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
? transmission
– genital/genital
– in utero or during birth
? 0.1-0.2 x 6-15um; 8-14 small,
regular spirals; actively
motile,
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
– actively motile
organisms
– brightly lit against
dark backdrop
– light shines at an
angle
– reflected from thin
organisms
? conventional light
microscopy
– light shines through
– NOT visualized
screening method
antibodies to
cardiolipin
specific diagnosis
antibodies to
treponemal antigen
fluorescence microscopy
antibody staining
PCR
? 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
? symptoms
–flu-like
–severe systemic disease
* kidney
* brain
* eye
Leptospirosis
Morphology ? 0.1-0.2 x 6-
20um; fine
coiling,one or
both ends are
usually hooked;
deep brown
color stained
with silver
impregnation
stain (Fontana
stain),Gram-
negative,
? infected urine
–rodents
–farm animals
? water
? through broken skin,
Transmission
Epidemiology
worldwide zoonosis
animal hosts,
rats,mice,wild
rodents,dogs,swine,and
cattle
Human is accidental
Epidemiology
E
E
E
E
E
E
E
E
E
E E
E
E
E
E
湖北省
安徽省
江苏省
浙江省
福建省
江西省 湖南省
台湾省
广东省 广西壮族自治区
贵州省
河南省
山东省
天津市
海南省
北京市
河北省 山西省
陕西省
宁夏回族自治区
四川省
%
% %
%
%
%
%
%
%
%
%
%
%
%
%
% %
%
%
%
%
%
%
%
$
$
$
$
$
$
$
$
$
$
$ $
$
$ $
$
$
E
云南省
甘肃省
青海省
西藏自治区
新疆维吾尔自治区
辽宁省
吉林省
黑龙江省
内蒙古自治区
中华人民共和国地图
E $paddy planting area
Leptospirosis area
2012-3-20
Pathogenicity
Multiply in kidney and
liver,
Shed in the urine for
life long of animal,
Damage to the capillary
endothelium is the main
cause
Laboratory Diagnosis
? serology
? most readily culturable of spirochetes
– culture still extremely difficult
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
? transmission
– genital/genital
– in utero or during birth
? 0.1-0.2 x 6-15um; 8-14 small,
regular spirals; actively
motile,
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
– actively motile
organisms
– brightly lit against
dark backdrop
– light shines at an
angle
– reflected from thin
organisms
? conventional light
microscopy
– light shines through
– NOT visualized
screening method
antibodies to
cardiolipin
specific diagnosis
antibodies to
treponemal antigen
fluorescence microscopy
antibody staining
PCR
? 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
? symptoms
–flu-like
–severe systemic disease
* kidney
* brain
* eye
Leptospirosis
Morphology ? 0.1-0.2 x 6-
20um; fine
coiling,one or
both ends are
usually hooked;
deep brown
color stained
with silver
impregnation
stain (Fontana
stain),Gram-
negative,
? infected urine
–rodents
–farm animals
? water
? through broken skin,
Transmission
Epidemiology
worldwide zoonosis
animal hosts,
rats,mice,wild
rodents,dogs,swine,and
cattle
Human is accidental
Epidemiology
E
E
E
E
E
E
E
E
E
E E
E
E
E
E
湖北省
安徽省
江苏省
浙江省
福建省
江西省 湖南省
台湾省
广东省 广西壮族自治区
贵州省
河南省
山东省
天津市
海南省
北京市
河北省 山西省
陕西省
宁夏回族自治区
四川省
%
% %
%
%
%
%
%
%
%
%
%
%
%
%
% %
%
%
%
%
%
%
%
$
$
$
$
$
$
$
$
$
$
$ $
$
$ $
$
$
E
云南省
甘肃省
青海省
西藏自治区
新疆维吾尔自治区
辽宁省
吉林省
黑龙江省
内蒙古自治区
中华人民共和国地图
E $paddy planting area
Leptospirosis area
2012-3-20
Pathogenicity
Multiply in kidney and
liver,
Shed in the urine for
life long of animal,
Damage to the capillary
endothelium is the main
cause
Laboratory Diagnosis
? serology
? most readily culturable of spirochetes
– culture still extremely difficult
