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Detailed information about three infectious diseases: syphilis caused by treponema pallidum, the plague caused by yersinia pestis, and lyme disease caused by borrellia burgdorferi. It covers their definitions, transmission methods, stages, and diagnostic methods. It also mentions related diseases such as rocky mountain spotted fever.
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spirochete not able to be cultured in vitro- too thin to see by Gram stain, but contains endotoxin3rd most commonly reported sexually transmitted disease in USAcoinfection with other STDs is commonSF ~ 30% of early syphilis patients are HIV+~5X greater in malespeak incidence is at later age than Chlamydia & gonorrheabi- & homosexual men ~65% of increaseMost common in blacks TERM 2
DEFINITION 2 Transmissioncommonly sexual intercourse (1/3 of exposed become infected)transplacental (congenital syphilis)direct contact via epithelial & mucosal microtraumas (infrequent) Pathogenesislocal replication - dissemination by blood & lymphaticsinfects endothelial cellsswollen lymph nodes - adenopathy TERM 3
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DEFINITION 7 may last a few months or a lifetimeno obvious symptoms, but still infected(positive serological tests, VDRL & RPR) Early latent (<1 year) infectious, secondary syphilis may reappear high risk of passage to fetus (congenital syphilis) Late latent (> 1 year) transmission rare~ 15- 50% of untreated latent cases progressto tertiary syphilis TERM 8
DEFINITION 8 may occur anytime(~5 - 50 years after primary infection)granulomatous lesions gummas may occur in practically any location skin, bone, liver, etc. heart (cardiovascular syphilis) CNS & brain (neurosyphilis & dementia) gummas in critical organs may cause death non- infectious (low number of spirochetes in lesions) TERM 9
DEFINITION 9 T. pallidum crosses placenta & infect fetus in utero75-95% chance of infecting fetusin utero - stillbirth/abortion variety of fetal abnormalitiesinfected infants may be initially asymptomatic latter develop - rhinitis (snuffles) & macular rashUntreated - developmental abnormalities of hard tissues saber shins Hutchinsons incisors & mulberry (Moons) molars TERM 10
DEFINITION 10 (1) Microscopy immediate observation of material from lesion - spirochetes w/ corkscrew motion used in presumptive diagnosis of 1syphilis in males (vaginal & oral lesions / indigenous spirochetes) may be used in males & females for diagnosis of 2 syphilisDarkfield microscopy (unstained)Fluorescent microscopy (direct immunofluorescence) stained w/ fluorescent- tagged antibody to T. pallidum
human diseases caused by microbes acquired from animals (not all veterinary diseases are zoonoses)acquired directly from the animal reservoir ortransmitted by insect vector (i.e. ticks, fleas, mosquitoes, etc)Significant causes of human diseases Many are life-threatening (ex. rabies & plague) Epidemic spread & frequently misdiagnosedThe Plague - Yersinia pestisLyme Disease - Borrellia burgdorferiRocky Mountain Spotted Fever - Rickettsia rickettsii TERM 17
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Septicemic w/ or w/o regional lymph node involvement (10-15% of cases) multi-organ involvement & septic shock Bubonic involvement of regional lymph nodes (80-85% of cases) inflammation & hemorrhagic / characteristic black buboesPneumonic (~100% fatality) involvement of the lungs & development of pneumonia (2-5% of cases) transmitted person-to- person by respiratory route (fleas not needed TERM 22
DEFINITION 22 Treatment streptomycin &/or tetracycline may be used prophylactically in close contacts Prevention vaccine (?) - inactivated whole bacteria - marginally effective high-risk individuals veterinarians park rangers militarysurveillance of rural rodent populations for plague urban rodent & flea control measures public education TERM 23
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doxycycline or amoxicillin for stage 1penicillin or ceftriaxone for late stagesvaccine(s) human vaccine licensed in 1999, but removed from market in 2002 (low demand?)vaccine available for dogs (used off-label for horses) management of deer populations avoid tick-infested areas (May-July, nymphs)wear light colored clothestuck in shirts, pants, etc.inspect yourself for ticks & remove promptly if found TERM 32
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DEFINITION 34 Pathogenesis 2 - 14 days following tick bite sudden onset of persistent fever, headache, & fatigue few days latter - rash 1st on extremities (palms, soles, arms) & then on body trunkif untreated severe complications may occur CNS damage - delirium & coma septic shock(~30% death rate)overall death rate ~2-5% of infected individuals TERM 35
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