skin rashes, mucuous patches in oropharynx are characteristic lesions.
  15. 15. Symptoms includes :- – Gummata: rubbery tumors – Bone deformities – Blindness – Loss of coordination – Paralysis  After several years manifestation tertiary syphilis occurs.  Tertiary lesions contain few spirochetes & may represent delayed hypersensitivity.
  16. 16. In few cases , neurological manifestations such as general paralysis develop several decades after initial infection & known as Quaternary (or) late syphilis.
  17. 17. Treponemes demonstrated under Dark background microscopy, Direct flourescent antibody staining(DFA-TP),in tissue by Silver impregnation method & immuno flourescence staining. Serological tests: 1.VDRLTEST:  Used to detect antibodies in CSF or in sample of blood.
  18. 18. In this test antigen used is cardiolipin collected from beefs heart. Serum+1 drop of freshly prepared cardiolipin antigen observed under microscope presence of clumps indicate +ve test & uniformly distributed crystals shows –ve test.  This test useful in detecting early syphilis.
  19. 19. It is almost similar toVDRL test but finely divided carbon particles are added to cardiolipin antigen.
  20. 20.  It is newer blood test that checks antibodies towards the organism that cause syphilis. TREATMENT:  Penicillin is the only antibiotic used in treatment of syphilis.  In early cases 2.4 million units of benzathine penicillin G used , for late syphilis this repeated for 3 weeks.
  21. 21. Those patients allergic to penicillin are given:  Ceftriaxone  Doxycycline  Tetracycline These given to treat  Azithromycin early syphilis.
  22. 22. ThankYouThankYou