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This Concept Map, created with IHMC CmapTools, has information related to: Bacteriology 9 Spirochetes intro, infected louse infected tick vector of Borrelia recurrentis, Leptospira interrogans causes Leptospirosis (if kidney's involved, Weill's disease), Leptospirosis (if kidney's involved, Weill's disease) diseases caused mild influenza-like febrile illness severe systemic infxn fever, jaundice, renal/hep failr vasculitis, myocarditis, meningitis, rash, death, Lyme borreliosis (Lyme disease) Tx Early disease – amoxicillin, doxycycline, or cefuroxime. Chronic state – intensive treatment Lyme arthritis/complications – ceftriaxone, doxycycline or amoxicillin. Neurological /musculoskeltal disease –prolonged treatment with IV pen G or ceftriaxone., borreliosis Relapsing fever Dx drk-field microscopy during fevers pt Hx of travel in endemic areas relapsing fever is feature, Lyme borreliosis (Lyme disease) Dx CDC criteria for Dx: ECM lesion (~5cm diam) or at least 1 late manifestation. plus lab confirmtn: isolatn of B. burgdorferi (difficult, long) threshld level of IgG,IgM to spirochetes incr in Ab serum titer between acute, convalescent periods serologic tests ELISA for IgM agnst org as screen. Western blot to confirm (gold std) sensitivity depends on stage of disease if ECM only, 50% pos. later->higher PCR amp is most promising patient Hx, Lyme borreliosis (Lyme disease) symptoms multi-sys inflm disorder erythema chronicum migrans (ECM) erythema migrans (EM) resolving bullseye lesion in 70% accompnyng symps (lasts ~4wks) fever, headache, myalgias, arthralgias, fatigue, malaise, arthritis, lymphadenopathy hematogenous dissemination stage marked by above plus: cardiac dysfunction myoperidcarditis, congestive heart failure nephritis neurological signs facial palsy, meningitis, encephalitis some pts continue complcatns yrs after due to deposit of Ag-Ab complexes arthritis (50%) neurological, musculoskeletal multi-system inflamm disorder, borreliosis Relapsing fever epi epidemics in history endemic in parts of world relapsng fvr: low mortality, Leptospirosis (if kidney's involved, Weill's disease) symptoms chills, rapid fever & headache, nausea, muscle pain, jaundice (10%), hemorrhage acute phase 3-10d then afebrile period., Lyme borreliosis (Lyme disease) epidemiology systemic, world-wide disease 1st found in arthritic kids in Lyme, CT most freq Dx'd tick disease in US incrsng in freq and geogrphy it's everywhere, Leptospirosis (if kidney's involved, Weill's disease) Tx IV pen or doxycycline need tetracycline for renal infx, Family: Spirochaetaceae Genus: Borrelia species Borrelia burgdorferi, infected tick Genus Ixodes vector of Borrelia burgdorferi, Leptospira interrogans char has hooks at ends motile, obligate aerobes cultivates in Fletcher's or Stuart's medium 19 serogroups, 200 serotypes, borreliosis Relapsing fever symptoms in addition to descrbd, macular rash -head/shldrs jaundice, CNS-related fatality, Order: Spirochaetales fam Family: Leptospiraceae Genus: Leptospira, Borrelia recurrentis causes borreliosis Relapsing fever, Order: Spirochaetales char Order: grouped based on morphology thin, helical, Gm neg Genus: weak staining, except w/ aniline dyes corkscrew motility w/ 7-20 flagella microaerophilic. some culturable., Leptospirosis (if kidney's involved, Weill's disease) Dx initial Dx only correct 25% of time. mortality in 5-10%. ------------------------ blood, CSF cultures only in day 7-10 of disease after 10d, use urine culture for 10wks (so not usu used) darkfield microscopy micrs agglutination test, ɮwk of infx, Lyme borreliosis (Lyme disease) symptoms Primary stage – Skin lesions (ECM) and flu-like symptoms Secondary stage – arthritis, cardiac ab- normailities, neuritis, chronic menin- gitis Tertiary stage – dementia, nerve fiber demyelination, joint destruction of long bones.