Spirochetes

Pantyo V., PhD

Department of microbiology, virology,
epidemiology with course of infectious
diseases
 Objectives
• General characteristic and classification of
spirochetes;
• Syphilis. Pathogenesis and laboratory
diagnosis. Non-veneral treponematoses;
• Borrelia. Relapse fever and Lyme disease;
• Leptospirosis. Epidemiology and
pathogenesis.
 Classification
• Class Spirochaetes;
• Order Spirochaetales;
• Family Spirochaetaceae; Leptospiraceae;
• Genera: Treponema, Borrelia, Leptospira.
Morphology
Structure
 Treponema pallidum
• Slender spirals measuring about 0.2 μm in
width and 5–15 μm in length
 Primary syphilis
• Hard chancre at the site of inoculation;
• Lymph nodes draining the affected region
become enlarged and firm.
 Secondary syphilis
• Signs and symptoms are more profuse and
intense;
• Peculiar red or brown rash
breaks out on all skin
surfaces.
 Tertiary syphilis
• Gummas develop in tissues such as the liver,
skin, bone, and cartilage;
 Congenital syphilis
• Interstitial keratitis, Hutchinson’s teeth,
saddlenose, periostitis, and a variety of central
nervous system anomalies.
 Laboratory diagnosis
• Non-treponemal test – VDRL;
• Treponemal test – TP-PA; TPHA; MHA-TP.
Wasserman’s reaction
 Bejel
• T. pallidum subsp. endemicum;
• chronic, inflammatory childhood disease
transmitted by direct contact.
 Yaws (frambesia)
• T. pallidum subsp. pertenue;
 Pinta
• T. pallidum subsp. carateum;
 Borrelia
• The borreliae form irregular spirals 10–30 μm
long and 0.3 μm wide. The distance between
turns varies from 2 to 4 μm.
 Relapsing fever
• Epidemic (louse-born) – B. reccurentis;
• Endemic (tick-born) – B. duttoni, B. hermsii,
B. parkeri.
Epidemiology of relapsing fever
 Lyme disease
• The disease has early manifestations with a
characteristic skin lesion, erythema migrans,
along with flulike symptoms, and late
manifestations often with arthralgia and arthritis
Epidemiology of Lyme disease
 Leptospira
• L. interrogans - tightly coiled, thin, flexible
spirochetes 5–15 μm long, with very fine
spirals 0.1–0.2 μm;
Antigenic structure
Epidemiology of leptospirosis
 Pathogenesis
• After an incubation period of 1–2 weeks, there is a
variable febrile onset during which spirochetes are
present in the bloodstream.
• They then establish themselves in the parenchymatous
organs, producing hemorrhage and necrosis of tissue
and
resulting in dysfunction
of those organs
(jaundice, hemorrhage,
nitrogen retention).
 Test 1
Bacterioscopic examination of chancre material
revealed some mobile, long, convoluted
microorganisms with 8-12 regular coils. These
features are typical for:

A. Vibrios
B. Borrellia
C. Leptospira
D. Treponema
E. Campylobacter
 Test 2
A 32-year-old patient undergoing dental examination was
found to have some rash-like lesions resembling secondary
syphilis in the oral cavity. The patient was referred for the
serological study with the purpose of diagnosis confirmation. In
order to detect antibodies in the serum, living Treponema were
used as diagnosticum. What serological test was performed?

A. Immobilization
B. Neutralization
C. Complement binding
D. Precipitation
E. Passive hemagglutination
 Test 3
During examination a sick person, hospitalized on the
5th day of illness with jaundice, muscle aches, chills,
nasal bleeding, the bacteriologist performed dark-field
microscopy of a patient's blood drop. What is the
pathogen?

A Bartonella bacilloformis
B Borrelia dutlonii
C Calymmatobacterium granulomatis
D Leptospira interrogans
E Rickettsia mooseri
 Test 4
For the serological diagnosis of syphilis in the Wasserman
reaction, the laboratory assistant prepared the following
reagents: cardiolipin antigen, alcohol extract of lipids
from the heart muscle of the bull with cholesterol,
antigens with treponem, destroyed by ultrasound,
hemolytic system, physiological solution, investigated
serum. What other component is required for the reaction?
A Complement
B Live treponemes
C Erythrocytes of a ram
D Diagnostic precipitating serum
E Antiglobulin serum
 Test 5
Deaths from acute infectious disease accompanied by fever,
jaundice, hemorrhagic rash on the skin and mucous
membranes, as well as acute renal insufficiency, with virologic
histological examination of the kidney tissue (coloring by
Romanovsky-Gimza) revealed vibe bacteria that have the form
of letters C and S What bacteria have been detected?

A Campylobacteria
B Treponemy
C Spiroll
D Borrelia
E Leptospiros