Author: Brian Holtry

Pneumonia, pericarditis, myocarditis, and endocarditis have been attributed to C psittaci infection (psittacosis or ornithosis) (Box 5). The incubation period for the pneumonia is usually 1-2 weeks. Its onset is gradual with body temperature increasing over a period of 5-7 days; however, there are cases in which the onset is sudden with rigors and temperatures as high as 104 °F.

C trachomatis is associated with urethritis, proctitis, conjunctivitis, and arthritis in women and men; epididymitis in men; and mucopurulent cervicitis (MPC), acute salpingitis, bartholinitis, and the Fitz-Hugh and Curtis syndrome in women (Box 1). C trachomatis and Neisseria gonorrhoeae (see site) coinfections are common in women with MPC and men with urethritis. In men, C trachomatis is the most common etiologic agent of the nongonococcal (NGU) and postgonococcal urethritis (PGU) syndromes.

Mycoplasma and Ureaplasma species (mycoplasmas) are ubiquitous in nature and are commonly found in plants, animals, and humans. These bacteria contain the smallest amount of double-stranded DNA that is capable of producing a free-living microorganism; they measure between 0.15 and 0.3 um in diameter and = 2 um in length.

Infected humans are the only source of M pneumoniae organisms for transmission to new susceptible hosts. M pneumoniae is spread from one individual to another by respiratory droplets produced by coughing. Individuals at any age can be infected and develop disease, but those between the ages of 5 and 20 years are most often affected. M pneumoniae is a leading cause of pneumonia in school-aged children and young adults — especially those in military and college populations.

The syndrome of relapsing fever consists of two clinical entities: epidemic relapsing fever caused by Borrelia recurrentis (LBRF) and transmitted by the human body louse and endemic relapsing fever caused by Borrelia spp. (TBRF) and transmitted by arthropods (Table 1). A. Epidemiology. 1. Louse-borne epidemic relapsing fever (LBRF).

Lyme disease is a tick-borne illness caused by the spirochete B burgdorferi. Lyme disease can be divided into early disease (stage 1, EM), disseminated infection (stage 2), and late disease (stage 3, persistent infection). The first stage involves the skin, followed by stages 2 and 3, which often affect the skin, joints, CNS, and heart.

The term syphilis was first used in 1530 by the Italian physician Girolamo Fracastoro in his epic poem Syphilis Sive Morbus Gallicus. Much has been learned since then about this sexually transmitted disease caused by T pallidum.

Tertiary disease, usually seen 5-20 years after initial infection, traditionally includes cardiovascular syphilis, late benign (or gummatous) syphilis, and neurosyphilis (see Box 1). Fewer organisms are found in lesions during this stage. The incidence of cardiovascular involvement is probably underestimated, although clinically significant disease eventually develops in ~ 10% of all untreated patients.

The secondary stage of syphilis occasionally overlaps with the primary phase but usually begins ~ 6 weeks after resolution of the chancre; however, it can develop as late as 6 months after infection (see Box  1). Most patients have some degree of skin or mucocutaneous involvement. A faint and evanescent macular rash of the trunk and abdomen known as roseola syphilitica is sometimes seen initially.

The lesions of primary syphilis appear at the site of inoculation after an incubation period that is inversely proportional to the number of infecting organisms, usually 3 weeks (Box 1). The chancre is an ulcerative lesion that varies in size from several millimeters to 2 cm.