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Syphilis
Renzo Reyes
Patrick Roquel
Syphilis Curriculum
Definition
a chronic bacterial disease that is
contracted chiefly by infection during
sexual intercourse, but also congenitally
by infection of a developing fetus.
a sexually transmitted infection (STI)
caused by a spirochaete bacterium,
Treponema pallidum.
Other modes of infection through direct
contact on open wounds, skin and mouth
Syphilis Curriculum
Treponema
pallidum
Spirillum pallidum
Microspironema
pallidum
Spironema
pallidum
Spirochaeta pallida
Gram-negative
bacteria which is
spiral in shape
Syphilis Curriculum
Synonyms
Lues
The great pretender
The pox
syph
Syphilis Curriculum
Pathogenesis
Treponema pallidum
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Pathogenesis
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Pathogenesis
Pathology
Penetration:
T. pallidum enters the body via skin and
mucous membranes through abrasions
during sexual contact
Transmitted transplacentally from mother to
fetus during pregnancy
Dissemination:
Travels via the circulatory system (including
the lymphatic system and regional lymph
nodes) throughout the body
Invasion of the central nervous system (CNS)
can occur during any stage of syphilis.
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Mode of action
migration between endothelial cells
Formation of lesions caused by
Infiltration of sites with CD4+ and
CD8+ T lymphocytes, macrophages,
a few plasma cells
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Clinical Manifestations
Primary Syphilis
Primary lesion or "chancre" develops at the site
of inoculation.
Chancre
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Clinical Manifestations
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Clinical Manifestations
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Clinical Manifestations
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Clinical Manifestations
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Clinical Manifestations
Secondary Syphilis
Secondary lesions occur several weeks after the
primary chancre appears; and may persist for
weeks to months.
Primary and secondary stages may overlap
Mucocutaneous lesions most common
Clinical Manifestations:
Rash (75%100%)
Lymphadenopathy (50%86%)
Malaise
Mucous patches (6%30%)
Condylomata lata (10%20%)
Alopecia (5%)
Liver and kidney involvement can occur
Splenomegaly is occasionally present
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Clinical Manifestations
Secondary
Syphilis
Papulosquamo
us Rash
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Clinical Manifestations
Secondary Syphilis
Palmar/Plantar Rash
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Clinical Manifestations
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Clinical Manifestations
Secondary Syphilis
Papulo-pustular Rash
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Clinical Manifestations
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Clinical Manifestations
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Clinical Manifestations
Secondary Syphilis
Alopecia
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Clinical Manifestations
Latent Syphilis
Host suppresses infection, but no
lesions are clinically apparent
Only evidence is a positive serologic
test
May occur between primary and
secondary stages, between secondary
relapses, and after secondary stage
Categories:
Early latent: <1 year duration
Late latent: 1 year duration
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Syphilis Curriculum
Clinical Manifestations
Neurosyphilis
Occurs when T. pallidum invades the central
nervous system (CNS)
May occur at any stage of syphilis
Can be asymptomatic
Early neurosyphilis occurs a few months to a few
years after infection
Clinical manifestations can include acute syphilitic
meningitis, meningovascular syphilis, and ocular
involvement
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Clinical Manifestations
NeurosyphilisSpirochetes in
Neural Tissue
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Clinical Manifestations
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Clinical Manifestations
Late SyphilisSerpiginous
Gummata of Forearm
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Clinical Manifestations
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Clinical Manifestations
Late Syphilis
Cardiovascular
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Clinical Manifestations
Congenital Syphilis
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Clinical Manifestations
Congenital SyphilisMucous
Patches
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Clinical Manifestations
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Clinical Manifestations
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Diagnosis
Laboratory Diagnosis
Identification of Treponema pallidum
in lesion exudate or tissue
Darkfield microscopy
Tests to detect T. pallidum
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Diagnosis
Darkfield Microscopy
What to look for
Advantage
Disadvantages
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Diagnosis
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Diagnosis
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Diagnosis
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Diagnosis
RPR/VDRL
Age
Autoimmune Diseases
FTA-ABS
Yes
Yes
Cardiovascular Disease
Yes
Yes
Yes
--
Dermatologic Diseases
Yes
Yes
Drug Abuse
Yes
Yes
Febrile Illness
Yes
Glucosamine/chondroitin sulfate
Leprosy
TP-PA
Possibly
Yes
Lyme disease
No
--
Yes
Malaria
Yes
No
Pinta, Yaws
Yes
Yes
Yes
Recent Immunizations
Yes
--
--
STD other
than Syphilis
Source:
Syphilis
Reference Guide, CDC/National Yes
Center
38
for Infectious Diseases, 2002
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Diagnosis of Latent
Syphilis
Diagnosis
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Diagnosis
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Diagnosis
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Diagnosis
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Management
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Management
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Management
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Management
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Management
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Jarisch-Herxheimer
Reaction
Management