1. Miscellaneous Bacterial Agents of Disease 2013274022 최재황 자료조사 발표 2013274025 염주희 자료조사 ppt 2013274001 한지웅 자료조사 ppt 2013274031 김소연 자료조사 quiz 2013274021 박완식 자료조사 quiz

2. contents Chapter1 Chapter2 The spirochetes Chapter3Leptospira and Leptospirosis Treponemes : Members of the genus Treponema Chapter4Borrelia : Arthropod-Borne Spirochetes

3. Chapter1 : The Spirochetes Gram Negative human pathogens Helical form Motility Periplasmic space Free living saprobes Commensals of animals, not primary pathogens -Treponema -Leptospira -Borrelia

5. Chapter 2 Treponemes : Members of the genus Treponema

6. Treponemes Members of the Genus Treponema Thin, Regular, Coiled cells Live in the oral cavity, intestinal tract, and perigenital regions of human and animals. Strict parasites with complex growth requirements

7. Treponematoses Diseases are called treponematoses. T. pallidum pallidum : Veneral and congenital syphilis T. pallidum endemicum : Nonvenereal endemic syphilis, bejel T. pallidum pertenue : Yaws T. carateum : Pinta

8. Treponema pallidum: The spirochete of Syphilis fastidious and sensitive bacterium Cannot survive for long outside the host Weak in heat, drying, disinfectants, soap, high oxygen tension, and pH changes. Survives a few minutes when protected by body secretions and stored blood. Major contributors are gay and bisexual men.

9. Pathogenesis and Host Response T. pallidum binds by tip to the epithelium. multiplies and penetrates the capillaries non-toxic. not kill cells directly. invade around arteries and stimulate an inflammatory response. Organs are damaged when granulomas form and block circulation.

11. Clinical Manifestations Distinct clinical stages as primary, secondary, and tertiary syphilis. Exhibit multiple signs and symptoms latent periods, the disease is quiescent. appears in the lesions and blood largely noncommunicable during the tertiary stage

13. Primary Syphilis appearance of a hard chancre. Begins as a small, red, hard bump that enlarges and breaks down. Most chancre appear on the internal and external genitalia but 20% occur on the lips, nipples, fingers or anus. leaving a shallow crater with firm margins.

15. Primary Syphilis Painless Escape notice Lymph nodes become enlarged and firm. No Systemic symptoms The chancre heals spontaneously

16. Secondary Syphilis About 3 weeks to 6 months Fever, headache, and sore throat occur. A peculiar red or brown rash that breaks out on all skin surfaces. occurring in the bones, hair follicles, joints, liver, eyes, and brain, can linger for months and years.

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18. Tertiary Syphilis About 30% can last for 20 years or longer. Cardiovascular syphilis damage to the small arteries. Insufficiency and heart failure. Painful swollen syphilitic tumors called gummas. (lead to death) Neurosyphilis affinity for the blood vessels in the brain, cranial nerves, and dorsal roots of the spinal cord.

19. Congenital Syphilis T. pallidum can pass from a pregnant women Occur in any of the three trimesters (most common in the second and third.) inhibits fetal growth and development. signs as nasal discharge, skin eruptions and loss, bone deformation, and nervous system abnormalities.

22. Clinical and Laboratory Diagnosis Dark-field microscopy A single negative test Microscopic test Patient samples can be tested with a DNA probe specific

24. Testing Blood for Syphilis RPR VDRL Kolmer Typical of these specific tests is the T.pallidum microhemagglutination assay (MHA-TP).

25. effective way to screen the population for people The most common screening tests (RPR and VDRL) false-positive result.

26. FTA-ABS (Fluorescent Treponemal ANtibody Absorbance) test. T. pallidum immobilization (TPI) test. Highly sensitive and specific and can rule out false-positive results. A Western blot test.

27. Treatment and Prevention Penicilin G Benzathine or procaine (maintain a blood level lethal.) tetracycline and erythromycin. No signs of infection. (immediate prophylactic penicillin in a single, long-acting dose.)

28. Nonsyphilitic Treponematoses rarely transmitted sexually or congenitally. Bejel, Yaws, and pinta cause these infections are nearly indistinguishable. slow and progressive and involve primary, secondary, and tertiary stages. Drug therapy

29. Bejel endemic syphilis and nonveneraeal childhood syphilis the subspecies T.pallidum endemicum chronic and inflammatory childhood disease. begins as small, moist patches in the oral cavity.

