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Spirochetes&Niesseria

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Spirochetes&Niesseria

Spirochetes&Niesseria


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  • 1. SPIROCHETES AND NEISSERIA Faculty: Dr. Alvin Fox www.freelivedoctor.com
  • 2.
    • Spirochete
    • Axial filament
    • Treponema pallidum
    • Syphilis
    • Chancre
    • Primary lesion
    • Darkfield microscopy
    • Secondary Lesion
    • Tertiary Lesion
    • Anti-cardiolipin antibodies
    • Borrelia burgdorferi
    • Lyme disease
    • Relapsing fever (other borrelia)
    • Leptospira (leptospirosis)
    • Neisseria
    • Thayer Martin agar
    • Oxidase test
    • N. gonorrhoeae
    • Gonorrhea
    • N. meningitidis
    • Meningitis
    Key Words www.freelivedoctor.com
  • 3. SPIROCHETES Treponema, Borrelia and Leptospira www.freelivedoctor.com
  • 4. Spirochetes
    • Gram negative
    • long, thin, helical, motile
    • axial filaments
      • locomotion
      • between peptidoglycan layer/outer membrane
        • runs parallel
    www.freelivedoctor.com
  • 5. Histology: Treponema pallidum - testis infected rabbit www.freelivedoctor.com
  • 6. Treponema pallidum
    • transmission
      • genital/genital
      • in utero or during birth
    www.freelivedoctor.com
  • 7. Syphilis
    • chronic
    • slowly progressive
    www.freelivedoctor.com
  • 8.
    • primary lesion - chancre
      • 10 to 60 days
      • area of ulceration/inflammation
      • many organisms
    www.freelivedoctor.com
  • 9.
    • Secondary (2-10 weeks later)
      • systemic spread
      • flu-like symptoms
      • skin, particularly
      • many organisms
    mouth muosa www.freelivedoctor.com
  • 10.
    • Tertiary
      • several years later
      • rare
      • skin,
      • central nervous system
      • delayed hypersensitivity
      • few organisms
        • control by immune response
    www.freelivedoctor.com
  • 11. Microbiological diagnosis
    • not culturable
    • dark field microscopy
      • actively motile organisms
      • brightly lit against dark backdrop
      • light shines at an angle
      • reflected from thin organisms
      • enters objective
    • conventional light microsrcopy
      • light shines through
      • NOT visualized
    www.freelivedoctor.com
  • 12.
    • fluorescence microscopy
      • antibody staining
    www.freelivedoctor.com
  • 13. Secondary and Tertiary Syphilis - serology
    • screening method
    • antibodies to cardiolipin
    • specific diagnosis
    • antibodies to treponemal antigen
    www.freelivedoctor.com
  • 14. Autoimminty
    • cardiolipin
      • self antigen
    www.freelivedoctor.com
  • 15.
    • no vaccine
    • antibiotics (e.g. penicillin)
      • effective
    www.freelivedoctor.com
  • 16. Other treponemal diseases
    • bejel, yaws and pinta
      • extremely rare in US
    www.freelivedoctor.com
  • 17. Borrelia burgdorferi and Lyme disease www.freelivedoctor.com
  • 18. Ixodes scapularis , tick vector for Lyme disease. Also known as Ixodes dammini . CDC www.freelivedoctor.com
  • 19. Lyme Disease erythematous rash www.freelivedoctor.com
  • 20.
    • A tick bite leads to transmission of B. burgdorferi
    www.freelivedoctor.com
  • 21.
    • Lyme disease - symptoms
    • bacteremia
      • acute
    • arthritis
    • cardiac
    • neurologic
      • chronic
        • weeks, months later
    www.freelivedoctor.com
  • 22. Therapy
    • early antibiotic therapy
      • curable
      • penicillin
      • tetracycline
    • late antibiotic administration
      • ineffective
    www.freelivedoctor.com
  • 23. Diagnosis
    • serum antibodies to B. burgdorferi .
    • laboratory strains
      • grow extremely slowly
      • tissue culture media
      • not bacteriological media
    • patient body fluids/tissue sample
      • almost never growth
    www.freelivedoctor.com
