36 Questions
What diseases can Borrelia cause in humans?
Relapsing fever & Lyme disease
How are Borrelia transmitted to humans?
Ticks
What is the main reservoir for tick-borne (endemic) relapsing fever?
Rodents & small animals
What is the morphology of Borreliae?
Highly motile Spirochaetas with irregular loose coils
How are Borrelia visualized best?
With Giemsa stain
What is the most important species causing tick-borne (endemic) relapsing fever?
B. hermsii
What type of fever is relapsing fever?
Febrile, septicemic disease with several relapses
What is the characteristic clinical manifestation of relapsing fever?
Symptoms appear after fever lasting for 3 to 5 days, followed by afebrile period
What type of disease is B. recurrentis transmitted by the human body louse?
Epidemic relapsing fever
What type of media do Borrelia grow on?
Highly enriched media containing serum & tissue extract
What is the growth characteristic of Borrelia?
Microaerophilic, slowly growing Spirochaetes
What is the characteristic of Borrelia in culture?
Some are Gram negative
What is the characteristic clinical manifestation of the first phase of leptospirosis?
Febrile influenza-like illness due to blood invasion
What is the mode of transmission of leptospirosis?
Contact with contaminated water, small skin abrasions, and consumption of contaminated food or drink
What is the causative agent of leptospirosis?
Leptospira interrogans
What is the characteristic skin lesion in the first stage of Lyme disease?
Spreading circular red lesion with clear center (erythema migrans)
What is the most suitable method for diagnosing Lyme disease?
Serological diagnosis by ELISA confirmed by Western blot
What is the most common mode of transmission of Lyme disease to humans?
Tick bites
What is the characteristic of Leptospira interrogans in culture?
Can be grown on serum-containing media
What is the main reservoir for Leptospira interrogans?
Rodents, dogs, swine, and cattle
What is the characteristic of B. recurrentis in culture?
Can be seen by dark-field microscopy
What is the characteristic clinical manifestation of the latent stage of Lyme disease?
Arthritis, CNS, and cardiac dysfunction
What is the characteristic of B. burgdorferi in culture?
Can be grown on serum-containing media
What is the characteristic clinical manifestation of the second phase of leptospirosis?
Dysfunction of liver (jaundice), kidney (uraemia), and CNS (aseptic meningitis)
Explain the etiology and gross characteristics of puerperal sepsis.
Puerperal sepsis is caused by pyogenic bacteria such as streptococcus hemolyticus or E coli. Grossly, the uterus appears large (subinvoluted), soft with shreddy (purulent) yellowish endometrium, and the myometrium shows septic thrombi in the veins (septic thrombophlebitis) & may show multiple abscesses.
What are the possible causes of acute endometritis?
Acute endometritis may be due to bacterial infections that arise after delivery or miscarriage (puerperal sepsis) and sexually transmitted diseases such as chlamydial or gonococcal infections.
Describe the microscopic features and potential complications of septic endometritis.
Microscopically, septic endometritis shows inflammation rich in neutrophils, pus cells, and necrosis. Complications of septic endometritis include severe toxemia and septicemia, septic thrombophlebitis causing pyemia, and the spread of infection to the parametrium and tubes causing parametritis and salpingitis.
What are the routes through which bacteria reach the endometrium in puerperal sepsis?
Bacteria reach the endometrium mainly through ascending infection from contaminated instruments or gloves, or less commonly spread from other organs.
Define endometriosis and describe its sites of involvement.
Endometriosis is the presence of endometrial glands and stroma in a location outside the inner lining of the uterus. It frequently involves pelvic structures (Douglas pouch, uterine ligaments, and fallopian tubes), ovaries, peritoneal cavity, periumbilical tissue, and rarely lymph nodes, lungs, or bone.
What are the theories used to explain the pathogenesis of endometriosis?
The theories used to explain endometriosis include the regurgitation theory, the metaplastic theory (more accepted), and the lymphatic or vascular dissemination theory.
What are the gross and microscopic features used for the diagnosis of endometriosis?
Gross features include red brown foci or nodules in pelvic structures, blood-filled cysts (chocolate cysts) in the ovaries, and fibrosis and adhesions around the fallopian tubes and ovaries. Microscopic features include the presence of endometrial glands, endometrial stroma, or hemosiderin pigments.
What are the complications associated with endometriosis?
Complications include painful menstruation (dysmenorrhea) due to intrapelvic bleeding, pain on defecation or painful intercourse (dyspareunia), and adhesions around the tubes causing infertility.
Define adenomyosis and describe its gross and microscopic features.
Adenomyosis is the down growth of endometrium and its entrapment deep within the myometrium. Gross features include an enlarged uterus with thick myometrium showing trabeculations and haemorrhagic foci. Microscopic features include foci of endometrial glands and stroma with hemorrhage or may be endometrial stroma only.
What are the complications associated with adenomyosis?
Complications include menorrhagia and dysmenorrhea.
What is chronic endometritis and how is its diagnosis confirmed?
Chronic endometritis occurs in association with chronic pelvic inflammatory disease (PID) and intrauterine contraceptive devices. Its diagnosis is confirmed by the identification of plasma cells in the stroma, which are not seen in normal endometrium.
What are the causes and clinical presentation of chronic tuberculous endometritis?
Chronic tuberculous endometritis is caused by the infection of the endometrium, either from miliary spread or from drainage of tuberculous salpingitis. It may present as abnormal bleeding, pain, discharge, and most importantly, infertility.
Test your knowledge of spirochaetes with this quiz. Learn about the morphology, pathogenicity, and transmission of Borrelia, the bacteria responsible for relapsing fever and Lyme disease.
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