1. Spirochetes and Misc Bacteria Slackers Facts by Mike Ori

2. Disclaimer The information represents my understanding only so errors and omissions are probably rampant. It has not been vetted or reviewed by faculty. The source is our class notes. The document can mostly be used forward and backward. I tried to mark questionable stuff with (?). If you want it to look pretty, steal some crayons and go to town. Finally… If you’re a gunner, buck up and do your own work.

3. Describe the morphology and size of a spirochete

4. Spirochetes are long but very narrow spiral shaped bacterial with internal flagella that course down the side of the bacterium essentially between the inner and outer membrane,

5. Name the spirochete visualization technique

6. Usually best visualized with dark-field microscopy. Antibody staining can also be used.

7. Name three medically important spirochete species

8. Treponema Leptospira Borrelia

9. What disease is associated with treponema

10. Syphilis

11. What diseases are associated with Borrelia

12. Recurring fevers Lyme disease

13. What disease is associated with Leptospira

14. Leptospirosis

15. Name the stages of syphilis

16. Primary Secondary (Latent) Tertiary

17. Primary syphilis time frame

18. 3 week incubation

19. Primary syphilis sx

20. Chancre at site of infection

21. Secondary syphilis time frame

22. Develops 2-8 weeks after chancre formation. Lasts days to weeks.

23. Secondary syphilis sx

24. Macular papular rash over body surface including soles and palms.

25. Latent syphilis sx

26. Essentially none. Low infectivity. May revert to secondary syphilis with high infectivity.

27. Tertiary syphilis time frame

28. Typically develops in 15-20 years

29. Tertiary syphilis affected systems

30. Neurosyphilis Cardiavascular syphilis

31. Neurosyphilis sx

32. Chronic meningitis Brain degeneration Psychosis

33. Cardiavascular syphilis sx

34. Ascending and transverse aortic dilation due to endarteritis of the vasa vasorum

35. Congenital syphilis timeframe

36. Active infection after the 4 th month

37. Congenital syphilis sx

38. Macular papular rash similar to secondary syphilis in adults Bone changes (saddle nose, saber shins) Anemia, thrombocytopenia, liver failure

39. Syphilis tests

40. VDRL – non-treponemal Fluorescent treponemal antibody (FTA)

41. Describe VDRL sensitivity and specificity

42. Sensitive but not specific as a number of other situations can increase cardiolipin antibody levels that form the basis of the test. Always confirm positive results.

43. Syphilis rule of thirds

44. 1/3 secondary 1/3 latent 1/3 chronic (~3% of original?)

45. Borrelia staining

46. Stains well with Geimsa or Wright stains

47. Borrelia recurrentis and hermsii disease characteristics

48. Up to four cycles of fever that are separated by a few days and that each last about a week.

49. Borrelia relapse basis

50. Limited antigenic variation allows immune escape

51. Relapsing fever vectors

52. Ticks and lice

53. Relapsing fever severity

54. Tick borne fatality rare Louse borne fatality more common

55. General lice infection mechanism

56. Infected lice are crushed and then their introduced into a superficial wound. Lice must move between hosts.

57. Etiologic agent: Bulls eye rash, arthritis, myalgia, myocarditis, meningoencephalitis

58. Borrelia burgdorferi

59. Borrelia burgdorferi cause disease common name

60. Lyme disease

61. Lyme disease lifecycle

62. Ixodes ticks feed on small animals and deer. Humans are incidental hosts.

63. Lyme disease time course

64. Erythema migrans (bulls eye rash) within first month Secondary progression to debilitating arthritis, cardiovascular disease, and nervous system involvement that can develop immediately or that may be delayed for years.

65. Lyme disease epidemiology

66. Outdoor people in the mid-atlantic and new england states

67. Leptospirosis vector

68. Rodents, cattle, dogs urine contaminated water

69. Leptospirosis sx

70. Flu-like with meningitis

71. Etiology: Large inflamed inguinal or axillary lymph node that is very painful that occurs after a visit to the four corners area

72. Yersinia pestis

73. Describe pneumonic plaque

74. Pneumonic involvement of Y. pestis that causes necrotizing hemorrhagic pneumonia with a fatality > 90%

75. Describe the potential for person to person spread of Y. pestis

76. Pneumonic involvement is highly contagious.

77. Yersinia pestis virulence factors

78. F1 capsular antigen expressed at 37C V and W antigens are antiphagocytic Intracellular survival in macrophage Outer membrane proteins

79. Tularemia sx

80. Similar to plague

81. Brucella sx

82. Recurrent bacteremia with fever. Infects reticuloendothelial system

83. Brucellosis epidemiology

84. Occupational contact with infected animals (farmers, vets, kinky fetishers) Unpasteurized dairy products