Spirochetes
• Borrelia
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•Causative agents of lyme boreliosis
• B. burgdorferi sensu lato
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•B. burgdorferi sensu stricto, afzelii, garinii
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•Microscopy: eclipsed, soft spirales, el. microscopy
•Cultivation: Barbour-Stoenner-Kelly medium
•Antigens stimulating production of antibodies: flagelin, Osp C (stimulates early response)
•p18, 39, 100 (stimulates later response), others (Osp A, B)
•Pathogenicity: 3 stages:
•I.early localised - 3-30 days after suckling of a tick occur erythema (5 cm high), erythema
migrans – occurs other lesions on the body, headache, joints
•II. early disseminate – borrelia lymphocytoma (skin lesion), neurological + cardial expresses
•III. later – acrodermatitis chronica atrophicans (skin lesion), arthritis, carditis, polyneuritis
•Epidemiology: transport due to ticks (Ixodes ricinus)
•Diagnostic:direct: cultivation, PCR , ELM, shadow microscopy
•Indirect: ELISA screening, in case of positivity WB confirmation
•3-4 weeks after beginning of disease occurs IgM (antibodies against flagelin, Osp C)
•In 4-6 weeks occurs IgG (against antigens p18, 39, 100)
•Therapy: PNC, doxycyclin, ceftriaxon
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Drawback fevers

B. recurrentis

Pathogenicity: repeated fevers

Epidemiology: transfer – body louse

Diagnostic: direct: shadow microscopy, indirect: agglutination

Therapy: doxycyclin

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Treponemas

T. pallidum (lues, syphilis)

Microscopy: eclipsed, spirales
Cultivation: not cultivable on medias, only on rabbit

Pathogenicity: stages - early
primary – ulcus durum, ulceration on genitals, heal itself, antibodies - 4 weeks later
secondary – fever, condylomata lata, heal itself, serology +
early latent – asymptomatic, about the year after secondary lues
later - later latent period (various length)
tertiary – gummata (on skin, bones), neurosyphilis (progressive paralysis, brain atrophy),
cardiovascular syphilis (aneurysma)

Congenital: early congenital lues - hepatosplenomegaly, periostitis
latence, later congenit. stage (after 2 years length) - malformation, deafness, saddle-back nose,
barrel incissors, + often abortion

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Diagnostic: direct: shadow microscopy, PCR, rabbit, immunofluorescence, silver staining
indirect: screening - 2 reactions: RRR and TPHA, in case of positivity confirmation via FTA-ABS,
ELISA and WB (IgM + IgG), TPIT (Treponema Pallidum Immobilisation Test) - obsolent
RRR - antigen is a cardiolipin, not treponema, must be completed TPHA
Therapy and epidemiology: transport - sex. contact, prevention – screening in pregnancy, screening
of blood-donors, safe sex, PNC, macrolides, doxycyclin

Leptospira

L. icterohaemorrhagiae, grippotyphosa, sejroe

Microscopy: spirales curved on both ends

Cultivation: long, special medias

Pathogenicity: 2 forms:
icteric – bleeding, icterus, renal insufficience – Weil’s disease (L. icterohaemorrhagiae)
anicteric – field fever (L. grippotyphosa)

Epidemiology: contact with animals (pigs, horses, crowfoots, rodents
 – rats, !on fields,  channels)
Therapy: PNC, doxycyclin

Diagnostic: direct: microscopy, cultivation
indirect: MAT (microscopic agglutination test),
specialised laboratories

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