SPIROCHETES
Treponema, Borrelia and
Leptospira
Spirochetes
• Gram negative
• Long, thin, helical, motile
• axial filaments
– locomotion
– between peptidoglycan layer/outer membrane
* runs parallel
Spirochete
spirochaetaceae leptospiraceae
cristispira leptonema
serpulina leptospira
spirochaeta
treponema
borrelia
Treponema
T.pallidum T.carateum
subsp.pallidum
subsp.endemicum
subsp.pertenue
Histology: Treponema pallidum
- testis infected rabbit
Treponema pallidum
0.1-0.2 x 6-15um; 8-14
small, regular spirals;
actively motile.
• transmission
– genital/genital
– in utero or during birth
syphilis
After initial infection, a primary chancre (an area of
ulceration/inflammation) is seen in genital areas or elsewhere
within 10-60 days. The organism, meantime, has penetrated and
systemically spread.
The patient has flu-like symptoms with secondary lesions
particularly affecting the skin . These occur 2-10 weeks later.
The final stage (if untreated) is tertiary syphilis (several years later).
In primary and secondary syphilis organisms are often present in
large numbers. However, as the disease progresses immunity
controls bacterial replication and fewer organisms are seen. It is
extremely difficult to detect spirochetes in tertiary syphilis. The
systemic lesions of skin, central nervous system and elsewhere
are suggestive of a delayed hypersensitivity reaction.
3w
2y
Congenital syphilis
Interstitial keratitis角膜炎
Hutchinson’s teeth
Saddlenosema马鞍鼻
Periostitis骨膜炎
A variety of central nervous system
anomalies
Microbiological diagnosis
• not culturable
• dark field microscopy screening method
– actively motile antibodies to
organisms cardiolipin
– brightly lit against specific diagnosis
dark backdrop antibodies to
– light shines at an treponemal antigen
angle fluorescence microscopy
– reflected from thin antibody staining
organisms
• conventional light PCR
microscopy
– light shines through
– NOT visualized
Autoimminty: cardiolipin/self antigen
no vaccine
antibiotics (e.g. penicillin)
– effective
Other treponemal diseases
bejel地方性梅毒
yaws 雅司
pinta品他病
Borrelia burgdorferi and Lyme disease
Lyme Disease - etiology
• reactive arthritis similar to
– Reiter's syndrome
– rheumatic fever
• resembles rheumatoid arthritis.
B . Recurrentis and Relapsing fever
• immune response develops disease
relapses
• new antigens expressed
• no immunity : disease reappears
• transmission
–tick-B. hermsii
* rodent host
– lice-B. recurrentis
* human host
Diagnosis
• serum antibodies to B. burgdorferi.
• laboratory strains
– grow extremely slowly
– tissue culture media
–patient body fluids/tissue sample
Therapy
• early antibiotic therapy
– curable
* penicillin
* tetracycline
• late antibiotic administration
– ineffective
Leptospirosis
Leptospirosis
• symptoms
–flu-like
–severe systemic disease
* kidney
* brain
* eye
0.1-0.2 x 6- Morphology
20um; fine
coiling, one or
both ends are
usually hooked;
deep brown
color stained
with silver
impregnation
stain (Fontana
stain), Gram-
negative.
Transmission
• infected urine
– rodents
– farm animals
• water
• through broken skin.
Epidemiology
worldwide zoonosis
animal hosts:
rats,mice,wild
rodents,dogs,swine,and
cattle
Human is accidental
Epidemiology
中华人民共和国地图
黑龙江省
%
吉林省
新疆维吾尔自治区 %
内蒙古自治区 %
辽宁省
甘肃省
北京市
% %
$
天津市
宁夏回族自治区
山西省 E
%%
河北省
青海省
% 山东省
西藏自治区
河南省
%
$ %E 安徽省江苏省
$ E %$
陕西省 E
$E 四川省
% E
湖北省
%E % 浙江省
$ $ E
%
% 福建省 $
江西省
湖南省
贵州省
E
% $ $ % $ E$
E E
$ 广西壮族自治区 广东省 % 台湾省
云南省
$paddy planting area % E
%$ % $
E E %E
$
Leptospirosis area %
海南省
E
$
Pathogenicity
Multiply in kidney and
liver.
Shed in the urine for
life long of animal.
Damage to the capillary
endothelium is the main
cause
2011/11/11
Laboratory Diagnosis
• serology
• most readily culturable of spirochetes
– culture still extremely difficult