SYPHILIS

Syphilis



Table of Contents

I. Structure and Morphology of Infectious Agent1

II. Effects on Human Physiology2

III. Symptoms2

IV. Epidemiology4

V. History5

VI. Treatment and Recovery5

References7

Syphilis

I. Structure and Morphology of Infectious Agent

The agent causing syphilis is Treponema pallidum, a motile, spiral microorganism. The organisms do not stain well, are best visualized by dark-field microscopy, and do not grow in artificial media. Most infections are contracted during sexual contact, including kissing and sexual intercourse. Rare cases occur from direct contact with infectious cutaneous or mucous membrane lesions. Rashes are not infectious if the skin is intact. Other modes of transmission include congenital and transfusion-related transmission. The estimated rate of transmission after sexual exposure to a person with a chancre is 30%. The risk of transmission persists during the first four years of untreated syphilis. Latent syphilis, neurosyphilis, and tertiary syphilis are rare in adolescents.

Syphilis is caused by a spirochete, Treponema pallidum . A spirochete is a thin spiral- or coil-shaped bacterium that enters the body through the mucous membranes or breaks in the skin. In 90% of cases, the spirochete is transmitted by sexual contact. Transmission by blood transfusion is possible but rare, not only because blood products are screened for the disease, but also because the spirochetes die within 24 hours in stored blood. Other methods of transmission are highly unlikely because T. pallidum is easily killed by heat and drying.

Syphilis should be considered in the differential diagnosis of any ulcerating lesion of the ano-genital or oral areas and occasionally of the breasts, face, and fingers. Syphilis is characterized by a chancre at the point of inoculation 9 to 90 days (mean 21 days) after contact.

Location: (a) Ninety-five percent are on the external genitalia. (b) Single lesions are typical but multiple lesions are common. (c) They may appear as “kissing lesions.”

The ulcer typically has a punched-out (1- to 2-cm), clean appearance, with elevated, firm margins.

Regional adeno-pathy: firm, non-suppurative, and bilateral and may be painless.

Healing: The chancre heals in 3 to 6 weeks.

The primary infection may manifest itself with an inconspicuous lesion, particularly in women. Infection may occur with no papule or ulcer at all, particularly in previously infected patients.

II. Effects on Human Physiology

The infecting organism penetrates intact mucous membranes or abrasions in the skin, entering lymphatics and blood. Systemic infection and systemic foci precede primary lesion development at the site of inoculation. Organ involvement occurs from dissemination.

Syphilis affects the genitals, the brain, eyesight, can cause sores or lesions on the skin and eventually death if not treated. If syphilis is not treated, it can cause serious effects such as damage to the heart, aorta, brain, eyes and bones.

III. Symptoms

Infections of syphilis may progress through four stages. The infection may be spread during the primary, secondary, and early latent stages as well as from a pregnant woman to a fetus. In the primary stage the infection is usually evidenced by one sore, although there may be more than one, at the site where syphilis entered the person's body. Most often the point of entry is the penis, vagina, ...