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Chapter 24 Lecture 4 (Bacterial STDs (Syphilis (Signs and symptoms…

- - - - Four phases of syphilis
      - Primary syphilis (a)- a typical sign would be a small painless, reddened , hard lesion (chancre) forms at site of infection 10-21 days p exposure
        
        The center of the chancre fills with serum that is extremely infectious (presence of millions of spirochetes)
      - Chancre can occur on mouth, anus, fingers, lips or nipples
      - Secondary syphilis (b)- pt will suffer sore throat, HA, mild fever. Malaise, myalgia and widespread rash
      - Latent syphilis- no symptoms my last decade
      - Tertiary syphilis-(c) Years later, untreated pts dementia, blindness, paralysis, heart failure, or syphilitic gummas (rubbery, swollen lesions in bones, nervous tissue, or on the skin)
    - - Treponema pallidum causes syphilis
        
        Lives only in humans
      - Virulence factors have been difficult to identify but believe virulent strains make hyaluronidase, which makes it easy for them to infiltrate intercellular spaces.
    - - Transmitted mostly via sexual contact
      - Sometimes transmitted from mother to child (congenital) can result in death of a fetus or mental retardation and malformation of many organs
      - Most individuals do not develop tertiary syphilis
    - - Syphilis occurs worldwide
      - Estimated 12 million new victim each year
      - Endemic among sex workers, men who have sex with men, and users of illegal drugs- It does occur in US
      - Goal of CDC to achieve an incidence of < than .2 cases per 100,000 population in q country by 2010– not met
      - Cannot be spread by fomites
    - - Antibody test is used to diagnose primary, secondary, and congenital syphilis such as MHA-TP that uses RBCs that have been artificially coated with Treponema antigens.
      - Tertiary syphilis is difficult to diagnose
      - Penicillin G is used to treat all but tertiary syphilis
      - Prevented with safe sex practices NO vaccine
  - - - Signs and symptoms
        
        s/s similar to gonorrhea- can mimic
        
        Women are usually asymptomatic 85%
        
        Men have painful urination and pus discharge from penis
        
        Causes numerous diseases
        
        Epididymitis: inflammation of the epididymis
        
        PID in females
        
        Orchitis: inflammation of the testes
        
        Trachoma: disease of the eye this for babies who are infected at birth
        
        Lymphogranuloma venereum: formation of a genital lesion and bubo in the groin (painfully inflamed lymph node in groin) can rupture causing drainage and sores)
      - Pathogens and virulence factors
        
        Caused by Chlamydia trachomatis
        
        All strains but one are pathogens of humans
        
        Grow only within vesicles inside host cells
        
        Developmental cycle
        
        Elementary bodies are the infective form
        
        Reticulate bodies are the noninfective,, obligately intracellular form
      - Pathogenesis
        
        Microbes enter body through scrapes or cuts
        
        Infect conjunctiva or cells lining mucous membranes, lungs
        
        Spread to the lymphatic system, causing proctitis
        
        Adolescent infection increases cervical cancer risk
      - Epidemiology
        
        Most common reportable STD in the United States
        
        Eye infections endemic in poor, crowded areas
      - Diagnosis, treatment, and prevention
        
        Detection of chlamydial DNA by PCR is diagnostic
        
        Treated with antimicrobial drugs
        
        Prevented by abstinence or mutual monogamy