  • 24.
    • acute
      • responds to antibiotic
      • antibodies not detectable
    • late diagnosis
      • not curable
      • antibodies detectable
    A physicians dilemma www.freelivedoctor.com
  • 25. Lyme Disease - etiology
    • reactive arthritis similar to
      • Reiter's syndrome
      • rheumatic fever
    • resembles rheumatoid arthritis.
    www.freelivedoctor.com
  • 26. Relapsing fever
    • <100/ per year in US
    • transmission
      • tick- B. hermsii
      • rodent, primary host
      • lice- B. recurrentis
      • human, primary host
    www.freelivedoctor.com
  • 27.
    • “ Relapsing” fever
    • immune response develops
      • disease relapses
    • new antigens expressed
      • no immunity
      • disease reappears
    www.freelivedoctor.com
  • 28. Diagnosis
    • no culture
    • no serological test
    • detected - blood smear
    www.freelivedoctor.com
  • 29. Leptospirosis www.freelivedoctor.com
  • 30.
    • <100 cases per year in US
    • symptoms
      • flu-like
      • severe systemic disease
        • kidney
        • brain
        • eye
    Leptospirosis www.freelivedoctor.com
  • 31.
    • infected urine
          • rodents
          • farm animals
    • water
    • through broken skin.
    Transmission www.freelivedoctor.com
  • 32. Laboratory Diagnosis
    • serology
    • most readily culturable of spirochetes
        • culture still extremely difficult
    www.freelivedoctor.com
  • 33. NEISSERIA Neisseria gonorrhoeae www.freelivedoctor.com
  • 34. www.freelivedoctor.com
  • 35.
    • Gram negative
    • diplococci (pairs of cocci)
    • oxidase positive
    • culture
    • Thayer Martin.
      • selective
      • chocolate agar
          • heated blood (brown)
    • Neisseria
    www.freelivedoctor.com
  • 36.
    • found only in man
    • gonorrhea
    • second most common venereal disease
    N. gonorrhoeae the “Gonococcus&quot; www.freelivedoctor.com
  • 37. www.freelivedoctor.com
  • 38. Smear
    • polymorphonuclear cell
    • Gram negative cocci
        • many in cells
    www.freelivedoctor.com
  • 39.
    • gonoccocal arthritis
      • “ septic” arthritis
    • dermatitis
    Dissemination -gonococci www.freelivedoctor.com
  • 40.
    •  lactamase-resistant cephalosporin
      • e.g. ceftriaxone
    • resistant strains
      • common
      • produce  lactamases
      • destroy penicillin
    Antibiotic therapy www.freelivedoctor.com
  • 41.
    • adhesion to genital epithelium
      • outer membrane
      • pili
          • Antigenicity
          • highly variable among strains
    • no vaccine
    • IgA protease
      • also N. meningitidis
    Pathogensis www.freelivedoctor.com
  • 42.
    • Tissue injury
      • lipopolysaccharide
      • peptidoglycan
    N. gonorrhoeae www.freelivedoctor.com
  • 43. N. meningitidis (the “Meningococcus&quot;) www.freelivedoctor.com
  • 44.
    • resides in man only
    • usually sporadic cases
      • mostly young children
    • outbreaks
      • adults
      • crowded conditions
          • e.g. army barracks
    N. meningitidis www.freelivedoctor.com
  • 45.
    • upper respiratory tract infection
      • adhesion pili
    • bloodstream
    brain Neisseria meningitidis www.freelivedoctor.com
  • 46.
    • second most common meningitis
      • pneumococcus, most common
    • fatal if untreated
    • responds well to antibiotic therapy
      • penicillin
    Meningococcal meninigitis www.freelivedoctor.com
  • 47.
    • Laboratory Diagnosis
    • spinal fluid
      • Gram negative diplococci
    • within polymorphonuclear cells
      • meningococcal antigens
    • Culture
      • Thayer Martin agar
    www.freelivedoctor.com
  • 48.
    • capsule
      • inhibit phagocytosis
    • anti-capsular antibodies
      • stop infection
    • antigenic variation
      • sero-groups
    • vaccine
      • multiple sero-groups
    Capsule www.freelivedoctor.com