Spirochaetes

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Spirochaetes
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Presentation Outline

• Morphology
• Organisms
• Diseases
• Leptospirosis
• Lyme disease
• Syphilis
• Tests

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Spirochete Morphology

• Gram negative cell wall
• often too small to see by light microscopy
• special stains
• Spiral morphology
• distinctive tight coils
• Motile
• Periplasmic flagella

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Spiral
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Spiral bacterium
Spirillum volutans
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Spirochete
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Axial Filament

• Between cell wall and cytoplasmic membrane
• Attached at either end of cell
• Overlap in the centre
• constrict at overlap
• pulls ends together

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SpirochetesFeatures

• Chemoorganotropic
• Range of oxygen requirements
• Life style
• Free living
• host associated

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Spirochaete Motility
Click on image
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Spirochetes genera

• Borrelia (lyme disease)
• Brachyspira
• Cristispira
• Leptonema
• Leptospira (Leptospirosis)
• Serpulina
• Spirochaeta
• Treponema (Syphilis)

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Leptospirosis
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Leptospira biflexa

• free living saprophyte in moist environments
• motile, flagella
• aerobic
• can be grown in 2 weeks

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Leptospirosis

• Leptospira interrogans
• Zoonosis of wild domestic animals
• acquired from urine of infected animals
• Dogs, rodents
• Portal of entry
• broken skin or mucosa
• Bacteremia

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L. interrogans

• Carried by wild and domestic animals
• source of human infection
• Streams, rivers, moist soil
• contaminated by animal urine
• Person to person very rare.

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Occupational exposure

• farmers, slaughter house
• workers, veterinarians.

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L. interrogans

• mild flu like febrile illness
• Weils disease
• renal and hepatic failure
• vasculitis
• meningitis
• myocarditis
• death
• Penetrate all organs including CNS
• Enter through small cuts

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Leptospirosis

• Febrile illness not clinically distinctive
• Acute phase
• Leptospiremic phase
• incubation 7 -14 days
• fever, headache, muscle pain nausea
• Immune phase
• found in urine
• meningitis

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Borrelia

• Relapsing Fevers
• Lyme Disease

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Relapsing Fever

• Borrelia recurrentis
• Tick borne Relapsing fever
• rodents are reservoir
• soft shelled ticks
• Louse borne Relapsing fever
• humans are reservoir
• body louse

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Borrelia

• Easily seen in blood smear
• Also confirmed by injecting mouse
• blood stream teaming with Borrelia

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B.recurrentis

• Tick borne relapsing fever is a zoonotic
• Clinical evolution relapsing fever
• Serological tests not useful
• treatment
• tetracycline

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Lyme Disease

• Lyme, Conneticut USA - spring/fall
• Borrelia burgdorfii
• reservoir rodents, pets, deer
• vector hard shelled ticks
• Bite incubation 3-30 days

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Lyme Disease Early Signs

• Erythema chronicum migrans
• Erythematous skin lesion
• small macule or papule - enlarges to 68 mm.
• Malaise, severe fatigue, headache, fever, chills,
  
• chronic neurologic, cardiac rheumatic
  manifestations.

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Lyme Disease Complications

• 1 month or more
• myalgia, lymphadenopathy
• Up to 2 years
• meningitis, encephalitis, peripheral nerve
  neuropathy.
• Cardiac disfunction, myopericarditis.

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Lyme Disease Serology

• Immunofluorescence assay
• Enzyme-linked immunoabsorbent assay (ELISA)
• False positives
• other spirochaetes
• infectious mononucleosis
• autoimmune disease

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Lyme DiseaseTreatment

• tetracycline or penicillin

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Syphilis
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Stages of Syphilis

• Primary
• Secondary
• Tertiary

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Primary syphilis
Chancre painless blister at the site of contact
Heals spontaneously even if untreated
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Syphilitic lesions of vulva
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Secondary Syphilis

• Lesions of secondary syphilis are dispersed over
  the body
• Lesions appear on the cooler parts of the body

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Secondary syphilis
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Syphilitic lesion on the cooler parts of the body
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Neuronal Syphilis

• Treponemes have invaded the nerve and set up a
  lesion

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Syphilic lesions on bones
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Cardio Syphilis
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Tests for Syphilis

• Break down products of infected cells
• cardiolipin
• VDRL, Wasserman
• Simple, well documented
• cross reactive eg TB
• presumtive test

• Treponemal antigens
• more expensive
• more specific
• confirmatory test

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Performance Objectives

• Key terms, concepts
• short answers

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Key Terms
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Key Terms
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Key Organisms
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Key Concepts
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Epidemiology of ???

• Disease/bacterial factors
• Transmission
• Who is at risk
• Geography/ season
• Incidence
• Modes of control

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Short Answers

• Construct a table of the virulence factors
  associated with ??? and the biological activity
  of each
• Use a series of no more than four diagrams to
  describe the mechanism of ??? activity
• Describe the clinical manifestions ???
• Construct a table listing the common ??? species
  and the associated human diseases.

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The End
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Icteric leptospirosis

• first stage 3-7 days - septicemic
• 10-30 days - immune
• Cultures positive blood, then CSF, then urine

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Icteric leptospirosis

• Jaundice, hemorrhage, renal failure, myocarditis
• Anicteric described
• Best in CSF, blood, and urine culture -- 1st
  week
• Lab test -- slide agglutination
• Doxycycline - treatment
• Prevention rodent control

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So What

• Know importance
• 1 communicable disease growing fast
• Know how it is spread
• Sexual intercourse
• skin-skin contact
• Know the symptoms
• Syphilis can be identified and cured