chapter 18

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1

Outside of the host pathogenic treponemes are extremely

susceptible to a variety of physical and chemical agents

2

pathogenic treponemes may remain viable for up to

5 days in tissue specimens removed from diseased animals and from frozen cryoprotected specimens

3

Refrigerated blood storage decreases accidental transmission of the microorganism

T pallidum

short survival period in stored blood

4

spirochetes do not appear to survive in units

of citrated blood at 4 C for more then 72 hrs

5

before clinical or serological manifestations develop patients are said to be

incubating syphillis

6

The incubation period usually lasts about

3 weeks but can range from 10 to 90 days

7

nontreponemal antibodies often called

reagin antibodies are produced by infected patients against components of their own or other mammalian cells

8

Infectious diseases in which reagin can be demonstrated include

measles

chicken pox

hepatitis

infectious mononucleosis

leprosy, tuberculosis, leptospirosis, malaria, rickettsial diseases, trypanosomiasis, lymphogranuloma venerum

9

In late syphillis treponema tests are generally

reactive

10

nontreponemal methods are

nonreative

i

11

in about 8 % of untreated patients, late syphillis involves the

CNS

12

initially CNS diseases in asymptomatic and can be detected only by

examination of cerebrospinal fluid

13

untreated congenital syphilllys can lead to

still birth, neonatal death, infant disorders

deafness

neurologic impairment

bone deformation

14

The FTA-ABS and MHA-TP can be used to confirm that a positive nontreponemal test result has been

caused by syphilis rather then other biological conditions that can produce a positive serologic result

15

We can not grow bacteria

treponema palladium that causes syphilis on artificial media

16

untreated syphilis is a

chronic diseases with subacute symptomatic periods separated by asymptomatic intervals, during which diagnosis can be made serologically

17

PRIMARY

painless chancre develops

1-5 weeks

may be some regional adenopathy

Dark field microscopy is done to see spirochetes from the lesion

antibodies rise after 1-3 weeks

18

secondary

2-8 week after chancre appears generalized illness

lymphadenopathy and lesions on skin development

resolves in 2-6 weeks

19

latent stage l

last 2-4 years

only diagnosed at this stage is serological methods

20

tertiary

3-10 years after primary infection, destructive granulomas or gummas

CNS involvement

CSF is the best specimens for evaluation of this stage of syphilis

21

congenital syphillis

transplacental transmission of the organism

22

nontroponemal antibodies

regain antibodies

are produced in infected patients against their own or other mammalian cells

23

reagin is an antibody against

cardiolipin

24

measurement of non treponema antibodies

VDRL

RPR

SCREENING TEST

FLOCCULATION TEST

25

measurement of treponema antibodies

FTA-ABS

MHT-TP

COMFIRMATORY TEST