All About Spirochetes | CHAPTER 2 | Microbiology & Parasitology for Nurses

All About Spirochetes – Basic microbiology, parasitology, and immunology; nature, reproduction, growth, and transmission of common microorganisms and parasites in Bangladesh; prevention including universal precaution and immunization, control, sterilization, and disinfection; and specimen collections and examination. Students will have an understanding of common organisms and parasites caused human diseases and acquire knowledge about the prevention and control of those organisms.

All About Spirochetes

Spirochete, (order Spirochaetales), also spelled spirochaete, any of a group of spiral- shaped bacteria, some of which are serious pathogens for humans, causing diseases such as syphilis, yaws, Lyme disease, and relapsing fever. Examples of genera of spirochetes include Spirochaeta, Treponema, Borrelia, and Leptospira.

or

Spirochetes (spirochaetes) are Gram-negative, spiral-shaped bacteria of the phylum Spirochaetes. In nature, they may exist as free-living bacteria, symbionts, or as parasites capable of causing diseases in animals. As such, they are widely distributed in nature, exhibiting varying characteristics in shape and size etc.

Classification of Spirochetes

Diseases Caused by Various Genus of Spirochetes

Syphilis

Definition of syphilis:

Syphilis is a multi-systemic infectious disease caused by the Treponema pallidum

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Syphilis is a highly contagious disease spread primarily by sexual activity, including oral and anal sex. Occasionally, the disease can be passed to another person through prolonged kissing or close bodily contact.

Classification of Syphilis:

A. Acquired syphilis

• Early stage: Primary and secondary syphilis
• Late stage: Latent syphilis, tertiary and quarternary syphilis.

B. Congenital syphilis: Early and late.

Diagnosis of Syphilis:

a) History: H/O exposure usually 14 – 28 days back.
b) Clinical features:

1. Primary lesion (chancre)

• Develops at the site of infection usually on the genitalia. It is nearly always painless. It possesses a characteristic indurate base. A small pink macule appears which becomes popular and ulcerate.
• Regional lymph nodes: Moderately enlarged, Mobile, discrete, rubbery, painless and non-tender.

1. In secondary syphilis:

• Starts 6 – 8 weeks after the chancre with mild fever, malaria and headache,
• Maculopapular rash Symmetrical and non-itchy. Palms and soils are affected- mucosal ulceration of genitalias, Mouth, pharynx, larynx. Early lesions are superficial but later become white bare and red margin of coalesce to from snail track ulcer.
• Lymphadenopathy: May be generalized and nodes are moderately enlarged, Mobile, Discrete, rubber, painless and non-tender.

c) Investigations:

1. Microscopic examination: Tissue fluid expressed from chancre and then

• Dark ground illumination test.
• Immunofluorescent test

1. Serological test:

✓ Nonspecific or lipoidal antigen tests:

• VDRL (Venereal disease research laboratory) Test.
• RPR (Rapid plasma regain) test.

✓ Specific treponemal antigen tests:

• TPHA (Treponema pallidum haemagglutination assay) test.
• ELISA (Treponemal enzyme linked immunosorbent assay) test
• FTA abs (Fluorescent treponemal antibody absorption) test.
• CSF examination and chest X-ray In the latent stage for detection of neurological and cardiovascular disease.

Treatment of Syphilis:

1) Early syphilis (primary, Secondary and early latent, [ not more than 2 years duration])

• Procain Benzylpenicillin – G: 6 lac IU, intramuscular route for 10 days. Or
• Benzathine penicillin – G: 2.4 million IU, intramuscular route once a week for two doses.

✓ Penicillin allergy and non-pregnant patient:

• Doxycycline hyclate, 100 mg orally 12 hourly 14 days. Or
• Tetracycline, 500 mg orally, 4 time daily for 14 days,

✓ Penicillin allergy and pregnant patient:

• Erythromycin, 500 mg orally, 6 hourly for 14 days.

2) Latent syphilis (More than two years duration)

• Procain Benzylpenicillin – G: 6 lac IU, intramuscular route for 17 days. Or
• Benzathine penicillin – G: 2.4 million IU, intramuscular route once a week for three doses.

✓ Penicillin allergy and non pregnant patients

• Doxycycline hyclate, 200 mg orally 12 hourly 28days. Or
• Tetracycline, 500 mg orally, 4 time daily for 30 days

✓ Penicillin allergy and pregnant patient:

• Erythromycin, 500 mg orally, 6 hourly for 30 days.

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