30. Yaws endemic to warm, humid, tropical regions of Africa, Asia, and South America. subspecies T.pallidum pertenue mother yaw can be prevented by improved hygiene

32. Pinta Skin infection caused by T.P.carateum. poor hygiene and inadequate health facilities. begins in the skin with a dry, scalypapule reminiscent of psoriases or leprosy. not life-threatening, but creates scars.

33. Chapter3 Leptospira and Leptospirosis

34. Leptospira and Leptospirosis tight, regular, individual coils with a bend or hook at one or both bends cause leptospirosis harmless L.biflexa L. interrogans

35. Epidemiology and Transmission of Leptospirosis zoonosis Leptospires shed in the urine of an infected animal. occurs almost entirely through contact of skin abrasions or mucous membranes.

36. Pathology of Leptospirosis and Host Response proceeds in two phases targets are the kidneys, liver, brain, and eyes. appears in the blood and cerebrospinal fluid high fever, chills, headache, muscle aches, conjunctivitis, and vomiting. Weil's syndrome

37. Diagnosis, Treatment, and Prevention support initial diagnosis of leptospirosis the macroscopic slide agglutination test L. interrogans penicillin or tetracyline Strain-specific vaccines Vaccination wear protective footwear and clothing and to avoid swimming or wading in livestock watering ponds

38. Chapter4 Borrelia : Arthropod-Bone rSpirochetes

39. Borrelia : Arthropod-Borne Spirochetes Morphologically distinct from other spirochetes. Human infection with Borrelia, termed borreliosis. Irregularly space and loose coil Abundance periplasmic flagella Grown artificially on formulated media.

40. Borrelia : Arthropod-Borne Spirochetes Induce relapsing fever Induce lyme disease : Borrelia burgdorferi : like neuromuscular rheumatoid : erythemamygrans

41. Epidemiology of relapsing fever Tick-borne relapsing fever (TBRF) : - in campers, backpackers - Borrelia hermsii - by soft tick Louse-borne relapsing fever (LBRF) : - famine, war, natural disaster, poor hygiene - Borrelia recurrentis

42. Epidemiology of relapsing fever Symptoms - high fever, headache, fatigue, nausea, vomiting, muscle aches → disappear - if not treated → cycle may continue, damage to the liver, spleen, heart, kidneys, cranial nerves - Half of the patients hemorrhage into organs - some develop a rash on shoulder and leg

45. Diagnosis, treatment, prevention Presence of Borrelia in blood smears Chloramphenicol, erythromycin, and doxycycline Vaccines are not available Louse-borne relapsing fever : improved hydrogen

46. Quiz

47. 1.Which of the follwing is correct about Spirochaeta ? a.Helical form b.Non-motility c.Gram posive d. aerophilic

48. 2. Which of the treponematoses is /are not(an) STD(s)? a. yaws b. pinta c. syphilis d. both a and b

49. 3. Which of the follwing is correct about Treponema? a.Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum b. Treponema pallidum can be grown on artificial laboratory media. c.VDRL test may give a false-negative result during total stages of syphilis. d.Treponema live in only Aerobic condition.

50. 4. Which of the following is incorrect about leptospria? a. Leptospria interrogans is harmless. b. Mainly in the tropics. c. Leptospira has bend or hook at one or both ends. d. Leptospria is not transmitted from person to person.

51. 5. Which is not proper explanation of Borrelia? a. Ticks are vector. b. Borrelia has 30~40 of periplasmic flagella. c. Borrelia causes relapsing fever and lyme disease. d. Borrelia is larger than other spirochetes comparatively. e. Borrelia has only four serotypes.

52. 6. Choose the correct answer. a. There is no latent period in spirochete infection b. Spirochete can make heart problem. c. Dark-field microscope is not helpful to diagnosis. d. lyme disease is caused by Borrelia burgdorferi.

53. reference Foundations in Microbiology/ Talaro, chess 외 / 제 8 판 / p627~636 병원 미생물학 / 김관천, 김충환 외 / 정문각 / 2013 년 2 월 / p221~229 Medical Microbiology( 병원 미생물학 )/ 권대 준, 김수정 외 / 고려의학 / 제 2 판 /p439~446

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