Page 210 - Review of Medical Microbiology and Immunology ( PDFDrive )

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24
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Spirochetes

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CHAPTER C ONTENT S

Introduction
Treponema
Other Spirochetes
1. Treponema pallidum
Self-Assessment Questions
2. Nonvenereal Treponematoses
Summaries of Organisms
Borrelia
Practice Questions: USMLE & Course Examinations
1. Borrelia burgdorferi
2. Borrelia recurrentis & Borrelia hermsii
3. Borrelia miyamotoi
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INTRODUCTION
Spirochetes are thin-walled, flexible, spiral rods
Three genera of spirochetes cause human infection: (1)
axial filaments that lie under the outer sheath. Treponemes
Treponema, which causes syphilis and the nonvenereal
and leptospirae are so thin that they are seen only by dark
treponematoses; (2) Borrelia, which causes Lyme disease
field microscopy, silver impregnation, or immunofluores-
and relapsing fever; and (3) Leptospira, which causes lepto-
cence. Borreliae are larger, accept Giemsa and other blood
spirosis (Table 24–1).
stains, and can be seen in the standard light microscope.

TABLE 24–1 Spirochetes of Medical Importance Morphology Growth in Treatment
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Bacteriologic
Mode of
Diagnosis
Disease
Transmission
Media
Species
Intimate (sexual)
-
Thin, tight, spirals, seen by
Syphilis
Penicillin G
Treponema
Microscopy; serologic
dark field illumination,
contact; across
pallidum
tests
silver impregnation, or
the placenta
immunofluorescent
stain
Large, loosely coiled; stain
Tetracycline or
+
Lyme disease
Clinical observations;
Borrelia
Tick bite
with Giemsa stain
burgdorferi
microscopy
amoxicillin for
acute; penicillin
G for chronic
Borrelia
microscopy
with Giemsa stain
recurrentis Relapsing Louse bite Clinical observations; Large, loosely coiled; stain + Tetracycline
fever
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Penicillin G
Serologic tests
Food or drink con-
Leptospirosis
Leptospira-
+
Thin, tight spirals, seen by
interrogans
dark field illumination
taminated by
urine of infected
animals (rats,
dogs, pigs, cows)
199
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