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23 Cards in this Set
- Front
- Back
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Syphilis: Epidemiology
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All ages
Transmitted through sexual activity, from mother to child, or transfusion Primary and secondary disease state are most infectious |
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Syphilis: Microbiology
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Gram stain: too small to see
Capsule: none Atmosphere: aerobic Motility: motile Hemolysis: N/A Colony morphology: N/A Other: will only grow in rabbits |
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Syphilis: Pathogenesis
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Enters body through mucous membrane or break in skin
Enters lymphatics or blood stream and disseminates throughout body in first few weeks (seronegative period) Less than 10 organisms may produce infection |
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Syphilis: Primary clinical manifestation
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Chancre forms at site of organism entry after 3 - 90 days (depending upon inoculum)
Painless, indurated Heals after 3-6 weeks In HIV positive patients – may be multiple simultaneous chancres which commonly persist into secondary phase |
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Syphilis: Secondary clinical manifestations
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2-8 weeks after chancre, 25% relapse
90% rash +/- generalized lymphadenopathy 70% fever, weight loss 35% oral mucosa (mucous patches, erosions) 25% genital lesions (chancre, mucous patches, condyloma lata) 8-33% abnormal CSF, 2% HA or aseptic meningitis rare - glomerulonephritis, hepatitis, arthritis, periostitis Papulosquamous skin lesions Alopecia HIV patients - rash |
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Syphilis: Tertiatery clinical manifestations
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>10 yrs
Gummas (15%): mass of granulomatous tissues, no pain Cardiovascular (10%): aortic aneurysms Neurosyphilis (8%): patients with AIDS may develop within 1 year, general paresis (dementia), tabes dorsalis (dorsal column problems), optic atrophy (blind) |
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Syphilis: Congenital clinical manifestation
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Retinitis
Anterior uveitis Mulberry molar Saber shins Palatal defect Osteochondritis Snuffles Hepatosplenomegaly |
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Syphilis: Diagnosis
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Dark field microscopy, immunofluorescent staining
Serology -VDRL (Veneral Disease Research Laboratory): 70% stage 1, 99% stage 2, <1% stage 3 -RPR (Rapid plasma-reagin card test): 80% stage 1, 99% stage 2, 0% stage 3 -FTA-ABS (Fluorescent treponemal antigen absorption test): 85% stage 1, 100% stage 2, 98% stage 3 -MHATT (microhemagglutination treponemal test): 65% stage 1, 100% stage 2, 95% stage 3 Note: Late HIV infection can cause false negative serology |
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Syphilis: Treatment
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Primary, secondary, early latent(<1yr): benzathine, doxycycline, azithromycin; no change if patient is HIV positive
Late latent, tertiary: benzathine CNS/HIV: Rocephin IV, penicillin G IV |
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Syphilis: Prevention
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Condom use
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Lyme Borreliosis (Borrelia burgdorferi): Epidemiology
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Any age
Tick exposure Geographic concentration |
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Lyme Borreliosis (Borrelia burgdorferi): Microbiology
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Gram stain: too small
Capsule: none Atmosphere: aerobic Motility: motile Hemolysis: N/A Colony morphology: N/A Other: will only grow in rabbits |
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Lyme Borreliosis (Borrelia burgdorferi): Pathogenesis
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Phagocyte avoidance: no mechanism identified
Toxic byproducts: unknown |
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Lyme Borreliosis (Borrelia burgdorferi): Clinical manifestations
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Stage 1: 3-32 days, erythema chronicum migrans, malaise, headache, fever, regional adenopathy
Stage 2: weeks to months, musculoskeletal complaints, neurologic or cardiac abnormalities Stage 3: months to years, chronic skin, nervous system, or joint involvement |
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Lyme Borreliosis (Borrelia burgdorferi): Diagnosis, treatment, and prevention
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Diagnosis: serology
Treatment: early - penicillin or tetracycline, late - ceftriaxone Prevention: minimize tick exposure, no vaccine (attempted vaccine caused cross reactive autoimmune arthritis) |
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Leptospirosis (Leptospira interrogans): Epidemiology
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Any age
Exposure to rat, dog, or swine urine More cases in rainy season |
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Leptospirosis (Leptospira interrogans): Microbiology
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Gram stain: too small
Capsule: none Atmosphere: aerobic, require CO2 Motility: motile Hemolysis: N/A Colony morphology: N/A Other: grow in liquid medias |
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Leptospirosis (Leptospira interrogans): Pathogenesis
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Phagocyte avoidance: no mechanism identified
Toxic byproduct: unknown |
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Leptospirosis (Leptospira interrogans): Clinical manifestations
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Mild (90%): week 1, conjunctivitis, sever myalgias, flu-like illness (meningitis, uveitis, rash, fever)
Severe (10%): second week, mild symptoms plus jaundice, hemorrhage, renal failure, myocarditis |
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Leptospirosis (Leptospira interrogans): Diagnosis, treatment, prevention
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Diagnosis: culture of urine, serology
Treatment: penicillin G Prevention: Vaccination of dogs, swine; rat control |
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Borreliosis (Borrelia recurrentis)
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Epidemiology: Endemic and epidemic varieties, S. and Central America louse or tick transmission
Pathogenesis: Relapses due to continous antigenic variation Clinical: Relapsing fever Treatment: Penicillin G |
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Yaws - T. pertenue
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Epidemiology: Nonvenereal, tropical
Clinical: Three stages of skin lesions, not visceral Treatment: Benzathine penicillin |
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Pinta - T. carateum
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Epidemiology: nonvenereal, central and S. America
Clinical: skin disease Treatment: penicillin |
