Spirochaetes

Suzan Matar (PhD Medical Microbiology and Immunology)

Department of Clinical Laboratory Sciences
 The spirochetes are a large,
heterogeneous group of spiral, motile
bacteria.

Borrelia, Treponema and Leptospira.

 Morphology

Have axial filaments, which are

otherwise similar to bacterial flagella
TREPONEMA PALLIDUM AND
SYPHILIS
 STAGES OF SYPHILIS

Lesions of primary and secondary syphilis

- Transmission is by direct contact with

lesions, body secretions, blood, semen
and saliva, usually during sexual contact,
and from mother to foetus by placental
transfer.
CLINICAL MANIFESTATION IN SUMMARY
Primary Syphilis - Chancre
Fluid From Chancre
Spirochetes in Blood
 Secondary Syphilis
Occurs 6-8 weeks after initial chancre,
becomes systemic, patient highly infectious.
Characterized by localized or diffuse
mucocutaneous lesions, often with
generalized lymphadenopathy.
Primary chancre may still be present.
Secondary lesions subside in about 2-6
weeks.
Serology tests nearly 100% positive.
 Secondary Syphilis

Mucocutaneous lesions, often with

generalized lymphadenopathy.
 Latent Syphilis

Asymptomatic
This stage may last for years.
It is rarely communicable sexually but
can be passed from mother to fetus.
 Tertiary Syphilis
Divided into three manifestations:
Gummatous syphilis
Cardiovascular syphilis
Neurosyphilis
Tertiary Syphilis
Tertiary Syphilis - Gumma
 Congenital Syphilis
Transmitted from mother to fetus.
Fetus affected during second or third
trimester.
Forty percent result in syphilitic
stillbirth-fetal death that occurs after
a 20 week gestation and the mother
had untreated or inadequately
treated syphilis at delivery.
 Congenital Syphilis
Bone deformities
Blindness
Deafness
Deformed faces
Dental deformities
Skin rashes
Neonatal death , Death from congenital
syphilis is usually through pulmonary
hemorrhage
 TESTS FOR SYPHILIS
Dark field Microscopy
VDRL, RPR
FTA-ABS, MHA-TP
Direct Fluorescent Antibody (DFA)
Antibiotic sensitivity and control

- Penicillin is the drug of choice; for allergic

patients, tetracycline is an alternative.
- Prevention of syphilis is based on early
detection, contact tracing and serological
testing of pregnant women.
 Borrelia
- B. burgdorferi Lyme disease
- B. Recurrentis Relapsing fever ( MILD)

Large, motile spirochete

Carried by Ixodes ticks

- Identification is by serology and

immunofluorescence or enzyme-linked
immunosorbent assay (ELISA).
Borrelia in blood smear
Lyme disease

Causative
agents:
Borrelia
burgdorferi

Erythema
Pathogenicity

- The agent of Lyme

disease, a generalized
infection with neurological
and cardiac manifestations
and arthritis.

- One of the earliest and

most common neurological
manifestations is unilateral
facial palsy.
Antibiotic sensitivity

Sensitive to tetracycline and

amoxicillin.
 Leptospira
These organisms are found in damp environments such as
stagnant water and wet soil.

The kidneys of some rodents and domestic animals act as a

reservoir for L. interrogans.

The urine of these animals serves as a vehicle of

transmission of human leptospirosis, the symptoms of
which vary from mild febrile illness to fatal attacks of
jaundice and renal failure.

Swimming in contaminated water or consuming

contaminated food or drink can result in human infection.
 Diagnosis is based on rise in IgM-antibody
titers. Occasionally, leptospiras are
isolated from blood and urine cultures.
Leptospira morphology
Clinical findings of
leptospirosis
 Species Disease Mode of Diagnosis Morphology Growth
Transmission Media

T. pallidum Syphilis Intimate Microscopy; Thin, tight, spirals, seen by

(sexual) serologic darkfield illumination, silver
contact; tests impregnation, or
across the immunofluorescent stain
placenta

B. Lyme Tick bite Clinical Large, loosely coiled; stain +

burgdorferi disease observation with Giemsa stain
s;
microscopy

B. Relapsin Louse bite Clinical Large, loosely coiled; +

recurrentis g fever observation stain with Giemsa stain
s;
microscopy

L. Leptospir Food or drink Serologic Thin, tight spirals, seen +

interrogans osis contaminated tests by darkfield illumination
by urine of
infected
animals (rats,
dogs, pigs,
cows)