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(BQ) Part 2 book "Textbook of diagnostic microbiology" presents the following contents: Laboratory identification of significant isolates, aboratory diagnosis of infectious diseases an organ system approach to diagnostic microbiology. | CHAPTER 23 I The Spirochetes A. Christian Whelen I CHAPTER OUTLINE LEPTOSPIRES General Characteristics Virulence Factors and Pathogenicity Infections Caused by Leptospires Epidemiology Laboratory Diagnosis Antimicrobial Susceptibility BORRELIAE General Characteristics Clinically Significant Species Borrelia recurrentis and Similar Borreliae Borrelia burgdorferi TREPONEMES General Characteristics Clinically Significant Species Treponema pallidum subsp. pallidum Other Treponemal Diseases OBJECTIVES _______________________________________________________ After reading and studying this chapter you should be able to 1. Describe the general characteristics of the genera of spirochetes. 2. List the risk factors associated with Borrelia spp. endemic relapsing fever infection. 3. Describe the pathogenesis and clinical manifestations of Borrelia spp. infection including high-risk factors. 4. Compare the causative agents and arthropod vectors of relapsing fever and Lyme disease. 5. Describe the laboratory diagnosis of relapsing fever and how it differs from the diagnosis of other spirochete diseases in the United States. 6. Compare and contrast the four human pathogens of the genus Treponema. 7. Describe the primary secondary and tertiary clinical manifestations of syphilis. 8. Discuss the epidemiology of leptospirosis in the United States. 9. Evaluate the diagnostic tests used to identify Treponema pallidum in the clinical laboratory. 10. Describe the two-tiered approach to laboratory diagnosis of Lyme disease. Case in Point A 29-year-old man arrived at a local medical clinic in Los Angeles complaining of diarrhea fever chills muscle aches and headaches. He had returned 2 days earlier after competing in the Eco-Challenge in Malaysian Borneo. During the competition he had completed various events including mountain biking caving climbing jungle trekking swimming and kayaking in fresh and salt water. He was still recovering from multiple abrasions from the jungle trekking and