Spirochetes

• What are the two families contained in the introduction of the lecture on spirochetes?

  Leptospiraceae and Spirochaetaceae
• Which genera are included in the families Leptospiraceae and Spirochaetaceae?


  Leptospira, Borrelia, and Treponema
• What important human diseases are caused by the genera Leptospira, Borrelia, and Treponema?


  Syphilis, Leptospirosis, Lyme disease, and Relapsing fever
• What is the size of Leptospira organisms?


  About 0.1 μm wide and 5-15 μm long
• What is the causative agent of Leptospirosis?

  Leptospira interrogans
• What is the habitat of Leptospira interrogans?


  Wild and domestic animals
• How is Leptospira transmitted to humans?


  Via animal urine, commonly from rats
• What are the virulence factors of Leptospira interrogans?


  Reduced phagocytosis, soluble hemolysin, and small amounts of endotoxins
• What symptoms are associated with the acute leptospiremic phase?


  Fever, chills, intense headache, and calf tenderness
• What is Weil Syndrome?


  The most severe form of Leptospirosis characterized by jaundice, bleeding, and uremia
• What is the gold standard for detecting Leptospira?


  Leptospire microscopic agglutination test (lepto MAT)
• What is the treatment for Leptospirosis?


  Doxycycline, Ampicillin, and Amoxicillin
• What is the preferred culture medium for Leptospira?


  Fletcher medium
• What are the key symptoms of Lyme disease?


  Bull's eye rash, fever, and muscle pain
• What is the incubation period for Borrelia burgdorferi?


  1. 15 days
• What are the stages of Lyme disease?


  Stage 1: erythema chronicum migrans; Stage 2: myocarditis and meningitis; Stage 3: autoimmune migratory polyarthritis
• What is the largest medically important bacteria?

  Borrelia burgdorferi
• How is Borrelia burgdorferi detected?


  By observing Giemsa- or Wright-stained smears of blood
• What is the treatment for Lyme disease?


  Doxycycline and Amoxicillin
• What is the size of Treponema pallidum?


  About 0.1-0.2 µm thick and 6-20 µm long
• Why is Treponema pallidum difficult to visualize?


  It is very thin and requires dark field microscopy
• What are the key points to remember about Leptospirosis?


  • Caused by Leptospira interrogans
  • Symptoms: fever, chills, calf pain, jaundice, uremia
  • Diagnostics: lepto MAT and culture
  • Treatment: doxycycline, ampicillin, amoxicillin
  • Severe form: Weil syndrome (triad: jaundice, bleeding, uremia)
• What are the key points to remember about Lyme disease?

  • Caused by Borrelia burgdorferi
  • Symptoms: bull's eye rash, fever, muscle pain
  • Stages: erythema chronicum migrans, myocarditis, autoimmune migratory polyarthritis
  • Diagnostics: Giemsa or Wright stain, culture on BSK medium
  • Treatment: doxycycline and amoxicillin
• What are the key points to remember about Treponema pallidum?


  • Pathogenic treponemes are very thin and spiral
  • Difficult to visualize under bright field microscopy
  • Requires dark field microscopy for visualization
• What are the common detection methods for spirochetes?


  • Darkfield microscopy
  • Culture on specific media (e.g., EMJH, BSK)
  • Serologic tests (e.g., lepto MAT, immunofluorescence)
• What is the mnemonic for Lyme disease symptoms?


  BAKE: Bell’s palsy, arthritis, cardiac block, erythema chronicum migrans
• How is borreliosis diagnosed?


  By observing Giemsa- or Wright-stained smears of blood during the febrile period
• What medium is used for the isolation and identification of Borrelia?


  Kelly (BSK) medium
• What serologic tests can be done for the detection of Borrelia?


  Immunofluorescence antibody and enzyme immunoassay (EIA)
• What specimens other than blood can be used for antigen testing in Borrelia detection?


  Urine and cerebrospinal fluid (CSF)
• What are the key characteristics of Borrelia?


  • Bull’s eye rash
  • Largest bacteria
  • Diagnostics: Staining and culture on BSK medium
  • Diseases: Lyme disease
  • Treatment: Doxycycline and amoxicillin
• What is the size range of Treponema pallidum?


  0.1-0.2 µm thick and 6-20 µm in length
• Why is Treponema pallidum difficult to visualize under bright field microscopy?


  Because it is very thin
• What microscopy technique is used to visualize Treponema pallidum?

  Dark field microscopy
• How many spirals per organism can be seen in Treponema pallidum under dark field microscopy?


  1. 14 spirals
• Why is Treponema pallidum not seen on Gram-stain?


  Because it is too thin
• Can Treponema pallidum be cultured in vitro?


  No, it cannot be cultured in vitro
• What type of oxygen requirement does Treponema pallidum have?


  Microaerophilic
• What are the four pathogenic strains of Treponema that affect humans?


  1. T. pallidum subsp. pallidum - Syphilis
  2. T. pallidum subsp. pertenue - Yaws
  3. T. pallidum subsp. endemicum - Endemic syphilis
  4. Treponema carateum - Pinta
• What is the causative agent for syphilis?

  Treponema pallidum subsp. pallidum