SyphilisSymptoms of Lyme Disease Primary Skin Rash (1/3 never develop) Flu-like symptoms Migratory joint pains Intermediate and Late Stages Confused with: Multiple Sclerosis Brain Tumor Stroke Mental Depression Alcoholism Personality Changes Alzheimers Disease Memory Loss ConcentrationFamily Rickettsiaceae Important Genera • Rickettsia • Coxiella--more closely related to Legionella; distant to Rickettsia • Erhlica Structure and Properties • Gram negative rod; 03-0.5 µ m • Require some cofactors from host; can synthesize some ATP • Intracellular parasite--can't be grown on artificial media Disease--organism grows in veins and capillaries--damage membranes; fevers often with a rash Examples: Fevers Rocky Mountain Spotted Fever--most important in North America Mediterranean Spotted Fever Typhus--associated with war, poverty, unsanitary conditionsTrench Fever--from prominence in the trenches in WWI. Bartonella quintana, vector is body louse. --showing up among homeless chills, headache, relapsing fever, rash Systemic--Q fever; Coxiella; sporelike; cause pneumonia; endocarditis; hepatitis; transmitted through milk. Prevented by pasteurization.Chlamydiae Properties • Obligate Intracellular Parasite • Among smallest bacteria • Unabale to synthesize amino acids • No detectable murein • Unique developmental cycle EB--infective; dormant RB--10-100X larger; noninfectious; replicates Diseases 1. Chlamydia psittaci Infections--psittacosis contracted through inhalation of respiratory secretions or dust form drops of infected birds, especially parrots. 1. Acute infection of lower respiratory tract. Occasionally become systemic--->myocarditis; encephalitis; hepatitis 2. Chlamydia trachomatis • Eye Infections-- Inclusion concunctivitis, acute infection; no permanent damage Trachoma--a chronic conjunctivitis; afflicts several hundred million worldwide. Has blinded millions particularly in Africa; control by improved sanitation and hygiene • Genital Infections--venereal disease caused by C. trachomatis is the number one STD. Clinical spectrum like gonorrhea. 1. Chlamydia pneumoniae--cause walking pneumonia; endocarditis; coronary artery diseaseChlamydiae and Heart Disease (Background) Indirect Evidence Chlamydiae pneumoniae first came under suspicion as a cause of heart attacks in 1988 when doctors in Helinski reported that people with coronary artery disease were more likely than healthy control subjects to have antibodies to the organism in their blood. A second study showed unusually high antibody levels in the heart attack victims. Most experts dismssed the studies as a statistical oddity. Later, Dr. Thomas Grayston, an epidemiologist at UW, repeated and confirmed the studies. Direct evidence 1993, South African Reseacher found C pneumoniae in tissue during autopsies. These findings were confirmed by the Seattle researchers and other laboratories. Few experts paid attention until 1995 when a team at University of Louisville recovered the live organism from blood vessels of a patient undergoing heart transplant. Animal studies that infection of healthy animals with C. pneumoniae can lead to Coronary artery disease. Today, no one familiar with the literature denies that C. pneumoniae is associated with vascular disease whatever age, sex or