Treponema pallidum: Overview
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Bacteria - Gram Negative
- Neisseria spp: Overview
- Neisseria gonorrhoeae
- Neisseria meningitidis
- Haemophilus influenzae
- Bordetella pertussis
- Brucella
- Legionella pneumophila
- Pseudomonas aeruginosa: Overview
- Pseudomonas aeruginosa: Disease
- Salmonella Overview
- Salmonella typhi
- Salmonella enteritidis
- Shigella
- Yersinia enterocolitica
- Escherichia coli: Overview
- Enterohemorrhagic E. Coli (EHEC)
- Enterotoxigenic E. Coli (ETEC)
- Klebsiella pneumoniae
- Campylobacter jejuni
- Vibrio spp.
- Helicobacter pylori
- Borrelia burgdorferi (Lyme Disease)
- Leptospira interrogans
- Treponema pallidum: Overview
- Treponema pallidum: Diagnosis
- Congenital syphilis
- Chlamydia: Overview
- Chlamydia trachomatis
- Chlamydia pneumoniae vs. psittaci
- Rickettsia rickettsii
- Rickettsia typhi vs. prowazekii
- Anaplasma vs. Ehrlichia
- Coxiella burnetii (Q fever)
Treponema pallidum overview
- Characteristics
- Spirochete
- Technically gram negative
- Too thin to be visualized on light microscopy
- Motile
- Transmission
- Sexually transmitted
- Frequent in MSM, HIV positive patients
- Most commonly intimate contact with infectious lesion
- Blood transfusion
- Transplacentally from mother to fetus
- Common in developing countries
- Sexually transmitted
- Disease (syphilis)
- Primary syphilis
- Painless chancre (ulcer on genitals)
- Localized disease, occurs within 5 weeks from contact
- Painless ulcer with raised, red borders
- Heals within weeks without treatment
- Painless chancre (ulcer on genitals)
- Secondary syphilis
- Disseminated disease presenting 5-10 weeks after chancre resolution
- condyloma lata
- smooth, painless, wart-like white/grey lesions on genitals
- maculopapular rash including palms and soles
- Note: Palm and soles rash is also seen in Coxsackievirus and Rocky Mountain spotted fever
- constitutional symptoms, lymphadenopathy, patchy hair loss also seen
- Latent syphilis (+ serology without symptoms) may follow
- Tertiary syphilis
- Occurs many years after untreated infection
- Gummas (chronic granulomas)
- Painless, indurated granulomatous lesion that may ulcerate
- Found in skin, bones, liver, heart (new murmur)
- Aortitis/aortic aneurysm
- Involvement and obliteration of vasa vasorum
- blood vessels supplying thoracic aorta (not present in abdominal aorta)
- Resulting inflammation and ischemia weakens the aortic wall, causing aneurysm
- Involvement and obliteration of vasa vasorum
- Neurosyphilis
- Can technically occur at any stage of syphilis, but more common in late-stage disease
- Tabes Dorsalis
- Occurs decades after initial infection with untreated syphilis
- Posterior column of spinal cord impaired
- Loss of proprioception and vibratory sense
- Hyporeflexia
- Stabbing nerve pain
- Sensory ataxia
- Broad-based gait
- Inability to maintain balance with eyes closed (+ Romberg sign)
- Charcot joint (joint damage due to neurodegeneration)
- Loss of bladder function (neurogenic incontinence)
- Argyll Robertson pupils
- Constrict normally in accommodation (light-near-dissociation)
- Fail to constrict in response to light (non-reactive)
- Thought to result from damage to tectum of midbrain
- Meningoencephalitis
- Presents with headaches, dementia, or stroke
- General paresis
- Presents with progressive dementia and diffuse paralysis
- Primary syphilis
- Treatment
- Penicillin G
- IM penicillin for primary or secondary syphilis and early latent syphilis
- IV penicillin G for late latent syphilis
- Doxycycline as alternative for treating early and late latent syphilis
- Treatment can cause Jarisch-Herxheimer reaction
- Flu-like syndrome (fever, chills, headache, myalgia) after antibiotics are started
- due to killed bacteria releasing gram-negative endotoxin
- Flu-like syndrome (fever, chills, headache, myalgia) after antibiotics are started
- Penicillin G