Yersinia pestis

• Plague atau Pes: penyakit hewan pengerat (tikus dll)

• Ditransmisikan ke manusia melalui gigitan flea (Xenopsylla cheopis)

• Infeksi serius sering terjadi, menimbulkan pandemi

• Morfologi • Facultative intracelluler parasit• Gram negatif, coccobacil, nonmotile• Facultative anaerob

• Struktur antigen, penentu patogenisitas• Memiliki LPS, aktivitas endotoxin

• Patogenesa & Infeksi klinis :• Hewan (tikus) yg terinfeksi Y.pestis digigit flea,

flea terinfeksi Y.pestis, flea menggigit manusia• Bakteri masuk aliran limfe, pembengkakan limfe,

masuk peredaran darah, ke organ lain• Inkubasi : 2-7 hari

• Klinis :• Bubonic plague:bubo inguinal, nyeri tekan,

panas• Pneumonic plague:cyanosis,dyspnea,hemoptoe• Septicemia plague:• Plague meningitis:

• Diagnosa lab.:• Pes harus dicurigai bila penderita panas,

terekspose dengan tikus di daerah endemis• Spesimen: darah, aspirasi bubo,sputum, cairan

spinal• Terapi:• Streptomycin, tetracyclin• Kontrol,pencegahan: kontrol flea, berantas tikus

Adult Rat Flea & Larva

Yersinia pestis stained with methylene blue

• BAKTERI SPIRAL

Family

TREPONEMATACEAE

Family

TREPONEMATACEAE

GenusTreponema

GenusTreponema

GenusBorrelia

GenusBorrelia

GenusLeptospira

GenusLeptospira

Family

SPIROCHAETACEAE

Order

SPIROCHAETALES

Treponema

Treponema pallidum Treponema pertenue Treponema carateum

Syphilis Yaws Pinta

• Treponema Pallidum;• Bakteri bentuk spiral, penyebab sifilis (raja

singa)• Primer menyerang manusia, mel.kontak sex• Morfologi:• Spiral silindris, gram negatif• Perbenihan : mikro aerofilik

• KLINIS:• Sifilis primer (lues I)• Lesi primer genital: laki di glands penis, urethra• Wanita:labia,perineum,vagina,servik• Ulcus durum, ciri: tidak nyeri, keras, lesi tunggal,

tepi meninggi, kemerahan• Sembuh sendiri 10-40 hari• Antibodi terdeteksi 30 hari

• Sifilis sekunder (Lues II)• 3 bln setelah lesi primer• Maculo-papular rash seluruh tubuh• Febris, sakit kepala, arthritis, kelainan ginjal• Hilang 3-12 bln, hilang timbul 4-5 thn• Tes serologi (+)

• Sifilis tersier (Lues III,late laten sifilis)• 3-10 th setelah lues II• Lesi granuloma (gumma)di :kulit, tulang, hepar• Sifilis kardiovaskular: aneurysma aorta, aorta

insufisiensi• Neurosifilis: dementia paralytica, gumma

medulla spinalis, seizure, optic atrofi

Spirochetes multiply locally at the site of entry, some spread to nearby lymph nodes and then reach the bloodstream

Primary lesion :

A papule develops at the site of infection and breaks down to form an ulcer with a clean, hard base (hard chancre)

Secondary lesion :

Red maculopapular rash anywhere in the body, condylomata lata in the anogenital region. There may also be syphilitic meningitis, chorioretinitis, hepatitis, nephritis & periostitis

Note :

Primary & secondary lesions always heal spontaneously ; they are rich treponemes and highly infectious

2 – 10 weeks

2 – 10 weeks Ulcus durum

Maculopapular rash

Tertiary lesions:

Development of : granulomatous lesion (gummas) in skin,bone,and liver; degenerative changes in CNS (tabes, paresis); cardiovascular lesions (aortitis, aortic aneurysm,aortic valve insuff)

Note :

In all tertiary lesions, treponemes are very rare.

Latent syphilis :

•No sign & symptom

•Positive serologic tests

Gumma

• Sifilis kongenital• T.palidum menembus plasenta:bakteriemia fetus

pada trimester 2 kehamilan• Klinis:abortus, bayi lahir dengan

kelainan:icterus, hepatosplenomegali, nerve deafness/tuli (n VIII), saddle nose

• Diagnosa lab:• Spesimen: serum, sekret, lesi kulit dilihat dg

darkfield mikroskop• Tes serologis:VDRL (venereal disease research

lab)• Terapi• penicillin