Spirochaetes

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

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Spirochaetes

  1. 1. SPIROCHAETES Dr. Ashish Jawarkar M.D.
  2. 2. Spirochaetes   Spiro = flexible, motile Three families    Treponema – syphilis Borrelia – relapsing fever, Lyme disease Leptospira - leptospirosis
  3. 3. 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
  4. 4. Syphilis       Acquired by sexual contact Enter through abrasions Multiply at site of lesion Primary Secondary Tertiary
  5. 5. 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
  6. 6. chancre
  7. 7. Secondary syphilis    1-3 months after chancre Rashes in oro pharynx, condylomata at mucocutaneous junctions Spirochetes are abundant in lesions
  8. 8. Condyloma acuminata
  9. 9. Latent syphilis   Following secondary syphilis, there is a latent period During this time, diagnosis is possible only by serological tests
  10. 10. Tertiary syphilis     Months to years after primary lesion Represents delayed hypersensitivity Organisms are not present in lesions Include aneurysms, gummata, neurological manifestations
  11. 11. aneurysm
  12. 12. gumma
  13. 13. Dementia paralytica
  14. 14. 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
  15. 15. Serological tests  Non specific     VDRL (veneral disease research laboratory) RPR (rapid plasma reagin) TPI Specific    FTA-ABS TPHA EIA
  16. 16. 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
  17. 17. RPR – rapid plasma reagin test  Antigen is attached to carbon particles – can see agglutination with naked eye
  18. 18. False positive reactions       Leprosy Malaria Relapsing fever Infectious mononucleosis Hepatitis Tropical eosinophlia
  19. 19. FTA-ABS    Fluoroscent treponemal antibody absorption test Mix patients serum with artificial treponemes The artificial treponemes are immotile under dark field microscope
  20. 20. Treatmemt    Penicillin G injection single shot is sufficient in early cases Doxycycline Ceftriaxone in neurosyphilis
  21. 21. Borrelia     Transmitted to humans through skin Bite of lice or ticks B. recurrentis – relapsing fever B. burgdorferi – Lyme disease
  22. 22. Lyme disease
  23. 23. Leptospira   Lepto – thin Delicate spirochaetes with large number of closely wound spirals and characteristic hooked ends
  24. 24. L. Interrogans - leptospirosis
  25. 25. Selective media  EMJH MEDIUM – (Ellinghausen, Mc Cullough, Johnson, Harris)
  26. 26. Leptospirosis
  27. 27. Leptospirosis    Fever Jaundice Hepato renal damage (Weil’s disease)
  28. 28. Lab diagnosis   Demonstration of leptospira in urine Serological tests like sensitized erythrocyte lysis test complement fixation agglutination indirect immunofluorosence

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